4.4 Article

Addressing the gaps in nutritional care before and during pregnancy

Journal

PROCEEDINGS OF THE NUTRITION SOCIETY
Volume 81, Issue 1, Pages 87-98

Publisher

CAMBRIDGE UNIV PRESS
DOI: 10.1017/S0029665121003724

Keywords

Pregnancy; Nutrition; Obesity; Antenatal; Dietary intakes

Funding

  1. Science Foundation Ireland (SFI) [12/RC/2273, 16/SP/3827]
  2. PrecisionBiotics Group Ltd.
  3. Science Foundation Ireland (SFI) [16/SP/3827] Funding Source: Science Foundation Ireland (SFI)

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Globally, issues such as overnutrition, undernutrition, and nutritional imbalances are common among women of reproductive age, increasing the risk of pregnancy complications and non-communicable diseases. Clinical practices regarding pregnancy nutrition vary, with a lack of consensus on the most important outcomes of nutrition interventions during pregnancy.
The present paper outlines current issues in the nutritional care of women during pregnancy and potential resources to address them. Globally, overnutrition, undernutrition and nutritional imbalances are widespread among women of reproductive age; increasing the risk of pregnancy complications and non-communicable diseases in both mothers and their children. Most women do not meet dietary guidelines for pregnancy. The World Health Organisation (WHO) recommends nutrition and weight counselling during pregnancy for all women. However, clinical practices focusing on nutrition vary and there is no consensus on which outcomes are most important for pregnancy nutrition interventions, with little consideration for the 'patient voice'. The International Federation of Gynaecology and Obstetrics (FIGO) nutrition checklist is a clinical practice tool that is available for healthcare professionals that will address this issue. The pregnancy nutrition core outcome set will also support advancement of antenatal nutrition by identifying the most critical nutrition-related outcomes from the perspective of healthcare professionals, researchers and women with experience of pregnancy. While poor nutrition can result in adverse outcomes across women of all weight categories, those with obesity may require specialist care to reduce their risk. Obesity is a chronic, progressive, relapsing disease that has high individual variability in its prognosis. The use of obesity staging systems, which consider mental, physical and functional health, can stratify individuals into risk categories and aid in treatment prioritisation in pregnancy. As the prevalence of obesity continues to rise, an obesity staging approach may support clinicians, especially those in limited resource settings.

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