The Associations Between Maternal Socioeconomic Factors and Adequacy of Energy and Macronutrient Intakes in Pregnant Women From Yucatan, Mexico

Nutritional fulfillment behavior of pregnant women based on the health belief model theory in Indonesia

Introduction

Introduction: malnutrition in pregnant women will cause impaired fetal development, premature delivery, impaired baby growth, and the risk of causing chronic disease. The Health Belief Model is used and has an important role in directing pregnant women to engage in preventive health behavior, namely preventing malnutrition. Objective: this study aims to analyze the factors related to the nutritional fulfillment behavior of pregnant women based on the theory of the health belief model. Methods: this research used correlational design with a cross-sectional approach. The total sample is 164 pregnant women. The variables were perceived susceptibility, perceived severity, perceived benefits, perceived barriers, cues to action, self-efficacy, and behavior of fulfilling the nutritional needs. Data were collected using a questionnaire and analyzed using Spearman's rho with a p-value ≤ 0.05. Result: factors related to the behavior of fulfilling nutritional needs of pregnant women are, perceived benefits (p = 0.021), perceived barriers (p = 0.034) and cues to action (p = 0.032). Meanwhile, perceived susceptibility, perceived severity, and self-efficacy do not correlate with the nutritional fulfillment behavior of pregnant women. Conclusion: factors related to the behavior of fulfilling nutritional needs are perceived benefits, perceived barriers, and cues to action. Future research is expected to develop a health belief model factor for intervention to improve behavior in fulfilling nutritional needs in pregnant women.

Nutritional knowledge and practices of low-income women during pregnancy: a qualitative study in two Oaxacan cities

BACKGROUND

Adequate dietary intake is critical for healthy pregnancies. Recent changes in social services in Mexico, coupled with high levels of food insecurity, call into question whether expecting women of the lowest socioeconomic status are able to meet their dietary and nutritional needs in this changing context. The aim of this study was to explore the nutritional practices, education and received and employed among women during their pregnancy.

METHODS

Guided by Ecological Systems Theory and an Intersectionality Framework, this qualitative study was carried out in Oaxaca City and Puerto Escondido, in Oaxaca, a Mexican state with high levels of food insecurity. Women who had at least one child in the past five years and had lived in Oaxaca for the past five years were eligible to participate. Twenty-five women participated in semi-structured in-depth interviews conducted between June and December of 2023. A grounded theory approach was used for coding. NVivo was used for coding and analyses.

RESULTS

Five key themes emerged linked to individual-level characteristics and the multiple social identities related to the social support for nutritional knowledge and practices among low-income Oaxacan women during pregnancy: (1) Life experiences, sociodemographic, and health characteristics that influence nutritional practices and knowledge during pregnancy; (2) Female family members as a primary source of nutritional knowledge and food support; (3) Support from other members of women's social networks; (4) Medical guidance for nutrition during pregnancy; and (5) Quality and gaps in the broader health care system and social services. These themes highlight how women's own experiences and social identities and the different interpersonal and community-level environments, particularly those of mothers and grandmothers and health care providers, interact and shape women's nutritional knowledge and practices, such as foods and nutritional supplements consumed, during pregnancy.

CONCLUSION

Nutritional knowledge and practices during pregnancy are impacted by multiple social identities women have and different factors at the individual, group, and structural level. Future multi-level approaches in research and programming that take into consideration the individual, family members, and other social influences are needed to address the gaps in nutrition that women in Oaxaca go through during the prenatal period.

The relationship between pre-pregnancy BMI and energy and macronutrients intakes during pregnancy in women from Yucatan, Mexico

