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Salazar N, Ortiz F, Edie A, Miller A. Clinicians Address Gestational Weight Gain and Nutrition Using the International Federation of Gynecology and Obstetrics (FIGO) Nutrition Checklist. J Midwifery Womens Health 2024; 69:422-426. [PMID: 38766896 DOI: 10.1111/jmwh.13646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 04/19/2024] [Indexed: 05/22/2024]
Abstract
The negative effects of excessive gestational weight gain (GWG) and obesity during pregnancy are well documented in the literature. However, lack of time, education, comfort, and confidence among health care providers often make it difficult to provide proper nutrition and weight gain guidance for pregnant persons. In response, the International Federation of Gynecology and Obstetrics (FIGO) has developed a nutrition checklist that can standardize recommendations for GWG, facilitate discussions with pregnant persons, and aid providers with nutrition education. The checklist is an innovative tool that can help reduce complications associated with excessive GWG. This article discusses the benefits of FIGO Nutrition Checklist and its implementation at a midwifery clinic that primarily serves Native American women. By using this quick, simple, guided, time-efficient tool, clinics can be successful in facilitating important conversations and education about nutrition and GWG during pregnancy.
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Affiliation(s)
| | - Felina Ortiz
- University of New Mexico School of Nursing, Albuquerque, New Mexico
| | - Alison Edie
- Duke University School of Nursing, Durham, North Carolina
| | - Anne Miller
- San Juan Regional Medical Center, Farmington, New Mexico
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2
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Cetin I, Carlson SE, Burden C, da Fonseca EB, di Renzo GC, Hadjipanayis A, Harris WS, Kumar KR, Olsen SF, Mader S, McAuliffe FM, Muhlhausler B, Oken E, Poon LC, Poston L, Ramakrishnan U, Roehr CC, Savona-Ventura C, Smuts CM, Sotiriadis A, Su KP, Tribe RM, Vannice G, Koletzko B. Omega-3 fatty acid supply in pregnancy for risk reduction of preterm and early preterm birth. Am J Obstet Gynecol MFM 2024; 6:101251. [PMID: 38070679 DOI: 10.1016/j.ajogmf.2023.101251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 12/03/2023] [Accepted: 12/04/2023] [Indexed: 01/14/2024]
Abstract
This clinical practice guideline on the supply of the omega-3 docosahexaenoic acid and eicosapentaenoic acid in pregnant women for risk reduction of preterm birth and early preterm birth was developed with support from several medical-scientific organizations, and is based on a review of the available strong evidence from randomized clinical trials and a formal consensus process. We concluded the following. Women of childbearing age should obtain a supply of at least 250 mg/d of docosahexaenoic+eicosapentaenoic acid from diet or supplements, and in pregnancy an additional intake of ≥100 to 200 mg/d of docosahexaenoic acid. Pregnant women with a low docosahexaenoic acid intake and/or low docosahexaenoic acid blood levels have an increased risk of preterm birth and early preterm birth. Thus, they should receive a supply of approximately 600 to 1000 mg/d of docosahexaenoic+eicosapentaenoic acid, or docosahexaenoic acid alone, given that this dosage showed significant reduction of preterm birth and early preterm birth in randomized controlled trials. This additional supply should preferably begin in the second trimester of pregnancy (not later than approximately 20 weeks' gestation) and continue until approximately 37 weeks' gestation or until childbirth if before 37 weeks' gestation. Identification of women with inadequate omega-3 supply is achievable by a set of standardized questions on intake. Docosahexaenoic acid measurement from blood is another option to identify women with low status, but further standardization of laboratory methods and appropriate cutoff values is needed. Information on how to achieve an appropriate intake of docosahexaenoic acid or docosahexaenoic+eicosapentaenoic acid for women of childbearing age and pregnant women should be provided to women and their partners.
