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Zhou Y, Lyu Y, Ye W, Shi H, Peng Y, Wen Z, Narayan A, Huang X, Chang S, Yang Y, Xu Y. The Prevalence of Anemia among Pregnant Women in China: A Systematic Review and Meta-Analysis. Nutrients 2024; 16:1854. [PMID: 38931209 PMCID: PMC11206842 DOI: 10.3390/nu16121854] [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] [Received: 05/22/2024] [Revised: 06/09/2024] [Accepted: 06/11/2024] [Indexed: 06/28/2024] Open
Abstract
The systematic review and meta-analysis were conducted to ascertain the prevalence of anemia, iron deficiency (ID), and iron deficiency anemia (IDA) among Chinese pregnant women. A total of 722 articles on maternal anemia during pregnancy published between January 2010 and December 2020 were compiled, and a systematic review and meta-analysis were conducted on 57 eligible studies including 1,376,204 pregnant women to ascertain the prevalence of anemia and the prevalence in different subgroups. The results showed that the prevalence of anemia, ID, and IDA among pregnant women in China were 30.7% (95% CI: 26.6%, 34.7%), 45.6% (95% CI: 37.0%, 54.2%), and 17.3% (95% CI: 13.9%, 20.7%), respectively. All prevalence increased with the progression of the pregnancy. There were sizable regional variations in the prevalence of anemia, ID, and IDA. Generally, lower prevalence was observed in the economically more advanced eastern region of the country, while the prevalence of ID was higher in the eastern region than that in the western region. The prevalence of anemia and IDA in rural areas was higher than that in urban areas, but ID prevalence was higher in urban areas. In conclusion, the regional differences and urban-rural disparities in the prevalence of anemia indicate the need for more context-specific interventions to prevent and treat anemia. It was found that dietary factors were one of the major causes of anemia, and iron-containing supplements and nutrition counseling could be effective interventions to reduce the prevalence of anemia, ID, and IDA among Chinese pregnant women.
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Affiliation(s)
- Yalin Zhou
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, NO.38 Xueyuan Road, Haidian District, Beijing 100083, China; (Y.Z.); (Y.L.); (W.Y.); (H.S.); (Y.P.); (Z.W.)
- PKUHSC-China Feihe Joint Research Institute of Nutrition and Healthy Lifespan Development, NO.38 Xueyuan Road, Haidian District, Beijing 100083, China
| | - Ying Lyu
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, NO.38 Xueyuan Road, Haidian District, Beijing 100083, China; (Y.Z.); (Y.L.); (W.Y.); (H.S.); (Y.P.); (Z.W.)
- PKUHSC-China Feihe Joint Research Institute of Nutrition and Healthy Lifespan Development, NO.38 Xueyuan Road, Haidian District, Beijing 100083, China
| | - Wanyun Ye
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, NO.38 Xueyuan Road, Haidian District, Beijing 100083, China; (Y.Z.); (Y.L.); (W.Y.); (H.S.); (Y.P.); (Z.W.)
- PKUHSC-China Feihe Joint Research Institute of Nutrition and Healthy Lifespan Development, NO.38 Xueyuan Road, Haidian District, Beijing 100083, China
| | - Hanxu Shi
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, NO.38 Xueyuan Road, Haidian District, Beijing 100083, China; (Y.Z.); (Y.L.); (W.Y.); (H.S.); (Y.P.); (Z.W.)
- PKUHSC-China Feihe Joint Research Institute of Nutrition and Healthy Lifespan Development, NO.38 Xueyuan Road, Haidian District, Beijing 100083, China
| | - Yile Peng
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, NO.38 Xueyuan Road, Haidian District, Beijing 100083, China; (Y.Z.); (Y.L.); (W.Y.); (H.S.); (Y.P.); (Z.W.)
- PKUHSC-China Feihe Joint Research Institute of Nutrition and Healthy Lifespan Development, NO.38 Xueyuan Road, Haidian District, Beijing 100083, China
| | - Zhang Wen
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, NO.38 Xueyuan Road, Haidian District, Beijing 100083, China; (Y.Z.); (Y.L.); (W.Y.); (H.S.); (Y.P.); (Z.W.)
- PKUHSC-China Feihe Joint Research Institute of Nutrition and Healthy Lifespan Development, NO.38 Xueyuan Road, Haidian District, Beijing 100083, China
| | - Anuradha Narayan
- Nutrition and Child Development Section, UNICEF Headquarters, 3 United Nations Plz, New York, NY 10017, USA;
| | - Xiaona Huang
- Child Health and Development Section, UNICEF Office for China, NO.12 Sanlitun Road, Chaoyang District, Beijing 100600, China; (X.H.); (S.C.); (Y.Y.)
| | - Suying Chang
- Child Health and Development Section, UNICEF Office for China, NO.12 Sanlitun Road, Chaoyang District, Beijing 100600, China; (X.H.); (S.C.); (Y.Y.)
| | - Yuning Yang
- Child Health and Development Section, UNICEF Office for China, NO.12 Sanlitun Road, Chaoyang District, Beijing 100600, China; (X.H.); (S.C.); (Y.Y.)
| | - Yajun Xu
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, NO.38 Xueyuan Road, Haidian District, Beijing 100083, China; (Y.Z.); (Y.L.); (W.Y.); (H.S.); (Y.P.); (Z.W.)
- PKUHSC-China Feihe Joint Research Institute of Nutrition and Healthy Lifespan Development, NO.38 Xueyuan Road, Haidian District, Beijing 100083, China
- Beijing Key Laboratory of Toxicological Research and Risk Assessment for Food Safety, Peking University, NO.38 Xueyuan Road, Haidian District, Beijing 100083, China
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Wan CS, Teede H, Nankervis A, Aroni R. Ethnic differences in physical activity participation when managing gestational diabetes mellitus: a mixed-methods study comparing ethnic Chinese migrants and Australian women. ETHNICITY & HEALTH 2024:1-20. [PMID: 38805266 DOI: 10.1080/13557858.2024.2359379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 05/20/2024] [Indexed: 05/30/2024]
Abstract
BACKGROUND Physical activity is a key component in gestational diabetes mellitus management to optimise glycaemic control and reduce adverse pregnancy outcomes. However, inadequate physical activity during pregnancy is common. Underpinned by a woman-centred pregnancy care model, appropriate strategies targeting patients' cultural needs may facilitate physical activity participation. Ethnic Chinese migrants have a four-fold higher risk of gestational diabetes mellitus than the Australian Caucasian host population. To identify potentially effective disease management strategies to improve physical activity participation, understanding and comparing ethnic Chinese migrants' and Caucasian women's views will provide insights into developing an end-user-informed intervention. AIMS This study aimed to compare perceptions and practices around physical activity participation during pregnancy between 44 ethnic Chinese migrants and 39 Australian-born Caucasian women with gestational diabetes mellitus. METHODS This mixed-methods study used in-depth, semi-structured audio-recorded interviews, validated pregnancy physical activity questionnaires and pedometers. Qualitative data were thematically analysed and compared between ethnicities. SPSS (SPSS Inc) was used in quantitative data analysis. Data triangulation was made to identify patterns in participant characteristics, physical activity beliefs and participation. RESULTS Despite both ethnic groups doing less physical activity than recommended, Chinese participants were less physically active than Caucasian participants. Chinese participants expressed greater safety concerns about physical activity and opted for a more sedentary lifestyle. Data triangulation indicated that non-Australian-born Chinese participants whose husbands were Asian were overcautious about miscarriage risk related to physical activity, which promoted a sedentary lifestyle. Chinese participants suggested individualised, specific physical activity advice on safe physical activity during pregnancy would mitigate their concerns. Caucasian participants reported that digital step measurement technologies motivated their participation in physical activity. CONCLUSION Different strategies are suggested by Chinese and Caucasian participants to improve physical activity participation to manage gestational diabetes mellitus among ethnic Chinese and Caucasian populations, which will be evaluated in future interventions.
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Affiliation(s)
- Ching Shan Wan
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Melbourne, Australia
| | - Helena Teede
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- Department of Endocrinology and Diabetes, Monash Health, Clayton, Australia
| | - Alison Nankervis
- Departments of Diabetes and Endocrinology, The Royal Melbourne and Royal Women's Hospitals, Parkville, Australia
- Department of Medicine, The University of Melbourne, Parkville, Australia
| | - Rosalie Aroni
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- ANU Medical School, College of Health and Medicine, Australian National University, Canberra, Australia
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Khammarnia M, Ansari-Moghaddam A, Kakhki FG, Clark CCT, Barahouei FB. Maternal macronutrient and energy intake during pregnancy: a systematic review and meta-analysis. BMC Public Health 2024; 24:478. [PMID: 38360655 PMCID: PMC10870573 DOI: 10.1186/s12889-024-17862-x] [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: 07/28/2023] [Accepted: 01/23/2024] [Indexed: 02/17/2024] Open
Abstract
BACKGROUND Nutritional status during pregnancy can have a significant impact on infant and maternal health outcomes. To maintain maternal homeostasis and support fetal growth, adequate macronutrient and energy intake during pregnancy is essential. Therefore, this study sought to systematically review and meta-analyze macronutrient and energy intakes during pregnancy. METHODS A systematic review and meta-analysis was carried out based on the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The required data were collected from four databases including: Web of Sciences, ProQuest, Scopus, and PubMed, from 1 January 1980 to 30 May 2023, by using a combination of search terms (dietary pattern" OR "diet quality" OR "food habits" OR "nutrition surveys" OR "diet surveys" OR "food-frequency questionnaire" OR "diet record" OR "dietary recall") AND ( "pregnancy" OR "reproduction" OR "maternal health" OR "neonatal outcomes") among interventional and observational studies. Excel and STATA version 11 were used for data analysis. RESULTS Among 7081 published articles, 54 studies were included in the review. Most of the 33 (61%) studies were cohort studies and a total of 135,566 pregnant women were included. The overall average of energy, carbohydrate, fat, and protein intake was 2036.10 kcal/day, 262.17 gr/day, 74.17 gr/day, and 78.21 gr/day, respectively. Also, energy intake during pregnancy was higher in American (2228.31 kcal/day, CI95%: 2135.06-2325.63) and Eastern Mediterranean regions (2226.70 kcal/day, CI95%: 2077.23-2386.92) than other regions (P < 0.001). Energy intake was higher in the third trimester than others (2115.64 kcal/day, CI95%: 1974.15-2267.27). Furthermore, based on the findings, there was a significant difference between energy intake in different World Health Organization (WHO) regions (P < 0.05). CONCLUSIONS According to the results of meta-analysis, the average total energy was below than average total energy required during pregnancy. More efforts are needed to encourage women to adopt healthy eating habits during pregnancy to support healthy fetal and infant development.
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Affiliation(s)
- Mohammad Khammarnia
- Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
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Ding Y, Li G, Zhang M, Shao Y, Wu J, Wang Z. Development and validation of a novel food exchange system for Chinese pregnant women. Nutr J 2023; 22:65. [PMID: 38037031 PMCID: PMC10690967 DOI: 10.1186/s12937-023-00902-4] [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] [Received: 02/12/2023] [Accepted: 11/28/2023] [Indexed: 12/02/2023] Open
Abstract
BACKGROUND The dietary nutritional status of pregnant women is critical for maintaining the health of both mothers and infants. Food exchange systems have been employed in the nutritional guidance of patients in China, although their application in the dietary guidance of healthy pregnant women is quite limited. This study aimed to develop a novel food exchange system for Chinese pregnant women (NFES-CPW) and evaluate the relative validation of its application. METHODS NFES-CPW covers approximately 500 types of food from ten categories and has more elaborate food portion sizes. It established a recommendation index for guiding food selection and used energy, water content, and protein as the exchange basis to balance the supply of energy and important nutrients throughout pregnancy. Furthermore, dietitians used the NFES-CPW and traditional food exchange system to generate new recipes based on the sample recipe. There were 40 derived recipes for each of the two food exchange methods. The food consumption, energy, and key nutrients of each recipe were calculated, and the differences between the two food exchange systems were compared using the Wilcoxon rank sum test or the Chi-square test. RESULTS The results revealed that compared to those derived from traditional food exchange system, the NFES-CPW derived recipes had a better dietary structure, as evidenced by the intakes of whole-grain cereals, beans excluding soybeans, potatoes, fruits, fish, shrimp and shellfish, as well as eggs (P < 0.05), which were more conducive to reaching the recommended range of balanced dietary pagoda. After calculating energy and nutrients, although these two food exchange systems have similar effects on the dietary energy and macronutrient intake of pregnant women, the intake of micronutrients in NFES-CPW derived recipes was significantly higher than that from the traditional food exchange system, which was more conducive to meeting the dietary requirements of pregnant women. The outstanding improvement are primarily vitamin A, vitamin B2, folic acid, vitamin B12, vitamin C, calcium, iron, and iodine (P < 0.05). Moreover, when compared to recipes obtained from the traditional food exchange system, the error ranges of energy and most nutrients were significantly reduced after employing the NFES-CPW. CONCLUSIONS Therefore, NFES-CPW is an appropriate tool that adheres to Chinese dietary characteristics and can provide suitable dietary guidance to pregnant women.
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Affiliation(s)
- Ye Ding
- Department of Maternal, Child and Adolescent Health, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Genyuan Li
- Department of Maternal, Child and Adolescent Health, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Man Zhang
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing, China
| | - Yingying Shao
- Department of Maternal, Child and Adolescent Health, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Jieshu Wu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Zhixu Wang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Nanjing Medical University, Nanjing, China.
