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Moore AP, Flynn AC, Adegboye ARA, Goff LM, Rivas CA. Factors Influencing Pregnancy and Postpartum Weight Management in Women of African and Caribbean Ancestry Living in High Income Countries: Systematic Review and Evidence Synthesis Using a Behavioral Change Theoretical Model. Front Public Health 2021; 9:637800. [PMID: 33681136 PMCID: PMC7925838 DOI: 10.3389/fpubh.2021.637800] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 01/18/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Women of black African heritage living in high income countries (HIC) are at risk of obesity and weight-related complications in pregnancy. This review aimed to synthesize evidence concerning attitudes to weight management-related health behaviors in pregnancy and postpartum, in women of black African ancestry, living in high-income countries. Methods: A systematic review of the literature and thematic evidence synthesis using the Capability-Opportunity-Motivation Behavioral change theoretical model (COM-B). Databases searched included MEDLINE, EMBASE, Web of Science, and Scopus. The CASP tool was used to assess quality. Results: Twenty-four papers met the selection criteria, most of which were from the US. Motivational factors were most commonly described as influencers on behavior. Normative beliefs about "eating for two," weight gain being good for the baby, the baby itself driving food choice, as well as safety concerns about exercising in pregnancy, were evident and were perpetuated by significant others. These and other social norms, including a cultural acceptance of larger body shapes, and daily fast food, created a challenge for healthy behavior change. Women also had low confidence in their ability to lose weight in the postpartum period. Behavior change techniques, such as provision of social support, use of credible sources, and demonstration may be useful to support change. Conclusions: The women face a range of barriers to engagement in weight-related health behaviors at this life-stage. Using a theoretical behavior change framework can help identify contextual factors that may limit or support behavior change.
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Affiliation(s)
- Amanda P. Moore
- Department of Nutrition, Kings College London, London, United Kingdom
| | - Angela C. Flynn
- Department of Women and Children's Health, King's College London, London, United Kingdom
| | | | - Louise M. Goff
- Department of Nutrition, Kings College London, London, United Kingdom
| | - Carol A. Rivas
- UCL Social Research Institute, University College London (UCL), London, United Kingdom
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Norris G, Martin CJH, Dickson A. An exploratory Interpretative Phenomenological Analysis (IPA) of childbearing women's perceptions of risk associated with having a high Body Mass Index (BMI). Midwifery 2020; 89:102789. [PMID: 32645602 DOI: 10.1016/j.midw.2020.102789] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 04/30/2020] [Accepted: 06/30/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND In 2016, the World Health Organization (WHO) labelled 13% of the world's adult population as obese. This increase in obesity is accompanied by mortality and morbidity problems, with maternal obesity and its accompanying risk for mother and infant requiring to be carefully managed. AIM To explore childbearing women with a high BMI (>35 kg/m2) perceptions of risk and its potential impacts upon pregnancy and outcome. METHOD Qualitative Interpretative Phenomenological Analysis (IPA) was used to gain deeper understanding of the lived experiences of childbearing women with a BMI>35 kg/m2 and perceptions of their risk and potential pregnancy outcome. FINDINGS One of the superordinate themes that emerged was (1) Risk or no risk, and its associated three subthemes of (1a) Emotional consequences of her risky position, (1b) Recognition of high-risk complicationsfinally sinking in, and (1c) Accepting the risk body. RECOMMENDATIONS FOR PRACTICE In general, health care professionals are uncomfortable about discussing obesity-associated risks with pregnant women. The participants in this study did not classify themselves as obese, with this absence of acknowledgement and 'risky talk' leaving participants' unaware of their obesity-associated risk. This downplaying of obesity related talk requires to be corrected, simply because women in denial will perceive no need to engage with health promotion messages. In response, directives are required to be embedded into policy and practice. CONCLUSION Specific training is required to teach maternity care professionals how to have difficult, sensitive conversations about obesity related risks with childbearing women with high BMI's. In addition, this risk information needs to be accompanied by relevant advice and support.
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Affiliation(s)
- Gail Norris
- School of Health and Social Care, Edinburgh Napier University (ENU), Sighthill Campus, Edinburgh, Scotland, UK, EH11 4BN.
| | - Caroline J Hollins Martin
- School of Health and Social Care, Edinburgh Napier University (ENU), Sighthill Campus, Edinburgh, Scotland, UK, EH11 4BN.
| | - Adele Dickson
- Department of Psychology, School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK, G4 0BA.