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Affiliation(s)
- Irene Cetin
- Fondazione IRCCS, Ospedale Maggiore Policlinico, University of Milan, Milan, Italy (Dr Cetin)
| | - Susan E Carlson
- Department of Dietetics and Nutrition, University of Kansas Medical Center, Kansas City, KS (Dr Carlson)
| | - Christy Burden
- Academic Women's Health Unit, Bristol Medical School: Translational Health Sciences, University of Bristol, Bristol, United Kingdom (Dr Burden)
| | - Eduardo B da Fonseca
- Department of Obstetrics and Gynaecology, Federal University of Paraíba, João Pessoa, Brazil (Dr da Fonseca)
| | - Gian Carlo di Renzo
- Centre of Perinatal and Reproductive Medicine, University of Perugia, Perugia, Italy (Dr di Renzo); PREIS School, Florence, Italy (Dr di Renzo)
| | - Adamos Hadjipanayis
- School of Medicine, European University Cyprus, Nicosia, Cyprus (Dr Hadjipanayis); European Academy of Paediatrics, Brussels, Belgium (Dr Hadjipanayis)
| | - William S Harris
- Fatty Acid Research Institute, Sioux Falls, SD (Dr Harris); Department of Internal Medicine, Sanford School of Medicine, University of South Dakota, Sioux Falls, SD (Dr Harris)
| | - Kishore R Kumar
- Cloudnine Hospitals, Bangalore, India (Dr Kumar); University of Notre Dame Australia, Perth, Australia (Dr Kumar)
| | - Sjurdur Frodi Olsen
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark (Dr Olsen); Department of Public Health, University of Copenhagen, Copenhagen, Denmark (Dr Olsen); Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA (Dr Olsen)
| | - Silke Mader
- European Foundation for the Care of Newborn Infants, Munich, Germany (Ms Mader)
| | - Fionnuala M McAuliffe
- UCD Perinatal Research Centre, National Maternity Hospital, University College Dublin, Dublin, Ireland (Dr McAuliffe)
| | - Beverly Muhlhausler
- Health and Biosecurity, Commonwealth Scientific and Industrial Research Organisation, Canberra, Australia (Dr Muhlhausler); School of Agriculture, Food and Wine, University of Adelaide, Adelaide, Australia (Dr Muhlhausler); South Australian Health and Medical Research Institute, Adelaide, Australia (Dr Muhlhausler)
| | - Emily Oken
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA (Dr Oken)
| | - Liona C Poon
- Maternal Medicine, Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Hong Kong, China (Dr Poon); Department of Women and Children's Health, King's College London, London, United Kingdom (Dr Poon)
| | - Lucilla Poston
- School of Life Course and Population Sciences, King's College London, London, United Kingdom (Dr Poston); International Society for Developmental Origins of Health and Disease (Dr Poston)
| | - Usha Ramakrishnan
- Hubert Department of Global Health, Emory University, Atlanta, GA (Dr Ramakrishnan); Doctoral Program in Nutrition and Health Sciences, Laney Graduate School, Emory University, Atlanta, GA (Dr Ramakrishnan)
| | - Charles C Roehr
- National Perinatal Epidemiology Unit, Clinical Trials Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom (Dr Roehr); Faculty of Health Sciences, University of Bristol, Bristol, United Kingdom (Dr Roehr); Newborn Care, Women and Children's Division, Southmead Hospital, Bristol, United Kingdom (Dr Roehr); European Society for Paediatric Research, Satigny, Switzerland (Dr Roehr)
| | - Charles Savona-Ventura
- Department of Obstetrics & Gynaecology, Mater Dei Hospital, University of Malta Medical School, Msida, Malta (Dr Savona-Ventura); Centre for Traditional Chinese Medicine & Culture, University of Malta, Msida, Malta (Dr Savona-Ventura)
| | - Cornelius M Smuts
- Centre of Excellence for Nutrition, North-West University, Potchefstroom, South Africa (Dr Smuts)
| | - Alexandros Sotiriadis
- Second Department of Obstetrics and Gynecology, Faculty of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece (Dr Sotiriadis)
| | - Kuan-Pin Su
- Mind-Body Interface Research Center (MBI-Lab), China Medical University Hospital, Taichung, Taiwan (Dr Su); An-Nan Hospital, China Medical University, Tainan, Taiwan (Dr Su); College of Medicine, China Medical University, Taichung, Taiwan (Dr Su)
| | - Rachel M Tribe
- Department of Women and Children's Health, School of Life Course and Population Sciences, King's College London, St Thomas' Hospital, London, United Kingdom (Dr Tribe)
| | | | - Berthold Koletzko
- Dr. von Hauner Children's Hospital, Ludwig Maximilian University of Munich Hospital, Munich, Germany (Dr Koletzko); Child Health Foundation (Stiftung Kindergesundheit), Munich, Germany (Dr Koletzko); European Academy of Paediatrics, Brussels, Belgium (Dr Koletzko).