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Er YT, Chan YM, Mohd Shariff Z, Abdul Hamid H, Mat Daud Z'A, Yong HY. Dietitian-led cluster randomised controlled trial on the effectiveness of mHealth education on health outcomes among pregnant women: a protocol paper. BMJ Open 2023; 13:e075937. [PMID: 37989361 PMCID: PMC10660825 DOI: 10.1136/bmjopen-2023-075937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 10/13/2023] [Indexed: 11/23/2023] Open
Abstract
INTRODUCTION Nutrition education is the cornerstone to maintain optimal pregnancy outcomes including gestational weight gain (GWG). Nevertheless, default for appointments is common and often lead to suboptimal achievement of GWG, accompanied with unfavourable maternal and child health outcomes. While mobile health (mHealth) usage is increasing and helps minimising barriers to clinic appointments among pregnant mothers, its effectiveness on health outcomes has been inconclusive. Therefore, this study aimed to address the gap between current knowledge and clinical care, by exploring the effectiveness of mHealth on GWG as the primary outcome, hoping to serve as a fundamental work to achieve optimal health outcomes with the improvement of secondary outcomes such as physical activity, psychosocial well-being, dietary intake, quality of life and sleep quality among pregnant mothers. METHODS AND ANALYSIS A total of 294 eligible participants will be recruited and allocated into 3 groups comprising of mHealth intervention alone, mHealth intervention integrated with personal medical nutrition therapy and a control group. Pretested structured questionnaires are used to obtain the respondents' personal information, anthropometry data, prenatal knowledge, physical activity, psychosocial well-being, dietary intake, quality of life, sleep quality and GWG. There will be at least three time points of data collection, with all participants recruited during their first or second trimester will be followed up prospectively (after 3 months or/and after 6 months) until delivery. Generalised linear mixed models will be used to compare the mean changes of outcome measures over the entire study period between the three groups. ETHICS AND DISSEMINATION Ethical approvals were obtained from the ethics committee of human subjects research of Universiti Putra Malaysia (JKEUPM-2022-072) and medical research & ethics committee, Ministry of Health Malaysia: NMRR ID-22-00622-EPU(IIR). The results will be disseminated through journals and conferences targeting stakeholders involved in nutrition research. TRIAL REGISTRATION NUMBER Clinicaltrial.gov ID: NCT05377151.
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Affiliation(s)
- Ying Ting Er
- Department of Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang 43400, Selangor, Malaysia
| | - Yoke Mun Chan
- Department of Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang 43400, Selangor, Malaysia
- Research Centre of Excellence Nutrition and Non-communicable Diseases, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang 43400, Selangor, Malaysia
| | - Zalilah Mohd Shariff
- Department of Nutrition, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang 43400, Selangor, Malaysia
| | - Habibah Abdul Hamid
- Department of Obstetrics & Gynaecology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Zulfitri 'Azuan Mat Daud
- Department of Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang 43400, Selangor, Malaysia
- Research Centre of Excellence Nutrition and Non-communicable Diseases, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang 43400, Selangor, Malaysia
| | - Heng Yaw Yong
- Division of Nutrition and Dietetics, School of Health Sciences, International Medical University, Bukit Jalil, 57000 Kuala Lumpur, Wilayah Persekutuan, Malaysia
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Mayasari NR, Bai CH, Chao JCJ, Chen YC, Huang YL, Wang FF, Wiratama BS, Chang JS. Relationships between Dietary Patterns and Erythropoiesis-Associated Micronutrient Deficiencies (Iron, Folate, and Vitamin B 12) among Pregnant Women in Taiwan. Nutrients 2023; 15:nu15102311. [PMID: 37242193 DOI: 10.3390/nu15102311] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 05/05/2023] [Accepted: 05/13/2023] [Indexed: 05/28/2023] Open
Abstract
Globally, anemia affects 56 million pregnant women, especially women with a low household income. Functional erythropoiesis requires a constant supply of micronutrients, and the demands significantly increase during fetal development. This study aims to identify dietary patterns for preventing gestational erythropoiesis-associated micronutrient deficiencies (e.g., iron, folic acid, and vitamin B12). A Nationwide Nutrition and Health Survey in Pregnant Women, Taiwan (NAHSIT-PW), was conducted between 2017 and 2019. Data on baseline information, diet, anthropometrics, and blood biochemistry were collected during a prenatal visit. Dietary patterns were identified using a reduced rank regression (RRR). Erythropoiesis-related micronutrient deficiencies were defined as single, double, and triple micronutrient deficiencies of an iron deficiency, folate depletion, and a vitamin B12 deficiency. In total, 1437 singleton pregnancies aged ≥20-48 years were included in the analysis. Prevalences of normal nutrition, and single, double, and triple erythropoiesis-related micronutrient deficiencies were 35.7%, 38.2%, 18.6%, and 7.5%, respectively. Anemic pregnant women with a low household income had the highest prevalence rates of double (32.5%) and triple (15.8%) erythropoiesis-related micronutrient deficiencies. Dietary pattern scores were positively correlated with nuts and seeds, fresh fruits, total vegetables, breakfast cereals/oats and related products, soybean products, and dairy products but negatively correlated with processed meat products and liver, organs, and blood products. After adjusting for covariates, the dietary pattern had 29% (odds ratio (OR): 0.71; 95% confidence interval (CI): 0.055-0.091, p = 0.006)) and 43% (OR: 0.57; 95% CI: 0.41-0.80, p = 0.001)) reduced odds of having double and triple erythropoiesis-related micronutrient deficiencies for those pregnant women with a low household income. For those women with anemia, dietary patterns had 54% (OR: 046, 95% CI: 0.27-0.78) and 67% (OR: 0.33; 95% CI: 0.170.64) reduced odds of double and triple erythropoiesis-related micronutrient deficiencies. In conclusion, increased consumption of breakfast cereals and oats, nuts, and seeds, fresh fruits and vegetables, soybean products, and dairy products may protect women against erythropoiesis-related micronutrient deficiencies during pregnancy.
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Affiliation(s)
- Noor Rohmah Mayasari
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, Taipei 11031, Taiwan
- Department of Nutrition, Faculty of Sports and Health Sciences, Universitas Negeri Surabaya, Surabaya 60213, Indonesia
| | - Chyi-Huey Bai
- School of Public Health, College of Public Health, Taipei Medical University, Taipei 11031, Taiwan
- Department of Public Health, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan
| | - Jane C-J Chao
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, Taipei 11031, Taiwan
| | - Yi-Chun Chen
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, Taipei 11031, Taiwan
| | - Ya-Li Huang
- School of Public Health, College of Public Health, Taipei Medical University, Taipei 11031, Taiwan
- Department of Public Health, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan
| | - Fan-Fen Wang
- Department of Internal Medicine, Yangming Branch, Taipei City Hospital, Taipei 11146, Taiwan
| | - Bayu Satria Wiratama
- Department of Biostatistics and Epidemiology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta 55281, Indonesia
| | - Jung-Su Chang
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, Taipei 11031, Taiwan
- Graduate Institute of Metabolism and Obesity Sciences, College of Nutrition, Taipei Medical University, Taipei 11031, Taiwan
- Nutrition Research Center, Taipei Medical University Hospital, Taipei 11031, Taiwan
- Chinese Taipei Society for the Study of Obesity (CTSSO), Taipei 100, Taiwan
- TMU Research Center for Digestive Medicine, Taipei Medical University, Taipei 11031, Taiwan
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Fernández-Gómez E, Mohatar-Barba M, López-Olivares M, Luque-Vara T, Sánchez-Ojeda MA, Martín-Salvador A, Enrique-Mirón C. Caloric and Lipid Profiles during Pregnancy in a Socio-Culturally Diverse Society. Foods 2023; 12:1111. [PMID: 36900628 PMCID: PMC10000863 DOI: 10.3390/foods12051111] [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: 01/30/2023] [Revised: 02/21/2023] [Accepted: 03/04/2023] [Indexed: 03/08/2023] Open
Abstract
This research analyzes the determining factors in diet quality among the Spanish pregnant population with the aim of promoting healthier eating habits and preventing the development of non-communicable diseases. It is a diagnostic, non-experimental, cross-sectional, and observational study, with correlational descriptive methodology, and 306 participants. The information was collected using the 24 h dietary recall. Various sociodemographic factors that influence diet quality were analyzed. It was found that pregnant women consume too much protein and fat, score high in SFA consumption, and do not achieve the CH recommendations, consuming twice as much sugar. Carbohydrate intake is inversely related to income (β = -0.144, p < 0.005). Likewise, protein intake is linked to marital status (β = -0.114, p < 0.005) and religion (β = 0.110, p < 0.005). Finally, lipid intake appears conditional upon age (β = 0.109, p < 0.005). As regards the lipid profile, a positive association is only observed with age and MFA consumption (β = 0.161, p < 0.01). On the other hand, simple sugars are positively related to education (β = 0.106, p < 0.005). The results of this research show that the diet quality of pregnant women does not meet the nutritional recommendations established for the Spanish population.
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Affiliation(s)
- Elisabet Fernández-Gómez
- Department of Nursing, Faculty of Health Sciences, Melilla Campus, University of Granada, C/Santander s/n, 52001 Melilla, Spain
| | - Miriam Mohatar-Barba
- Department of Nursing, Faculty of Health Sciences, Melilla Campus, University of Granada, C/Santander s/n, 52001 Melilla, Spain
| | | | - Trinidad Luque-Vara
- Department of Nursing, Faculty of Health Sciences, Melilla Campus, University of Granada, C/Santander s/n, 52001 Melilla, Spain
| | - María Angustias Sánchez-Ojeda
- Department of Nursing, Faculty of Health Sciences, Melilla Campus, University of Granada, C/Santander s/n, 52001 Melilla, Spain
| | - Adelina Martín-Salvador
- Department of Nursing, Faculty of Health Sciences, Melilla Campus, University of Granada, C/Santander s/n, 52001 Melilla, Spain
| | - Carmen Enrique-Mirón
- HUM-613 Research Group, Department of Inorganic Chemistry, Faculty of Health Sciences, Melilla Campus, University of Granada, C/Santander s/n, 52001 Melilla, Spain
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Mengie T, Dessie Y, Egata G, Muche T, Habtegiorgis SD, Getacher L. Food taboos and associated factors among agro-pastoralist pregnant women: A community-based cross-sectional study in Eastern Ethiopia. Heliyon 2022; 8:e10923. [PMID: 36247145 PMCID: PMC9557892 DOI: 10.1016/j.heliyon.2022.e10923] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 11/17/2021] [Accepted: 09/28/2022] [Indexed: 11/16/2022] Open
Abstract
In underdeveloped nations, cultural norms that are harmful to women's health, such as food taboos, are responsible for five to fifteen percent of pregnancy-related deaths. Food Taboo traditions prevent women from consuming particular foods, which reduces dietary diversity and food quality and may have detrimental nutritional effects. However, little is known about Ethiopia's dietary taboos and related issues. So, the purpose of this study was to find out how common food taboos are among pregnant women in agro pastoralist settings, as well as the accompanying factors. 636 pregnant women were enrolled in a community-based cross-sectional study using a two-stage cluster sampling strategy, distributed over seven clusters. Data were exported from Epi Data version 3.01 to Statistical Package for Social Science version 20 after being entered. The prevalence of dietary taboos in this study was 67.4% (95% CI: 63.7%, 71.1%). Food taboos were independently and significantly predicted by lack of formal education [AOR = 1.97 (95% CI: 1.583, 4.496), low wealth index [AOR = 2.26 (95% CI: 1.173, 4.353)], absence of antenatal care visits [AOR = 6.16 (95% CI: 4.996, 10.128), lack of knowledge of maternal nutrition [AOR = 4.94 (95% CI: 3.799, 8.748)], and negative attitude toward maternal nutrition [ In the research area, dietary taboos were very common. Food taboos were independently predicted by low wealth index, lack of maternity care visits, lack of formal education, ignorance of maternal nutrition, and unfavorable attitudes. Therefore, it is highly advised that strong community-based maternal nutrition education and counseling, raising women's income, and preparing young women for study in order to improve their educational standing be implemented.
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Affiliation(s)
- Tesfa Mengie
- Amhara Regional Health Bureau, CDC Project, Monitoring and Evaluation Officer, Dessie, Ethiopia
| | - Yadeta Dessie
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Gudina Egata
- School of Public Health, College of Health Science, Addis Ababa University, Addis Ababa, Ethiopia
| | - Temesgen Muche
- Department of Nutrition, School of Public Health, College of Health Science, Dilla University, Dilla, Ethiopia
| | - Samuel Derbie Habtegiorgis
- Department of Public Health, College of Health Science, Institute of Medicine and Health Science, Debre Markos University, Debre Markos, Ethiopia
| | - Lemma Getacher
- School of Public Health, Asrat Woldeyes Health Science Campus, Debre Berhan University, Debre Berhan, Ethiopia,Corresponding author.
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Maggiulli O, Rufo F, Johns SE, Wells JC. Food taboos during pregnancy: meta-analysis on cross cultural differences suggests specific, diet-related pressures on childbirth among agriculturalists. PeerJ 2022; 10:e13633. [PMID: 35846875 PMCID: PMC9281602 DOI: 10.7717/peerj.13633] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 06/03/2022] [Indexed: 01/17/2023] Open
Abstract
Pregnancy is the most delicate stage of human life history as well as a common target of food taboos across cultures. Despite puzzling evidence that many pregnant women across the world reduce their intake of nutritious foods to accomplish cultural norms, no study has provided statistical analysis of cross-cultural variation in food taboos during pregnancy. Moreover, antenatal practices among forager and agriculturalists have never been compared, despite subsistence mode being known to affect staple foods and lifestyle directly. This gap hinders to us from understanding the overall threats attributed to pregnancy, and their perceived nutritional causes around the world. The present study constitutes the first cross-cultural meta-analysis on food taboos during pregnancy. We examined thirty-two articles on dietary antenatal restrictions among agricultural and non-agricultural societies, in order to: (i) identify cross-culturally targeted animal, plant and miscellaneous foods; (ii) define major clusters of taboo focus; (iii) test the hypothesis that food types and clusters of focus distribute differently between agricultural and non-agricultural taboos; and (iv) test the hypothesis that food types distribute differently across the clusters of taboo focus. All data were analysed in SPSS and RStudio using chi-squared tests and Fisher's exact tests. We detected a gradient in taboo focus that ranged from no direct physiological interest to the fear of varied physiological complications to a very specific concern over increased birth weight and difficult delivery. Non-agricultural taboos were more likely to target non-domesticated animal foods and to be justified by concerns not directly linked to the physiological sphere, whereas agricultural taboos tended to targed more cultivated and processed products and showed a stronger association with concerns over increased birth weight. Despite some methodological discrepancies in the existing literature on food taboos during pregnancy, our results illustrate that such cultural traits are useful for detecting perception of biological pressures on reproduction across cultures. Indeed, the widespread concern over birth weight and carbohydrate rich foods overlaps with clinical evidence that obstructed labor is a major threat to maternal life in Africa, Asia and Eurasia. Furthermore, asymmetry in the frequency of such concern across subsistence modes aligns with the evolutionary perspective that agriculture may have exacerbated delivery complications. This study highlights the need for the improved understanding of dietary behaviors during pregnancy across the world, addressing the role of obstructed labor as a key point of convergence between clinical, evolutionary and cultural issues in human behavior.
