Effects of vitamin and multiple micronutrient supplementation for pregnant and/or lactating women on maternal and infant nutritional status in low- and middle-income countries: a systematic review and meta-analysis

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#humans #female #pregnancy #dietary-supplements #lactation

Effects of vitamin and multiple micronutrient supplementation for pregnant and/or lactating women on maternal and infant nutritional status in low- and middle-income countries: a systematic review and meta-analysis

Shinde et al., 2025 | Adv Nutr | Meta Analysis

Citation

Shinde Sachin, Yelverton Cara A, ... Fawzi Wafaie W. Effects of vitamin and multiple micronutrient supplementation for pregnant and/or lactating women on maternal and infant nutritional status in low- and middle-income countries: a systematic review and meta-analysis. Adv Nutr. 2025-Dec;16(12):100487. doi:10.1016/j.advnut.2025.100487

Abstract

BACKGROUND: Globally, over half of women of reproductive age are affected by at least one micronutrient deficiency, often exacerbated during pregnancy and lactation, contributing to adverse maternal and child health outcomes. This systematic review and meta-analysis synthesized impact of vitamin supplementation on maternal, infant and lactational nutritional status in low- and middle-income countries. METHODS: MEDLINE, EMBASE, CENTRAL, and WHO library databases were searched. Eligible studies included randomized controlled trials of micronutrient supplementation in healthy pregnant/lactating women, assessing maternal/infant micronutrient status or milk composition. Random-effects meta-analysis was performed for outcomes with ≥2 studies, and evidence quality was evaluated using GRADE. RESULTS: Eighty-seven papers (76 trials, including 65 for meta-analysis) were included. Maternal vitamin B-12 supplementation during pregnancy increased serum cobalamin concentrations (standard mean difference [SMD] 0.39; 95% CI 0.11, 0.68; P=0.01) and reduced deficiency (OR 0.43; 95% CI 0.19, 0.95; P=0.04), with improved B-12 concentrations in milk, especially when administered postpartum (SMD 0.33; 95% CI 0.02, 0.63; P=0.04), but had no consistent effect on infant or cord serum cobalamin concentrations. Vitamin A supplementation during pregnancy or postpartum improved maternal serum concentrations (SMD 0.60; 95% CI 0.13, 1.08; P<0.001) and reduced deficiency at thresholds ≤0.7 μmol/L (OR 0.55; 95% CI 0.43, 0.71; P<0.001); however, its effects on infant and cord serum levels were negligible. Postpartum vitamin A supplementation improved milk vitamin A concentrations (SMD 0.53; 95% CI 0.19, 0.86; P<0.001), particularly with single high-dose regimens. Supplementation with vitamin D during pregnancy increased maternal serum vitamin D concentrations (SMD 1.68; 95% CI 0.99, 2.37; P<0.001), reduced deficiency at thresholds ≤50 nmol/L (OR 0.30; 95% CI 0.14, 0.64; P<0.001) and increased vitamin D concentrations in infant and cord serum. CONCLUSIONS: Micronutrient supplementation during pregnancy and lactation improved maternal nutritional status but showed inconsistent effects on infant nutritional status, highlighting the need for further research. PROSPERO REGISTRATION ID: CRD42022308715; https://tinyurl.com/y33cxekr.

Key Findings

Eighty-seven papers (76 trials, including 65 for meta-analysis) were included. Maternal vitamin B-12 supplementation during pregnancy increased serum cobalamin concentrations (standard mean difference [SMD] 0.39; 95% CI 0.11, 0.68; P=0.01) and reduced deficiency (OR 0.43; 95% CI 0.19, 0.95; P=0.04), with improved B-12 concentrations in milk, especially when administered postpartum (SMD 0.33; 95% CI 0.02, 0.63; P=0.04), but had no consistent effect on infant or cord serum cobalamin concentrations

Outcomes Measured

  • Requires manual extraction

Population

Field Value
Population healthy pregnant
Sample Size 2
Age Range See abstract
Condition deficiency

MeSH Terms

  • Humans
  • Female
  • Pregnancy
  • Dietary Supplements
  • Lactation
  • Nutritional Status
  • Micronutrients
  • Maternal Nutritional Physiological Phenomena
  • Vitamins
  • Developing Countries
  • Infant
  • Infant, Newborn
  • Milk, Human
  • Infant Nutritional Physiological Phenomena
  • Randomized Controlled Trials as Topic
  • Vitamin B 12
  • Adult
  • Pregnancy Complications

Evidence Classification

  • Level: Meta Analysis
  • Publication Types: Journal Article, Systematic Review, Meta-Analysis
  • Vertical: vitamin-a

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09