Micronutrients are vitamins, minerals and trace elements that are used in minute doses as cofactors, antioxidants and modulators of gene transcription homeostasis. MMNs may have a role in averting or treating adverse pregnancy outcomes and maternal complications. In 2016, WHO suggested the use of iron-folic acid (IFA) rather than multiple micronutrients (MMNs) during pregnancy owing to some feared adverse outcomes like perinatal mortalities. However, this effect is debatable as such complications could be also due to genetic or environmental factors. Therefore, this appraisal should provide appropriate information and guidance to health workers, scholars and policymakers. This review includes large sample-sized studies with a special focus on developing countries like Ethiopia. The articles were selected using systematic searching with Boolean operators, advanced search techniques, snowballing and search limits. Mendeley was used as a reference management tool where the source of databases and references were PubMed, AJOL, Google Scholar, IRIS, Summon, DOAJ, Cochrane Library, Oxford Medicine Online, WHO reproductive health libraries majorly from the Hinari program. Articles from BMC, American Society for Nutrition, Lancet, Elsevier, John Wiley and Sons LTD, PLoS One, Springer and Nature Publishing Groups were also used. The results showed that there are no variations in adverse effects between MMNs and IFA. Moreover, MMNs are valuable in anemic pregnant women with lower preconception weight as it increases maternal weight and reduces low birth weight and anemia more than IFA. Therefore, MMNs may have greater health benefits than IFA for the offspring by minimizing fetal complications and the cost of their treatment, resulting from the MMN deficiency state.

Introduction Low birth weight is a global public health problem, with 15–20% of all births globally, described by weight at birth of less than 2500 g ensuing fetal and neonatal mortality and morbidity, poor cognitive growth, and an increased risk of chronic diseases later in life. The prevalence is critical in East Africa where about 11% have low birth weight out of 54% of neonates whose weight was measured at birth. There are many causes of low birth weight, including early induction of labor or cesarean birth, multiple pregnancies, infections, diabetes, and high blood pressure. Moreover, socioeconomic factors and unhealthy dietary habits could contribute to low birth weight in areas with poor intake of a diversified diet. This study has indicated the association between poor dietary diversity and low birth weight in the study area for the first time. Methods An institutional-based cross-sectional study was conducted on eligible 423 pregnant women recruited from Gestational Age of less than 17 weeks until delivery where the birth outcomes were recorded in health institutions in randomly selected five Woredas in East Gojjam Zone, Amhara, Ethiopia from June 2019 to December 2020. Questionnaires were used to collect data on socio-economic-demographic, dietary diversity scores, and food consumption scores. Results The study found a prevalence of low birth weight of 9.6%, low dietary diversity score of 53.2%, low food consumption score of 19.7%, and preterm delivery of 9.1%. Ever attended school and a higher level of education (diploma and above) decreased the risk of low birth weight with an Adjusted Odds Ratio (AOR) of 0.149 (0.024, 0.973) P ≤ 0.042; 0.059 (0.007, 0.513) P ≤ 0.007; whereas low dietary diversity score group and low food consumption group increased the risk of low birth weight with AOR 2.425 (1.342, 6.192) P ≤ 0.011and 2.983 (1.956, 9.084) P ≤ 0.044 respectively. Conclusion and recommendation Participants with no formal education, no diploma, and above (no college or university training/degree), low diversity score group, and low food consumption group had an increased risk of low birth weight. Therefore the use of a diversified diet, educating women to a higher educational level, and health education on the intake of a diversified food rich in multiple micronutrients are recommended as strategies that will ameliorate the occurrence of low birth weight.