O'Connor Hannah, Meloncelli Nina, Wilkinson Shelley A, Scott Anna Mae, Vincze Lisa, Rushton Alita, Dawson Samantha, Hollis Jenna, Whiteoak Bree, Gauci Sarah, de Jersey Susan
Faculty of Medicine, Centre for Health Services Research, The University of Queensland, Herston, Brisbane, QLD, 4000, Australia.
Chief Allied Health Practitioner, Metro North Health, Brisbane, QLD, Australia.
BMC Pregnancy Childbirth. 2025 Feb 3;25(1):112. doi: 10.1186/s12884-025-07185-z.
Improving dietary intake during pregnancy can mitigate adverse consequences for women and their children. The effective techniques and features for supporting and sustaining dietary change during pregnancy and postpartum are minimally reported. The primary aims of this systematic review and meta-analysis were to summarise the effectiveness of dietary interventions for pregnant woman, identify which behaviour change techniques (BCTs) and intervention features were most frequently used and determine which were most effective at improving dietary intake. Six databases were searched to identify randomised control trials (RCTs) reporting on dietary intake in pregnant women over the age of sixteen, with an active intervention group compared to a control group receiving usual care or less intensive interventions. The Cochrane Risk of Bias Tool 1 was used to assess study validity. BCTs were coded by two authors using Michie et al.'s BCT taxonomy V1. A random effect model assessed intervention effects on indices of dietary quality and food groups (fruit, vegetables, grains and cereals, meat, and dairy) in relation to the use of BCTs and intervention features. Thirty- seven RCTs met the inclusion criteria. High heterogeneity was observed across intervention characteristics and measures of fidelity. Only half of the available BCTs were used, with eleven used once. The BCT category Reward and threat was successful in improving dietary quality and vegetable intake, whilst 'Action planning' (1.4) from the category Goals and planning significantly improved dietary quality. Interventions delivered by a nutrition professional and those that included group sessions improved dietary quality more than those delivered by other health professionals, research staff, or application-delivered interventions and delivered via other modalities. Future dietary interventions during pregnancy should incorporate and report on BCTs used in the intervention. Successful design elements for improving antenatal dietary intake may include multimodal interventions delivered by nutrition professionals and the use of Rewards and Goal setting.
孕期改善饮食摄入可减轻对女性及其子女的不良后果。关于孕期和产后支持及维持饮食改变的有效技术和特点的报道极少。本系统评价和荟萃分析的主要目的是总结饮食干预对孕妇的有效性，确定哪些行为改变技术（BCTs）和干预特点使用最为频繁，并确定哪些在改善饮食摄入方面最有效。检索了六个数据库，以识别报告16岁以上孕妇饮食摄入情况的随机对照试验（RCTs），将积极干预组与接受常规护理或强度较低干预的对照组进行比较。使用Cochrane偏倚风险工具1评估研究的有效性。两位作者使用Michie等人的BCT分类法V1对BCTs进行编码。随机效应模型评估了干预对饮食质量指标和食物组（水果、蔬菜、谷物、肉类和乳制品）的影响，这些影响与BCTs的使用和干预特点有关。37项RCTs符合纳入标准。在干预特征和保真度测量方面观察到高度异质性。仅使用了一半可用的BCTs，其中11项仅使用过一次。奖励和威胁BCT类别成功改善了饮食质量和蔬菜摄入量，而目标和计划类别中的“行动计划”（1.4）显著改善了饮食质量。由营养专业人员实施的干预以及包括小组会议的干预比由其他卫生专业人员、研究人员或应用程序实施的干预以及通过其他方式实施的干预更能改善饮食质量。未来孕期的饮食干预应纳入并报告干预中使用的BCTs。改善产前饮食摄入的成功设计要素可能包括由营养专业人员实施的多模式干预以及奖励和目标设定的使用。
