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Pnv7.0
Prenatal Multivitamin – Forschung
Überwiegend Mechanismus / Beobachtung
65 begutachtete Studien
Was die Evidenz sagt
Überwiegend Mechanismus / Beobachtung
Die meisten Studien zu Prenatal Multivitamin sind mechanistisch oder beobachtend statt RCTs, die einen klinischen Effekt messen — betrachte die Ergebnisse als vorläufig.
Die meiste Evidenz stammt aus hochwertigen Meta-Analysen und randomisierten Studien, veröffentlicht 1991–2026 mit einer typischen Studiengröße von 412 Teilnehmenden.
Basierend auf 65 Studien · 17 Meta-Analysen · 16 RCTs · 295,496 Teilnehmende insgesamt
Konfidenz
Hohe Konfidenz
Nach Outcome
Maternal micronutrient status
Überwiegend Mechanismus / Beobachtung43 Studien
Birthweight & fetal growthRoughly 70% reduction in neural tube defect risk when folic acid is started before conception; reduced low birthweight. No demonstrated effect on stillbirth or perinatal mortality · Must start before conception for the neural tube benefit
Überwiegend Mechanismus / Beobachtung17 Studien
Maternal anaemia & iron status
Überwiegend Mechanismus / Beobachtung13 Studien
Preterm birthRoughly 70% reduction in neural tube defect risk when folic acid is started before conception; reduced low birthweight. No demonstrated effect on stillbirth or perinatal mortality · Must start before conception for the neural tube benefit
Überwiegend Mechanismus / Beobachtung8 Studien
Child neurodevelopment & cognition
Überwiegend Mechanismus / Beobachtung8 Studien
Neural tube defects & birth defectsRoughly 70% reduction in neural tube defect risk when folic acid is started before conception; reduced low birthweight. No demonstrated effect on stillbirth or perinatal mortality · Must start before conception for the neural tube benefit
Überwiegend Mechanismus / Beobachtung7 Studien
Safety profile
Überwiegend Mechanismus / Beobachtung4 Studien
Pre-eclampsia & pregnancy complicationsRoughly 70% reduction in neural tube defect risk when folic acid is started before conception; reduced low birthweight. No demonstrated effect on stillbirth or perinatal mortality · Must start before conception for the neural tube benefit
Zu wenige bewertete Studien2 Studien
Product quality & label accuracy
Zu wenige bewertete Studien2 Studien
Aktives Forschungsgebiet
47 Studien in den letzten 5 Jahren · Neueste Meta-Analyse: 2026
199120082026
1Meta-Analyse2015
Einfach gesagt: Cochrane rates folic acid's prevention of neural tube defects as high-quality evidence, and finds the effect is not improved by adding other vitamins and minerals.
De-Regil LM et al. · Cochrane Database Syst Rev (2015)
Neural tube defects: RR 0.31 (95% CI 0.17-0.58) across 5 studies, 6,708 births — HIGH quality evidence
Recurrence specifically: RR 0.34 (95% CI 0.18-0.64)
Effect NOT altered by dose (400 mcg vs higher), nor by whether folic acid was given alone or with other micronutrients
Einfach gesagt: Multi-micronutrient supplements reduce low birthweight at high certainty, but show no effect on stillbirth or newborn mortality, and the evidence is almost entirely from low- and middle-income countries.
Keats EC et al. · Cochrane Database Syst Rev (2019)
Low birthweight: RR 0.88 (95% CI 0.85-0.91), 18 trials, 68,801 participants — HIGH quality
Small-for-gestational-age: RR 0.92 (0.88-0.97) — MODERATE, downgraded for possible publication bias
Einfach gesagt: Omega-3 reduces preterm and early preterm birth at high quality, but increases post-term pregnancy and shows very few differences in child cognition.
Middleton P et al. · Cochrane Database Syst Rev (2018)
Preterm birth under 37 weeks: 13.4% vs 11.9%, RR 0.89 (95% CI 0.81-0.97) — HIGH quality
Early preterm birth under 34 weeks: 4.6% vs 2.7%, RR 0.58 (95% CI 0.44-0.77) — HIGH quality
Einfach gesagt: Daily iron substantially reduces maternal anaemia and iron deficiency at term, with a modest low-birthweight benefit but no effect on preterm birth or mortality.
