A Community Prenatal Intervention in Social Nutrition: Evaluating the Impact on Pregnancy and Birthweight Outcomes.

Elise Carbonneau,Bénédicte Fontaine-Bisson,Alex Dumas,Annie Brodeur-Doucet

doi:10.3390/nu14061151

Elise Carbonneau, Bénédicte Fontaine-Bisson + Show 2 more

Open Access

https://doi.org/10.3390/nu14061151

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Abstract

This study aims to assess the associations between structural features of the Montreal Diet Dispensary’s social nutrition intervention and pregnancy (i.e., anemia, gestational diabetes mellitus (GDM), gestational weight gain (GWG), hypertension) and birthweight outcomes (i.e., small- or large-for-gestational-age) among pregnant women, most of them recent immigrants. The study consists of a secondary analysis of the digital client database of the Montreal Diet Dispensary (n = 2925). Logistic regressions were used to estimate the odds of pregnancy and birthweight outcomes, depending on structural features of the intervention. Pregnant women who attended a welcoming group session presented lower odds of GDM and anemia compared to those who did not attend. A longer duration of intervention was also associated with lower odds of GDM and anemia. Each additional appointment with a dietitian was associated with higher odds of excessive GWG and lower odds of insufficient GWG only among women with a pre-pregnancy BMI lower than 25 kg/m2. This study emphasizes the importance of providing nutritional services early in pregnancy to reduce the risk of GDM and anemia. It also stresses the importance of using appropriate nutritional guidelines to avoid increasing the risk of excessive GWG.

Highlights

Malnutrition during pregnancy—which includes undernutrition and overnutrition—is associated with a wide range of adverse outcomes for maternal and infants’ physical, mental and neurodevelopmental health [1–5]
Further analyses were stratified by pre-pregnancy BMI (Table 3). These analyses showed that a higher number of appointments with a dietitian was associated with higher odds of excessive gestational weight gain (GWG) and lower odds of insufficient GWG among women with a pre-pregnancy BMI lower than 25 kg/m2, but not among women with a pre-pregnancy BMI corresponding to overweight or obesity
Our results indicate that a longer duration of intervention is associated with a decreased risk of developing gestational diabetes mellitus (GDM) and anemia

Summary

Introduction

Malnutrition during pregnancy—which includes undernutrition (e.g., caloric/protein or micronutrient deficiencies) and overnutrition (e.g., excess of calories with micronutrient excess or deficiencies)—is associated with a wide range of adverse outcomes for maternal and infants’ physical, mental and neurodevelopmental health [1–5]. These outcomes are important for young children, given that their first 1000 days of life, extending from conception to early childhood, constitute a critical period during which malnutrition and food insecurity can have serious negative consequences for their growth, development and health [6–8].

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