e-Library of Evidence for Nutrition Actions (eLENA)

Balanced energy and protein supplementation during pregnancy

The nutritional status of women prior to and during pregnancy plays a key role in fetal growth and development. Undernourished pregnant women may be at increased risk for adverse pregnancy outcomes, including giving birth to low-birth-weight infants.

Providing balanced protein energy supplementation (i.e. supplements in which protein provides less than 25% of the total energy content) to undernourished pregnant women has been shown to promote gestational weight gain and improve pregnancy outcomes.

Current evidence indicates that balanced energy and protein supplementation improves fetal growth, and may reduce the risk of stillbirth, low-birth-weight infants and infants born small-for-gestational age, especially among undernourished pregnant women. High-protein supplementation during pregnancy does not appear to be beneficial and may be harmful to the fetus. The evidence further suggests that antenatal nutritional advice with the aim of increasing maternal energy and protein intake may be effective in increasing maternal protein intake and reducing the risk of preterm birth.

WHO recommendations

In undernourished populations, balanced energy and protein dietary supplementation is recommended for pregnant women to reduce the risk of stillbirths and small for gestational age neonates.

WHO documents

WHO documents

GRC-approved guidelines


Systematic reviews used to develop the guidelines
Other related systematic reviews
Clinical trials

Last update:

15 June 2017 11:06 CEST

Category 1 intervention

Guidelines have been recently approved by the WHO Guidelines Review Committee

Global targets

Implementation of this intervention may contribute to the achievement of the following targets:

Global nutrition targets

Target 1: 40% reduction in the number of children under-5 who are stunted

Target 3: 30% reduction in low birth weight

Target 6: Reduce and maintain childhood wasting to less than 5%