Systematic ReviewObstetricsA systematic review and metaanalysis of energy intake and weight gain in pregnancy
Section snippets
Search strategy
A systematic literature search was undertaken in August to October 2014 by 2 independent student dietitians (J.M. and H.J.). A starting date of 1990 was specified so that the outcomes reflected the current generation of women whose pregnancy advice may have been influenced by the IOM guidelines.20 We searched Ovid Medline, Cochrane Library, Excerpta Medica DataBASE (EMBASE), Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Science Direct for studies that reported energy
Results
The electronic search revealed 2440 articles with a further 47 identified by hand-searching. Of these, 2301 did not meet inclusion criteria because they did not report energy intake at 2 time points at least 12 weeks apart. Three potential studies were excluded because of missing data.28, 29, 30 The screening and selection process resulted in 18 studies of 2644 women published between 1992 and 2013 (Figure 1). Fourteen studies were observational studies,23, 24, 31, 32, 33, 34, 35, 36, 37, 38, 39
Comment
To our knowledge, this is the first study to use metaanalysis to explore the relationship between changes in food energy intake in pregnancy and maternal weight gain. In a comprehensive body of literature from developed and developing countries, we found no relationship between the increment in energy intake from early to late pregnancy and the amount of GWG. Indeed, despite a large highly significant increase in body weight (+12.0 kg), there was only a small, nonsignificant increase in
Conclusions
Despite a period of uniquely rapid weight gain, women appear to consume only one quarter of the theoretical requirement for additional energy (2000 kJ/day in trimester 3) during pregnancy. Given the high prevalence of obesity and excessive GWG in the current generation of women of reproductive age, dietary guidelines for pregnancy may need to be revised.
Acknowledgments
This research project was undertaken by 2 students J.M. and H.J. as part of their MNUTRDIET degree with special thanks to T.P. for her work on statistical analysis and to supervisors J.C.Y.L. and J.C.B.M. for their time, guidance, and overall contribution to this research project. J.C.Y.L. and J.C.B.M. conceptualized the metaanalysis. J.M. and H.J. developed the search strategy under the guidance of J.C.Y.L. and J.C.B.M. J.M. and H.J. carried out the systematic search, screened and reviewed the
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The authors report no conflict of interest.
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These authors contributed equally to this work.