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Cormick G, Betrán AP, Romero IB, Lombardo CF, Gülmezoglu AM, Ciapponi A, Belizán JM. Global inequities in dietary calcium intake during pregnancy: a systematic review and meta-analysis. BJOG 2019; 126:444-456. [PMID: 30347499 PMCID: PMC6518872 DOI: 10.1111/1471-0528.15512] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/11/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND Evidence shows that adequate calcium intake during pregnancy reduces the risk of hypertensive disorders of pregnancy. In most low- and middle-income countries (LMICs) the daily calcium intake is well below recommendations. Mapping calcium intake during pregnancy worldwide and identifying populations with low calcium intake will provide the evidence base for more targeted actions to improve calcium intake. OBJECTIVE To assess dietary calcium intake during pregnancy worldwide. SEARCH STRATEGY MEDLINE and EMBASE (from July 2004 to November 2017). SELECTION CRITERIA Cross-sectional, cohort, and intervention studies reporting calcium intake during pregnancy. DATA COLLECTION AND ANALYSIS Five reviewers working in pairs independently performed screening, extraction, and quality assessment. We reported summary measures of calcium intake and calculated the weighted arithmetic mean for high-income countries (HICs) and LMICs independently, and for geographic regions, among studies reporting country of recruitment, mean intake, and total number of participants. When available, inadequate intakes were reported. MAIN RESULTS From 1880 citations 105 works met the inclusion criteria, providing data for 73 958 women in 37 countries. The mean calcium intake was 948.3 mg/day (95% CI 872.1-1024.4 mg/day) for HICs and 647.6 mg/day (95% CI 568.7-726.5 mg/day) for LMICs. Calcium intakes below 800 mg/day were reported in five (29%) countries from HICs and in 14 (82%) countries from LMICs. CONCLUSION These results are consistent with a lack of improvement in calcium dietary intake during pregnancy and confirm the gap between HICs and LMICs, with alarmingly low intakes recorded for pregnant women in LMICs. From the public health perspective, in the absence of specific local data, calcium supplementation of pregnant women in these countries should be universal. TWEETABLE ABSTRACT Despite dietary recommendations, women in LMICs face pregnancy with diets low in calcium.
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Affiliation(s)
- G Cormick
- Department of Mother and Child Health ResearchInstitute for Clinical Effectiveness and Health Policy (IECS‐CONICET)Buenos AiresArgentina
- Department of Human BiologyFaculty of Health SciencesUniversity of Cape TownCape TownSouth Africa
| | - AP Betrán
- Department of Reproductive Health and ResearchWorld Health OrganizationHRP – UNDP, UNFPA, UNICEF, WHO, World Bank Special Programme of Research, Development and Research Training in Human ReproductionGenevaSwitzerland
| | - IB Romero
- Departamento de SaludUniversidad Nacional de la MatanzaSan JustoArgentina
| | - CF Lombardo
- Departamento de SaludUniversidad Nacional de la MatanzaSan JustoArgentina
| | - AM Gülmezoglu
- Department of Reproductive Health and ResearchWorld Health OrganizationHRP – UNDP, UNFPA, UNICEF, WHO, World Bank Special Programme of Research, Development and Research Training in Human ReproductionGenevaSwitzerland
| | - A Ciapponi
- Department of Mother and Child Health ResearchInstitute for Clinical Effectiveness and Health Policy (IECS‐CONICET)Buenos AiresArgentina
| | - JM Belizán
- Department of Mother and Child Health ResearchInstitute for Clinical Effectiveness and Health Policy (IECS‐CONICET)Buenos AiresArgentina
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Denize KM, Acharya N, Prince SA, da Silva DF, Harvey AL, Ferraro ZM, Adamo KB. Addressing cultural, racial and ethnic discrepancies in guideline discordant gestational weight gain: a systematic review and meta-analysis. PeerJ 2018; 6:e5407. [PMID: 30186674 PMCID: PMC6118200 DOI: 10.7717/peerj.5407] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Accepted: 07/18/2018] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE To systematically review the literature and describe the discrepancies in achieving the 2009 Institute of Medicine (IOM) gestational weight gain (GWG) guidelines across cultures. METHODS Ten databases were searched from inception to April 2018. Observational cohort studies were included that examined adult women; reported on a measure of culture; compared cultural groups, and reported on GWG. Articles were broken down into papers that used the current 2009 IOM GWG guidelines and those that used others. A meta-analysis was conducted for studies using the 2009 guidelines examining the prevalence of discordant GWG across cultural groups. RESULTS The review included 86 studies. Overall, 69% of women experienced discordant GWG irrespective of culture. White women experienced excessive GWG most often, and significantly more than Asian and Hispanic women; Black women had a higher prevalence of excessive GWG than Hispanic and Asian women; however, this difference was not significant. CONCLUSIONS The majority of women experience excessive GWG, with White women experiencing this most often. Culturally diverse GWG guidelines are needed to individualize antenatal care and promote optimal maternal-fetal health outcomes across cultural groups.
