The impact of antenatal multiple micronutrient supplementation on child growth and cognitive advancement: a systematic review and meta-analysis

Abstract Background Receiving multiple micronutrient supplementations (MMS) in developing countries has demonstrated favorable effects on birth outcomes. The objective of this review is to assess the effectiveness of MMS interventions in relation to the long-term physical and cognitive development of children. Methods We conducted a comprehensive search for eligible studies through databases in May 2023. Meta-analyses were conducted using Stata, version 15, on all randomized controlled trials (RCTs) that evaluated the long-term developmental outcomes of children by assessing the impact of preconceptional and antenatal MMS. Results The review encompassed a total of twelve studies. The trials included a total of 13,899 pregnant women and 12,986 children, serving as the foundation for individual participant data meta-analyses MMS involving iron plus folic acid supplementation (IFAS). Our analysis revealed that MMS did not demonstrate any significant improvements in key anthropometric and body composition measurements, including weight-for-age z score (WAZ) (Mean Difference [MD]: 0.01; 95% Confidence Interval [CI]: -0.05 to 0.07), height-for-age z score (HAZ) (MD: 0.00; 95% CI: -0.05 to 0.05), Body Mass Index (BMI)-for-age (MD: 0.04; 95% CI: -0.04 to 0.12), weight-for-length z score (WLZ) (MD: 0.00; 95% CI: -0.07 to 0.08), head circumference (HC) (MD: 0.06; 95% CI: -0.05 to 0.17), and mid-upper arm circumference (MUAC) (MD: 0.04; 95% CI: -0.04 to 0.12). However, the administration of prenatal MMS exhibited a significant positive correlation with the enhancement of children's Full Scale Intelligence Quotient (FSIQ) scores (MD: 0.97, 95% CI: 0.09 to 1.84). Conclusions The antenatal maternal MMS interventions do not appear to have a discernible impact on child growth outcomes. However, there is potential evidence suggesting that maternal MMS interventions may positively influence the cognitive development of offspring. Trial registration: CRD42023428221 (31/05/2023)