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Affiliation(s)
| | | | | | - Jonathan C.K. Wells
- University College London Great Ormond Street Institute of Child Health, London, United Kingdom
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Darmawati D, Nizwan-Siregar T, Hajjul K, Teuku T. Exploring Indonesian mothers' perspectives on anemia during pregnancy: A qualitative approach. ENFERMERIA CLINICA (ENGLISH EDITION) 2022; 32 Suppl 1:S31-S37. [PMID: 35688565 DOI: 10.1016/j.enfcle.2020.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 11/02/2020] [Indexed: 06/15/2023]
Abstract
OBJECTIVE The study aims to investigate the perceptions of anemia among pregnant women to design culturally relevant interventions in Indonesia. METHOD Qualitative study with dates from 24 pregnant women in a province in Indonesia through focus group discussions. Data were analyzed using the inductive content analysis method. RESULTS Five themes emerged from the experiences of pregnant women with anemia: (1) anemia during pregnancy is perceived as a woman's destiny; (2) lack of knowledge related to clinical indicators of anemia; (3) the traditional taboo related to anemia; (4) the husband and family provide support related to anemia prevention; and (5) there is a need for cultural and religious-based health counseling. CONCLUSIONS Interventions to provide health information about anemia in pregnancy should be designed with consideration of local knowledge, beliefs and values, combined with medical elements. It is likely these interventions can change the perceptions of pregnant women's perceptions about anemia, ensuring that they are able to maintain their pregnancy. The implementation of programs to support these women should involves health workers who can understand their needs and who are adequately trained in cultural competence.
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Affiliation(s)
- Darmawati Darmawati
- Graduate School of Mathematics and Applied Science, Department of Maternity Nursing, Faculty of Nursing, Universitas Syiah Kuala, Aceh, Indonesia.
| | | | - Kamil Hajjul
- Department of Management Nursing, Faculty of Nursing, Universitas Syiah Kuala, Aceh, Indonesia
| | - Tahlil Teuku
- Department of Community Nursing, Faculty of Nursing, Universitas Syiah Kuala, Aceh, Indonesia
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Afrinis N, Verawati B, Rizqi ER, Lasepa W, Alini A, Syuryadi N. Energy Intake and Food Restriction as Determinant Factors of Chronic Energy Deficiency among Pregnant Women in Rural Area of Sungai Sembilan, Riau, Indonesia. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.9042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND OF THE STUDY: Maternal malnutrition is a major public health problem in Indonesia which is shown by high prevalence of chronic energy deficiency (CED) among pregnant women. CED was expressed by the measurement of Mid Upper Arm Circumference (MUAC) showing value less than 23.5 cm.
AIM OF THE STUDY: This study aimed to identify the factors associated with chronic energy deficiency among pregnant women in rural area, Riau Province.
METHODOLOGY: A community- based cross sectional study was conducted among 130 samples of pregnant women in Sungai Sembilan Community Health Center in June 2020. Data was collected using structured and field-study questionnaires. Mid Upper Arm Circumference (MUAC) was measured by MUAC tape. Energy and protein intake were assessed using 24-hour food recall. Multiple logistic regression was employed to analyse factors associated with CED by using SPSS version 20.
RESULTS: The prevalence of CED among pregnant women was 64.9%. Age of mothers, food restriction, infection disease status, protein and energy intake were associated significantly with CED. Furthermore, energy intake and food restriction in pregnancy were risk factors of CED (AOR = 3.04, 95% CI: 1.1 – 8.3 and AOR = 6.73, 95% CI: 1.33 – 33.9, respectively). We found that proportion of energy intake below 80% RDA and mothers with food restriction were higher among CED group.
CONCLUSION: High prevalence of chronic energy deficiency (CED) was found among pregnant women. Hence, innovative intervention was required to overcome this problem.
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Fite MB, Tura AK, Yadeta TA, Oljira L, Roba KT. Prevalence and determinants of dietary practices among pregnant women in eastern Ethiopia. BMC Nutr 2022; 8:3. [PMID: 35012664 PMCID: PMC8751267 DOI: 10.1186/s40795-021-00494-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Accepted: 12/22/2021] [Indexed: 11/10/2022] Open
Abstract
Introduction Appropriate dietary practices in pregnancy are critical to meet the increased metabolic and physiological demands; however, information about dietary practices among pregnant women, particularly rural residents, is limited. The study aimed to assess the level of appropriate dietary practices and associated determinants among pregnant women in Haramaya District, eastern Ethiopia, 2021. Methods A community-based cross-sectional study was conducted among 448 pregnant women in Haramaya District, Eastern Ethiopia. Data was collected through face-to-face interviews by trained research assistants, using a validated frequency questionnaire. The pregnant women were labeled as “appropriate dietary practice” when they consumed at least four meals daily, had a good food variety score, high dietary diversity score, and high consumption of animal source foods during the reference period. Otherwise, they were defined as “inappropriate.” A Poisson regression model with robust variance estimation was used to investigate the association of the independent variables with the dietary practice. An adjusted prevalence ratio with a 95% confidence interval was reported to show an association using a p-value < 0.05. Results The appropriate dietary practice among the study participants was 15.2% (95% CI = 12–18%). Of the respondents, 29.46, 37.5, and 24.7% had a high dietary diversity, high food variety score, and high consumption of animal source foods. The appropriate dietary practice was more prevalent among merchant women (APR = 2.07; 95% CI 1.07–4.02) and those whose husbands have at least a high school educational level (APR = 1.96; 95% CI 1.06–3.46). However, the prevalence of appropriate dietary practice was significantly lower among those who chewed khat (APR = 0.58; 95% CI 0.37–0.90) and among respondents who reported restriction of the intake of some foods (APR = 0.36; 95% CI 0.20–0.65). Conclusion We found sup-optimal appropriate dietary practice among pregnant women in this predominantly rural setting. Additionally, the lower appropriate dietary practice was observed among women who reported chewing khat and experienced restriction of dietary consumption during pregnancy. Therefore, nutrition policy programs and interventions aimed at encouraging maternal nutritional guidance and counseling are recommended. Supplementary Information The online version contains supplementary material available at 10.1186/s40795-021-00494-4.
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Affiliation(s)
- Meseret Belete Fite
- Department of Public Health, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia.
| | - Abera Kenay Tura
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.,Department of Obstetrics and Gynaecology, University Medical Centre Groningen, University of Groningen, Groningen, the Netherlands
| | - Tesfaye Assebe Yadeta
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Lemessa Oljira
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Kedir Teji Roba
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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Darmawati D, Siregar T, Kamil H, Husna C, Tahlil T. Husband’s Perception on Anemia among Pregnant Women based on Cultural Perspective: A Qualitative Study. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.7617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: Anemia is one of the most common nutritional problems during pregnancy. Husbands have an important role in supporting their wives in pregnancy to prevent complications. Husband’s culture and beliefs will affect support for the health status of pregnant women.
AIM: This study aims to explore husbands’ perceptions regarding anemia and cultural beliefs related to pregnancy.
METHODS: This qualitative study was conducted using twelve in-depth interviews (IDIs) with husbands who have pregnant wives who were recruited through a purposive sampling method. Data were collected through IDIs using open-ended questions to gain insight about Husband’s Perception on Anemia among Pregnant Women based on Cultural Perspective. Data analysis was conducted by an inductive content analysis method to evaluate, encode, and analyze the interview’s result.
RESULTS: Four themes emerged from interviews: (1) Husbands’ happiness and support to their wives during pregnancy; (2) Husbands’ perceptions and actions related to anemia symptoms; (3) Cultural beliefs during pregnancy believed by Acehnese people; and (4) the importance of local wisdom-based counseling.
CONCLUSIONS: Our findings provide new insights into how husbands’ perceptions on anemia during pregnancy, how they support their pregnant wives, and what their believed in cultural views about pregnancy. These findings would assist in developing/adapting more strategic policies to prevent anemia in pregnancy.
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Wang Z, Shen J, Wu Y, Cui X, Song Q, Shi Z, Guo C, Su J, Zang J. A China Healthy Diet Index-Based Evaluation of Dietary Quality among Pregnant Women in Shanghai across Trimesters and Residential Areas. J Nutr Sci Vitaminol (Tokyo) 2021; 67:301-309. [PMID: 34719615 DOI: 10.3177/jnsv.67.301] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Good dietary quality among pregnant women is critical for maternal and fetal health. The primary objective of our study was to analyze the dietary quality of pregnant woman and its influencing factors. Pregnant women were enrolled using a multistage, stratified, random-sampling method in Shanghai. We used a personal food frequency questionnaire and a household condiment weighing method for dietary assessments. Participants' scores on the China Healthy Diet Index (CHDI) were analyzed to evaluate diet quality. Significant differences in the median daily intake of almost all food types were found across all trimesters, and all food types were found across all residential areas (urban, suburban and rural). The median of total CHDI score was 71.6 in all subjects, 71.1 in early pregnancy, 71.5 in middle pregnancy and 72.3 in late pregnancy. The results of uni-variate analysis showed that significant differences in CHDI scores were found across trimesters and residential areas. Eighty one point six percent of participants scored below 80 points, indicating general or poor dietary quality. Logistic regression models showed that participants in early and middle pregnancy had lower scores than those in late pregnancy. Women in urban areas had higher scores than those in suburban and rural areas. Most of pregnant women living in Shanghai suffer from a general or poor dietary quality. Education on balance diet should be strengthened to guide pregnant women in making reasonable food choices and intake, especially those living in suburban and rural areas and those in their first and second trimesters.
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Affiliation(s)
- Zhengyuan Wang
- Division of Health Risk Factors Monitoring and Control, Shanghai Municipal Center for Disease Control and Prevention
| | - Jiaying Shen
- Division of Health Risk Factors Monitoring and Control, Shanghai Municipal Center for Disease Control and Prevention
| | - Yiwen Wu
- Division of Health Risk Factors Monitoring and Control, Shanghai Municipal Center for Disease Control and Prevention
| | - Xueying Cui
- Division of Health Risk Factors Monitoring and Control, Shanghai Municipal Center for Disease Control and Prevention
| | - Qi Song
- Division of Health Risk Factors Monitoring and Control, Shanghai Municipal Center for Disease Control and Prevention
| | - Zehuan Shi
- Division of Health Risk Factors Monitoring and Control, Shanghai Municipal Center for Disease Control and Prevention
| | - Changyi Guo
- General Office, Shanghai Municipal Center for Disease Control and Prevention
| | - Jin Su
- Division of Health Risk Factors Monitoring and Control, Shanghai Municipal Center for Disease Control and Prevention
| | - Jiajie Zang
- Division of Health Risk Factors Monitoring and Control, Shanghai Municipal Center for Disease Control and Prevention
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Gelebo DG, Gebremichael MA, Asale GA, Berbada DA. Prevalence of undernutrition and its associated factors among pregnant women in Konso district, southern Ethiopia: a community-based cross-sectional study. BMC Nutr 2021; 7:32. [PMID: 34247657 PMCID: PMC8273999 DOI: 10.1186/s40795-021-00437-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 05/04/2021] [Indexed: 01/31/2023] Open
Abstract
Background Undernutrition during pregnancy is an important public health problem. It is highly prevalent in Ethiopia but not sufficiently addressed yet. Hence, this study aimed to assess the prevalence of undernutrition and its associated factors among pregnant mothers in Konso district, Ethiopia. Methods Community-based cross-sectional study was conducted with a qualitative inquiry from December 2018 to January 2019. A multistage stratified sampling technique was used to select 527 subjects and quantitative data were collected from these subjects using a structured interviewer-administered questionnaire and additionally qualitative data were generated through two focus group discussions among purposely selected discussants. Mid upper arm circumference (MUAC) was measured by standard non-stretchable MUAC tape. Data were entered into Epi-data version3.1 and analyzed by SPSS version 21. In multivariable binary logistic regression, a statistically significant association was declared at p-value < 0.05 while thematic framework analysis was employed for the qualitative data. Results Among 501 participants, the overall prevalence of undernutrition (MUAC < 23 cm) was 43.1% (95% CI 38.7–47.5%). Household food security (AOR = 3.1; 95% CI: 2.1–4.6), low dietary diversity score (AOR = 4.9; 95% CI: 2.6–9.2), medium dietary diversity score (AOR = 2.3; 95% CI: 1.2–4.7), absence of latrine (AOR = 1.8; 95% CI: 1.2–2.6) and having family resource decision making by husband only (AOR = 1.7; 95% CI: 1.1–2.6) were significantly associated factors. Traditional believes to restrict food such as egg, milk, and milk products, avocado for women, weak nutrition education and malnutrition screening program, daily consumption of locally prepared alcoholic drink called “Cheka”, drought-prone nature of this setting, traditional way of farming practices and low socio-economic status were found to be barriers for women’s undernutrition. Conclusions The prevalence of undernutrition was found to be higher than previously reported findings. Household food security, dietary diversity, latrine availability, family resource decision making, food restrictions, weak maternal nutrition education, and malnutrition screening program, the practice of depending on a local alcoholic drink called “Cheka”, drought, traditional way of farming and low socio-economic status were identified factors. Hence, interventions targeting maternal nutrition education, hygiene, and sanitation promotion, household food insecurity improvement strategies should be implemented to improve the nutritional status of pregnant women.
