Prentice A M
Dunn Nutrition Unit, Cambridge, UK.
Acta Paediatr Scand Suppl. 1991;374:67-77. doi: 10.1111/j.1651-2227.1991.tb12009.x.
Many nutritional intervention programmes throughout the world have targeted food supplements towards women during the "at risk" periods of pregnancy and lactation. Some of these programmes, together with a number of small-scale scientific studies, have attempted to evaluate the efficacy of supplementation in terms of birth outcome or lactational performance. After reviewing the available evidence it is concluded: (a) that supplementation during late pregnancy can have a significant beneficial effect on birthweight in women who are genuinely "at risk" due to an inadequate home diet; (b) that statistical projections would predict that the increase in birthweight should be accompanied by a significant decrease in neonatal mortality; (c) that supplementation during lactation is most unlikely to increase breast-milk output or significantly improve its composition except perhaps in extremely malnourished women. Since pregnant women form a small and easily identifiable target group, and since the potential benefits of extra food may be substantial, it is recommended that future efforts are focussed in this direction. Large-scale effectiveness and cost-benefit trials are required with neonatal mortality as the primary outcome.
世界各地的许多营养干预项目都在孕妇怀孕和哺乳的“高危”时期为其提供食品补充剂。其中一些项目，连同一些小规模的科学研究，试图从出生结局或哺乳表现方面评估补充剂的功效。在审查现有证据后得出以下结论：(a) 对于因家庭饮食不足而真正“处于危险之中”的女性，妊娠晚期补充剂可对出生体重产生显著有益影响；(b) 统计预测表明，出生体重增加应伴随着新生儿死亡率的显著下降；(c) 哺乳期补充剂极不可能增加母乳产量或显著改善其成分，可能除了极度营养不良的女性外。由于孕妇是一个规模小且易于识别的目标群体，而且额外食物的潜在益处可能很大，建议未来的工作朝这个方向集中。需要进行以新生儿死亡率为主要结果的大规模有效性和成本效益试验。
