e-Library of Evidence for Nutrition Actions (eLENA)

Multiple micronutrient supplementation during pregnancy

Micronutrients are only needed in very small quantities but are essential for normal physiological function, growth and development. Deficiencies of micronutrients such as vitamin A, iron, iodine and folate are particularly common among during pregnancy, due to increased nutrient requirements of the mother and developing fetus. These deficiencies can negatively impact the health of the mother, her pregnancy, as well as the health of the newborn baby.

The most current evidence shows that giving multiple micronutrient supplements to pregnant women may reduce the risk of low birth weight and of small size for gestational age, compared with iron and folic acid supplementation alone. However, there is also some evidence of risk, as well as some important gaps in the evidence.

WHO recommendations

Multiple micronutrient supplementation is not recommended for pregnant women to improve maternal and perinatal outcomes.*

* There is some evidence of additional benefit of multiple micronutrient supplements containing 13 to 15 different micronutrients over iron and folic acid, but also some evidence of risk, and some important gaps in the evidence. Although the WHO guideline development group that developed this recommendation agreed that overall there was insufficient evidence to warrant a recommendation, the group agreed that policymakers in populations with a high prevalence of nutritional deficiencies might consider the benefits of multiple micronutrient supplements on maternal health to outweigh the disadvantages, and may choose to give multiple micronutrient supplements that include iron and folic acid.

WHO documents

WHO documents

GRC-approved guidelines


Systematic reviews used to develop the guidelines
Related Cochrane reviews
Other related systematic reviews
Clinical trials

Last update:

15 June 2017 14:51 CEST

Category 1 intervention

Guidelines have been recently approved by the WHO Guidelines Review Committee