ABSTRACT More than 9 million neonatal deaths occur each year, 98% of them in developing countries. Neonatal
deaths account for two-thirds of deaths in infancy and 40% of deaths before age 5 y. The major direct causes of
neonatal death are infections, preterm delivery and asphyxia. Important indirect causes include low birth weight and
hypothermia. The present body of work on multiple micronutrient interventions is not sufficient for us to draw
conclusions on their effects on neonatal well-being. Because studies have generally concentrated on single
micronutrients and a range of outcomes, this paper reviews the findings for individual nutrients and then summarizes
the situation. The evidence for the contribution of micronutrient deficiencies to perinatal mortality and duration of
gestation is limited, and the evidence base for individual micronutrient effects on neonatal mortality and morbidity is
patchy. To translate knowledge into policy, community evaluations of effect and an expanded evidence base that
includes affordability, acceptability and scalability are also required. A balance between supply-side and demandside
interventions must be struck, with an emphasis on effect and sustainability. Among the key requirements are
randomized, controlled community effectiveness trials of the effect of micronutrient supplementation in pregnancy on
perinatal mortality and neurodevelopment, studies on improving adherence and studies on the relation between
micronutrient deficiencies and sepsis and neonatal encephalopathy. It would also be helpful to look at mechanisms
for bringing the periconceptional period within the ambit of trials. J. Nutr. 133: 1757S–1764S, 2003.