Influence of Nutrition Knowledge on the Association between Maternal Nutrition and Birth Outcomes
DOI:
https://doi.org/10.6000/1929-4247.2023.12.02.3Keywords:
Maternal nutrition, migrant population, urban slums, birth outcomes, nutrition knowledge, maternal-fetal relationsAbstract
Maternal undernutrition is a complex condition that arises from various factors, including social, cultural, psycho-social, biological, and ecological factors. The intergenerational consequences of chronic malnutrition, starting with mothers and their children, account for a significant proportion of infant deaths, cognitive disability, and reduced productivity in adulthood. Therefore, having nutritional knowledge throughout pregnancy is crucial for better risk assessment of undernutrition and healthy pregnancy outcomes. The study examined whether trimester-specific nutrition education and awareness could significantly impact the relationship between maternal nutrition and birth outcomes and found that this association was stronger in women with higher levels of nutrition knowledge. As a result, a food-based approach that is both low-cost and high-nutrition can help meet the specific nutritional requirements of pregnancy, alter certain nutrients that target fetal metabolic vulnerabilities, or enhance fetal growth and development in the migrant population. The review explores recent research and discusses how nutrition literacy and knowledge influence pregnancy and birth outcomes, providing an overview of the current understanding of maternal nutritional trimester-specific needs and highlighting areas that still require further study. The findings emphasize the importance of considering diet diversity and peer support during pregnancy, considering the impact that nutrition knowledge has on pregnancy outcomes.
References
Short VL, Geller SE, Moore JL, McClure EM, Goudar SS, Dhaded SM, et al. The Relationship between Body Mass Index in Pregnancy and Adverse Maternal, Perinatal, and Neonatal Outcomes in Rural India and Pakistan. Am J Perinatol 2018; 35(9): 844-851. Epub 2018. https://doi.org/10.1055/s-0037-1621733
Woldeamanuel GG, Geta TG, Mohammed TP, Shuba MB, Bafa TA. Effect of nutritional status of pregnant women on birth weight of newborns at Butajira Referral Hospital, Butajira, Ethiopia. SAGE Open Med 2019; 7: 2050312119827096. https://doi.org/10.1177/2050312119827096
Marshall NE, Abrams B, Barbour LA, Catalano P, Christian P, Friedman JE, et al. The importance of nutrition in pregnancy and lactation: lifelong consequences. American Journal of Obstetrics and Gynecology 2022; 226(5): 607-632. https://doi.org/10.1016/j.ajog.2021.12.035
Mousa A, Naqash A, Lim S. Macronutrient and Micronutrient Intake during Pregnancy: An Overview of Recent Evidence. Nutrients 2019; 11(2): 443. https://doi.org/10.3390/nu11020443
Wang S, Ge X, Zhu B, Xuan Y, Huang K, Rutayisire E, et al. Maternal Continuing Folic Acid Supplementation after the First Trimester of Pregnancy Increased the Risk of Large-for-Gestational-Age Birth: A Population-Based Birth Cohort Study Nutrients 2016; 8(8): 493. https://doi.org/10.3390/nu8080493
United Nations Children's Fund. UNICEF Technical Brief. Counseling to Improve Maternal Nutrition. Considerations for programming with quality, equity, and scale. New York: UNICEF, 2021.
Borge TC, Aase H, Brantsæter AL, et al. The importance of maternal diet quality during pregnancy on cognitive and behavioral outcomes in children: a systematic review and meta-analysis. BMJ Open 2017; 7: e016777. https://doi.org/10.1136/bmjopen-2017-016777
Osborn AJ, Muhammad GM, Ravishankar SL, Mathew AC. Prevalence and correlates of anemia among women in the reproductive age (15-49 years) in a rural area of Tamil Nadu: An exploratory study. J Educ Health Promot 2021; 10: 355. https://doi.org/10.4103/jehp.jehp_1526_20
Natekar P, Deshmukh C, Limaye D, Ramanathan V, Pawar A. A micro review of a nutritional public health challenge: Iron deficiency anemia in India. Clinical Epidemiology and Global Health 2022; 14: 100992. https://doi.org/10.1016/j.cegh.2022.100992
World Health Organization. (2021, June 9). "Malnutrition – Key Facts". Retrieved from https://www.who.int/news-room/fact-sheets/detail/malnutrition
Guidelines for the control of iron deficiency anemia, National Iron+ Initiative, Adolescent Division, Ministry of Health and Family Welfare, Government of India 2013.
