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Review

Effects of Maternal Nutritional Supplements and Dietary Interventions on Placental Complications: An Umbrella Review, Meta-Analysis and Evidence Map

1
Department of Obstetrics and Gynaecology, BC Children’s and Women’s Hospital and University of British Columbia, Vancouver, BC V6Z 2K8, Canada
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Department of Pediatrics, University of British Columbia, Vancouver, BC V6H 0B3, Canada
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Department of Women & Children’s Health, King’s College London, London WC2R 2LS, UK
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Medical Research Council Unit, The Gambia at the London School of Hygiene and Tropical Medicine, Fajara, P.O. Box 273 Banjul, The Gambia
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School of Population and Public Health, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
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Division of Neonatology, BC Women’s Hospital and Health Centre, Vancouver, BC V6H 3N1, Canada
*
Author to whom correspondence should be addressed.
Membership of the PRECISE Conceptual Framework Working Group is provided in the Acknowledgements.
Academic Editor: Clive J. Petry
Nutrients 2021, 13(2), 472; https://doi.org/10.3390/nu13020472
Received: 25 December 2020 / Accepted: 26 January 2021 / Published: 30 January 2021
(This article belongs to the Section Nutritional Epidemiology)
The placenta is a vital, multi-functional organ that acts as an interface between maternal and fetal circulation during pregnancy. Nutritional deficiencies during pregnancy alter placental development and function, leading to adverse pregnancy outcomes, such as pre-eclampsia, infants with small for gestational age and low birthweight, preterm birth, stillbirths and maternal mortality. Maternal nutritional supplementation may help to mitigate the risks, but the evidence base is difficult to navigate. The primary purpose of this umbrella review is to map the evidence on the effects of maternal nutritional supplements and dietary interventions on pregnancy outcomes related to placental disorders and maternal mortality. A systematic search was performed on seven electronic databases, the PROSPERO register and references lists of identified papers. The results were screened in a three-stage process based on title, abstract and full-text by two independent reviewers. Randomized controlled trial meta-analyses on the efficacy of maternal nutritional supplements or dietary interventions were included. There were 91 meta-analyses included, covering 23 types of supplements and three types of dietary interventions. We found evidence that supports supplementary vitamin D and/or calcium, omega-3, multiple micronutrients, lipid-based nutrients, and balanced protein energy in reducing the risks of adverse maternal and fetal health outcomes. However, these findings are limited by poor quality of evidence. Nutrient combinations show promise and support a paradigm shift to maternal dietary balance, rather than single micronutrient deficiencies, to improve maternal and fetal health. The review is registered at PROSPERO (CRD42020160887). View Full-Text
Keywords: maternal dietary interventions; nutritional supplements; pre-eclampsia; small for gestational age; low birthweight; stillbirths; maternal mortality; umbrella review maternal dietary interventions; nutritional supplements; pre-eclampsia; small for gestational age; low birthweight; stillbirths; maternal mortality; umbrella review
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MDPI and ACS Style

Kinshella, M.-L.W.; Omar, S.; Scherbinsky, K.; Vidler, M.; Magee, L.A.; von Dadelszen, P.; Moore, S.E.; Elango, R.; The PRECISE Conceptual Framework Working Group. Effects of Maternal Nutritional Supplements and Dietary Interventions on Placental Complications: An Umbrella Review, Meta-Analysis and Evidence Map. Nutrients 2021, 13, 472. https://doi.org/10.3390/nu13020472

AMA Style

Kinshella M-LW, Omar S, Scherbinsky K, Vidler M, Magee LA, von Dadelszen P, Moore SE, Elango R, The PRECISE Conceptual Framework Working Group. Effects of Maternal Nutritional Supplements and Dietary Interventions on Placental Complications: An Umbrella Review, Meta-Analysis and Evidence Map. Nutrients. 2021; 13(2):472. https://doi.org/10.3390/nu13020472

Chicago/Turabian Style

Kinshella, Mai-Lei W., Shazmeen Omar, Kerri Scherbinsky, Marianne Vidler, Laura A. Magee, Peter von Dadelszen, Sophie E. Moore, Rajavel Elango, and The PRECISE Conceptual Framework Working Group. 2021. "Effects of Maternal Nutritional Supplements and Dietary Interventions on Placental Complications: An Umbrella Review, Meta-Analysis and Evidence Map" Nutrients 13, no. 2: 472. https://doi.org/10.3390/nu13020472

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