The effect of prenatal balanced energy and protein supplementation on gestational weight gain: An individual participant data meta-analysis in low- and middle-income countries.
<h4>Background</h4>Understanding the effects of balanced energy and protein (BEP) supplements on gestational weight gain (GWG) and how the effects differ depending on maternal characteristics and the nutritional composition of the supplements will inform the implementation of prenatal BE...
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Public Library of Science (PLoS)
2025-02-01
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| Series: | PLoS Medicine |
| Online Access: | https://doi.org/10.1371/journal.pmed.1004523 |
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| author | Dongqing Wang Uttara Partap Enju Liu Janaína Calu Costa Ilana R Cliffer Molin Wang Sudeer Kumar Nookala Vishak Subramoney Brittany Briggs Imran Ahmed Alemayehu Argaw Shabina Ariff Nita Bhandari Ranadip Chowdhury Daniel Erchick Armando García-Guerra Masoumah Ghaffarpour Giles Hanley-Cook Lieven Huybregts Fyezah Jehan Fatemeh Kaseb Nancy F Krebs Carl Lachat Tsering Pema Lama Dharma S Manandhar Elizabeth M McClure Sophie E Moore Ameer Muhammad Lynnette M Neufeld Andrew M Prentice Amado D Quezada-Sánchez Dominique Roberfroid Naomi M Saville Yasir Shafiq Bhim P Shrestha Bakary Sonko Sajid Soofi Sunita Taneja James M Tielsch Laéticia Céline Toe Naser Valaei Wafaie W Fawzi |
| author_facet | Dongqing Wang Uttara Partap Enju Liu Janaína Calu Costa Ilana R Cliffer Molin Wang Sudeer Kumar Nookala Vishak Subramoney Brittany Briggs Imran Ahmed Alemayehu Argaw Shabina Ariff Nita Bhandari Ranadip Chowdhury Daniel Erchick Armando García-Guerra Masoumah Ghaffarpour Giles Hanley-Cook Lieven Huybregts Fyezah Jehan Fatemeh Kaseb Nancy F Krebs Carl Lachat Tsering Pema Lama Dharma S Manandhar Elizabeth M McClure Sophie E Moore Ameer Muhammad Lynnette M Neufeld Andrew M Prentice Amado D Quezada-Sánchez Dominique Roberfroid Naomi M Saville Yasir Shafiq Bhim P Shrestha Bakary Sonko Sajid Soofi Sunita Taneja James M Tielsch Laéticia Céline Toe Naser Valaei Wafaie W Fawzi |
| author_sort | Dongqing Wang |
| collection | DOAJ |
| description | <h4>Background</h4>Understanding the effects of balanced energy and protein (BEP) supplements on gestational weight gain (GWG) and how the effects differ depending on maternal characteristics and the nutritional composition of the supplements will inform the implementation of prenatal BEP interventions.<h4>Methods and findings</h4>Individual participant data from 11 randomized controlled trials of prenatal BEP supplements (N = 12,549, with 5,693 in the BEP arm and 6,856 in the comparison arm) in low- and middle-income countries were used. The primary outcomes included GWG adequacy (%) and the estimated total GWG at delivery as continuous outcomes, and severely inadequate (<70% adequacy), inadequate GWG (<90% adequacy), and excessive GWG (>125% adequacy) as binary outcomes; all variables were calculated based on the Institute of Medicine recommendations. Linear and log-binomial models were used to estimate study-specific mean differences or risk ratios (RRs), respectively, with 95% confidence intervals (CIs) of the effects of prenatal BEP on the GWG outcomes. The study-specific estimates were pooled using meta-analyses. Subgroup analyses were conducted by individual characteristics. Subgroup analyses and meta-regression were conducted for study-level characteristics. Compared to the comparison group, prenatal BEP led to a 6% greater GWG percent adequacy (95% CI: 2.18, 9.56; p = 0.002), a 0.59 kg greater estimated total GWG at delivery (95% CI, 0.12, 1.05; p = 0.014), a 10% lower risk of severely inadequate GWG (RR: 0.90; 95% CI: 0.83, 0.99; p = 0.025), and a 7% lower risk of inadequate GWG (RR: 0.93; 95% CI: 0.89, 0.97; p = 0.001). The effects of prenatal BEP on GWG outcomes were stronger in studies with a targeted approach, where BEP supplements were provided to participants in the intervention arm under specific criteria such as low body mass index or low GWG, compared to studies with an untargeted approach, where BEP supplements were provided to all participants allocated to the intervention arm.<h4>Conclusions</h4>Prenatal BEP supplements are effective in increasing GWG and reducing the risk of inadequate weight gain during pregnancy. BEP supplementation targeted toward pregnant women with undernutrition may be a promising approach to delivering the supplements. |
| format | Article |
| id | doaj-art-b3c59014dca2489aa53ebb07bae4edfa |
| institution | Kabale University |
| issn | 1549-1277 1549-1676 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS Medicine |
