Academic Journal
Effects of prenatal small-quantity lipid-based nutrient supplements on pregnancy, birth, and infant outcomes: a systematic review and meta-analysis of individual participant data from randomized controlled trials in low- and middle-income countries
| Title: | Effects of prenatal small-quantity lipid-based nutrient supplements on pregnancy, birth, and infant outcomes: a systematic review and meta-analysis of individual participant data from randomized controlled trials in low- and middle-income countries |
|---|---|
| Authors: | Kathryn G. Dewey, K. Ryan Wessells, Charles D. Arnold, Seth Adu‐Afarwuah, Benjamin F. Arnold, Per Ashorn, Ulla Ashorn, Ana Garcés, Lieven Huybregts, Nancy F. Krebs, Anna Lartey, Jef L. Leroy, Kenneth Maleta, Susana L. Matias, Sophie E. Moore, Malay K Mridha, Harriet Okronipa, Christine P. Stewart |
| Contributors: | Tampere University, Lapset ja naiset, diagnostiset alat, psykiatria, Children's and Women's health, Diagnostic Medicine, Psychiatry |
| Source: | Am J Clin Nutr Dewey, K G, Wessells, K R, Arnold, C D, Adu-Afarwuah, S, Arnold, B F, Ashorn, P, Ashorn, U, Garcés, A, Huybregts, L, Krebs, N F, Lartey, A, Leroy, J L, Maleta, K, Matias, S L, Moore, S E, Mridha, M K, Okronipa, H & Stewart, C P 2024, 'Effects of prenatal small-quantity lipid-based nutrient supplements on pregnancy, birth, and infant outcomes : a systematic review and meta-analysis of individual participant data from randomized controlled trials in low-and middle-income countries', American Journal of Clinical Nutrition, vol. 120, no. 4, pp. 814-835. https://doi.org/10.1016/j.ajcnut.2024.08.008 The American Journal of Clinical Nutrition, vol 120, iss 4 |
| Publisher Information: | Elsevier BV, 2024. |
| Publication Year: | 2024 |
| Subject Terms: | 0301 basic medicine, infant stunting, FOS: Health sciences, fetal growth restriction, Pregnancy, Birth Weight, Original Research Article, Micronutrients, Prenatal Nutritional Physiological Phenomena, Internal medicine, Randomized Controlled Trials as Topic, 2. Zero hunger, 0303 health sciences, Nutrition and Dietetics, Pregnancy Outcome, Prenatal Care, 16. Peace & justice, Lipids, 3. Good health, Obstetrics, Environmental health, Randomized controlled trial, infant wasting, Medicine, Female, maternal nutrition, antenatal interventions, Nursing, 03 medical and health sciences, Health Sciences, Genetics, Humans, low birth weight, Developing Countries, Biology, Maternal and Child Nutrition in Developing Countries, Low Birth Weight, Infant, Newborn, Infant, preterm birth, balanced energy protein supplementation, Maternal and Child Undernutrition, Infant, Low Birth Weight, Newborn, Meta-analysis, Nutrition-sensitive Interventions, FOS: Biological sciences, Dietary Supplements, Malnutrition Impacts |
| Description: | BackgroundUndernutrition during pregnancy increases the risk of giving birth to a small vulnerable newborn. Small-quantity lipid-based nutrient supplements (SQ-LNS) contain both macro- and micronutrients and can help prevent nutritional deficiencies during pregnancy and lactation.ObjectivesWe examined effects of SQ-LNS provided to pregnant women, compared to a) iron and folic acid or standard of care (IFA/SOC) or b) multiple micronutrient supplements (MMS), and identified characteristics that modified effects of SQ-LNS on birth outcomes.MethodsWe conducted a 2-stage meta-analysis of individual participant data from 4 randomized controlled trials of SQ-LNS provided to pregnant women (n = 5,273). We generated study-specific and subgroup estimates of SQ-LNS compared with IFA/SOC or MMS and pooled the estimates. In sensitivity analyses, we examined whether results differed depending on methods for gestational age dating, birth anthropometry, or study design.ResultsSQ-LNS (vs IFA/SOC) increased birth weight (mean difference: +49g; 95% CI: 26, 71g), duration of gestation (+0.12 wk; 95% CI: 0.01, 0.24 wk), and all birth anthropometric z-scores (+0.10-0.13 SD); it reduced risk of low birthweight by 11%, newborn stunting by 17%, newborn wasting by 11%, and small head size by 11%. Only 2 trials compared SQ-LNS and MMS; birth outcomes did not differ except for a marginal increase in head circumference for gestational age (+0.11; 95% CI: -0.01, 0.23). Effect estimates for SQ-LNS vs IFA/SOC were greater among female infants and among women with body mass index < 20 kg/m2, inflammation, malaria, or household food insecurity. Effect estimates for SQ-LNS vs MMS were greater among female infants, first-born infants, and women < 25 y.ConclusionsSQ-LNS had positive impacts on multiple outcomes compared to IFA/SOC, but further research directly comparing SQ-LNS and MMS is needed. Targeting SQ-LNS to vulnerable subgroups may be worth considering. Analysis registered atwww.crd.york.ac.uk/PROSPERO(CRD42021283391). |
| Document Type: | Article Other literature type |
| File Description: | application/pdf; fulltext |
| Language: | English |
| ISSN: | 0002-9165 |
| DOI: | 10.1016/j.ajcnut.2024.08.008 |
| DOI: | 10.1101/2024.05.17.24307546 |
| DOI: | 10.60692/m07fp-kp505 |
| DOI: | 10.60692/p9h4f-03b64 |
| Access URL: | https://pubmed.ncbi.nlm.nih.gov/39154665 https://kclpure.kcl.ac.uk/portal/en/publications/d57e6021-46ad-4104-b72d-22a5aca04b8c https://escholarship.org/content/qt21z565p4/qt21z565p4.pdf https://escholarship.org/uc/item/21z565p4 |
| Rights: | CC BY |
| Accession Number: | edsair.doi.dedup.....270fa63668505762b5febece9f1fade0 |
| Database: | OpenAIRE |
| ISSN: | 00029165 |
|---|---|
| DOI: | 10.1016/j.ajcnut.2024.08.008 |