Background
Methods
Search strategy
Theme | Nutritional Intake | Pregnancy | Age | Nutritional Status |
---|---|---|---|---|
Search Terms | nutrient | pregnan* | adolescen* | biomarker* |
nutrition* | gestatio* | teen | iron | |
diet* | matern* | teenage* | folate | |
eat* | mother* | youth | calcium | |
food | gravid* | anaemi* | ||
nutrition assessment (MH) | Pregnancy in adolescence (MH) | anemi* | ||
Food habits (MH) | Biological markers (MH) | |||
Dietary surveys (MH) |
Inclusion criteria
Quality appraisal
Data extraction
Data synthesis
Results
Study Information | Participants | Supplements | Measurement | Quality | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Study | Country | Study design | Study groups | Number | Age | Inclusion criteria | Exclusion criteria | Supplement type and dose | Number with available data | Estimated compliance: N (%) | Data collection method (s) | Time period(s) | Quality rating |
Baker et.al (2009) [23] | UK | Cross-sectional study | NA | 500 | 14–18 | Singleton pregnancy, age 14–18, gestational age < =20 weeks | Inability to provide informed consent, preeclampsia, clotting disorders, HIV/AIDS, haemoglobinopathies, diabetes, renal disease, hypertension, multiple gestations, history of 3= > previous miscarriages | Preconception folic acid | 498 | 34 (6.9) | 24 h recall (multiple) | Third trimester | + |
Folic acid in early pregnancy | 498 | 220 (44.2) | |||||||||||
Iron in early pregnancy | 498 | 39 (7.8) | |||||||||||
Multivitamins in early pregnancy | 498 | 19 (3.8) | |||||||||||
Folic acid only in 3rd trimester | 290 | 5 (1.7) | |||||||||||
Iron and folic acid in 3rd trimester | 290 | 13 (4.5) | |||||||||||
Iron only in 3rd trimester | 290 | 42 (14.5) | |||||||||||
Multivitamins in 3rd trimester | 290 | 7 (2.4) | |||||||||||
Castillo-Duran et.al (2001) [43] | Chile | RCT | Zinc supplemented | 249 | 16.4 (mean) | Beginning prenatal visits before 20 weeks gestation, aged <19 at estimated due date | Adolescents whose background included chronic diseases, drug abuse, mental retardation, illiteracy or pregnancy due to incest or rape | 20 mg Zinc sulphate daily | Intervention group - 249 | At least 50 % compliance | 24 h recall (multiple) | Second and third trimester | + |
Placebo | 258 | 40 mg iron sulphate | All participants - 507 | ||||||||||
Chan et.al (2006) [24] | USA | RCT | Control group, 2 intervention groups excluded from review* | 23 | 15–17 | Enrolled before 20 weeks gestation | Hypertension, diabetes, renal or liver disease, alcohol or tobacco use, using medicines effecting Ca metabolism | No additional supplements reported | Food diary (weighing not mentioned) | Second and third trimester | −/+ | ||
Chang et.al (2003) [37] | USA | Retrospective chart review | NA | 918 | 12–17 | Self-reported racial group as African-American; singleton pregnancy | Birth results not available due to abortion, miscarriage or transfer of care | 90 mg carbonyl iron daily plus additional up to 120 mg for those classified as anaemic | 918 | Not reported | Not reported | Second and third trimester | + |
