Effect of Nutrition Interventions Before and/or During Early Pregnancy on Low Birth Weight in Sub-Saharan Africa: A Systematic Review and Meta-Analysis

Background: This review aimed at synthesizing evidence on the effectiveness of nutritional interventions that were carried out before and/or during early pregnancy versus the control groups on reducing the risk of low weight at birth in sub-Saharan Africa. Methods: We have searched on MEDLINE, SCOPUS, CINAHL, HINARI, and Cochrane Library of systematic review databases for published articles in English language from 2010 to 2021 years. For unpublished studies, we searched on Google scholar. Randomized controlled trial studies of nutritional interventions carried out before/or during early pregnancy in sub-Saharan Africa to improve low birth weight were considered. The data were extracted and pooled using the Joanna Briggs Institute software. The effect size was calculated using fixed-effect models. Mantel-Haenszel method was used to calculate the relative risk with their respective 95% CI. Heterogeneity was assessed using the standard chi-square and I 2 tests. Results: Seven studies were included in the review with a total of 5934 participants. Three types of nutritional interventions were identified: iron supplementations, lipid-based supplementations, and nutritional education and counseling. We have identified only one intervention started during preconception. The meta-analysis showed that none of the identified nutrition interventions had a statistically significant effect on low birth weight. Conclusions: Based on the review evidence, nutritional interventions before and/or during early pregnancy in sub-Saharan Africa had no significant effect on low birth weight. However, since our evidence was derived from a small number of trials and participants, a large-scale randomized controlled trials review might be required to elucidate the finding.