(P27-004-25) The Effects of Antenatal Interventions on Gestational Weight Gain in Low- and Middle-Income Countries: A Systematic Review

Objectives: Gestational weight gain (GWG) during pregnancy is a critical factor affecting maternal and child health outcomes. Inadequate and excessive GWG are significant challenges in low- and middle-income countries (LMICs). This systematic review aimed to assess the impact of various interventions on GWG in LMICs.

Methods: Randomized controlled trials on antenatal interventions on GWG in LMICs included were educational, behavioral (counseling/education), nutritional (food and micronutrient) supplementation, and medical interventions. A systematic literature search was conducted using PubMed, Embase, Web of Science, CINAHL, and the Cochrane Library from the start of each database through October 2022. The data extracted included study setting, year of intervention, sample size sample characteristics, timing and duration of intervention, and main findings. 

Registration: PROSPERO ID: CRD42022366354.

Results: Out of the 33,642 unique articles identified, 60 articles were included in this review. Micronutrient supplementation such as multiple micronutrient supplementation was found to reduce the risk of severely inadequate or inadequate GWG among pregnant women compared to iron only or iron and folic acid supplementation. With food supplementation, though mixed findings were identified, most of these interventions helped pregnant women attain optimal GWG. Counseling/education interventions such as nutritional education, personalized educational materials, one-on-one counseling, group counseling, and lifestyle interventions, were found to be effective in attaining optimum GWG. Physical activity such as a structured aquatic program, supervised cycling program, and antenatal physical exercise programs, when implemented during the first trimester, was found to reduce the risk of excessive GWG. Medical interventions such as preventive treatment with Sulphadoxine-Pyrimethamine (SP) (1500/75 mg) and azithromycin (4g) during pregnancy were found to reduce the risk of inadequate GWG compared SP plus chloroquine.

Conclusions: Well-structured antenatal interventions, initiated before 20 weeks of gestation and continuing beyond this period, tailored to local cultural contexts and available resources, can effectively help pregnant women in LMICs in achieving optimal GWG.

Funding Sources: No funding was received.