Dawson et.al (2000) [35] | USA | RCT | One-A-Day without Iron | 20 | 16–20 | Aged 16–20, less than 16 weeks gestation, no iron supplementation for previous 30 days | Hypertension; diabetes; other medical problems; haemoglobin <11 g/dL; haematocrit <30 % | Vitamin A 5000 IU, vitamin D 400 IU, vitamin E 10 mg, vitamin C 60 mg, folic acid 0.4 mg, thiamine 1.5 mg, riboflavin 1.7 mg, niacin 20 mg, pyridoxine 2 mg, vitamin B- 6 mg, pantothenic acid 10 mg | 20 | Not reported | Venous blood sample | Second and third trimester and delivery | −/+ |
One-A-Day with Iron | 20 | 18 mg Iron, Vitamin A 5000 IU, vitamin D 400 IU, vitamin E 10 mg, vitamin C 60 mg, folic acid 0.4 mg, thiamine 1.5 mg, riboflavin 1.7 mg, niacin 20 mg, pyridoxine 2 mg, vitamin B- 6 mg, pantothenic acid 10 mg | 20 | ||||||||||
Derbyshire (2009) [39] | UK | Cross-sectional study | NA | 20 | 15–19 | Attending antenatal classes or community clinics | Incomplete diary | None reported | Food diary unweighed | Third trimester | + | ||
Gadowsky et.al (1995) [42] | Canada | Cross-sectional study | NA | 58 | 14–19 | Not reported | Not reported | Folic Acid Mean 479 μg/day | 58 | 82 % | Venous blood sample | Third trimester | + |
Elemental Iron Mean 31.5 mg/day | |||||||||||||
Cyanocobalamin (B12) Mean 2.24 μg/d | |||||||||||||
Giddens et.al (2000) [27] | USA | RCT (subset from a larger study) | NA | 59 | 13–18 | Singleton pregnancies, between 13 and 19 weeks gestation | Not reported | Reported that any contribution from supplements was not included in analysis | Food diary weighed | Mean over pregnancy | −/+ | ||
Ginde et.al (2010) [32] | USA | Secondary analysis of cross sectional survey | NA | 84 | 13–19 | Not reported | Not reported | Some participants taking vitamin D supplements | Not reported | Not reported | Venous blood sample | Mean over pregnancy | + |
Gutierrez et.al (1999) [28] | USA | Cross-sectional study | NA | 46 | 13–18 | Self-identified ethnicity as Mexican American, primigravida, 13–18 years of age | History of miscarriage or health problems, involved in competitive athletic performances or heavy exercise, planned to move away during study period | None reported | 24 h recall (single) | Second and third trimester | + | ||
Iannotti et.al (2005) [36] | USA | Cross-sectional study | NA | 80 | 13–18 | Self-reported racial group as African-American; singleton pregnancy | Not reported | None reported | 10 ml Venous blood sample | Second and third trimesters | + | ||
Job et.al (1995) [41] | Australia | Cross-sectional study | NA | 35 | 13–19 | Not reported | Not reported | None reported | 24 h recall | Mean over pregnancy | + | ||
Lee et.al (2013) [25] | USA | Cross-sectional study | NA | 156 | 13–18 | Age 18 or under, carrying a single fetus, 12–30 weeks gestation at recruitment | Not reported | Reported that any contribution from supplements was not included in analysis | 24 h recall (multiple) | <23 weeks gestation, 23–30 weeks gestation and Mean over pregnancy | + | ||
McGuire et.al. (2010) [31] | USA | Cross-sectional study | NA | 80 | Under 18 (mean 16.5) | Self-reported ethnic group as African American, singleton pregnancy | Not reported | Routinely prescribed prenatal supplements containing 400 IU vitamin D | Data not available | Venous blood sample | Second and third trimester | + | |
Meier et.al (2002) [34] | USA | RCT | Iron supplemented | 20 | 15–18 | Not reported | Iron deficiency anaemia at recruitment | 60 mg elemental iron & 1 mg folic acid | 20 | Venous blood sample | Second and third trimesters | + | |
