Maternal Micronutrient and Protein Intake and Birth Outcomes: A Systematic Review in LMICs

Abstract

Maternal nutrition is a critical determinant of fetal growth and neonatal health. This systematic review aimed to synthesize current evidence on the impact of maternal nutritional intake and interventions—including micronutrient supplementation, protein–energy support, and dietary counseling—on key outcomes such as birth weight, gestational age, preterm birth, intrauterine growth restriction (IUGR), and neonatal morbidity. A systematic search was conducted in PubMed, Scopus, and Web of Science for studies published between 2018 and 2024, following the PRISMA framework. Eligible studies included original research assessing maternal diet, nutritional status, or interventions during pregnancy. Fifteen studies met the inclusion criteria, comprising 6 cohort studies, 6 randomized controlled trials, 3 case-control studies, and 1 community-based trial conducted across Asia, Africa, and Latin America. Findings showed that adequate intake of iron, folic acid, calcium, vitamin D, and protein was associated with improved birth outcomes, including higher birth weight, reduced preterm delivery, and better Apgar scores. Conversely, undernutrition, protein–energy deficiency, and low dietary diversity were strongly linked to IUGR and neonatal morbidity. This review concludes that maternal nutrition interventions can effectively improve perinatal health, particularly in resource-limited settings. Future research should employ multicenter, longitudinal designs with standardized measures to generate stronger causal evidence for maternal nutrition policies.