Evidence map›Paper›PMID 39899474›Full record

SynthesisPLoS medicine2025

The effect of prenatal balanced energy and protein supplementation on gestational weight gain: An individual participant data meta-analysis in low- and middle-income countries.

Dongqing Wang, Uttara Partap, Enju Liu, Janaína Calu Costa, Ilana R Cliffer, Molin Wang, Sudeer Kumar Nookala, Vishak Subramoney, Brittany Briggs, Imran Ahmed and 32 more

Abstract readMeta-Analysis
In one paragraph

Synthesis in PLoS medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Trial
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

42 authors.

Dongqing WangDepartment of Global and Community Health, College of Public Health, George Mason University, Fairfax, Virginia, United States of America.ORCID https://orcid.org/0000-0003-3369-5972
Uttara PartapDepartment of Global Health and Population, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, United States of America.ORCID https://orcid.org/0000-0002-2531-1804
Enju LiuInstitutional Centers for Clinical and Translational Research, Boston Children's Hospital, Boston, Massachusetts, United States of America.
Janaína Calu CostaDepartment of Global Health and Population, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, United States of America.ORCID https://orcid.org/0000-0002-7912-8685
Ilana R ClifferDepartment of Global Health and Population, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, United States of America.ORCID https://orcid.org/0000-0002-0740-787X
Molin WangDepartment of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, United States of America.
Sudeer Kumar NookalaCytel Inc., India on behalf of the Bill & Melinda Gates Foundation, Seattle, Washington, United States of America.
Vishak SubramoneyDVPL Tech, Dubai, United Arab Emirates.
Brittany BriggsCertara USA, Inc. on behalf of the Bill & Melinda Gates Foundation, Seattle, Washington, United States of America.ORCID https://orcid.org/0009-0009-5679-2063
Imran AhmedAga Khan University, Karachi, Pakistan.
Alemayehu ArgawDepartment of Food Technology, Safety and Health, Ghent University, Ghent, Belgium.ORCID https://orcid.org/0000-0003-3982-5408
Shabina AriffAga Khan University, Karachi, Pakistan.
Nita BhandariSociety for Applied Studies, New Delhi, India.
Ranadip ChowdhurySociety for Applied Studies, New Delhi, India.ORCID https://orcid.org/0000-0002-0055-6653
Daniel ErchickDepartment of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America.ORCID https://orcid.org/0000-0002-2852-280X
Armando García-GuerraCentro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, Mexico.ORCID https://orcid.org/0000-0003-0377-8136
Masoumah GhaffarpourFaculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Giles Hanley-CookDepartment of Food Technology, Safety and Health, Ghent University, Ghent, Belgium.ORCID https://orcid.org/0000-0001-9907-594X
Lieven HuybregtsDepartment of Food Technology, Safety and Health, Ghent University, Ghent, Belgium.
Fyezah JehanDepartment of Pediatrics and Child Health, the Aga Khan University, Karachi, Pakistan.
Fatemeh KasebDepartment of Paramedical, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
Nancy F KrebsUniversity of Colorado School of Medicine, Aurora, Colorado, United States of America.
Carl LachatDepartment of Food Technology, Safety and Health, Ghent University, Ghent, Belgium.ORCID https://orcid.org/0000-0002-1389-8855
Tsering Pema LamaNepal Nutrition Intervention Project, Sarlahi, Kathmandu, Nepal.ORCID https://orcid.org/0000-0001-6054-4075
Dharma S ManandharMother and Infant Research Activities (MIRA), Kathmandu, Nepal.
Elizabeth M McClureRTI International, Durham, North Carolina, United States of America.
Sophie E MooreDepartment of Women & Children's Health, King's College London, London, United Kingdom.ORCID https://orcid.org/0000-0003-1650-3238
Ameer MuhammadVITAL Pakistan Trust, Karachi, Pakistan.ORCID https://orcid.org/0000-0001-8485-641X
Lynnette M NeufeldFood and Agriculture Organization of the United Nations (FAO), Rome, Italy.
Andrew M PrenticeMRC Unit The Gambia at the London School of Hygiene and Tropical Medicine, Fajara, The Gambia.ORCID https://orcid.org/0000-0001-5389-451X
Amado D Quezada-SánchezColonia Santa María Ahuacatitlán, Cerrada Los Pinos y Caminera. Cuernavaca, Mexico.ORCID https://orcid.org/0000-0003-3258-8198
Dominique RoberfroidFaculty of Medicine, Namur University, Namur, Belgium; Belgian Health Care Knowledge Centre, Brussels, Belgium.ORCID https://orcid.org/0000-0003-3881-5558
Naomi M SavilleInstitute for Global Health, University College London, London, United Kingdom.ORCID https://orcid.org/0000-0002-1735-3684
Yasir ShafiqCenter of Excellence for Trauma and Emergencies and Community Health Sciences, The Aga Khan University, Karachi, Pakistan.ORCID https://orcid.org/0000-0003-1576-724X
Bhim P ShresthaMother and Infant Research Activities (MIRA), Kathmandu, Nepal.
Bakary SonkoMRC Unit The Gambia at the London School of Hygiene and Tropical Medicine, Fajara, The Gambia.ORCID https://orcid.org/0000-0003-3822-2680
Sajid SoofiAga Khan University, Karachi, Pakistan.
Sunita TanejaSociety for Applied Studies, New Delhi, India.ORCID https://orcid.org/0000-0003-3338-9799
James M TielschDepartment of Global Health, Milken Institute School of Public Health, George Washington University, Washington, DC, United States of America.
Laéticia Céline ToeDepartment of Food Technology, Safety and Health, Ghent University, Ghent, Belgium.
Naser ValaeiFaculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Wafaie W FawziDepartment of Global Health and Population, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, United States of America.