Placebo | 17 | 1 mg folic acid | 17 | ||||||||||
Mistry et.al (2014) [40] | UK | Cross-sectional study | Appropriate for gestational age babies | 107 | 14–18 | Not reported | Inability to provide informed consent, pre-eclampsia, clotting disorders, HIV/AIDS, Haemoglobinpathies, diabetes, renal disease, hypertension, multiple pregnancy and previous miscarriage | None reported | 30 ml venous blood sample | Third trimester | + | ||
Small for gestational age babies | 9 | ||||||||||||
O’Brien et.al (2003) [33] | USA | Cross-sectional study | NA | 23 | Mean 16.5 | First, singleton pregnancies; no medical problems; no medications known to influence calcium metabolism; non-smokers; no history of drug or alcohol abuse | Not reported | Prenatal supplement including 5 mmol Ca | 23 | 39 % | Not reported | Third trimester | + |
Pobocik et.al (2003) [38] | Guam (USA Teritory) | Cross-sectional study | NA | 434 | 14–20 | Not reported | Not reported | Reported that any contribution from supplements was not included in analysis | 24 h recall (single) | Mean over pregnancy | −/+ | ||
Rycel et.al (2009) [44] | Poland | Retro-spective cohort | NA | 102 | 15–18 | Not reported | Not reported | none reported | Venous blood sample | Before and after delivery | −/+ | ||
Young et.al (2010) [29] | USA | Cross-sectional study | NA | 92 | 14–18 | Healthy, singleton pregnancy | HIV, diabetes, pre-eclampsia, eating disorders, malabsorption diseases, self-reported drug use | Prenatal supplement including 27 mg iron | 92 | Not reported | Venous blood sample | Second trimester and delivery | + |
Young et.al (2012) [30] | USA | Cross-sectional study | NA | 171 | Under 18 (mean 17.1) | Healthy, singleton pregnancy | HIV, diabetes, pre-eclampsia, eating disorders, malabsorption diseases | 400 IU Vitamin D supplement given to participants found to be deficient | 46 (estimated from reported percentages) | 26.4 % - daily, 35.8 % at least twice per week | 10 ml venous blood sample | Delivery | + |
Nutrient intakes
Study | Second Trimester | Third Trimester | Mean over pregnancy | |||||||
---|---|---|---|---|---|---|---|---|---|---|
N= | Mean | Confidence Interval | N= | Mean | Confidence Interval | N= | Mean | Confidence Interval | ||
Energy kcal/day a | Baker (2009) | 290 | ↓2147 | 2075, 2219 | ||||||
Castillo-Duran (2001) a | 249 | ↓1887 | 1825, 1949 | 249 | ↓2030 | 1968, 2092 | ||||
Castillo-Duran (2001) b | 258 | ↓1863 | 1790, 1936 | 258 | ↓1982 | 1927, 2038 | ||||
Chan (2006) | 23 | ↔2223 | 2057, 2389 | 23 | ↓2276 | 2059, 2493 | ||||
Derbyshire (2009) | 20 | ↓2273 | 2052, 2494 | |||||||
Giddens (2000) | 59 | ↓2342 | 2187, 2497 | |||||||
Gutierrez (1999) | 46 | ↔2390 | 2150, 2630 | 46 | ↔2620 | 2389, 2851 | ||||
Job (1995) | 70 | ↓2134 | 1949, 2320 | |||||||
Lee (2013) | 133 | ↓2303 | 2161, 2446 | 156 | ↔2273 | 2167, 2379 | ||||
Pobocik (2003) | 434 | ↑2487 | 2388, 2586 |
Comparison to UK Dietary Reference Value | Comparison to US Dietary Reference Value | ||||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Nutrient | Study | Second Trimester | Third Trimester | Mean over pregnancy | Second Trimester | Third Trimester | Mean over pregnancy | ||||||||||||
N= | Mean | Confidence Interval | N= | Mean | Confidence Interval | N= | Mean | Confidence Interval | N= | Mean | Confidence Interval | N= | Mean | Confidence Interval | N= | Mean | Confidence Interval | ||
