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Life-Long Health Begins With Maternal Nutrition
Trimacare® is a multi-micronutrient supplement (MMS) including iron, folate, calcium. Scientifically formulated for each trimester of pregnancy.
More than 50% of pregnant women walk into clinics with depleted reserves of an average of 7-8 micronutrients
Pregnancy in India begins from a position of nutritional deficit.
These figures are not driven by iron deficiency alone. Pregnant Indian women routinely present with simultaneous deficiencies of folate, vitamin B12, vitamin D, iodine, zinc, choline, and other essential micronutrients – a constellation termed hidden hunger.
An iron-folic acid regimen addresses two of those deficiencies. The remaining five or more go unaddressed. IFA is the foundation – but it was never designed for a deficiency landscape this broad.
60% adverse pregnancy outcomes linked to hidden hunger.
IFC covers 3. She needs 20+.
Three Pillars of Lifelong Health
Three converging frameworks establish maternal nutrition as a primary determinant of long-term offspring health.
1. Developmental Origins of Health and Disease (DOHaD)
"The DOHaD framework, established through decades of cohort and mechanistic research, has reframed maternal nutrition from a peripartum concern to a public-health lever that shapes a generation. Indian cohort data, most notably from the Pune Maternal Nutrition Study, confirm DOHaD effects in South Asian populations and document the distinctive thin-fat phenotype of Indian neonates – low overall body weight with relatively high fat mass, predisposing to lifelong metabolic risk."
Foundation of Developmental Origins of Health & Disease (DOHaD)
2. Epigenetics
The first human evidence came from the Dutch Hunger Winter cohort, where periconceptional famine exposure was associated with persistent DNA methylation differences six decades later. In the Indian context, the Pune Maternal Nutrition Study demonstrated that the imbalance between maternal vitamin B12 and folate during pregnancy is associated with offspring insulin resistance – linking one-carbon metabolism directly to long-term metabolic phenotype.
One-Carbon Metabolism Pathway
Adequate nutrition
Deficient nutrition
3. The intergenerational cycle of malnutrition
If that child is female, she enters her own pregnancy already deficient. Recent analyses of Indian populations explicitly trace the micronutrient pathway through this cycle - maternal anaemia and chronic micronutrient shortages are associated with the thin-fat phenotype in newborns, perpetuating the intergenerational transmission of metabolic risk. The Lancet Maternal and Child Nutrition Series has documented that the effects of under-nutrition span at least three generations. The clinical implication is that intervention in this generation is intervention in the next.
The Intergenerational cycle of malnutrition
Maternal nutrition is the single most modifiable factor influencing pregnancy outcomes & the lifelong health of the offspring.
IFA alone is insufficient
Iron–folic acid (IFA) supplementation has been the cornerstone of antenatal nutrition programs in India since 1973. However, despite over five decades of implementation, anaemia continues to affect more than 50% of pregnant women.
This persistent burden highlights a critical gap: IFA addresses only two micronutrients in a clinical setting where deficiencies often span 7 or more essential micronutrients. It's time to move beyond a limited approach and embrace comprehensive, multi-micronutrient supplementation for better maternal and fetal outcome.
Comparison of adverse pregnancy outcomes:
Yesterday
Today's standard
MMS improves pregnancy outcomes
- Reduced risk of preterm birth by 55%.
- Decreased risk of low birth weight by 15%.
- Improved body composition, growth, respiratory health, & cognitive outcomes.
- Lower risk of non-communicable diseases in adulthood, such as diabetes and cardiovascular disorders.
- Reduced risk of pre-eclampsia by 45%.
- Lower risk of gestational diabetes, osteoporosis, & thyroid dysfunction.
- Reduced incidence of maternal anemia compared to iron & folate supplementation alone.
- Enhanced energy levels, improved immunity, & faster postpartum recovery.
Antenatal multiple micronutrient supplements that include iron and folic acid are recommended in the context of rigorous research, in pregnant populations with documented micronutrient deficiencies.
