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Questions remain, however, about the ability of MMS to prevent anemia as effectively as IFA, especially at a lower dose of daily iron and in areas of high anemia prevalence. Analyzing data from 11 trials from a recent Cochrane review, we compared MMS to IFA, delivering either 30 or 60 mg of iron, in sustaining hemoglobin and preventing third trimester anemia and iron deficiency anemia (IDA), accounting for daily iron dose, total supplemental iron intake, and baseline prevalence of anemia. There were no differences between MMS and IFA in third trimester hemoglobin concentration or risks of anemia or IDA by iron dose or total supplemental iron consumed. MMS providing 30 mg of iron was comparable to IFA with 60 mg of iron: mean hemoglobin difference of \u22120.26 g\/L (95% CI: \u22121.41 to 0.89), risk ratios of 0.99 (95% CI: 0.92\u20131.07) for anemia, and 1.31 (95% CI: 0.66\u20132.60) for IDA. Baseline prevalence of anemia did not explain heterogeneity in findings. Compared to IFA, MMS results in comparable hemoglobin concentration and protection against anemia during pregnancy, independently of iron dose.<\/jats:p>","DOI":"10.1111\/nyas.14756","type":"journal-article","created":{"date-parts":[[2022,2,26]],"date-time":"2022-02-26T06:53:58Z","timestamp":1645858438000},"page":"114-125","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":34,"title":["Multiple micronutrient supplements versus iron\u2010folic acid supplements and maternal anemia outcomes: an iron dose analysis"],"prefix":"10.1111","volume":"1512","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 New York"},{"name":"NOVA Medical School Lisbon Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8464-1037","authenticated-orcid":false,"given":"Rina","family":"Agustina","sequence":"additional","affiliation":[{"name":"Department of Nutrition, Faculty of Medicine Universitas Indonesia \u2010 Dr Cipto Mangunkusumo General Hospital Jakarta Indonesia"},{"name":"Human Nutrition Research Centre, Indonesian Medical Education and Research Institute, Faculty of Medicine Universitas Indonesia Jakarta Indonesia"}],"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"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Parul","family":"Christian","sequence":"additional","affiliation":[{"name":"Johns Hopkins Bloomberg School of Public Health Baltimore Maryland"}],"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":"University of California, Davis Davis California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Klaus","family":"Kraemer","sequence":"additional","affiliation":[{"name":"Johns Hopkins Bloomberg School of Public Health Baltimore Maryland"},{"name":"Sight and Life Foundation Basel Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anuraj H.","family":"Shankar","sequence":"additional","affiliation":[{"name":"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":"The George Washington University Washington DC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Thorne\u2010Lyman","sequence":"additional","affiliation":[{"name":"Johns Hopkins Bloomberg School of Public Health Baltimore Maryland"}],"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"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1201-3397","authenticated-orcid":false,"given":"Megan W.","family":"Bourassa","sequence":"additional","affiliation":[{"name":"The New York Academy of Sciences New York New York"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,2,25]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)60937-X"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrendo.2016.37"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/nyas.14121"},{"key":"e_1_2_9_5_1","article-title":"Multiple\u2010micronutrient supplementation for women during pregnancy","volume":"3","author":"Keats E.C.","year":"2019","journal-title":"Cochrane Database Syst. 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