Nutrition during pregnancy and early development (NuPED) in urban South Africa: a study protocol for a prospective cohort

Abstract

BackgroundAdequate nutrition during pregnancy is important to ensure optimal birth outcomes, maternal health and offspring development. However, little is known about the dietary intake and nutritional status of pregnant women residing in urban South Africa. Therefore, the Nutrition during Pregnancy and Early Development (NuPED) cohort study was initiated to assess early nutrition-related exposures predictive of early childhood development in urban South Africa.MethodsThe aims of this prospective cohort study are: 1) to assess dietary intake and nutritional status of urban pregnant women in Johannesburg, South Africa, and 2) to determine associations with birth outcomes, measures of maternal health, as well as measures of offspring health and development. Pregnant women (< 18 weeks’ gestation) (n = 250) are being recruited from primary healthcare clinics in Johannesburg and are followed-up at a provincial hospital. Participants’ dietary intake and nutrient status (focus on micronutrients and fatty acids) are assessed at < 18, 22 and 36 weeks’ gestation. Additional assessments during pregnancy include anthropometric and blood pressure measurements, obstetric ultrasound screens, and assessments of food security, maternal fatigue, prenatal depression, allergy, immune function, morbidity and gestational diabetes. At birth, maternal and neonatal health is assessed and an umbilical cord blood sample collected. Maternal and offspring health is followed-up at 6 weeks, as well as at 6, ≈7.5 and 12 months after birth. Follow-up assessments of mothers include anthropometric measures, diet history, nutrient status, blood pressure, breast milk composition, and measures of postnatal depression and fatigue. Follow-up assessments of the offspring include feeding practices, nutrient status, measures of growth, psychomotor, socio-emotional and immune development, morbidity, allergy, as well as analysis of the gut microbiome and the epigenome.DiscussionEnsuring adequate nutrition during pregnancy is one of the key actions endorsed by the South African Government to promote optimal early childhood development in an effort to eradicate poverty. The results from this study may serve as a basis for the development of context-specific nutritional interventions which can improve birth outcomes and long-term quality of life of the mother and her offspring.

The Nutritional Behaviour of Pregnant Women in Poland

“…Epidemiological studies have shown that the prenatal period of development largely determines the occurrence of lifestyle and civilization diseases in later life [1,2,3,4]. Proper preparation of a woman for pregnancy has a significant impact on embryo genesis.…”

Weight Addition on Pregnant Women as A Quality Predictor of Family Daily Food Consumption Pattern

“…The nutritional status of pregnant women is a main priority that must be fulfilled by the family in order to mothers are able to deliver healthy babies (Symington et al, 2018) (Wu et al, 2004). Many factors affect the nutritional status of pregnant women including their low education.…”

Sistem Informasi Nutrisi Ibu Hamil (Nutrition information system for Pregnant Women)

“…Gestational weight gain measurements can be determined by weight, height, and gestational age (Committee, O. N. S. D. P., & Institute, O. M., 1990). Measurement of weight (kg) and height (cm) is determined based on the nearest 0.05 kg for weight, and 0.1 cm for height (Symington, 2018). Detailed description of the standard operating procedure (SOP) for weight and height measurement are provide in appendices.…”

“…Pregnancy outcomes measurement will be take in the end of pregnancy. The infant is weighted on a calibrated scale with minimum of clothing, namely only a vest, and without nappy, and recorded to the nearest 5 g (Symington, 2018). The categories neonatal birth weight measured according to Chan, et al (2011) are divide into three groups: very low birthweight (<1.500g), low birthweight (<2.500g), and normal birthweight (2.500 or more).…”

“…In order to nutritional requirement met for mothers and babies, the dietary intake must ensure from diverse sources. One of the challenges to set the optimal birth outcomes, maternal health and offspring development by consumption pattern in the practice of pregnant women (Symington, 2018). Evidence states that risk factors that related among infant mortality and low birth prevalence related to nutrition problems and behaviour (committee review, 2016).…”