– World Health Organization Antenatal Care guideline (2016, updated 2020)
Why guidelines are moving beyond IFA alone
Trimacare® Patented Pregnancy Supplement
20+ Multi-micronutrient Supplement (MMS), including Iron, Folate & Calcium
Scientifically Formulated for each Trimester of Pregnancy
Scientifically formulated for each trimester of pregnancy
Reduces
Morning sickness
Ginger + B6 anti-emetic blend
Supports
Neural tube formation
5-MTHF + Choline methyl-donor support
Reduces
Pregnancy fatigue
B-complex + Iodine energy metabolism
4th Generation Bioactive Folate (6S)-5-MTHF): 570 mcg | Choline: 100 mg | Veg Omega 3 (EPA:DHA 2:3): 100 mg | Anti emetic botanical blend: 200 mcg | Iodine: 200 mcg | Vitamin D: 600 IU | Vit B12: 2.45 mcg
For your IVF & ART patients
Replace Folic Acid with Trimacare® 1 for Superior Outcomes in IVF Therapy.
- Improved embryo quality.
- Higher success rates in first attempt to achieve pregnancy.
- Better fertilization & clinical pregnancy outcomes.
Pregnancy (%) in first attempt
Fertilization rate (%)
Pregnancy rate (%)
Reduces Anemia Risk
Iron + Vit C + Folate + Zinc + B12 for normal RBC formation
Reduces Brain Fog
Choline + DHA + Iodine Neurotransmission support
Support Bone & Muscle
B-complex + Calcium + Vit D + Magnesium + Iron Energy metabolism
Iron (ferrous fumarate): 27 mg | Vit C: 60 mg | Choline: 200 mg | Algal Omega 3 (EPA+DHA; 2:3): 200 mg | Vit B12: 2.45 mcg | Iodine: 200 mcg | Zinc: 12 mg | (6S)-5-MTHF: 570 mcg (Dietary Folate) | Calcium: 500 mg | Vit D: 600 IU | Magnesium: 206 mg | B-complex & more
Relief from
Constipation
Bowel regulator (Dietary fiber)
Reduces
Leg Cramps
Higher Mg + Calcium + Vit D for muscle function
Support
Postpartum recovery
Iron + Folate + B complex + Vit D + Calcium
Iron (ferrous fumarate): 27 mg | Vit C: 60 mg | Choline: 200 mg | Algal Omega 3 (EPA+DHA; 2:3): 200 mg | Vit B12: 2.45 mcg | Iodine: 200 mcg | Zinc: 12 mg | (6S)-5-MTHF: 570 mcg (Dietary Folate) | Calcium: 500 mg | Vit D: 600 IU | Higher Magnesium: 310 mg | Bowel regulator (Dietary Fiber): 125 mg | B-complex & more
Superior patient compliance
of patients prefer a single pill vs multiple pills
of patients reported better tolerability as compared to iron tablets
of patients reported fewer pregnancy symptoms like morning sickness, constipation & fatigue
IFC
- Nutritional Insufficiency
- Poor Compliance
- Low Absorption & GI Side Effects
- Limited Symptomatic Relief
- Non-Specific Formulation
Trimacare®
- Comprehensive Nutritional Support
- Enhanced Compliance
- Superior Absorption
- Enhanced Symptomatic Relief
- Pregnancy-Specific Formulation
What leading Ob-Gyns say about MMS
Prof. Dr. Narendra Malhotra
MBBS, MD, FIAJAGO, FICMU, FICMCH, FICOG,FICS, FRCOG, FMAS, AFIAPM
Managing Director, Ujala Cygnus RainbowHospital, Global Rainbow Health Care and ARTRainbow IVF
Prof. Dr. Jaideep Malhotra
MBBS, MD, FICMCH, FIAJAGO, FICOG, MASRM,FICMU, FRCOG
Founder of the Infertility Centre of Rainbow IVF
Dr. Hrishikesh D. Pai
MD FRCOG (UK-HON) FCPS FICOG MSc (USA)Past President FOGSI/ISAR/IAGE
Founder and Medical Director, Bloom IVF Group,Mumbai
Prof. Dr. Jaideep Malhotra
MBBS, MD, FICMCH, FIAJAGO, FICOG, MASRM,FICMU, FRCOG
Founder of the Infertility Centre of Rainbow IVF