Protein grams/day a | Castillo-Duran (2001) a | 249 | ↑60 | 58, 62 | 249 | ↑62 | 59, 64 | 249 | ↓60 | 58, 62 | 249 | ↓62 | 59, 64 | ||||||
Castillo-Duran (2001) b | 258 | ↑59 | 57, 61 | 258 | ↑60 | 58, 61 | 258 | ↓59 | 57, 61 | 258 | ↓60 | 58, 61 | |||||||
Chan (2006) | 23 | ↑76 | 65, 87 | 23 | ↑76 | 65, 87 | 23 | ↔76 | 65, 87 | 23 | ↔76 | 65, 87 | |||||||
Derbyshire (2009) | 20 | ↑72 | 65, 79 | 20 | ↔72 | 65, 79 | |||||||||||||
Giddens (2000) | 59 | ↑82 | 77, 87 | 59 | ↑82 | 77, 87 | |||||||||||||
Gutierrez (1999) | 46 | ↑111 | 98, 124 | 46 | ↑118 | 105, 130 | 46 | ↑111 | 98, 124 | 46 | ↑118 | 105, 130 | |||||||
Job (1995) | 70 | ↑73 | 73, 73 | 70 | ↑73 | 73, 73 | |||||||||||||
Lee (2013) | 133 | ↑81 | 76, 87 | 156 | ↑70 | 65, 75 | 133 | ↑81 | 76, 87 | 156 | ↔70 | 65, 75 | |||||||
Pobocik (2003) | 434 | ↑99 | 95, 103 | 434 | ↑99 | 95, 103 | |||||||||||||
Englyst Fibre grams/day b | Derbyshire (2009) | ↓12 | 11, 13 | ||||||||||||||||
AOAC Fibre grams/day c | Giddens (2000) | 59 | ↓14 | 13, 15 | |||||||||||||||
Lee (2013) | 133 | ↓13 | 12, 14 | 156 | ↓14 | 13,14 | |||||||||||||
N= | % of Energy | N= | % of Energy | N= | % of Energy | ||||||||||||||
Total Carbohydrate | Derbyshire (2009) | 20 | 54 % | ||||||||||||||||
Giddens (2000) | 59 | 50 % | |||||||||||||||||
Lee (2013) | 133 | 51 % | 156 | 52 % | |||||||||||||||
Gutierrez (1999) | 46 | 56 % | 46 | 56 % | |||||||||||||||
Total Fat | Chan (2006) | 23 | 29 % | 23 | 29 % | ||||||||||||||
Gutierrez (1999) | 46 | 29 % | 46 | 27 % | |||||||||||||||
Saturated Fat | Chan (2006) | 23 | 9 % | 23 | 10 % | ||||||||||||||
Total Sugars | Derbyshire (2009) | 20 | 25 % | ||||||||||||||||
Added Sugars | Lee (2013) | 133 | 17 % | 156 | 17 % |
Comparison to UK Dietary Reference Value | Comparison to US Dietary Reference Value | ||||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Nutrient | Study | Second Trimester | Third Trimester | Mean over pregnancy | Second Trimester | Third Trimester | Mean over pregnancy | ||||||||||||
N= | Mean | Confidence Interval | N= | Mean | Confidence Interval | N= | Mean | Confidence Interval | N= | Mean | Confidence Interval | N= | Mean | Confidence Interval | N= | Mean | Confidence Interval | ||
Calcium mg/day a | Baker (2009) | 290 | ↔840 | 800, 880 | 290 | ↓840 | 800, 880 | ||||||||||||
Chan (2006) | 23 | ↔835 | 711, 959 | 23 | ↔862 | 714, 1010 | 23 | ↓835 | 711, 959 | 24 | ↓862 | 714, 1010 | |||||||
Derbyshire (2009) | 20 | ↑1007 | 867, 1147 | 20 | ↓1007 | 867, 1147 | |||||||||||||
Giddens (2000) | 59 | ↑989 | 904, 1074 | 59 | ↓989 | 904, 1074 | |||||||||||||
Gutierrez (1999) | 46 | ↑1561 | 1334, 1789 | 46 | ↑1655 | 1424, 1886 | 46 | ↑1561 | 1334, 1789 | 46 | ↑1655 | 1424, 1886 | |||||||
Job (1995) | 70 | ↔923 | 756, 1090 | 70 | ↓923 | 756, 1090 | |||||||||||||
Lee (2013) | 133 | ↑916 | 838, 995 | 156 | ↑886 | 824, 948 | 133 | ↓916 | 838, 995 | 156 | ↓886 | 824, 948 | |||||||
Pobocik (2003) | 434 | ↓743 | 689, 797 | 434 | ↓743 | 689, 797 | |||||||||||||
Phosphorous mg/day b | Chan (2006) | 23 | ↑934 | 811, 1057 | 23 | ↑961 | 812, 1110 | 23 | ↓934 | 811, 1057 | 24 | ↓961 | 812, 1110 | ||||||
Giddens (2000) | 59 | ↑1340 | 1248, 1432 | 59 | ↔1340 | 1248, 1432 | |||||||||||||
