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Preconception and periconception interventions to prevent low birth weight, small for gestational age and preterm

Uttara Partap1, Ranadip Chowdhury2, Sunita Taneja2

  • 1Department of Global Health and Population, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA upartap@hsph.harvard.edu.

BMJ Global Health
|August 10, 2022
PubMed

Insights

Evidence on preconception and periconception interventions for low birth weight (LBW), preterm birth (PTB), and small for gestational age (SGA) is very limited. Folic acid supplementation showed a reduced risk of birth defects.

Area of Science:

  • Maternal and Child Health
  • Public Health
  • Evidence Synthesis

Background:

  • Low birth weight (LBW), encompassing preterm birth (PTB) and small for gestational age (SGA), represents a substantial global health challenge.
  • Existing evidence on interventions aimed at improving birth outcomes during the preconception and periconception periods requires comprehensive summarization.

Purpose of the Study:

  • To systematically review and meta-analyze the current evidence on the effectiveness of preconception and periconception interventions in reducing LBW, PTB, and SGA.
  • To categorize interventions by type and delivery timing to identify potential impacts on adverse birth outcomes.

Main Methods:

  • A systematic review and meta-analysis was conducted, searching major databases for randomized controlled trials and quasi-experimental studies up to November 28, 2020.
  • Studies were classified by intervention type (nutrition, health, social) and delivery period (preconception, periconception, or pregnancy).
  • Meta-analyses were performed using fixed- or random-effects models, with evidence quality assessed using the GRADE approach.

Main Results:

  • The review included 58 studies, with interventions primarily focused on nutrition (28 studies) and health (30 studies).
  • Overall, the evidence regarding the impact of these interventions on LBW, SGA, and PTB was generally very uncertain.
  • Nutritional supplementation with folic acid during preconception and periconception was associated with a reduced risk of birth defects (RR: 0.37, 95% CI: 0.24 to 0.55).

Conclusions:

  • There is a significant paucity of evidence on the effectiveness of preconception and periconception interventions for improving LBW, SGA, and PTB.
  • Further research is needed to explore a wider range of interventions and ascertain their potential effectiveness in reducing adverse birth outcomes.
Abstract

Keywords:
Child healthMaternal healthPublic HealthSystematic review

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