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Affiliation(s)
- Kathryn M. Denize
- School of Human Kinetics, Faculty of Health Science, University of Ottawa, Ottawa, Canada
| | - Nina Acharya
- School of Human Kinetics, Faculty of Health Science, University of Ottawa, Ottawa, Canada
| | - Stephanie A. Prince
- Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Canada
| | - Danilo Fernandes da Silva
- Department of Physical Education, State University of Midwest/Parana (UNICENTRO), Guarapuava, Paraná, Brazil
| | - Alysha L.J. Harvey
- School of Human Kinetics, Faculty of Health Science, University of Ottawa, Ottawa, Canada
| | | | - Kristi B. Adamo
- School of Human Kinetics, Faculty of Health Science, University of Ottawa, Ottawa, Canada
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Flynn AC, Begum S, White SL, Dalrymple K, Gill C, Alwan NA, Kiely M, Latunde-Dada G, Bell R, Briley AL, Nelson SM, Oteng-Ntim E, Sandall J, Sanders TA, Whitworth M, Murray DM, Kenny LC, Poston L. Relationships between Maternal Obesity and Maternal and Neonatal Iron Status. Nutrients 2018; 10:nu10081000. [PMID: 30061547 PMCID: PMC6115715 DOI: 10.3390/nu10081000] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Revised: 07/20/2018] [Accepted: 07/24/2018] [Indexed: 12/29/2022] Open
Abstract
Obesity in pregnancy may negatively influence maternal and infant iron status. The aim of this study was to examine the association of obesity with inflammatory and iron status in both mother and infant in two prospective studies in pregnancy: UPBEAT and SCOPE. Maternal blood samples from obese (n = 245, BMI ≥ 30 kg/m2) and normal weight (n = 245, BMI < 25 kg/m2) age matched pregnant women collected at approximately 15 weeks’ gestation, and umbilical cord blood samples collected at delivery, were analysed for a range of inflammatory and iron status biomarkers. Concentrations of C- reactive protein and Interleukin-6 in obese women compared to normal weight women were indicative of an inflammatory response. Soluble transferrin receptor (sTfR) concentration [18.37 nmol/L (SD 5.65) vs. 13.15 nmol/L (SD 2.33)] and the ratio of sTfR and serum ferritin [1.03 (SD 0.56) vs. 0.69 (SD 0.23)] were significantly higher in obese women compared to normal weight women (P < 0.001). Women from ethnic minority groups (n = 64) had higher sTfR concentration compared with white women. There was no difference in maternal hepcidin between obese and normal weight women. Iron status determined by cord ferritin was not statistically different in neonates born to obese women compared with neonates born to normal weight women when adjusted for potential confounding variables. Obesity is negatively associated with markers of maternal iron status, with ethnic minority women having poorer iron statuses than white women.
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Affiliation(s)
- Angela C Flynn
- Department of Women and Children's Health, Faculty of Life Sciences and Medicine, King's College London, 10th Floor North Wing St Thomas' Hospital, London SE1 7EH, UK.
| | - Shahina Begum
- Department of Women and Children's Health, Faculty of Life Sciences and Medicine, King's College London, 10th Floor North Wing St Thomas' Hospital, London SE1 7EH, UK.
| | - Sara L White
- Department of Women and Children's Health, Faculty of Life Sciences and Medicine, King's College London, 10th Floor North Wing St Thomas' Hospital, London SE1 7EH, UK.
| | - Kathryn Dalrymple
- Department of Women and Children's Health, Faculty of Life Sciences and Medicine, King's College London, 10th Floor North Wing St Thomas' Hospital, London SE1 7EH, UK.
| | - Carolyn Gill
- Department of Women and Children's Health, Faculty of Life Sciences and Medicine, King's College London, 10th Floor North Wing St Thomas' Hospital, London SE1 7EH, UK.
| | - Nisreen A Alwan
- Academic Unit of Primary Care and Population Sciences, Faculty of Medicine, University of Southampton, Southampton General Hospital, Tremona Road, Southampton SO16 6YD, UK.
