The study is designed as an open-label, parallel, superiority randomized controlled trial. The study will be conducted at the Obstetrics OPD, Sri Madhusudan Sai Institute of Medical Sciences and Research from July 2024 to June 2025. The study population includes pregnant women aged 18 to 35 years who are registered at 12 to 16 weeks of gestation and have not started on Iron Folic Acid supplementation, with Hemoglobin levels above 8 g / dL. Consecutive sampling will be used, and the sample size is calculated to include 160 participants, with 80 in each group. Eligible participants will provide informed consent and be assigned a unique study ID. Randomization will be conducted using a Microsoft Excel-generated sequence with a 1:1 allocation ratio, concealed from the recruitment team. The intervention group will receive standard care, Iron Folic Acid tablets, and a Multi-Micronutrient Supplement powder, while the control group will receive standard care and Iron Folic Acid tablets only. Data collection will be done at baseline, monthly follow-up, and end line. Hemoglobin will be measured at baseline, after 3 months, and in the 9th month of pregnancy, with neonatal birth weight and length recorded at delivery. Peripheral smear will be done for those pregnant women with Hemogobin 8 to 10.99 g / dl, and serum ferritin and Vitamin B 12 will be done based on the peripheral smear report. Ethical clearance will be obtained from the Institutional Ethics Committee prior to the study initiation.