Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on sleep in brain health

LIVE: Thursday 2nd May 2024, 18:00-19:30 (CEST)

Quality sleep is essential for health. But what happens to our brains when sleep patterns are disturbed? Join our experts to explore the interplay between sleep disruption and neurological diseases, and the questions that you need to be asking your patients to help you prevent the harmful effects of sleep deprivation.
ADVANCED SEARCH
Log in
Top
BMC Pregnancy and Childbirth
Published in: BMC Pregnancy and Childbirth 1/2018

Open Access 01-12-2018 | Research article

Are women with history of pre-eclampsia starting a new pregnancy in good nutritional status in South Africa and Zimbabwe?

Authors: Gabriela Cormick, Ana Pilar Betrán, Janetta Harbron, Tina Dannemann Purnat, Catherine Parker, David Hall, Armando H. Seuc, James M. Roberts, José M. Belizán, G. Justus Hofmeyr, on behalf of the Calcium and Pre-eclampsia Study Group

Published in: BMC Pregnancy and Childbirth | Issue 1/2018

Login to get access

Abstract

Background

Maternal nutritional status before and during pregnancy is an important contributor to pregnancy outcomes and early child health. The aim of this study was to describe the preconceptional nutritional status and dietary intake during pregnancy in high-risk women from South Africa and Zimbabwe.

Methods

This is a prospective observational study, nested to the CAP trial. Anthropometric measurements before and during pregnancy and dietary intake using 24-h recall during pregnancy were assessed. The Intake Distribution Estimation software (PC-SIDE) was used to evaluate nutrient intake adequacy taking the Estimated Average Requirement (EAR) as a cut-off point.

Results

Three hundred twelve women who had pre-eclampsia in their last pregnancy and delivered in hospitals from South Africa and Zimbabwe were assessed. 73.7 and 60.2% women in South Africa and Zimbabwe, respectively started their pregnancy with BMI above normal (BMI ≥ 25) whereas the prevalence of underweight was virtually non-existent. The majority of women had inadequate intakes of micronutrients. Considering food and beverage intake only, none of the micronutrients measured achieved the estimated average requirement. Around 60% of pregnant women reported taking folic acid or iron supplements in South Africa, but almost none did so in Zimbabwe.

Conclusion

We found a high prevalence of overweight and obesity and high micronutrient intake inadequacy in pregnant women who had the previous pregnancy complicated with pre-eclampsia. The obesity figures and micronutrient inadequacy are issues of concern that need to be addressed. Pregnant women have regular contacts with the health system; these opportunities could be used to improve diet and nutrition.