Lee (2013) | 133 | ↑1264 | 1182, 1347 | 156 | ↑1196 | 1131, 1261 | 133 | ↔1264 | 1182, 1347 | 156 | ↔1196 | 1131, 1261 | |||||||
Pobocik (2003) | 434 | ↑1338 | 1279, 1397 | 434 | ↑1338 | 1279, 1397 | |||||||||||||
Iron mg/day c | Baker (2009) | 290 | ↑17 | 15, 19 | 290 | ↓17 | 15, 19 | ||||||||||||
Castillo-Duran (2001) a | 249 | ↑15.5 | 15, 16 | 249 | ↑16.8 | 16, 17 | 249 | ↓15.5 | 15, 16 | 249 | ↓16.8 | 16, 17 | |||||||
Castillo-Duran (2001) b | 258 | ↑16.6 | 16, 17 | 258 | ↑16.8 | 16, 17 | 258 | ↓16.6 | 16, 17 | 258 | ↓16.8 | 16, 17 | |||||||
Chan (2006) | 23 | ↑22 | 18, 26 | 23 | ↑25 | 20, 30 | 23 | ↓22 | 18, 26 | 23 | ↔25 | 20, 30 | |||||||
Derbyshire (2009) | 20 | ↓12.6 | 11, 14 | 20 | ↔12.6 | 11, 14 | |||||||||||||
Giddens (2000) | 59 | ↔16 | 15, 17 | 59 | ↓16 | 15, 17 | |||||||||||||
Gutierrez (1999) | 46 | ↑17.7 | 15, 20 | 46 | ↑22.7 | 17, 28 | 46 | ↓17.7 | 15, 20 | 46 | ↔22.7 | 17, 28 | |||||||
Job (1995) | 70 | ↓11.2 | 10, 12 | 70 | ↓11.2 | 10, 12 | |||||||||||||
Lee (2013) | 133 | ↑18.8 | 17, 20 | 156 | ↑18.6 | 17, 20 | 133 | ↓18.8 | 17, 20 | 156 | ↓18.6 | 17, 20 | |||||||
Pobocik (2003) | 434 | ↑20 | 19, 21 | 434 | ↓20 | 19, 21 | |||||||||||||
Magnesium mg/day d | Baker (2009) | 290 | ↓236 | 227, 245 | ↓236 | 227, 245 | |||||||||||||
Chan (2006) | 23 | ↓263 | 230, 296 | 23 | ↓264 | 231, 297 | ↓263 | 230, 296 | ↓264 | 231, 297 | |||||||||
Derbyshire (2009) | 20 | ↓244 | 218, 270 | ↓244 | 218, 270 | ||||||||||||||
Giddens (2000) | 59 | ↓252 | 234, 270 | ↓252 | 234, 270 | ||||||||||||||
Lee (2013) | 133 | ↓237 | 222, 253 | 156 | ↓231 | 218, 244 | ↓237 | 222, 253 | ↓231 | 218, 244 | |||||||||
Pobocik (2003) | 434 | ↓270 | 258, 282 | ↓270 | 258, 282 | ||||||||||||||
Potassium mg/day e | Chan (2006) | 23 | ↓2802 | 2512, 3092 | 23 | ↓2954 | 2635, 3273 | 23 | ↓2802 | 2512, 3092 | 23 | ↓2954 | 2635, 3273 | ||||||
Derbyshire (2009) | 20 | ↓2948 | 2659, 3237 | 20 | ↓2948 | 2659, 3237 | |||||||||||||
Zinc mg/day f | Baker (2009) | 290 | ↑8.1 | 7.8, 8.4 | 290 | ↓8.1 | 7.8, 8.4 | ||||||||||||
Castillo-Duran (2001) a | 249 | ↑7.4 | 7.1, 7.7 | 249 | ↑7.7 | 7.4, 8 | 249 | ↓7.4 | 7.1, 7.7 | 249 | ↓7.7 | 7.4, 8 | |||||||
Castillo-Duran (2001) b | 258 | ↑7.4 | 7.1, 7.7 | 258 | ↑7.4 | 7.2, 7.6 | 258 | ↓7.4 | 7.1, 7.7 | 258 | ↓7.4 | 7.2, 7.6 | |||||||
Chan (2006) | 23 | ↑16 | 11.9, 20.1 | 23 | ↑18 | 13.5, 22.5 | 23 | ↔16 | 11.9, 20.1 | 23 | ↑18 | 13.5, 22.5 | |||||||
Derbyshire (2009) | 20 | ↑8.1 | 7.4, 8.9 | 20 | 7.4, 8.9 | ||||||||||||||
Giddens (2000) | 59 | ↑11.6 | 10.5, 12.7 | 59 | ↑11.6 | 10.5, 12.7 | |||||||||||||
Gutierrez (1999) | 46 | ↑14.5 | 12.6, 16.4 | 46 | ↑15.3 | 13.4, 17.2 | 46 | ↑14.5 | 12.6, 16.4 | 46 | ↑15.3 | 13.4, 17.2 | |||||||
Job (1995) | 70 | ↑9.5 | 8.5, 10.5 | 70 | ↑9.5 | 8.5, 10.5 | |||||||||||||
Lee (2013) | 133 | ↑12.8 | 156 | ↑12.6 | 11.4, 13.8 | 133 | ↑12.8 | 156 | ↑12.6 | 11.4, 13.8 | |||||||||
Pobocik (2003) | 434 | ↑13 | 12.2, 13.8 | 434 | ↑13 | 12.2, 13.8 | |||||||||||||
Sodium mg/day g | Chan (2006) | 23 | ↑3316 | 2809, 3823 | 23 | ↑3323 | 2812, 3834 | ↑3316 | 2809, 3823 | ↑3323 | 2812, 3834 | ||||||||
Derbyshire (2009) | 20 | ↑3089 | 2722, 3456 | ↑3089 | 2722, 3456 | ||||||||||||||
Copper μg/day h | Giddens (2000) | 59 | ↑1200 | 1098, 1302 | 59 | ↑1200 | 1098, 1302 | ||||||||||||
Lee (2013) | 133 | ↑1100 | 1015, 1185 | 156 | ↑1085 | 1021, 1151 | 133 | ↑1100 | 1015, 1185 | 156 | ↑1085 | 1021, 1151 | |||||||