Reynolds LP, Borowicz PP, Caton JS, Crouse MS, Dahlen CR, Ward AK. Developmental Programming of Fetal Growth and Development. Vet Clin North Am Food Anim Pract 2019; 35(2): 229-247. https://doi.org/10.1016/j.cvfa.2019.02.006
Ministry of Health and Family Welfare (MoHFW), Government of India, UNICEF and Population Council. Comprehensive National Nutrition Survey (CNNS) National Report. New Delhi 2019.
International Institute for Population Sciences (IIPS) and ICF. National Family Health Survey (NFHS-4), 2015-16: India 2017.
Ministry of Health and Family Welfare (MoHFW), Government of India, UNICEF and Population Council. Comprehensive National Nutrition Survey (CNNS), National Report. New Delhi 2019.
Reynolds LP, Borowicz PP, Caton JS, Crouse MS, Dahlen CR, Ward AK. Developmental Programming of Fetal Growth and Development. Vet Clin North Am Food Anim Pract 2019; 35(2): 229-247. https://doi.org/10.1016/j.cvfa.2019.02.006
Kumari S, Garg N, Kumar A, Guru P, Ansari S, Anwar S, et al. Maternal and severe anemia in delivering women is associated with risk of preterm and low birth weight: A cross-sectional study from Jharkhand, India. One Health (Amsterdam, Netherlands) 2019; 8: 100098. https://doi.org/10.1016/j.onehlt.2019.100098
Ballard CK, Bricker L, Reed K, Wood L, Neilson JP. Nutritional advice for improving outcomes in multiple pregnancies. Cochrane Database of Systematic Reviews 2010; 12: CD008867. https://doi.org/10.1002/14651858.CD008867
World Health Organization. WHO recommendations on antenatal care for a positive pregnancy experience. World Health Organization 2016. https://apps.who.int/iris/handle/10665/250796
World Health Organization (WHO) [Internet] e-Library of evidence for nutrition actions (eLENA). Nutrition counselling during pregnancy. [[Cited 2019 January 29]]. Available from: https://www.who.int/elena/titles/nutrition_counselling_pregnancy/en/
WHO. World Health Organization. Double-duty actions. Policy brief. Geneva: World Health Organization 2017b.
Pal A, Pari AK, Sinha A, Dhara PC. Prevalence of undernutrition and associated factors: A cross-sectional study among rural adolescents in West Bengal, India. Int J Pediatr Adolesc Med 2017; 4(1): 9-18. https://doi.org/10.1016/j.ijpam.2016.08.009
Behere RV, Deshmukh AS, Otiv S, Gupte MD, Yajnik CS. Maternal Vitamin B12 Status During Pregnancy and Its Association with Outcomes of Pregnancy and Health of the Offspring: A Systematic Review and Implications for Policy in India. Front Endocrinol (Lausanne) 2021; 12: 619176. https://doi.org/10.3389/fendo.2021.619176
Copp K, DeFranco EA, Kleiman J, Rogers LK, Morrow AL, Valentine CJ. Nutrition Support Team Guide to Maternal Diet for the Human-Milk-Fed Infant. Nutr Clin Pract 2018; 33(5): 687-693. https://doi.org/10.1002/ncp.10071
Victora CG, Christian P, Vidaletti LP, Gatica-Domínguez G, Menon P, Black RE. Revisiting maternal and child undernutrition in low-income and middle-income countries: variable progress towards an unfinished agenda. Lancet 2021; 397(10282): 1388-1399. https://doi.org/10.1016/S0140-6736(21)00394-9
Kathrin A. Dunlap, Sheep, Editor(s): Michael K. Skinner, Encyclopedia of Reproduction (Second Edition), Academic Press, 2018; pp. 656-666, ISBN 9780128151457, https://doi.org/10.1016/B978-0-12-809633-8.20523-2
South CA, Keown-Stoneman CDG, Birken CS, et al. Underweight in the First 2 Years of Life and Growth in Later Childhood. JAMA Netw Open 2022; 5(7): e2224417.