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Zhang Y, Gao X, Zhu H, Sun S, Contento IR, Koch PA, Yu H. Lipid-focused dietary education intervention in pregnant women: study protocol for an open-label, parallel, randomised, intervention study addressing adverse pregnancy outcomes in China. BMJ Open 2024; 14:e076911. [PMID: 38176858 PMCID: PMC10773410 DOI: 10.1136/bmjopen-2023-076911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 12/04/2023] [Indexed: 01/06/2024] Open
Abstract
INTRODUCTION The incidence of infants who are large-for-gestational-age (LGA) is on the rise in China, and its detrimental effects on health have received increasing attention. Diet-based interventions have the potential to reduce adverse birth outcomes, particularly in decreasing the occurrence of LGA infants. We aim to evaluate the effect of lipid-focused diet education based on the theories of behaviour change in pregnant women on maternal and offspring outcomes through a randomised controlled trial. METHODS AND ANALYSIS We have designed an open-label, parallel, multicentre randomised controlled trial in collaboration with three hospitals in Beijing, China.Pregnant women will be recruited before reaching 12 weeks of gestation and will be randomised in a 1:1:1 ratio into three arms: (1) online education arm, (2) pregnancy nutrition checklist and 'one-page flyer' arm and (3) routine antenatal education. The primary outcome LGA will be recorded at birth. Demographic information, physical activity, sleep and medical history will be collected through questionnaires and case cards prior to enrolment. Questionnaires will also be used to collect dietary behaviours and psychosocial factors of pregnant women at enrolment, at 24-28 weeks and 34-36 weeks of gestation. Additionally, information on breastfeeding and complementary food supplementation for infants and young children will be obtained through questionnaires. Physical development indicators of children and taste tests will be assessed 3 years after delivery. ETHICS AND DISSEMINATION The study has received ethical approval from the Capital Medical University Ethics Committee and other collaborating study centres. Informed consent will be introduced to pregnant women, and their consent will be obtained. The findings will be reported in relevant national and international academic conferences and peer-reviewed publications. TRIAL REGISTRATION NUMBER ChiCTR2300071126.
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Affiliation(s)
- Yadi Zhang
- School of Public Health, Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, China
| | - Xiaoge Gao
- Program in Nutrition, Department of Health Studies & Applied Educational Psychology, Teachers College, Columbia University, New York city, New York, USA
| | - Haiyan Zhu
- Department of Obstetrics and Gynecology, Capital Medical University, Beijing, China
| | - Shengzhi Sun
- School of Public Health, Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, China
| | - Isobel R Contento
- Program in Nutrition, Department of Health Studies & Applied Educational Psychology, Teachers College, Columbia University, New York city, New York, USA
| | - Pamela Ann Koch
- Program in Nutrition, Department of Health Studies & Applied Educational Psychology, Teachers College, Columbia University, New York city, New York, USA
| | - Huanling Yu
- School of Public Health, Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, China
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Grammatikopoulou MG, Nigdelis MP, Haidich AB, Kyrezi M, Ntine H, Papaioannou M, Mintziori G, Bogdanos DP, Mavromatidis G, Goulis DG. Diet Quality and Nutritional Risk Based on the FIGO Nutrition Checklist among Greek Pregnant Women: A Cross-Sectional Routine Antenatal Care Study. Nutrients 2023; 15:2019. [PMID: 37432147 DOI: 10.3390/nu15092019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 04/16/2023] [Accepted: 04/19/2023] [Indexed: 07/12/2023] Open
Abstract
The International Federation of Gynecology and Obstetrics (FIGO) nutrition checklist is a tool for everyday antenatal clinical practice, easy to use by most healthcare professionals, aiming to initiate a conversation regarding gestational weight gain (GWG) and nutrition and identify women who might require further assessment. The present cross-sectional study aimed to apply the FIGO nutrition checklist to pregnant women attending routine antenatal care and identify nutritional risk factors. Pregnant women (n = 200) were recruited from the outpatient pregnancy clinics of two hospitals in Thessaloniki and completed the checklist. The FIGO-diet quality score and the FIGO-nutritional risk score (NRS) were calculated. The results revealed that 99% of the women exhibited at least one nutritional risk factor based on the checklist. The median FIGO diet quality score of the sample was 4.0 (3.0-5.0), with 95% of the participants responding negatively to at least one question, indicating the need for improving diet quality. Improved diet quality was noted in cases of hyperemesis gravidarum and among those receiving vitamin D supplements. A large percentage of the participants (36%) exhibited five or more nutritional risk factors, as indicated by a total FIGO-NRS below 5. Women with low middle-upper arm circumference, indicative of protein-energy malnutrition (20.6% of the sample), exhibited more nutritional risk factors compared with the rest. On the other hand, being in the third trimester of pregnancy was associated with lower nutritional risk and, subsequently, better diet quality.
