Foetal growth retardation results in low birth weight (LBW) babies with a higher mortality and morbidity risk during the neonatal period and beyond. Women that initiate pregnancy undernourished are particularly at risk of poor birth outcome. This project proposes to study the mechanism on how prenatal nutritional supplementation effects foetal and postnatal child growth. A first study evaluates the effect of prenatal supplementation on child growth and development in a cohort of children in Burkina Faso that participated in a study of prenatal food supplementation (MISAME-II). In a second study cord blood samples from this MISAME-II cohort will be analysed using a metabolomics approach. The goal is to identify new molecular markers/patterns that characterise (LBW) pregnancies to gain insights on what physiological pathways are associated with reduced foetal growth and if prenatal nutritional supplementation exhibits any influence on these patterns. Finally, a 3-arm intervention study will be conducted to test the effect of a daily food supplement (FS) with varying doses of multiple micronutrients on foetal growth in pregnant women with suboptimal early-pregnancy nutritional status. This study will test the hypothesis that undernourished mothers have higher gestational micronutrient requirements by providing different doses of micronutrients.