Bosaeus M, Hussain A, Karlsson T, et al. A randomized longitudinal dietary intervention study during pregnancy: effects on fish intake, phospholipids, and body composition. Nutr J 2015; 14(1). https://doi.org/10.1186/1475-2891-14-1
Johri M, Subramanian SV, Sylvestre MP, Dudeja S, Chandra D, Koné GK, Sharma JK, Pahwa S. Association between maternal health literacy and child vaccination in India: a cross-sectional study. Journal of Epidemiology and Community Health 2015; 69(9): 849-857. https://doi.org/10.1136/jech-2014-205436
Ota E, Hori H, Mori R, Tobe-Gai R, Farrar D. Antenatal dietary education and supplementation to increase energy and protein intake. Cochrane Database Syst Rev 2015; (6): CD000032. https://doi.org/10.1002/14651858.CD000032.pub3
Zelalem A, Endeshaw M, Ayenew M, Shiferaw S, Yirgu R. Effect of nutrition education on pregnancy-specific nutrition knowledge and healthy dietary practice among pregnant women in Addis Ababa. Clinics Mother Child Health 2017; 14(3): 265. https://doi.org/10.4172/2090-7214.1000265
Kaleem R, Adnan M, Nasir M, Rahat T. Effects of antenatal nutrition counseling on dietary practices and nutritional status of pregnant women: A quasi-experimental hospital-based study. Pak J Med Sci 2020; 36(4): 632-636. https://doi.org/10.12669/pjms.36.4.1919
Diddana TZ, Kelkay GN, Dola AN, Sadore AA. Effect of Nutrition Education Based on Health Belief Model on Nutritional Knowledge and Dietary Practice of Pregnant Women in Dessie Town, Northeast Ethiopia: A Cluster Randomized Control Trial. J Nutr Metab 2018; 2018: 6731815. https://doi.org/10.1155/2018/6731815
Br, Abha and Ayushree, Abha and Ayushree, Sunita and Kumari, Usha and Singh. Nutrition counseling during pregnancy on maternal weight gain. International Journal of Home Science Extension and Communication Management 2020; 6: 336-339.
Villar J, Merialdi M, Gülmezoglu AM, et al. Nutritional interventions during pregnancy for the prevention or treatment of maternal morbidity and preterm delivery: an overview of randomized controlled trials. J Nutr 2003; 133(5 suppl 2): 1606S-1625S. https://doi.org/10.1093/jn/133.5.1606S
Cheatham CL. Nutritional Factors in Fetal and Infant Brain Development. Ann Nutr Metab 2019; 75(suppl 1): 20-32. https://doi.org/10.1159/000508052
Lukose A, Ramthal A, Thomas T, Bosch R, Kurpad AV, Duggan C, Srinivasan K. Nutritional factors associated with antenatal depressive symptoms in the early stage of pregnancy among urban South Indian women. Matern Child Health J 2014; 18(1): 161-170. https://doi.org/10.1007/s10995-013-1249-2
Martin CL, Sotres-Alvarez D, Siega-Riz AM. Maternal Dietary Patterns during the Second Trimester Are Associated with Preterm Birth. J Nutr 2015; 145(8): 1857-64. https://doi.org/10.3945/jn.115.212019
Starling AP, Sauder KA, Kaar JL, Shapiro AL, Siega-Riz AM, Dabelea D. Maternal Dietary Patterns during Pregnancy Are Associated with Newborn Body Composition. J Nutr 2017; 147(7): 1334-1339. https://doi.org/10.3945/jn.117.248948
King JC. A Summary of Pathways or Mechanisms Linking Pre-conception Maternal Nutrition with Birth Outcomes. J Nutr 2016; 146(7): 1437S-44S. https://doi.org/10.3945/jn.115.223479
