First-of-its-kind research identifies beneficial prenatal vitamins to reduce risk of infant death

Dongqing Wang, an assistant professor of Global and Community Health at George Mason’s College of Public Health, is pioneering research in prenatal nutritional interventions. His latest report identifies prenatal supplements that reduce health risks to small and vulnerable babies. This research was published in the prestigious The Lancet Global Health journal and funded by the Bill and Melinda Gates Foundation. 

Wang found that compared to folic acid and iron alone, a multiple micronutrient supplement led to a 27% lower risk of giving birth to “small vulnerable newborn types,” or babies who suffered from preterm birth, low birthweight, and small-for-gestational-age birth—the three groups most likely to result in infant death. 

In the past, these birth outcomes were all treated as separate conditions. Wang, however, delves into emerging science to look at different combinations across the three outcomes. Low birthweight, for example, can occur because of a short pregnancy, and growth restrictions can lead to babies born too small for their developmental age.  

“Small vulnerable newborn types may have distinct mechanisms, health impacts, and intervention strategies,” says Wang. “This work is the first to examine the effects of prenatal multiple micronutrient supplements and small-quantity lipid-based nutrient supplements on the emerging outcomes of small vulnerable newborns.” 

Folic acid and iron have been used to support prenatal health since the 1970s. Wang explored the effects of two additional types of prenatal supplements on women in low- and middle-income countries: prenatal multiple micronutrient supplements (MMS), similar to a common multivitamin, and small-quantity lipid-based nutrient supplements (SQ-LNS), which provide caloric nutrition and fatty acids in addition to vitamins. 

He found that nearly all of these vitamins conferred some type of benefit—and some of them were hugely beneficial. 

“This study underscores the important promise of nutritional supplements in prenatal care in low- and middle-income countries,” says Wang. “In particular, the protective effects of prenatal multiple micronutrients on most small vulnerable newborn types, particularly those with the greatest mortality risk, strongly supports switching from iron and folic acid supplements to MMS as the standard care.” 

Combining 16 different studies, Wang analyzed how prenatal nutrition correlates to the occurrence of small vulnerable newborns. He believes that the right prenatal supplements can help mitigate them. Since more than 90% of pregnancies resulting in low birthweight occur in low- and middle-income countries, including those in sub-Saharan Africa and South Asia, Wang focused this work on those regions.  

The Lancet Global Health will publish "The effects of prenatal multiple micronutrient supplements and small-quantity lipid- based nutrient supplements on small vulnerable newborn types in low- and middle- income countries: a meta-analysis of individual participant data” in January 29, 2025. Additional authors include Enju Liu, Nandita Perumal, Uttara Partap, Ilana R. Cliffer, Janaína Calu Costa, Molin Wang, Wafaie W. Fawzi, and more than 40 data contributors from all over the world who provided the individual participant data used in this landmark analysis.  

## 

post-embargo link to paper: https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(24)00449-2/fulltext