Effects of Preconception Care and Periconception Interventions on Maternal Nutritional Status and Birth Outcomes in Low- and Middle-Income Countries: A Systematic Review

Nutrients

Jai K Das¹  Wajeeha Tariq¹  Yamna Jadoon¹  Zulfiqar A Bhutta¹  Sophie GE Kedzior²  Zohra S Lassi² 

[1] Department of Pediatrics, the Aga Khan University, Karachi 74800, Pakistan;Robinson Research Institute, Faculty of Health and Medical Sciences, the University of Adelaide, Adelaide 5005, Australia;

关键词: periconception;    folic acid;    iron folic acid;    delaying pregnancy;    inter pregnancy interval;    family planning;    maternal health;    neonatal health;   

DOI  :  10.3390/nu12030606

来源: DOAJ

【 摘 要 】

Pregnancy in adolescence and malnutrition are common challenges in low- and middle-income countries (LMICs), and are associated with many complications and comorbidities. The preconception period is an ideal period for intervention as a preventative tactic for teenage pregnancy, and to increase micronutrient supplementation prior to conception. Over twenty databases and websites were searched and 45 randomized controlled trials (RCTs) or quasi-experimental interventions with intent to delay the age at first pregnancy (n = 26), to optimize inter-pregnancy intervals (n = 4), and supplementation of folic acid (n = 5) or a combination of iron and folic acid (n = 10) during the periconception period were included. The review found that educational interventions to delay the age at first pregnancy and optimizing inter-pregnancy intervals significantly improved the uptake of contraception use (RR = 1.71, 95% CI = 1.42−2.05; two studies, n = 911; I² = 0%) and (RR = 2.25, 95% CI = 1.29−3.93; one study, n = 338), respectively. For periconceptional folic acid supplementation, the incidence of neural tube defects were reduced (RR = 0.53; 95% CI = 0.41−0.77; two studies, n = 248,056; I² = 0%), and iron-folic acid supplementation improved the rates of anemia (RR = 0.66, 95% CI = 0.53−0.81; six studies; n = 3430, I² = 88%), particularly when supplemented weekly and in a school setting. Notwithstanding the findings, more robust RCTs are required from LMICs to further support the evidence.

【 授权许可】

Unknown