Current evidence on the role of prepregnancy diets on child health outcomes

In a recent scoping review published in Journal of Preventive Medicine and Public HealthThe researchers examined the existing evidence on pre-pregnancy diet and maternal and child outcomes.

The study completed this review to outline what has been researched on pre-pregnancy diet and children’s health to chart the way for future research.

survey: Prepregnancy diet for maternal and child health: a review of the current evidence. Image credit: Groundpicture/Shutterstock.com

Background

Pre-pregnancy health has gained attention as a convenient window for preparing for a healthy pregnancy and includes aspects of nutrition and lifestyle such as diet.

A healthy diet can prevent malnutrition and reduce the risk of related non-communicable diseases. Evidence suggests an association between women’s nutritional status before pregnancy and maternal/child outcomes.

However, the contribution of prepregnancy diet to these outcomes is less certain.

About the research

In the current study, researchers examined the evidence for pre-pregnancy diet in relation to maternal and child health outcomes. They systematically searched the PubMed database using the Population, Intervention, Comparison, Outcomes and Study Design (PICOS) framework. Peer-reviewed articles published in English or Indonesian were selected.

Additionally, they searched the Science and Technology Index (SINTA) and Google Scholar databases using local (Indonesian) terms. Preprints, conferences, and methodological articles were excluded.

Two authors independently screened titles and abstracts for relevance, followed by full-text reviews. The selected papers were stratified into primary and secondary studies.

They extracted data on study design, population, sample size, age of participants, country, outcome variables, dietary assessment and maternal/child health outcomes.

Study quality was assessed using the National Institutes of Health (NIH) quality assessment tools, and articles were classified as having poor, fair, or good quality.

Findings

Initially, 296 records were identified from the indicated databases and 286 were checked for relevance after duplicate removal.

After screening and exclusion, 42 articles were included for analysis; 37 were primary research articles and five were secondary research articles. The primary studies were published between 2009 and 2022.

Twenty-five studies were from high-income countries, and 12 were conducted in low-income, lower-middle-income, or upper-middle-income countries.

Diet, as exposure was measured by food frequency questionnaires, 24-hour dietary recall, or interviews. Thirteen studies included pregnant subjects, relying on dietary recall from the pre-pregnancy phase.

Fifteen studies recruited participants up to six months before pregnancy to track pregnancy outcomes. Secondary scientific articles were published between 2012 and 2022. The team rated the average research quality at 70%.

Three articles were of poor quality, ten were good and 29 were good. Poor quality articles included one randomized controlled trial and two reviews.

Fair-rated studies did not justify sample size, study power and effect and failed to report whether investigators were explicitly blinded to exposure status.

Fair-rated studies are based on self-reported information and are considered to be at high risk of bias. There were 13 and 16 observations of dietary patterns and quality, respectively.

Gestational diabetes mellitus is the most discussed of maternal outcomes. Hypertensive disorder of pregnancy and asthma represented the second most valued maternal outcomes.

Fetal/neonatal anthropometry, neonatal morbidity and preterm birth were the most valued child health outcomes.

Conclusions

The authors note that a significant proportion of research on pre-pregnancy diets has been conducted in high-income countries, particularly the United States (US) and Canada, with the least in the African region.

Dietary patterns and quality are the most commonly observed/assessed diet-related exposures.

Gestational diabetes mellitus, hypertensive disorder of pregnancy, and fetal/neonatal anthropometry were the most commonly assessed outcomes. Overall, current evidence on pre-pregnancy diets is limited and research should be encouraged in low- and middle-income countries.

Future studies should focus on less studied outcomes such as anaemia, congenital anomalies and micronutrient deficiencies.

Written by

Tarun Sai Lomte

Tarun is a writer based in Hyderabad, India. He has an M.Sc in Biotechnology from the University of Hyderabad and is enthusiastic about research. He enjoys reading scientific articles and literature reviews and is passionate about writing.

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