Effects of preconception care and periconception interventions on maternal nutritional status and birth outcomes in low-and middle-income countries: A systematic review

Zohra S. Lassi, Sophie G.E. Kedzior, Wajeeha Tariq, Yamna Jadoon, Jai K. Das, Zulfiqar A. Bhutta

Research output: Contribution to journalReview articlepeer-review

32 Citations (Scopus)

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.

Original languageEnglish
Article number606
JournalNutrients
Volume12
Issue number3
DOIs
Publication statusPublished - Mar 2020

Keywords

  • Delaying pregnancy
  • Family planning
  • Folic acid
  • Inter pregnancy interval
  • Iron folic acid
  • Maternal health
  • Neonatal health
  • Periconception

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