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Silva TPRD, Viana TGF, Duarte CK, Inácio MLC, Velasquez-Melendez G, Pessoa MC, Mendes LL, Matozinhos FP. Environmental factors associated with excessive gestational weight gain: a meta-analysis and systematic review. CIENCIA & SAUDE COLETIVA 2023; 28:171-180. [PMID: 36629562 DOI: 10.1590/1413-81232023281.14432021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 07/29/2022] [Indexed: 01/11/2023] Open
Abstract
The aim is, systematically examine the scientific evidences that associated environmental factors (environment, social environment, environmental planning and spatial population distribution) with the excessive gestational weight gain. A meta-analysis and systematic review carried out as per the Cochrane Handbook recommendations and following the steps recommended by the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes. The inclusion studies were done with the following PECO criteria: P-pregnant women, E-environmental factors, O-weight gain. The search procedure was conducted on the databases EMBASE, Web of Science, Cinahl, LILACS and MEDLINE (PubMed). The relationship between the socioeconomic factors of the micro-region of residence and gestational weight gain was evidenced by the linkage between residing in high-poverty neighborhoods and inadequate gestational weight gain. This study revealed the higher prevalence of excessive gestational weight gain in pregnant women those lives in urban areas. Environmental factors of the pregnant women's residence area implicated in the excessive gestational weight gain. Our findings can therefore contribute to the development of public policies to prevent inadequate gestational weight gain.
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Affiliation(s)
- Thales Philipe Rodrigues da Silva
- Programa de Pós-Graduação em Enfermagem, Escola de Enfermagem, Universidade Federal de Minas Gerais (UFMG). Av. Alfredo Balena 190, Santa Efigênia. 30130-100 Belo Horizonte MG Brasil.
| | - Thamara Gabriela Fernandes Viana
- Programa de Pós-Graduação em Enfermagem, Escola de Enfermagem, Universidade Federal de Minas Gerais (UFMG). Av. Alfredo Balena 190, Santa Efigênia. 30130-100 Belo Horizonte MG Brasil.
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Formoso G, Bianchi C, Burlina S, Manicardi E, Sculli MA, Resi V, Sciacca L. Knowledge, attitude, and practice of the 2009 Institute of Medicine (IOM) recommendations on the nutritional management of diabetes in pregnancy: an online national survey. Acta Diabetol 2022; 59:1597-1607. [PMID: 36053391 PMCID: PMC9581811 DOI: 10.1007/s00592-022-01950-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 07/22/2022] [Indexed: 11/17/2022]
Abstract
AIMS As recommended by the Institute of Medicine (IOM), health practitioners should encourage a healthy nutrition and adequate weight gain during pregnancy in order to ensure favorable pregnancy and fetal outcomes, and to prevent diseases later in life for both mother and child. The purpose of this online survey was to determine the knowledge, attitude, and practice of the 2009 IOM recommendations among healthcare professionals managing nutritional therapy in pregnancies complicated by diabetes in Italy. METHODS A cross-sectional survey was conducted by using an online self-administered questionnaire undertaken between October and December 2021. RESULTS Of the 220 participants 89% were diabetologists/endocrinologists/internal medicine specialists and 11% dietitians/nutritionists. The survey found that the 53% of respondents provide a personalized diet to pregnant women with diabetes, while 32% a standard diet plan and only 15% healthy dietary advice. The 69% of the participants investigated for appropriate gestational weight gain, mainly based on pre-pregnancy BMI (96%), gestational weight gain (GWG) at first prenatal visit (80%) and presence of twin pregnancy (58%). Maternal weight gain was evaluated at each regularly scheduled prenatal visit and compared with IOM recommendations for the 87% of healthcare professionals. Diet plan was periodically re-evaluated and/or modified (90% of participants), based on inadequate maternal weight gain and/or fetal growth abnormalities (78%), trimester transition (53%), changes in physical activity and/or a "feel hungry" (50%). CONCLUSIONS This survey reported the knowledge and attitude of IOM guidelines and the nutritional knowledge and practice of Italian professionals on the nutritional management of diabetes in pregnancy. The application of these recommendations seemed more feasible in clinics/team dedicated to "Diabetes in Pregnancy".
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Affiliation(s)
- Gloria Formoso
- Interassociative Diabetes and Pregnancy Study Group, Italian Association of Diabetologists (AMD), Italian Society of Diabetology (SID), Rome, Italy.