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Affiliation(s)
- Maria G Grammatikopoulou
- Unit of Immunonutrition and Clinical Nutrition, Department of Rheumatology and Clinical Immunology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Biopolis, GR-41110 Larissa, Greece
| | - Meletios P Nigdelis
- Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Papageorgiou General Hospital, Aristotle University of Thessaloniki, GR-56403 Thessaloniki, Greece
- Klinik für Frauenheilkunde, Geburtshilfe und Reproduktionsmedizin, Universitätsklinikum des Saarlandes, Gebäude 9, Kirrberger Straße, DE-66421 Homburg, Germany
| | - Anna-Bettina Haidich
- Department of Hygiene, Social-Preventive Medicine & Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, University Campus, GR-54124 Thessaloniki, Greece
| | - Maria Kyrezi
- Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Papageorgiou General Hospital, Aristotle University of Thessaloniki, GR-56403 Thessaloniki, Greece
| | - Helga Ntine
- 2nd Academic Department of Obstetrics and Gynaecology, Hippokration General Hospital, Aristotle University of Thessaloniki, 49 Konstantinoupoleos Street, GR-54642 Thessaloniki, Greece
| | - Maria Papaioannou
- 2nd Academic Department of Obstetrics and Gynaecology, Hippokration General Hospital, Aristotle University of Thessaloniki, 49 Konstantinoupoleos Street, GR-54642 Thessaloniki, Greece
| | - Gesthimani Mintziori
- Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Papageorgiou General Hospital, Aristotle University of Thessaloniki, GR-56403 Thessaloniki, Greece
| | - Dimitrios P Bogdanos
- Unit of Immunonutrition and Clinical Nutrition, Department of Rheumatology and Clinical Immunology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Biopolis, GR-41110 Larissa, Greece
| | - George Mavromatidis
- 2nd Academic Department of Obstetrics and Gynaecology, Hippokration General Hospital, Aristotle University of Thessaloniki, 49 Konstantinoupoleos Street, GR-54642 Thessaloniki, Greece
| | - Dimitrios G Goulis
- Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Papageorgiou General Hospital, Aristotle University of Thessaloniki, GR-56403 Thessaloniki, Greece
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5
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Balsarkar G. Pregnancy as an Opportunity to the Obstetricians to Improve Long-Term Maternal Health. J Obstet Gynaecol India 2023; 73:1-2. [PMID: 37063474 PMCID: PMC9984658 DOI: 10.1007/s13224-023-01741-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 01/17/2023] [Indexed: 02/04/2023] Open
Affiliation(s)
- Geetha Balsarkar
- Seth G.S. Medical College, Nowrosjee Wadia Maternity Hospital, Mumbai, India
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6
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McAuliffe FM. Impact of pregnancy on long-term health: Advances in postpregnancy care-An opportunity to improve long-term maternal health. Int J Gynaecol Obstet 2023; 160 Suppl 1:4-6. [PMID: 36635076 DOI: 10.1002/ijgo.14536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Affiliation(s)
- Fionnuala M McAuliffe
- UCD Perinatal Research Centre, School of Medicine, National Maternity Hospital, University College Dublin, Dublin, Ireland.,FIGO Committee on Impact of Pregnancy on Long-Term Health, FIGO, London, UK
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7
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Soepnel LM, Draper CE, Mabetha K, Mogashoa L, Mabena G, McAuliffe FM, Killeen SL, Jacob CM, Hanson MA, Norris SA. Evaluating implementation of the FIGO Nutrition Checklist for preconception and pregnancy within the Bukhali trial in Soweto, South Africa. Int J Gynaecol Obstet 2023; 160 Suppl 1:68-79. [PMID: 36635078 PMCID: PMC10107177 DOI: 10.1002/ijgo.14541] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
