Effect on birthweight of an antenatal multiple micronutrient supplementation programme compared with iron-folic acid supplementation: a cluster-randomised, controlled trial in 85,698 Ethiopian womeni

Prenatal multiple micronutrient supplementation (MMS) including iron, folic acid, and other essential micronutrients, has shown potential to improve birth outcomes in controlled studies. We did an effectiveness study in Ethiopia to determine the effect on mean birthweight of MMS provided as part of routine antenatal care, relative to iron–folic acid supplementation (IFA). The findings of this trial are consistent with those from efficacy trials in other settings, indicating that the transition from IFA to MMS as part of routine antenatal care in Ethiopia could lead to a small but clear improvement in birthweight, although adherence to supplements and programme sustainability require careful attention.