New guidelines, position paper, and insights from the FIGO Pregnancy Obesity and Nutrition Initiative (PONI)

Hanson, Mark A.; McAuliffe, Fionnuala M.; Killeen, Sarah Louise; Jacob, Chandni Maria; Hod, Moshe

doi:10.1002/ijgo.13321

Cited by 7 publications

(9 citation statements)

References 7 publications

(3 reference statements)

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“… In the present study, antenatal diet intervention reduced GWG by approximately 23%, likely limiting longer-term obesity and noncommunicable disease risks given the evidence of postpartum weight benefits. Physical activity specifically declines in pregnancy, with barriers to engagement and improvement. The present study supports physical activity intervention in pregnancy to improve maternal health outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…1 In the US, obesity prevalence is higher, affecting 25% of women who become pregnant. 2 Preconception and pregnancy are priority life stages for healthy lifestyles and obesity prevention, 3,4 with excess weight being associated with adverse pregnancy outcomes, long-term noncommunicable disease in women, and epigenetic consequences across generations. [4][5][6] In metaanalyses of more than 1.3 million pregnancies worldwide, gestational weight gain (GWG) that exceeds international recommendations affected approximately half of pregnancies 6,7 and was an independent risk factor in adverse maternal and neonatal pregnancy outcomes.…”

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confidence: 99%

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Association of Antenatal Diet and Physical Activity–Based Interventions With Gestational Weight Gain and Pregnancy Outcomes

et al. 2022

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IMPORTANCE Excessive gestational weight gain (GWG) is common and associated with adverse pregnancy outcomes. Antenatal lifestyle interventions limit GWG; yet benefits of different intervention types and specific maternal and neonatal outcomes are unclear. OBJECTIVE To evaluate the association of different types of diet and physical activity-based antenatal lifestyle interventions with GWG and maternal and neonatal outcomes.DATA SOURCES A 2-stage systematic literature search of MEDLINE, Embase, Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, Cochrane Central Register of Controlled Trials, and Health Technology Assessment Database was conducted from February 1, 2017, to May 31, 2020. Search results from the present study were integrated with those from a previous systematic review from 1990 to February 2017. STUDY SELECTION Randomized trials reporting GWG and maternal and neonatal outcomes.DATA EXTRACTION AND SYNTHESIS Data were extracted for random-effects meta-analyses to calculate the summary effect estimates and 95% CIs. MAIN OUTCOMES AND MEASURESOutcomes were clinically prioritized, with mean GWG as the primary outcome. Secondary outcomes included gestational diabetes, hypertensive disorders of pregnancy, cesarean section, preterm delivery, large or small for gestational age neonates, neonatal intensive care unit admission, or fetal death.RESULTS A total of 117 randomized clinical trials of antenatal lifestyle interventions (involving 34 546 women) were included. Overall lifestyle intervention was associated with reduced GWG (−1.15 kg; 95% CI, −1.40 to −0.91), risk of gestational diabetes (odds ratio [OR], 0.79; 95% CI, 0.70-0.89), and total adverse maternal outcomes (OR, 0.89; 95% CI, 0.84-0.94) vs routine care. Compared with routine care, diet was associated with less GWG (−2.63 kg; 95% CI, −3.87 to −1.40) than physical activity (−1.04 kg; 95% CI, −1.33 to −0.74) or mixed interventions (eg, unstructured lifestyle support, written information with weight monitoring, or behavioral support alone) (−0.74 kg; 95% CI, −1.06 to −0.43). Diet was associated with reduced risk of gestational diabetes (OR, 0.61; 95% CI, 0.45-0.82), preterm delivery (OR, 0.43; 95% CI, 0.22-0.84), large for gestational age neonate (OR, 0.19; 95% CI, 0.08-0.47), neonatal intensive care admission (OR, 0.68; 95% CI, 0.48-0.95), and total adverse maternal (OR, 0.75; 95% CI, 0.61-0.92) and neonatal outcomes (OR, 0.44; 95% CI, 0.26-0.72). Physical activity was associated with reduced GWG and reduced risk of gestational diabetes (OR, 0.60; 95% CI, 0.47-0.75), hypertensive disorders (OR, 0.66; 95% CI, 0.48-0.90), cesarean section (OR, 0.85; 95% CI, 0.75-0.95), and total adverse maternal outcomes (OR, 0.78; 95% CI, 0.71-0.86). Diet with physical activity was associated with reduced GWG (−1.35 kg; 95% CI, −1.95 to −0.75) and reduced risk of gestational diabetes (OR, 0.72; 95% CI, 0.54-0.96) and total adverse maternal outcomes (OR, 0.81; 95% CI, 0.69-0.95). Mixed interventions were associated with reduced GWG on...