- Department of Medicine and Aging Sciences, Center for Advanced Studies and Technology (CAST, Ex CeSIMet) G. d'Annunzio University Chieti-Pescara, Chieti, Italy.
| | - Cristina Bianchi
- Interassociative Diabetes and Pregnancy Study Group, Italian Association of Diabetologists (AMD), Italian Society of Diabetology (SID), Rome, Italy
- Metabolic Diseases and Diabetes Unit, University Hospital of Pisa, Pisa, Italy
| | - Silvia Burlina
- Interassociative Diabetes and Pregnancy Study Group, Italian Association of Diabetologists (AMD), Italian Society of Diabetology (SID), Rome, Italy
- Department of Medicine, DIMED, University of Padova, Padova, Italy
| | - Elisa Manicardi
- Interassociative Diabetes and Pregnancy Study Group, Italian Association of Diabetologists (AMD), Italian Society of Diabetology (SID), Rome, Italy
- Diabetes Unit, Primary Health Care, Local Health Authority of Reggio Emilia-IRCCS, Reggio Emilia, Italy
| | - Maria Angela Sculli
- Interassociative Diabetes and Pregnancy Study Group, Italian Association of Diabetologists (AMD), Italian Society of Diabetology (SID), Rome, Italy
- Endocrinology and Diabetes, Bianchi-Melacrino-Morelli Hospital, Reggio Calabria, Italy
| | - Veronica Resi
- Interassociative Diabetes and Pregnancy Study Group, Italian Association of Diabetologists (AMD), Italian Society of Diabetology (SID), Rome, Italy
- Endocrinology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Laura Sciacca
- Interassociative Diabetes and Pregnancy Study Group, Italian Association of Diabetologists (AMD), Italian Society of Diabetology (SID), Rome, Italy
- Department of Clinical and Experimental Medicine, Endocrinology Section, University of Catania, Catania, Italy
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J-P NA, Minami M, Eitoku M, Maeda N, Fujieda M, Suganuma N. Lack of concern about body image and health during pregnancy linked to excessive gestational weight gain and small-for-gestational-age deliveries: the Japan Environment and Children's Study. BMC Pregnancy Childbirth 2021; 21:396. [PMID: 34020606 PMCID: PMC8139142 DOI: 10.1186/s12884-021-03827-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Accepted: 04/22/2021] [Indexed: 11/29/2022] Open
Abstract
Background Pregnant women in Japan express various reasons for limiting gestational weight gain (GWG). We aimed to identify and characterise groups where the women share common reasons to limit GWG and to examine how these groups are associated with inappropriate GWG and abnormal foetal size. Methods We prospectively studied information from the Japan Environment and Childrens Study (JECS) on 92,539 women who gave birth to live singletons from 2011 through 2014. Pregnant women were recruited during early pregnancy. Their reasons for limiting GWG and other information were collected through self-reported questionnaires and medical records. We applied latent class analysis to group the women based on their reported reasons. We used multinomial logistic regression to compare the risks of inappropriate (inadequate and excessive) GWG and abnormal foetal size (determined by new-born weight for gestational age) between the identified groups. Results We identified three groups: Group 1 (76.7%), concerned about delivery and new-born health (health-conscious women); Group 2 (14.5%), concerned about body shape, delivery, and new-born health (body-shape- and health-conscious women); and Group 3 (8.8%), women without strong reasons to limit GWG (women lacking body-shape and health consciousness). Compared with Group 1 members, Group 2 members tended to be younger, have lower pre-pregnancy weight, be unmarried, be nulliparous, have practiced weight loss before pregnancy, and not have chronic medical conditions. Group 3 members tended to be less educated, unmarried, multiparous, smokers, and have a higher prevalence of pre-pregnancy underweight and previous caesarean delivery. Relative to Group 1, Group 2 had a lower unadjusted risk for inadequate GWG (relative risk ratio [RRR]=0.86, 95% CI: 0.810.90) and large-for-gestational-age birth (RRR=0.91, 95% CI 0.860.97), whereas Group 3 had a higher unadjusted risk for excessive GWG (RRR=1.36, 95% CI: 1.291.43) and small-for-gestational-age (SGA) births (RRR=1.15, 95% CI: 1.051.25). Conclusions In this Japanese nationwide birth cohort study, pregnant women who were less conscious about body shape and health had complex risks for excessive GWG and SGA birth. Health care providers should consider a womans perception of GWG when addressing factors affecting GWG and foetal growth. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-021-03827-0.
