A systematic review of the effects of dietary interventions on neonatal outcomes in adolescent pregnancy

© 2015 The Royal College of Midwives. Background. Poor nutrition negatively impacts on pregnancy outcome, fetal growth and neonatal survival. Adolescent mothers, with competing demands of a growing baby and their own rising nutritional requirements, often have poor diets. Despite recognition of their physiological immaturity and nutritional inadequacies, along with evidence highlighting significant differences between adolescent and adult pregnancy outcomes, systematic evidence on the effects of supplementation on adolescent pregnancy is scarce. Aim. To evaluate the effectiveness of dietary interventions on neonatal outcomes in adolescent pregnancy (19 and under). Method. CENTRAL, EMBASE, CINAHL, Cochrane, Maternity and Infant Care, Scopus and MEDLINE databases were searched using selected terminology. Titles and abstracts were screened with selected papers reviewed in full by two authors against the inclusion criteria. Any randomised controlled trials in which the effects of nutritional interventions were evaluated in adolescent pregnancy were included. Data were extracted on study quality, design, compliance, dose and duration of intervention, and main birth outcomes, and analysed using Review Manager. Results. Five studies out of 18 identified were included. Four used supplementation (three zinc, one calcium) with one intervention comparing dairy products to fortified orange juice. The limited available data showed a significant effect from zinc supplementation in reducing the likelihood of low birthweight (RR [95%CI]: 0.39 [0.15, 0.98], one study, n=507) and that having four servings of dairy per day increased average birthweight in adolescent pregnancy (MD [95%CI]: 240g [110.83, 369.17]). Conclusion. High-quality comparative studies between supplements and food sources to improve birth outcomes for adolescent pregnancies, focusing on the clinical effectiveness and acceptability are urgently needed.