Maternal and fetal outcome in pregnant women after nutritional health education program An interventional study at Zagazig university hospitals

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Alzahraa Mohammad Soliman
Alsayed Hassan
Howaida Henary
Amira Abdelsalam
Mostafa Abdo


Gestational weight gain, nutritional education, obstetric outcome


Background: Nutrition during pregnancy is an important element for the pregnant women and their fetus, they must take enough calories and nutrients to provide the essential requirements for both themselves and their fetus and to prevent complications of abnormal weight gain in pregnancy. Objectives: To determine the effect of the nutritional health education on changing knowledge, attitude and practice towards healthy pregnancy, obtaining optimal weight and its effect on obstetric outcome. Subjects and Methods; An interventional study (pre-posttest) was conducted in Zagazig university antenatal care clinic and included 135 pregnant female. Methods: Data collection was done through a semi-structured questionnaire about females’ socio-demographic characteristics, obstetric, family and clinical history. Health education sessions were applied on the pregnant females and their knowledge, attitude and practice about healthy nutrition were assessed before and after the intervention. Ultrasound was performed, obstetric outcomes were detected. Results: This study was conducted on 135 pregnant female. After the nutritional education program, the proportion of adequate knowledge, attitude and practice was increased from (28.2% to 77.3%-8.2% to 75.5% and 32.7% to 77.3%) respectively (p-value <0.001). There was statistically significant higher cesarean section, intra and post-partum complications (85.7% vs 42.9%p<0.001), (71.4% vs17.2% p<0.001) and (25.7%vs7.1% p=0.008) (Odds (C.I 95%); 8(2.7-23.1), 12.1(4.6-31.6) and 4.5(1.4-14.7)), higher neonatal weight and blood glucose (p<0.001& 0.009) in over-weight versus optimal weight gain groups respectively. Conclusion: The intervention was effective on improving pregnant females’ knowledge, attitude and practice towards healthy nutrition during pregnancy, getting optimal weight gain and consequently maternal and fetal outcome.

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(1) Alavi N, Haley S, Chow K, etal.(2013): Comparison of national gestational weight gain guidelines and energy intake recommendations. Obesity Reviews.;14: 68–85.
(2) Chung GY, Taylor RS, Thompson JMD, etal.(2013): Gestational weight gain and adverse pregnancy outcomes in a nulliparous cohort. European Journal of Obstetrics and Gynecology and Reproductive Biology.; 167(2): 149–53.
(3) Kominiarek A and Rajan P.(2016): Nutrition Recommendations in Pregnancy and Lactation. Med Clin North Am.; 100(6): 1199–1215. doi:10.1016/j.mcna.2016.06.004.
(4) Marchi J., Berg M., Dencker A., Olander K. & Begley C.(2015): Risks associated with obesity in pregnancy, for the mother and baby: a systematic review of reviews. Obesity Reviews.; 16(8):621-638.‏.
(5) El-Gilany A., El-Wehady A., & El-Wasify M.(2012): Updating and validation of the socioeconomic status scale for health research in Egypt. Eastern Mediterranean Health Journal.; 18(9).‏
(6) Fallah F, Pourabbas A, Delpisheh A, Vei¬sani Y, Shadnoush M.(2013): Effects of Nutrition Education on Levels of Nutritional Awareness of Pregnant Women in Western Iran. Int J Endocrinol Metab.; 11(3):175-178. DOI: 10.5812/ijem.9122.
(7) Institute of Medicine and National Research Council.(2009) : Weight Gain during Pregnancy: Reexamining the Guidelines. Washington, DC: The National Academies Press 2009; Available on last accessed May, 2019.
(8) Calderon A., Quintana M., Marcolin C., Berezowski T., Brito O. & Geraldo D., etal. (2014); Obesity and pregnancy, a transversal study from a low-risk maternity. BMC Pregnancy and Childbirth; 14:249.
(9) Tsai H., Chen P., Sun J., Wu H. and Yeh L. (2012); Associations of the pre-pregnancy body mass index and gestational weight gain with pregnancy outcomes in Taiwanese women. Asia Pac J Clin Nutr; 21: 82-87.
(10) Skouteris H., Hartley L., McCabe M., Milgromv J., Kentv B., Herring J., & Gale, J. (2010) : Preventing excessive gestational weight gain: a systematic review of interventions. Obesity reviews.; 11(11):757-768.
(11) Jariyapitaksakul C. and Tannirandorn Y. (2013); The occurrence of small for gestational age infants and perinatal and maternal outcomes in normal and poor maternal weight gain singleton pregnancies. J Med Assoc Thai.; 96(3):259-265.
(12) Girard W& Oludea O. (2012): Nutrition Education and Counselling Provided during Pregnancy: Effects on Maternal, Neonatal and Child Health Outcomes. Paediatric and Perinatal Epidemiology.; 26 (1):191–204.
(14) Zelalem A, Endeshaw M, Ayenew M, Shiferaw S, Yirgu R. (2017): Effect of Nutrition Education on Pregnancy Specific Nutrition Knowledge and Healthy Dietary Practice among Pregnant Women in Addis Ababa. Clinics Mother Child Health.; 14: 265.
(15) Aşcı, Ö., & Rathfisch, G. (2016): Effect of lifestyle interventions of pregnant women on their dietary habits, lifestyle behaviors, and weight gain: a randomized controlled trial. Journal of Health, Population and Nutrition.; 35(1).
(16)Dunneram Y., & Jeewon R. (2015): Healthy diet and nutrition education program among women of reproductive age: A Necessity of multilevel strategies or community responsibility. Health promotion perspectives.; 5(2):116.‏
(17) Lim X., Wong L., Lim Y. & Soon K. (2018): Knowledge of nutrition during pregnancy and associated factors among antenatal mothers. International Journal of Public Health and Clinical Sciences.; 5(1):117-128.
(18) Walker R., Bennett C., Blumfield M., Gwini S., Ma J., Wang F. & Truby H. (2018): Attenuating pregnancy weight gain, what works and why: a systematic review and meta-analysis. Nutrients.; 10(7): 944.‏
(19) Whitaker M., Wilcox S., Liu J., Blair N., & Pate R. (2016): Provider advice and women’s intentions to meet weight gain, physical activity, and nutrition guidelines during pregnancy. Maternal and child health journal.; 20(11):2309-2317.
(20) Stang, J., & Huffman, L. (2016); Position of the academy of nutrition and dietetics: obesity, reproduction, and pregnancy outcomes. Journal of the Academy of Nutrition and Dietetics.; 116(4):677-691.‏
(21) Denison C., Aedla R., Keag O., Hor K., Reynolds M.& Milne A. (2018): on behalf of the Royal College of Obstetricians and Gynaecologists. Care of Women with Obesity in Pregnancy. Green-top Guideline No. 72. BJOG.; 13: 130-201.
(22) Fukami T., Koga H. & Goto M. (2019): Incidence and risk factors for postpartum hemorrhage among transvaginal deliveries at a tertiary perinatal medical facility in Japan. PLOS One.; 14(1): 0208873.
(23) Butwick J., Abreo A., Bateman M., Lee H., El-Sayed Y.&Stephansson O. (2019) : Effect of Maternal Body Mass Index on Postpartum Hemorrhage; Obstetric Anesthesia Digest.; 39(1):18–19.