Maternal and Child Survival Program (MCSP), Washington, District of Columbia, USA.
PATH, Maternal, Newborn, Child Health, and Nutrition, Washington, District of Columbia, USA.
Matern Child Nutr. 2018 Jan;14(1). doi: 10.1111/mcn.12508. Epub 2017 Aug 24.
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.
在“最初 1000 天”窗口期间，母体营养充足至关重要，从受孕开始到生命的前 6 个月，这有助于改善营养状况并降低不良出生结局（如低出生体重和早产）的风险。遗憾的是，许多项目都针对婴儿和幼儿实施和监测营养干预措施，而不是针对孕妇或产后妇女。进行了文献回顾，以确定妊娠和哺乳期食物选择和消费的障碍，并研究中低收入国家在方案中如何解决孕产妇营养问题。对同行评议和灰色文献进行了文献回顾，作者对标题和摘要进行了审查。本综述纳入了 23 项研究。妊娠期间营养不足的障碍包括与孕妇应食用的食物量、孕期应增加的体重以及孕期“节食”以避免产下巨大儿的相关文化观念有关的知识。被认为不适合在孕期或哺乳期食用的食物会导致食物限制。食物选择的驱动因素受到食物厌恶、经济限制和家庭食物供应的影响。对孕妇饮食和孕期体重增加的咨询很少进行。支持孕妇健康饮食和孕期体重增加的方案很少。需要关注的领域包括针对妊娠和哺乳期饮食以及孕期体重增加的量身定制、具有文化共鸣的营养教育和咨询，以及对孕产妇营养进展的监测。
