JMIR Publications

ABSTRACT

Background:

Gestational weight gain (GWG) is a crucial determinant of maternal and child outcomes yet remains an underutilized target for antenatal interventions in low- and middle-income countries (LMICs).

Objective:

This systematic review aims to identify and summarize educational, behavioral, nutritional, and medical interventions on GWG from randomized controlled trials conducted in LMICs.

Methods:

Randomized controlled trials that documented the effects of antenatal interventions on GWG in LMICs will be included. The interventions of interest will include educational, behavioral, nutritional, medical, or other types. A systematic literature search will be conducted using PubMed, Embase, Web of Science, CINAHL, and the Cochrane Library from the inception of each database through October 2022 (with an updated search in October 2023). Two team members will independently perform the screening of studies and data extraction. A narrative synthesis of all the included studies will be provided. The risk of bias will be assessed using the Cochrane Risk of Bias tool. The certainty of the evidence for each homogeneous group of interventions will be assessed using the Grading of Recommendation, Assessment, Development, and Evaluation approach. A narrative synthesis of the included studies will be conducted to summarize mean differences (with 95% confidence intervals) for continuous outcomes and risk ratios, rate ratios, hazard ratios, or odds ratios (with 95% confidence intervals) for dichotomous or categorical outcomes. Available information on the costs of interventions will also be summarized to facilitate the adoption and scale-up of effective GWG interventions.

Results:

The development of the research questions, search strategy, and search protocol was started on September 20, 2022. The database searches and the importation of the identified records into Covidence were performed on October 7, 2023. As of April 2023, the title and abstract screening was ongoing. The target completion time of this systematic review is April 2024.

Conclusions:

Without effective interventions to manage GWG, the potential to improve maternal and child health through optimal GWG remains unrealized in LMICs. This systematic review will inform the design and implementation of antenatal interventions to prevent inadequate and excessive GWG in resource-limited settings. Clinical Trial: This protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO). The registration ID is CRD42022366354.