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Section: Discussionmentioning

confidence: 99%

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Association of Antenatal Diet and Physical Activity–Based Interventions With Gestational Weight Gain and Pregnancy Outcomes

et al. 2022

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“…The importance of nutrition during pregnancy for supporting optimal maternal and child health is well-established and recognized by healthcare professionals [ 1 , 2 , 3 ]. However, dietary intake during pregnancy is typified by inadequate consumption of vegetables, fruit, and whole grains, as well as excessive intake of empty calories, fat, and sodium [ 4 , 5 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

Greater Ultra-Processed Food Intake during Pregnancy and Postpartum Is Associated with Multiple Aspects of Lower Diet Quality

et al. 2022

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Low diet quality during pregnancy and postpartum is associated with numerous adverse maternal and infant health outcomes. This study examined relations of ultra-processed food intake with diet quality during pregnancy and postpartum. Using data from 24-h recalls, ultra-processed food intake was operationalized as percent energy intake from NOVA-classified ultra-processed foods; diet quality was measured using Healthy Eating Index 2015 (HEI) total and component scores. Pearson correlations examined associations of ultra-processed food intake with HEI total and component scores, and food group intake was compared across four levels of ultra-processed food intake. On average, ultra-processed food comprised 52.6 ± 15.1% (mean ± SD) of energy intake in pregnancy and 50.6 ± 16.6% in postpartum. Ultra-processed food intake was inversely correlated with HEI total and 8 of 13 component scores. Compared to participants with the highest ultra-processed food intake (≥60% energy), those with the lowest ultra-processed food intake (<40% energy) had a 17.6-point higher HEI total score and consumed 2–3 times more fruit, vegetables, and seafood and plant proteins, and 1½ times more total protein. Additionally, they consumed 2/3 as much refined grains and 1/2 as much added sugar. Greater ultra-processed food intake was associated with lower diet quality across most HEI components. Reducing ultra-processed food intake may broadly improve adherence to dietary guidelines in pregnant and postpartum populations.

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“…These are important issues to be addressed before, 3,4 during, and after pregnancy, and across the life course. 5,6 It is estimated that one-third of the world's population suffers from malnutrition, whether it be thinness or obesity or micronutrient deficiencies. Suboptimal nutrition and obesity are conditions that affect all women globally, spanning from high-to low-and middle-income countries.…”

Section: Impact Of Pregnancy On Long-term Health: Advances In Postpre...mentioning

confidence: 99%

Impact of pregnancy on long‐term health: Advances in postpregnancy care—An opportunity to improve long‐term maternal health

McAuliffe

2023

Intl J Gynecology & Obste

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New guidelines, position paper, and insights from the FIGO Pregnancy Obesity and Nutrition Initiative (PONI)

Abstract: The FIGO PONI Supplement highlights the importance of weight and nutrition for women before, during, and after pregnancy, and provides recommendations and tools for clinical practice.

Cited by 7 publications

References 7 publications

Association of Antenatal Diet and Physical Activity–Based Interventions With Gestational Weight Gain and Pregnancy Outcomes

Association of Antenatal Diet and Physical Activity–Based Interventions With Gestational Weight Gain and Pregnancy Outcomes

Greater Ultra-Processed Food Intake during Pregnancy and Postpartum Is Associated with Multiple Aspects of Lower Diet Quality

Impact of pregnancy on long‐term health: Advances in postpregnancy care—An opportunity to improve long‐term maternal health

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