Pregnancy Interventions to Improve Birth Outcomes: What Are the Effects on Maternal Outcomes? A Scoping Review

Abstract

Objectives: Interventions in pregnancy are commonly evaluated for their effects on birth outcomes because maternal infection and poor nutrition are the primary contributors to adverse pregnancy outcomes, especially in low- and middle-income countries (LMICs). However, the extent to which such interventions directly impact maternal health and nutrition has not been succinctly characterized.Methods: We conducted a scoping review of systematic reviews and meta-analyses of 27 pregnancy interventions to summarize the evidence of impact on maternal outcomes.Results: Overall, these were reported incompletely, and we failed to find any evidence for eight interventions. Influenza vaccination, insecticide-treated bed nets, intermittent preventive treatment for malaria, anthelmintic therapy, and treatment of bacterial vaginosis, asymptomatic bacteriuria, and periodontal disease during pregnancy provided direct benefit to women, with reductions in infection risk. Nutritional interventions such as micronutrient supplementation and balanced energy and protein improved outcomes of maternal anemia and gestational weight gain, particularly in deficient populations. Calcium and low dose aspirin significantly reduced the risk of pre-eclampsia.Conclusion: These findings highlight antenatal interventions benefitting maternal health and provide insights into pathways for impacting birth and infant outcomes.

Global disability-adjusted life years and deaths attributable to child and maternal malnutrition from 1990 to 2019

“…Previous study has summarized evidence-based interventions that have been effective in reducing CMM over the past decade, including providing preventive zinc, preventive small-quantity lipid-based nutrient supplements, maternal and child multiple micronutrient powder (MMN), maternal calcium vitamin A supplementation, promotion of breastfeeding, farm input subsidies, appropriate complementary feeding and management of moderate and severe acute malnutrition, etc. ( 7 , 29 , 30 ). These measures have considerably improved the nutritional health of children and pregnant women, thereby decreasing the disease burden caused by CMM ( 31–33 ).…”

Trends of the Global, Regional and National Incidence, Mortality, and Disability-Adjusted Life Years of Malaria, 1990–2019: An Analysis of the Global Burden of Disease Study 2019

“…25,26 One in four pregnant women in malaria-endemic African malariaendemic areas was believed to carry a malaria infection at the time of delivery. 27 WHO reported that 34% of pregnancies in the 33 moderate and high-transmission countries of the WHO African Region were exposed to malaria infection in 2020. 2 Because the GBD database lacks data on pregnant women, this article cannot estimate the global burden of malaria among them.…”