Dr. Hrishikesh D. Pai
MD FRCOG (UK-HON) FCPS FICOG MSc (USA)Past President FOGSI/ISAR/IAGE
Founder and Medical Director, Bloom IVF Group,Mumbai
Dr. Hrishikesh D. Pai
MD FRCOG (UK-HON) FCPS FICOG MSc (USA)Past President FOGSI/ISAR/IAGE
Founder and Medical Director, Bloom IVF Group,Mumbai
Prof. Dr. Jaideep Malhotra
MBBS, MD, FICMCH, FIAJAGO, FICOG, MASRM,FICMU, FRCOG
Founder of the Infertility Centre of Rainbow IVF
Dr.(Prof) Shweta Mittal Gupta
Co-Director & Unit HeadCentre of IVF & Human Reproduction,Sir Ganga Ram Hospital, Delhi
Dr.(Prof) Shweta Mittal Gupta
Co-Director & Unit HeadCentre of IVF & Human Reproduction,Sir Ganga Ram Hospital, Delhi
Dr. Sheena Sobti
Infertility Specialist and Laparoscopic SurgeonSharma Medicare Hospital, Noida
Proud Academic Partner of ICOG Campus of FOGSI
Academic resources for the practising clinician
Get your Free CopyFAQ — Answers from practising specialists.
FOGSI's 2024 GCPR establishes the current Indian standard of care: iron 60–100 mg + folic acid 400 mcg daily plus calcium 1.5 g daily. This is the evidence-aligned foundation of antenatal supplementation in India. Indian pregnant women, however, present with documented simultaneous deficiencies of vitamin B12, vitamin D, iodine, zinc, choline, magnesium, and omega-3 — none of which an IFA + calcium regimen addresses.
Trimacare is a multiple micronutrient supplement (MMS) that provides over 20 nutrients in a trimester-specific, patented formulation. Cochrane systematic review (2019) and the New York Academy of Sciences expert review (2019) found that MMS reduces the risk of low birth weight, small-for-gestational-age, and stillbirth compared with IFA alone in low- and middle-income countries.
Quatrefolic® is the glucosamine salt of (6S)-5-methyltetrahydrofolate — the biologically active form of folate. Unlike synthetic folic acid, it does not require enzymatic conversion and is directly available for cellular use, making it particularly beneficial for women with MTHFR polymorphisms.
Choline is essential for fetal brain development, particularly hippocampal formation and neural tube closure. Most prenatal supplements and dietary intakes fall short of the AI of 450 mg/day during pregnancy. Trimacare addresses this gap directly.
Trimacare uses ergocalciferol (D2) as it is suitable for vegetarian formulations while still contributing to vitamin D status. At the doses provided, D2 effectively raises serum 25(OH)D levels in pregnant women who are at risk of deficiency.
Multiple Cochrane reviews and WHO guidance support MMS supplementation over standard IFA in low- and middle-income countries. The UNIMMAP formulation has been studied in large randomised controlled trials across South Asia and sub-Saharan Africa, consistently showing reduced rates of low birth weight and small-for-gestational-age outcomes.
Trimacare is designed to be started at the point of conception confirmation or as early as possible in the first trimester, and continued throughout pregnancy. The trimester-specific formulations (T1, T2, T3) adjust nutrient levels to match the evolving demands of each stage of fetal development.
Rx Trimacare®
from the first antenatal visit
Improved Birth Outcomes.
Superior Patient Compliance.