Finkelstein JL et al. · Cochrane Database Syst Rev (2024)
Maternal anaemia: RR 0.30 (95% CI 0.20-0.47), low certainty; iron-deficiency anaemia at term RR 0.41 (0.26-0.63), moderate
Low birthweight: RR 0.84 (95% CI 0.72-0.99), moderate certainty
No meaningful effect on preterm birth (RR 0.93), neonatal death, maternal death, or congenital anomalies
Einfach gesagt: Folic acid cut recurrent neural tube defects by 72%, while the seven other vitamins tested showed no significant protection at all.
MRC Vitamin Study Research Group · Lancet (1991)
27 neural tube defects total: 6 in folic acid arms vs 21 in non-folic-acid arms — 72% protective effect, RR 0.28 (95% CI 0.12-0.71)
The other seven vitamins (A, D, B1, B2, B6, C, nicotinamide) showed NO significant protection: RR 0.80 (95% CI 0.32-1.72)
Randomized double-blind factorial trial across 33 centres in 7 countries
6RCTn=1,105 · large study2022
Einfach gesagt: Prenatal MMS and MQ-LNS had limited effect on anthropometric measures of child growth up to 24 mo of age as compared with IFA in rural Niger.
Bliznashka L et al. · The American journal of clinical nutrition (2022)
Children in the MQ-LNS arm had significantly higher mid-upper arm circumference at 24 mo than children in the MMS arm: mean difference 0.50 cm (95% CI 0.10, 0.91 cm).
Prenatal MMS and MQ-LNS had limited effect on anthropometric measures of child growth up to 24 mo of age as compared with IFA in rural Niger.
Einfach gesagt: The quality of evidence was very low, and triangulation was of limited utility because alternative methods were used infrequently and often not robustly applied.
Friel C et al. · Nutrients (2021)
Quality assessment was guided using Newcastle-Ottawa in individual studies, and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) for the body of evidence.
The effect estimates from multivariate regression were meta-analysed in a random effects model and causal approaches were narratively synthesised.
The quality of evidence was very low, and triangulation was of limited utility because alternative methods were used infrequently and often not robustly applied.
Einfach gesagt: Our study shows potential benefit of early life exposure to micronutrient supplementation for child-related behavior outcomes in a South Asian setting where inadequate diets and nutrition deficiencies exist.
Christian P et al. · The American journal of clinical nutrition (2025)
Our study shows potential benefit of early life exposure to micronutrient supplementation for child-related behavior outcomes in a South Asian setting where inadequate diets and nutrition deficiencies exist.
Published in The American journal of clinical nutrition (2025)
Einfach gesagt: Cochrane removed 20 of 30 previously included studies after a scientific-integrity assessment, leaving vitamin D evidence in pregnancy very uncertain.
Palacios C et al. · Cochrane Database Syst Rev (2024)
20 of the previous 30 studies were moved to awaiting classification after trustworthiness assessment
Very uncertain for pre-eclampsia (RR 0.53), gestational diabetes (RR 0.53) and preterm birth (RR 0.76)
May reduce severe postpartum haemorrhage (RR 0.68) but from a single study
Einfach gesagt: This review highlights the importance of ensuring preconceptional nutrition and preventing anaemia during pregnancy for favourable reproductive outcomes.
Wang D et al. · BMJ global health (2025)
From RCTs, there was no clear evidence for an effect of prenatal multiple micronutrient supplementation on the risk of miscarriage (8 RCTs; risk ratio (RR): 0.87; 95% CI 0.75, 1.02; moderate certainty of evidence) or stillbirth (15 RCTs; RR: 0.86; 95% CI 0.73, 1.02; low certainty of evidence).
From observational cohort studies, preconceptional obesity was associated with a greater risk of miscarriage (12 studies; RR: 1.27; 95% CI 1.10, 1.47; very low certainty of evidence) and stillbirth (4 studies; RR: 1.66; 95% CI 1.28, 2.14; very low certainty of evidence).
Any anaemia during pregnancy was associated with a greater risk of stillbirth (10 studies; RR: 1.26; 95% CI 1.01, 1.58; very low certainty of evidence).
Einfach gesagt: These results suggest that the increased offspring size at birth, including (regionalized) adiposity associated with pregnancy, and MMS may be partially related to the development of GDM.