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Affiliation(s)
| | - Mathewos Alemu Gebremichael
- School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia.
| | - Gistane Ayele Asale
- School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Dessalegn Ajema Berbada
- School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
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Shrestha V, Paudel R, Sunuwar DR, Lyman ALT, Manohar S, Amatya A. Factors associated with dietary diversity among pregnant women in the western hill region of Nepal: A community based cross-sectional study. PLoS One 2021; 16:e0247085. [PMID: 33831015 PMCID: PMC8031299 DOI: 10.1371/journal.pone.0247085] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 02/01/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Dietary diversity can play an important role in providing essential nutrients for both mother and fetus during pregnancy. This study aimed to assess the factors associated with dietary diversity during pregnancy in the western hill region of Nepal. METHODS A cross-sectional study of 327 pregnant women was conducted in an urban municipality of Baglung district in the western hill region of Nepal. A semi-structured questionnaire was used to collect information on household demographic and socioeconomic status, food taboos, household food security status, nutrition-related knowledge in pregnancy, and women's empowerment. Women consuming ≥5 of 10 food groups in the past 24 hours were defined as consuming a diverse diet using the Minimum Dietary Diversity Score for Women (MDD-W) tool. Bivariate and multivariate logistic regression was used to estimate crude odds ratio (cOR) and adjusted odds ratios (aOR) and 95% confidence intervals (CIs) to understand factors associated with dietary diversity. RESULTS Almost 45% (95% CI: 39.6-50.4) of the participants did not consume a diverse diet and the mean dietary diversity score was 4.76 ± 1.23. Multivariable analysis revealed that women with greater empowerment (aOR = 4.3, 95% CI: 1.9-9.9), from wealthier households (aOR = 5.1, 95% CI: 2.7-9.3), joint families (aOR = 2.7, 95% CI: 1.4-5.1), employment (aOR = 2.2, 95% CI: 1.2-4.1), and had adequate nutrition knowledge (aOR: 1.9, 95% CI 1.1-3.4) had higher odds of dietary diversity. CONCLUSION Along with socioeconomic status, women's empowerment and nutrition knowledge were modifiable risk factors that should be considered as targets for programs to improve women's health during pregnancy.
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Affiliation(s)
- Vintuna Shrestha
- Department of Nursing, Dhaulagiri Prabhidhik Shikshya Pratisthan, Council for Technical Education and Vocational Training, Baglung, Nepal
| | - Rajan Paudel
- Central Department of Public Health, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - Dev Ram Sunuwar
- Department of Nutrition and Dietetics, Armed Police Force Hospital, Kathmandu, Nepal
| | - Andrew L. Thorne Lyman
- Center for Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America
| | - Swetha Manohar
- Center for Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America
- International Development Program, Nitze School of Advanced of International Studies (SAIS), Johns Hopkins University, Washington DC, United States of America
| | - Archana Amatya
- Central Department of Public Health, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
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Bukari M, Saaka M, Masahudu A, Ali Z, Abubakari AL, Danquah LO, Abdulai AN, Abizari AR. Household factors and gestational age predict diet quality of pregnant women. MATERNAL AND CHILD NUTRITION 2021; 17:e13145. [PMID: 33528101 PMCID: PMC8189244 DOI: 10.1111/mcn.13145] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Revised: 12/28/2020] [Accepted: 01/12/2021] [Indexed: 11/28/2022]
Abstract
Adequate diet during pregnancy has positive effects on the mother and pregnancy outcome. Assessment of diet quality during pregnancy is particularly important in areas where household food security is suboptimal, to enable appropriate targeting and intervention. This study assessed diet quality and identified predicting factors among pregnant women in northern Ghana. A cross‐sectional study involving 403 pregnant women was conducted in May 2018. Pregnant women attending antenatal care clinics (ANC) were selected using simple random sampling technique. We assessed socio‐demographic characteristics, 24‐h recall and household food security. The minimum dietary diversity for women (MDD‐W) was used as a proxy measure for diet quality based on Food and Agricultural Organization (FAO) guidelines. Logistic regression models were fitted to determine the predictors of diet quality. The mean dietary diversity score (DDS) of 10 food groups was 4.4 ± 1.1 (95% CI: 4.3–4.5). Logistic regression showed that women of high educational level (adjusted odds ratio [AOR] = 2.42; 95% confidence interval [CI] [1.21–4.84]; P = 0.01), women of high household wealth index (AOR = 1.78; 95% CI [1.14–2.77]; P = 0.01], none/mild household hunger (AOR = 2.71; 95% CI [1.26–5.82]; P = 0.01), medium household size (6–15 members) (AOR = 1.66; 95% CI [1.04–2.66]; P = 0.03) and women of gestational age 20–35 weeks (AOR = 1.89; 95% CI [1.05–3.40]; P = 0.03) were more likely to have quality diets after adjusting for potential confounding variables. Diet quality among pregnant women was low and was predicted by educational level, household wealth, gestational age and food security. Women education and improvements in household food security could impact diets of pregnant women in northern Ghana.
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Affiliation(s)
- Mohammed Bukari
- Department of Nutritional Sciences, School of Allied Health Sciences, University for Development Studies, Tamale, Ghana
| | - Mahama Saaka
- Department of Nutritional Sciences, School of Allied Health Sciences, University for Development Studies, Tamale, Ghana
| | - Azaratu Masahudu
- Department of Nutritional Sciences, School of Allied Health Sciences, University for Development Studies, Tamale, Ghana
| | - Zakari Ali
- Medical Research Council Unit, The Gambia at the London School of Hygiene and Tropical Medicine, Banjul, The Gambia
| | - Abdul-Latif Abubakari
- Department of Nutritional Sciences, School of Allied Health Sciences, University for Development Studies, Tamale, Ghana
| | - Lillian Owusuwaa Danquah
- Department of Nutritional Sciences, School of Allied Health Sciences, University for Development Studies, Tamale, Ghana
| | - Ayishetu Napari Abdulai
- Department of Nutritional Sciences, School of Allied Health Sciences, University for Development Studies, Tamale, Ghana
| | - Abdul-Razak Abizari
- Department of Nutritional Sciences, School of Allied Health Sciences, University for Development Studies, Tamale, Ghana
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Darmawati D, Nizwan-Siregar T, Kamil H, Tahlil T. Exploring Indonesian mothers' perspectives on anemia during pregnancy: A qualitative approach. ENFERMERIA CLINICA 2020; 32:S1130-8621(20)30551-9. [PMID: 33384251 DOI: 10.1016/j.enfcli.2020.11.002] [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: 05/01/2020] [Revised: 10/23/2020] [Accepted: 11/02/2020] [Indexed: 02/01/2023]
Abstract
OBJECTIVE The study aims to investigate the perceptions of anemia among pregnant women to design culturally relevant interventions in Indonesia. METHOD Qualitative study with dates from 24 pregnant women in a province in Indonesia through focus group discussions. Data were analyzed using the inductive content analysis method. RESULTS Five themes emerged from the experiences of pregnant women with anemia: (1) anemia during pregnancy is perceived as a woman's destiny; (2) lack of knowledge related to clinical indicators of anemia; (3) the traditional taboo related to anemia; (4) the husband and family provide support related to anemia prevention; and (5) there is a need for cultural and religious-based health counseling. CONCLUSIONS Interventions to provide health information about anemia in pregnancy should be designed with consideration of local knowledge, beliefs and values, combined with medical elements. It is likely these interventions can change the perceptions of pregnant women's perceptions about anemia, ensuring that they are able to maintain their pregnancy. The implementation of programs to support these women should involves health workers who can understand their needs and who are adequately trained in cultural competence.
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Affiliation(s)
- Darmawati Darmawati
- Graduate School of Mathematics and Applied Science, Department of Maternity Nursing, Faculty of Nursing, Universitas Syiah Kuala, Aceh, Indonesia.
| | | | - Hajjul Kamil
- Department of Management Nursing, Faculty of Nursing, Universitas Syiah Kuala, Aceh, Indonesia
| | - Teuku Tahlil
- Department of Community Nursing, Faculty of Nursing, Universitas Syiah Kuala, Aceh, Indonesia
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Chen Q, Wu W, Yang H, Zhang P, Feng Y, Wang K, Wang Y, Wang S, Zhang Y. A Vegetable Dietary Pattern Is Associated with Lowered Risk of Gestational Diabetes Mellitus in Chinese Women. Diabetes Metab J 2020; 44:887-896. [PMID: 33081427 PMCID: PMC7801758 DOI: 10.4093/dmj.2019.0138] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Accepted: 01/16/2020] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Identification of modifiable dietary factors, which are involved in the development of gestational diabetes mellitus (GDM), could inform strategies to prevent GDM. METHODS We examined the dietary patterns in a Chinese population and evaluated their relationship with GDM risk using a case-control study including 1,464 cases and 8,092 control subjects. Propensity score matching was used to reduce the imbalance of covariates between cases and controls. Dietary patterns were identified using factor analysis while their associations with GDM risk were evaluated using logistic regression models. RESULTS A "vegetable" dietary pattern was characterized as the consumption of green leafy vegetables (Chinese little greens and bean seedling), other vegetables (cabbages, carrots, tomatoes, eggplants, potatoes, mushrooms, peppers, bamboo shoots, agarics, and garlic), and bean products (soybean milk, tofu, kidney beans, and cowpea). For every quartile increase in the vegetables factor score during 1 year prior to conception, the first trimester, and the second trimester of pregnancy, the GDM risk lowered by 6% (odds ratio [OR], 0.94; 95% confidence interval [CI], 0.89 to 0.99), 7% (OR, 0.94; 95% CI, 0.88 to 0.99), and 9% (OR, 0.91; 95% CI, 0.86 to 0.96). CONCLUSION In conclusion, our study suggests that the vegetable dietary pattern is associated with lower GDM risk; however, the interpretation of the result should with caution due to the limitations in our study, and additional studies are necessary to explore the underlying mechanism of this relationship.
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Affiliation(s)
- Qiong Chen
- Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, China
- Department of Epidemiology, Shanxi Medical University School of Public Health, Taiyuan, China
| | - Weiwei Wu
- Department of Epidemiology, Shanxi Medical University School of Public Health, Taiyuan, China
| | - Hailan Yang
- Department of Obstetrics, The First Affiliated Hospital, Shanxi Medical University, Taiyuan, China
| | - Ping Zhang
- Department of Epidemiology, Shanxi Medical University School of Public Health, Taiyuan, China
| | - Yongliang Feng
- Department of Epidemiology, Shanxi Medical University School of Public Health, Taiyuan, China
| | - Keke Wang
- Department of Epidemiology, Shanxi Medical University School of Public Health, Taiyuan, China
| | - Ying Wang
- Department of Epidemiology, Shanxi Medical University School of Public Health, Taiyuan, China
| | - Suping Wang
- Department of Epidemiology, Shanxi Medical University School of Public Health, Taiyuan, China
- Corresponding authors: Yawei Zhang https://orcid.org/0000-0002-9762-7752 Department of Surgery, Yale University School of Medicine, 60 College Street, LEPH 440, New Haven, CT 06520, USA E-mail:
| | - Yawei Zhang
- Department of Epidemiology, Shanxi Medical University School of Public Health, Taiyuan, China
- Department of Surgery, Yale University School of Medicine, New Haven, CT, USA
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, USA
- Corresponding authors: Yawei Zhang https://orcid.org/0000-0002-9762-7752 Department of Surgery, Yale University School of Medicine, 60 College Street, LEPH 440, New Haven, CT 06520, USA E-mail:
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Muze M, Yesse M, Kedir S, Mustefa A. Prevalence and associated factors of undernutrition among pregnant women visiting ANC clinics in Silte zone, Southern Ethiopia. BMC Pregnancy Childbirth 2020; 20:707. [PMID: 33213406 PMCID: PMC7678074 DOI: 10.1186/s12884-020-03404-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 11/10/2020] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Maternal undernutrition is highly prevalent in underdeveloped countries. Hence, this study was intended to determine the prevalence and associated factors of undernutrition among pregnant women visiting ANC clinics in Silte Zone. METHOD Facility-based cross-sectional study was conducted from July to January 2019. Systematic random sampling technique was used to select 422 study participants from 11 randomly selected health facilities. Data was collected by using a structured-interviewer administered questionnaire. Mid upper arm circumference (MUAC) was measured by standard non stretchable MUAC tape. Data was entered into a computer using Epi data 3.1 and edited, cleaned, and analyzed using SPSS version 20. Both bivariate and multiple logistic regression analyses were employed to identify factors associated with maternal undernutrition. RESULT In this study, the overall prevalence of undernutrition among study subjects was 21.8%. Age greater than 31 years of women (AOR = 0.15; 95% CI: 0.03, 0.93), Birth intervals > 2 years (AOR = 0.18; 95% CI: 0.04, 0.76), good nutritional knowledge (AOR = 0.34; 95% CI: 0.17, 0.67), and having no dietary change as a result of current pregnancy AOR = 6.02; 95% CI: 2.99, 12.14) were significantly associated with undernutrition. CONCLUSIONS The prevalence of undernutrition among pregnant women was 21.8%. Current estimate is lower than previously reported in the study area but higher than reported in developed country. Age of women, Birth intervals, and Dietary change as a result of current pregnancy and Nutrition knowledge were important risk factors/ predictors of undernutrition (MUAC < 23 cm). Interventions targeting maternal nutrition education and child spacing with giving special emphasis to adolescent pregnant women are recommended.
