Addressing barriers to maternal nutrition in low- and middle-income countries: A review of the evidence and programme implications.
Addressing barriers to maternal nutrition in low- and middle-income countries: A review of the evidence and programme implications.
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DOI：
10.1111/mcn.12508
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发表时间：
2018-01
影响因子：
3.4
通讯作者：
Landry M
中科院分区：
文献类型：
--
作者：
Kavle JA;Landry M
在“最初1000天”窗口期间获得充足的孕产妇营养，对于改善营养状况和减少低出生体重和早产等不良出生结果的风险至关重要。不幸的是，许多规划针对婴幼儿实施和监测营养干预措施，而不是针对怀孕或产后妇女。进行了一项文献综述，以确定怀孕和哺乳期间食物选择和消费的障碍，并检查低收入和中等收入国家如何在规划中解决孕产妇营养问题。我们对同行评议文献和灰色文献进行了文献综述，并对标题和摘要进行了作者评审。本综述纳入了23项研究。怀孕期间获得充足营养的障碍包括与怀孕期间食物摄入量、怀孕期间体重增加量的知识有关的文化信仰，以及怀孕期间因担心生下一个大婴儿而“狼吞虎咽”。被认为不适合在怀孕或哺乳期间食用的食物导致了食物限制。食物选择的驱动因素受食物厌恶、经济约束和家庭食物供应的影响。很少对孕妇在怀孕期间的饮食和体重增加进行咨询。支持孕妇健康饮食和孕期体重增加的规划很少。有针对性的、在文化上引起共鸣的营养教育和关于怀孕和哺乳期间饮食和怀孕期间体重增加的咨询，以及监测产妇营养方面的进展，都是需要注意的领域。
Adequate maternal nutrition during the “first 1,000 days” window is critical from conception through the first 6 months of life to improve nutritional status and reduce the risk of poor birth outcomes, such as low birthweight and preterm birth. Unfortunately, many programmes have targeted implementation and monitoring of nutrition interventions to infants and young children, rather than to women during pregnancy or post‐partum. A literature review was conducted to identify barriers to food choice and consumption during pregnancy and lactation and to examine how low‐ and middle‐income countries have addressed maternal nutrition in programmes. A literature review of peer‐reviewed and grey literature was conducted, and titles and abstracts reviewed by authors. Twenty‐three studies were included in this review. Barriers to adequate nutrition during pregnancy included cultural beliefs related to knowledge of quantity of food to eat during pregnancy, amount of weight to gain during pregnancy, and “eating down” during pregnancy for fear of delivering a large baby. Foods considered inappropriate for consumption during pregnancy or lactation contributed to food restriction. Drivers of food choice were influenced by food aversions, economic constraints, and household food availability. Counselling on maternal diet and weight gain during pregnancy was seldom carried out. Programming to support healthy maternal diet and gestational weight gain during pregnancy is scant. Tailored, culturally resonant nutrition education and counselling on diet during pregnancy and lactation and weight gain during pregnancy, as well as monitoring of progress in maternal nutrition, are areas of needed attention.
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