Antenatal multiple micronutrient supplementation: call to action for change in recommendation

Abstract

We appreciate the comments by Devakumar et al .1 and agree that there are still some unanswered questions regarding the long‐term impact of multiple micronutrient supplementation (MMS) during pregnancy. However, in their assessment, Devakumar and colleagues ignore the significant benefits shown in the individual patient data (IPD) meta‐analysis, which strongly influenced our task force's conclusions. Rather, their comments focus only on the birth size data from the Cochrane reviews.2, 3 In the IPD meta‐analysis, which included data from nearly 113,000 pregnancies, the authors found that, in addition to reducing the risk of low birthweight, MMS significantly reduces the risk of preterm birth (RR = 0.93 (0.87–0.98), random effects).2 The Cochrane review also states that MMS “probably led to a slight reduction in preterm births” on the basis of data from 91,425 participants with moderate quality evidence (RR = 0.95 (0.90–1.01)