Background: Multiple micronutrient deficiencies are highly prevalent among Filipino pregnant women, but the interventions are still focused on single micronutrient. To date there is no local data that looks into the benefits of multiple micronutrient supplementation on hemoglobin level and micronutrient status of Filipino pregnant women. Also the efficacy of prenatal micronutrient supplementation needs to be assessed with use of other endpoints such as birthweight, and other birth outcomes such as incidence of low birthweight, preterm delivery and infant mortality. Objectives: The study examined the effect of multiple micronutrient (MN) supplementation on hemoglobin level and micronutrient status of pregnant women. It also compared whether multiple MN supplementation was more effective than is supplementation with iron plus folic acid or iron alone in improving the hemoglobin of some anemic Filipino pregnant women. It also assessed the impact of supplementation on birth outcome and identified the significant variables associated with hemoglobin levels. Methods: The study employed a randomized, experimental trial wherein 131 pregnant women at the 2nd trimester (13-20 weeks of gestation), not taking any vitamin-mineral supplement at recruitment and whose hemoglobin levels fall between 8.5 – 10.9 mg/dl, were randomly allocated to three supplementation groups, those receiving multi-MN (Group I), iron-folic acid (Group II), and iron alone (Group III-placebo). Blood samples were collected at baseline (13-16 weeks gestation), at midline (30-32 weeks) and at endline (37-38 weeks gestation). Hemoglobin was analyzed by cyanmethemoglobin method, serum ferritin and serum folate by radio-immunoassay (RIA) method and riboflavin by erythrocyte glutathione reductase activity (EGR-AC). Serum retinol (vitamin A) was assessed by high precision liquid chromatography (HPLC) and serum zinc by atomic absorption spectrophotometry (AAS). Univariate and multivariate analysis were performed using SPSS. Results: The present study indicates that anemic women who were supplemented with multi MN had remarkably improved haemoglobin status. An average increase of 1.3 g/dl was obtained for multi MN (Group 1), 0.8g/dL in iron-folic acid (Group II) and 0.5 g/dL in iron alone (Group III). With multi MN supplementation, anemia prevalence dropped significantly to 12.8% compared to the final anemia prevalences of 27.3% and 46.9% for Groups II and III. Multiple MN supplementation also improved riboflavin status and folate status of pregnant women. These two nutrients, together with serum ferritin were the important predictors of hemoglobin status. Multi MN supplementation was associated with improved birthweight. There were comparable rates in terms of incidences of low birthweight, premature delivery and neonatal death for Group 1 and II, but slightly higher rates for the same pregnancy outcomes among pregnant women in Group III. Mothers who had limited education or those who had reached either elementary or high school were the most at risk of anemia with an odd’s ratio of 2.240. Conclusions: Multi micronutrient supplementation among pregnant women was more effective and even better than iron-folic or iron alone acid alone in improving the hematologic status of anemic pregnant women. Comparing with iron supplemented alone (placebo), both the MN supplements and iron-folic acid supplements reduced the incidence of LBW as well as incidence of premature delivery and occurrence of neonatal deaths. Recommendations: These findings underscore the need for large-scale evaluation of multiple micronutrient supplements during pregnancy in appropriate circumstances as part of health system interventions to improve maternal nutrition and health during pregnancy. Given that low income pregnant women bear a substantially greater anemia risk, more attention should be given to them by preventing iron and other micronutrient deficiencies during and after pregnancy. >>>>>Abstracts and Posters