Maternal Nutrition and Birth Outcomes: Effect of Balanced Protein-Energy Supplementation
Maternal Nutrition and Birth Outcomes: Effect of Balanced Protein-Energy Supplementation
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DOI：
10.1111/j.1365-3016.2012.01308.x
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发表时间：
2012-07-01
影响因子：
2.8
通讯作者：
Bhutta, Zulfiqar A.
中科院分区：
文献类型：
--
作者：
Imdad, Aamer;Bhutta, Zulfiqar A.
妇女在怀孕前和怀孕期间的营养状况对健康的妊娠结局很重要。产妇营养不良是导致胎儿发育不良、出生体重低以及婴儿短期和长期发病率和死亡率的关键因素。本文综述了孕妇营养与出生结局相关的证据，以及孕期均衡补充蛋白质-能量的效果。对PubMed、WHOLIS、PAHO和Cochrane图书馆进行文献检索。只考虑纳入干预性研究，如果可以从一项以上的研究中获得数据，则通过荟萃分析来结合数据。该综述纳入了16项干预研究。合并分析显示，与对照组相比，均衡的蛋白质能量补充对新生儿体重有积极影响[平均差异73(G)[95%可信区间(CI)30,117]]。与营养充足的女性相比，这种影响在营养不良的女性中更为明显。来自五项研究的综合数据显示，与对照组相比，干预组LBW的风险降低了32%[相对风险(RR)0.68[95%CI 0.51，0.92]]。与对照组相比，干预组小于胎龄儿的风险降低了34%[RR 0.66[95%CI 0.49，0.89]]。干预组死产风险也比对照组降低38%[RR 0.62[95%CI 0.40，0.98]]。总之，均衡的蛋白质-能量补充是降低低出生体重和小于胎龄儿发生率的有效干预措施，特别是在营养不良的妇女中。
The nutritional status of a woman before and during pregnancy is important for a healthy pregnancy outcome. Maternal malnutrition is a key contributor to poor fetal growth, low birthweight (LBW) and short- and long-term infant morbidity and mortality. This review summarised the evidence on association of maternal nutrition with birth outcomes along with review of effects of balanced protein-energy supplementation during pregnancy. A literature search was conducted on PubMed, WHOLIS, PAHO and Cochrane library. Only intervention studies were considered for inclusion and data were combined by meta-analyses if available from more than one study. Sixteen intervention studies were included in the review. Pooled analysis showed a positive impact of balanced protein-energy supplementation on birthweight compared with control [mean difference 73 (g) [95% confidence interval (CI) 30, 117]]. This effect was more pronounced in undernourished women compared with adequately nourished women. Combined data from five studies showed a reduction of 32% in the risk of LBW in the intervention group compared with control [relative risk (RR) 0.68 [95% CI 0.51, 0.92]]. There was a reduction of 34% in the risk of small-for-gestational-age babies in the intervention compared with the control group [RR 0.66 [95% CI 0.49, 0.89]]. The risk of stillbirth was also reduced by 38% in the intervention group compared with control [RR 0.62 [95% CI 0.40, 0.98]]. In conclusion, balanced protein-energy supplementation is an effective intervention to reduce the prevalence of LBW and small-for-gestational-age births, especially in undernourished women.