Selenium μg/day i | Giddens (2000) | 59 | ↑116 | 109, 123 | 59 | ↑116 | 109, 123 |
Comparison to UK Dietary Reference Value | Comparison to US Dietary Reference Value | ||||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Nutrient | Study | Second Trimester | Third Trimester | Mean over pregnancy | Second Trimester | Third Trimester | Mean over pregnancy | ||||||||||||
N= | Mean | Confidence Interval | N= | Mean | Confidence Interval | N= | Mean | Confidence Interval | N= | Mean | Confidence Interval | N= | Mean | Confidence Interval | N= | Mean | Confidence Interval | ||
Vitamin D μg/day a | Baker (2009) | 290 | ↓2.1 | 2, 2.3 | 290 | ↓2.1 | 2, 2.3 | ||||||||||||
Chan (2006) | 23 | ↓2.8 | 1.9, 3.7 | 23 | ↓3.1 | 2.2, 4 | 23 | ↓2.8 | 1.9, 3.7 | 23 | ↓3.1 | 2.2, 4 | |||||||
Derbyshire (2009) | 20 | ↓2.0 | 1.5, 2.6 | 20 | ↓2.0 | 1.5, 2.6 | |||||||||||||
Giddens (2000) | 59 | ↓6.4 | 5.7, 7.1 | 59 | ↓6.4 | 5.7, 7.1 | |||||||||||||
Lee (2013) | 133 | ↓5.4 | 4.7, 6.1 | 156 | ↓5.1 | 4.6, 5.6 | 133 | ↓5.4 | 4.7, 6.1 | 156 | ↓5.1 | 4.6, 5.6 | |||||||
Vitamin E b | Baker (2009) | 290 | ↓8.9 | 8.3, 9.5 | |||||||||||||||
Derbyshire (2009) | 20 | ↓7.7 | 6.5, 8.9 | ||||||||||||||||
Gutierrez (1999) | 46 | ↓10.7 | 10.7 | 46 | ↓11.2 | 8.2, 14.1 | |||||||||||||
Lee (2013) | 133 | ↓6.9 | 6.2, 7.6 | 156 | ↓6.9 | 6.4, 7.4 | |||||||||||||
Pobocik (2003) | 434 | ↓8 | 7.2, 8.8 | ||||||||||||||||
Vitamin C c | Baker (2009) | 290 | ↑160 | 146, 174 | 290 | ↑160 | 146, 174 | ||||||||||||
Derbyshire (2009) | 20 | ↑138 | 111, 165 | 20 | ↑138 | 111, 165 | |||||||||||||
Giddens (2000) | 59 | ↑128 | 112, 144 | 59 | ↑128 | 112, 144 | |||||||||||||
Gutierrez (1999) | 46 | ↑252 | 208, 296 | 46 | ↑231 | 190, 271 | 46 | ↑252 | 208, 296 | 46 | ↑231 | 190, 271 | |||||||
Job (1995) | 70 | ↑135 | 92, 178 | 70 | ↑135 | 92, 178 | |||||||||||||
Lee (2013) | 133 | ↑97 | 81, 113 | 156 | ↑106 | 94, 118 | 133 | ↑97 | 81, 113 | 156 | ↑106 | 94, 118 | |||||||
Pobocik (2003) | 434 | ↑167 | 150, 184 | 434 | ↑167 | 150, 184 | |||||||||||||
Folate d | Baker (2009) | 290 | ↔285 | 269, 301 | 290 | ↓285 | 269, 301 | ||||||||||||
Derbyshire (2009) | 20 | ↓227 | 205, 249 | 20 | ↓227 | 205, 249 | |||||||||||||
Giddens (2000) | 59 | ↔312 | 277, 347 | 59 | ↓312 | 277, 347 | |||||||||||||
Gutierrez (1999) | 46 | ↑447 | 355, 540 | 46 | ↑393 | 340, 445 | 46 | ↓447 | 355, 540 | 46 | ↓393 | 340, 445 | |||||||
Lee (2013) | 133 | ↑829 | 723, 935 | 156 | ↑849 | 645, 1053 | 133 | ↑829 | 723, 935 | 156 | ↑849 | 645, 1053 | |||||||
Pobocik (2003) | 434 | ↔292 | 269, 315 | 434 | ↓292 | 269, 315 | |||||||||||||
Riboflavin e | Chan (2006) | 23 | ↑2.3 | 1.8, 2.8 | 23 | ↑2.4 | 2, 2.8 | 23 | ↑2.3 | 1.8, 2.8 | 23 | ↑2.4 | 2, 2.8 | ||||||
Giddens (2000) | 59 | ↑2.3 | 59 | ↑2.3 | 2.1, 2.5 | ||||||||||||||
Lee (2013) | 133 | ↑2.5 | 2.3, 2.7 | 156 | ↑2.4 | 133 | ↑2.5 | 2.3, 2.7 | 156 | ↑2.4 | 2.2, 2.6 | ||||||||
Pobocik (2003) | 434 | ↑2.1 | 434 | ↑2.1 | 2, 2.2 | ||||||||||||||
B12 f | Baker (2009) | 290 | ↑5.3 | 4.7, 5.9 | 290 | ↑5.3 | 4.7, 5.9 | ||||||||||||
Chan (2006) | 23 | ↑5 | 3.8, 6.2 | 23 | ↑5.2 | 3.7, 6.7 | 23 | ↑5 | 3.8, 6.2 | 23 | ↑5.2 | 3.7, 6.7 | |||||||
Giddens (2000) | 59 | ↑5.3 | 4.6, 6 | 59 | ↑5.3 | 4.6, 6 | |||||||||||||
Lee (2013) | 133 | ↑5.6 | 5, 6.2 | 156 | ↑5.5 | 5, 6 | 133 | ↑5.6 | 5, 6.2 | 156 | ↑5.5 | 5, 6 | |||||||
