PROTOCOL: Effectiveness of nutrition counselling for pregnant women in low‐ and middle‐income countries to improve maternal, infant and child behavioural, nutritional and health outcomes: A systematic review

Dewidar, Omar; Saad, Ammar; Baqar, Aqeel; John, Jessica C.; Riddle, Alison; Ota, Erika; Kung’u, Jacqueline K.; Arabi, Mandana; Raut, Manoj Kumar; Klobodu, Seth Selorm; Rowe, Sarah; Busch‐Hallen, Jennifer; Jalal, Chowdhury; Wuehler, Sara; Welch, Vivian

doi:10.1002/cl2.1202

Cited by 4 publications

(6 citation statements)

References 39 publications

(50 reference statements)

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“…Nutritional education through counseling interventions is expected to increase motivation for behavioral change and self‐efficacy by helping pregnant women understand the challenges and provide goals and opportunities to improve their nutrition (Dewidar et al, 2021). In this program, pregnant women used their own data measured using the BDHQ in a dedicated booklet, making it easier for them to understand improvement points and challenges based on their nutrient intake and set goals.…”

Section: Discussionmentioning

confidence: 99%

Effects of an individualized nutritional educational program in pregnant women: A randomized controlled trial in Japan

Fujimoto,

Iida,

Takeuchi

et al. 2024

Japan Journal Nursing Sci

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AimTo evaluate the effectiveness of an individualized nutritional education program in promoting adequate nutrient intake in pregnant women.MethodsA stratified randomized controlled trial was conducted. Participants were stratified by factors affecting the primary outcome and randomly assigned to the intervention or control groups. Intervention group participants received an individualized 30‐min booklet‐based education program in their 2nd and 3rd trimesters; the control group received usual care. The primary outcome was protein intake after the intervention, which was compared between the intervention and control groups. Secondary outcomes included comparing the amount of increase of protein before and after the intervention. Nutrient intake was measured using a self‐administered short dietary history questionnaire, and analyses of covariance and t tests were performed.ResultsOf the 130 participants, 66 were assigned to the intervention group and 64 to the control group. There was no difference in protein intake between the two groups after the intervention (p = .051, 95% CI [−0.021, 12.4]). Comparing the increase in protein intake before and after intervention, the intervention group was 7.4 g/day higher than that of the control group (p = .040; F = 4.31; effect size = 0.36).ConclusionsThe primary outcome, a comparison of protein intake between the groups after the program, revealed no significant differences. However, on comparing the amount of protein increase before and after the intervention, the intervention group's increase was significantly higher than that of the control group. Results indicate the potential for individualized face‐to‐face interventions for pregnant women in Japan.

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Section: Discussionmentioning

confidence: 99%

Effects of an individualized nutritional educational program in pregnant women: A randomized controlled trial in Japan

Fujimoto,

Iida,

Takeuchi

et al. 2024

Japan Journal Nursing Sci

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“…[ 35 ] However, they need comprehensive understanding of both healthy lifestyle promotion in pregnant women and their own role in antenatal care to support pregnant women in health behavior change to achieve positive outcomes. [ 36 , 37 ] In Thailand, large industries have to hire professional nurses to work full or part time. However, these nurses do not specialize in advanced midwifery.…”

Section: Discussionmentioning

confidence: 99%

Exploring the Experiences of Health-Promoting Behavior in the Workplace among Thai Pregnant Women: A Phenomenological Approach

Nuampa,

Tangsuksan,

Patil

2023

Iranian Journal of Nursing and Midwifery Research

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Background: Inappropriate working conditions during pregnancy can negatively affect health-promoting behaviors and pregnancy outcomes. This study aimed to explore the experiences of health-promoting behavior in the workplace among Thai pregnant women. Materials and Methods: Giorgi's phenomenological methodology was used, and data were gathered through semi-structured interviews with 21 working-pregnant women in large industries in two regions of Thailand. Data were collected from December 2019 to June 2020. Purposive and snowball sampling were used to recruit pregnant women at 13–42 weeks of gestation. To analyze the data, three steps of Giorgi's phenomenological approach were employed. Results: The pregnant women described their lived experiences with health-promoting behaviors in the workplace into four major categories. Firstly, “positive attitude toward work in promoting health behaviors” contained three subcategories (“self-discipline,” “social interaction,” and “self-esteem”). Secondly, the idea that “changing temporary health behaviors is worthwhile for infants” was expressed into two subcategories (“eating adaptation” and “managing negative emotions”). Thirdly, “insufficient support from workplace policy” had three subcategories (“inconvenient accommodations,” “inflexible break times,” and “lack of healthcare support”). Finally, “negative perception of new work positions” consisted of two subcategories (“stress” and “low self-efficacy”). Conclusions: Positive attitudes toward work and infant health may encourage pregnant women to engage in healthy behaviors, while workplace support and policies are important in promoting healthy behavior and avoiding negative emotions. Health promotion interventions should encourage the value of work, promote maternal–fetal attachment, and increase health support policy to avoid mental health issues and promote healthy behaviors among working-pregnant women.

