Toggle Main Menu Toggle Search

Open Access padlockePrints

The effectiveness of smoking cessation, alcohol reduction, diet and physical activity interventions in improving maternal and infant health outcomes: A systematic review of meta-analyses

Lookup NU author(s): Dr Louise HayesORCiD, Catherine McParlin, Dr James Newham, Dr Nicola HeslehurstORCiD



This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


© 2021 by the authors. Licensee MDPI, Basel, Switzerland. Diet, physical activity, smoking and alcohol behaviour-change interventions delivered in pregnancy aim to prevent adverse pregnancy outcomes. This review reports a synthesis of evidence from meta-analyses on the effectiveness of interventions at reducing risk of adverse health outcomes. Sixty-five systematic reviews (63 diet and physical activity; 2 smoking) reporting 602 meta-analyses, published since 2011, were identified; no data were identified for alcohol interventions. A wide range of outcomes were reported, including gestational weight gain, hypertensive disorders, gestational diabetes (GDM) and fetal growth. There was consistent evidence from diet and physical activity interventions for a significantly reduced mean gestational weight gain (ranging from -0.21 kg (95% confidence interval -0.34, -0.08) to -5.77 kg (95% CI -9.34, -2.21). There was evidence from larger diet and physical activity meta-analyses for a significant reduction in postnatal weight retention, caesarean delivery, preeclampsia, hypertension, GDM and preterm delivery, and for smoking interventions to significantly increase birth weight. There was no statistically significant evidence of interventions having an effect on low or high birthweight, neonatal intensive care unit admission, Apgar score or mortality outcomes. Priority areas for future research to capitalise on pregnancy as an opportunity to improve the lifelong wellbeing of women and their children are highlighted.

Publication metadata

Author(s): Hayes L, McParlin C, Azevedo LB, Jones D, Newham J, Olajide J, McCleman L, Heslehurst N

Publication type: Review

Publication status: Published

Journal: Nutrients

Year: 2021

Volume: 13

Issue: 3

Online publication date: 23/03/2021

Acceptance date: 19/03/2021

ISSN (electronic): 2072-6643

Publisher: MDPI AG


DOI: 10.3390/nu13031036