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Ooi KJ, Taylor RM, Fenton S, Hutchesson MJ, Collins CE. Evaluating Validated Diet Quality Indices Used in Pregnant Women in High-Income Countries: A Systematic Review. Nutr Rev 2024:nuae073. [PMID: 38899508 DOI: 10.1093/nutrit/nuae073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/21/2024] Open
Abstract
CONTEXT Diet quality indices (DQIs) assess the level of adherence to dietary recommendations and a specified dietary pattern in populations; however, there is limited evidence regarding the construct criteria and validation methodology of DQIs used in pregnant women. OBJECTIVES The objectives of this study were to (i) identify and describe characteristics of DQIs that have been validated for use in pregnant women in high-income countries, and (ii) evaluate criteria used to develop DQIs and validation methodologies employed. DATA SOURCES CINAHL, Embase, Medline, SCOPUS, and Web of Science were systematically searched for eligible articles published between 1980 and November 2022 that focused on DQIs validated for use in pregnant women from high-income countries. DATA EXTRACTION Characteristics, development criteria, and validation methodologies used in the included articles were extracted by one reviewer and checked by a second reviewer. DATA ANALYSIS A narrative synthesis and descriptive statistics were used to summarize the review findings. Reporting was guided by the Preferred Reporting Items for Systematic Reviews and Meta-analyses statement. RESULTS Six articles with 5 validated DQIs were identified. In total, 3777 participants were included - five articles had pregnant women aged 31-50 years and in their second trimester. Food frequency questionnaires were used as the dietary assessment method in all studies, and 3 DQIs were used to assess dietary intake at 1 time point, using 2 different dietary assessment methods. No indices fulfilled preferred features for the DQI development criteria developed by Burggraf et al (2018). Construct validity was assessed by all DQIs, followed by criterion validity (n = 4) and test-retest reliability (n = 2). CONCLUSION Limited high-quality validated DQIs for use in pregnant women in high-income countries were identified. Scoring for DQI components were not specific to nutrient requirements for pregnant women. Findings from this review may inform the development of DQIs that evaluate specific dietary requirements and specific food safety considerations applicable to pregnancy. SYSTEMATIC REVIEW REGISTRATION https://osf.io/u2hrq.
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Affiliation(s)
- Kee June Ooi
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia
- Food and Nutrition Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
| | - Rachael M Taylor
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia
- Food and Nutrition Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
| | - Sasha Fenton
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia
- Food and Nutrition Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
| | - Melinda J Hutchesson
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia
- Food and Nutrition Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
| | - Clare E Collins
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia
- Food and Nutrition Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
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Mitran AM, Popa AD, Gherasim A, Nita O, Mihalache L, Arhire LI, Gafitanu D, Hancianu M, Cioanca O. Dietary Patterns of Pregnant Women and Their Association with Diet Quality Measures: A Comparative Analysis. Nutrients 2024; 16:1736. [PMID: 38892669 PMCID: PMC11174872 DOI: 10.3390/nu16111736] [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: 04/29/2024] [Revised: 05/27/2024] [Accepted: 05/30/2024] [Indexed: 06/21/2024] Open
Abstract
Healthy dietary patterns during pregnancy are crucial for ensuring maternal and foetal health outcomes. Numerous methodologies exist for assessing the diet of pregnant women, including dietary patterns and various appraisal tools of diet quality. This study aimed to assess the dietary patterns and diet quality of pregnant women and to investigate the relationship between dietary patterns, diet quality estimators, and the adequacy of nutrient intake. EPIC FFQ was applied to a sample of 251 pregnant women, and questionnaires were interpreted with the FETA program. Dietary patterns were then determined by means of principal component analysis. Our results showed a substantial association between dietary patterns and total diet quality, as measured by the Diet Quality Index for Pregnancy (DQI-Pc), PURE Healthy Diet Score, and FIGO Diet Quality Score. We also found correlations between certain dietary patterns and particular nutrient intakes recommended by the European Food Safety Authority during pregnancy. The most deficient intake was registered for iron (86.1%), zinc (87.3%) and magnesium (79.3%), posing a threat to normal bone development, anaemia prophylaxis, and immune status. These results highlight the importance of assessing and understanding eating habits during pregnancy in order to achieve optimal outcomes for both the mother and the foetus.
