Dietary Patterns during Pregnancy and Gestational Weight Gain: A Systematic Review

Abstract The present systematic review (PROSPERO: CRD42020148630) hypothesizes the association of excessive weight gain during pregnancywith dietary patterns composed of ultraprocessed foods. Thus, the objective was to investigate the association between dietary patterns after analysis and weight gain during pregnancy. The search for articles was performed in nine databases. Two reviewers selected the articles in the databases and extracted from them the data used in the review. Two scales were used to evaluate the quality of the selected studies: New Castle-Ottawa Quality Assessment for cohort-based studies and Appraisal tool for Cross-Sectional Studies (AXIS) for cross-sectional-based studies. In total, 11 studies were identified with sample size variation (n=173-5,733). Women presenting more adherence to healthy and traditional patterns (fruits, vegetables, salads, nuts, and dairy) recorded less excessive gestational weight gain (GWG). Higher intake ofmixed patterns and western patterns rich in ultraprocessed foods were associated with a higher prevalence of excessive GWG (24.48- 55.20%). Gestational dietary patterns a posteriori-derived that have presented ultraprocessed components rich in fat and sugars presented association with high GWG; healthy and traditional dietary patterns were related to better mother-child health conditions, such as adequate GWG.

摘要 本项系统评价（PROSPERO注册号：CRD42020148630）提出假说：妊娠期体重过度增加与以超加工食品（ultraprocessed foods）为主要构成的膳食模式存在关联。本研究旨在探讨经分析确定的膳食模式与妊娠期体重增加之间的关联。本研究在9个数据库中开展文献检索，由2名研究者独立完成文献筛选及综述所需数据的提取工作。本研究采用2种量表对纳入研究的方法学质量进行评价：针对队列研究的纽卡斯尔-渥太华质量评价量表（Newcastle-Ottawa Quality Assessment），以及针对横断面研究的横断面研究评价工具（Appraisal tool for Cross-Sectional Studies, AXIS）。最终共纳入11项研究，样本量范围为173~5733例。对健康及传统膳食模式（涵盖水果、蔬菜、沙拉、坚果及乳制品）依从性更高的孕妇，其发生妊娠期过度体重增加（gestational weight gain, GWG）的风险更低。对富含超加工食品的混合膳食模式及西方膳食模式依从性更高的孕妇，其出现过度GWG的比例更高（24.48%~55.20%）。经事后推导得到的、富含脂肪与糖类超加工成分的妊娠期膳食模式，与过度GWG存在显著关联；而健康及传统膳食模式则与更优的母婴健康结局相关，例如妊娠期体重增加符合临床推荐标准。