Effects of maternal nutritional supplements and dietary interventions on placental complications: An umbrella review, meta-analysis and evidence map

Mai Lei Woo Kinshella; Shazmeen Omar; Kerri Scherbinsky; Marianne Vidler; Laura A. Magee; Peter von Dadelszen; Sophie E. Moore; Rajavel Elango; The PRECISE Conceptual Framework Working Group

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, Shazmeen Omar, Kerri Scherbinsky, Marianne Vidler, Laura A. Magee, Peter von Dadelszen, Sophie E. Moore, Rajavel Elango^*, The PRECISE Conceptual Framework Working Group

^*Corresponding author for this work

Women & Children's Health

Research output: Contribution to journal › Article › peer-review

33 Citations (Scopus)

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 diffi-cult 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).

Original language	English
Article number	472
Pages (from-to)	1-31
Number of pages	31
Journal	Nutrients
Volume	13
Issue number	2
DOIs	https://doi.org/10.3390/nu13020472
Publication status	Published - Feb 2021

Keywords

Low birthweight
Maternal dietary interventions
Maternal mortality
Nutritional supplements
Pre-eclampsia
Small for gesta-tional age
Stillbirths
Umbrella review

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.3390/nu13020472

Cite this

Kinshella, M. L. W., Omar, S., Scherbinsky, K., Vidler, M., Magee, L. A., von Dadelszen, P., Moore, S. E., Elango, R., & The PRECISE Conceptual Framework Working Group (2021). Effects of maternal nutritional supplements and dietary interventions on placental complications: An umbrella review, meta-analysis and evidence map. Nutrients, 13(2), 1-31. Article 472. https://doi.org/10.3390/nu13020472

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title = "Effects of maternal nutritional supplements and dietary interventions on placental complications: An umbrella review, meta-analysis and evidence map",

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 diffi-cult 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 gesta-tional age, Stillbirths, Umbrella review",

author = "Kinshella, {Mai Lei Woo} and Shazmeen Omar and Kerri Scherbinsky and Marianne Vidler and Magee, {Laura A.} and {von Dadelszen}, Peter and Moore, {Sophie E.} and Rajavel Elango and {The PRECISE Conceptual Framework Working Group} and Hiten Mistry",

note = "Funding Information: Funding: The PRECISE Network is funded by the UK Research and Innovation Grand Challenges Research Fund GROW Award scheme (grant number: MR/P027938/1). MWK is supported by the Vanier Canada Graduate Scholarship funded by the Government of Canada through the Canadian Institutes of Health Research (CIHR); and Canadian Institute of Health Research (FRN 10321) to R.E. Publisher Copyright: {\textcopyright} 2021 by the authors. Licensee MDPI, Basel, Switzerland. Copyright: Copyright 2021 Elsevier B.V., All rights reserved.",

year = "2021",

month = feb,

doi = "10.3390/nu13020472",

language = "English",

volume = "13",

pages = "1--31",

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Kinshella, MLW, Omar, S, Scherbinsky, K, Vidler, M, Magee, LA , von Dadelszen, P , Moore, SE, Elango, R & The PRECISE Conceptual Framework Working Group 2021, 'Effects of maternal nutritional supplements and dietary interventions on placental complications: An umbrella review, meta-analysis and evidence map', Nutrients, vol. 13, no. 2, 472, pp. 1-31. https://doi.org/10.3390/nu13020472

TY - JOUR

T1 - Effects of maternal nutritional supplements and dietary interventions on placental complications

T2 - An umbrella review, meta-analysis and evidence map

AU - Kinshella, Mai Lei Woo

AU - Omar, Shazmeen

AU - Scherbinsky, Kerri

AU - Vidler, Marianne

AU - Magee, Laura A.

AU - von Dadelszen, Peter

AU - Moore, Sophie E.

AU - Elango, Rajavel

AU - The PRECISE Conceptual Framework Working Group

AU - Mistry, Hiten

N1 - Funding Information: Funding: The PRECISE Network is funded by the UK Research and Innovation Grand Challenges Research Fund GROW Award scheme (grant number: MR/P027938/1). MWK is supported by the Vanier Canada Graduate Scholarship funded by the Government of Canada through the Canadian Institutes of Health Research (CIHR); and Canadian Institute of Health Research (FRN 10321) to R.E. Publisher Copyright: © 2021 by the authors. Licensee MDPI, Basel, Switzerland. Copyright: Copyright 2021 Elsevier B.V., All rights reserved.

PY - 2021/2

Y1 - 2021/2

N2 - 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 diffi-cult 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).

AB - 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 diffi-cult 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).

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KW - Maternal dietary interventions

KW - Maternal mortality

KW - Nutritional supplements

KW - Pre-eclampsia

KW - Small for gesta-tional age

KW - Stillbirths

KW - Umbrella review

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DO - 10.3390/nu13020472

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SN - 2072-6643

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JO - Nutrients

JF - Nutrients

IS - 2

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ER -

Effects of maternal nutritional supplements and dietary interventions on placental complications: An umbrella review, meta-analysis and evidence map

Abstract

Keywords

UN SDGs

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