Cochrane for Clinicians

Putting Evidence into Practice

Impact of Antenatal Dietary Education and Supplementation on Maternal and Infant Health Outcomes


Am Fam Physician. 2016 Apr 1;93(7):557-558.

Clinical Question

Does antenatal dietary education or supplementation to increase energy and protein intake in pregnancy impact maternal and infant health outcomes?

Evidence-Based Answer

Antenatal dietary education appears to decrease the rate of preterm birth and increase infant birth weight among undernourished women. Providing balanced energy and protein supplements to pregnant women decreases the risk of stillbirth, low birth weight, and having an infant that is small for gestational age (number needed to treat [NNT] = 28). The use of high-protein supplements does not improve any outcomes and may cause fetal harm. Neither dietary advice nor supplementation affects maternal outcomes. (Strength of Recommendation: B, based on inconsistent or limited-quality patient-oriented evidence.)

Practice Pointers

As of 2010, the infant mortality rate in the United States ranked number 26 out of 29 developed nations surveyed.1 Preterm births and low birth weight are important factors that influence infant mortality. In the United States, 11% of births are preterm (i.e., born before 37 weeks of gestation) and 8% of infants are born at a low birth weight (i.e., less than 2,500 g [5 lb, 8 oz]).2 Reducing the incidence of low birth weight and preterm births is a stated objective of Healthy People 2020.3 The authors of this Cochrane review hoped to determine

The practice recommendations in this activity are available at


Ota E, Hori H, Mori R, Tobe-Gai R, Farrar D. Antenatal dietary education and supplementation to increase energy and protein intake. Cochrane Database Syst Rev. 2015;(6):CD000032.


show all references

1. MacDorman MF, Matthews TJ, Mohangoo AD, Zeitlin J. International comparisons of infant mortality and related factors: United States and Europe, 2010. Natl Vital Stat Rep. 2014;63(5):1–6....

2. Martin JA, Hamilton BE, Osterman MJ, Curtin SC, Matthews TJ. Births: final data for 2013. Natl Vital Stat Rep. 2015;64(1):1–65.

3. U.S. Department of Health and Human Services. Maternal, infant, and child health. Accessed August 24, 2015.

4. Akkerman D, Cleland L, Croft G, et al.; Institute for Clinical Systems Improvement. Routine prenatal care. Updated July 2012. Accessed February 29, 2016.

5. Kirkham C, Harris S, Grzybowski S. Evidence-based prenatal care. Part I. General prenatal care and counseling issues. Am Fam Physician. 2005;71(7):1307–1316.

These are summaries of reviews from the Cochrane Library.

This series is coordinated by Corey D. Fogleman, MD, Assistant Medical Editor.

A collection of Cochrane for Clinicians published in AFP is available at


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