In Tanzania, 1075 HIV-1-infected pregnant women received either no micronutrients, vitamin A, multivitamins excluding vitamin A or multivitamins including vitamin A in a randomized, double-blind, placebo-controlled trial. Among women assigned multivitamins, 30 fetal deaths occurred compared with 49 among those not on multivitamins. Multivitamin supplementation decreased the risk of low birth weight (LBW) by 44%, severe preterm birth by 39%, and small size for gestational age (SGA) at birth by 43%. Vitamin A supplementation had no significant effect on these variables. Multivitamins, but not vitamin A, resulted in a significant increase in CD4, CD8, and CD3 counts. The results suggested that multivitamin supplementation is a low-cost way of substantially decreasing adverse pregnancy outcomes and increasing T-cell counts in HIV-1-infected women. 

This study examined the effect of daily maternal micronutrient supplementation (MMS) on fetal loss and infant mortality in rural Nepal.  Pregnant women received either vitamin A only, or in addition to Vitamin A, folic acid only,  iron-folic acid (IFA), IFA, and zinc or multiple micronutrients. Results showed that MMS failed to reduce overall fetal loss or early infant mortality. Among preterm infants, folic acid alone or with iron reduced mortality in the first 3 months of life. Multiple micronutrients may increase mortality risk among term infants, but this effect needs further evaluation.

This study evaluated the acceptability of multiple micronutrient supplementation (MMS) and its potential benefits on pregnancy outcomes and maternal micronutrient status in a cohort of pregnant women in rural and urban Sindh, Pakistan through a cluster-randomized design. Pregnant women received either iron-folic acid (IFA) or MMS. The data suggest that MMS are well tolerated during pregnancy, but the effect on birthweight is modest. The observed effect of MMS on early neonatal mortality, though not statistically significant, suggests the need for further studies and careful assessment of the intervention in health system settings.

This study examined the effects of home fortification of pregnant women’s diets with small-quantity lipid-based nutrient supplement (SQ-LNS) on the birth size of newborns in an African community in Malawi. The women were provided with one daily iron-folic acid (IFA) capsule, one capsule containing multiple micronutrients (MMNs), or one 20-g sachet of SQ-LNS (LNS, containing 118 kcal, protein, carbohydrates, essential fatty acids, and 21 micronutrients). The study findings do not support a hypothesis that the provision of SQ-LNS to all pregnant women would increase the mean birth size in rural Malawi.

The International Lipid-Based Nutrient Supplements Project has developed a small-quantity (20 g/d) lipid-based nutrient supplement (LNS) for pregnant and lactating women. This study evaluated the effects of prenatal LNS supplementation on fetal growth. In a community-based, partially double-blind, individually randomized controlled trial, 1320 pregnant women received iron-folic acid (IFA), or 1–2 Recommended Dietary Allowances of 18 micronutrients, including iron (MMN), or LNS with the same micronutrients as the MMN group, plus 4 minerals and macronutrients contributing 118 kcal (LNS) daily until delivery. Fetal growth was compared across groups by using intention-to-treat analysis. Among primiparous women the LNS group had greater mean birth length than did the IFA group; similar differences were found when comparing the LNS and MMN groups. Prenatal LNS supplementation can improve fetal growth among vulnerable women in Ghana, particularly primiparous women.

This study estimated the impact of scaling up iron-folic acid (IFA), calcium, multiple micronutrients (MMS), and balanced energy protein (BEP) supplementation for pregnant women, on human capital outcomes in low- and middle-income countries (LMIC). Results showed that across 132 LMIC, scaling up prenatal nutrition interventions to 90% coverage was estimated to increase school years and lifetime income per birth cohort by: 2.28 million y and $8.26 billion for IFA; 4.08 million y  and $18.9 billion for calcium; 5.02 million y and $18.1 billion for MMS; and 0.53 million y and $1.34 billion for BEP supplementation. Therefore, increasing coverage of prenatal nutrition interventions in LMIC may lead to substantial gains in schooling and lifetime income, particularly for MMS compared to IFA.

Supplementary Data

As a global community, we have a unique opportunity to elevate women – their voices, their empowerment, and their nutrition – within global and national efforts taking place in preparations towards and beyond the U.N. Food Systems Summit. This Guide details narratives, opportunities, and information on Summit architecture that to draw from towards advocacy efforts.

As a global community, we have a unique opportunity to elevate women – their voices, their empowerment, and their nutrition – within global and national efforts taking place in preparations towards and beyond the U.N. Food Systems Summit. This Guide details narratives, opportunities, and information on Summit architecture that to draw from towards advocacy efforts.

As a global community, we have a unique opportunity to elevate women – their voices, their empowerment, and their nutrition – within global and national efforts taking place in preparations towards and beyond the U.N. Food Systems Summit. This Guide details narratives, opportunities, and information on Summit architecture that to draw from towards advocacy efforts.

In December 2021, under the auspices of the Olympic Games, the Nutrition For Growth Summit (N4G) will take place. This high-level event, hosted by the Government of Japan, will celebrate the N4G commitments made throughout the year and announce final financial and policy commitments, looking ahead to 2030. The Summit outcomes will be enshrined in the 2021 Compact designed to accelerate the achievement of the objectives of the U.N. Decade of Action on Nutrition and the Sustainable Development Goals (SDGs). On March 31, 2021, Healthy Mothers Healthy Babies Consortium (HMHB) hosted a workshop webinar to help create an advocacy agenda for multiple micronutrient supplementation (MMS) and maternal nutrition, including engagement and joint action with the maternal health sector, and commitments for MMS at N4G. Following this workshop, using inputs from participants, HMHB produced an N4G Commitment Guide to support the sector in getting more engaged in the event. This guide will help MMS stakeholders in planning for policy, program, and financial commitments for MMS at N4G. This document will be updated regularly.