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11 The details were verified by other co-authors (FG, UR) and effect sizes were calculated for each study outcome by dividing the difference between the mean values for the treatment (i.e. MM supplements) and control groups by the pooled SD. If the study reported only the SE or 95% CI, we calculated the SD from the SE or 95% CI. Pooled analyses were conducted where data were available from more than one study for an outcome and the results are presented as risk ratios (RR) for dichotomous variables or weighted mean difference (WMD) for selleck chemical continuous variables with 95% confidence intervals (95% CIs). In the case of trials with more than one comparison that shared the same treatment or control group, we selected the most appropriate comparison; we also conducted sensitivity analysis in which we used pooled estimates that combined the results for more than one arm that shared the same control or treatment group.12 The overall mean effect size and 95% CI across studies was estimated by a fixed or random effects model that used the weighted mean effect size for each study where the weight was the inverse of the intra-study variance. For all outcomes of interest, we conducted an overall comparison of all studies that provided MM (��5 micronutrients) with control (��3 micronutrients). To examine dose�Cresponse relationships, we carried out subanalysis for the following comparisons: MM (including 30?mg iron) vs. control (60?mg iron with or without folic acid); MM (including ��60?mg tuclazepam iron) vs. control (��60?mg iron with or without folic acid). We also compared subanalysis by timing of initiation of the intervention namely began intervention in the (i) first trimester (��12 weeks gestation) and (ii) second or third trimester (>12 weeks gestation). In all cases, we assessed heterogeneity of effect sizes using the chi-squared test of homogeneity; P?50% were deemed as exhibiting substantial statistical heterogeneity. selleckchem Estimates based on the random effects model were used in cases with significant heterogeneity. We evaluated the presence of publication bias using funnel plots.13 The Begg's rank correlation test was used for statistical testing of funnel plot symmetry.14 Finally, we assessed the overall quality of evidence for the outcomes by the GRADE criteria.11,15 All statistical analyses were conducted using Review Manager Version 5.0 (Cochrane Collaboration, Copenhagen, Denmark). All statistical tests were 2-sided, with P?