Venkataramani Maya, Ogunwole S Michelle, Caulfield Laura E, Sharma Ritu, Zhang Allen, Gross Susan M, Hurley Kristen M, Lerman Jennifer L, Bass Eric B, Bennett Wendy L
Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland (M.V., S.M.O.).
Center for Human Nutrition, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland (L.E.C., K.M.H., J.L.L.).
Ann Intern Med. 2022 Oct;175(10):1411-1422. doi: 10.7326/M22-0604. Epub 2022 Sep 6.
The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is intended to improve maternal and child health outcomes. In 2009, the WIC food package changed to better align with national nutrition recommendations.
To determine whether WIC participation was associated with improved maternal, neonatal-birth, and infant-child health outcomes or differences in outcomes by subgroups and WIC enrollment duration.
Search (January 2009 to April 2022) included PubMed, Embase, CINAHL, ERIC, Scopus, PsycInfo, and the Cochrane Central Register of Controlled Trials.
Included studies had a comparator of WIC-eligible nonparticipants or comparison before and after the 2009 food package change.
Paired team members independently screened articles for inclusion and evaluated risk of bias.
We identified 20 observational studies. We found: moderate strength of evidence (SOE) that maternal WIC participation during pregnancy is likely associated with lower risk for preterm birth, low birthweight infants, and infant mortality; low SOE that maternal WIC participation may be associated with a lower likelihood of inadequate gestational weight gain, as well as increased well-child visits and childhood immunizations; and low SOE that child WIC participation may be associated with increased childhood immunizations. We found low SOE for differences in some outcomes by race and ethnicity but insufficient evidence for differences by WIC enrollment duration. We found insufficient evidence related to maternal morbidity and mortality outcomes.
Data are from observational studies with high potential for selection bias related to the choice to participate in WIC, and participation status was self-reported in most studies.
Participation in WIC was likely associated with improved birth outcomes and lower infant mortality, and also may be associated with increased child preventive service receipt.
Agency for Healthcare Research and Quality. (PROSPERO: CRD42020222452).
妇女、婴儿和儿童特殊补充营养计划（WIC）旨在改善母婴健康状况。2009年，WIC食品套餐进行了调整，以更好地符合国家营养建议。
确定参与WIC是否与改善孕产妇、新生儿出生和婴幼儿健康状况相关，或按亚组及WIC登记持续时间划分的结果差异。
检索（2009年1月至2022年4月）包括PubMed、Embase、CINAHL、ERIC、Scopus、PsycInfo以及Cochrane对照试验中央注册库。
纳入的研究有符合WIC资格但未参与者作为对照，或有2009年食品套餐变更前后的对比。
配对的团队成员独立筛选纳入文章并评估偏倚风险。
我们确定了20项观察性研究。我们发现：有中等强度证据表明孕期母亲参与WIC可能与早产、低体重儿和婴儿死亡率风险较低相关；有低强度证据表明母亲参与WIC可能与孕期体重增加不足的可能性较低以及儿童健康检查次数增加和儿童免疫接种增加相关；有低强度证据表明儿童参与WIC可能与儿童免疫接种增加相关。我们发现按种族和民族划分的某些结果存在差异的证据强度较低，但按WIC登记持续时间划分的差异证据不足。我们发现与孕产妇发病和死亡结果相关的证据不足。
数据来自观察性研究，因参与WIC的选择存在选择偏倚的可能性很高，且在大多数研究中参与状况为自我报告。
参与WIC可能与改善出生结局和降低婴儿死亡率相关，也可能与儿童预防性服务接受率增加相关。
医疗保健研究与质量局。（国际前瞻性系统评价注册库：CRD42020222452）