| spelling | doaj-art-b3c59014dca2489aa53ebb07bae4edfa2025-02-09T05:30:23ZengPublic Library of Science (PLoS)PLoS Medicine1549-12771549-16762025-02-01222e100452310.1371/journal.pmed.1004523The effect of prenatal balanced energy and protein supplementation on gestational weight gain: An individual participant data meta-analysis in low- and middle-income countries.Dongqing WangUttara PartapEnju LiuJanaína Calu CostaIlana R ClifferMolin WangSudeer Kumar NookalaVishak SubramoneyBrittany BriggsImran AhmedAlemayehu ArgawShabina AriffNita BhandariRanadip ChowdhuryDaniel ErchickArmando García-GuerraMasoumah GhaffarpourGiles Hanley-CookLieven HuybregtsFyezah JehanFatemeh KasebNancy F KrebsCarl LachatTsering Pema LamaDharma S ManandharElizabeth M McClureSophie E MooreAmeer MuhammadLynnette M NeufeldAndrew M PrenticeAmado D Quezada-SánchezDominique RoberfroidNaomi M SavilleYasir ShafiqBhim P ShresthaBakary SonkoSajid SoofiSunita TanejaJames M TielschLaéticia Céline ToeNaser ValaeiWafaie W Fawzi<h4>Background</h4>Understanding the effects of balanced energy and protein (BEP) supplements on gestational weight gain (GWG) and how the effects differ depending on maternal characteristics and the nutritional composition of the supplements will inform the implementation of prenatal BEP interventions.<h4>Methods and findings</h4>Individual participant data from 11 randomized controlled trials of prenatal BEP supplements (N = 12,549, with 5,693 in the BEP arm and 6,856 in the comparison arm) in low- and middle-income countries were used. The primary outcomes included GWG adequacy (%) and the estimated total GWG at delivery as continuous outcomes, and severely inadequate (<70% adequacy), inadequate GWG (<90% adequacy), and excessive GWG (>125% adequacy) as binary outcomes; all variables were calculated based on the Institute of Medicine recommendations. Linear and log-binomial models were used to estimate study-specific mean differences or risk ratios (RRs), respectively, with 95% confidence intervals (CIs) of the effects of prenatal BEP on the GWG outcomes. The study-specific estimates were pooled using meta-analyses. Subgroup analyses were conducted by individual characteristics. Subgroup analyses and meta-regression were conducted for study-level characteristics. Compared to the comparison group, prenatal BEP led to a 6% greater GWG percent adequacy (95% CI: 2.18, 9.56; p = 0.002), a 0.59 kg greater estimated total GWG at delivery (95% CI, 0.12, 1.05; p = 0.014), a 10% lower risk of severely inadequate GWG (RR: 0.90; 95% CI: 0.83, 0.99; p = 0.025), and a 7% lower risk of inadequate GWG (RR: 0.93; 95% CI: 0.89, 0.97; p = 0.001). The effects of prenatal BEP on GWG outcomes were stronger in studies with a targeted approach, where BEP supplements were provided to participants in the intervention arm under specific criteria such as low body mass index or low GWG, compared to studies with an untargeted approach, where BEP supplements were provided to all participants allocated to the intervention arm.<h4>Conclusions</h4>Prenatal BEP supplements are effective in increasing GWG and reducing the risk of inadequate weight gain during pregnancy. BEP supplementation targeted toward pregnant women with undernutrition may be a promising approach to delivering the supplements.https://doi.org/10.1371/journal.pmed.1004523 |
| spellingShingle | Dongqing Wang Uttara Partap Enju Liu Janaína Calu Costa Ilana R Cliffer Molin Wang Sudeer Kumar Nookala Vishak Subramoney Brittany Briggs Imran Ahmed Alemayehu Argaw Shabina Ariff Nita Bhandari Ranadip Chowdhury Daniel Erchick Armando García-Guerra Masoumah Ghaffarpour Giles Hanley-Cook Lieven Huybregts Fyezah Jehan Fatemeh Kaseb Nancy F Krebs Carl Lachat Tsering Pema Lama Dharma S Manandhar Elizabeth M McClure Sophie E Moore Ameer Muhammad Lynnette M Neufeld Andrew M Prentice Amado D Quezada-Sánchez Dominique Roberfroid Naomi M Saville Yasir Shafiq Bhim P Shrestha Bakary Sonko Sajid Soofi Sunita Taneja James M Tielsch Laéticia Céline Toe Naser Valaei Wafaie W Fawzi The effect of prenatal balanced energy and protein supplementation on gestational weight gain: An individual participant data meta-analysis in low- and middle-income countries. PLoS Medicine |
| title | The effect of prenatal balanced energy and protein supplementation on gestational weight gain: An individual participant data meta-analysis in low- and middle-income countries. |
| title_full | The effect of prenatal balanced energy and protein supplementation on gestational weight gain: An individual participant data meta-analysis in low- and middle-income countries. |
| title_fullStr | The effect of prenatal balanced energy and protein supplementation on gestational weight gain: An individual participant data meta-analysis in low- and middle-income countries. |
| title_full_unstemmed | The effect of prenatal balanced energy and protein supplementation on gestational weight gain: An individual participant data meta-analysis in low- and middle-income countries. |
| title_short | The effect of prenatal balanced energy and protein supplementation on gestational weight gain: An individual participant data meta-analysis in low- and middle-income countries. |
| title_sort | effect of prenatal balanced energy and protein supplementation on gestational weight gain an individual participant data meta analysis in low and middle income countries |
| url | https://doi.org/10.1371/journal.pmed.1004523 |
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