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Meta-Analysis
. 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
Meta-Analysis

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.

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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

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