Table 16

Impact of balanced protein-energy supplementation on stillbirth and perinatal mortality


Location and Type of Study


Stillbirths/Perinatal Outcomes

Reviews and meta-analyses

Kramer and Kakuma 2003 [112]

Gambia, India, Greece, Chile, Colombia, USA.

Meta-analysis (Cochrane). 6 RCTs included.

Assessed the impact of balanced antenatal protein-energy supplementation on pregnancy outcomes in supplemented individuals compared to controls.

SBR: RR = 0.55 (95% CI: 0.31–0.97).

Other intervention studies

Kielmann et al. 1978 [117]

India, Rural health research centre, Narangwal (Punjab).

Quasi-RCT, clustered by village.

Villages allocated to 1 of 3 service groups (medical care: MC), nutrition supplementation (NUT), and nutrition+medical care (NUT+MC) provided by auxiliary health workers resident in each village, or control villages receiving no care. Outcomes measured via longitudinal and cross-sectional surveys.

SBR: Lower in all service input villages combined (P < 0.05 compared to controls), lowest in NUT villages (P < 0.025 compared to controls).

PMR: Higher in MC+NUT than NUT [NS]

ENMR: Lower in all service input villages combined (P < 0.005 compared to controls). Lowest in MC +NUT villages (28/1000 live births), intermediate in MC and in the NUT villages (37/1000) and high in control villages (52.1/1000).

Yakoob et al. BMC Pregnancy and Childbirth 2009 9(Suppl 1):S3   doi:10.1186/1471-2393-9-S1-S3

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