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton SO16 6YD, UK.
| | - Mairead Kiely
- School of Food and Nutritional Sciences, Food Science Building, University College Cork, T12 Y337 Cork, Ireland.
- The Irish Centre for Fetal and Neonatal Translational Research (INFANT), Department of Obstetrics and Gynaecology, University College Cork, T12 Y337 Cork, Ireland.
| | - Gladys Latunde-Dada
- Department of Nutritional Sciences, King's College London, Franklin-Wilkins Building, 150 Stamford Street, London SE1 7EH, UK.
| | - Ruth Bell
- Institute of Health & Society, Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne NE2 4AX, UK.
| | - Annette L Briley
- Department of Women and Children's Health, Faculty of Life Sciences and Medicine, King's College London, 10th Floor North Wing St Thomas' Hospital, London SE1 7EH, UK.
| | - Scott M Nelson
- School of Medicine, University of Glasgow, New Lister Building, Glasgow Royal Infirmary, Glasgow G31 2ER, UK.
| | - Eugene Oteng-Ntim
- Department of Women and Children's Health, Faculty of Life Sciences and Medicine, King's College London, 10th Floor North Wing St Thomas' Hospital, London SE1 7EH, UK.
| | - Jane Sandall
- Department of Women and Children's Health, Faculty of Life Sciences and Medicine, King's College London, 10th Floor North Wing St Thomas' Hospital, London SE1 7EH, UK.
| | - Thomas A Sanders
- Department of Nutritional Sciences, King's College London, Franklin-Wilkins Building, 150 Stamford Street, London SE1 7EH, UK.
| | - Melissa Whitworth
- Manchester University NHS Foundation Trust, St Mary's Hospital, Manchester M13 9WL, UK.
| | - Deirdre M Murray
- The Irish Centre for Fetal and Neonatal Translational Research (INFANT), Department of Obstetrics and Gynaecology, University College Cork, T12 Y337 Cork, Ireland.
- Department of Paediatrics & Child Health, University College Cork, T12 Y337 Cork, Ireland.
| | - Louise C Kenny
- The Irish Centre for Fetal and Neonatal Translational Research (INFANT), Department of Obstetrics and Gynaecology, University College Cork, T12 Y337 Cork, Ireland.
- Department of Obstetrics and Gynaecology, University College Cork, T12 Y337 Cork, Ireland.
| | - Lucilla Poston
- Department of Women and Children's Health, Faculty of Life Sciences and Medicine, King's College London, 10th Floor North Wing St Thomas' Hospital, London SE1 7EH, UK.
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Vinturache AE, Winn A, Tough SC. Recall of Prenatal Counselling Among Obese and Overweight Women from a Canadian Population: A Population Based Study. Matern Child Health J 2018; 21:2092-2101. [PMID: 28721648 DOI: 10.1007/s10995-017-2324-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Objective The objective of this study was to evaluate the recall of prenatal counselling received among overweight and obese women in primary care settings. Methods A sample of 1996 women with singleton, term deliveries and pre-pregnancy BMI >18.5 kg/m2 were identified from the All Our Babies pregnancy cohort. Information on socio-demographic characteristics and women's experiences with prenatal counselling on nutrition, vitamin and mineral supplements, exercise, weight gain, employment, alcohol and drug use, and smoking during pregnancy were collected through questionnaires administered at <25 weeks and 34-36 weeks gestation. Multivariable logistic regression analyses explored the associations between pre-pregnancy BMI and the domains of prenatal counselling, controlling for confounders. Results Women reported high levels of comfort asking questions and satisfaction with their health care provider. Women reported getting information about nutrition (69.3%), weight gain (67.8%), exercise (64.4%), vitamins and minerals supplementation (86.1%). Obese women (211, 10.6%) were more likely than normal weight women (1313, 65.8%) to be Caucasian (p = 0.004), less educated (p = 0.001), and to have been born or lived in Canada for at least 5 years (p = 0.01). There was no difference in the prenatal advice received on nutrition, weight gain and exercise in pregnancy between obese, overweight, and normal weight women. Conclusions for Practice Pre-pregnancy BMI did not appear to influence the recall of prenatal counselling women receive in community health care centers. Given the importance of nutrition and weight gain during pregnancy, and guidelines for weight gain based on pre-pregnancy BMI, there are missed opportunities in knowledge exchange between women and providers in the prenatal period.