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“…This review was conducted according to a published protocol (Dewidar et al, 2021 ). We conformed to the Cochrane Collaboration's Effective Practice and Organisation of Care (EPOC) criteria for the selection of studies (EPOC, 2017 ) as randomized trials may not be sufficiently available to address the effects of two‐way nutrition counseling on health outcomes.…”

Section: Methodsmentioning

confidence: 99%

“…• What are the documented potential effects of nutrition counseling interventions on maternal and infant behavioral and health outcomes across participants' PROGRESS+ characteristics? This review was conducted according to a published protocol (Dewidar et al, 2021). We conformed to the Cochrane Collaboration's Effective Practice and Organisation of Care (EPOC) criteria for the selection of studies (EPOC, 2017) as randomized trials may not be sufficiently available to address the effects of two-way nutrition counseling on health outcomes.…”

Section: Objectivesmentioning

confidence: 99%

Effectiveness of nutrition counseling for pregnant women in low‐ and middle‐income countries to improve maternal and infant behavioral, nutritional, and health outcomes: A systematic review

Dewidar,

John,

Baqar

et al. 2023

Campbell Systematic Reviews

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BackgroundNutritional counseling, which includes two‐way interactive education, has been hypothesized to improve the health and nutritional status of pregnant women, but little is known about the impact such practice of care might have on maternal and infant health and behavioral outcomes of pregnant women living in low income, low‐middle income, and upper‐middle‐income countries (LMIC)s.ObjectivesWe conducted a systematic review to appraise the effectiveness and impact on health equity of two‐way nutritional counseling practices in LMICs on maternal and infant behavioral, nutritional, and health outcomes.Search MethodsWe conducted electronic searches for relevant studies on Medline, Embase, CINAHL, PsychInfo, and the Cochrane CENTRAL for randomized and non‐randomized trials on the effectiveness of two‐way interactive nutritional counseling among pregnant women from the date of database inception up to June 22, 2021. In addition, we searched references of included studies in systematic reviews, gray literature resources, and unpublished studies or reports that satisfied our eligibility criteria using a focused Google search.Selection CriteriaWe included randomized and non‐randomized controlled studies (NRS), controlled before and after, and interrupted time series that assessed the effectiveness of two‐way interactive nutrition counseling targeting pregnant women in LMICs.Data Collection and AnalysisData extraction and risk of bias were conducted in duplicate. The risk of bias (ROB) for randomized trials (RCT) was assessed according to the Cochrane Handbook of Systematic Reviews, and ROB for NRS was assessed using the Newcastle‐Ottawa scale (NOS). RCT and NRS were meta‐analyzed separately.Main ResultsOur search identified 6418 records and 52 studies met our inclusion criteria, but only 28 were used in the quantitative analysis. Twenty‐eight studies were conducted in Asia, the most in Iran. Eight studies were conducted in Africa. Two‐way interactive nutritional counseling during pregnancy may improve dietary caloric intake (mean difference [MD]: 81.65 calories, 95% confidence interval [CI], 15.37–147.93, three RCTs; I2 = 42%; moderate certainty of evidence using GRADE assessment), may reduce hemorrhage (relative risk [RR]: 0.63; 95% CI, 0.25–1.54, two RCTs; I2 = 40%; very low certainty of evidence using GRADE assessment), may improve protein (MD: 10.44 g, 95% CI, 1.83–19.05, two RCTs; I2 = 95%; high certainty of evidence using GRADE assessment), fat intake (MD: 3.42 g, 95% CI, −0.20 to 7.04, two RCTs; I2 = 0%; high certainty of evidence using GRADE assessment), and may improve gestational weight gain within recommendations (RR: 1.84; 95% CI, 1.10–3.09, three RCTs; I2 = 69%). Nutrition counseling probably leads to the initiation of breastfeeding immediately after birth (RR: 1.72; 95% CI, 1.42–2.09, one RCT). There was little to no effect on reducing anemia (RR: 0.77; 95% CI, 0.50–1.20, three RCTs; I2 = 67%; very low certainty of evidence using GRADE assessment) risk of stillbirths (RR: 0.81; 95% CI, 0.52–1.27, three RCTs; I2 = 0%; moderate certainty of evidence using GRADE assessment) and risk of cesarean section delivery (RR: 0.96; 95% CI, 0.76–1.20, four RCTs; I2 = 36%; moderate certainty of evidence using GRADE assessment).Authors’ ConclusionsOur review highlights improvements in maternal behavioral and health outcomes through interactive nutrition counseling during pregnancy. However, we are uncertain about the effects of nutrition counseling due to the low certainty of evidence and a low number of studies for some key outcomes. Moreover, the effects on health equity remain unknown. More methodologically rigorous trials that focus on a precise selection of outcomes driven by the theory of change of nutrition counseling to improve maternal and infant behavioral and health outcomes and consider equity are required.

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PROTOCOL: Effectiveness of nutrition counselling for pregnant women in low‐ and middle‐income countries to improve maternal, infant and child behavioural, nutritional and health outcomes: A systematic review

Cited by 4 publications

References 39 publications

Effects of an individualized nutritional educational program in pregnant women: A randomized controlled trial in Japan

Effects of an individualized nutritional educational program in pregnant women: A randomized controlled trial in Japan

Exploring the Experiences of Health-Promoting Behavior in the Workplace among Thai Pregnant Women: A Phenomenological Approach

Effectiveness of nutrition counseling for pregnant women in low‐ and middle‐income countries to improve maternal and infant behavioral, nutritional, and health outcomes: A systematic review

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