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Affiliation(s)
- Mohammed Muze
- Department of Nursing, Collage of Medicine and Health Science, Werabe University, Werabe, Ethiopia.
| | - Mubarek Yesse
- Department of Nursing, Collage of Medicine and Health Science, Werabe University, Werabe, Ethiopia
| | - Shemsu Kedir
- Department of Nursing, Collage of Medicine and Health Science, Werabe University, Werabe, Ethiopia
| | - Abdilmejid Mustefa
- Department of Nursing, Collage of Medicine and Health Science, Werabe University, Werabe, Ethiopia
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21
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Mshanga N, Martin H, Petrucka P. <p>Knowledge and Dietary Practices on Vitamin A and Iron Among Maasai Pregnant Women: A Mixed-Method Study, Ngorongoro, Tanzania</p>. NUTRITION AND DIETARY SUPPLEMENTS 2020. [DOI: 10.2147/nds.s264592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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22
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Nahrisah P, Somrongthong R, Viriyautsahakul N, Viwattanakulvanid P, Plianbangchang S. Effect of Integrated Pictorial Handbook Education and Counseling on Improving Anemia Status, Knowledge, Food Intake, and Iron Tablet Compliance Among Anemic Pregnant Women in Indonesia: A Quasi-Experimental Study. J Multidiscip Healthc 2020; 13:43-52. [PMID: 32021233 PMCID: PMC6970256 DOI: 10.2147/jmdh.s213550] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Accepted: 12/13/2019] [Indexed: 12/19/2022] Open
Abstract
Purpose To determine the effect of individual education through a pictorial handbook on anemia in conjunction with counseling on improving hemoglobin and hematocrit level, birth weight, knowledge, iron-rich food and iron-folic acid (IFA) intake. Patients and Methods The study developed a pictorial handbook that was conceptualized based on the Health Belief Model and adjusted to some cultural and local contexts. A quasi-experimental pre-test–post-test control group design was used, purposefully conducted between two homogenous municipalities, each having a rate of anemic pregnancy that was 40% or greater. The sample consists of 140 anemic pregnant women randomly allocated via lottery into two groups; the intervention group (n=70), which received two home visits—one for education and another for a counseling session, and control group (n=70), which received routine antenatal care. A chi-square test and a Mann–Whitney U-test were conducted to compare the baseline socio-demographics. An analysis of covariance (ANCOVA), controlling some possible confounders, was performed to analyze the effect of intervention. Results The post-test means of hemoglobin F (1, 132) = 122, p-value <0.001, and hematocrit levels F (1, 132) = 373, p-value <0.001, were significantly different and higher in the intervention group compared to the control group. Similar results were found in knowledge, food frequency score, number of IFA intake (with p-value <0.001), birth weight and daily iron intake from food (with p-value <0.05). The intervention had a particularly large effect on food frequency score and number of IFA intake, and medium effect on hemoglobin and hematocrit levels. Conclusion Individual education through a pictorial handbook on anemia in conjunction with the counseling intervention program had a positive impact on hemoglobin and hematocrit levels for anemic pregnant women in their third trimester of pregnancy.
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Affiliation(s)
- Putri Nahrisah
- College of Public Health Sciences, Chulalongkorn University, Pathumwan, Bangkok 10330, Thailand.,Health Office of Kota Langsa Municipality, Kota Langsa, Province of Aceh, Indonesia
| | - Ratana Somrongthong
- College of Public Health Sciences, Chulalongkorn University, Pathumwan, Bangkok 10330, Thailand
| | | | | | - Samlee Plianbangchang
- College of Public Health Sciences, Chulalongkorn University, Pathumwan, Bangkok 10330, Thailand
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23
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Tang D, Bu T, Dong X. Are parental dietary patterns associated with children's overweight and obesity in China? BMC Pediatr 2020; 20:12. [PMID: 31926550 PMCID: PMC6954549 DOI: 10.1186/s12887-020-1910-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 01/03/2020] [Indexed: 11/16/2022] Open
Abstract
Background It is believed that parents have a great influence on their children’s dietary behaviours. However, it is not clear whether parental food patterns are associated with children’s nutritional status in China, which includes a vast territory with rich, diverse cultures. The goal of this project is to systematically study the associations between parental food intake and children’s overweight and obesity in China, according to children’s ages and regional differences. Methods Based on individual food consumption data from the China Health and Nutrition Survey (CHNS) package in 2011, cross-sectional studies have previously been conducted to analyse the association between different categories of food intake of parents and children. The current study extends this research by directly. Results Our analysis results show that parental food intake is highly correlated with children’s food intake, with the estimated coefficients of most food intake categories being greater than 0.5. Furthermore, this association between parental food intake and children’s overweight and obesity is most significant in young children, but it begins to weaken in relation to children aged between 13 and 18. Additionally, the associations between parental food intake and children’s overnutrition are more significant in rural areas than they are in urban areas. Conclusions The association between parental food intake and childhood overweight and obesity is significant, although it varies considerably according to food categories, children’s ages and area differences. These results show promise for intervening in the overnutrition of children by controlling household dietary patterns according to children’s developmental stages and regional differences.
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Affiliation(s)
- Daisheng Tang
- School of Economics and Management, Beijing Jiaotong University, Beijing, 100044, China
| | - Tao Bu
- School of Economics and Management, Beijing Jiaotong University, Beijing, 100044, China.
| | - Xuefan Dong
- School of Economics and Management, Beijing Jiaotong University, Beijing, 100044, China
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24
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Diddana TZ. Factors associated with dietary practice and nutritional status of pregnant women in Dessie town, northeastern Ethiopia: a community-based cross-sectional study. BMC Pregnancy Childbirth 2019; 19:517. [PMID: 31870426 PMCID: PMC6929309 DOI: 10.1186/s12884-019-2649-0] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Accepted: 11/28/2019] [Indexed: 11/25/2022] Open
Abstract
Background Maternal undernutrition is highly prevalent in resource-poor settings. Hence, this study was intended to determine factors associated with the dietary practice and nutritional status of pregnant women in Dessie town, northeastern Ethiopia. Methods Community-based cross-sectional study design was employed. Six hundred four (604) pregnant women have participated. A two-stage sampling method was applied to select participants. Socio-demographic and socio-economic data were collected using a structured interviewer-administered questionnaire. The dietary practice was measured using 13 dietary practice questions. Mid upper arm circumference (MUAC) was measured by standard nonstretchable MUAC tape. Data were entered into Epi-Info 7 and exported to SPSS version 20. Binary and multiple logistic regression analysis was conducted. Variables with P < 0.2 in bivariate analysis were entered for multiple logistic regression. At a 95% confidence interval, variable with 푃< 0.05 in multiple logistic regression analysis was considered statistically significant. Result About 54.8% of the pregnant women had poor dietary practice and 19.5% were undernourished. First trimester of pregnancy (AOR = 0.46; 95% CI: 0.26, 0.80), no history of illness 2 weeks before data collection date (AOR = 0.42; 95% CI: 0.22, 0.80), poor perceived severity (AOR = 1.64; 95% CI: 1.15, 2.33), poor perceived benefits (AOR = 1.63; 95% CI: 1.14, 2.32) and poor self efficacy (AOR = 4.74; 95% CI: 2.94, 7.65) were significantly associated with poor dietary practice. Not attending antenatal care (ANC) (AOR = 3.46; 95% CI: 2.07, 5.78), illness (AOR = 1.93; 95% CI: 1.10, 3.5), poor dietary diversity (AOR = 5.92; 95% CI: 3.59, 9.76), poor nutrition knowledge (AOR = 3.03; 95% CI: 1.87, 4.92), poor dietary practice (AOR = 3.25; 95% CI: 1.91, 5.54) and poor perceived self efficacy (AOR = 5.59; 95% CI: 3.56, 8.79) were significantly associated (P < 0.05) with undernutrition. Conclusion The dietary practice of pregnant women was suboptimal and nutritional status was relatively high. Being in the first trimester of pregnancy and no history illness were negatively associated while poorly perceived severity to malnutrition, poor perceived benefits, and poor self-efficacy were positively associated with the poor dietary practice. Not attending ANC, history of illness, poor dietary diversity, poor nutritional knowledge, poor dietary practice, poorly perceived self-efficacy were positively associated with undernutrition. Government, health extension workers and other concerned bodies should encourage pregnant women to attend ANC, promote health during pregnancy, strength and counsel to improve dietary diversity and practice of good nutrition. They should focus on the perceived belief of dietary behaviors.
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Affiliation(s)
- Tona Zema Diddana
- School of Nutrition, Food Science and Technology, Hawassa University, Hawassa, Ethiopia.
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25
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Caut C, Leach M, Steel A. Dietary guideline adherence during preconception and pregnancy: A systematic review. MATERNAL AND CHILD NUTRITION 2019; 16:e12916. [PMID: 31793249 PMCID: PMC7083492 DOI: 10.1111/mcn.12916] [Citation(s) in RCA: 68] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 10/25/2019] [Accepted: 10/30/2019] [Indexed: 12/25/2022]
Abstract
The aim of this study is to determine the level of adherence to dietary guidelines among men and women during preconception, and pregnant women, and factors associated with adherence. Searches were conducted in CINAHL, AMED, EMBASE, and Maternity and Infant Care from inception to March 2018. Observational studies assessing the primary outcome (adherence to dietary guidelines and/or nutritional recommendations) and/or secondary outcome (factors associated with adherence) were eligible. Study quality was assessed using the National Institutes of Health Quality Assessment Tool for Observational Cohort and Cross‐sectional studies. Men or women (aged ≥18 years) who identified as trying/intending to conceive or were pregnant. Eighteen studies were included. The quality of studies was fair (44%) to good (56%). Most studies indicated preconceptual and pregnant women do not meet recommendations for vegetable, cereal grain, or folate intake. Pregnant women did not meet iron or calcium intake requirements in 91% and 55% of included studies, respectively, and also exceeded fat intake recommendations in 55% of included studies. Higher level education was associated with improved guideline adherence in pregnant women, whereas older age and non‐smoking status were associated with greater guideline adherence in preconceptual and pregnant women. The findings of this review suggest that preconceptual and pregnant women may not be meeting the minimum requirements stipulated in dietary guidelines and/or nutritional recommendations. This could have potential adverse consequences for pregnancy and birth outcomes and the health of the offspring. Major knowledge gaps identified in this review, which warrant further investigation, are the dietary intakes of men during preconception, and the predictors of guideline adherence.
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Affiliation(s)
- Cherie Caut
- Office of Research, Endeavour College of Natural Health, Queensland, Australia
| | - Matthew Leach
- Department of Rural Health, Division of Health Sciences, University of South Australia, Whyalla, South Australia, Australia
| | - Amie Steel
- Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, Ultimo, New South Wales, Australia
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26
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Xiang M, Zhang J, Liang H, Zhang Z, Konishi M, Hu H, Nishimaki M, Kim HK, Tabata H, Shimizu H, Arao T, Sakamoto S. Physical activity and dietary intake among Chinese pregnant women: an observational study. BMC Pregnancy Childbirth 2019; 19:295. [PMID: 31412799 PMCID: PMC6693271 DOI: 10.1186/s12884-019-2452-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2018] [Accepted: 08/07/2019] [Indexed: 02/01/2023] Open
Abstract
Background Physical activity (PA) and dietary intake are important modifiable factors associated with health outcomes. However, Chinese pregnant women’s PA and dietary intake are only vaguely understood. The aim of this study was to reveal the characteristics of PA and dietary intake of Chinese women in different trimesters as well as the associations between PA and dietary intake. Methods This is a cross-sectional observational study. PA, dietary intake, and demographics of 1077 Chinese pregnant women were measured. The Chi-square test, Kruskal-Wallis test, multiple logistic regression, and multiple linear regression were used for data analysis. Results About 57.1% of the participants met the international guideline for PA. Household activity and occupational activity contributed the most to the total PA, while sports/exercise contributed little. The mean energy intake of the participants was 2008 ± 748.0 kcal. Most participants had normal energy intake, but they obtained excessive energy from fat (mean = 41.7 ± 8.7%). PA was not found to be significantly associated with dietary intake. Further, the participants who were unemployed during pregnancy (OR = 0.72, 95% CI: 0.55–0.95; p < 0.05) or had no exercise habits before pregnancy (OR = 0.62, 95% CI: 0.47–0.80; p < 0.01) were less likely to meet the PA guideline. The participants in the third trimester (OR = 1.43, 95% CI: 1.03–1.99; p < 0.05) were more likely to meet the PA guideline compared to those in the first trimester. The older participants (> 30 years) showed higher dietary intake than the younger (< 25 years) participants (p < 0.01). Conclusions The total PA of Chinese women during pregnancy mostly consists of household and occupational activities, but little sports/exercise. Starting exercise before pregnancy may help women achieve adequate PA during pregnancy. Moreover, these women consumed an excessive amount of fat and their diet intake varies by age.
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Affiliation(s)
- Mi Xiang
- School of Public Health, Shanghai Jiao Tong University, Shanghai, China
| | - Jing Zhang
- School of Public Health, Shanghai Jiao Tong University, Shanghai, China
| | - Huigang Liang
- Department of Business Information & Technology, Fogelman College of Business & Economics, University of Memphis, Memphis, USA.
| | - Zhiruo Zhang
- School of Public Health, Shanghai Jiao Tong University, Shanghai, China.
| | | | - Huanhuan Hu
- National Center for Global Health and Medicine, Tokyo, Japan
| | - Mio Nishimaki
- Graduate School of Sport Sciences, Waseda University, Saitama, Japan
| | - Hyeon-Ki Kim
- Faculty of Sport Sciences, Waseda University, Saitama, Japan.,Research Fellow of the Japan Society for the Promotion of Science, Tokyo, Japan
| | - Hiroki Tabata
- Graduate School of Sport Sciences, Waseda University, Saitama, Japan.,Research Fellow of the Japan Society for the Promotion of Science, Tokyo, Japan
| | - Hisao Shimizu
- Graduate School of Sport Sciences, Waseda University, Saitama, Japan
| | - Takashi Arao
- Faculty of Sport Sciences, Waseda University, Saitama, Japan
| | - Shizuo Sakamoto
- Faculty of Sport Sciences, Waseda University, Saitama, Japan
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27
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Wan CS, Nankervis A, Teede H, Aroni R. Dietary intervention strategies for ethnic Chinese women with gestational diabetes mellitus: A systematic review and meta-analysis. Nutr Diet 2019; 76:211-232. [PMID: 30938046 PMCID: PMC6850048 DOI: 10.1111/1747-0080.12524] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2018] [Revised: 02/01/2019] [Accepted: 02/06/2019] [Indexed: 12/19/2022]
Abstract
Aim Ethnic Chinese women are one of the populations at high risk of gestational diabetes mellitus (GDM) internationally. This systematic review aimed to determine which dietary intervention strategies were found to be effective in improving glycaemic control and pregnancy outcomes among ethnic Chinese women with GDM. Methods The review protocol was registered with PROSPERO (CRD42016043585). Eight English and four Chinese language databases were searched for randomised controlled trials and cohort studies of dietary intervention among ethnic Chinese women with GDM. Review Manager 5.3 and GRADE criteria were used in meta‐analysis and assessment of quality of evidence. Results Included studies comprised 3944 women in 29 eligible studies. Compared to standard treatment, low glycaemic index (GI) diets, low glycaemic load (GL) diets and fibre‐enriched diets were associated with a reduction in fasting plasma glucose, 2‐hour plasma glucose and HbA1c, and improved neonatal outcomes. Low GL diets were associated with reduced caesarean section risk. Conclusions In ethnic Chinese women with GDM, low GI diets, low GL diets and fibre‐enriched diets were associated with improved glycaemic control and pregnancy outcomes. Given the lack of direct comparison of these three diets, future direct comparison trials are necessary to determine optimal dietary intervention strategies.
