The Nutritional Behaviour of Pregnant Women in Poland

Ługowska, Katarzyna; Kolanowski, Wojciech

doi:10.3390/ijerph16224357

Cited by 15 publications

(20 citation statements)

References 46 publications

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“…Our study suggests that, despite the universal access to information for both rural and urban inhabitants and development of prenatal care, there is still a need for education about proper nutrition and other health-related issues regardless of place of residence. These suggestions are also supported by Ługowska et al and Dereń et al [38,39] and in other populations [40]. Progress in antenatal care has been made worldwide, which is also supported by our results [41].…”

Section: Discussionsupporting

confidence: 91%

Health-Related Behaviors of Pregnant Women Residing in Urban and Rural Areas in Poland

Szubert

Ilowiecka

Wilczyński

et al. 2020

IJERPH

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The aim of this study was to evaluate the knowledge regarding a healthy lifestyle and prophylaxis during pregnancy among women from rural and urban areas and how this changed within a 5-year period. Analyses of the population of pregnant women in Poland were made using a questionnaire survey. The survey was conducted in the years 2010–2012 and 2017. Questionnaires from 6128 pregnant women were collected. The statistical analyses were conducted using IBM SPSS. The examined population was comprised of 41% women from rural areas and 59% women from urban areas. Alcohol consumption was lower among women from rural areas than among urban inhabitants in 2010–2012; in 2017 a trend of even lower consumption was observed. Folic acid supplementation was more broadly developed in the urban population; however, in 2017, higher percentage rates of both populations admitted taking folates before pregnancy. More women in urban than in rural areas performed physical activity during pregnancy, but the differences decreased in 2017. Knowledge of a healthy lifestyle and prophylaxis during pregnancy increased regardless of place of residence; however, the most evident change could be observed among women from rural areas.

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Section: Discussionsupporting

confidence: 91%

Health-Related Behaviors of Pregnant Women Residing in Urban and Rural Areas in Poland

Szubert

Ilowiecka

Wilczyński

et al. 2020

IJERPH

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“…At the same time, randomized studies provided good effects in the area of dietetic counselling in women with GDM [ 3 ]. In our country, nutrition standards for pregnant women are similar to the recommendations of the World Health Organization (WHO) and the European Food Safety Authority (EFSA) or the Institute of Medicine (IOM) [ 54 ], as described in our earlier study [ 25 ]. The quality of diet is also important (also shown by our earlier studies) [ 46 , 54 , 55 ].…”

Section: Discussionmentioning

confidence: 99%

The Role of Maternal Weight in the Hierarchy of Macrosomia Predictors; Overall Effect of Analysis of Three Prediction Indicators

Lewandowska

2021

Nutrients

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So far it has not been established which maternal features play the most important role in newborn macrosomia. The aim of this study is to provide assessment of a hierarchy of twenty six (26) maternal characteristics in macrosomia prediction. A Polish prospective cohort of women with singleton pregnancy (N = 912) which was recruited in the years 2015−2016 has been studied. Two analyses were performed: for probability of macrosomia >4000 g (n = 97) (vs. 755 newborns 2500−4000 g); and for birthweight >90th percentile (n = 99) (vs. 741 newborns 10−90th percentile). A multiple logistic regression was used (with 95% confidence intervals (CI)). A hierarchy of significance of potential predictors was established after summing up of three prediction indicators (NRI, IDI and AUC) calculated for the basic prediction model (maternal age + parity) extended with one (test) predictor. ‘Net reclassification improvement’ (NRI) focuses on the reclassification table describing the number of women in whom an upward or downward shift in the disease probability value occurred after a new factor had been added, including the results for healthy and ill women. ‘Integrated discrimination improvement’ (IDI) shows the difference between the value of mean change in predicted probability between the group of ill and healthy women when a new factor is added to the model. The area under curve (AUC) is a commonly used indicator. Results. The macrosomia risk was the highest for prior macrosomia (AOR = 7.53, 95%CI: 3.15−18.00), p < 0.001). A few maternal characteristics were associated with more than three times higher macrosomia odds ratios, e.g., maternal obesity and gestational age ≥38 weeks. A different hierarchy was shown by the prediction study. Compared to the basic prediction model (AUC = 0.564 (0.501−0.627), p = 0.04), AUC increased most when pre-pregnancy weight (kg) was added to the base model (AUC = 0.706 (0.649−0.764), p < 0.001). The values of IDI and NRI were also the highest for the model with maternal weight (IDI = 0.061 (0.039−0.083), p < 0.001), and NRI = 0.538 (0.33−0.746), p < 0.001). Adding another factor to the base model was connected with significantly weaker prediction, e.g., for gestational age ≥ 38 weeks (AUC = 0.602 (0.543−0.662), p = 0.001), IDI = 0.009 (0.004; 0.013), p<0.001), and NRI = 0.155 (0.073; 0.237), p<0.001). After summing up the effects of NRI, IDI and AUC, the probability of macrosomia was most strongly improved (in order) by: pre-pregnancy weight, body mass index (BMI), excessive gestational weight gain (GWG) and BMI ≥ 25 kg/m2. Maternal height, prior macrosomia, fetal sex-son, and gestational diabetes mellitus (GDM) occupied an intermediate place in the hierarchy. The main conclusions: newer prediction indicators showed that (among 26 features) excessive pre-pregnancy weight/BMI and excessive GWG played a much more important role in macrosomia prediction than other maternal characteristics. These indicators more strongly highlighted the differences between predictors than the results of commonly used odds ratios.

