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A modular systematic review of antenatal interventions to address undernutrition during pregnancy in the prevention of low birth weight

Hunter, Patricia J; Muthiani, Yvonne; Näsänen-Gilmore, Pietka K; Koivu, Annariina M; Pörtfors, Pia; Bastola, Kalpana; Vimpeli, Raija; ... Ashorn, Per; + view all (2023) A modular systematic review of antenatal interventions to address undernutrition during pregnancy in the prevention of low birth weight. The American Journal of Clinical Nutrition , 117 (Supp 2) S134-S147. 10.1016/j.ajcnut.2023.01.024.

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Abstract

Background: Poor nutrition during pregnancy can lead to adverse birth outcomes including low birth weight (LBW).// Objective: This modular systematic review aimed to provide evidence for the effects of seven antenatal nutritional interventions on the risks of LBW, preterm birth (PTB), small-for-gestational-age (SGA) and stillbirth (SB).// Methods: We searched MEDLINE, Embase, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials and CINAHL Complete between April and June 2020, with a further update in September 2022 (Embase only). We included randomized controlled trials (RCTs) and reviews of RCTs to estimate the effect sizes of the selected interventions on the four birth outcomes.// Results: Evidence suggests that balanced protein and energy (BPE) supplementation for pregnant women with undernutrition can reduce the risk of LBW, SGA and SB. Evidence from low and lower middle-income countries (MIC) suggests that multiple micronutrient (MMN) supplementation can reduce the risk of LBW and SGA in comparison with iron or iron and folic acid supplementation and lipid-based nutrient supplements (LNS) with any quantity of energy can reduce the risk of LBW in comparison with MMN supplementation. Evidence from high and upper MIC suggests that supplementation with omega-3 fatty acids (O3FA) can reduce the risk and supplementation with high-dose calcium might possibly reduce the risk of LBW and PTB. Antenatal dietary education programs might possibly reduce the risk of LBW in comparison with standard-of-care. No RCTs were identified for monitoring weight gain followed by interventions to support weight gain in women who are underweight.// Conclusions: Provision of BPE, MMN and LNS to pregnant women in populations with undernutrition can reduce the risk of LBW and related outcomes. The benefits of O3FA and calcium supplementation to this population require further investigation. Targeting interventions to pregnant women who are not gaining weight has not been tested with RCTs.

Type: Article
Title: A modular systematic review of antenatal interventions to address undernutrition during pregnancy in the prevention of low birth weight
DOI: 10.1016/j.ajcnut.2023.01.024
Publisher version: https://doi.org/10.1016/j.ajcnut.2023.01.024
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: nutrition, undernutrition, pregnancy, antenatal care, low birth weight, preterm birth, small-for-gestational-age, stillbirth.
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Infection, Immunity and Inflammation Dept
URI: https://discovery.ucl.ac.uk/id/eprint/10168081
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