Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2021 Jan 30;13(2):472.
doi: 10.3390/nu13020472.

Effects of Maternal Nutritional Supplements and Dietary Interventions on Placental Complications: An Umbrella Review, Meta-Analysis and Evidence Map

Mai-Lei Woo Kinshella  1 , Shazmeen Omar  1 , Kerri Scherbinsky  1   2 , Marianne Vidler  1 , Laura A Magee  1   3 , Peter von Dadelszen  1   3 , Sophie E Moore  3   4 , Rajavel Elango  2   5   6 , The Precise Conceptual Framework Working Group
Affiliations
Review

Effects of Maternal Nutritional Supplements and Dietary Interventions on Placental Complications: An Umbrella Review, Meta-Analysis and Evidence Map

Mai-Lei Woo Kinshella et al. Nutrients. .

Abstract

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).

Keywords: low birthweight; maternal dietary interventions; maternal mortality; nutritional supplements; pre-eclampsia; small for gestational age; stillbirths; umbrella review.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Figure 1
Figure 1
PRISMA flow diagram.
Figure 2
Figure 2
Quality assessment of reviews with meta-analyses.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. FAO. IFAD. UNICEF. WFP. WHO . The State of Food Security and Nutrition in the World 2020: Transforming Food Systems for Affordable Healthy Diets. FAO; Rome, Italy: 2020.
    1. Mason J.B., Shrimpton R., Saldanha L.S., Ramakrishnan U., Victora C.G., Girard A.W., McFarland D.A., Martorell R. The first 500 days of life: Policies to support maternal nutrition. Glob. Health Action. 2015;8:23623. doi: 10.3402/gha.v7.23623. - DOI - PMC - PubMed
    1. King J.C. A Summary of Pathways or Mechanisms Linking Preconception Maternal Nutrition with Birth Outcomes. J. Nutr. 2016;146:1437S–1444S. doi: 10.3945/jn.115.223479. - DOI - PMC - PubMed
    1. Belkacemi L., Nelson D.M., Desai M., Ross M.G. Maternal Undernutrition Influences Placental-Fetal Development. Biol. Reprod. 2010;83:325–331. doi: 10.1095/biolreprod.110.084517. - DOI - PubMed
    1. Lumey L.H. Compensatory placental growth after restricted maternal nutrition in early pregnancy. Placenta. 1998;19:105–111. - PubMed

LinkOut - more resources