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Affiliation(s)
- Angela E Vinturache
- Department of Paediatrics, Cumming School of Medicine, University of Calgary, 3330 Hospital Drive NW, Calgary, AB, T2N 4N1, Canada.
| | - Anika Winn
- Faculty of Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Suzanne C Tough
- Department of Paediatrics, Cumming School of Medicine, University of Calgary, 3330 Hospital Drive NW, Calgary, AB, T2N 4N1, Canada.,Department of Community of Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
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Emery RL, Benno MT, Salk RH, Kolko RP, Levine MD. Healthcare provider advice on gestational weight gain: uncovering a need for more effective weight counselling. J OBSTET GYNAECOL 2018; 38:916-921. [PMID: 29564951 DOI: 10.1080/01443615.2018.1433647] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Limited research has examined the factors related to knowledge of gestational weight gain (GWG) recommendations and the receipt of advice from healthcare providers regarding GWG recommendations among women with pre-pregnancy overweight/obesity. Women with pre-pregnancy overweight/obesity (N = 191) reported the amount of gestational weight they believed they should gain and that healthcare providers advised them to gain. Only 24% (n = 46) of women had a correct knowledge of GWG recommendations. Women were less likely to have a correct knowledge of GWG recommendations if they had pre-pregnancy obesity, were of a minority race, or were socioeconomically disadvantaged. Meanwhile, only 17% (n = 32) of women reported being correctly advised about GWG recommendations by healthcare providers. There were no differences between women who did and did not report being correctly advised about GWG recommendations from healthcare providers. These findings indicate that women with pre-pregnancy overweight/obesity lack knowledge of GWG recommendations and report being incorrectly advised about GWG recommendations from healthcare providers. Impact statement What is already known on this subject? Extant literature indicates that women's knowledge of gestational weight gain (GWG) recommendations and women's receipt of information from their healthcare providers regarding GWG recommendations are predictive of meeting the Institute of Medicine guidelines for GWG. What do the results of this study add? Findings from the present study indicate that the majority of women with pre-pregnancy overweight/obesity lack knowledge of GWG recommendations and report that education on GWG recommendations from healthcare providers is an aspect of their prenatal care that is largely insufficient. Although there were no differences between women who did and did not report being correctly advised about GWG recommendations by healthcare providers, women were less likely to have a correct knowledge of GWG recommendations if they had pre-pregnancy obesity, were of a minority race, or were socioeconomically disadvantaged. What are the implications of these findings for clinical practise and/or further research? These findings highlight a need for more effective tailoring of prenatal care to ensure that women receive accurate advice from healthcare providers regarding GWG recommendations.
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Affiliation(s)
- Rebecca L Emery
- a Department of Psychology , University of Pittsburgh , Pittsburgh , PA , USA
| | - Maria Tina Benno
- b Department of Psychiatry , Western Psychiatric Institute and Clinic University of Pittsburgh Medical Center , Pittsburgh , PA , USA
| | - Rachel H Salk
- b Department of Psychiatry , Western Psychiatric Institute and Clinic University of Pittsburgh Medical Center , Pittsburgh , PA , USA
| | - Rachel P Kolko
- b Department of Psychiatry , Western Psychiatric Institute and Clinic University of Pittsburgh Medical Center , Pittsburgh , PA , USA
| | - Michele D Levine
- b Department of Psychiatry , Western Psychiatric Institute and Clinic University of Pittsburgh Medical Center , Pittsburgh , PA , USA
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Meireles JFF, Neves CM, de Carvalho PHB, Ferreira MEC. Body dissatisfaction among pregnant women: an integrative review of the literature. CIENCIA & SAUDE COLETIVA 2017; 20:2091-103. [PMID: 26132248 DOI: 10.1590/1413-81232015207.05502014] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2014] [Accepted: 09/19/2014] [Indexed: 12/19/2022] Open
Abstract
The body image of pregnant women is an issue that should be further investigated by professionals in the area, especially in view of the fact that maternal and infant health has gained such prominence. The scope of this integrative review is to analyze the literature relating to body image and body dissatisfaction among pregnant women. Research was based on articles extracted from the Scopus, PubMed, BVS and PsycINFO databases, by cross-referencing "pregnancy" with the keywords "body image" and "body dissatisfaction." Once the inclusion and exclusion criteria had been adopted, forty studies were analyzed. These produced inconclusive data about body dissatisfaction during pregnancy. Symptoms of depression, low self-esteem, an inadequate approach towards healthy eating and weight gain above recommended limits have been associated with a negative body image. The contradictory findings could be related to the different instruments used to measure body image. In view of the possible impact that a negative body image can have on maternal and infant health during pregnancy, it is recommended that further investigations are made, in particular related to the development of a specific tool to evaluate the body image of pregnant women.