Trial registration

PACTR20110500026​7371. Registered 06 December 2010.
Literature
1.
Young MF, Nguyen PH, Addo OY, Hao W, Nguyen H, Pham H, Martorell R, Ramakrishnan U. The relative influence of maternal nutritional status before and during pregnancy on birth outcomes in Vietnam. Eur J Obstet Gynecol Reprod Biol. 2015;194:223–7.CrossRefPubMed
2.
Popkin BM. Nutrition in transition: The changing global nutrition challenge. Asia Pac J Clin Nutr. 2001;10:Suppl S13–8.CrossRefPubMed
3.
Lindsay KL, Gibney ER, McAuliffe FM. Maternal nutrition among women from sub-Saharan Africa, with a focus on Nigeria, and potential implications for pregnancy outcomes among immigrant populations in developed countries. J Hum Nutr Die. 2012;25(6):534–46.CrossRef
4.
Mission JF, Marshall NE, Caughey AB. Pregnancy risks associated with obesity. Obstet Gynecol Clin N Am. 2015;42(2):335–53.CrossRef
5.
Black RE, Victora CG, Walker SP, Bhutta ZA, Christian P, de Onis MUR. Maternal and child undernutrition and overweight in low-income and middle-income countries. Lancet. 2013;382(9890):427–51.CrossRefPubMed
6.
Marchi J, Berg M, Dencker A, Olander EK, Begley C. Risks associated with obesity in pregnancy, for the mother and baby: a systematic review of reviews. Obes Rev. 2015;16(8):621–38.CrossRefPubMed
7.
Spradley FT, Palei AC, Granger JP. Increased risk for the development of preeclampsia in obese pregnancies: weighing in on the mechanisms. Am J Physiol Regul Integr Comp Physiol. 2015;309(11):R1326–43.CrossRefPubMedPubMedCentral
8.
Ramakrishnan U, Grant F, Goldenberg T, Zongrone A, Martorell R. Effect of women's nutrition before and during early pregnancy on maternal and infant outcomes: a systematic review. Paediatr Perinat Epidemiol. 2012;26(Suppl 1):285–301.CrossRefPubMed
9.
10.
11.
Temel S, van Voorst SF, Jack BW, Denktaş S, Steegers EA. Evidence-based preconceptional lifestyle interventions. Epidemiol Rev. 2014;36:19–30.CrossRefPubMed
12.
13.
Shisana O, Labadarios D, Rehle T, Simbayi L, Zuma K, Dhansay A, Reddy P, Parker W, Hoosain E, Naidoo P, Hongoro C, Mchiza Z, Steyn NP, Dwane N, Makoae M, Maluleke T, Ramlagan S, Zungu N, Evans MG, Jacobs L, Faber M, the SANHANES-1 Team. South African National Health and nutrition examination survey (SANHANES-1): edition. Cape Town: HSRC Press; 2014.
14.
Martorell R, Khan LK, Hughes ML, Grummer-Strawn LM. Obesity in women from developing countries. EurJClinNutr. 2000;54:247–52.
15.
16.
17.
WHO Consultation on Obesity. Obesity: preventing and managing the global epidemic: report of a WHO consultation. Geneva: World Health Organization; 1999.
18.
19.
Steyn NP, Senekal M. A Guide for the use of the Dietary Assessment and Education Kit (DAEK). Cape Town: South African Medical Research Council; 2004.
20.
Dodd KW, Guenther PM, Freedman LS, Subar AF, Kipnis V, Midthune D, Tooze JA. Statistical methods for estimating usual intake of nutrients and foods: a review of the theory. J Am Diet Assoc. 2006;106(10):1640–50.CrossRefPubMed
21.
Allen LH, De Benoist B, Dary O, Hurrell R, editors. Guidelines on food fortification with micronutrients. Geneva: World Health Organization; 2006.
22.
Boon N, Hul GB, Stegen JH, Sluijsmans WE, Valle C, Langin D, Viguerie N, Saris WH. An intervention study of the effects of calcium intake on faecal fat excretion, energy metabolism and adipose tissue mRNA expression of lipid-metabolism related proteins. Int J Obes. 2007;31(11):1704–12.CrossRef
23.
IOM (Institute of Medicine) and NRC (National Research Council). Weight gain during pregnancy: Reexamining the Guidelines. Washington: The National Academies Press; 2009.
24.
Nusser SM, Carriquiry AL, Dodd KW, et al. A semi- parametric transformation approach to estimating usual daily intake distributions. J Am Stat Assoc. 1996;91:1440–9.CrossRef
25.
Goldberg GR, Black AE, Jebb SA, Cole TJ, Murgatroyd PR, Coward WA, Prentice AM. Critical evaluation of energy intake data using fundamental principles of energy physiology: 1. Derivation of cut-off limits to identify under-recording. Eur J Clin Nutr. 1991;45:569–81.PubMed
26.
WHO Technical Report Series. Guidelines for Good Clinical Practice (GCP) for Trials on Pharmaceutical Products, vol. 850. Geneva: World Health Organization; 1995. p. 97–137.
27.
28.
Ng M, Fleming T, Robinson M, Thomson B, Graetz N, Margono C, et al. Global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013: a systematic analysis for the global burden of disease study 2013. Lancet. 2014;384:766–81.CrossRefPubMedPubMedCentral