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Affiliation(s)
- Andreea-Maria Mitran
- Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 16 Universitatii Street, 700115 Iași, Romania;
| | - Alina Delia Popa
- Department of Nursing, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 16 Universitatii Street, 700115 Iași, Romania
| | - Andreea Gherasim
- Department of Internal Medicine II, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 16 Universitatii Street, 700115 Iași, Romania; (A.G.); (O.N.); (L.M.); (L.I.A.)
| | - Otilia Nita
- Department of Internal Medicine II, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 16 Universitatii Street, 700115 Iași, Romania; (A.G.); (O.N.); (L.M.); (L.I.A.)
| | - Laura Mihalache
- Department of Internal Medicine II, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 16 Universitatii Street, 700115 Iași, Romania; (A.G.); (O.N.); (L.M.); (L.I.A.)
| | - Lidia Iuliana Arhire
- Department of Internal Medicine II, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 16 Universitatii Street, 700115 Iași, Romania; (A.G.); (O.N.); (L.M.); (L.I.A.)
| | - Dumitru Gafitanu
- Department Maternal and Child Health, “Grigore T. Popa” University of Medicine and Pharmacy, 16 Universitatii Street, 700115 Iași, Romania;
| | - Monica Hancianu
- Faculty of Pharmacy, “Grigore T. Popa” University of Medicine and Pharmacy, 16 Universitatii Street, 700115 Iași, Romania; (M.H.); (O.C.)
| | - Oana Cioanca
- Faculty of Pharmacy, “Grigore T. Popa” University of Medicine and Pharmacy, 16 Universitatii Street, 700115 Iași, Romania; (M.H.); (O.C.)
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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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4
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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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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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6
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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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7
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Martin K, Shah K, Shrestha A, Barrett E, Shrestha K, Zhang C, Shrestha A, Byham-Gray L, Rawal S. Reproducibility and Relative Validity of a Dietary Screener Adapted for Use among Pregnant Women in Dhulikhel, Nepal. Matern Child Health J 2023; 27:49-58. [PMID: 36167941 PMCID: PMC9869922 DOI: 10.1007/s10995-022-03547-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/09/2022] [Indexed: 01/25/2023]
Abstract
OBJECTIVES Here we examined the reproducibility and validity of a dietary screener which was translated and adapted to assess diet quality among pregnant Nepalese women. METHODS A pilot cohort of singleton pregnant women (N = 101; age 25.9 ± 4.1 years) was recruited from a tertiary, periurban hospital in Nepal. An adapted Nepali version of the PrimeScreen questionnaire, a brief 21-item dietary screener that assesses weekly consumption of 12 healthy and 9 unhealthy food groups, was administered twice, and a month apart, in both the 2nd and 3rd trimesters. Up to four inconsecutive 24-h dietary recalls (24-HDRs) were completed each trimester and utilized as the reference method for validation. For each trimester, data from multiple 24-HDRs were averaged across days, and items were grouped to match the classification and three weekly consumption categories (0-1, 2-3, or 4 + servings/week) of the 21 food groups represented on the PrimeScreen. RESULTS Gwet's agreement coefficients (AC1) were used to evaluate the reproducibility and validity of the adapted PrimeScreen against the 24-HDRs in both the 2nd and 3rd trimester. AC1 indicated good to excellent (≥ 0.6) reproducibility for the majority (85%) of food groups across trimesters. There was moderate to excellent validity (AC1 ≥ 0.4) for all food groups except for fruits and vegetables in the 2nd trimester, and green leafy vegetables and eggs in both the 2nd and 3rd trimesters. CONCLUSIONS The modified PrimeScreen questionnaire appears to be a reasonably valid and reliable instrument for assessing the dietary intake of most food groups among pregnant women in Nepal.