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“…The diet of pregnant women should provide the right amount of nutrients and calories. Nutrition standards in Poland are similar to those recommended by World Health Organization (WHO), Institute of Medicine, and European Food Safety Authority (EFSA) [30]. According to Polish guidelines, four to five meals a day are recommended and an energy consumption in the second and third trimesters increased by 360 and 475 kcal/day, respectively.…”

Section: Discussionmentioning

confidence: 82%

“…Physical activity is essential in the treatment of obesity. According to WHO, adults should show a minimum of 150 min of moderate activity a week; similar guidelines apply in pregnancy, but with possible contraindications [30].…”

Section: Discussionmentioning

confidence: 99%

“…In Poland, 300 g/400 g of fruit/vegetables is the recommended daily amount in the first trimester, and 400 g/500 g in the second–third trimester. The diet should provide the right amount of macro- and micro-nutrients (e.g., vitamins and trace elements) [ 30 ]. According to the recommendations of the Institute of Medicine (IOM) of 2009, optimal weight gain depends on the pre-pregnancy BMI, and for underweight, normal weight, overweight, and obesity, it should be 12.5–18, 11.5–16, 7–11.5, and 5–9 kg, respectively [ 7 ].…”

Section: Discussionmentioning

confidence: 99%

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Pre-Pregnancy Obesity vs. Other Risk Factors in Probability Models of Preeclampsia and Gestational Hypertension

Lewandowska

Więckowska

Sajdak³

et al. 2020

Nutrients

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In the face of the obesity epidemic around the world, attention should be focused on the role of maternal obesity in the development of pregnancy. The purpose of this analysis was to evaluate the prediction of preeclampsia (PE) and isolated gestational hypertension (GH) for a number of maternal factors, in order to investigate the importance of pre-pregnancy obesity (body mass index, BMI ≥ 30 kg/m2), compared to other risk factors (e.g., prior PE, pregnancy weight gain (GWG), infertility treatment, interpregnancy interval, family history, the lack of vitamin supplementation, urogenital infection, and socioeconomic factors). In total, 912 women without chronic diseases were examined in a Polish prospective cohort of women with a single pregnancy (recruited in 2015–2016). Separate analyses were performed for the women who developed GH (n = 113) vs. 775 women who remained normotensive, as well as for those who developed PE (n = 24) vs. 775 controls. The probability of each disease was assessed for the base prediction model (age + primiparity) and for the model extended by one (test) variable, using logistic regression. Three measures were used to assess the prediction: area under curve (AUC) of the base and extended model, integrated discrimination improvement (IDI) (the index shows the difference between the value of the mean change in the predicted probability between the group of sick and healthy women when a new factor is added to the model), and net reclassification improvement (NRI) (the index focuses on the reclassification table describing the number of women in whom an upward or downward shift in the disease probability value occurred after a new factor had been added, including results for healthy and sick women). In the GH prediction, AUC increased most strongly when we added BMI (kg/m2) as a continuous variable (AUC = 0.716, p < 0.001) to the base model. The highest IDI index was obtained for prior GH/PE (IDI = 0.068, p < 0.001). The addition of BMI as a continuous variable or BMI ≥ 25 kg/m2 improved the classification for healthy and sick women the most (NRI = 0.571, p < 0.001). In the PE prediction, AUC increased most strongly when we added BMI categories (AUC = 0.726, p < 0.001) to the base model. The highest IDI index was obtained for prior GH/PE (IDI = 0.050, p = 0.080). The addition of BMI categories improved the classification for healthy and sick women the most (NRI = 0.688; p = 0.001). After summing up the results of three indexes, the probability of hypertension in pregnancy was most strongly improved by BMI, including BMI ≥ 25 kg/m2 for the GH prediction, and BMI ≥ 30 kg/m2 for the PE prediction. Main conclusions: Pre-pregnancy BMI was the most likely factor to increase the probability of developing hypertension in pregnancy, compared to other risk factors. Hierarchies of PE and GH risk factors may suggest different (or common) mechanisms of their development.

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The Nutritional Behaviour of Pregnant Women in Poland

Cited by 15 publications

References 46 publications

Health-Related Behaviors of Pregnant Women Residing in Urban and Rural Areas in Poland

Health-Related Behaviors of Pregnant Women Residing in Urban and Rural Areas in Poland

The Role of Maternal Weight in the Hierarchy of Macrosomia Predictors; Overall Effect of Analysis of Three Prediction Indicators

Pre-Pregnancy Obesity vs. Other Risk Factors in Probability Models of Preeclampsia and Gestational Hypertension

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