{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T12:11:42Z","timestamp":1786450302991,"version":"build-2736575974"},"reference-count":38,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2023,3,31]],"date-time":"2023-03-31T00:00:00Z","timestamp":1680220800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","award":["OPP1171060"],"award-info":[{"award-number":["OPP1171060"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Maternal &amp; Child Nutrition"],"published-print":{"date-parts":[[2023,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Meta\u2010analyses consistently have found that antenatal multiple micronutrient supplementation (MMS) compared with iron and folic acid (IFA) alone reduce adverse birth outcomes. In 2020, the World Health Organization (WHO) placed a conditional recommendation for MMS and requested additional trials using ultrasounds to establish gestational age, because the evidence on low birthweight (LBW), preterm birth and small for gestational age\u00a0(SGA) was considered inconsistent. We conducted meta\u2010analyses to determine if the effects of MMS on LBW, preterm birth\u00a0and SGA differed by gestational age assessment method. Using data from the 16 trials in the WHO analyses, we calculated the effect estimates of MMS versus IFA on birth outcomes (generic inverse variance method and random effects model) stratified by method of gestational age assessment: ultrasound, prospective collection of the date of last menstrual period (LMP) and confirmation of pregnancy by urine test\u00a0and recall of LMP. The effects of MMS versus IFA on birthweight, preterm birth\u00a0and SGA appeared consistent across subgroups with no evidence of subgroup differences (<jats:italic>p<\/jats:italic>\u2009&gt;\u20090.05). When limited to the seven trials that used ultrasound, the beneficial effects of MMS were demonstrated: risk ratios\u00a0of 0.87 (95% confidence interval [CI] 0.78\u20130.97) for LBW, 0.90 (95% CI, 0.79\u20131.03) for preterm birth and 0.9 (95% CI, 0.83\u20130.99) for SGA. Sensitivity analyses indicated consistency in the results. These results, together with recent analyses demonstrating comparable effects of MMS (vs. IFA) on maternal anaemia outcomes, strengthen the evidence to support a transition from IFA to MMS programmes in low\u2010 and middle\u2010income countries.<\/jats:p>","DOI":"10.1111\/mcn.13509","type":"journal-article","created":{"date-parts":[[2023,4,1]],"date-time":"2023-04-01T06:45:10Z","timestamp":1680331510000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Antenatal multiple micronutrient supplements versus iron\u2010folic acid supplements and birth outcomes: Analysis by gestational age assessment method"],"prefix":"10.1111","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1702-1433","authenticated-orcid":false,"given":"Filomena","family":"Gomes","sequence":"first","affiliation":[{"name":"The New York Academy of Sciences  New York City New York USA"},{"name":"NOVA Medical School Universidade NOVA de Lisboa  Lisboa Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sufia","family":"Askari","sequence":"additional","affiliation":[{"name":"Sight and Life Foundation  Basel Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9926-7984","authenticated-orcid":false,"given":"Robert E.","family":"Black","sequence":"additional","affiliation":[{"name":"Johns Hopkins Bloomberg School of Public Health  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Parul","family":"Christian","sequence":"additional","affiliation":[{"name":"Johns Hopkins Bloomberg School of Public Health  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4185-3451","authenticated-orcid":false,"given":"Kathryn G.","family":"Dewey","sequence":"additional","affiliation":[{"name":"Department of Nutrition University of California, Davis  Davis California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8358-4448","authenticated-orcid":false,"given":"Martin N.","family":"Mwangi","sequence":"additional","affiliation":[{"name":"The Micronutrient Forum  Washington District of Columbia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ziaul","family":"Rana","sequence":"additional","affiliation":[{"name":"The New York Academy of Sciences  New York City New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Reed","sequence":"additional","affiliation":[{"name":"The Bill &amp; Melinda Gates Foundation  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anuraj H.","family":"Shankar","sequence":"additional","affiliation":[{"name":"Nuffield Department of Medicine University of Oxford  Oxford UK"},{"name":"Summit Institute for Development Mataram Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily R.","family":"Smith","sequence":"additional","affiliation":[{"name":"Milken Institute School of Public Health The George Washington University Washington District of Columbia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8955-1479","authenticated-orcid":false,"given":"Alison","family":"Tumilowicz","sequence":"additional","affiliation":[{"name":"The Bill &amp; Melinda Gates Foundation  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,3,31]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.3945\/ajcn.114.091546"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.3945\/jn.114.207225"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/15648265090304s404"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(18)30565-5"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/nyas.14121"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.326.7389.571"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000002046"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/nyas.14132"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/80.1.178"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1186\/s41043-016-0072-y"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrendo.2016.37"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/nyas.14756"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-017-18234-9"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/mcn.12367"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)60993-9"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1093\/nutrit\/nuab004"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD004905.pub6"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.ejcn.1602215"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2013.1632"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-3016.2007.00865.x"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(17)30325-X"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(05)71084-9"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2012.4061"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.3945\/ajcn.2008.26296.1"},{"key":"e_1_2_10_26_1","first-page":"128","volume-title":"Modern Epidemiology","author":"Rothman K. 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