Pobocik (2003) | 434 | ↑5.5 | 4.8, 6.2 | 434 | ↑5.5 | 4.8, 6.2 | |||||||||||||
Thiamin g | Baker (2009) | 290 | ↑1.6 | 1.5, 1.7 | 290 | ↑1.6 | 1.5, 1.7 | ||||||||||||
Giddens (2000) | 59 | ↑2.1 | 1.9, 2.3 | 59 | ↑2.1 | 1.9, 2.3 | |||||||||||||
Lee (2013) | 133 | ↑2.1 | 1.9, 2.3 | 156 | ↑2.1 | 1.9, 2.3 | 133 | ↑2.1 | 1.9, 2.3 | 156 | ↑2.1 | 1.9, 2.3 | |||||||
Pobocik (2003) | 434 | 2.4 | 2.3, 2.5 | 434 | 2.4 | 2.3, 2.5 | |||||||||||||
Niacin h | Baker (2009) | 290 | ↑33 | 32, 35 | 290 | ↑34 | 32, 35 | ||||||||||||
Giddens (2000) | 59 | ↑24 | 22, 26 | 59 | ↑24 | 22, 26 | |||||||||||||
Lee (2013) | 133 | ↑28 | 26, 30 | 156 | ↑26 | 24, 27 | 133 | ↑28 | 26, 30 | 156 | ↑26 | 24, 27 | |||||||
Pobocik (2003) | 434 | ↑30 | 29, 31 | 434 | ↑30 | 29, 31 | |||||||||||||
B6 i | Baker (2009) | 290 | ↑2.3 | 2.1, 2.4 | 290 | ↑2.3 | 2.1, 2.4 | ||||||||||||
Giddens (2000) | 59 | ↑1.9 | 1.7, 2.1 | 59 | ↑1.9 | 1.7, 2.1 | |||||||||||||
Lee (2013) | 133 | ↑2.2 | 2, 2.4 | 156 | ↑2.1 | 1.9, 2.3 | 133 | ↑2.2 | 2, 2.4 | 156 | ↑2.1 | 1.9, 2.3 | |||||||
Pobocik (2003) | 434 | ↑2 | 1.9, 2.1 | 434 | ↑2 | 1.9, 2.1 | |||||||||||||
Vitamin A j | Baker (2009) | 290 | ↑759 | 651, 867 | 290 | ↑759 | 651, 867 | ||||||||||||
Derbyshire (2009) | 20 | ↑555 | 439, 671 | 20 | ↓555 | 439, 671 | |||||||||||||
Giddens (2000) | ↑105 | 59 | ↑1053 | 907, 1199 | ↑1053 | 59 | ↑1053 | 907, 1199 | |||||||||||
Gutierrez (1999) | 46 | ↑2492 | 1466, 3518 | 46 | ↑197 | 1432, 2523 | 46 | ↑2492 | 1466, 3518 | 46 | ↑1978 | 1432, 2523 | |||||||
Job (1995) | 70 | ↑973 | 802, 1144 | 70 | ↑973 | 802, 1144 | |||||||||||||
Lee (2013) | 133 | ↑698 | 614, 783 | 156 | ↑666 | 615, 717 | 133 | ↑698 | 614, 783 | 156 | ↓666 | 615, 717 | |||||||
Pobocik (2003) | 434 | ↑109 | 944, 1242 | 434 | ↑1093 | 944, 1242 | |||||||||||||
Vitamin K k | Lee (2013) | 133 | ↔70 | 57, 83 | 156 | ↔70 | 59, 81 |
Biological markers
Study ID | First Trimester | Second Trimester | Third Trimester | Delivery | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
N= | Mean | Confidence Interval | N= | Mean | Confidence Interval | N= | Mean | Confidence Interval | N= | Mean | Confidence Interval | ||
Haemoglobin (g/L) a | Baker (2009) | 404 | ↑122 | 121, 123 | 362 | ↓108 | 107, 109 | ||||||
Chang (2003) | 445 | ↑121 | 121, 122 | 319 | ↑112 | 112, 114 | 836 | ↓107 | 107, 109 | ||||
Dawson (2000) a | 21 | ↑124 | 123, 125 | 21 | ↑115 | 114, 116 | 20 | ↑114 | 111, 112 | ||||
Dawson (2000) b | 20 | ↑125 | 124, 126 | 20 | ↑119 | 118, 120 | 21 | ↑116 | 112, 114 | ||||
Dawson (2000) a | 21 | ↑114 | 113, 115 | ||||||||||
Dawson (2000) b | 20 | ↑120 | 119, 121 | ||||||||||
Gadowsky (1995) | 50 | ↑119 | 115, 123 | ||||||||||
Iannotti (2005) | 35 | ↔111 | 107, 115 | 70 | ↔107 | 104, 110 | |||||||
McGuire Davies (2010) | 78 | ↑118 | 118, 118 | 76 | ↓107 | 107, 108 | |||||||
Meier (2002) a | 20 | ↑125 | 122, 129 | 15 | ↑123 | 119, 128 | |||||||
Meier (2002) b | 17 | ↑128 | 124, 132 | 16 | ↑117 | 112, 123 | |||||||
Meier (2002) a | 19 | ↑116 | 112, 120 | ||||||||||
Meier (2002) b | 16 | ↑113 | 110, 116 | ||||||||||
Rycel (2009) | 102 | ↑120 | 120, 229 | ||||||||||
Rycel (2009) | 102 | ↓103 | 103, 103 | ||||||||||
Young (2010) | 48 | ↑113 | 62 | ↑117 | 113, 121 | ||||||||
Ferritin (μg/L or ng/ml) b | Gadowsky (1995) | 50 | ↓7.4 | 5.7, 9.1 | |||||||||
