Effects of prenatal small-quantity lipid-based nutrient supplements on pregnancy, birth and infant outcomes: A systematic review and meta-analysis of individual participant data from randomized controlled trials in low- and middle-income countries
Background Undernutrition during pregnancy increases the risk of giving birth to a small vulnerable newborn. Small-quantity lipid-based nutrient supplements (SQ-LNS) contain both macro- and micronutrients and can help prevent multiple nutritional deficiencies. Objectives We examined effects of SQ-L...
| Autores principales: | , , , , , , , , , , , , , , , , , |
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| Formato: | Journal Article |
| Lenguaje: | Inglés |
| Publicado: |
Elsevier
2024
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| Materias: | |
| Acceso en línea: | https://hdl.handle.net/10568/151828 |
| _version_ | 1855526672663576576 |
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| author | Dewey, Kathryn G. Wessells, K. Ryan Arnold, Charles D. Adu-Afarwuah, Seth Arnold, Benjamin F. Ashorn, Per Ashorn, Ulla Garcés, Ana Huybregts, Lieven Krebs, Nancy F. Lartey, Anna Leroy, Jef L. Maleta, Kenneth Matias, Susana L. Moore, Sophie E. Mridha, Malay K. Okronipa, Harriet Stewart, Christine P. |
| author_browse | Adu-Afarwuah, Seth Arnold, Benjamin F. Arnold, Charles D. Ashorn, Per Ashorn, Ulla Dewey, Kathryn G. Garcés, Ana Huybregts, Lieven Krebs, Nancy F. Lartey, Anna Leroy, Jef L. Maleta, Kenneth Matias, Susana L. Moore, Sophie E. Mridha, Malay K. Okronipa, Harriet Stewart, Christine P. Wessells, K. Ryan |
| author_facet | Dewey, Kathryn G. Wessells, K. Ryan Arnold, Charles D. Adu-Afarwuah, Seth Arnold, Benjamin F. Ashorn, Per Ashorn, Ulla Garcés, Ana Huybregts, Lieven Krebs, Nancy F. Lartey, Anna Leroy, Jef L. Maleta, Kenneth Matias, Susana L. Moore, Sophie E. Mridha, Malay K. Okronipa, Harriet Stewart, Christine P. |
| author_sort | Dewey, Kathryn G. |
| collection | Repository of Agricultural Research Outputs (CGSpace) |
| description | Background
Undernutrition during pregnancy increases the risk of giving birth to a small vulnerable newborn. Small-quantity lipid-based nutrient supplements (SQ-LNS) contain both macro- and micronutrients and can help prevent multiple nutritional deficiencies.
Objectives
We examined effects of SQ-LNS provided during pregnancy, compared to a) iron and folic acid or standard of care (IFA/SOC) or b) multiple micronutrient supplements (MMS), and identified characteristics that modified the estimates of effects of SQ-LNS on birth outcomes.
Methods
We conducted a 2-stage meta-analysis of individual participant data from 4 randomized controlled trials of SQ-LNS provided during pregnancy (n = 5,273). We generated study-specific and subgroup estimates of SQ-LNS compared with IFA/SOC or MMS and pooled the estimates. In sensitivity analyses, we examined whether results differed depending on methods for gestational age dating, birth anthropometry, or study design.
Results
SQ-LNS (vs IFA/SOC) increased birth weight (mean difference: +49g; 95% CI: 26, 71g) and all birth anthropometric z-scores (+0.10-0.13 SD); it reduced risk of low birthweight by 11%, newborn stunting by 17%, newborn wasting by 11%, and small head size by 15%. Only 2 trials compared SQ-LNS and MMS; p-values for birth outcomes were >0.10 except for head circumference (e.g., z-score for gestational age +0.11; 95% CI: -0.01, 0.23). Effect estimates for SQ-LNS vs IFA/SOC were greater among female infants and, for certain outcomes, among mothers with body mass index < 20 kg/m2, inflammation, malaria, or household food insecurity. Effect estimates for SQ-LNS vs MMS were greater for certain outcomes among female infants, first-born infants, and mothers < 25 y.