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Affiliation(s)
- Naw Awn J-P
- Department of Environmental Medicine, Kochi Medical School, Kochi University, Nankoku, Kochi, 783-8505, Japan
| | - Marina Minami
- Department of Environmental Medicine, Kochi Medical School, Kochi University, Nankoku, Kochi, 783-8505, Japan
| | - Masamitsu Eitoku
- Department of Environmental Medicine, Kochi Medical School, Kochi University, Nankoku, Kochi, 783-8505, Japan.
| | - Nagamasa Maeda
- Department of Obstetrics and Gynecology, Kochi Medical School, Kochi University, Nankoku, Kochi, Japan
| | - Mikiya Fujieda
- Department of Pediatrics, Kochi Medical School, Kochi University, Nankoku, Kochi, Japan
| | - Narufumi Suganuma
- Department of Environmental Medicine, Kochi Medical School, Kochi University, Nankoku, Kochi, 783-8505, Japan
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Martínez-Hortelano JA, Cavero-Redondo I, Álvarez-Bueno C, Garrido-Miguel M, Soriano-Cano A, Martínez-Vizcaíno V. Monitoring gestational weight gain and prepregnancy BMI using the 2009 IOM guidelines in the global population: a systematic review and meta-analysis. BMC Pregnancy Childbirth 2020; 20:649. [PMID: 33109112 PMCID: PMC7590483 DOI: 10.1186/s12884-020-03335-7] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 10/14/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Previous studies have reported a high prevalence of excessive gestational weight gain (GWG) in women with prepregnancy BMI classified as overweight and obese. However, the joint evidence regarding GWG and prepregnancy BMI in the worldwide population has not been synthesized. Thus, this systematic review and meta-analysis aimed to estimate global and regional mean GWG and the prevalence of GWG above, within and below 2009 Institute of Medicine (IOM) guidelines. Second, we aimed to estimate global and regional prepregnancy BMI and the prevalence of BMI categories according to World Health Organization (WHO) classification. METHODS We searched Medline, Embase, the Cochrane Library and Web of Science to identify observational studies until 9 May 2018. We included studies published from 2009 that used 2009 IOM guidelines, reporting data from women in general population with singleton pregnancies. The 2009 IOM categories for GWG and the WHO categories for prepregnancy BMI were used. DerSimonian and Laird random effects methods were used to estimate the pooled and their respective 95% confidence intervals (95% CIs) of the mean and by category rates of GWG and prepregnancy BMI, calculated by global and regions. RESULTS Sixty-three published studies from 29 countries with a total sample size of 1,416,915 women were included. The global prevalence of GWG above and below the 2009 IOM guidelines, was 27.8% (95% CI; 26.5, 29.1) and 39.4% (95% CI; 37.1, 41.7), respectively. Furthermore, meta-regression analyses showed that the mean GWG and the prevalence of GWG above guidelines have increased. The global prevalence of overweight and obesity, was 23.0% (95% CI; 22.3, 23.7) and 16.3% (95% CI; 15.4, 17.4), respectively. The highest mean GWG and prepregnancy BMI were in North America and the lowest were in Asia. CONCLUSIONS Considering the high prevalence of GWG above the 2009 IOM guidelines and women with overweight/obesity and their continuously increasing trend in most regions, clinicians should recommend lifestyle interventions to improve women's weight during reproductive age. Due to regional variability, these interventions should be adapted to each cultural context. TRIAL REGISTRATION Prospectively registered with PROSPERO ( CRD42018093562 ).
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Affiliation(s)
| | - Iván Cavero-Redondo
- Universidad de Castilla-La Mancha, Social and Health Care Research Center, Santa Teresa Jornet s/n, 16071, Cuenca, Spain
- Universidad Politécnica y Artística del Paraguay, Asunción, Paraguay
| | - Celia Álvarez-Bueno
- Universidad de Castilla-La Mancha, Social and Health Care Research Center, Santa Teresa Jornet s/n, 16071, Cuenca, Spain.
- Universidad Politécnica y Artística del Paraguay, Asunción, Paraguay.
| | - Miriam Garrido-Miguel
- Universidad de Castilla-La Mancha, Social and Health Care Research Center, Santa Teresa Jornet s/n, 16071, Cuenca, Spain
| | - Alba Soriano-Cano
- Universidad de Castilla-La Mancha, Social and Health Care Research Center, Santa Teresa Jornet s/n, 16071, Cuenca, Spain
| | - Vicente Martínez-Vizcaíno
- Universidad de Castilla-La Mancha, Social and Health Care Research Center, Santa Teresa Jornet s/n, 16071, Cuenca, Spain
- Faculty of Health Sciences, Universidad Autónoma de Chile, Talca, Chile
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