Effects of preconception care and periconception interventions on maternal nutritional status and birth outcomes in low- and middle-income countries: a systematic review
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Authors
Lassi, Zohra S.
Kedzior, Sophie G. E.
Tariq, Wajeeha
Jadoon, Yamna
Das, Jai K.
Bhutta, Zulfiqar A.
Issue Date
2020-02-26
Type
Article
Language
en_US
Keywords
Periconception , Folic Acid , Iron Folic Acid , Delaying Pregnancy , Inter Pregnancy Interval , Family Planning , Maternal Health , Neonatal Health
Alternative Title
Abstract
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.
Description
Citation
Lassi, Z. S., Kedzior, S. G., Tariq, W., Jadoon, Y., Das, J. K., & Bhutta, Z. A. (2020). Effects of Preconception Care and Periconception Interventions on Maternal Nutritional Status and Birth Outcomes in Low- and Middle-Income Countries: A Systematic Review. Nutrients, 12(3), 606. https://doi.org/10.3390/nu12030606
Publisher
Nutrients