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Affiliation(s)
- Kelly Martin
- Department of Clinical and Preventive Nutrition Sciences, School of Health Professions, Rutgers The State University of New Jersey, 65 Bergen Street. Room 157, Newark, NJ, 07107, USA
- Department of Human Ecology, SUNY Oneonta, Oneonta, NY, USA
| | - Krupali Shah
- Department of Clinical and Preventive Nutrition Sciences, School of Health Professions, Rutgers The State University of New Jersey, 65 Bergen Street. Room 157, Newark, NJ, 07107, USA
| | - Abha Shrestha
- Department of Obstetrics and Gynecology, Dhulikhel Hospital, Dhulikhel, Nepal
| | - Emily Barrett
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Environmental and Occupational Health Sciences Institute, Rutgers The State University of New Jersey, Piscataway, NJ, USA
| | - Kusum Shrestha
- Department of Public Health, Kathmandu University School of Medical Sciences, Dhulikhel, Nepal
| | - Cuilin Zhang
- Eunice Kennedy Shriver National Institute of Child Health and Development, Bethesda, MD, USA
| | - Archana Shrestha
- Department of Public Health, Kathmandu University School of Medical Sciences, Dhulikhel, Nepal
- Department of Chronic Disease and Epidemiology, Center of Methods for Implementation and Prevention Science, Yale School of Public Health, New Haven, CT, USA
- Institute for Implementation Science and Health, Kathmandu, Nepal
| | - Laura Byham-Gray
- Department of Clinical and Preventive Nutrition Sciences, School of Health Professions, Rutgers The State University of New Jersey, 65 Bergen Street. Room 157, Newark, NJ, 07107, USA
| | - Shristi Rawal
- Department of Clinical and Preventive Nutrition Sciences, School of Health Professions, Rutgers The State University of New Jersey, 65 Bergen Street. Room 157, Newark, NJ, 07107, USA.
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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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9
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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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Jacob CM, Hanson M. The preconception period as a platform for preventing diabetes and non‐communicable diseases. PRACTICAL DIABETES 2022. [DOI: 10.1002/pdi.2404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Chandni Maria Jacob
- Institute of Developmental Sciences, School of Human Development and Health, Faculty of Medicine, University of Southampton Southampton UK
| | - Mark Hanson
- Institute of Developmental Sciences, School of Human Development and Health, Faculty of Medicine, University of Southampton Southampton UK
- Southampton NIHR Biomedical Research Centre University Hospital Southampton 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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Hanson MA, McAuliffe FM, Louise Killeen S, Maria Jacob C, Hod M. New guidelines, position paper, and insights from the FIGO Pregnancy Obesity and Nutrition Initiative (PONI). Int J Gynaecol Obstet 2020; 151 Suppl 1:1-3. [PMID: 32894585 DOI: 10.1002/ijgo.13321] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Mark A Hanson
- Institute of Developmental Sciences, University of Southampton, Southampton, UK.,NIHR Southampton Biomedical Research Centre, University Hospital Southampton, Southampton, UK
| | - 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
- Institute of Developmental Sciences, University of Southampton, Southampton, UK.,NIHR Southampton Biomedical Research Centre, University Hospital Southampton, Southampton, UK
| | - Moshe Hod
- Rabin Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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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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Jacob CM, Killeen SL, McAuliffe FM, Stephenson J, Hod M, Diaz Yamal I, Malhotra J, Mocanu E, McIntyre HD, Kihara AB, Ma RC, Divakar H, Kapur A, Ferriani R, Ng E, Henry L, Van Der Spuy Z, Rosenwaks Z, Hanson MA. Prevention of noncommunicable diseases by interventions in the preconception period: A FIGO position paper for action by healthcare practitioners. Int J Gynaecol Obstet 2020; 151 Suppl 1:6-15. [PMID: 32894587 PMCID: PMC7590173 DOI: 10.1002/ijgo.13331] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
With the increase in obesity prevalence among women of reproductive age globally, the risks of type 2 diabetes, gestational diabetes, pre-eclampsia, and other conditions are rising, with detrimental effects on maternal and newborn health. The period before pregnancy is increasingly recognized as crucial for addressing weight management and reducing malnutrition (both under- and overnutrition) in both parents to reduce the risk of noncommunicable diseases (NCDs) in the mother as well as the passage of risk to her offspring. Healthcare practitioners, including obstetricians, gynecologists, midwives, and general practitioners, have an important role to play in supporting women in planning a pregnancy and achieving healthy nutrition and weight before pregnancy. In this position paper, the FIGO Pregnancy Obesity and Nutrition Initiative provides an overview of the evidence for preconception clinical guidelines to reduce the risk of NCDs in mothers and their offspring. It encourages healthcare practitioners to initiate a dialogue on women's health, nutrition, and weight management before conception. While acknowledging the fundamental importance of the wider social and environmental determinants of health, this paper focuses on a simple set of recommendations for clinical practice that can be used even in short consultations. The recommendations can be contextualized based on local cultural and dietary practices as part of a system-wide public health approach to influence the wider determinants as well as individual factors influencing preconception health.
