Effectiveness of Prenatal Lipid-Based Nutrient Supplementation to Improve Birth Outcomes: A Meta-analysis.

This study was performed to examine whether prenatal lipid-based nutrient supplementation is an effective means of improving birth outcomes compared with other types of supplementation including iron folic acid (IFA), United Nations multiple micronutrient preparation (UNIMAP), other multiple micronutrients (MMN), and fortified corn-soy blend (CSB). A meta-analysis was performed to determine the relative risks and mean differences in birth outcomes between prenatal lipid-based nutrients versus prenatal IFA, UNIMAP, other MMN, and CSB in randomized controlled trials. Eleven databases, including PubMed (MEDLINE), were searched. Study quality was assessed using the Cochrane Collaboration's tool for assessing the risk of bias. Fifty-eight overall good-quality studies extracted from 11 eligible articles with 101,553 mother-baby pairs were included. Lipid-based nutrient supplementation significantly reduced the risks of low birthweight, small for gestational age, and stunting (n = 5, 5, and 4, respectively) and significantly increased the means of birthweight, birth length, arm circumference, and weight-for-age z-score (n = 5, 5, 4, and 3, respectively). Lipid-based nutrient supplementation did not significantly reduce the risk of preterm birth, stillbirth, abortion, perinatal death, or underweight (n = 5, 5, 5, 3, or 3, respectively) or significantly increase the mean of head circumference or height-for-age z-score (n = 4 or 2, respectively). In conclusion, the results supported the efficacy of prenatal lipid-based nutrient supplementation compared with IFA, UNIMAP, other MMN, and CSB for reducing the risk of small birth size.