Maternal nutrient supplementation for suspected impaired fetal growth

Too little evidence to show whether extra carnitine, solcoseryl, glucose or galactose for pregnant women benefits babies in the womb who are smaller than expected.

Babies growing more slowly than expected in the womb (impaired fetal growth) may be receiving too few nutrients from their mothers. Some nutrients thought to improve an unborn baby's growth include carnitine (amino acid which releases energy from fat), solcoseryl (protein-free calf blood extract), glucose and galactose (fruit, meat and milk sugars). The review of four trials, involving 165 women, found that there is too little evidence to show whether the baby's growth improves when a pregnant woman supplements her intake of these nutrients by mouth or injection. More research is needed into the effects of pregnant women supplementing their diets with these nutrients.

Authors' conclusions: 

There is not enough evidence to evaluate the use of nutrient therapy for suspected impaired fetal growth. The studies were too small to assess clinical outcomes adequately.

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Background: 

One way of attempting to improve fetal growth has been nutrient supplementation for the mother when fetal growth is impaired. Different nutrients such as carbohydrates and amino acids have been suggested as treatments for impaired fetal growth.

Objectives: 

The objective of this review was to assess the effects of nutrient administration for suspected fetal growth impairment on fetal growth and perinatal outcome.

Search strategy: 

We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (March 2010).

Selection criteria: 

Acceptably controlled trials of nutrient administration for suspected impaired fetal growth compared to placebo or no treatment.

Data collection and analysis: 

We assessed trial quality.

Main results: 

Four studies, involving 165 women, were included. The trials were small or had methodological limitations, or both. Carnite was associated with shorter pregnancy duration after enrolment (mean difference -2.12, 95% confidence interval -3.58 to -0.66 weeks). Intraamniotic administration of nutrients was related to higher birthweight (2575 g, standard deviation (SD) 780) as compared to intravenous administration (2080 g SD 457). No other differences were found.

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