Effects of Maternal Nutritional Supplements and Dietary Interventions on Placental Complications: An Umbrella Review, Meta-Analysis and Evidence Map.
Effects of Maternal Nutritional Supplements and Dietary Interventions on Placental Complications: An Umbrella Review, Meta-Analysis and Evidence Map.
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DOI：
10.3390/nu13020472
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发表时间：
2021-01-30
期刊：
影响因子：
5.9
通讯作者：
The Precise Conceptual Framework Working Group
中科院分区：
文献类型：
--
作者：
Kinshella MW;Omar S;Scherbinsky K;Vidler M;Magee LA;von Dadelszen P;Moore SE;Elango R;The Precise Conceptual Framework Working Group
胎盘是一个重要的多功能器官，在怀孕期间起着母体和胎儿循环之间的接口作用。孕期营养不足会改变胎盘的发育和功能，导致不良妊娠结局，如先兆子痫、小于胎龄和低出生体重的婴儿、早产、死产和产妇死亡。孕妇营养补充可能有助于降低风险，但证据基础很难导航。这一总括审查的主要目的是绘制关于产妇营养补充剂和饮食干预对与胎盘紊乱和产妇死亡率有关的妊娠结局的影响的证据。对7个电子数据库、普罗斯佩罗登记册和已确认论文的参考资料清单进行了系统搜索。结果由两名独立审查员根据标题、摘要和全文分三个阶段进行筛选。纳入了关于母亲营养补充剂或饮食干预效果的随机对照试验荟萃分析。共纳入91项荟萃分析，涵盖23种补充剂和3种饮食干预措施。我们发现了支持补充维生素D和/或钙、omega-3、多种微量营养素、基于脂肪的营养素和平衡的蛋白质能量的证据，以降低不利的母婴健康结局的风险。然而，这些发现受到证据质量不佳的限制。营养组合显示了改善孕产妇和胎儿健康的前景，并支持向产妇膳食平衡而不是单一微量营养素缺乏症的范式转变。这项审查注册在Propero(CRD42020160887)上。
The placenta is a vital, multi-functional organ that acts as an interface between maternal and fetal circulation during pregnancy. Nutritional deficiencies during pregnancy alter placental development and function, leading to adverse pregnancy outcomes, such as pre-eclampsia, infants with small for gestational age and low birthweight, preterm birth, stillbirths and maternal mortality. Maternal nutritional supplementation may help to mitigate the risks, but the evidence base is difficult to navigate. The primary purpose of this umbrella review is to map the evidence on the effects of maternal nutritional supplements and dietary interventions on pregnancy outcomes related to placental disorders and maternal mortality. A systematic search was performed on seven electronic databases, the PROSPERO register and references lists of identified papers. The results were screened in a three-stage process based on title, abstract and full-text by two independent reviewers. Randomized controlled trial meta-analyses on the efficacy of maternal nutritional supplements or dietary interventions were included. There were 91 meta-analyses included, covering 23 types of supplements and three types of dietary interventions. We found evidence that supports supplementary vitamin D and/or calcium, omega-3, multiple micronutrients, lipid-based nutrients, and balanced protein energy in reducing the risks of adverse maternal and fetal health outcomes. However, these findings are limited by poor quality of evidence. Nutrient combinations show promise and support a paradigm shift to maternal dietary balance, rather than single micronutrient deficiencies, to improve maternal and fetal health. The review is registered at PROSPERO (CRD42020160887).
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DOI：
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发表时间：
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影响因子：
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作者：
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