Iron deficiency anemia (IDA) is a common public health occurrence of pregnancy which is particularly prevalent in developing countries like Pakistan. During this critical period, the deficiency of iron is very common as the iron requirements are greatly enhanced. IDA during pregnancy is associated with intrauterine growth retardation, premature birth, low birthweight, increased labor time, higher risk of infection, elevated maternal and prenatal mortality, muscle dysfunction, and low physical capacity. The present study was aimed to check the prevalence, effect of diet on IDA and its association with the pregnancy outcome, that is, birthweight. Five different public sector hospitals of Rawalpindi and Islamabad were analyzed. A sample size of 500 pregnant females of third trimester was observed which were then followed after delivery from September 2020 to January 2021. A well-designed questionnaire was developed where different demographic factors, dietary recalls, biomarkers, and other determinants were obtained. The data from the questionnaires were later coded for the purpose of analysis in the statistical package (SPSS) using chi-square test. Our study indicated that IDA is a moderate public health problem among pregnant women in twin cities and more than half of study subjects have depleted iron stores. Approximately 63% of the subjects were having iron deficiency and 24.8% were facing severe iron deficiency anemia. Only 12% of the subjects were considered as normal. The high prevalence of anemia in our subjects was probably due to low iron intake and poor dietary habits. The results of the study may not be generalizable due to time constraints and other factors. Maternal anemia still remains a major public health concern that requires more attention especially in developing and underdeveloping countries.

https://onlinelibrary.wiley.com/doi/pdf/10.1002/fsn3.2373

Dietary association of iron deficiency anemia and related pregnancy outcomes.

Recommendations for nutrition and the use of dietary supplements for pregnant women are updated on regular basis but it remains to be seen to what extent they may be applicable in twin pregnancies. The aim of this narrative review is to present the current state of knowledge about the energy and nutrient demand in twin pregnancy. There is general consensus in literature that the energy demand is higher than in a singleton pregnancy, but there is a lack of position statements from scientific societies on specific energy intake that is required. In turn, recommended maternal weight gain, which favors the normal weight of the neonate, has been determined. There is even a larger knowledge gap when it comes to vitamins and minerals, the body stores of which are theoretically used up faster. The greatest number of studies so far focused on vitamin D, and most of them concluded that its concentration in maternal blood is lower in twin as compared to singleton pregnancy. Few randomized studies focus on iron supplementation and there are no other studies that would assess dietary interventions. In light of a growing incidence of multiple pregnancies, more studies are necessary to establish the nutritional demands of the mother and the course of action for adequate supplementation.

/pdf/review-of-dietary-recommendations-for-twin-pregnancy-does-jvbngbqn.pdf

Review of Dietary Recommendations for Twin Pregnancy: Does Nutrition Science Keep Up with the Growing Incidence of Multiple Gestations?

Despite the global tendency of maternal anaemia to decline, the persistence of anaemia in Brazil is an important health problem given its vulnerability to deficiencies and the significant increase in nutritional requirements during pregnancy. The aim of this study was to estimate the prevalence of anaemia in Brazilian pregnant women through a systematic literature review and meta-analysis. The systematic review was carried out according to Systematic Reviews and Meta-Analyses PRISMA checklist recommendations and using the following electronic databases: Medline, Scopus, Embase, Web of Science, Lilacs, Scielo, Google Scholar, and CAPES Catalog of Theses and Dissertations. Studies that presented a prevalence of anaemia data in Brazilian pregnant women, considering all gestational trimesters, were included. The total sample included 12,792 pregnant women covering all gestational trimesters. The pooled prevalence of anaemia in Brazilian pregnant women was 23% (95% CI: 20–27), with the highest prevalence in the Northeast Region at 26% (95% CI 23–29), while the lowest prevalence was observed in the North Region with 17% (95% CI 14–20). Among the subgroups, no statistical difference was observed. The prevalence of anaemia status in Brazil is still classified as a moderate public health problem according to the World Health Organization maternal anaemia classification.

