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Associations of maternal nutritional status and supplementation with fetal, newborn, and infant outcomes in low-income and middle-income settings: an overview of reviews

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González-Fernández, Doris, Muralidharan, Oviya, Neves, Paulo, Bhutta, Zulfiqar·2024·Nutrients
DOI 10.3390/nu16213725PMC PMC11547697
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Abstract

Background/Objectives: Despite advances in maternal nutritional knowledge, the effect of maternal diet, micronutrient status and undernutrition, and the effect of maternal supplementation on fetal, neonatal and infant outcomes still have gaps in the literature. This overview of reviews is intended to assess the available information on these issues and identify the main maternal nutritional factors associated with offspring outcomes in low- and middle-income countries as possible targets for public health interventions. Methods: The literature search was performed in Medline (PubMed) and Cochrane Library datasets in June 2024. Pre-specified outcomes in offspring were pooled using standard meta-analytical methods. Results: We found consistent evidence on the impact of maternal undernutrition indicated by low body mass index (BMI), mid-upper arm circumference (MUAC), and stature, but not of individual micronutrient status, on intrauterine-growth retardation, preterm birth, low birth weight, and small for gestational age, with research showing a possible effect of maternal undernutrition in later child nutritional status. Studies on micronutrient supplementation showed possible beneficial effects of iron, vitamin D, and multiple micronutrients on birthweight and/or decreasing small for gestational age, as well as a possible effect of calcium on preterm birth reduction. Interventions showing more consistent beneficial outcomes were balanced protein-energy and lipid base supplements, which demonstrated improved weight in newborns from supplemented mothers and a decreased risk of adverse neonatal outcomes. Conclusions: Further research is needed to identify the benefits and risks of maternal individual micronutrient supplementation on neonatal and further child outcomes.

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  • Adequate maternal nutrition and supplementation are essential for achieving improved fetal and neonatal outcomes in low- and middle-income countries, which are closely related to long-term metabolic outcomes.

    “Moreover, evidence from low- and middle-income countries emphasizes that adequate maternal nutrition and supplementation are essential for achieving improved fetal and neonatal outcomes, which are closely related to long-term metabolic outcomes (10).”

    From Maternal nutritional status and the risk of metabolic syndrome in pregnancy: implications for public health nutrition (2026) · cites this paper as [10]

    The Conclusions report that maternal nutritional interventions can improve fetal and neonatal outcomes, and the Introduction links low birth weight to later metabolic development. But the claim’s categorical statement that nutrition and supplementation are essential is stronger than the paper’s qualified findings; it does not establish that the interventions improve long-term metabolic outcomes. (LLM, conf=0.82)

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Cited by

Sorted by citations

Authors
González-Fernández, D., Muralidharan, O., Neves, P., & Bhutta, Z.
Affiliations
  • Centre for Global Child Health, Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
  • Hospital for Sick Children (CA)
Corresponding author
Bhutta, Zulfiqar
ORCID
Venue
Nutrients
Publisher
MDPI AG
Published
2024-10-31
Volume
16
Issue
21
Pages
3725
ISSN
2072-6643 (ISSN-L)
DOI
10.3390/nu16213725
PMC
PMC11547697
OpenAlex
W4403942929
Cited by
29
References
3
Citations by year
2026: 15 · 2025: 13 · 2024: 1
FWCI
1.70
Type
journal article
Language
en
Open access
Licence
Locations
  • Nutrients (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
Funders
Bill and Melina Gates Foundation (INV-058017)
Topics
  • Health Sciences › Nursing › Nutrition and Dietetics › Child Nutrition and Water Access
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Birth, Development, and Health
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Public Health and Nutrition
Keywords
maternal nutritional status, maternal undernutrition, micronutrient supplementation, fetal outcomes, neonatal outcomes, infant outcomes, low birth weight, small for gestational age, preterm birth, fetal growth restriction, iron supplementation, vitamin D supplementation, calcium supplementation, lipid-based nutrient supplements, maternal body mass index, mid-upper arm circumference, low- and middle-income countries
MeSH terms
Developing Countries, Female, Humans, Infant, Infant, Newborn, Nutritional Status, Poverty, Pregnancy, Micronutrients, Dietary Supplements, Maternal Nutritional Physiological Phenomena, Malnutrition, Premature Birth

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