Overnutrition or undernutrition during all or part of the reproductive cycle predisposes sows to metabolic consequences and poor reproductive health which contributes to a decrease in sow longevity and an increase in perinatal mortality. This represents not only an economic problem for the pig industry but also results in poor animal welfare. To maximise profitability and increase sustainability in pig production, it is pivotal to provide researchers and practitioners with synthesised information about the repercussions of maternal obesity or malnutrition on reproductive health and perinatal outcomes, and to pinpoint currently available nutritional managements to keep sows’ body condition in an optimal range. Thus, the present review summarises recent work on the consequences of maternal malnutrition and highlights new findings.

In the present systematic review and meta-analysis, we evaluated the effects of providing piglets with creep feed during lactation on piglet pre- and post-weaning performance. A total of 20 articles met the inclusion criteria. Creep feeding in lactation improved pre-weaning piglet performance in 46% of the studies selected, while 58% of the included studies reported that creep feeding in lactation improved piglet performance during the nursery phase. Creep feeding increased the average piglet body weight (creep = 7.23 ± 0.30, no creep = 6.96 ± 0.31; p = 0.03) and litter weight (creep = 81.2 ± 4.18, no creep = 76.4 ± 4.22; p < 0.001) at weaning. The average piglet body weight and litter weight were positively associated (p < 0.001 and p < 0.001, respectively) with total creep feed intake. Creep feeding of piglets for more than 14 days increased (p = 0.003) the litter weight at weaning compared to litters not provided or provided for shorter periods with creep feed. The present work strengthened the notion that creep feeding during lactation presents opportunities for improving weaning weights and post-weaning piglet performance compared to litters not provided or provided for shorter periods with creep feed.

Modern hyperprolific sows are increasingly susceptible to health challenges. Their rapid growth rates predispose them to locomotor disorders, while high metabolic demands, reduced backfat thickness, and increased protein accretion heighten their vulnerability to heat stress and dystocia. Additionally, prolonged farrowing negatively affects the oxidative and inflammatory status of these females. Additionally, prevalent conditions such as gastric ulcers and cystitis raise ethical, welfare, and economic concerns. Despite the several studies related to sow nutrition, there are no studies which compile and extrapolate nutrition approaches from the rearing period and their impact on sows’ health and longevity. Also, the aim of our review was to shed light on gaps that require further investigation. Controlling body condition scores is crucial for maximizing productivity in sows. During gestation, high-fiber diets help maintain optimal body condition and prevent constipation, particularly during the peripartum period. Antioxidants offer a range of beneficial effects during this critical phase. Additionally, probiotics and acidifiers can enhance gut health and lower the risk of genitourinary infections. On the day of farrowing, energy supplementation emerges as a promising strategy to reduce farrowing duration. Collectively, these strategies address major health challenges, enhancing welfare and promoting sow’s longevity.

Progesterone plays an important role in initial conceptus development and in a successful pregnancy, but results related to progesterone or its analogues (altrenogest) supplementation in early pregnancy of pigs are conflicting. The present study evaluated the effects of altrenogest supplementation in sows during days 6 and 12 of pregnancy on reproductive performance. On day 6 of pregnancy, 301 females were allocated at random to one of the following treatments: CON (Control: non-supplemented females, n = 163) or ALT (females daily supplemented with 20 mg of altrenogest, orally, from day 6 to 12 of pregnancy, n = 138). Ovulation was considered as occurred at 48 h after the first estrus detection to standardize the first day of pregnancy. The supplementation increased the number of total piglets born (ALT: 17.3 ± 0.4; CON: 16.6 ± 0.4), piglets born alive (ALT: 15.6 ± 0.4; CON: 14.8 ± 0.3), and placenta weight (ALT: 4.2 ± 0.1; CON: 3.8 ± 0.1) and decreased the stillbirth rate (ALT: 5.9 ± 0.6; CON: 7.6 ± 0.6) and the number of piglets born weighing less than 800 g (ALT: 6.6 ± 0.6; CON: 8.0 ± 0.6), without impairment on farrowing rate. These results demonstrated that altrenogest supplementation on swine females between days 6 and 12 of pregnancy may be used to improve reproductive performance.