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Affiliation(s)
- Ching S Wan
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia.,School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia
| | - Alison Nankervis
- Department of Medicine, University of Melbourne, Clayton, Victoria, Australia.,Departments of Diabetes and Endocrinology, The Royal Melbourne and Royal Women's Hospitals, Clayton, Victoria, Australia
| | - Helena Teede
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia.,School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia.,Department of Endocrinology and Diabetes, Monash Health, Clayton, Victoria, Australia
| | - Rosalie Aroni
- School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia.,Medical School, College of Health and Medicine, Australian National University, Canberra, Australian Capital Territory, Australia
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28
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Yang J, Wang H, Du H, Xu L, Liu S, Yi J, Qian X, Chen Y, Jiang Q, He G. Factors associated with exposure of pregnant women to perfluoroalkyl acids in North China and health risk assessment. THE SCIENCE OF THE TOTAL ENVIRONMENT 2019; 655:356-362. [PMID: 30471604 DOI: 10.1016/j.scitotenv.2018.11.042] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Revised: 11/03/2018] [Accepted: 11/03/2018] [Indexed: 05/18/2023]
Abstract
Perfluoroalkyl acids (PFAAs) have been frequently found in blood of pregnant women, but the predictors and potential health risk have not been well studied in China. We recruited 534 pregnant women in Tangshan City of Hebei Province in North China between 2013 and 2014 and measured five PFAAs in serum during their early term of pregnancy, including perfluorooctanoic acid (PFOA), perfluorooctane sulfonic acid (PFOS), perfluorohexane sulfonic acid (PFHxS), perfluoro‑n‑undecanoic acid (PFUdA), and perfluorononanoic acid (PFNA). We explored the factors associated with the levels of serum PFAAs and assessed associated health risks. Food consumption information was obtained by food frequency questionnaire covering 100 items. Multiple linear regression model was used to determine the associations of sociodemographic, anthropometric, and food factors with the concentrations of serum PFAAs. Some PFAAs in serum were positively associated with age and body mass index (BMI). Consumption of beans, aquatic products, and eggs was positively associated with the concentrations of several PFAAs after adjusting for important covariates. Pregnant women who ate more cereal, vegetables, mushrooms and alga tended to have lower levels of serum PFOA, PFOS and PFNA. The Hazard index (HI) for reproductive toxicity and developmental toxicity was below 0.8, and the HI for hepatotoxicity beyond 1 was found in 0.37% of pregnant women. These results suggested that age, BMI, and some food consumption were predictors for the exposure to PFAAs in Chinese pregnant women. More attention should be paid to the hepatotoxicity for these exposures.
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Affiliation(s)
- Jiaqi Yang
- School of Public Health/Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai 200032, China
| | - Hexing Wang
- School of Public Health/Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai 200032, China
| | - Hongyi Du
- School of Public Health/Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai 200032, China
| | - Linji Xu
- Maternal and Child Health Care Hospital, Tangshan Municipality, No. 14 South Jianshe Road, Tangshan 063000, Hebei Province, China
| | - Shuping Liu
- Maternal and Child Health Care Hospital, Tangshan Municipality, No. 14 South Jianshe Road, Tangshan 063000, Hebei Province, China
| | - Jianping Yi
- Maternal and Child Health Care Hospital, Tangshan Municipality, No. 14 South Jianshe Road, Tangshan 063000, Hebei Province, China
| | - Xu Qian
- School of Public Health/Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai 200032, China
| | - Yue Chen
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario K1G 5Z3, Canada
| | - Qingwu Jiang
- School of Public Health/Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai 200032, China
| | - Gengsheng He
- School of Public Health/Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai 200032, China.
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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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30
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Lewicka I, Kocyłowski R, Grzesiak M, Gaj Z, Sajnóg A, Barałkiewicz D, von Kaisenberg C, Suliburska J. Relationship between pre-pregnancy body mass index and mineral concentrations in serum and amniotic fluid in pregnant women during labor. J Trace Elem Med Biol 2019; 52:136-142. [PMID: 30732874 DOI: 10.1016/j.jtemb.2018.12.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 11/10/2018] [Accepted: 12/13/2018] [Indexed: 12/16/2022]
Abstract
The aim of the study was to determine the correlations between body mass index (BMI) values before pregnancy and the concentrations of selected elements (Mg, Co, Cu, Zn, Sr, Cd, Ba, Pb, U, Ca, Cr, Al, Mn, V, Fe) in blood serum and amniotic fluid (AF) in pregnant women. Elemental analysis of serum and amniotic fluid in 225 Polish women (Caucasian/white) showed a relationship between the concentration of minerals in the above-mentioned samples and the pre-pregnancy BMI. Analysis of blood serum was performed by using ICP-MS and it demonstrated that iron concentration was significantly lower in overweight and obese women. Being underweight in pregnant women was associated with a significantly lower concentration of magnesium and cobalt in the blood serum. Both underweight and overweight women were associated with significantly lower concentrations of calcium and strontium in the blood serum. The concentration of cobalt was significantly higher in underweight women. The concentration of lead in the blood serum of overweight and obese women was significantly higher than in other groups. Analysis of the AF showed that the concentration of copper was significantly lower in overweight and obese women, and the concentration of manganese and vanadium significantly higher than in other groups of women. A deficiency in essential minerals and an excess of heavy metals in women may be associated with abnormal body weight and this is important in the etiopathogenesis of pregnancy and fetal development disorders.
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Affiliation(s)
- Iwona Lewicka
- Institute of Human Nutrition and Dietetics, Poznan University of Life Sciences, ul. Wojska Polskiego 31, 60-624 Poznań, Poland.
| | - Rafał Kocyłowski
- Department of Obstetric, Perinatology and Gynecology, Polish Mother's Memorial Hospital Research Institute, ul. Rzgowska281/289, 93-338 Łódz, Poland; PreMediCare New Med Medical Centre, ul. Drużbickiego 13, 61-693 Poznań, Poland.
| | - Mariusz Grzesiak
- Department of Obstetric, Perinatology and Gynecology, Polish Mother's Memorial Hospital Research Institute, ul. Rzgowska281/289, 93-338 Łódz, Poland.
| | - Zuzanna Gaj
- Department of Obstetric, Perinatology and Gynecology, Polish Mother's Memorial Hospital Research Institute, ul. Rzgowska281/289, 93-338 Łódz, Poland; Scientific Laboratory of the Center of Medical Laboratory Diagnostics and Screening, Polish Mother's Memorial Hospital-Research Institute, ul. Rzgowska281/289, Łódz, 93-338, Poland.
| | - Adam Sajnóg
- Department of Trace Element Analysis by Spectroscopy Method, Faculty of Chemistry, Adam Mickiewicz University in Poznań, ul. Umultowska89b, 61-614 Poznan, Poland.
| | - Danuta Barałkiewicz
- Department of Trace Element Analysis by Spectroscopy Method, Faculty of Chemistry, Adam Mickiewicz University in Poznań, ul. Umultowska89b, 61-614 Poznan, Poland.
| | - Constantin von Kaisenberg
- Department of Obstetrics and Gynecology, Hannover Medical School, Carl-Neuberg-Str. 1, D-30625 Hannover, Germany.
| | - Joanna Suliburska
- Institute of Human Nutrition and Dietetics, Poznan University of Life Sciences, ul. Wojska Polskiego 31, 60-624 Poznań, Poland.
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Nguyen CL, Hoang DV, Nguyen PTH, Ha AVV, Chu TK, Pham NM, Lee AH, Duong DV, Binns CW. Low Dietary Intakes of Essential Nutrients during Pregnancy in Vietnam. Nutrients 2018; 10:nu10081025. [PMID: 30082626 PMCID: PMC6116189 DOI: 10.3390/nu10081025] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 08/01/2018] [Accepted: 08/02/2018] [Indexed: 01/05/2023] Open
Abstract
Inadequate intake of nutrients during pregnancy has been associated with poor pregnancy and infant outcomes; however, evidence remains limited in low-resource settings in Asia. This paper assessed food, macronutrient, and micronutrient intakes among 1944 Vietnamese pregnant women. Dietary information was collected via an interviewer-administered food frequency questionnaire, and nutrient intakes were estimated using the Vietnamese food composition tables. The levels of nutrient intakes were evaluated against the Vietnamese recommended nutrient intakes (RNI) for pregnancy. The diet profiles were reported as means and percentages. The average daily food intakes across socio-demographic factors were compared using ANOVA, with adjustment for multiple comparisons by the Tukey–Kramer test. Rice, fruits, and vegetables were the main food sources consumed. The mean energy intake was 2004 kcal/day with 15.9%, 31.8%, and 52.2% of energy deriving from proteins, fats, and carbohydrates, respectively. Just over half of the women did not meet the RNI for total energy intake. The intakes of essential micronutrients including folate, calcium, iron, and zinc were below the RNI, and almost all pregnant women failed to meet the recommendations for these micronutrients. The associations of maternal age, education, and pre-pregnancy body mass index with nutrient intakes varied across the nutrient subgroups. Targeted programs are needed to improve nutrient intakes in Vietnamese pregnant women.
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Affiliation(s)
- Cong Luat Nguyen
- National Institute of Hygiene and Epidemiology, Hanoi 100000, Vietnam.
- School of Public Health, Faculty of Health Sciences, Curtin University, Perth, WA 6102, Australia.
| | - Dong Van Hoang
- National Institute of Hygiene and Epidemiology, Hanoi 100000, Vietnam.
| | - Phung Thi Hoang Nguyen
- School of Public Health, Faculty of Health Sciences, Curtin University, Perth, WA 6102, Australia.
- Department of Nutrition and Food, Faculty of Public Health, University of Medicine and Pharmacy, Ho Chi Minh City 700000, Vietnam.
| | - Anh Vo Van Ha
- School of Public Health, Faculty of Health Sciences, Curtin University, Perth, WA 6102, Australia.
- Department of Environmental and Occupational Health, Pham Ngoc Thach University of Medicine, Ho Chi Minh City 700000, Vietnam.
| | - Tan Khac Chu
- School of Public Health, Faculty of Health Sciences, Curtin University, Perth, WA 6102, Australia.
- Department of Epidemiology, Faculty of Public Health, Hai Phong University of Medicine and Pharmacy, Hai Phong 180000, Vietnam.
| | - Ngoc Minh Pham
- School of Public Health, Faculty of Health Sciences, Curtin University, Perth, WA 6102, Australia.
- Department of Epidemiology, Faculty of Public Health, Thai Nguyen University of Medicine and Pharmacy, Thai Nguyen 250000, Vietnam.
| | - Andy H Lee
- School of Public Health, Faculty of Health Sciences, Curtin University, Perth, WA 6102, Australia.
| | - Dat Van Duong
- Department of Sexual & Reproductive Health, United Nations Population Fund, Hanoi 100000, Vietnam.
| | - Colin W Binns
- School of Public Health, Faculty of Health Sciences, Curtin University, Perth, WA 6102, Australia.
