Effect of balanced protein energy supplementation during pregnancy on birth outcomes

Effect of balanced protein energy supplementation during pregnancy on birth outcomes

The nutritional status of the mother prior to and during pregnancy plays a vital role in foetal growth and development, and maternal undernourishment may lead to adverse perinatal outcomes including intrauterine growth restriction (IUGR). Several macronutrient interventions had been proposed for adequate protein and energy supplementation during pregnancy. The objective of this paper is to review the effect of balanced protein energy supplementation during pregnancy on birth outcomes. This paper is a part of a series of reviews undertaken for getting estimates of effectiveness of an intervention for input to Lives Saved Tool (LiST) model.

The final number of studies included in this review is eleven comprising of both RCTs and quasi-RCTs. The review meta-analysis indicates that providing pregnant females with balanced protein energy supplementation results in a significant reduction of 31% in the risk of giving birth to small for gestational age infants (Relative risk (RR) =0.69, 95% Confidence interval (CI) 0.56 to 0.85). This estimate has been recommended for LiST as a proxy for reduction in IUGR. Pooled results for mean birth weight show that balanced protein supplemented group gain more weight compared to control [Mean difference 59.89 g, 95 % CI 33.09-86.68]. This effect is more pronounced in malnourished women compared to adequately nourished women. There is no statistically significant effect of balanced protein energy supplementation on neonatal mortality (RR= 0.63, 95% CI 0.37 to 1.06).

Providing pregnant females with balanced protein energy supplementation leads to reduction in risk of small for gestational age infants, especially among undernourished pregnant women. Given these findings, the review recommends balanced protein energy supplementation as an intervention among undernourished women for inclusion in the LiST model with a point estimate of 31% [95% CI 15% to 44%] reduction in IUGR.

[Adapted from author]