Design, development, and evaluation of the Maternal Outcomes and Nutrition Tool (MONT)

Vanderlelie

et al. 2020

Nutrition & Dietetics

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Aim: This study aimed to examine dietary intake and decision-making in a cohort of pregnant South-East Queensland women to determine compliance with dietary guidelines and the relationships between dietary intake, decisionmaking and birth outcomes.Methods: Pregnant women attending maternity services at participating hospitals reported food frequency and motivations using the Maternal Outcomes and Nutrition Tool, a novel digital instrument. Birth outcomes were sourced from hospital records. A cross-sectional cohort design was used to examine the data.Results: Analysis demonstrated suboptimal intake of core food groups; meat and alternatives (median [IQR]) (2.6 [2.0-3.4] serves/day) and grains (3.1 [2.1-4.1]) fell below recommendations; fruit (3.8 [2.5-5.3]) and discretionary foods (3.1 [2.1-4.4]) exceeded them. Hypertensive disorders demonstrated a negative linear relationship with vegetable intake (P = .017). Cultural diversitywas significantly associated with decreased birthweight (P = .022) but increased intake of meat and alternatives (3.1 vs 2.6, P < .001) compared to Caucasian women; median intake of meat and alternatives was lower in women who reported smoking in the examined time frame. Smokers were less likely to declare health motives for food selection than non-smokers; smoking and health were inversely associated with increasing maternal age. Food choice was primarily sensory-driven.Conclusions: This cohort demonstrated poor adherence to dietary guidelines. Culturally and linguistically diverse women and smokers exhibit dietary behaviours which may contribute to suboptimal birth outcomes; targeted nutrition counselling may improve outcomes in these women. These findings highlight the need for transdisciplinary maternity care and provide a foundation for further research aimed at optimising nutrition-related birth outcomes in at-risk groups. K E Y W O R D Sbirth outcomes, cultural diversity, decision-making, diet, nutritional status, pregnancy

Section: Methodsmentioning

confidence: 99%

Influence of dietary intake and decision‐making during pregnancy on birth outcomes

James-McAlpine

Vanderlelie

et al. 2020

Nutrition & Dietetics

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“…Dietary data were self-reported by participants using the MONT, an instrument designed for exclusive administration in a digital format. 18 Food frequency questionnaires (FFQs) in the tool were adapted from the previously validated Norwegian Mother and Child (MoBa) Study 21 with reference to the Harvard, 22 the Block, 23 and diet history questionnaires. 24 Surveys were designed with a minimal language component, facilitating engagement with women with English literacy limitations.…”

Section: Participants and Methodsmentioning

confidence: 99%

“…Based on previously validated food frequency questionnaires, the MONT collects self-reported data regarding 259 individual foods, micronutrient supplements, 190 constituent nutrients, their related components, and 8 birth outcomes. 18 These combined methods offer a novel approach to assessing the intake of trace minerals during pregnancy, the effect of diet and supplements on serum mineral levels and their potential influence on birth outcomes.…”

Section: Introductionmentioning

confidence: 99%

Essential Mineral Intake During Pregnancy and Its Association With Maternal Health and Birth Outcomes in South East Queensland, Australia

McAlpine

McKeating

et al. 2019

Nutr Metab Insights

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Micronutrient supplements are often recommended during pregnancy, yet their role and necessity remain poorly understood in the Australian population. This study aimed to determine the essential mineral intake of a population of pregnant women in South East Queensland and investigate the effects of supplements on their micronutrient status and birth outcomes. Women completing the Oral Glucose Tolerance Test at two South East Queensland hospitals between 180 and 210 days gestation provided fasting blood samples and dietary data using the Maternal Outcomes and Nutrition Tool (n = 127). Birth outcomes were sourced from medical records. Serum elemental profiles were determined by inductively coupled plasma mass spectrometry (ICP-MS) analysis. Intake of 8 essential minerals was compared with Australian dietary recommendations; matched serum mineral levels were compared with the current Queensland pregnancy reference ranges. Data were examined using cross-sectional cohort design and independent sample t-tests. Supplement use had no significant influence on serum values of trace elements or the incidence of hypertensive disorders, gestational diabetes, preterm birth or infant birthweight. Dietary selenium, zinc and iodine were significantly higher in women birthing beyond 41 completed weeks; selenium ( P = .026) and zinc ( P = .034) both made unique contributions to the regression models when controlling for confounders. Women exhibited adequate to excessive serum micronutrient levels compared with pregnancy reference ranges, a finding consistent with dietary intake calculations. Data suggest that excessive essential mineral intake contributed to prolonged pregnancy in this cohort, supporting previous studies in this population. Further research is required to determine individual needs and eliminate the potential for harm before recommending pregnancy supplements.

Use of micronutrient supplements in pregnant women of south‐east Queensland

McAlpine

Vanderlelie

et al. 2020

Aust NZ J Obst Gynaeco

BackgroundMultiple micronutrient supplement use in the Australian pregnant population is rising, despite little evidence of benefit in low‐risk women. While some supplement recommendations are grounded in high‐quality evidence, others warrant further investigation. This highlights a research gap regarding appropriate use of supplements during pregnancy in the Australian population.AimsTo describe micronutrient supplement use during pregnancy in the context of current evidence and national recommendations in a population of south‐east Queensland women.Material and MethodsA cross‐sectional observational design was used to examine data gathered from pregnant women aged 16–44 years residing in south‐east Queensland, Australia. Women were recruited to the study between 23 May 2016 and 30 September 2017.ResultsPregnancy multivitamin use was declared by 42% of the cohort, with 26.8% declaring multivitamins in combination with individual micronutrients and 9.8% declaring specific micronutrient supplement use. Nulliparous women were more likely to declare use of supplements than their multiparous peers (adjusted odds ratio (aOR) 1.938, 95% CI 1.053–3.571,P = 0.034); smoking (aOR 2.717, 95% CI 1.011–7.302,P = 0.047) and low socio‐economic status were associated with no supplement use (aOR 2.451, 95% CI 1.010–5.949,P = 0.048).ConclusionsCurrent recommendations regarding micronutrient supplements throughout pregnancy are based on varying degrees of evidence, resulting in supplement advice of poor cohesion and consistency. Adherence to micronutrient supplement recommendations in the peri‐conception period in this population was poor; second and third trimester supplement use was high. Contemporary empirical research is required to determine what constitutes appropriate supplementation in high‐income regions and the populations they will benefit most.