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Lu MS, He JR, Chen Q, Lu J, Wei X, Zhou Q, Chan F, Zhang L, Chen N, Qiu L, Yuan M, Cheng KK, Xia H, Qiu X. Maternal dietary patterns during pregnancy and preterm delivery: a large prospective cohort study in China. Nutr J 2018; 17:71. [PMID: 30045719 PMCID: PMC6060524 DOI: 10.1186/s12937-018-0377-3] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Accepted: 07/05/2018] [Indexed: 11/12/2022] Open
Abstract
Background Evidence about the associations between maternal dietary patterns and preterm delivery is scarce in Eastern countries. The purpose of this study was to examine the associations between maternal dietary patterns during pregnancy and preterm delivery in a Chinese population. Methods A total of 7352 mothers were included in the Born in Guangzhou Cohort Study, a prospective study in China. A validated self-administered food frequency questionnaire (FFQ) was used to assess maternal diet at 24–27 weeks of gestation. Dietary patterns were identified by cluster analysis. Gestational age was obtained from routine medical records. Preterm delivery was defined as delivery before 37 completed weeks of gestation, and was further classified into spontaneous and iatrogenic preterm delivery, and also early/moderate and late preterm delivery. Associations between dietary patterns and preterm delivery outcomes were assessed using logistic regression analyses. Results Six dietary patterns were identified, including ‘Milk’, ‘Cereals, eggs, and Cantonese soups’, ‘Meats’, ‘Fruits, nuts, and Cantonese desserts’, ‘Vegetables’, and ‘Varied’. There were 351 (4.8%) preterm deliveries in this study population. Among those of preterm delivery, 16.2 and 83.8% were early/moderate and late preterm delivery, respectively. Compared with women of ‘Vegetables’ pattern, those of ‘Milk’ pattern had greater odds of overall preterm delivery (adjusted odds ratio [OR] 1.59, 95% confidence interval [CI] 1.11, 2.29, p < 0.05), spontaneous preterm delivery (adjusted OR 1.73, 95% CI 1.14, 2.62, p < 0.05) and late preterm delivery (adjusted OR 1.73, 95% CI 1.08, 2.62, p < 0.05); those of ‘Cereals, eggs, and Cantonese soups’ and ‘Fruits, nuts, and Cantonese desserts’ patterns had greater odds of late preterm delivery (adjusted OR 1.54, 95% CI 1.01, 2.35 for ‘Cereals, eggs, and Cantonese soups’, adjusted OR 1.61, 95% CI 1.04, 2.50 for ‘Fruits, nuts, and Cantonese desserts’, respectively). Conclusion Maternal diet with frequent consumption of milk and less frequent consumption of vegetables during pregnancy might be associated with increased odds of preterm delivery. Future interventions should investigate whether increasing vegetable intake reduces preterm deliveries. Electronic supplementary material The online version of this article (10.1186/s12937-018-0377-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Min-Shan Lu
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, 9 Junsui Road, Zhujiang Newtown, Tianhe District, Guangzhou, 510623, China.,Department of Woman and Child Health Care, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.,Department of Obstetrics and Gynecology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Jian-Rong He
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, 9 Junsui Road, Zhujiang Newtown, Tianhe District, Guangzhou, 510623, China.,Department of Woman and Child Health Care, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Qiaozhu Chen
- Department of Obstetrics and Gynecology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Jinhua Lu
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, 9 Junsui Road, Zhujiang Newtown, Tianhe District, Guangzhou, 510623, China.,Department of Woman and Child Health Care, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Xueling Wei
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, 9 Junsui Road, Zhujiang Newtown, Tianhe District, Guangzhou, 510623, China.,Department of Woman and Child Health Care, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Qianling Zhou
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, 9 Junsui Road, Zhujiang Newtown, Tianhe District, Guangzhou, 510623, China
| | - Fanfan Chan
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, 9 Junsui Road, Zhujiang Newtown, Tianhe District, Guangzhou, 510623, China.,Department of Woman and Child Health Care, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Lifang Zhang
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, 9 Junsui Road, Zhujiang Newtown, Tianhe District, Guangzhou, 510623, China.,Department of Woman and Child Health Care, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Niannian Chen
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, 9 Junsui Road, Zhujiang Newtown, Tianhe District, Guangzhou, 510623, China.,Department of Woman and Child Health Care, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Lan Qiu
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, 9 Junsui Road, Zhujiang Newtown, Tianhe District, Guangzhou, 510623, China.,Department of Woman and Child Health Care, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Mingyang Yuan
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, 9 Junsui Road, Zhujiang Newtown, Tianhe District, Guangzhou, 510623, China.,Department of Woman and Child Health Care, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Kar Keung Cheng
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Huimin Xia
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, 9 Junsui Road, Zhujiang Newtown, Tianhe District, Guangzhou, 510623, China. .,Department of Neonatal Surgery, Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, 9 Junsui Road, Zhujiang Newtown, Tianhe District, Guangzhou, 510623, China.
| | - Xiu Qiu
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, 9 Junsui Road, Zhujiang Newtown, Tianhe District, Guangzhou, 510623, China. .,Department of Woman and Child Health Care, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China. .,Department of Obstetrics and Gynecology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.
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Nana A, Zema T. Dietary practices and associated factors during pregnancy in northwestern Ethiopia. BMC Pregnancy Childbirth 2018; 18:183. [PMID: 29801471 PMCID: PMC5970492 DOI: 10.1186/s12884-018-1822-1] [Citation(s) in RCA: 62] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Accepted: 05/02/2018] [Indexed: 11/27/2022] Open
Abstract
Background Pregnancy is the most crucial nutritionally demanding period of every woman’s life. The high demand of nutrients to deposit energy in the form of new tissue, growth of existing maternal tissues such as breast and uterus and increased energy requirements for tissue synthesis makes pregnant women more vulnerable to malnutrition. Dietary practice is defined as an observable actions or behavior of dietary habit and can be classified as good dietary practices and poor dietary practices. The incidence of dietary inadequacies as a result of dietary habits and patterns in pregnancy is higher during pregnancy when compared to any other stage of the life cycle. Thus, this study aimed to assess dietary practices and associated factors during pregnancy in Bahir Dar town, Northwest Ethiopia. Methods A community based cross sectional study was conducted from March 1 to April 1, 2016. A total of 616 pregnant women were participated in the study. All eligible pregnant women were identified through house-to-house visit with the help of health extension workers. Cluster sampling was used to select eligible pregnant women. The data were collected using interviewer administered questionnaire prepared in English and translated in to Amharic. Data were analyzed by using Statistical Package for Social Sciences (SPSS) version 20. Multivariate logistic regression analysis was employed to identify factors associated with dietary practices. Result This study has shown that 39.3% of the study participants had good dietary practices and the rest 60.7% of pregnant women reported poor dietary practices. Concerning dietary knowledge, 61.4% of the study participants had good dietary knowledge while 38.6% had poor dietary knowledge. Husband income, ownership of radio, history of disease and dietary knowledge were shown to have significant association (P < 0.05) with dietary practices. Conclusion Dietary practices of pregnant women in the study area was suboptimal. Husband income, ownership of radio, history of disease and dietary knowledge were independent predictors of women dietary practices. Awareness should be created among pregnant women by concerned bodies such as governmental and non-governmental organization through local mass media.
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Affiliation(s)
- Amanuel Nana
- Faculty of Chemical and Food Engineering, Bahir Dar Institute of Technology, Bahir Dar University, Bahir Dar, Ethiopia.
| | - Tona Zema
- School of Nutrition, Food Science and Technology, Hawassa University, Hawassa, Ethiopia
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Zhang Y, Zhou H, Perkins A, Wang Y, Sun J. Maternal Dietary Nutrient Intake and Its Association with Preterm Birth: A Case-control Study in Beijing, China. Nutrients 2017; 9:nu9030221. [PMID: 28257050 PMCID: PMC5372884 DOI: 10.3390/nu9030221] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Accepted: 02/27/2017] [Indexed: 11/16/2022] Open
Abstract
This study aimed to evaluate dietary nutrient intake among Chinese pregnant women by comparison with Chinese Dietary Reference Intakes (DRIs) and to explore the association between dietary nutrients and preterm birth. A case-control design was conducted in Beijing with 130 preterm delivery mothers in case group and 381 term delivery mothers in control group. Information on mothers’ diet was collected using a food frequency questionnaire, and nutrients and energy intakes were subsequently calculated based on DRIs. Multivariate analysis of variance was used to compare the differences between term and preterm groups in relation to dietary nutrients. Dietary nutrient intakes were imbalanced in both groups compared with Chinese DRIs. Preterm delivery mothers had a lower level of fat and vitamin E intake than term delivery mothers (p < 0.05). Multivariate analysis showed lower vitamin E intake in preterm delivery mothers with a prepregnancy BMI < 18.5 kg/m2 (p < 0.05) and higher carbohydrate intake in preterm delivery mothers with prepregnancy BMI ≥ 24 kg/m2 (p < 0.05). An imbalanced diet in both groups and low level of dietary intakes of fat and vitamin E in preterm group suggest health education measures should be taken to improve the dietary quality of pregnant women, especially for those with an abnormal prepregnancy BMI.
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Affiliation(s)
- Yan Zhang
- Department of Child, Adolescent and Women's Health, School of Public Health, Peking University, Beijing 100871, China.
| | - Hong Zhou
- Department of Child, Adolescent and Women's Health, School of Public Health, Peking University, Beijing 100871, China.
| | - Anthony Perkins
- Menzies Health Institute Queensland, Griffith University, Queensland 4222, Australia.
| | - Yan Wang
- Department of Child, Adolescent and Women's Health, School of Public Health, Peking University, Beijing 100871, China.
| | - Jing Sun
- Menzies Health Institute Queensland, Griffith University, Queensland 4222, Australia.
- School of Medicine, Griffith University, Queensland 4222, Australia.
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Zhou S, Yuan H, Ma X, Liu Y. Hair chemical element contents and influence factors of reproductive-age women in the West Ujimqin Banner, Inner Mongolia, China. CHEMOSPHERE 2017; 166:528-539. [PMID: 27718426 DOI: 10.1016/j.chemosphere.2016.09.126] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Revised: 09/23/2016] [Accepted: 09/26/2016] [Indexed: 06/06/2023]
Abstract
Women have an increased risk for chemical element deficiencies during reproductive age, particularly due to higher chemical element requirements and poor diets. Twenty-one chemical elements (Al, B, Ba, Ca, Cd, Co, Cr, Cu, Fe, Mg, Mn, Mo, Ni, Pb, Se, Si, Sn, Sr, Ti, V and Zn) in hair samples, which were collected from 71 non-pregnant and 236 pregnant women living in the West Ujimqin Banner, central Inner Mongolia, China, were measured, and the environment, dietary habits and ethnic group influence factors associated with the biomarker were analyzed. The results indicated that the average values of the chemical element contents from hair were greatly different compared to those from other areas, especially the Al, Cd, Pb, Ca and Sr contents. There was no significant difference among the three ethnicities for any element except Mn and Ti in non-pregnant women. Compared to non-pregnant women, in the first trimester group, the levels of nine chemical elements (Ba, Cd, Cu, Pb, Se, Si, Sn and Ti) decreased, while the others increased, and the contents of all of the chemical elements decreased in the second trimester group, while in the third trimester, there was a slight increase. Three chemical elements (Cu, Mn and Zn) displayed a synergistic correlation between each other in the third trimester group, which may protect the placenta from some oxidant damage. The high levels of Cd and Pb in hair likely originate from house renovations and traffic pollution. This study provided basic and useful information on the levels of chemical elements in reproductive-age women, and the results of this study are helpful to control the contents and improve the health of pregnant and non-pregnant women.
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Affiliation(s)
- Shanshan Zhou
- College of Life and Environmental Sciences, Minzu University of China, Beijing, 100081, China; Beijing Engineering Research Center of Food Environment and Public Health, Minzu University of China, Beijing, 100081, China
| | - Haodong Yuan
- College of Life and Environmental Sciences, Minzu University of China, Beijing, 100081, China
| | - Xiaoling Ma
- College of Life and Environmental Sciences, Minzu University of China, Beijing, 100081, China
| | - Ying Liu
- College of Life and Environmental Sciences, Minzu University of China, Beijing, 100081, China; Beijing Engineering Research Center of Food Environment and Public Health, Minzu University of China, Beijing, 100081, China.
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Gao H, Wang Q, Hormann E, Stuetz W, Stiller C, Biesalski HK, Scherbaum V. Breastfeeding practices on postnatal wards in urban and rural areas of the Deyang region, Sichuan province of China. Int Breastfeed J 2016; 11:11. [PMID: 27182280 PMCID: PMC4867090 DOI: 10.1186/s13006-016-0070-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2015] [Accepted: 05/02/2016] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Despite the efforts that have been made to promote breastfeeding in China since the 1990s, there is still a very low prevalence of exclusive breastfeeding. The objective of this study was to assess the current situation of infant feeding practices during the postpartum hospital stay in urban and rural areas of the Deyang region. METHODS Cross-sectional sampling was used in two urban hospitals and five rural clinics in the Deyang region of southwestern China. Interviews with mothers after delivery (urban n = 102, rural n = 99) were conducted before discharge and five focus group discussions were held. RESULTS The prevalence of Caesarean section was high in both urban and rural areas (63.9 % urban vs. 68.4 % rural). After birth, nearly all mothers (98.0 % urban vs. 99.0 % rural) initiated breastfeeding. One week after delivery, the prevalence of exclusive breastfeeding was 8.0 % (9.8 % urban vs. 6.1 % rural), almost exclusive breastfeeding 34.5 % (29.4 % urban vs. 39.8 % rural), mixed feeding 56.0 % (58.8 % urban vs. 53.1 % rural), and exclusive formula feeding 1.5 % (2.0 % urban vs. 1.0 % rural). Breastfeeding initiation (≤ two days after birth) was positively associated (Odds Ratio [OR] 1.97, 95 % Confidence Interval [CI] 1.11, 3.50) with exclusive and almost exclusive breastfeeding, whereas birth length under 50 cm (OR 0.48, 95 % CI 0.26, 0.87), mother's education > 12 years (OR 0.46, 95 % CI 0.24, 0.88) and mother's lack of knowledge about the importance of colostrum (OR 0.35, 95 % CI 0.14, 0.86) were negatively associated with almost exclusive breastfeeding. CONCLUSION Although disparities between urban and rural areas exist, the situation of infant feeding is inadequate in both settings. The high prevalence of Caesarean section, the mothers' poor knowledge of the physiology of breast milk production, the mothers' lack of breastfeeding confidence, the widespread advertising of breast milk substitutes, and the changing perception of the function of breasts, may influence the unfavorable breastfeeding behavior observed in the study area.
