Effects of preconception nutrition interventions on pregnancy and birth outcomes in South Asia: a systematic review
Effects of preconception nutrition interventions on pregnancy and birth outcomes in South Asia: a systematic review
Undernutrition amongst reproductive age women, low birth weight, small for gestational age and preterm birth present significant health burdens in South Asia which interventions in pregnancy alone have not resolved. Effectiveness of preconception nutrition interventions is not well-documented. This systematic review summarises evidence on the effect of preconception nutrition interventions on pregnancy and birth outcomes in South Asia. We found highly heterogeneous evidence across four micronutrient supplementation, two food supplementation, and three complex interventions trials. Preconception micronutrient supplementation alone did not affect birth size, but food supplementation was effective with and without multiple micronutrients, especially when initiated at least 90 days before conception. Combined health, nutrition, psychosocial care, and WaSH interventions addressing determinants at multiple levels were most effective. However intensive delivery by project employees poses problems for scale-up. More robust South Asian preconception intervention trials to identify scalable interventions that are effective in real-world delivery settings are needed.
Funding: UNICEF Regional Office for South Asia contract number 43384734.
Birth outcomes, Complex intervention, Food supplementation, Micronutrient supplementation, Preconception nutrition, Pregnancy outcomes, South asia, Systematic review
Saville, Naomi M.
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Dulal, Sophiya
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Miller, Faith
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Schoenaker, Danielle
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Chowdhury, Ranadip
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Hazra, Avishek
13ece825-d6fe-47d4-934c-162e728bfb52
Hirst, Jane
dc9d0781-7e08-4c9a-bd55-b19eae70991d
Murira, Zivai
58b552a5-b390-4bef-9000-20e4261b090c
Sethi, Vani
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12 May 2025
Saville, Naomi M.
255fcbcb-b84e-4ea7-bd03-d7f0079cb287
Dulal, Sophiya
26134196-10c6-432a-ad79-77a75e8f3533
Miller, Faith
1d45dbbb-28f6-4f7f-bd32-8b30289fe6cb
Schoenaker, Danielle
84b96b87-4070-45a5-9777-5a1e4e45e818
Chowdhury, Ranadip
9ad421c3-c996-442e-afae-587a28167621
Hazra, Avishek
13ece825-d6fe-47d4-934c-162e728bfb52
Hirst, Jane
dc9d0781-7e08-4c9a-bd55-b19eae70991d
Murira, Zivai
58b552a5-b390-4bef-9000-20e4261b090c
Sethi, Vani
e36793e8-a35a-4f95-a9c9-b212818b7526
Saville, Naomi M., Dulal, Sophiya, Miller, Faith, Schoenaker, Danielle, Chowdhury, Ranadip, Hazra, Avishek, Hirst, Jane, Murira, Zivai and Sethi, Vani
(2025)
Effects of preconception nutrition interventions on pregnancy and birth outcomes in South Asia: a systematic review.
The Lancet Regional Health - Southeast Asia, 36, [100580].
(doi:10.1016/j.lansea.2025.100580).
Abstract
Undernutrition amongst reproductive age women, low birth weight, small for gestational age and preterm birth present significant health burdens in South Asia which interventions in pregnancy alone have not resolved. Effectiveness of preconception nutrition interventions is not well-documented. This systematic review summarises evidence on the effect of preconception nutrition interventions on pregnancy and birth outcomes in South Asia. We found highly heterogeneous evidence across four micronutrient supplementation, two food supplementation, and three complex interventions trials. Preconception micronutrient supplementation alone did not affect birth size, but food supplementation was effective with and without multiple micronutrients, especially when initiated at least 90 days before conception. Combined health, nutrition, psychosocial care, and WaSH interventions addressing determinants at multiple levels were most effective. However intensive delivery by project employees poses problems for scale-up. More robust South Asian preconception intervention trials to identify scalable interventions that are effective in real-world delivery settings are needed.
Funding: UNICEF Regional Office for South Asia contract number 43384734.
Text
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Accepted/In Press date: 1 April 2025
e-pub ahead of print date: 24 April 2025
Published date: 12 May 2025
Keywords:
Birth outcomes, Complex intervention, Food supplementation, Micronutrient supplementation, Preconception nutrition, Pregnancy outcomes, South asia, Systematic review
Identifiers
Local EPrints ID: 502827
URI: http://eprints.soton.ac.uk/id/eprint/502827
PURE UUID: 4303af3b-c567-4f2a-aec4-fd9a131e5fe8
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Date deposited: 09 Jul 2025 16:30
Last modified: 22 Aug 2025 02:29
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Contributors
Author:
Naomi M. Saville
Author:
Sophiya Dulal
Author:
Faith Miller
Author:
Ranadip Chowdhury
Author:
Avishek Hazra
Author:
Jane Hirst
Author:
Zivai Murira
Author:
Vani Sethi
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