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Effects of dietary interventions on pregnancy outcomes: a systematic review and meta-analysis

机译：饮食干预对妊娠结局的影响：系统评价和荟萃分析

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摘要

Dietary intake during pregnancy influences maternal health. Poor dietary practices during pregnancy have been linked to maternal complications. The objective was to determine the effect of dietary intervention before or during pregnancy on pregnancy outcomes. A systematic review was conducted without date restrictions. Randomised controlled trials (RCTs) evaluating whole diet or dietary components and pregnancy outcomes were included. Two authors independently identified papers for inclusion and assessed methodological quality. Meta-analysis was conducted separately for each outcome using random effects models. Results were reported by type of dietary intervention: (1) counselling; (2) food and fortified food products; or (3) combination (counselling + food); and collectively for all dietary interventions. Results were further grouped by trimester when the intervention commenced, nutrient of interest, country income and body mass index. Of 2326 screened abstracts, a total of 28 RCTs were included in this review. Dietary counselling during pregnancy was effective in reducing systolic [standardised mean difference (SMD) -0.26, 95% confidence interval (CI) -0.45 to -0.07; P < 0.001] and diastolic blood pressure (SMD -0.57, 95% CI -0.75 to -0.38; P < 0.001). Macronutrient dietary interventions were effective in reducing the incidence of preterm delivery (SMD -0.19, 95% CI -0.34 to -0.04; P = 0.01). No effects were seen for other outcomes. Dietary interventions showed some small, but significant differences in pregnancy outcomes including a reduction in the incidence of preterm birth. Further high-quality RCTs, investigating micronutrient provision from food, and combination dietary intervention, are required to identify maternal diet intakes that optimise pregnancy outcomes.
机译：怀孕期间的饮食摄入会影响孕产妇的健康。怀孕期间不良的饮食习惯与孕产妇并发症有关。目的是确定妊娠前或妊娠期间饮食干预对妊娠结局的影响。进行了系统的审查，没有日期限制。包括评估整体饮食或饮食成分以及妊娠结局的随机对照试验（RCT）。两位作者独立确定了论文的收录和评估方法学质量。使用随机效应模型对每种结局分别进行荟萃分析。通过饮食干预类型报告结果：（1）咨询; （二）食品和强化食品;或（3）组合（辅导+食物）;或并集体进行所有饮食干预。当干预开始时，将结果按孕早期，感兴趣的营养，国家收入和体重指数进一步分组。在2326篇筛选的摘要中，本评价总共包括28篇RCT。怀孕期间的饮食咨询可有效降低收缩期[标准平均差（SMD）-0.26，95％置信区间（CI）-0.45至-0.07; P <0.001]和舒张压（SMD -0.57，95％CI -0.75至-0.38; P <0.001）。大量营养饮食干预措施可有效减少早产的发生率（SMD -0.19，95％CI -0.34至-0.04; P = 0.01）。其他结果未见效果。饮食干预显示妊娠结局有一些微小但显着的差异，包括早产的发生率降低。需要进一步的高质量RCT，研究食物中微量营养素的提供以及组合饮食干预，以识别可优化妊娠结局的母体饮食摄入量。

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