Friis 2004

Methods	This trial was carried out in Zimbabwe in 1996‐1997.
Participants	Pregnant women who were between 22 and 36 weeks of gestation were eligible for enrolment. Participants 1669 were randomised into 2 groups, MMN group n = 837 and placebo n = 832. Out of the 1106 women that were followed, 725 were HIV+ve and 360 were HIV‐ve.
Interventions	MMN group received daily supplementation of vitamin A 3000 mcg RE, beta carotene 3.5 mg, thiamine 1.5 mg, riboflavin 1.6 mg, B6 2.2 mg, B12 4 mcg, niacin 17 mg, C 80 mg, D 10 mcg, E 10 mg, zinc 15 mg, copper 1.2 mcg and selenium 65 mcg while the other group received a placebo. An iron folic acid supplement was given separately as part of the routine antenatal care and was not part of the MMN tablet. Tablets were given from the day of enrolment until delivery.
Outcomes	Gestational age, birthweight, birth length, head circumference, preterm delivery (< 37 weeks of gestation), LBW (< 2500 g), IUGR‐LBW (> 37 weeks' gestational age and < 2500 g birthweight). It should be noted that the data for SGA was obtained from a separate report (Food and Nutrition Bulletin 2009) and not from the individual trial report.
Notes	Study intervention was approximately the RDA for pregnant or lactating women, except for vitamin A for which a higher amount was given. Out of 1106 women who were followed, 725 were HIV‐ve whereas 360 were HIV+ve and HIV status of 21 was indeterminate. We have used data of HIV‐ve women only in this review. The intervention and the placebo groups were comparable at baseline except for the higher proportion of primigravida in the placebo group.
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Quote: "Allocation to daily supplementation with multimicronutrient or identical‐looking placebo tablets was based on simple blocked randomization. The digits 0–5 in a computer‐generated random sequence were replaced by 6 preassigned permuted blocks of 4: AABB, ABAB, ABBA, BABA, BBAA, and BAAB; the digits 6–9 were deleted". Comment: probably done.
Allocation concealment (selection bias)	Low risk	Quote: "Containers with 110 multimicronutrient or placebo tablets, which were coded A or B, respectively, were delivered by the manufacturer together with the code in 2 sealed envelopes. Duplicate containers, which corresponded to the random sequence, were consecutively numbered from 1 to 1800. The study participants were numbered consecutively at recruitment". Comment: probably done.
Incomplete outcome data (attrition bias) All outcomes	High risk	Attrition was > 20% and reasons for it were reported. Exclusions were not reported in the study.
Selective reporting (reporting bias)	Low risk	Comment: all outcomes in the methods section were presented in the paper.
Other bias	Low risk	Comment: no other bias was identified.
Blinding of participants and personnel (performance bias) All outcomes	Low risk	Quote: "double blind", "multimicronutrient or identical‐looking placebo tablets". Comment: study participants and care providers were probably blinded to the treatment assignment.
Blinding of outcome assessment (detection bias) All outcomes	Low risk	Quote: "double blind", "multimicronutrient or identical‐looking placebo tablets". Comment: investigators were probably blinded to the treatment assignment.