Assessing Nutrition Knowledge and Practices among pregnant women and healthcare providers, and evaluating the effectiveness of nutrition counseling on pregnant women with overweight and/or obesity in Lebanon

  1. Rizk, Jessy
  2. School of Sciences and Engineering |
  3. Department of Life and Health Sciences
  4. English
  5. 303 p.
  6. Zambelas, Antonis
  7. Andreou, Eleni | Hileti, Dona
  8. Nutrition | Pregnancy | Healthcare Providers | Knowledge | Attitudes | Gestation | Overweight/Obesity | Weight Gain
    • Introduction Adhering to nutritional guidelines during pregnancy is crucial for improving pregnancy outcomes. It is essential for healthcare providers (HCP) and pregnant women to have access to accurate nutritional information related to maternal dietary intake and healthy lifestyles. Although HCP are ideally positioned to discuss healthy behaviors during pregnancy, there is limited published research on what prenatal HCPs in Lebanon know about the importance of nutrition during pregnancy. Furthermore, not all pregnant women receive adequate nutrition advice, and many report insufficient knowledge of dietary recommendations. Women's understanding of nutritional guidelines during pregnancy in Lebanon is also limited. Pre-pregnancy obesity, excessive gestational weight gain (EGWG), and postpartum weight retention are emerging public health challenges associated with adverse maternal and child outcomes, such as obstetrical or neonatal complications and long-term morbidity. To mitigate these outcomes, weight management during pregnancy and postpartum should be prioritized globally. Objectives The objectives of this project were threefold: To explore the knowledge, attitudes, and practices of Lebanese prenatal HCP regarding nutrition during pregnancy. To assess the knowledge of food sources, energy recommendations, food safety practices, and diet-health relationships among pregnant women in Lebanon. To evaluate the effectiveness of nutrition counseling on gestational weight gain (GWG) and birth outcomes in pregnant women with a body mass index (BMI) above 25 kg/m² in a randomized controlled trial (RCT). Methods The study involved two sub-populations. The first sub-population was prenatal HCP including physicians and midwives and the second sub-population were pregnant women seeking prenatal care in Lebanon. All nationalities were included, including Lebanese and Syrian and Palestinian refugees. The study took place in two phases. In the first phase of the study, nutrition assessment was obtained using a cross-sectional design and included all pregnant women and prenatal HCPs. The second phase was an intervention that included only women who have a pre-pregnancy BMI ≥25kg/m2 and during the first trimester of pregnancy. Results The results of this dissertation indicate that around 60% of HCP were very confident in providing general nutrition advice, weight gain recommendations, providing advice on vitamins, obesity, and diabetes to pregnant women. However, their knowledge in several areas related to nutrition during pregnancy is lacking with the lowest scores for the questions that assessed their knowledge of the healthy weight gain range during pregnancy and the daily recommended servings of dairy foods (75.2% incorrect responses for both questions). These findings suggest a need for continued nutrition education for HCP. Moreover, pregnant women demonstrated a good level of knowledge in various nutrition-related topics with the highest levels of knowledge for the behaviors that can minimize the effect of nausea/vomiting, heartburn, and constipation during pregnancy (63.9%) but they lacked understanding of critical nutrients and behaviors that could adversely affect mothers and/or babies with the lowest levels of knowledge for the importance of iodine and omega-3 fatty acids in pregnancy (28.4%). Finally, the intervention study did not show a significant difference in GWG between the intervention group and the control group. Implications and Future Research There is a need for continued nutrition education for health care providers to improve their knowledge in several areas related to nutrition during pregnancy and implementing nutrition education programs to achieve better health outcomes. Collaboration between HCPs and dietitians is essential to ensure that pregnant women receive comprehensive and accurate nutritional advice throughout their pregnancy journey. While nutrition counseling may have some benefits, it may not be sufficient on its own to significantly impact GWG. Future studies should explore novel lifestyle interventions such as telehealth platforms, motivational interviewing, multidisciplinary care, and combining digital interventions with a human component that target maternal overweight and obesity to reduce the risk of complications during pregnancy and postpartum. Conclusion In conclusion, enhancing the nutritional knowledge of both HCPs and pregnant women is vital for improving pregnancy outcomes. Addressing gaps in knowledge and implementing effective interventions can help manage weight gain during pregnancy and reduce associated health risks. Continued research and education are necessary to support these efforts and promote healthier pregnancies.
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