New research shows that prenatal multiple micronutrient supplements can cut the risk of babies being born too small or too early by 27%.
Unlike traditional prenatal care, which focuses on iron and folic acid alone, this study highlights the importance of a broader nutrient profile to support fetal development.
Pioneering Research in Prenatal Nutrition
Dongqing Wang, an assistant professor of Global and Community Health at George Mason University’s College of Public Health, is leading research on improving prenatal nutrition. His latest study, published today (January 30) in The Lancet Global Health and funded by the Bill and Melinda Gates Foundation, identifies prenatal supplements that significantly reduce health risks for vulnerable newborns.
Wang’s research found that compared to taking only folic acid and iron, expectant mothers who took a multiple micronutrient supplement had a 27% lower risk of giving birth to “small vulnerable newborn types.” These include babies born preterm, with low birth weight, or small for their gestational age — three conditions strongly linked to infant mortality.
Traditionally, these birth outcomes have been treated as separate issues. However, Wang’s work highlights how they are interconnected. For example, low birth weight can result from a shortened pregnancy, while growth restrictions in the womb can lead to babies being born too small for their stage of development. His findings emphasize the need for a more comprehensive approach to prenatal care.
Examining the Power of Prenatal Supplements
“Small vulnerable newborn types may have distinct mechanisms, health impacts, and intervention strategies,” says Wang. “This work is the first to examine the effects of prenatal multiple micronutrient supplements and small-quantity lipid-based nutrient supplements on the emerging outcomes of small vulnerable newborns.”
Folic acid and iron have been used to support prenatal health since the 1970s. Wang explored the effects of two additional types of prenatal supplements on women in low- and middle-income countries: prenatal multiple micronutrient supplements (MMS), similar to a common multivitamin, and small-quantity lipid-based nutrient supplements (SQ-LNS), which provide caloric nutrition and fatty acids in addition to vitamins.
He found that nearly all of these vitamins conferred some type of benefit—and some of them were hugely beneficial.
The Case for Multiple Micronutrients
“This study underscores the important promise of nutritional supplements in prenatal care in low- and middle-income countries,” says Wang. “In particular, the protective effects of prenatal multiple micronutrients on most small vulnerable newborn types, particularly those with the greatest mortality risk, strongly supports switching from iron and folic acid supplements to MMS as the standard care.”
Combining 16 different studies, Wang analyzed how prenatal nutrition correlates to the occurrence of small vulnerable newborns. He believes that the right prenatal supplements can help mitigate them. Since more than 90% of pregnancies resulting in low birth weight occur in low- and middle-income countries, including those in sub-Saharan Africa and South Asia, Wang focused this work on those regions.
Reference: “The effects of prenatal multiple micronutrient supplementation and small-quantity lipid-based nutrient supplementation on small vulnerable newborn types in low-income and middle-income countries: a meta-analysis of individual participant data” by Dongqing Wang, Enju Liu, Nandita Perumal, Uttara Partap, Ilana R Cliffer, Janaína Calu Costa, Molin Wang, Wafaie W Fawzi, Seth Adu-Afarwuah, Per Ashorn, Ulla Ashorn, Malay Kanti Mridha, Shams Arifeen, Zulfiqar A Bhutta, Yue Cheng, Parul Christian, Anthony M Costello, Kathryn G Dewey, Henrik Friis, Exnevia Gomo, Rebecca Grais, Ousmane Guindo, Nancy F Krebs, Lieven Huybregts, Sheila Isanaka, Carl Lachat, Anna Lartey, Steven C LeClerq, Kenneth Maleta, Dharma S Manandhar, Reynaldo Martorell, Susana L Matias, Elizabeth M McClure, Sophie E Moore, David Osrin, Willy Urassa, Andrea B Pembe, Andrew M Prentice, Usha Ramakrishnan, Juan Rivera, Arjumand Rizvi, Dominique Roberfroid, Abu Ahmed Shamim, Sajid Soofi, Kerry Schulze, Keith P West Jr, Lee Wu, Lingxia Zeng and Zhonghai Zhu, February 2025, The Lancet Global Health.
DOI: 10.1016/S2214-109X(24)00449-2
Additional authors include Enju Liu, Nandita Perumal, Uttara Partap, Ilana R. Cliffer, Janaína Calu Costa, Molin Wang, Wafaie W. Fawzi, and more than 40 data contributors from all over the world who provided the individual participant data used in this landmark analysis.
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