Nutrition Education and Counselling Provided during Pregnancy: Effects on Maternal, Neonatal and Child Health Outcomes
Nutrition Education and Counselling Provided during Pregnancy: Effects on Maternal, Neonatal and Child Health Outcomes
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DOI：
10.1111/j.1365-3016.2012.01278.x
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发表时间：
2012-07-01
影响因子：
2.8
通讯作者：
Olude, Oluwafunke
中科院分区：
文献类型：
--
作者：
Girard, Amy Webb;Olude, Oluwafunke
营养教育和咨询（NEC）是一个普遍适用的战略，以改善孕妇怀孕期间的营养。然而，除了特殊人群和特定饮食外，NEC对孕产妇，新生儿和儿童健康结果的影响尚未得到系统的审查。我们采用改良的儿童健康流行病学参考组方法，系统地回顾了文献，并确定和提取了37篇文章。我们对NEC对孕产妇、新生儿和婴儿健康结局的影响进行了荟萃分析，包括妊娠期体重增加、孕产妇贫血、出生体重、低出生体重和早产。NEC显著改善了妊娠期体重增加0.45 kg，将妊娠晚期贫血的风险降低了30%，出生体重增加了105 g，早产风险降低了19%。NEC对低出生体重风险的影响不显著。在提供营养支持的情况下，NEC的效果更大，例如，食品或微量营养素补充剂或营养安全网。由于高度异质性、不良研究设计和其他偏倚，所有结局的证据总体质量均被认为较低。需要以适当的行为改变理论为基础的其他精心设计的研究，以提高对NEC效果的信心。此外，需要进行成本效益研究，以澄清向全国选举委员会提供营养支助和/或安全网的额外好处和可持续性，特别是在粮食不安全和性别偏见可能限制妇女遵守全国选举委员会信息的能力的地区。
Nutrition education and counselling (NEC) is a commonly applied strategy to improve maternal nutrition during pregnancy. However, with the exception special populations and specific diets, the effect of NEC on maternal, neonatal and child health outcomes has not been systematically reviewed. Using a modified Child Health Epidemiology Reference Group method we systematically reviewed the literature and identified and abstracted 37 articles. We conducted meta-analyses for the effect of NEC on maternal, neonatal and infant health outcomes including gestational weight gain, maternal anaemia, birthweight, low birthweight and preterm delivery. NEC significantly improved gestational weight gain by 0.45 kg, reduced the risk of anaemia in late pregnancy by 30%, increased birthweight by 105 g and lowered the risk of preterm delivery by 19%. The effect of NEC on risk of low birthweight was not significant. The effect of NEC was greater when provided with nutrition support, for example, food or micronutrient supplements or nutrition safety nets. The overall quality of the body of evidence was deemed low for all outcomes due to high heterogeneity, poor study designs and other biases. Additional well-designed research that is grounded in appropriate theories of behaviour change is needed to improve confidence in the effect of NEC. Further, cost-effectiveness research is needed to clarify the added benefit and sustainability of providing NEC with nutritional support and/or safety nets, especially in areas where food insecurity and gender bias may limit women's capacity to adhere to NEC messages.