Maternal undernutrition before and during pregnancy is linked to poor pregnancy outcomes. Maternal micronutritional deficiency can jeopardise the intrauterine growth or development of the fetus and increase perinatal morbidity and mortality by disrupting protein metabolism, gene transcription, endocrine functions, and transport of nutrients.1

About 20% and 50% of women in south Asia and sub-Saharan Africa, respectively, have low body mass index (<18.5), a known risk factor for poor pregnancy outcomes.2 During pregnancy, 50-70% of women in developing countries have anaemia and night blindness, a sign of vitamin A deficiency.3 In the linked randomised controlled trial (doi:10.1136/bmj.a2001), Zeng and colleagues compare the effect of antenatal supplementation with multiple micronutrients, iron and folic acid, or folic acid alone on birth weight, duration of gestation, and maternal haemoglobin in the third trimester.4

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