biostudies-literatureUnknown122(1)Sauer CMichael Smith Health Research BCOntario Ministry of Health and Long-Term CareCanadian Institutes of Health Research<h4>Background</h4>The Cambodian Ministry of Health is exploring transitioning from iron and folic acid (IFA) to multiple micronutrient supplements (MMS) during pregnancy and is seeking rigorous evidence to inform this policy change.<h4>Objective</h4>We aimed to assess the adherence and acceptability of MMS compared with IFA supplementation during pregnancy.<h4>Methods</h4>We conducted an open-label cluster-randomized noninferiority trial across 48 health centers in Cambodia. A total of 1546 healthy pregnant individuals (18-45 y) were recruited at their first antenatal care (ANC) visit (<14 weeks of gestation) and randomized to 1 of 3 arms at the health center level: 1) IFA for 90 d (IFA-90, n = 515), the current standard of care; 2) MMS for 180 d via 1 180-tablet bottle (MMS-180, n = 516)The American journal of clinical nutrition166-173https://www.ebi.ac.uk/biostudies/studies/S-EPMC12308091biostudies-literatureAssessing the adherence and acceptability to iron and folic acid compared with multiple micronutrient supplements during pregnancy: a cluster-randomized noninferiority trial in Cambodia.PMC12308091Karakochuk CDSokhal VHoang MALabonte JMKroeun HChea MMishra APanicker AKlemm RSokchea MGupta ASNgik RSauer CfalseAssessing the adherence and acceptability to iron and folic acid compared with multiple micronutrient supplements during pregnancy: a cluster-randomized noninferiority trial in Cambodia.<h4>Background</h4>The Cambodian Ministry of Health is exploring transitioning from iron and folic acid (IFA) to multiple micronutrient supplements (MMS) during pregnancy and is seeking rigorous evidence to inform this policy change.<h4>Objective</h4>We aimed to assess the adherence and acceptability of MMS compared with IFA supplementation during pregnancy.<h4>Methods</h4>We conducted an open-label cluster-randomized noninferiority trial across 48 health centers in Cambodia. A total of 1546 healthy pregnant individuals (18-45 y) were recruited at their first antenatal care (ANC) visit (<14 weeks of gestation) and randomized to 1 of 3 arms at the health center level: 1) IFA for 90 d (IFA-90, n = 515), the current standard of care; 2) MMS for 180 d via 1 180-tablet bottle (MMS-180, n = 516)2025-01-01T00:00:00Z2025 Jul2026-07-15T05:44:45.672Z2025-08-14T03:06:11.462ZS-EPMC123080914033475010.1016/j.ajcnut.2025.04.033