In this observational study, our aim was to analyse the association between pre-pregnancy BMI and adequacy rates of energy and macronutrient intakes in a sample of pregnant women from Yucatan, Mexico. From September to December 2019, we collected data on socioeconomic, pregnancy, and dietary characteristics, and took anthropometric measurements of women during household visits. Pre-pregnancy BMI was calculated from measured height and self-reported body weight. Energy and macronutrient intakes (obtained from three 24-h dietary recalls) were compared with the estimated trimester-specific requirements to calculate adequacies (%). Multiple linear regression models showed that after accounting for maternal socioeconomic characteristics and perinatal variables, each unit increase in pre-pregnancy BMI was associated with decreases of 2%, 2%, and 2.6% in energy, carbohydrate, and total fat intakes, respectively. These results were significant when under- and over-reporters were excluded from the analyses. Women who enter pregnancy with higher BMI values may voluntarily or involuntarily reduce their food intake.IMPACT STATEMENTWhat is already know about this subject? Some studies have analysed the relationship between pre-pregnancy BMI categories (normal weight, overweight, and obesity) and diet quality during pregnancy, but few studies have focussed on quantitative energy and macronutrient intakes or their adequacies in relation to pre-pregnancy BMI.What do the results of this study contribute? In this sample of Mexican women belonging to a middle socioeconomic status, we found that after excluding under- and over-reporters from the analyses and accounting for maternal socioeconomic characteristics and perinatal variables, BMI was negatively associated with adequacy intake rates of energy, carbohydrates, and total fats during pregnancy.What are the implications of these findings for clinical practice and/or further research? Women who enter pregnancy with higher BMI values may voluntarily or involuntarily reduce their food intake. These results can be used to accordingly plan diet counselling during pregnancy.

Nutritional Knowledge and Practices of Low-Income Women During Pregnancy: A Qualitative Study in Two Oaxacan Cities

Background

Adequate dietary intake is critical for healthy pregnancies. Recent changes in social services in Mexico, coupled with high levels of food insecurity, call into question whether expecting women of the lowest socioeconomic status are able to meet their dietary and nutritional needs in this changing context. The aim of this study was to explore the nutritional practices, education and received and employed among women during their pregnancy.

Methods

Guided by Ecological Systems Theory and an Intersectionality Framework, this qualitative study was carried out in Oaxaca City and Puerto Escondido, in Oaxaca, a Mexican state with high levels of food insecurity. Women who had at least one child in the past five years and had lived in Oaxaca for the past five years were eligible to participate. Twenty-five women participated in semi-structured in-depth interviews conducted between June and December of 2023. A grounded theory approach was used for coding. NVivo was used for coding and analyses.

Results

Five key themes emerged linked to individual-level characteristics and the multiple social identities related to the social support for nutritional knowledge and practices among low-income Oaxacan women during pregnancy: 1) Life experiences, sociodemographic, and health characteristics that influence nutritional practices and knowledge during pregnancy; 2) Female family members as a primary source of nutritional knowledge and food support; 3) Support from other members of women's social networks; 4) Medical guidance for nutrition during pregnancy; and 5) Quality and gaps in the broader health care system and social services. These themes highlight how women's own experiences and social identities and the different interpersonal and community-level environments, particularly those of mothers and grandmothers and health care providers, interact and shape women's nutritional knowledge and practices, such as foods and nutritional supplements consumed, during pregnancy.

Conclusion

Nutritional knowledge and practices during pregnancy are impacted by multiple social identities women have and different factors at the individual, group, and structural level. Future research and programming that use multi-level approaches (considering the individual and the family and other social influences) are needed to address the gaps in nutrition that women in Oaxaca go through during the prenatal period.

Maternal macronutrient and energy intake during pregnancy: a systematic review and meta-analysis

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.

Dietary Patterns and Factors Associated with Food Affinity in Pregnant Women from Quito, Ecuador

Nutrition during pregnancy influences perinatal outcomes and predispositions to chronic diseases. A prospective cohort study was carried out with the objectives of describing the dietary patterns in the pregnant population in the city of Quito, Ecuador and analysing the sociodemographic and lifestyle factors that influence the adherence to each dietary pattern. The body mass index was calculated for each patient, and the patients were classified according to the Atalah criteria. The Global Physical Activity Questionnaire was also applied. The dietary patterns were assessed using a dietary survey with a 24 h recall on two occasions. A total of 535 pregnant women were included. A positive association was found between the pattern "dairy, salads and sweet snacks/dressings" and foreign nationality (β = 0.82 (0.43;1.21)). The "refined carbohydrates" pattern was negatively associated with education equal to or less than 7 years and an income of up to one basic salary (β = -0.59 (-1.05; -0.14)). The "traditional Ecuadorian" pattern showed a positive association with being born in the coastal region of Ecuador (β = 0.62 (0.22; 1.01)). This study identified three dietary patterns in pregnant women and their possible associations with certain sociodemographic factors. More studies are needed to better understand these patterns as well as to analyse their nutritional and caloric properties.