title: Effects of dietary interventions on neonatal and infant outcomes: a systematic review and meta-analysis.
abstract: BACKGROUND
  Nutrition plays a fundamental role in fetal growth and birth outcomes.
  
  
  OBJECTIVE
  We synthesized effects of dietary interventions before or during pregnancy on neonatal and infant outcomes.
  
  
  METHODS
  Randomized controlled trials that assessed the whole diet or dietary components and neonatal or infant outcomes were included. Two authors independently identified articles to be included and assessed the methodologic quality. A meta-analysis was conducted separately for each outcome by using a random-effects model. Results were reported by dietary intervention as follows: 1) counseling, 2) food and fortified food products, or 3) a combination (counseling plus food) intervention, and 4) collectively for all dietary interventions. Results were subanalyzed by the nutrient of interest, country income, and BMI.
  
  
  RESULTS
  Of 2326 abstracts screened, a total of 29 randomized controlled trials (31 publications) were included in this review. Food and fortified food products were effective in increasing birth weight [standardized mean difference (SMD): 0.27; 95% CI: 0.14, 0.40; P < 0.01] and reducing the incidence of low birth weight (SMD: -0.22; 95% CI: -0.37, -0.06; P < 0.01). All dietary interventions and those focused on macronutrient intake also increased birth weight (P < 0.01) and length (P < 0.05) and reduced the incidence of low birth weight (P < 0.01). Dietary interventions in low-income countries and underweight or nutritionally at-risk populations increased birth weight (P < 0.05) and reduced the incidence of low birth weight (P = 0.01). No effects were seen for the following other outcomes: placental weight, head circumference, macrosomia, Apgar score, small for gestational age, large for gestational age, and perinatal mortality.
  
  
  CONCLUSIONS
  Additional high-quality randomized controlled trials that test different dietary interventions are required to identify maternal diet intakes that optimize neonatal and infant outcomes.
authors.affiliation: From the Research Centre for Gender, Health and Ageing, School of Medicine and Public Health, Faculty of Health (EG, JEB, and AJH) and the Clinical Research Design Information Technology and Statistical Support Unit (AB), University of Newcastle, Callaghan, Australia.
authors.forename: Ellie
authors.initials: E
authors.lastname: Gresham
authors.affiliation: From the Research Centre for Gender, Health and Ageing, School of Medicine and Public Health, Faculty of Health (EG, JEB, and AJH) and the Clinical Research Design Information Technology and Statistical Support Unit (AB), University of Newcastle, Callaghan, Australia.
authors.forename: Julie E
authors.initials: JE
authors.lastname: Byles
authors.affiliation: From the Research Centre for Gender, Health and Ageing, School of Medicine and Public Health, Faculty of Health (EG, JEB, and AJH) and the Clinical Research Design Information Technology and Statistical Support Unit (AB), University of Newcastle, Callaghan, Australia.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Bisquera
authors.affiliation: From the Research Centre for Gender, Health and Ageing, School of Medicine and Public Health, Faculty of Health (EG, JEB, and AJH) and the Clinical Research Design Information Technology and Statistical Support Unit (AB), University of Newcastle, Callaghan, Australia.
authors.forename: Alexis J
authors.initials: AJ
authors.lastname: Hure
mesh_terms: D001724:Birth Weight; D015992:Body Mass Index; D016208:Databases, Factual; D004032:Diet; D005260:Female; D047109:Fetal Development / Q000502:physiology; D006801:Humans; D007223:Infant; D007230:Infant, Low Birth Weight; D039382:Maternal Nutritional Physiological Phenomena; D011247:Pregnancy; D011256:Pregnancy Outcome; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome; D015430:Weight Gain