Petry CJ et al. · Nutrients (2020)
Offspring size at birth was assessed using standard anthropometric measurements and adiposity using skinfold calipers.
There was no association with quadriceps skinfold thickness (p = 0.2), suggesting that the increased adiposity was partially regionalized.
In women who underwent oral glucose tolerance testing, nearly all of these associations were attenuated by adjusting for GDM.
Einfach gesagt: Prenatal maternal vitamin B-12 supplementation has benefits on short-term HM status, and postnatal maternal vitamin B-12 supplementation has benefits on long-term HM status.
Wang D et al. · The American journal of clinical nutrition (2024)
The prevalence of HM vitamin B-12 of <310 pmol/L was 73.3% and 68.4% at 6 wk and 7 mo postpartum, respectively.
Prenatal supplementation increased HM vitamin B-12 concentration (percent difference: 34.4; 95% CI: 17.0, 54.5; P < 0.001) at 6 wk; this effect was not present at 7 mo.
Postnatal supplementation increased HM vitamin B-12 concentration (percent difference: 15.9; 95% CI: 1.91, 31.9; P = 0.025) at 7 mo.
Einfach gesagt: In a population with maternal micronutrient deficiencies, providing maternal MMS was not associated with milk micronutrient concentrations above MAEs; however, infants born to mothers with milk below MAEs for all investigated micronutrients appeared to experience poorer growth.
Baxter JB et al. · The American journal of clinical nutrition (2025)
Independent of allocation, having all 5 milk micronutrients below MAEs was associated with decreased infant length-for-age z-score (β: -0.39, 95% CI: -0.73, -0.04; P = 0.03).
In a population with maternal micronutrient deficiencies, providing maternal MMS was not associated with milk micronutrient concentrations above MAEs; however, infants born to mothers with milk below MAEs for all investigated micronutrients appeared to experience poorer growth.
Further research is needed to understand longer-term implications, if any.
Einfach gesagt: Prenatal MMS and SQ-LNS reduce the risk of giving birth to small vulnerable newborns to varying extents, with the greatest magnitude of effects observed for small vulnerable newborn types that confer the greatest neonatal mortality risk.
Wang D et al. · The Lancet. Global health (2025)
Prenatal MMS and SQ-LNS reduce the risk of giving birth to small vulnerable newborns to varying extents, with the greatest magnitude of effects observed for small vulnerable newborn types that confer the greatest neonatal mortality risk.
This study underscores the importance of nutritional supplements in prenatal care.
Einfach gesagt: A folic-acid-containing multivitamin started before conception eliminated first-occurrence neural tube defects and reduced all congenital malformations — versus a trace-element comparator rather than a true placebo.
Czeizel AE, Dudás I · N Engl J Med (1992)
The comparator was NOT placebo — it was a trace-element supplement (copper, manganese, zinc and a very low dose of vitamin C)
6 neural tube defects in the trace-element control group vs 0 in the vitamin group (P=0.029)
All congenital malformations: 22.9 per 1,000 with trace elements vs 13.3 per 1,000 with the vitamin (P=0.02)
17Meta-Analyse2017
Einfach gesagt: Cochrane found insufficient data to reach meaningful conclusions on routine iodine supplementation in pregnancy.
Harding KB et al. · Cochrane Database Syst Rev (2017)
Insufficient data for meaningful conclusions on benefits and harms of routine iodine supplementation
Digestive intolerance increased roughly 15-fold: RR 15.33 (95% CI 2.07-113.70), 1 trial, very low quality
No clear differences for hypothyroidism, preterm birth, low birthweight, or neonatal thyroid measures
Einfach gesagt: Above about 10,000 IU per day of supplemental preformed vitamin A, this cohort found cranial-neural-crest defects specifically to be about 4.8 times as prevalent — the origin of the supplemental vitamin A ceiling, from a single observational study.
Rothman KJ et al. · N Engl J Med (1995)
Over 10,000 IU/day preformed vitamin A from supplements alone: cranial-neural-crest defect prevalence ratio 4.8 (95% CI 2.2-10.5)
Over 15,000 IU/day from food plus supplements: prevalence ratio 3.5 (95% CI 1.7-7.3)
The 10,000 IU/day threshold was 'apparent' from a SMOOTHED REGRESSION CURVE, not a directly tested cut-point — and the excess was in cranial-neural-crest defects specifically, not birth defects overall