Balancedproteinenergysupplementationinpregnancy.docVIP

Balanced protein/energy supplementation Balanced protein/energy supplementation in pregnancy Kramer MS Date of most recent substantive amendment : 26 February 1997 Objectives: To assess the effects of providing pregnant women with a balanced protein/energy supplement (ie, a supplement in which the protein accounts for 25% of the total energy content) on gestational weight gain, the outcome of pregnancy, and postnatal infant outcomes. Search strategy: The register of clinical trials maintained and updated by the Cochrane Pregnancy and Childbirth Group. Selection criteria: All acceptably controlled comparisons of energy/protein supplementation, as long as the protein content of the supplement provided 25 % of its total energy content. Data collection and analysis: Data were extracted by the author from published reports, and supplemented by additional information from trialists contacted by the author. Main results: Balanced protein/energy supplementation results in modest increases in maternal weight gain and fetal growth. These increases do not appear larger in undernourished women, nor do they seem to confer long-term benefits to the child in terms of growth or neurocognitive development. The available evidence is inadequate to reach conclusions concerning effects on preterm birth, fetal and infant survival, or maternal health. Conclusions: Balanced energy/protein supplementation modestly improves fetal growth but is unlikely to be of long-term benefit to pregnant women or their infants. Background Observational studies have reported that gestational weight gain is strongly and positively associated with fetal growth, and possibly associated with a reduced risk of preterm birth. Nonrandomized trials of energy/protein supplementation have reported similar associations. Moreover, evidence from the quasi-experimental Dutch Famine Study strongly suggests that energy/protein restriction is associated