Randomized controlled trials and observational studies were evaluated for associations between multivitamins (3 or more vitamins or minerals in tablets or capsules) and adverse birth outcomes
We identified 35 eligible studies including 98,926 women
When comparing the use of multivitamins to those who did not take supplements
No change in risk of preterm birth (relative risk [RR] 0.84; 95% CI 0.69–1.03)
No change in risk for trisomy 21 (RR 0.98; 95% CI, 0.70–1.37)
There were significant decreases in risk for the following outcomes
Small for gestational age (RR 0.77; 95% CI 0.63–0.93)
Neural tube defects (RR 0.67; 95% CI 0.52–0.87)
Cardiovascular defects (RR 0.83; 95% CI 0.70–0.98)
Urinary tract defects (RR 0.60; 95% CI 0.46–0.78)
Limb deficiencies (RR 0.68; 95% CI 0.52-0.89)
Evidence quality was low or very low for all outcomes except for recurrence of neural tube defects (moderate degree)
Routine use of multivitamins in high-income countries can be recommended but authors recommend caution because results are mostly based on low quality evidence
Results do not indicate causality due to large number of observational studies
This study did not confirm the results of previous studies regarding decreased risk of clefting and hydrocephalus, but likely related to differences in search and eligibility criteria
None of the studies compared the use of folic acid and iron vs the use of multivitamins and therefore the authors of this study could not determine if beneficial effects the results of only these two components
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