Among the interventions that have been tested by randomized clinical trials to prevent IUGR, balanced energy protein supplementation has been shown to reduce the risk of SGA by approximately 30%. On the basis of these results, it has been proposed that universal balanced energy supplementation should be provided to women in areas with a high prevalence of maternal undernutrition to prevent impaired fetal growth. There is evidence that magnesium supplementation and calcium supplementation may be effective, even though for the latter it is not clear if the observed effect on low birthweight is due to a direct effect on fetal growth or mediated by a prolongation of gestational age at delivery. Other interventions, such as nutritional advice, energy protein restriction, salt restriction, iron and/or folate supplementation, fish oil supplementation, zinc supplementation, and vitamins E, C, and D supplementation, did not show any effect in preventing IUGR. Interestingly, high protein supplementation in women of low socioeconomic status in the United States has been associated with an increase in the rate of SGA infants, suggesting that nutritional supplementation may, in some cases, have potentially harmful effects.
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