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Preconception nutritional supplementation and behavioral interventions and their association with maternal and neonatal health: A systematic review and meta-analysis
The health and nutrition of women prior to conception play a crucial role in determining pregnancy outcomes. Inadequate nutrition and unhealthy behaviors have been linked to conditions such as anemia, preeclampsia, and fetal growth restriction. Nonetheless, research on effective preconception interventions remains sparse and often poorly integrated.
This review aimed to consolidate findings regarding the influence of nutritional supplementation and behavioral strategies on maternal and neonatal health outcomes. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a systematic review and meta-analysis were conducted, with registration in PROSPERO (#CRD42024592645). Researchers identified studies published through October 1, 2024, across six databases and ultimately selected 24 studies that met the inclusion criteria. These studies encompassed randomized, non-randomized, and controlled before-and-after designs involving women aged 18 to 45 who were preparing for pregnancy or in the interconception period. Interventions included nutritional supplements such as folic acid, calcium, and multiple micronutrients, as well as lifestyle strategies such as counseling, dietary adjustments, and physical activity.
The analysis demonstrated that lifestyle modifications significantly reduced the risk of gestational diabetes mellitus (GDM). Furthermore, these interventions reduced gestational weight gain (GWG) by an average of 3.88 kg and improved GWG adequacy. Regarding nutritional supplementation, findings indicated a reduced risk of GDM (RR: 0.55; 95% CI: 0.43–0.71), an increase in birth weight of 72.26 g, a reduced risk of preeclampsia associated with calcium, and a reduced risk of neurodevelopmental disorders with folic acid or multivitamins.
Despite these promising results, the study found no pooled associations across different intervention types. The specific evidence indicates that preconception nutritional and behavioral approaches can improve maternal and neonatal health outcomes. However, the variability and limitations within the studies pose challenges for establishing direct causal relationships. Thus, there is a pressing need for more comprehensive longitudinal and integrated intervention research to address existing knowledge gaps. [NPID: Pregnancy, neonatal health, preconception, nutritional supplementation]
Year: 2026