Funding

Nutrition-specific interventions to improve long-term maternal-child health outcomesUG1HD076474 · NICHD · UNIVERSITY OF COLORADO DENVER · PI Edwin Jose Asturias, NANCY F KREBS · 2018 to 2026
$5.4M
Balanced Energy Protein Supplement in Early Lactation on Infant Growth in Southern NepalR01HD109385 · NICHD · JOHNS HOPKINS UNIVERSITY · PI Daniel Joseph Erchick · 2022 to 2026
$2.7M
Gates Foundation INV-007640Gates Foundation INV-016436NICHD NIH HHS R01 HD109385NICHD NIH HHS UG1 HD076474
6 · The paper itself

Abstract

backgroundUnderstanding the effects of balanced energy and protein (BEP) supplements on gestational weight gain (GWG) and how the effects differ depending on maternal characteristics and the nutritional composition of the supplements will inform the implementation of prenatal BEP interventions. METHODS AND

findingsIndividual participant data from 11 randomized controlled trials of prenatal BEP supplements (N = 12,549, with 5,693 in the BEP arm and 6,856 in the comparison arm) in low- and middle-income countries were used. The primary outcomes included GWG adequacy (%) and the estimated total GWG at delivery as continuous outcomes, and severely inadequate (<70% adequacy), inadequate GWG (<90% adequacy), and excessive GWG (>125% adequacy) as binary outcomes; all variables were calculated based on the Institute of Medicine recommendations. Linear and log-binomial models were used to estimate study-specific mean differences or risk ratios (RRs), respectively, with 95% confidence intervals (CIs) of the effects of prenatal BEP on the GWG outcomes. The study-specific estimates were pooled using meta-analyses. Subgroup analyses were conducted by individual characteristics. Subgroup analyses and meta-regression were conducted for study-level characteristics. Compared to the comparison group, prenatal BEP led to a 6% greater GWG percent adequacy (95% CI: 2.18, 9.56; p = 0.002), a 0.59 kg greater estimated total GWG at delivery (95% CI, 0.12, 1.05; p = 0.014), a 10% lower risk of severely inadequate GWG (RR: 0.90; 95% CI: 0.83, 0.99; p = 0.025), and a 7% lower risk of inadequate GWG (RR: 0.93; 95% CI: 0.89, 0.97; p = 0.001). The effects of prenatal BEP on GWG outcomes were stronger in studies with a targeted approach, where BEP supplements were provided to participants in the intervention arm under specific criteria such as low body mass index or low GWG, compared to studies with an untargeted approach, where BEP supplements were provided to all participants allocated to the intervention arm.

conclusionsPrenatal BEP supplements are effective in increasing GWG and reducing the risk of inadequate weight gain during pregnancy. BEP supplementation targeted toward pregnant women with undernutrition may be a promising approach to delivering the supplements.

Indexed as

Developing CountriesDietary ProteinsDietary SupplementsEnergy IntakeGestational Weight GainPrenatal CareAdultFemaleHumansPregnancyRandomized Controlled Trials as TopicDietary Proteins

Identifiers

PMID39899474
PMCPMC11790098

What Socratic holds

Textmetadata
LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.