Objectives:The study aimed at identifying predictors of multivitamin use during pregnancy in Brazil.Methods:Birth registry data of 1,774 infants at maternity hospitals in Brazil were used. The effects of maternal health and fertility risk indicators, enabling factors and other maternal characteristics on multivitamin use were evaluated both pooled and stratified by African ancestry.Results:About 14% of the women used multivitamins during pregnancy. Number of previous live births, maternal age and education, number of ultrasound exams and year of pregnancy had significant effects on multivitamin use in the group reporting African ancestry. Maternal acute illnesses and education had significant effects on use in the group without African ancestry. Significant geographic variation in multivitamin use was observed in both groups.Conclusions:The study identifies several risk indicators, health care access and enabling factors that are predictive of multivitamin use with differences by African ancestry. The study highlights the importance of increasing the awareness of women of childbearing age of the benefits of multivitamin use and identifies barriers that need to be addressed to promote use.