Pregnancy with Multiple Micronutrients: Perinatal Mortality Reduction

Given the high burden of multiple micronutrient deficiencies during pregnancy, supplementation with multiple micronutrients (MMN) could prove beneficial; however, there are concerns regarding its impact on perinatal mortality. In this chapter, we evaluated the evidence available from MMN supplementation trials during pregnancy and conducted a meta-analysis to estimate the effect on the risk of perinatal and neonatal mortality, and stillbirth. Of 23 prospective randomized controlled trials evaluating MMN supplementation during pregnancy, 12 trials measured perinatal mortality. Supplementation with MMN did not show any significant impact on the risk of perinatal mortality as compared to iron folic acid, supplementation with two or less micronutrients, no supplementation, or a placebo. There was also no significant association with stillbirth or neonatal mortality risk. Review of trials evaluating MMN supplementation during pregnancy does not provide evidence of an increase in the risk of perinatal mortality, neonatal mortality, or stillbirths in low- or middle-income countries.