Does dietary advice, or an increase in energy or protein intake in pregnancy have a positive effect on gestational weight gain and the outcome of pregnancy?

From: The Cochrane Collaboration

Journal rating:
rating: 98%
Study Quality:
rating: 100%

Overall Reliability

Article Quality:
rating: 65%
rating: 50%


  • 27 trials involving 7,752 women


  • The paper is a systematic review / meta analysis of all relevant trials.
  • This means that the data from all similar trials has been grouped to form an overall outcome.


  • In five trials (1135 women), nutritional advice to increase energy and protein intakes was successful in achieving those goals, but no consistent benefit was observed on pregnancy outcomes.
  • In 13 trials (4665 women), balanced energy/protein supplementation was associated with modest increases in maternal weight gain and in mean birthweight, and a substantial reduction in risk of small-for-gestational-age (SGA) birth. No significant effects were detected on preterm birth, but significantly reduced risks were observed for stillbirth and neonatal death.
  • In two trials (529 women), high-protein supplementation was associated with a small, non-significant increase in maternal weight gain but a non-significant reduction in mean birthweight, a significantly increased risk of SGA birth, and a non-significantly increased risk of neonatal death. In three trials, involving 966 women, isocaloric protein supplementation was also associated with an increased risk of SGA birth.
  • In four trials (457 women), energy/protein restriction of pregnant women who were overweight, or exhibited high weight gain, significantly reduced weekly maternal weight gain and mean birthweight but had no effect on pregnancy-induced hypertension or pre-eclampsia.


  • Yes (without confidence); for balanced energy/protein supplementation


Editors Notes

  • Gestational weight gain is positively associated with foetal growth.