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Affiliation(s)
- Chandni Maria Jacob
- Institute of Developmental SciencesFaculty of MedicineUniversity of SouthamptonSouthamptonUK
- NIHR Southampton Biomedical Research CentreUniversity Hospital SouthamptonSouthamptonUK
| | - Sarah Louise Killeen
- UCD Perinatal Research CentreSchool of MedicineUniversity College DublinNational Maternity HospitalDublinIreland
| | - Fionnuala M. McAuliffe
- UCD Perinatal Research CentreSchool of MedicineUniversity College DublinNational Maternity HospitalDublinIreland
| | - Judith Stephenson
- Elizabeth Garrett Anderson Institute for Women’s HealthUniversity College LondonLondonUK
| | - Moshe Hod
- Mor Comprehensive Women’s Health Care CenterTel AvivIsrael
- FIGO Pregnancy and Non‐Communicable Diseases CommitteeInternational Federation of Gynecology and ObstetricsLondonUK
| | - Ivonne Diaz Yamal
- Faculty of MedicineUniversity Militar Nueva GranadaBogotaColombia
- Fertility Center Procreation Medicamente AsistidaBogotaColombia
- FIGO Committee for Reproductive Medicine, Endocrinology, and InfertilityInternational Federation of Gynecology and ObstetricsLondonUK
| | - Jaideep Malhotra
- Malhotra Nursing and Maternity HomeAgraIndia
- Rainbow HospitalAgraIndia
| | - Edgar Mocanu
- RCSI Department of Reproductive MedicineRotunda HospitalDublinIreland
| | - H. David McIntyre
- Mater ResearchThe University of QueenslandSouth BrisbaneQldAustralia
| | - Anne B. Kihara
- African Federation of Obstetricians and GynaecologistsKhartoumSudan
- Department of Obstetrics and GynecologySchool of MedicineUniversity of NairobiNairobiKenya
| | - Ronald C. Ma
- Department of Medicine and TherapeuticsThe Chinese University of Hong KongHong Kong SARChina
- Hong Kong Institute of Diabetes and ObesityThe Chinese University of Hong KongHong Kong SARChina
| | | | - Anil Kapur
- World Diabetes FoundationBagsværdDenmark
| | - Rui Ferriani
- Ribeirão Preto Medical SchoolHuman Reproduction SectorDepartment of Gynecology and ObstetricsUniversity of São PauloSão PauloBrazil
| | - Ernest Ng
- Department of Obstetrics and GynecologyLi Ka Shing Faculty of MedicineUniversity of Hong KongHong Kong SARChina
| | - Laurie Henry
- Department of Gynecology and ObstetricsCentre de Procréation Médicalement Assistée (CPMA)University of LiègeCHR de la CitadelleLiègeBelgium
| | - Zephne Van Der Spuy
- Department of Obstetrics and GynecologyUniversity of Cape TownGroote Schuur HospitalCape TownSouth Africa
| | - Zev Rosenwaks
- The Ronald O. Perelman and Claudia Cohen Center for Reproductive MedicineWeill Cornell MedicineNew YorkNYUSA
| | - Mark A. Hanson
- Institute of Developmental SciencesFaculty of MedicineUniversity of SouthamptonSouthamptonUK
- NIHR Southampton Biomedical Research CentreUniversity Hospital SouthamptonSouthamptonUK
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