RCTs offer little conclusive evidence for interventions changing environmental risk factors during pregnancy to potentially improve birth outcomes. A 'magic bullet' approach to problem-solving may not be effective and it is essential to thoroughly examine the effects of more comprehensive interventions, especially in low- and middle-income countries. The achievement of global targets for reducing low birth weight and sustainably improving long-term population health is likely to be facilitated by global, interdisciplinary action to mitigate harmful environmental exposures.
The limited evidence from randomized controlled trials suggests that interventions to modify environmental factors during pregnancy may not significantly improve birth outcomes. A magic bullet approach may not be successful, therefore underscoring the need for a comprehensive examination of broader intervention strategies, especially in low- and middle-income countries. A global, interdisciplinary approach to lessening harmful environmental exposures is expected to be instrumental in achieving global targets for low birth weight reduction, fostering sustainable improvements in long-term population health.
Socioeconomic circumstances, psychosocial well-being, and harmful behaviors during pregnancy can increase the probability of negative birth outcomes, including low birth weight (LBW).
A comparative evidence synthesis, resulting from a systematic search and review, assesses the influence of eleven antenatal interventions addressing psychosocial risk factors on the occurrence of adverse birth outcomes.
Our database search of MEDLINE, Embase, the Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, and CINAHL Complete spanned the period from March 2020 through May 2020. bio-based plasticizer We analyzed randomized controlled trials (RCTs) and reviews of such trials involving eleven antenatal interventions for pregnant females. These interventions were assessed in relation to outcomes like low birth weight (LBW), preterm birth (PTB), small-for-gestational-age (SGA) status, and stillbirth. Where randomization was not a viable or ethical approach for interventions, non-randomized controlled studies were accepted.
Data from seven records informed quantitative estimations of effect sizes, while twenty-three records provided insights for narrative analysis. Prenatal psychosocial programs designed to curb smoking practices in pregnant women could have possibly decreased the risk of low birth weight, and professionally facilitated psychosocial support for at-risk pregnant women may have reduced the likelihood of premature births. Smoking cessation aids, such as financial incentives, nicotine replacement therapy, or virtually delivered psychosocial support, did not seem to decrease the likelihood of adverse birth outcomes. Data on the efficacy of these interventions was predominantly collected from high-income nations. For interventions like psychosocial support to curb alcohol use, group-based support programs, strategies to prevent intimate partner violence, antidepressant medication, and cash transfers, the collected data offered little clarity on their effectiveness, and the data was often in disagreement.
The provision of professional psychosocial support during pregnancy, specifically targeting smoking cessation, can contribute to the overall well-being of the newborn. Improving global low birth weight reduction rates necessitates increased funding for research and implementation of psychosocial interventions.
The provision of psychosocial support during pregnancy, particularly in relation to smoking reduction, can positively impact the health of newborns. The insufficiency of investment in research and implementation of psychosocial interventions needs to be tackled to meet the global targets for reducing low birth weight.
Unhealthy eating habits during pregnancy can cause negative birth outcomes, including a reduced birth weight (LBW).
Using a modular methodology, this systematic review explored the evidence supporting the effects of seven antenatal nutritional interventions in reducing the risk of low birth weight, preterm birth, small-for-gestational-age babies, and stillbirth.
In the period of April through June 2020, searches were executed within MEDLINE, Embase, the Cochrane Database of Systematic Reviews, the Cochrane Central Register of Controlled Trials, and CINAHL Complete. Embase underwent a further update in September of 2022. Our assessment of the effect sizes of selected interventions on the four birth outcomes relied on the inclusion of randomized controlled trials (RCTs) and reviews of RCTs.