29.
Nieuwoudt M, van der Merwe JL, Harvey J, Hall DR. Pregnancy outcomes in super-obese women - an even bigger problem? A prospective cohort study. S Afr J OG. 2014;20(2):54–9.CrossRef
30.
O’Brien TE, Ray JG, Chan WS. Maternal body mass index and the risk of preeclampsia: a systematic overview. Epidemiology. 2003;14(3):368–74.PubMedCrossRef
31.
Rasmussen KM, Catalano PM, Yaktine AL. New guidelines for weight gain during pregnancy: What obstetrician/gynecologists should know. Curr Opin Obstet Gynecol. 2009;21(6):521–6.CrossRefPubMedPubMedCentral
32.
Trends in energy intake among adults in the United States: findings from NHANES. Am J Clin Nutr. 2013;97(4):848–53.
33.
Fryar C, Carrol MD, Ogden CL. Prevalence of Overweight, Obesity, and Extreme Obesity Among Adults: United States, 1960–1962 Through 2011–2012. Atlanta: National Center for Health Statistics; 2016. Accessed 29 May 2016
34.
Standard Treatment Guidelines and Essential Medicines List for South Africa. Hospital Level, Adults. 4th ed. Pretoria: The National Department of Health; 2015.
35.
36.
Zhao Y, Monahan FJ, McNulty BA, Gibney MJ, Gibney ER. Effect of vitamin E intake from food and supplement sources on plasma α- and γ-tocopherol concentrations in a healthy Irish adult population. Br J Nutr. 2014;112(9):1575–85.CrossRefPubMed
37.
Olza J, Aranceta-Bartrina J, González-Gross M, Ortega RM, Serra-Majem L, Varela-Moreiras G, Gil Á. Reported dietary intake and food sources of zinc, selenium, and vitamins A, E and C in the Spanish population: findings from the ANIBES Study. Nutrients. 2017;9(7):697.CrossRefPubMedCentral
38.
Rush D, Kristal AR. Methodologic studies during pregnancy: the reliability of the 24-hour dietary recall. Am J Clin Nutr. 1982;35(5 Suppl):1259–68.CrossRefPubMed
39.
Holmes B, Dick K, Nelson M. A comparison of four dietary assessment methods in materially deprived households in England. Public Health Nutr. 2007;11(05)
40.
Scagliusi F. Underreporting of energy intake in Brazilian women varies according to dietary assessment: a cross-sectional study using doubly labeled water. J Am Diet Assoc. 2008;108(12):2031–40.CrossRefPubMed
41.
Merchant AT, Dehghan M. Food composition database development for between country comparisons. Nutr J. 2006;19(5):2.CrossRef
42.
Kleinerta S, Hortona R. Rethinking and reframing obesity. Lancet. 2015;385(14):61746–3.
43.
Lobstein T, Jackson-Leach R, Moodie ML, Hall KD, Gortmaker SL, Swinburn BA, et al. Child and adolescent obesity: part of a bigger picture. Lancet. 2015;385(9986):2510–20.CrossRefPubMedPubMedCentral
44.
Thomas M, Hutchison M, Castro G, Nau M, Shumway M, Stotland N, Spielvogel A. Meeting women where they are: integration of care as the Foundation of Treatment for at-risk pregnant and postpartum women. Matern Child Health J. 2017;21(3):452–7.CrossRefPubMed
45.
Craici IM, Wagner SJ, Hayman SR, Garovic VD. Pre-eclamptic pregnancies: an opportunity to identify women at risk for future cardiovascular disease. Womens Health (Lond). 2008;4(2):133–5.CrossRef
Metadata
Title
Are women with history of pre-eclampsia starting a new pregnancy in good nutritional status in South Africa and Zimbabwe?
Authors
Gabriela Cormick
Ana Pilar Betrán
Janetta Harbron
Tina Dannemann Purnat
Catherine Parker
David Hall
Armando H. Seuc
James M. Roberts
José M. Belizán
G. Justus Hofmeyr
on behalf of the Calcium and Pre-eclampsia Study Group
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Pregnancy and Childbirth / Issue 1/2018
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/s12884-018-1885-z

Other articles of this Issue 1/2018

BMC Pregnancy and Childbirth 1/2018 Go to the issue

Research article

Factors associated with gestational weight gain: a cross-sectional survey

Research article

Trajectory of vitamin D status during pregnancy in relation to neonatal birth size and fetal survival: a prospective cohort study

Research article

Predictors of uterine rupture in a large sample of women in Senegal and Mali: cross-sectional analysis of QUARITE trial data

Research article

Attitude, knowledge and informed choice towards prenatal screening for Down Syndrome: a cross-sectional study

Research article

Knowledge of hypertensive disorders in pregnancy of Moroccan women in Morocco and in the Netherlands: a qualitative interview study

Research article

Placental erythropoietin expression is upregulated in growth-restricted fetuses with abnormal umbilical artery Doppler findings: a case–control study of monochorionic twins