American Journal of Clinical Nutrition, Vol 58, 627-635, Copyright © 1993 by The American Society for Clinical Nutrition, Inc

REVIEW ARTICLES

Effects of energy and protein intakes on pregnancy outcome: an overview of the research evidence from controlled clinical trials

MS Kramer
Cochrane Centre, Oxford, UK.

This overview summarizes the evidence from controlled clinical trials bearing on the effects of energy and protein intakes during gestation on the outcome of pregnancy, based on meta-analyses of reports contained in the Oxford Database of Perinatal Trials. Trials of nutritional advice to increase energy and protein intakes, and of balanced energy and protein supplementation, have demonstrated only modest increases in maternal weight gain and fetal growth, even in undernourished women, and no long-term benefits to the child in terms of growth or neurocognitive development. Neither balanced isoenergetic protein supplementation nor high-protein supplementation appears beneficial to either mother or infant and may even impair fetal growth. The same can be said for energy and protein restriction in pregnant women who are overweight or exhibit high weight gain. Future trials should concentrate on prevention of preterm birth and fetal and neonatal death; such trials will require substantially larger sample sizes than those used in the past.

This article has been cited by other articles:

				S. Rao, C. S. Yajnik, A. Kanade, C. H. D. Fall, B. M. Margetts, A. A Jackson, R. Shier, S. Joshi, S. Rege, H. Lubree, et al. Intake of Micronutrient-Rich Foods in Rural Indian Mothers Is Associated with the Size of Their Babies at Birth: Pune Maternal Nutrition Study J. Nutr., April 1, 2001; 131(4): 1217 - 1224. [Abstract] [Full Text]

				K. Gray-Donald, E. Robinson, A. Collier, K. David, L. Renaud, and S. Rodrigues Intervening to reduce weight gain in pregnancy and gestational diabetes mellitus in Cree communities: an evaluation Can. Med. Assoc. J., November 1, 2000; 163(10): 1247 - 1251. [Abstract] [Full Text] [PDF]

				L. A. SCHIEVE, M. E. COGSWELL, K. S. SCANLON, G. PERRY, C. FERRE, C. BLACKMORE-PRINCE, S. M. YU, and D. ROSENBERG Prepregnancy Body Mass Index and Pregnancy Weight Gain: Associations With Preterm Delivery Obstet. Gynecol., August 1, 2000; 96(2): 194 - 200. [Abstract] [Full Text] [PDF]

				J. C Konje and O. A Ladipo Nutrition and obstructed labor Am. J. Clinical Nutrition, July 1, 2000; 72(1): 291S - 297. [Abstract] [Full Text] [PDF]

				R. T. Hall Prevention of Premature Birth: Do Pediatricians Have a Role? Pediatrics, May 1, 2000; 105(5): 1137 - 1140. [Abstract] [Full Text]

				R. L. Goldenberg and D. J. Rouse Prevention of Premature Birth N. Engl. J. Med., July 30, 1998; 339(5): 313 - 320. [Full Text] [PDF]

				S. M Ceesay, A. M Prentice, T. J Cole, F. Foord, E. M E Poskitt, L. T Weaver, and R. G Whitehead Effects on birth weight and perinatal mortality of maternal dietary supplements in rural gambia: 5 year randomised controlled trial BMJ, September 27, 1997; 315(7111): 786 - 790. [Abstract] [Full Text]