OBJECTIVE To evaluate implementation of the FIGO Nutrition Checklist in a low/middle-income South African setting. METHODS This is a mixed-methods study. Following administration of the FIGO Nutrition Checklist by a dietitian between July 2021 and May 2022, quantitative responses from pregnant (n = 96) and nonpregnant (n = 291) participants with overweight or obesity were analyzed, using logistic regression. Qualitative data from in-depth interviews with the dietitian and a subgroup of participants (n = 15) were analyzed using reflexive thematic analysis. RESULTS Of 387 participants, 97.4% (n = 377) answered 'no' to at least one diet quality question on the FIGO Nutrition Checklist, indicative of an at-risk dietary practice. Food insecurity was positively associated with having more than three at-risk practices (OR 1.87; 95% CI, 1.10-3.18; P = 0.021). Themes from the dietitian interview included ease of use of the checklist; required adaptations to it, including explanation and translation; and benefits of the tool. Despite challenges to healthy nutrition, participant interviews identified that the checklist is acceptable and supported improved awareness of dietary intakes. CONCLUSION Considering the high incidence of at-risk dietary practices identified by the FIGO Nutrition Checklist in this population, further research into use of the tool across South African healthcare settings is warranted.
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Affiliation(s)
- Larske M Soepnel
- SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Pediatrics, Faculty of Health Sciences, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa.,Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Catherine E Draper
- SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Pediatrics, Faculty of Health Sciences, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
| | - Khuthala Mabetha
- SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Pediatrics, Faculty of Health Sciences, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
| | - Lethabo Mogashoa
- SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Pediatrics, Faculty of Health Sciences, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
| | - Gugulethu Mabena
- SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Pediatrics, Faculty of Health Sciences, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
| | - Fionnuala M McAuliffe
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland
| | - Sarah Louise Killeen
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland
| | - Chandni Maria Jacob
- School of Human Development and Health, University of Southampton, Southampton, UK.,NIHR Southampton Biomedical Research Centre, University Hospital Southampton, Southampton, UK
| | - Mark A Hanson
- School of Human Development and Health, University of Southampton, Southampton, UK.,NIHR Southampton Biomedical Research Centre, University Hospital Southampton, Southampton, UK
| | - Shane A Norris
- SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Pediatrics, Faculty of Health Sciences, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa.,School of Human Development and Health, University of Southampton, Southampton, UK
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8
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Killeen SL, Donnellan N, O'Reilly SL, Hanson MA, Rosser ML, Medina VP, Jacob CM, Divakar H, Hod M, Poon LC, Bergman L, O'Brien P, Kapur A, Jacobsson B, Maxwell CV, McIntyre HD, Regan L, Algurjia E, Ma RC, Adam S, McAuliffe FM. Using FIGO Nutrition Checklist counselling in pregnancy: A review to support healthcare professionals. Int J Gynaecol Obstet 2023; 160 Suppl 1:10-21. [PMID: 36635083 PMCID: PMC10108324 DOI: 10.1002/ijgo.14539] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
The period before and during pregnancy is increasingly recognized as an important stage for addressing malnutrition. This can help to reduce the risk of noncommunicable diseases in mothers and passage of risk to their infants. The FIGO Nutrition Checklist is a tool designed to address these issues. The checklist contains questions on specific dietary requirements, body mass index, diet quality, and micronutrients. Through answering these questions, awareness is generated, potential risks are identified, and information is collected that can inform health-promoting conversations between women and their healthcare professionals. The tool can be used across a range of health settings, regions, and life stages. The aim of this review is to summarize nutritional recommendations related to the FIGO Nutrition Checklist to support healthcare providers using it in practice. Included is a selection of global dietary recommendations for each of the components of the checklist and practical insights from countries that have used it. Implementation of the FIGO Nutrition Checklist will help identify potential nutritional deficiencies in women so that they can be addressed by healthcare providers. This has potential longstanding benefits for mothers and their children, across generations.
