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
GRC-approved guidelines
-
WHO recommendations on antenatal care for a positive pregnancy experience
Publication date: 2016
Evidence
Systematic reviews used to develop the guidelines
-
Antenatal dietary education and supplementation to increase energy and protein intake
Ota E, Hori H, Mori R, Tobe-Gai R, Farrar D.
Cochrane Database of Systematic Reviews. 2015; Issue 6. Art. No.: CD000032. - Summary of this review
Other related systematic reviews
-
The effect of balanced protein energy supplementation in undernourished pregnant women and child physical growth in low- and middle-income countries: a systematic review and meta-analysis
Stevens B, Buettner P, Watt K, Clough A, Brimblecombe J, Judd J.
Maternal & Child Nutrition. 2015; 11(4):415-32. -
Effects of protein energy supplementation during pregnancy on fetal growth: a review of the literature focusing on contextual factors
Liberato SC, Singh G, Mulholland K.
Food & Nutrition Research. 2013; 57. -
Maternal nutrition and birth outcomes: effect of balanced protein-energy supplementation
Imdad A, Bhutta ZA.
Paediatric and Perinatal Epidemiology. 2012; 26 (Suppl.1):178-90. -
Effect of balanced protein energy supplementation during pregnancy on birth outcomes
Imdad A, Bhutta ZA.
BMC Public Health. 2011; 11(Suppl.3):S17.