/pdf/the-prevalence-of-nutritional-anaemia-in-brazilian-pregnant-1abh8ukx.pdf

The Prevalence of Nutritional Anaemia in Brazilian Pregnant Women: A Systematic Review and Meta-Analysis

Abstract Inadequately diversified food consumption during pregnancy can lead to micronutrient deficiencies, which can affect maternal and newborn health outcomes. Previous studies on maternal dietary diversity have either been limited to a specific geographical region or consist entirely of systematic reviews, without meta‐analyses. Thus, this study aimed to determine the pooled estimate of the association between inadequate dietary diversity during pregnancy, maternal anemia, and low birth weight in Africa. A systematic review of observational studies published between January 2000 and April 2022 was undertaken using the Google Scholar, PubMed, and CINAHL databases. The PRISMA checklist was followed to present the results. Microsoft Excel was used to abstract the data. STATA version 17 was used to analyze the data, and a random‐effects meta‐analysis model was applied to compute the pooled estimates. The study was registered in PROSPERO with protocol number CRD42022320873. A total of 22 publications with 9,696 participants were included in the final meta‐analysis. The pooled adjusted odds ratio (AOR) for inadequate dietary diversity and maternal anemia was 2.15 (95% CI, 1.66–2.65), while that for low birth weight was 2.04 (95% CI, 1.46–2.63). The highest pooled estimate of maternal anemia was reported in Cameroon (AOR = 9.8, 95% CI: 1.68–17.92), followed by Ethiopia (AOR = 2.6, 95% CI: 1.95–3.25). Similarly, the pooled estimates of low birth weight were highest in Cameroon (AOR = 3.04, 95% CI: 1.19–4.88) and Ethiopia (AOR = 1.8, 95% CI: 1.29–2.39). In Africa, pregnant mothers with inadequate dietary diversity are two times more likely to develop anemia and low birth weight. Social protection policies that prioritize pregnant women, maternal nutrition promotion in the community, and dietary counseling during antenatal care visits, using national food‐based dietary guidelines, should be strengthened.

https://onlinelibrary.wiley.com/doi/pdfdirect/10.1002/fsn3.3388

Inadequate dietary diversity during pregnancy increases the risk of maternal anemia and low birth weight in Africa: A systematic review and meta‐analysis

Background Pregnant women have self-declared that they have difficulties in estimating nutrient intakes. The Nutrition Information System for Indonesian Pregnant Women (SISFORNUTRIMIL) application was created as a dietary assessment and calorie-counting tool to guide pregnant women to eat the right portion sizes for each meal. Objective The study aimed to examine the effectiveness of the SISFORNUTRIMIL application in helping users achieve a balanced diet and healthy maternal weight gain in comparison to nonusers in Indonesia. Methods First-pregnancy women in the second trimester aged 19-30 years (N=112) participated in the randomized controlled trial. Recruited women who were eligible and consented to participate in the study were allocated into the intervention group, or application user (n=56), and the control group, or application nonuser (n=56). The intervention recommended that pregnant women consume at least 5 food groups and calculate a recommended average portion size for 12 weeks. Both groups were self-monitored and recorded their intake in food records for 3 days every week. The dietary diversity consumed, macro- and micronutrient intake, and maternal weight gain were assessed pre- and postintervention. Data were collected three times during the intervention. Diversity food consumption was measured by the Minimum Dietary Diversity for Women of reproductive age. Furthermore, the Indonesian recommended dietary allowances were used to refer to and validate appropriate energy and nutrient amounts. Independent sample t test was used to compare differences between the intervention and control groups. Results The mean dietary diversity score for the application user group (7.79, SD 1.20) was significantly greater than for the application nonuser group (7.02, SD 1.39; adjusted mean difference 0.77, 95% CI 0.28-1.25; d=0.28; P=.005). Macro- and micronutrient intake was significantly more in accordance with the dietary recommendations for the user group compared to the control group, including an energy daily intake of 156.88 kcal (95% CI 114.52-199.23; d=–1.39; P=.002), 102.43 g of carbohydrates (95% CI –125.2 to –79.60; d=–1.68; P=.02), 14.33 g of protein (95% CI 11.40-17.25; d=1.86; P<.001), and 10.96 g of fat (95% CI –13.71 to –8.20; d=–1.49; P<.001). Furthermore, there was a significantly higher intake of daily vitamins and minerals in the intervention group than in the control group. Other results showed that maternal weight gain in the intervention group was in accordance with the parameters of healthy weight gain. Conclusions Recording food intake using the application was significantly effective in improving the dietary diversity consumed, improving adequate energy and nutrient intake, and producing healthy maternal weight during pregnancy. Trial Registration ISRCTN Registry ISRCTN42690828; https://www.isrctn.com/ISRCTN42690828

https://jmir.org/api/download?alt_name=formative_v7i1e38378_app1.pdf&filename=e224bbc3c1907def5a9177147cdeec9b.pdf

The Effectiveness of a Web-Based Application for a Balanced Diet and Healthy Weight Among Indonesian Pregnant Women: Randomized Controlled Trial

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Dietary association of iron deficiency anemia and related pregnancy outcomes.