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Myles M, Gennaro S, Dubois N, O'Connor C, Roberts K. Nutrition of Black Women During Pregnancy. J Obstet Gynecol Neonatal Nurs 2017; 46:e83-e94. [PMID: 28396154 DOI: 10.1016/j.jogn.2017.01.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/01/2017] [Indexed: 10/19/2022] Open
Abstract
OBJECTIVE To examine the consistency and adequacy of nutritional intake in a population of Black women in the second and third trimesters of pregnancy. DESIGN This was a longitudinal descriptive study. Data were collected from women with low-risk pregnancies at 22- to 24-week prenatal visits and two subsequent visits. SETTING Participants were recruited from urban prenatal clinics in one city in the Northeastern United States. PARTICIPANTS Pregnant women who self-identified as Black (N = 195). METHODS A 24-hour diet recall was obtained at each of the three study time points. Food models and measuring cups were used to improve the accuracy of portion size reporting. Data from diet recalls were manually entered in Food Processor software to compute nutritional content. RESULTS A linear mixed-effects model was used to examine dietary intake. Dietary patterns were stable from the second to the third trimesters, and caloric intake was inadequate. Women met minimal daily requirements for carbohydrate and protein intake, but the overall percentages of fat, protein, and carbohydrates indicated that additional calories needed to come from protein. Although more than 80% of women regularly took prenatal vitamins, micronutrient and fiber intake were consistently inadequate. CONCLUSION Prenatal care to help women identify foods that are rich in fiber, protein, and micronutrients is important for the health of women and newborns. Knowing that nutritional intake is consistently inadequate, nurses can counsel pregnant women whenever they have contact with them to attempt to improve nutritional intake and make women aware of inexpensive nutrient sources.
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Abstract
AIM To report an analysis of the concept of risk perception in pregnancy. BACKGROUND Pregnant women are increasingly exposed to the view that pregnancy and childbirth are intrinsically dangerous, requiring medical monitoring and management. Societal pressures are applied to women that dictate appropriate behaviours during pregnancy. These changes have resulted in increased perception of risk for pregnant women. DESIGN Walker and Avant's method was selected to guide this analysis. DATA SOURCES Peer-reviewed articles published in English from CINAHL, Scopus, PubMed and Psychinfo. No date limits were applied. METHODS Thematic analysis was conducted on 79 articles. Attributes, antecedents and consequences of the concept were identified. RESULTS The attributes of the concept are the possibility of harm to mother or infant and beliefs about the severity of the risk state. The physical condition of pregnancy combined with the cognitive ability to perceive a personal risk state is antecedents. Risk perception in pregnancy influences women's affective state and has an impact on decision-making about pregnancy and childbirth. There are limited empirical referents with which to measure the concept. CONCLUSION Women today know more about their developing infant than at any other time in history; however, this has not led to a sense of reassurance. Nurses and midwives have a critical role in assisting pregnant women, and their families make sense of the information they are exposed to. An understanding of the complexities of the concept of risk perception in pregnancy may assist in enabling nurses and midwives to reaffirm the normalcy of pregnancy.
