Li Qian, Li Jing
Nursing Department, Affiliated People's Hospital of Jiangsu University, Zhenjiang City, Jiangsu Province, China.
Department of Nursing, School of Medical and Health Engineering, Changzhou University, Changzhou City, Jiangsu Province, China.
BMC Pregnancy Childbirth. 2025 Jul 31;25(1):798. doi: 10.1186/s12884-025-07876-7.
Pregnancy presents a critical "teachable moment" for promoting healthy dietary behaviors, with significant implications for maternal and neonatal outcomes. However, achieving sustained dietary behavior change remains complex. This systematic review aimed to examine the effectiveness of dietary interventions during pregnancy and explore the underlying mechanisms of behavior change, focusing on behavior change techniques (BCTs) through the lens of the COM-B model.
This review was conducted following the PRISMA 2020 guidelines and employed a narrative synthesis approach. A comprehensive search of six electronic databases and grey literature sources was performed. Studies were eligible if they evaluated dietary interventions targeting pregnant women and reported outcomes related to eating behavior or gestational weight gain. Forty-five studies met the inclusion criteria. Intervention components were coded using the Behavior Change Technique (BCT) Taxonomy V1. Risk of bias was assessed using the Cochrane tool for randomized controlled trials and ROBINS-I for non-randomized studies.
The review revealed mixed findings regarding the effectiveness of dietary interventions, largely due to substantial heterogeneity in intervention designs, delivery methods, and outcome measures. Commonly employed BCTs included goal setting, action planning, knowledge shaping, and feedback. Most interventions targeted psychological capability and reflective motivation, while fewer addressed social opportunity and environmental restructuring.
Current dietary interventions predominantly focus on enhancing individual motivation and capabilities but often overlook social and environmental barriers. Future research should design interventions that incorporate broader COM-B dimensions, address health literacy disparities, and tailor strategies to participants' contextual needs. A deeper understanding of behavior change mechanisms may enhance the effectiveness and sustainability of dietary interventions during pregnancy.
Registered on PROSPERO database (CRD42022310860).
怀孕是促进健康饮食行为的关键“可教时刻”，对母婴结局具有重大影响。然而，实现持续的饮食行为改变仍然很复杂。本系统评价旨在研究孕期饮食干预的有效性，并通过COM-B模型探讨行为改变的潜在机制，重点关注行为改变技术（BCTs）。
本评价遵循PRISMA 2020指南进行，采用叙述性综合方法。对六个电子数据库和灰色文献来源进行了全面检索。如果研究评估了针对孕妇的饮食干预，并报告了与饮食行为或孕期体重增加相关的结果，则符合纳入标准。45项研究符合纳入标准。干预成分使用行为改变技术（BCT）分类法V1进行编码。使用Cochrane随机对照试验工具和ROBINS-I对非随机研究进行偏倚风险评估。
该评价显示，关于饮食干预的有效性存在混合结果，这主要是由于干预设计、实施方法和结局测量方面存在很大异质性。常用的BCTs包括目标设定、行动计划、知识塑造和反馈。大多数干预针对心理能力和反思性动机，而涉及社会机会和环境重构的较少。
当前的饮食干预主要侧重于增强个人动机和能力，但往往忽视社会和环境障碍。未来的研究应设计纳入更广泛COM-B维度的干预措施，解决健康素养差异问题，并根据参与者的具体情况需求调整策略。对行为改变机制的更深入理解可能会提高孕期饮食干预的有效性和可持续性。
在PROSPERO数据库（CRD42022310860）注册。
