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

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cg.authorship.typesCGIAR and advanced research instituteen_US
cg.authorship.typesNot CGIAR developing country instituteen_US
cg.contributor.affiliationGeorge Mason Universityen_US
cg.contributor.affiliationHarvard Universityen_US
cg.contributor.affiliationBoston Children’s Hospitalen_US
cg.contributor.affiliationCytel Inc., Indiaen_US
cg.contributor.affiliationDVPL Techen_US
cg.contributor.affiliationCertara USAen_US
cg.contributor.affiliationAga Khan Universityen_US
cg.contributor.affiliationGhent Universityen_US
cg.contributor.affiliationSociety for Applied Studiesen_US
cg.contributor.affiliationJohns Hopkins Universityen_US
cg.contributor.affiliationCentro de Investigación en Nutrición y Saluden_US
cg.contributor.affiliationShahid Beheshti University of Medical Sciencesen_US
cg.contributor.affiliationInternational Food Policy Research Instituteen_US
cg.contributor.affiliationShahid Sadoughi University of Medical Sciencesen_US
cg.contributor.affiliationUniversity of Colorado School of Medicineen_US
cg.contributor.affiliationNepal Nutrition Intervention Projecten_US
cg.contributor.affiliationMother and Infant Research Activitiesen_US
cg.contributor.affiliationRTI Internationalen_US
cg.contributor.affiliationKing’s College Londonen_US
cg.contributor.affiliationVITAL Pakistan Trusten_US
cg.contributor.affiliationFood and Agriculture Organization of the United Nationsen_US
cg.contributor.affiliationLondon School of Hygiene and Tropical Medicine,en_US
cg.contributor.affiliationInstituto Nacional de Salud Públicaen_US
cg.contributor.affiliationNamur Universityen_US
cg.contributor.affiliationInstitute for Global Healthen_US
cg.contributor.donorBill & Melinda Gates Foundationen_US
cg.contributor.initiativeSustainable Healthy Dietsen_US
cg.creator.identifierLieven Huybregts: 0000-0002-3068-2853en_US
cg.howPublishedFormally Publisheden_US
cg.identifier.doihttps://doi.org/10.1371/journal.pmed.1004523en_US
cg.identifier.projectIFPRI - Nutrition, Diets, and Health Uniten_US
cg.identifier.publicationRankA Plusen_US
cg.isijournalISI Journalen_US
cg.issn1549-1277en_US
cg.issue2en_US
cg.journalPLOS Medicineen_US
cg.reviewStatusPeer Reviewen_US
cg.subject.actionAreaSystems Transformationen_US
cg.subject.impactAreaNutrition, health and food securityen_US
cg.volume22en_US
dc.contributor.authorWang, Dongqingen_US
dc.contributor.authorPartap, Uttaraen_US
dc.contributor.authorLiu, Enjuen_US
dc.contributor.authorCosta, Janaína Caluen_US
dc.contributor.authorCliffer, Ilana R.en_US
dc.contributor.authorWang, Molinen_US
dc.contributor.authorNookala, Sudeer Kumaren_US
dc.contributor.authorSubramoney, Vishaken_US
dc.contributor.authorBriggs, Brittanyen_US
dc.contributor.authorAhmed, Imranen_US
dc.contributor.authorArgaw, Alemayehuen_US
dc.contributor.authorAriff, Shabinaen_US
dc.contributor.authorBhandari, Nitaen_US
dc.contributor.authorChowdhury, Ranadipen_US
dc.contributor.authorErchick, Danielen_US
dc.contributor.authorGarcía-Guerra, Armandoen_US
dc.contributor.authorGhaffarpour, Masoumahen_US
dc.contributor.authorHanley-Cook, Gilesen_US
dc.contributor.authorHuybregts, Lievenen_US
dc.contributor.authorJehan, Fyezahen_US
dc.contributor.authorKaseb, Fatemehen_US
dc.contributor.authorKrebs, Nancy F.en_US
dc.contributor.authorLachat, Carlen_US
dc.contributor.authorLama, Tsering Pemaen_US
dc.contributor.authorManandhar, Dharma S.en_US
dc.contributor.authorMcClure, Elizabeth M.en_US
dc.contributor.authorMoore, Sophie E.en_US
dc.contributor.authorMuhammad, Ameeren_US
dc.contributor.authorNeufeld, Lynnette M.en_US
dc.contributor.authorPrentice, Andrew M.en_US
dc.contributor.authorQuezada-Sánchez, Amado D.en_US
dc.contributor.authorRoberfroid, Dominiqueen_US
dc.contributor.authorSaville, Naomi M.en_US
dc.contributor.authorShafiq, Yasiren_US
dc.contributor.authorShrestha, Bhim P.en_US
dc.contributor.authorSonko, Bakaryen_US
dc.contributor.authorSoofi, Sajiden_US
dc.contributor.authorTaneja, Sunitaen_US
dc.contributor.authorTielsch, James M.en_US
dc.contributor.authorToe, Laéticia Célineen_US
dc.contributor.authorValaei, Naseren_US
dc.contributor.authorFawzi, Wafaie W.en_US
dc.date.accessioned2025-02-06T15:17:43Zen_US
dc.date.available2025-02-06T15:17:43Zen_US
dc.identifier.urihttps://hdl.handle.net/10568/172867en_US
dc.titleThe effect of prenatal balanced energy and protein supplementation on gestational weight gain: An individual participant data meta-analysis in low- and middle-income countriesen_US
dcterms.abstractBackground 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. Methods and findings 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. Conclusions 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.en_US
dcterms.accessRightsOpen Accessen_US
dcterms.audienceScientistsen_US
dcterms.available2025-02-03en_US
dcterms.bibliographicCitationWang, Dongqing; Partap, Uttara; Liu, Enju; Costa, Janaína Calu; Cliffer, Ilana R.; Wang, Molin; et al. 2025. 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 22(2): e1004523. https://doi.org/10.1371/journal.pmed.1004523en_US
dcterms.extente1004523en_US
dcterms.issued2025en_US
dcterms.languageenen_US
dcterms.licenseCC-BY-4.0en_US
dcterms.publisherPLOSen_US
dcterms.subjectbody mass indexen_US
dcterms.subjectdataen_US
dcterms.subjectenergy balanceen_US
dcterms.subjectperinatal perioden_US
dcterms.subjectpregnancyen_US
dcterms.subjectweight gainen_US
dcterms.typeJournal Articleen_US

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