Zamora AN, Peterson KE, Téllez-Rojo MM, Cantoral A, Song PXK, Mercado-García A, Solano-González M, Fossee E, Jansen EC. Third-Trimester Maternal Dietary Patterns Are Associated with Sleep Health among Adolescent Offspring in a Mexico City Cohort. J Nutr 2022; 152(6): 1487-1495. https://doi.org/10.1093/jn/nxac045
Sethi V, Tiwari K, Sareen N, et al. Delivering an Integrated Package of Maternal Nutrition Services in Andhra Pradesh and Telangana (India). Food and Nutrition Bulletin 2019; 40(3): 393-408. https://doi.org/10.1177/0379572119844142
Morisaki N, Nagata C, Yasuo S, Morokuma S, Kato K, Sanefuji M, et al. Japan Environment and Children’s Study Group. Optimal protein intake during pregnancy for reducing the risk of fetal growth restriction: the Japan Environment and Children's Study. Br J Nutr 2018; 120(12): 1432-1440. https://doi.org/10.1017/S000711451800291X
Morrison JL, Regnault TRH. Nutrition in Pregnancy: Optimising Maternal Diet and Fetal Adaptations to Altered Nutrient Supply. Nutrients 2016; 8(6): 342. https://doi.org/10.3390/nu8060342
Raghavan R, Dreibelbis C, Kingshipp BL, Wong YP, Abrams B, Gernand AD, et al. Dietary patterns before and during pregnancy and birth outcomes: a systematic review. Am J Clin Nutr 2019; 109(Suppl_7): 729S-756S. https://doi.org/10.1093/ajcn/nqy353
Kumar A, Rajpal S, Alambusha R, Sharma S, Joe W. Can Anganwadi services strengthening improve the association between maternal and child dietary diversity? Evidence from Project Spotlight implemented in tribal-dominated Gadchiroli and Chandrapur districts of Maharashtra, India. PLoS One 2022; 17(3): e0264567. https://doi.org/10.1371/journal.pone.0264567
Nutritional anemias: tools for effective prevention and control. Geneva: World Health Organization. License: CC BY-NC-SA 3.0 IGO 2017.
Prasad JB, Pezhhan A, Patil SH. Effect of wealth, social inequality, Mother's BMI, and education level on child malnutrition in India. Diabetes Metab Syndr 2021; 15(6): 102304. https://doi.org/10.1016/j.dsx.2021.102304
World Health Organization. WHO recommendation on community mobilization through facilitated participatory learning and action cycles with women’s groups for maternal and newborn health. World Health Organization 2014. https://apps.who.int/iris/handle/10665/127939
Marshall NE, Abrams B, Barbour LA, Catalano P, Christian P, Friedman JE, et al. The importance of nutrition in pregnancy and lactation: lifelong consequences. Am J Obstet Gynecol 2022; 226(5): 607-632. https://doi.org/10.1016/j.ajog.2021.12.035
Moher D, Liberati A, Tetzlaff J, Altman DG. PRISMA Group. Preferred Reporting Items for Systematic Reviews and Meta-Analyses: the PRISMA statement. Ann Intern Med 2009; 339: b2535 [Internet]. https://doi.org/10.1136/bmj.b2535
How to scale up maternal nutrition: A successful operational approach based on WHO’s antenatal care guidelines and Alive and Thrive’s Implementation Framework. Alive and Thrive; 2017. https://www.aliveandthrive.org/wp-content/uploads/2018/07/How-to-scale-up-maternal-nutrition-brief.pdf
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