Conclusions
SQ-LNS had positive impacts on multiple outcomes compared to IFA/SOC, but further research directly comparing SQ-LNS and MMS is needed. Targeting SQ-LNS to vulnerable subgroups may be worth considering. Analysis registered at
www.crd.york.ac.uk/PROSPERO (CRD42021283391). |
| format | Journal Article |
| id | CGSpace151828 |
| institution | CGIAR Consortium |
| language | Inglés |
| publishDate | 2024 |
| publishDateRange | 2024 |
| publishDateSort | 2024 |
| publisher | Elsevier |
| publisherStr | Elsevier |
| record_format | dspace |
| spelling | CGSpace1518282025-12-08T09:54:28Z Effects of prenatal small-quantity lipid-based nutrient supplements on pregnancy, birth and infant outcomes: A systematic review and meta-analysis of individual participant data from randomized controlled trials in low- and middle-income countries Dewey, Kathryn G. Wessells, K. Ryan Arnold, Charles D. Adu-Afarwuah, Seth Arnold, Benjamin F. Ashorn, Per Ashorn, Ulla Garcés, Ana Huybregts, Lieven Krebs, Nancy F. Lartey, Anna Leroy, Jef L. Maleta, Kenneth Matias, Susana L. Moore, Sophie E. Mridha, Malay K. Okronipa, Harriet Stewart, Christine P. birth data nutrients perinatal period pregnancy supplements undernutrition Background Undernutrition during pregnancy increases the risk of giving birth to a small vulnerable newborn. Small-quantity lipid-based nutrient supplements (SQ-LNS) contain both macro- and micronutrients and can help prevent multiple nutritional deficiencies. Objectives We examined effects of SQ-LNS provided during pregnancy, compared to a) iron and folic acid or standard of care (IFA/SOC) or b) multiple micronutrient supplements (MMS), and identified characteristics that modified the estimates of effects of SQ-LNS on birth outcomes. Methods We conducted a 2-stage meta-analysis of individual participant data from 4 randomized controlled trials of SQ-LNS provided during pregnancy (n = 5,273). We generated study-specific and subgroup estimates of SQ-LNS compared with IFA/SOC or MMS and pooled the estimates. In sensitivity analyses, we examined whether results differed depending on methods for gestational age dating, birth anthropometry, or study design. Results SQ-LNS (vs IFA/SOC) increased birth weight (mean difference: +49g; 95% CI: 26, 71g) and all birth anthropometric z-scores (+0.10-0.13 SD); it reduced risk of low birthweight by 11%, newborn stunting by 17%, newborn wasting by 11%, and small head size by 15%. Only 2 trials compared SQ-LNS and MMS; p-values for birth outcomes were >0.10 except for head circumference (e.g., z-score for gestational age +0.11; 95% CI: -0.01, 0.23). Effect estimates for SQ-LNS vs IFA/SOC were greater among female infants and, for certain outcomes, among mothers with body mass index < 20 kg/m2, inflammation, malaria, or household food insecurity. Effect estimates for SQ-LNS vs MMS were greater for certain outcomes among female infants, first-born infants, and mothers < 25 y. Conclusions SQ-LNS had positive impacts on multiple outcomes compared to IFA/SOC, but further research directly comparing SQ-LNS and MMS is needed. Targeting SQ-LNS to vulnerable subgroups may be worth considering. Analysis registered at www.crd.york.ac.uk/PROSPERO (CRD42021283391). 2024-10 2024-08-23T15:16:12Z 2024-08-23T15:16:12Z Journal Article https://hdl.handle.net/10568/151828 en Open Access Elsevier Dewey, Kathryn G.; Wessells, K. Ryan; Arnold, Charles D.; Adu-Afarwuah, Seth; Adu-Afarwuah, Seth; Arnold, Benjamin F.; et al. 2024. Effects of prenatal small-quantity lipid-based nutrient supplements on pregnancy, birth and infant outcomes: A systematic review and meta-analysis of individual participant data from randomized controlled trials in low- and middle-income countries. American Journal of Clinical Nutrition 120(4): 814-835. https://doi.org/10.1016/j.ajcnut.2024.08.008 |
| spellingShingle | birth data nutrients perinatal period pregnancy supplements undernutrition Dewey, Kathryn G. Wessells, K. Ryan Arnold, Charles D. Adu-Afarwuah, Seth Arnold, Benjamin F. Ashorn, Per Ashorn, Ulla Garcés, Ana Huybregts, Lieven Krebs, Nancy F. Lartey, Anna Leroy, Jef L. Maleta, Kenneth Matias, Susana L. Moore, Sophie E. Mridha, Malay K. Okronipa, Harriet Stewart, Christine P. Effects of prenatal small-quantity lipid-based nutrient supplements on pregnancy, birth and infant outcomes: A systematic review and meta-analysis of individual participant data from randomized controlled trials in low- and middle-income countries |
| title | Effects of prenatal small-quantity lipid-based nutrient supplements on pregnancy, birth and infant outcomes: A systematic review and meta-analysis of individual participant data from randomized controlled trials in low- and middle-income countries |
| title_full | Effects of prenatal small-quantity lipid-based nutrient supplements on pregnancy, birth and infant outcomes: A systematic review and meta-analysis of individual participant data from randomized controlled trials in low- and middle-income countries |
| title_fullStr | Effects of prenatal small-quantity lipid-based nutrient supplements on pregnancy, birth and infant outcomes: A systematic review and meta-analysis of individual participant data from randomized controlled trials in low- and middle-income countries |
| title_full_unstemmed | Effects of prenatal small-quantity lipid-based nutrient supplements on pregnancy, birth and infant outcomes: A systematic review and meta-analysis of individual participant data from randomized controlled trials in low- and middle-income countries |
| title_short | Effects of prenatal small-quantity lipid-based nutrient supplements on pregnancy, birth and infant outcomes: A systematic review and meta-analysis of individual participant data from randomized controlled trials in low- and middle-income countries |
| title_sort | effects of prenatal small quantity lipid based nutrient supplements on pregnancy birth and infant outcomes a systematic review and meta analysis of individual participant data from randomized controlled trials in low and middle income countries |
| topic | birth data nutrients perinatal period pregnancy supplements undernutrition |
| url | https://hdl.handle.net/10568/151828 |
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