Interventions to improve birth outcomes of pregnant women living in low- and middle-income countries: a systematic review and network meta-analysis

摘要: Background: Improving the health of pregnant women is important to prevent adverse birth outcomes, such as preterm and low birthweight. We evaluated comparative effectiveness interventions under domains micronutrient, balanced energy protein, deworming, maternal education, water sanitation hygiene (WASH) for their effects on these outcomes. Methods: For this network meta-analysis, we searched randomized clinical trials (RCTs) provided in low- middle-income countries (LMICs). reports published until September 17, 2019 hand-searched bibliographies existing reviews. extracted data from eligible studies study characteristics, interventions, participants’ characteristics at baseline, compared (<37 gestational week), birthweight (LBW; <2500 g), (continuous) using conducted LMICs. Results: Our meta-analyses were based 101 RCTs (132 papers) pertaining 206,531 participants. Several micronutrients food supplement demonstrated over standard-of-care. instance, versus standard-of-care, micronutrient supplements women, iron calcium, decreased risks (iron: RR=0.70, 95% credible interval [Crl] 0.47, 1.01; calcium: RR=0.76, 95%Crl 0.56, 0.99). Daily intake 1500kcal local (RR=0.36, 0.16, 0.77) LBW (RR=0.17, 0.09, 0.29), respectively when Educational deworming did not show improvements no WASH intervention reported Conclusion: found several pregnancy that improve However, most have only a single domain (e.g. micronutrients) even though causes outcomes are multi-faceted. There need combine different packages test effectiveness. Registration: PROSPERO CRD42018110446 ; registered 17 October 2018.