Nutrition During Pregnancy | Annotated Bibliography

Geraldine O’Sullivan, et al (2009) did this study to investigate the effect of feeding during labour on obstetric and neonatal outcomes. Prospective randomized controlled trial was used as design in this study. Setting of this study was at Birth centre in London teaching hospital. 2426 nulliparous, non-diabetic women at term, with a singleton cephalic presenting fetus and in labour with a cervical dilatation of less than 6 cm. were participants. In this study they provide light diet or water during labour and they measure the outcome of spontaneous vaginal delivery rate. Other outcomes measured included during this duration of labour, was need for augmentation of labour, instrumental and caesarean delivery rates, incidence of vomiting, and neonatal outcome. Result was the spontaneous vaginal delivery rate was the same in both groups (44%; relative risk 0.99, 95% confidence interval 0.90 to 1.08). No clinically important differences were found during duration of labour (geometric mean: eating, 597 min v water, 612 min; ratio of geometric means 0.98, 95% confidence interval 0.93 to 1.03), the caesarean delivery rate (30% v 30%; relative risk 0.99, 0.87 to 1.12), or the incidence of vomiting (35% v 34%; relative risk 1.05, 0.9 to 1.2).Outcomes of neonatal were also similar

Hazel M Inskip et al (2009) conducted this to examine the extent to which women planning a pregnancy completely with recommendations for nutrition and life style .Design was used for this study were prospective cohort study. Setting was at Southampton, United Kingdom. Participants are 445 non-pregnant women aged 20-34 recruited to the Southampton Women’s Survey through general practices, 238 of whom became pregnant within three months of being interviewed. Result was the 238 women who became pregnant within three months of the interview were only marginally more likely to completely with recommendations for those planning a pregnancy than those who did not become pregnant in this period. Among those who became pregnant, 2.9% were taking 400 μg or more of folic acid supplements a day and drinking four or few units of alcohol a week, compared with of those who did not become pregnant. 74% of those who became antenatal mothers were non-smokers compared with 69% of those who did not become antenatal mother (P=0.08). Women in both groups were equally likely to consume five or more portions of fruit and vegetables per day (53% in each group, P=1.0), but only 57% of those who became antenatal mothers had taken any strenuous exercise in the past three months compared with 64% in those who did not become antenatal mothers (P=0.03).Concluded the study as only a small proportion of women planning a pregnancy follow the recommendations for nutritional diet and lifestyle. Greater publicity for the recommendations is also needed, but as many pregnancies are unplanned, improved nutritional diet and lifestyles of women of childbearing age is also required.

Alison M. Stuebe,(2009) e tal did this study to identify modifiable risk factors for excessive gestational weight gain (GWG). Project Viva cohort study was used as a design. In this study they assessed associations of diet and physical activity with excessive GWG among 1388 women. Three hundred seventy-nine women (27%) were overweight (body mass index ≥ 26 kg/m2) and 703 (51%) experienced excessive GWG, according to Institute of Medicine guidelines. In multivariable logistic regression models, they found that intake of total energy (odds ratio [OR], 1.10; 95% confidence interval [CI], 1.00-1.22, per 500 kcal/d), dairy (OR, 1.08; 95% CI, 1.00-1.17, per serving per day), and fried foods (OR, 3.47; 95% CI, 0.91-13.24, per serving per day) were associated with excessive GWG. In first trimester vegetarian diet (OR, 0.46; 95% CI, 0.28-0.78) and mid pregnancy walking (OR, 0.92; 95% CI, 0.83-1.01, per 30 minutes per day) and vigorous physical activity (OR, 0.76; 95% CI, 0.60-0.97, per 30 minutes per day) were inversely associated with excessive GWG.

Hannah Tait Neufeld et al. (2008) did this study to describe how aboriginal women in an urban setting perceive dietary treatment recommendations associated with gestational diabetes mellitus (GDM).Design used was Semi-structured explanatory model interviews explored Aboriginal women’s illness experiences with GD. Twenty-nine self-declared Aboriginal women who had received a diagnosis of GDM were participated .Result was participants associated fear, anxiety, and frustration with GDM. Emotional reactions appeared alongside negative relationships with food and other prescribed in lifestyle treatments. Results suggested that the experience of living with GDM can be overwhelming, as suggested by some of the complex factors influencing women’s perceptions and reported behaviors. Discussions indicated that many felt socially isolated and had a poor self-image and sense of failure resulting from ineffective management GDM of practices.

Penelope McLernon et al (2008) did this study. In this study, one of the most prevalent complications of pregnancy is asthma which is associated with an increased incidence of intrauterine growth restriction. The mechanisms that affect fetal development in pregnancies complicated by asthma were not clearly defined. Dietary fatty acids (FA) especially polyunsaturated fatty acids (PUFA) are particularly important during pregnancy due to their role in fetal growth and other development. The current study was designed to characterize the fatty acid profile in pregnant women with asthma to determine whether asthma severity or reduced fetal growth were associated with an altered FA profile. Maternal dietary intake and plasma fatty acid profile were examined in mother with and without asthma at 18, 30 and 36 weeks of gestation and maternal fatty acids levels were related to measures of fetal growth using Doppler ultrasound and birth outcomes. This was used as a method for data collection. Results of this was that pregnant women with moderate and severe asthma had increased circulating plasma fatty acid levels at 36 weeks gestation but reduced dietary intake of fats compared to those women with mild asthma and healthy pregnant controls. In addition, women with moderate and severe asthma had increased circulating levels at 36 weeks gestation which was associated with reduced fetal and neonatal head circumference.

Ruth M. McManus, (2007) et al did this study to compare the associated costs of actual food choices versus the cost of a constructed recommended diet. In this study costs associated with nutritious foods may be a barrier to healthy dietary choices and of particular concern to pregnancies complicated by diabetes. Survey was conducted in a tertiary care diabetes and pregnancy clinic to compare the associated costs of actual food choices versus the cost of a constructed recommended diet. Method which used this study was women with types 1, 2 and gestational diabetes mellitus (GDM) completed 24-hour dietary recalls under the supervision of the research coordinator (Actual Diet). Recommended Diet for this population was constructed independent of responses of participants. Actual and Recommended Diets were standardized per 2000 kcal, priced and compared for content and cost of diet. Result was Seventy-five women participated: 27 with GDM, 29 with type 1 diabetes and 19 with type 2 diabetes. There were no significant cost differences between Recommended and Actual Diets .Food choices expressed per 2000 kcal: Recommended Diet $10.14±3.72; Actual Diet GDM: $11.30±3.88; Actual Diet of type 1 diabetes: $9.00±3.16; Actual Diet of type 2 diabetes: $10.24±3.92. Percentage of fiber intake was lower for Actual Diets than Recommended Diet for all, while percentage of protein intake was lower in Actual than Recommended Diet for women in type 1 diabetes.

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