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Affiliation(s)
- Suzanne Lydia Lennon
- College of Nursing, Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
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11
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Whitaker KM, Wilcox S, Liu J, Blair SN, Pate RR. African American and White women׳s perceptions of weight gain, physical activity, and nutrition during pregnancy. Midwifery 2016; 34:211-220. [PMID: 26612000 PMCID: PMC4792697 DOI: 10.1016/j.midw.2015.11.005] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Revised: 10/29/2015] [Accepted: 11/02/2015] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To describe African American and White women's perceptions of weight gain, physical activity, and nutrition during pregnancy and to explore differences in perceptions by race. DESIGN Qualitative interview study. SETTING Two Ob/Gyn clinics in South Carolina, USA. PARTICIPANTS Thirty pregnant women (15 African American, 15 White) between 20 and 30 weeks gestation, equally represented across pre-pregnancy BMI categories (10 normal weight, 10 overweight, and 10 obese). FINDINGS White women more frequently described intentions to meet weight gain, physical activity, and dietary guidelines in pregnancy than African American women. African American women were more concerned with inadequate weight gain while White women more commonly expressed concerns about excessive weight gain. More White women discussed the importance of physical activity for weight management. Regardless of race, few women described risks of excessive weight gain or benefits of physical activity as it relates to the baby's health. The primary cited barrier of healthy eating was the high cost of fresh produce. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE Several knowledge gaps as well as race differences were identified in women's perceptions and intentions toward weight gain, physical activity, and nutrition during pregnancy. Future interventions should seek to educate women about common misperceptions. It may be necessary to culturally tailor gestational weight gain interventions to optimise health outcomes.
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Affiliation(s)
- Kara M Whitaker
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, USA.
| | - Sara Wilcox
- Department of Exercise Science, University of South Carolina, Columbia, SC, USA; Prevention Research Center, University of South Carolina, Columbia, SC, USA.
| | - Jihong Liu
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC, USA.
| | - Steven N Blair
- Department of Exercise Science, University of South Carolina, Columbia, SC, USA; Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC, USA.
| | - Russell R Pate
- Department of Exercise Science, University of South Carolina, Columbia, SC, USA.
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Dunlop AL, Mulle JG, Ferranti EP, Edwards S, Dunn AB, Corwin EJ. Maternal Microbiome and Pregnancy Outcomes That Impact Infant Health: A Review. Adv Neonatal Care 2015; 15:377-85. [PMID: 26317856 PMCID: PMC4658310 DOI: 10.1097/anc.0000000000000218] [Citation(s) in RCA: 112] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
The maternal microbiome is recognized as a key determinant of a range of important maternal and child health outcomes, and together with perinatal factors influences the infant microbiome. This article provides a summary review of research investigating (1) the role of the maternal microbiome in pregnancy outcomes known to adversely influence neonatal and infant health, including preterm birth, cardiometabolic complications of pregnancy such as preeclampsia and gestational diabetes, and excessive gestational weight gain; (2) factors with an established link to adverse pregnancy outcomes that are known to influence the composition of the maternal microbiome; and (3) strategies for promoting a healthy maternal microbiome, recognizing that much more research is needed in this area.
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Affiliation(s)
- Anne L. Dunlop
- Emory University School of Nursing, 1520 Clifton Road NE, Atlanta, GA 30322, 404-712-8520 (phone); 404-727-6945 (fax)
| | - Jennifer G. Mulle
- Rollins School of Public Health & School of Medicine, Department of Human Genetics, Emory University Atlanta, GA 30322
| | - Erin P. Ferranti
- Nell Hodgson Woodruff School of Nursing, Emory University,Atlanta, GA 30322
| | - Sara Edwards
- Nell Hodgson Woodruff School of Nursing, Emory University,Atlanta, GA 30322
| | - Alexis B. Dunn
- Nell Hodgson Woodruff School of Nursing, Emory University,Atlanta, GA 30322
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Gollop ND, Childs CA, Coupe B, MacFarlane S, Burrell J, Kumar B. Body weight, body image and primary postpartum haemorrhage: a review of the literature. J OBSTET GYNAECOL 2014; 34:373-82. [PMID: 24694033 DOI: 10.3109/01443615.2014.896882] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The prevalence of obesity during pregnancy is rising. Elevated BMI is a significant risk factor for adverse maternal and fetal outcomes, including primary postpartum haemorrhage (PPH). Addressing the issues surrounding obesity in pregnancy presents many biological, social and psychological challenges. BMI is an easily measured and modifiable anthropometrical risk factor and should be recorded in all pregnancies. BMI should be proactively managed prior to and during pregnancy. All women should be educated as to the risks of an elevated BMI during pregnancy and those at risk should have access to specialist medical and surgical support if required. Our aim was to investigate the associations between elevated BMI and adverse maternal and fetal outcomes including PPH, and to explore the psychological challenges of having an elevated BMI during pregnancy.
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Affiliation(s)
- N D Gollop
- The Norfolk and Norwich University Hospital , Colney Lane, Norwich
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