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Affiliation(s)
- Sarah Louise Killeen
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland
| | - Niamh Donnellan
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland
| | - Sharleen L O'Reilly
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland.,School of Agriculture and Food Science, University College Dublin, Dublin, Ireland
| | - Mark A Hanson
- Institute of Developmental Sciences, University Hospital Southampton, Southampton, UK.,NIHR Southampton Biomedical Research Centre, University of Southampton, Southampton, UK
| | - Mary L Rosser
- Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York, New York, USA
| | - Virna P Medina
- Department of Obstetrics and Gynecology, Faculty of Health, Universidad del Valle, Clínica Imbanaco Quirón Salud, Universidad Libre, Cali, Colombia
| | - Chandni Maria Jacob
- Institute of Developmental Sciences, University Hospital Southampton, Southampton, UK.,NIHR Southampton Biomedical Research Centre, University of Southampton, Southampton, UK
| | | | - Moshe Hod
- Helen Schneider Hospital for Women, Rabin Medical Center, Petah Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Liona C Poon
- Department of Obstetrics and Gynecology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Lina Bergman
- Department of Obstetrics and Gynecology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Obstetrics and Gynecology, Stellenbosch University, Cape Town, South Africa.,Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Patrick O'Brien
- Institute for Women's Health, University College London, London, UK
| | - Anil Kapur
- World Diabetes Foundation, Bagsvaerd, Denmark
| | - Bo Jacobsson
- Department of Obstetrics and Gynecology, Sahlgrenska University Hospital, Gothenburg, Sweden.,Department of Genetics and Bioinformatics, Domain of Health Data and Digitalization, Institute of Public Health, Oslo, Norway
| | - Cynthia V Maxwell
- Maternal Fetal Medicine, Sinai Health and Women's College Hospital, University of Toronto, Toronto, Canada
| | - Harold David McIntyre
- Mater Health, University of Queensland, Mater Health Campus, South Brisbane, Queensland, Australia
| | | | - Esraa Algurjia
- The World Association of Trainees in Obstetrics & Gynecology, Paris, France.,Elwya Maternity Hospital, Baghdad, Iraq
| | - Ronald C Ma
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China.,Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Sumaiya Adam
- Department of Obstetrics and Gynecology, School of Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.,Diabetes Research Centre, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Fionnuala M McAuliffe
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland
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Jacob CM, Inskip HM, Lawrence W, McGrath C, McAuliffe FM, Killeen SL, Divakar H, Hanson M. Acceptability of the FIGO Nutrition Checklist in Preconception and Early Pregnancy to Assess Nutritional Status and Prevent Excess Gestational Weight Gain: A Study of Women and Healthcare Practitioners in the UK. Nutrients 2022; 14:nu14173623. [PMID: 36079880 PMCID: PMC9460608 DOI: 10.3390/nu14173623] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 08/24/2022] [Accepted: 08/30/2022] [Indexed: 11/16/2022] Open
Abstract
Optimum nutrition and weight before and during pregnancy are associated with a lower risk of conditions such as pre-eclampsia and gestational diabetes. There is a lack of user-friendly tools in most clinical settings to support healthcare practitioners (HCPs) in implementing them. This study aimed to evaluate the acceptability of (1) using a nutrition checklist designed by the International Federation of Gynecology and Obstetrics (FIGO) for nutritional screening of women in the preconception and early pregnancy period and (2) routine discussion of nutrition and weight in clinical care. An online cross-sectional survey was conducted with women (aged 18-45) and HCPs (e.g., general practitioners, obstetricians, and midwives). Quantitative statistical analysis and qualitative content analysis were performed. The concept and content of the checklist were acceptable to women (n = 251) and HCPs (n = 47) (over 80% in both groups). Several barriers exist to implementation such as lack of time, training for HCPs, and the need for sensitive and non-stigmatizing communication. Routine discussion of nutrition was considered important by both groups; however, results suggest that nutrition is not regularly discussed in perinatal visits in the UK. The FIGO nutrition checklist presents a valuable resource for use in clinical practice, offering long-term and intergenerational benefits for both mother and baby.
