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妊娠期饮食干预对中低收入国家母婴和儿童结局的影响。

Impact of Dietary Interventions during Pregnancy on Maternal, Neonatal, and Child Outcomes in Low- and Middle-Income Countries.

机构信息

Robinson Research Institute, University of Adelaide, Adelaide 5005, Australia.

Department of Pediatrics, Aga Khan University, Karachi 74800, Pakistan.

出版信息

Nutrients. 2020 Feb 19;12(2):531. doi: 10.3390/nu12020531.

Abstract

Optimal nutrition plays a crucial role in pregnancy. Maternal malnutrition is a risk factor for maternal, fetal, and neonatal complications and is more prevalent in low and middle-income countries (LMICs). This review aims to study the effectiveness of antenatal macronutrient nutritional interventions on maternal, neonatal, and child outcomes. We searched the CENTRAL, PubMed, Embase, and other databases for randomized controlled trials and quasi-experimental designs on healthy pregnant women in LMICs. We also searched grey literature and reports from Google Scholar, Web of Science, and websites of different organizations. Title/abstract screening, full-text screening, and data extraction filtered 15 studies for inclusion. Balanced energy protein (BEP) supplementation ( = 8) studies showed a reduced incidence of perinatal mortality, stillbirths, low birth weight (LBW) infants, small for gestational age (SGA) babies and increased birth weight. Food distribution programs (FDPs) ( =5) witnessed reduced rates of SGA, stunting, wasting, and increased birth weight and birth length. Studies on intervention for obesity prevention ( = 2) showed reductions in birth weight. Other findings were statistically insignificant. Subgroup analyses were conducted to study the effectiveness of supplementation between regions, location, the timing of supplementation and nutritional status; however, there were a limited number of studies in each subgroup. Data from our review supports the antenatal supplementation of BEP and FDP for the prevention of adverse maternal, neonatal, and child outcomes that can be utilized for future policymaking. However, more research is required before recommending obesity prevention programs.

摘要

孕期最佳营养至关重要。母体营养不良是孕产妇、胎儿和新生儿并发症的一个风险因素,在中低收入国家(LMICs)更为普遍。本综述旨在研究产前宏量营养素营养干预对孕产妇、新生儿和儿童结局的有效性。我们在CENTRAL、PubMed、Embase 和其他数据库中搜索了针对 LMIC 健康孕妇的随机对照试验和准实验设计。我们还搜索了灰色文献以及来自 Google Scholar、Web of Science 和不同组织网站的报告。经过标题/摘要筛选、全文筛选和数据提取,有 15 项研究被纳入。能量蛋白质平衡(BEP)补充( = 8)研究表明,围产期死亡率、死产、低出生体重(LBW)婴儿、小于胎龄儿(SGA)婴儿的发生率降低,出生体重增加。食物分配计划(FDPs)( = 5)观察到 SGA、发育迟缓、消瘦的发生率降低,出生体重和出生体长增加。预防肥胖干预( = 2)研究表明出生体重降低。其他发现无统计学意义。进行了亚组分析,以研究补充剂在不同地区、地点、补充时间和营养状况方面的有效性;然而,每个亚组的研究数量有限。我们的综述数据支持在产前补充 BEP 和 FDP 以预防孕产妇、新生儿和儿童不良结局,可以为未来的决策提供依据。然而,在推荐肥胖预防计划之前,还需要更多的研究。

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