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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dc.creatorWang, Dongqing
dc.creatorPartap, Uttara
dc.creatorLiu, Enju
dc.creatorCosta, Janaína Calu
dc.creatorCliffer, Ilana R.
dc.creatorWang, Molin
dc.creatorNookala, Sudeer Kumar
dc.creatorSubramoney, Vishak
dc.creatorBriggs, Brittany
dc.creatorAhmed, Imran
dc.creatorArgaw, Alemayehu
dc.creatorAriff, Shabina
dc.creatorBhandari, Nita
dc.creatorChowdhury, Ranadip
dc.creatorErchick, Daniel
dc.creatorGarcía-Guerra, Armando
dc.creatorGhaffarpour, Masoumah
dc.creatorHanley-Cook, Giles
dc.creatorHuybregts, Lieven
dc.creatorJehan, Fyezah
dc.creatorKaseb, Fatemeh
dc.creatorKrebs, Nancy F.
dc.creatorLachat, Carl
dc.creatorLama, Tsering Pema
dc.creatorManandhar, Dharma S.
dc.creatorMcClure, Elizabeth M.
dc.creatorMoore, Sophie E.
dc.creatorMuhammad, Ameer
dc.creatorNeufeld, Lynnette M.
dc.creatorPrentice, Andrew M.
dc.creatorQuezada-Sánchez, Amado D.
dc.creatorRoberfroid, Dominique
dc.creatorSaville, Naomi M.
dc.creatorShafiq, Yasir
dc.creatorShrestha, Bhim P.
dc.creatorSonko, Bakary
dc.creatorSoofi, Sajid
dc.creatorTaneja, Sunita
dc.creatorTielsch, James M.
dc.creatorToe, Laéticia Céline
dc.creatorValaei, Naser
dc.creatorFawzi, Wafaie W.
dc.date2025-02
dc.date2025-02-06T15:17:43Z
dc.date2025-02-06T15:17:43Z
dc.date.accessioned2026-06-27T15:38:00Z
dc.descriptionBackground 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.
dc.identifierhttps://hdl.handle.net/10568/172867
dc.identifier.urihttp://hdl.handle.net/123456789/110054
dc.languageen
dc.publisherPublic Library of Science
dc.rightsOpen Access
dc.sourceWang, 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 Med 22(2): e1004523. https://doi.org/10.1371/journal.pmed.1004523
dc.subjectbody mass index
dc.subjectdata
dc.subjectenergy balance
dc.subjectperinatal period
dc.subjectpregnancy
dc.subjectweight gain
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 countries
dc.typeJournal Article

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Instituto Internacional de Investigación sobre Políticas Alimentarias (IFPRI)