Examining the use of the FIGO Nutrition Checklist in routine antenatal practice: multistakeholder feedback to implementation

Killeen, Sarah Louise; Callaghan, Shauna; Jacob, Chandni Maria; Hanson, Mark A.; McAuliffe, Fionnuala M.

doi:10.1002/ijgo.13323

Cited by 18 publications

(35 citation statements)

References 28 publications

(23 reference statements)

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“…This is in line with FIGO's vision 'making the best of every contact' with women in the reproductive age group. The FIGO nutrition checklist is another tool for clinicians (48).…”

Section: Implications For Research and Practicementioning

confidence: 99%

Gestational diabetes mellitus follow-up in Norwegian primary health care: a qualitative study

2021

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BackgroundWomen with gestational diabetes mellitus (GDM) have a tenfold increased risk of developing diabetes, and a high risk of recurrent GDM. Endorsing the life-course approach aiming to prevent disease and promote health across generations, the Norwegian GDM guideline recommends follow-up in primary care after delivery, with information on the increased risks, lifestyle counselling, and annual diabetes screening. Few reports exist on Norwegian women’s experiences of GDM follow-up. AimTo elucidate women’s experiences with follow-up of GDM in pregnancy and after delivery, and to explore their attitudes to diabetes risk and motivation for lifestyle changes. Design & settingQualitative study in primary care in the region of Stavanger, Norway. MethodSemi-structured in-depth interviews were conducted 24–30 months after delivery with 14 women aged 28–44 years, with a history of GDM. Data were analysed thematically. ResultsMost women were satisfied with the follow-up during pregnancy; however, only two women were followed-up according to the guideline after delivery. In most encounters with GPs after delivery, GDM was not mentioned. To continue the healthy lifestyle adopted in pregnancy, awareness of future risk was a motivational factor, and the women asked for tailored information on individual risk and improved support. The main themes emerging from the analysis were as follows: stigma and shame; uncertainty; gaining control and finding balance; and a need for support to sustain change. ConclusionWomen experienced a lack of support for GDM in Norwegian primary care after delivery. To maintain a healthy lifestyle, women suggested being given tailored information and improved support.

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“…This is in line with FIGO's vision 'making the best of every contact' with women in the reproductive age group. The FIGO nutrition checklist is another tool for clinicians (48).…”

Section: Implications For Research and Practicementioning

confidence: 99%

Gestational diabetes mellitus follow-up in Norwegian primary health care: a qualitative study

2021

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“…Women may further struggle with complex nutrition recommendations, such as those for fish intake (94) . All of this is compounded by the limited nature of nutrition counselling in antenatal care and potential nutrition information deficits amongst healthcare providers (87,93,95,96) . In a recent systematic review, Callaghan et al found obstetricians and midwives had insufficient knowledge of gestational weight gain guidelines (97) .…”

Section: Nutrition Counsellingmentioning

confidence: 99%

“…With knowledge of the need for more implementation research to support meaningful change in clinical practice globally, Killeen et al conducted an acceptability and feasibility study of the checklist with 105 women in a busy, routine antenatal outpatient department in Dublin, Ireland. They found that most of the pregnant women, and two out of three obstetricians who took part recommended using the checklist to improve how nutrition is addressed in regular antenatal care (87) . Importantly, the checklist encouraged obstetricians to address nutrition in cases when they otherwise would not have, however time was a potential barrier to implementation (87) .…”

Section: The Figo Nutrition Checklistmentioning

confidence: 99%

“…In the study by Tsoi et al, 95 % of women reported at least one suboptimal dietary practice that could put them at nutritional risk for their pregnancy (114) . Likewise, the study by Killeen et al found that the checklist captured at least one suboptimal dietary practice in over 80 % of their convenience sample of women attending routine antenatal services, 16 % of which reported three or more out of six potential issues with diet quality (87) . There has been much research to date looking at a variety of dietary indices in predicting adverse outcomes in pregnant women (115,116) .…”

Section: The Figo Nutrition Checklistmentioning

confidence: 99%

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Addressing the gaps in nutritional care before and during pregnancy

et al. 2021

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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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“…Resources, such as the FIGO Nutrition Checklist, are available to health care practitioners to identify and address nutrition and weight issues before and during pregnancy. 76,77 A preconception risk assessment by health care professionals may identify women with preexisting diabetes, and also identify women at risk of GDM. 78 Risk assessment tools have shown nulliparous women at risk of GDM may be accurately identified before pregnancy based on a set of easily obtainable lifestyle and health-related characteristics 79,80 ; however, further research is needed to determine if preconception risk identification is acceptable and if model implementation followed by targeted preconception care reduces rates of GDM.…”

Section: Pre-and Interconception Interventionsmentioning

confidence: 99%

Prevention of Gestational Diabetes: The Role of Dietary Intake, Physical Activity, and Weight before, during, and between Pregnancies

et al. 2020

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Gestational diabetes mellitus (GDM) is the most common complication of pregnancy and a significant clinical and public health problem with lifelong and intergenerational adverse health consequences for mothers and their offspring. The preconception, early pregnancy, and interconception periods represent opportune windows to engage women in preventive and health promotion interventions. This review provides an overview of findings from observational and intervention studies on the role of diet, physical activity, and weight (change) during these periods in the primary prevention of GDM. Current evidence suggests that supporting women to increase physical activity and achieve appropriate weight gain during early pregnancy and enabling women to optimize their weight and health behaviors prior to and between pregnancies have the potential to reduce rates of GDM. Translation of current evidence into practice requires further development and evaluation of co-designed interventions across community, health service, and policy levels to determine how women can be reached and supported to optimize their health behaviors before, during, and between pregnancies to reduce GDM risk.

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Examining the use of the FIGO Nutrition Checklist in routine antenatal practice: multistakeholder feedback to implementation

Cited by 18 publications

References 28 publications

Gestational diabetes mellitus follow-up in Norwegian primary health care: a qualitative study

Gestational diabetes mellitus follow-up in Norwegian primary health care: a qualitative study

Addressing the gaps in nutritional care before and during pregnancy

Prevention of Gestational Diabetes: The Role of Dietary Intake, Physical Activity, and Weight before, during, and between Pregnancies

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