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Evidence Gaps in Efficacy and Long-Term Safety Although folic acid, iron, iodine, and multiple-micronutrient supplementation have robust evidence in low-resource settings [35,46], important uncertainties remain: • Optimal dosing of vitamin D, choline, and DHA in well-nourished populations [41,44,45] • Potential epigenetic consequences of sustained supra-physiological doses of synthetic vitamins [61] • Long-term neurodevelopmental outcomes beyond 2–3 years of age [62] • True effectiveness of “premium” versus generic prenatal multivitamins in high-income countries [63]
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