Prenatal Multiple Micronutrient Supplementation and Child Neurodevelopment: A Systematic Review and Meta-analysis.

Abstract There are various inconclusive individual studies that have reported the association between child neurodevelopment and prenatal multiple micronutrient supplementation during pregnancy. Hence, the main aim of the current systematic review and meta-analysis is to determine the pooled effect size of prenatal multiple micronutrients supplementation on different neurodevelopmental outcomes in children. Systematic electronic search of PubMed/MEDLINE, Web of Science, Cochrane Library, CINAHL, Science Direct, and Google Scholar was conducted to access relevant articles to the current systematic review and meta-analysis. Eligible articles were selected based on predefined eligibility criteria, and data from the selected articles were extracted using Excel templates. Data analysis was performed using R and STATA software. Statistically significant heterogeneity among included studies was assessed using Cochran’s Q-test and I² statistics. Potential publication bias was evaluated by examining asymmetry in the funnel plots. Pooled Odds Ratios and Pooled Mean Differences, along with the corresponding 95% confidence intervals for prenatal micronutrient supplementation on neurodevelopmental outcomes in children, were calculated using a random-effects meta-analysis model. Statistical significance was defined as a p-value of < 0.05. The present systematic review and meta-analysis revealed that prenatal multiple micronutrients supplementation is significantly associated with autistic-like behavior (pooled Odds Ratio: 0.44, 95%CI: 0.30, 0.63), cognitive development (pooled mean difference: 0.18, 95%CI; 0.02, 0.34), and psychomotor development (pooled mean difference: 0.73, 95%CI: 0.19, 1.27) in children during postnatal life. The present systematic review and meta-analysis revealed that multiple micronutrients supplementation during pregnancy significantly reduces the risk of autistic-like behavior in children by 56% as compared to no supplementation or supplementations with iron and folic acid. The present meta-analysis also demonstrates a significant association between multiple micronutrient supplementation and improvements in cognitive and psychomotor development.