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Affiliation(s)
- Haoyue Gao
- />Institute of Social Science in Agriculture (430b), University of Hohenheim, Museumsfluegel, Stuttgart, 70599 Germany
| | - Qi Wang
- />Medical Society of Deyang City, Sichuan, Public Health Bureau of Deyang, Lushan Nan Road No. 299, Jingyang District, Deyang, 618000 China
| | - Elizabeth Hormann
- />Europäisches Institut für Stillen und Laktation, Wittberg 14, Kramsach, 6233 Austria
| | - Wolfgang Stuetz
- />Institute of Biological Chemistry and Nutrition (140a), University of Hohenheim, Garbenstraße 30, Stuttgart, 70599 Germany
| | - Caroline Stiller
- />Institute of Biological Chemistry and Nutrition (140a), University of Hohenheim, Garbenstraße 30, Stuttgart, 70599 Germany
| | - Hans Konrad Biesalski
- />Institute of Biological Chemistry and Nutrition (140a), University of Hohenheim, Garbenstraße 30, Stuttgart, 70599 Germany
- />Food Security Center (793), University of Hohenheim, Wollgrasweg 43, Stuttgart, 70599 Germany
| | - Veronika Scherbaum
- />Institute of Biological Chemistry and Nutrition (140a), University of Hohenheim, Garbenstraße 30, Stuttgart, 70599 Germany
- />Food Security Center (793), University of Hohenheim, Wollgrasweg 43, Stuttgart, 70599 Germany
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Lu MS, Chen QZ, He JR, Wei XL, Lu JH, Li SH, Wen XX, Chan FF, Chen NN, Qiu L, Mai WB, Zhang RF, Hu CY, Xia HM, Qiu X. Maternal Dietary Patterns and Fetal Growth: A Large Prospective Cohort Study in China. Nutrients 2016; 8:nu8050257. [PMID: 27136584 PMCID: PMC4882670 DOI: 10.3390/nu8050257] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Revised: 04/18/2016] [Accepted: 04/22/2016] [Indexed: 12/28/2022] Open
Abstract
There was limited evidence revealing the association of Chinese maternal dietary patterns with fetal growth. We aimed to examine the relationship of maternal dietary patterns during pregnancy to neonatal birth weight and birth weight for gestational age in a Chinese population. A total of 6954 mother-child pairs were included from the Born in Guangzhou Cohort Study. Maternal diet during pregnancy was assessed using a self-administered food frequency questionnaire. Cluster analysis was used to identify dietary patterns. The following six dietary patterns were identified: "Cereals, eggs, and Cantonese soups" (n 1026, 14.8%), "Dairy" (n 1020, 14.7%), "Fruits, nuts, and Cantonese desserts" (n 799, 11.5%), "Meats" (n 1066, 15.3%), "Vegetables" (n 1383, 19.9%), and "Varied" (n 1224, 17.6%). The mean neonatal birth weight Z scores of women in the above patterns were 0.02, 0.07, 0.20, 0.01, 0.06, and 0.14, respectively. Women in the "Fruits, nuts, and Cantonese desserts" and "Varied" groups had significantly heavier infants compared with those in the "Cereals, eggs, and Cantonese soups" group. Compared with women in the "Cereals, eggs, and Cantonese soups" group, those in the "Varied" group had marginally significantly lower odds of having a small-for-gestational age (SGA) infant after adjustment for other confounders (OR 0.77, 95% CI 0.57, 1.04, p = 0.08). These findings suggest that compared to a traditional Cantonese diet high in cereals, eggs, and Cantonese soups, a diet high in fruits, nuts, and Cantonese desserts might be associated with a higher birth weight, while a varied diet might be associated with a greater birth weight and also a decreased risk of having a SGA baby.
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Affiliation(s)
- Min-Shan Lu
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, 9 Junsui Road, Tianhe District, Guangzhou 510623, China.
| | - Qiao-Zhu Chen
- Department of Obstetrics and Gynecology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, 9 Junsui Road, Tianhe District, Guangzhou 510623, China.
| | - Jian-Rong He
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, 9 Junsui Road, Tianhe District, Guangzhou 510623, China.
| | - Xue-Ling Wei
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, 9 Junsui Road, Tianhe District, Guangzhou 510623, China.
| | - Jin-Hua Lu
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, 9 Junsui Road, Tianhe District, Guangzhou 510623, China.
| | - Sheng-Hui Li
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, 9 Junsui Road, Tianhe District, Guangzhou 510623, China.
| | - Xing-Xuan Wen
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, 9 Junsui Road, Tianhe District, Guangzhou 510623, China.
| | - Fan-Fan Chan
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, 9 Junsui Road, Tianhe District, Guangzhou 510623, China.
| | - Nian-Nian Chen
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, 9 Junsui Road, Tianhe District, Guangzhou 510623, China.
| | - Lan Qiu
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, 9 Junsui Road, Tianhe District, Guangzhou 510623, China.
| | - Wei-Bi Mai
- Department of Obstetrics and Gynecology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, 9 Junsui Road, Tianhe District, Guangzhou 510623, China.
| | - Rui-Fang Zhang
- Department of Obstetrics and Gynecology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, 9 Junsui Road, Tianhe District, Guangzhou 510623, China.
| | - Cui-Yue Hu
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, 9 Junsui Road, Tianhe District, Guangzhou 510623, China.
| | - Hui-Min Xia
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, 9 Junsui Road, Tianhe District, Guangzhou 510623, China.
| | - Xiu Qiu
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, 9 Junsui Road, Tianhe District, Guangzhou 510623, China.
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D'Souza L, Jayaweera H, Pickett KE. Pregnancy diets, migration, and birth outcomes. Health Care Women Int 2015; 37:964-978. [PMID: 26491790 DOI: 10.1080/07399332.2015.1102268] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Women in low- and middle-income countries are known to make changes to their diets during pregnancy. We set out to explore the subject of traditional pregnancy diets with a view to finding out if migrant women follow these practices, and if such information might help explain differences in birth outcomes between migrant women and destination-country-born women. This review found that traditional pregnancy diets vary from region to region, that migrant women may follow some of these practices, and that there is a dearth of studies looking into the impact of pregnancy diets on birth outcomes.
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Affiliation(s)
| | - Hiranthi Jayaweera
- b Centre on Migration, Policy and Society, University of Oxford , Oxford , UK
| | - Kate E Pickett
- c Department of Health Sciences , University of York , York , UK
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Maternal dietary patterns and gestational diabetes mellitus: a large prospective cohort study in China. Br J Nutr 2015; 113:1292-300. [PMID: 25821944 DOI: 10.1017/s0007114515000707] [Citation(s) in RCA: 91] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Few studies have explored the relationship between dietary patterns and the risk of gestational diabetes mellitus (GDM). Evidence from non-Western areas is particularly lacking. In the present study, we aimed to examine the associations between dietary patterns and the risk of GDM in a Chinese population. A total of 3063 pregnant Chinese women from an ongoing prospective cohort study were included. Data on dietary intake were collected using a FFQ at 24-27 weeks of gestation. GDM was diagnosed using a 75 g, 2 h oral glucose tolerance test. Dietary patterns were determined by principal components factor analysis. A log-binomial regression model was used to examine the associations between dietary pattern and the risk of GDM. The analysis identified four dietary patterns: vegetable pattern; protein-rich pattern; prudent pattern; sweets and seafood pattern. Multivariate analysis showed that the highest tertile of the vegetable pattern was associated with a decreased risk of GDM (relative risk (RR) 0·79, 95% CI 0·64, 0·97), compared with the lowest tertile, whereas the highest tertile of the sweets and seafood pattern was associated with an increased risk of GDM (RR 1·23, 95% CI 1·02, 1·49). No significant association was found for either the protein-rich or the prudent pattern. The protective effect of a high vegetable pattern score was more evident among women who had a family history of diabetes (P for interaction=0·022). These findings suggest that the vegetable pattern was associated with a decreased risk of GDM, while the sweets and seafood pattern was associated with an increased risk of GDM. These findings may be useful in dietary counselling during pregnancy.
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Widyawati W, Jans S, Utomo S, van Dillen J, Janssen ALML. A qualitative study on barriers in the prevention of anaemia during pregnancy in public health centres: perceptions of Indonesian nurse-midwives. BMC Pregnancy Childbirth 2015; 15:47. [PMID: 25886505 PMCID: PMC4348154 DOI: 10.1186/s12884-015-0478-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2014] [Accepted: 02/12/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Anemia in pregnancy remains a major problem in Indonesia over the past decade. Early detection of anaemia in pregnancy is one of the components which is unsuccessfully implemented by nurse-midwives. This study aims to explore nurse-midwives' experiences in managing pregnant women with anaemia in Public Health Centres. METHODS We conducted a qualitative study with semi-structured face to face interviews from November 2011 to February 2012 with 23 nurse-midwives in five districts in Yogyakarta Special Province. Data analysis was thematic, using the constant comparison method, making comparison between participants and supported by ATLAS.ti software. RESULTS Twelve nurse-midwives included in the interviews had less than or equal to 10 years' working experience (junior nurse-midwives) and 11 nurse-midwives had more than 10 years' working experience (senior nurse-midwives) in Public Health Centres. The senior nurse-midwives mostly worked as coordinators in Public Health Centres. Three main themes emerged: 1) the lack of competence and clinical skill; 2) cultural beliefs and low participation of family in antenatal care programme; 3) insufficient facilities and skilled support staff in Public Health Centres. The nurse-midwives realized that they need to improve their communication and clinical skills to manage pregnant women with anaemia. The husband and family involvement in antenatal care was constrained by the strength of cultural beliefs and lack of health information. Moreover, unfavourable work environment of the Public Health Centres made it difficult to apply antenatal care the pregnant womens' need. CONCLUSIONS The availability of facilities and skilled staffs in Public Health Centre as well as pregnant women's husbands or family members contribute to the success of managing anaemia in pregnancy. Nurse-midwives and pregnant women need to be empowered to achieve the optimum result of anaemia management. We recommend a more comprehensive approach in managing pregnant women with anaemia, which synergizes the available resources and empowers nurse-midwives and pregnant women.
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Affiliation(s)
- Widyawati Widyawati
- School of Nursing, Faculty of Medicine, Universitas Gadjah Mada, Yogyakarta, Indonesia.
- Department of Primary and Community Care, Gender & Women's Health, Radboud University Medical Center, 117, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands.
| | - Suze Jans
- Royal Dutch Organisation of Midwives (KNOV), Nijmegen, Netherlands.
| | - Sutarti Utomo
- Provincial Health Office of Yogyakarta Special Province, Yogyakarta, Indonesia.
| | - Jeroen van Dillen
- Department of Obstetrics and Gynaecology, Radboud University Medical Center, Nijmegen, The Netherlands.
| | - A L M Lagro Janssen
- Department of Primary and Community Care, Gender & Women's Health, Radboud University Medical Center, 117, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands.
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41
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Zhang Y, Dong S, Zuo J, Hu X, Zhang H, Zhao Y. Physical activity level of urban pregnant women in Tianjin, China: a cross-sectional study. PLoS One 2014; 9:e109624. [PMID: 25286237 PMCID: PMC4186867 DOI: 10.1371/journal.pone.0109624] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2014] [Accepted: 09/02/2014] [Indexed: 11/30/2022] Open
Abstract
Objective To determine the physical activity level and factors influencing physical activity among pregnant urban Chinese women. Methods This prospective cross-sectional study enrolled 1056 pregnant women (18–44 years of age) in Tianjin, China. Their socio-demographic characteristics were recorded, and the Pregnancy Physical Activity Questionnaire was used to assess their physical activity during pregnancy. The data were analyzed by multinomial logistic regression with adjustment for potential confounders. Results Median total energy expenditure of pregnant women in each of the three trimesters ranged from 18.50 to 21.90 metabolic equivalents of task (METs) h/day. They expended 1.76–1.85 MET h/day on moderate and vigorous activities and 0.11 MET h/day on exercise. Only 117 of the women (11.1%) met the international guideline for physical activity in pregnancy (≥150 min moderate intensity exercise per week). The most frequent reason given for not being more physically active was the fear of miscarriage. Higher education level (OR: 4.11, 95% CI: 1.59–10.62), habitual exercise before pregnancy (OR: 2.14, 95% CI: 1.39–3.28), and husbands who exercised regularly (OR: 2.21, 95% CI: 1.33–3.67) significantly increased the odds of meeting the guideline (p<0.001). A low pre gravid body mass index (OR: 0.42, 95% CI: 0.20–0.87) significantly decreased the odds (p<0.001). Conclusions Few urban Chinese pregnant women met the recommended physical activity guideline. They also expended little energy exercising. Future interventions should be based on the clinic environment and targeting family members as well as the subjects. All pregnant women should be targeted, not just those in high-risk groups.
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Affiliation(s)
- Yan Zhang
- School of Nursing, Tianjin Medical University, Tianjin, China
| | - Shengwen Dong
- School of Nursing, Tianjin Medical University, Tianjin, China
| | - Jianhua Zuo
- Obstetrics and Gynecology Department, Wangdingdi Hospital, Tianjin, China
| | - Xiangqin Hu
- Tianjin Central Hospital of Gynecology and Obstetrics, Tianjin, China
| | - Hua Zhang
- School of Nursing, Tianjin Medical University, Tianjin, China
| | - Yue Zhao
- School of Nursing, Tianjin Medical University, Tianjin, China
- * E-mail:
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Li M, Halldorsson TI, Bjerregaard AA, Che Y, Mao Y, Hu W, Wang Y, Zhou W, Olsen SF, Strøm M. Relative validity and reproducibility of a food frequency questionnaire used in pregnant women from a rural area of China. Acta Obstet Gynecol Scand 2014; 93:1141-9. [DOI: 10.1111/aogs.12460] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2013] [Accepted: 07/09/2014] [Indexed: 01/19/2023]
Affiliation(s)
- Min Li
- School of Public Health; Fudan University; Shanghai China
- Department of Epidemiology and Social Science on Reproductive Health; National Population and Family Planning Key Laboratory of Contraceptive Drugs and Devices; Shanghai Institute of Planned Parenthood Research; Shanghai China
| | - Thorhallur I. Halldorsson
- Center for Fetal Programming; Department of Epidemiology Research; Statens Serum Institut; Copenhagen Denmark
- The Unit for Nutrition Research; Faculty of Food Science and Nutrition; School of Health Sciences; University of Iceland; Reykjavik Iceland
| | - Anne A. Bjerregaard
- Center for Fetal Programming; Department of Epidemiology Research; Statens Serum Institut; Copenhagen Denmark
| | - Yan Che
- Department of Epidemiology and Social Science on Reproductive Health; National Population and Family Planning Key Laboratory of Contraceptive Drugs and Devices; Shanghai Institute of Planned Parenthood Research; Shanghai China
| | - Yanyan Mao
- Department of Epidemiology and Social Science on Reproductive Health; National Population and Family Planning Key Laboratory of Contraceptive Drugs and Devices; Shanghai Institute of Planned Parenthood Research; Shanghai China
| | - Wenfu Hu
- Minle Maternal and Child Health Care Center; Gansu China
| | - Yu Wang
- Department of Nutrition and Food Hygiene Institute; School of Public Health; Lanzhou University; Gansu China
| | - Weijin Zhou
- Department of Epidemiology and Social Science on Reproductive Health; National Population and Family Planning Key Laboratory of Contraceptive Drugs and Devices; Shanghai Institute of Planned Parenthood Research; Shanghai China
| | - Sjúrdur F. Olsen
- Center for Fetal Programming; Department of Epidemiology Research; Statens Serum Institut; Copenhagen Denmark
| | - Marin Strøm
- Center for Fetal Programming; Department of Epidemiology Research; Statens Serum Institut; Copenhagen Denmark
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