The provision of balanced protein and energy (BPE) supplementation to pregnant women who are undernourished is linked to a potential reduction in the risk of low birth weight, small gestational age, and stillbirth, based on evidence. Findings from low and lower middle-income nations suggest that multiple micronutrient supplementation may decrease the occurrence of low birth weight and small gestational age, as compared to iron, iron-folic acid, and lipid-based nutrient supplements. Lipid-based nutrient supplements can decrease the risk of low birth weight, irrespective of energy content, when compared to the use of multiple micronutrient supplements. High and upper MIC evidence suggests that supplementing with omega-3 fatty acids (O3FA) may reduce the risk of low birth weight (LBW) and preterm birth (PTB), while high-dose calcium supplementation may also potentially decrease the risk of LBW and PTB. Enhancing prenatal dietary knowledge could potentially diminish the risk of low birth weight compared with standard obstetric care. buy EPZ004777 No randomized controlled trials (RCTs) were discovered for monitoring weight gain, followed by interventions designed to support weight gain in underweight women.
Expectant mothers in undernourished communities can benefit from BPE, MMN, and LNS provision to lessen their risk of low birth weight and its accompanying conditions. Further research into the benefits of O3FA and calcium supplementation for this particular group is essential. No randomized controlled trials have been conducted to assess the impact of programs designed to encourage weight gain in pregnant women who are not meeting weight goals.
In populations affected by undernutrition, the provision of BPE, MMN, and LNS to pregnant women might decrease the occurrence of low birth weight and associated outcomes. A more thorough investigation is warranted to assess the impact of O3FA and calcium supplementation on this group. A systematic assessment of the impact of interventions for pregnant women who are underweight, using randomized controlled trials, has not yet been undertaken.
There is evidence suggesting a relationship between maternal infections during pregnancy and an elevated risk for adverse birth outcomes, encompassing low birth weight, premature birth, small for gestational age newborns, and stillbirths.
The article's objective was to collate and summarize evidence from published studies exploring the effect of interventions aimed at maternal infections on adverse birth outcomes.
MEDLINE, Embase, the Cochrane Database of Systematic Reviews, the Cochrane Central Register of Controlled Trials, and CINAHL Complete were searched between March 2020 and May 2020, subsequently updated to encompass data up to August 2022. We scrutinized randomized controlled trials (RCTs) and reviews of RCTs, examining 15 antenatal interventions for pregnant women, reporting outcomes including low birth weight (LBW), preterm birth (PTB), small for gestational age (SGA), and stillbirth (SB).
Among the 15 interventions examined, administering three or more doses of intermittent preventive treatment during pregnancy, utilizing sulphadoxine-pyrimethamine (IPTp-SP), demonstrated a reduction in low birth weight risk, with a risk ratio of 0.80 (95% confidence interval 0.69 to 0.94), when compared to the administration of only two doses. Screening and treatment of asymptomatic bacteriuria, alongside periodontal treatment and the provision of insecticide-treated bed nets, could potentially decrease the chances of low birth weight (LBW). Influenza vaccines for expectant mothers, the treatment protocol for bacterial vaginosis, a comparative assessment of intermittent preventive treatment with dihydroartemisinin-piperaquine against IPTp-SP, and periodic malaria screening and treatment during pregnancy versus IPTp were deemed unlikely to lessen the rate of adverse birth outcomes.
Existing randomized controlled trial data is limited for potentially important interventions relating to maternal infections, thus these interventions require further research prioritization.
Currently, a scarcity of randomized controlled trial data exists for certain potentially significant maternal infection interventions, which warrant prioritisation in future research endeavors.
The link between low birth weight (LBW) and neonatal mortality, and the sequelae of lifelong health problems, can be mitigated; this is accomplished by prioritizing effective antenatal interventions, resulting in optimal resource allocation and improved health outcomes.
We endeavored to pinpoint the most auspicious interventions, presently absent from the World Health Organization (WHO)'s policy recommendations, that could supplement antenatal care and diminish the incidence of low birth weight (LBW) and its associated adverse birth outcomes in low- and middle-income nations.
An adapted Child Health and Nutrition Research Initiative (CHNRI) prioritization method was implemented by us.
In addition to the WHO's existing procedures for preventing low birth weight (LBW), we found six promising antenatal interventions not currently endorsed by WHO: (1) multiple micronutrient supplementation; (2) low-dose aspirin; (3) high-dose calcium supplementation; (4) prophylactic cerclage; (5) psychosocial support for smoking cessation; and (6) psychosocial support tailored for particular demographics and locations. Health care-associated infection We have identified seven interventions requiring further implementation research and six interventions necessitating efficacy research.