The Impact of MMS on Moms and Babies

Official title: Modifiers of the effect of maternal multiple micronutrient supplementation on stillbirth, birth outcomes, and infant mortality: a meta-analysis of individual patient data from 17 randomised trials in low-income and middle-income countries

Published: November 2017

Publication: The Lancet Global Health

Authors: Emily R Smith, Anuraj H Shankar, Lee S-F Wu, Said Aboud, Seth Adu-Afarwuah, Hasmot Ali, Rina Agustina, Shams Arifeen, Per Ashorn, Zulfiqar A Bhutta, Parul Christian, Delanjathan Devakumar, Kathryn G Dewey, Henrik Friis, Exnevia Gomo, Piyush Gupta, Pernille Kæstel, Patrick Kolsteren, Hermann Lanou, Kenneth Maleta, Aissa Mamadoultaibou, Gernard Msamanga, David Osrin, Lars-Åke Persson, Usha Ramakrishnan, Juan A Rivera, Arjumand Rizvi, H P S Sachdev, Willy Urassa, Keith P West Jr, Noel Zagre, Lingxia Ze

Read the original paper here.


  • Pregnant women need extra nutrition for themselves and their babies.
  • Many pregnant women don’t get enough nutrients from the food they eat.  
  • Micronutrient deficiencies during pregnancy put both mothers and babies at risk of birth complications and death.
  • Lack of nutrients in this critical period can prevent children from reaching their full physical and mental potential.
  • To help avoid this, nutrition programs often give pregnant women iron and folic acid (IFA) to supplement the nutrients they get from the food they eat.
  • Recent research has suggested that women might be better off if they got a multiple micronutrient supplement (MMS) instead of just iron and folic acid (IFA). 
  • Researchers have been trying to figure out if MMS is safe, effective, and cheap enough to recommend switching out IFA and replacing it with MMS
  • This paper analyzed 17 different studies testing MMS and IFA.
  • The analysis found that compared to IFA, MMS:
    1. Reduced the risk of low birthweight babies, preterm babies, and small babies.
    2. Reduced the number of infant deaths in the days after birth, especially for girls. 
    3. Reduced the number of kids who were born to anemic mothers and died before 6 months.
    4. Reduced the number of preterm births.
  • Researchers also discovered something they hadn’t known before: The benefits of taking MMS during pregnancy instead of IFA were even bigger if moms were malnourished. Malnourished women who took MMS while they were pregnant saw an even greater decrease in low bithweight, preterm, and small births compared to malnourished women who only took IFA while they were pregnant. 
  • The studies didn’t find any negative effects of taking MMS



  • MMS is safe and more effective than IFA at preventing multiple conditions and death in newborns and babies, especially when moms are malnourished. 
  • The WHO should consider updating its guidelines to reflect the benefits of MMS