Office of Research, Endeavour College of Natural Health, Queensland, Australia.
Department of Rural Health, Division of Health Sciences, University of South Australia, Whyalla, South Australia, Australia.
Matern Child Nutr. 2020 Apr;16(2):e12916. doi: 10.1111/mcn.12916. Epub 2019 Dec 2.
The aim of this study is to determine the level of adherence to dietary guidelines among men and women during preconception, and pregnant women, and factors associated with adherence. Searches were conducted in CINAHL, AMED, EMBASE, and Maternity and Infant Care from inception to March 2018. Observational studies assessing the primary outcome (adherence to dietary guidelines and/or nutritional recommendations) and/or secondary outcome (factors associated with adherence) were eligible. Study quality was assessed using the National Institutes of Health Quality Assessment Tool for Observational Cohort and Cross-sectional studies. Men or women (aged ≥18 years) who identified as trying/intending to conceive or were pregnant. Eighteen studies were included. The quality of studies was fair (44%) to good (56%). Most studies indicated preconceptual and pregnant women do not meet recommendations for vegetable, cereal grain, or folate intake. Pregnant women did not meet iron or calcium intake requirements in 91% and 55% of included studies, respectively, and also exceeded fat intake recommendations in 55% of included studies. Higher level education was associated with improved guideline adherence in pregnant women, whereas older age and non-smoking status were associated with greater guideline adherence in preconceptual and pregnant women. The findings of this review suggest that preconceptual and pregnant women may not be meeting the minimum requirements stipulated in dietary guidelines and/or nutritional recommendations. This could have potential adverse consequences for pregnancy and birth outcomes and the health of the offspring. Major knowledge gaps identified in this review, which warrant further investigation, are the dietary intakes of men during preconception, and the predictors of guideline adherence.
本研究旨在确定备孕、孕期男性和女性遵循饮食指南的水平，以及与依从性相关的因素。检索了 CINAHL、AMED、EMBASE 和母婴护理从成立到 2018 年 3 月的文献。符合条件的研究是评估主要结局（饮食指南和/或营养建议的依从性）和/或次要结局（与依从性相关的因素）的观察性研究。使用国家卫生研究院观察性队列和横断面研究质量评估工具评估研究质量。男性或女性（年龄≥18 岁），自述正在尝试/打算怀孕或已经怀孕。纳入了 18 项研究。研究质量为良好（56%）至中等（44%）。大多数研究表明，备孕和孕期女性蔬菜、谷物或叶酸的摄入量未达到推荐标准。在纳入的研究中，91%的研究表明孕妇的铁摄入量不符合要求，55%的研究表明孕妇的钙摄入量不符合要求，在纳入的研究中，55%的研究还超过了脂肪摄入量的建议。较高的教育水平与孕妇更好地遵循指南相关，而年龄较大和不吸烟与备孕和孕妇更好地遵循指南相关。本综述的结果表明，备孕和孕妇可能未达到饮食指南和/或营养建议规定的最低要求。这可能对妊娠和分娩结局以及后代的健康产生潜在的不良后果。本综述确定了一些需要进一步研究的主要知识空白，包括备孕期间男性的饮食摄入，以及遵循指南的预测因素。