Iannotti (2005) | 44 | ↑33 | 26.8, 40.6 | 59 | ↔15 | 12.6, 17.8 | |||||||
Meier (2002) a | 19 | ↑42 | 31.3, 52.8 | 15 | ↔25 | 14.6, 35.4 | |||||||
Meier (2002) b | 17 | ↑57 | 36.5, 77.5 | 15 | ↓6.8 | 5.2, 8.5 | |||||||
Meier (2002) a | 19 | ↑46 | 24, 68.8 | ||||||||||
Meier (2002) b | 16 | ↓10 | 7.9, 13 | ||||||||||
Young (2010) | 81 | ↔16 | 12.9, 20.1 | 88 | ↔17 | 14.9, 20.3 | |||||||
Haematocrit (g/L) c | Chang (2003) | 445 | ↑36 | 35.7, 36.3 | 319 | ↔33 | 32.7, 33.3 | 836 | ↓32 | 31.8, 32.2 | |||
Gadowsky (1995) | 50 | ↑36 | 34.8, 37.2 | ||||||||||
Iannotti (2005) | 35 | ↔33 | 32, 34 | 70 | ↓32 | 31.3, 32.7 | |||||||
Rycel (2009) | 102 | 34 | 34.6, 34.8 | ||||||||||
Rycel (2009) | 102 | ↓31 | 31.4, 31.6 | ||||||||||
Zinc μmol/L-1 d | Castillo-Duran (2001) a | 249 | ↑11.9 | 11.7, 12.1 | 249 | ↑10.9 | 10.7, 11.1 | ||||||
Castillo-Duran (2001) b | 258 | ↑11.7 | 11.5, 11.9 | 258 | ↑10.9 | 10.7, 11.1 | |||||||
Castillo-Duran (2001) a | 249 | ↑10.5 | 10.3, 10.7 | ||||||||||
Castillo-Duran (2001) b | 258 | ↑10.2 | 10, 10.4 | ||||||||||
Chan (2006) | 23 | ↑26.3 | 23.2, 29.4 | ||||||||||
Mistry (2014) a | 107 | ↑9.71 | 8.8, 10.5 | ||||||||||
Mistry (2014) b | 19 | ↑10.8 | 7.8, 13.9 | ||||||||||
Magnesium mmol/l e | Chan (2006) | 23 | ↑0.99 | 0.9, 1.1 | |||||||||
Phosphorous mg/dl f | Chan (2006) | 23 | ↑5 | 4, 6 | |||||||||
Copper μg/dl g | Mistry (2014) a | 107 | ↑206 | 1991, 2128 | |||||||||
Mistry (2014) b | 19 | ↑196 | 1712, 2207 | ||||||||||
Selenium μg/L h | Dawson (2000) a | 21 | ↓49 | 46, 52 | 21 | ↓55 | 52.9, 57.1 | 21 | ↑114 | 108.9, 119.1 | |||
Dawson (2000) b | 20 | ↓44 | 39.6, 48.4 | 20 | ↓53 | 50.8, 55.2 | 20 | ↓55 | 50.2, 59.8 | ||||
Dawson (2000) a | 21 | ↓50 | 46.2, 53.8 | 21 | ↔85 | 76.9, 93.1 | |||||||
Dawson (2000) b | 20 | ↓44 | 39.6, 48.4 | 20 | ↓62 | 57.2, 66.8 | |||||||
Mistry (2014) a | 107 | ↓65 | 62.7, 67.5 | ||||||||||
Mistry (2014) b | 19 | ↓49 | 45.9, 52.9 | ||||||||||
Red blood cell folate (nmol/l) i | Baker (2009) | 266 | ↑647 | 616, 680 | |||||||||
Serum folate (nmol/l) j | Baker (2009) | 291 | ↑12 | 12, 14 | |||||||||
Chan (2006) | 23 | ↔13 | 10, 17 | ||||||||||
Vitamin A (μg/dL) | Chan (2006) | 23 | ↑38 | 31, 45 | |||||||||
B12 (pmol/l) k | Baker (2009) | 293 | ↑177 | 169, 185 | |||||||||
Chan (2006) | 23 | ↑265 | 216, 315 | ||||||||||
Gadowsky (1995) | 50 | ↑170 | 146, 194 | ||||||||||
Homocysteine (μmol/L) l | Baker (2009) | 293 | 7.9 | 7.6, 8.2 | |||||||||
Gadowsky (1995) | 50 | 6.1 | 3, 9 | ||||||||||
25OHD (nmol/L) m | Baker (2009) | 263 | ↑33 | 30.4, 35.8 | |||||||||
Chan (2006) | 23 | ↑57 | 48, 67 | ||||||||||
Ginde (2010) | |||||||||||||
McGuire Davies (2010) | 44 | ↑52 | 46, 58 | 36 | ↑56 | 50, 63 | |||||||
O’Brien (2003) | 23 | ↑50 | 41, 60 | ||||||||||
Young (2012) | 171 | ↑54 | 51, 59 |
Biological Marker | Pooled Mean | Confidence Interval | Target Value | Number of studies |
---|---|---|---|---|
Haemoglobin (g/dL) | 112.4 | 95.4–133.8 | 110 | 9 |
25_OH_D (nmol/L) | 55.9 | 6.2–105.7 | 25 | 6 |
Ferritin (μg/L) | 18.2 | 0–48.3 | 15 | 4 |
Haematocrit (g/L) | 32.5 | 28.0–39.4 | 33 | 4 |
Zinc (μmol/L-1) | 11.5 | 5.9–17.1 | 6.12 | 3 |
B12 (pmol/L) | 181.6 | 0–271.1 | 150 | 3 |
Serum Folate (nmol/L) | 12.8 | 0–26.8 | 10 | 2 |
Selenium (μg/L) | 61.8* | 39.2–84.4 | 90 | 2 |
Homocystine (μmol/L) | 7.6 | 0–17.0 | Less than 13 | 2 |