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Affiliation(s)
- Chandni Maria Jacob
- Institute of Developmental Sciences, School of Human Development and Health, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, University of Southampton, Southampton SO16 6YD, UK
- Correspondence:
| | - Hazel M. Inskip
- Medical Research Council Lifecourse Epidemiology Centre, University of Southampton, Southampton SO16 6YD, UK
| | - Wendy Lawrence
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, University of Southampton, Southampton SO16 6YD, UK
- Medical Research Council Lifecourse Epidemiology Centre, University of Southampton, Southampton SO16 6YD, UK
| | - Carmel McGrath
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, University of Southampton, Southampton SO16 6YD, UK
- School of Human Development and Health, Faculty of Medicine, University of Southampton, Southampton SO17 1BJ, UK
| | - Fionnuala M. McAuliffe
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, D02 YH21 Dublin, Ireland
| | - Sarah Louise Killeen
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, D02 YH21 Dublin, Ireland
| | - Hema Divakar
- Divakar’s Specialty Hospital, Bengaluru 560078, India
| | - Mark Hanson
- Institute of Developmental Sciences, School of Human Development and Health, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, University of Southampton, Southampton SO16 6YD, UK
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Abstract
The present paper outlines current issues in the nutritional care of women during pregnancy and potential resources to address them. Globally, overnutrition, undernutrition and nutritional imbalances are widespread among women of reproductive age; increasing the risk of pregnancy complications and non-communicable diseases in both mothers and their children. Most women do not meet dietary guidelines for pregnancy. The World Health Organisation (WHO) recommends nutrition and weight counselling during pregnancy for all women. However, clinical practices focusing on nutrition vary and there is no consensus on which outcomes are most important for pregnancy nutrition interventions, with little consideration for the 'patient voice'. The International Federation of Gynaecology and Obstetrics (FIGO) nutrition checklist is a clinical practice tool that is available for healthcare professionals that will address this issue. The pregnancy nutrition core outcome set will also support advancement of antenatal nutrition by identifying the most critical nutrition-related outcomes from the perspective of healthcare professionals, researchers and women with experience of pregnancy. While poor nutrition can result in adverse outcomes across women of all weight categories, those with obesity may require specialist care to reduce their risk. Obesity is a chronic, progressive, relapsing disease that has high individual variability in its prognosis. The use of obesity staging systems, which consider mental, physical and functional health, can stratify individuals into risk categories and aid in treatment prioritisation in pregnancy. As the prevalence of obesity continues to rise, an obesity staging approach may support clinicians, especially those in limited resource settings.
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McAuliffe FM, Killeen SL, Jacob CM, Hanson MA, Hadar E, McIntyre HD, Kapur A, Kihara AB, Ma RC, Divakar H, Hod M. Management of prepregnancy, pregnancy, and postpartum obesity from the FIGO Pregnancy and Non-Communicable Diseases Committee: A FIGO (International Federation of Gynecology and Obstetrics) guideline. Int J Gynaecol Obstet 2020; 151 Suppl 1:16-36. [PMID: 32894590 PMCID: PMC7590083 DOI: 10.1002/ijgo.13334] [Citation(s) in RCA: 57] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Fionnuala M McAuliffe
- UCD Perinatal Research Centre, School of Medicine, National Maternity Hospital, University College Dublin, Dublin, Ireland
| | - Sarah Louise Killeen
- UCD Perinatal Research Centre, School of Medicine, National Maternity Hospital, University College Dublin, Dublin, Ireland
| | - Chandni Maria Jacob
- Institute of Developmental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.,NIHR Southampton Biomedical Research Centre, University Hospital Southampton, Southampton, UK
| | - Mark A Hanson
- Institute of Developmental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.,NIHR Southampton Biomedical Research Centre, University Hospital Southampton, Southampton, UK
| | - Eran Hadar
- Maternal-Fetal Medicine Unit, Rabin Medical Center, Petach-Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel
| | - H David McIntyre
- Mater Research, The University of Queensland, South Brisbane, Qld, Australia
| | - Anil Kapur
- World Diabetes Foundation, Bagsvaerd, Denmark
| | - Anne B Kihara
- African Federation of Obstetricians and Gynaecologists, Khartoum, Sudan.,Department of Obstetrics and Gynecology, School of Medicine, University of Nairobi, Nairobi, Kenya
| | - Ronald C Ma
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, China.,Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Hong Kong SAR, China
| | | | - Moshe Hod
- Mor Comprehensive Women's Health Care Center, Tel Aviv, Israel.,FIGO Pregnancy and Non-Communicable Diseases Committee, International Federation of Gynecology and Obstetrics, London, UK
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