Ultra-processed food consumption during pregnancy and newborn weight / Consumo de alimentos ultraprocessados durante a gestação e peso ao nascer do recém-nascido

Abstract Objectives: to assess the association between pregnant women's consumption of ultra-processed foods and newborn body weight. Methods: prospective study with pregnant women (n=214) selected from all Basic Health Units in the city of Pinhais, Paraná. Socioeconomic, demographic, and health data were collected. Food consumption data were assessed using a 24-hour dietary recall and tabulated with GloboDiet software. Daily relative energy intake of ultra-processed food was estimated and logistic regression analysis was utilized. The infuence of covariates on the association analysis was also explored (e.g., income and education). Results: ultra-processed foods contributed to 26.9% of pregnant women's total energy intake. About 5.7% of newborns were classifed as small-for-gestational-age and 10.7% as large-for-gestational-age. A borderline statistically signifcant association was observed between large-for-gestational-age newborn weight and maternal consumption of ultra-processed foods (OR= 1.027; p=0.048). Additionally, family income was associated with the consumption of ultra-processed foods (OR= 0.144; p=0.008). With each additional 1% consumption of ultra-processed foods, mothers' likelihood of having large-for-gestational-age babies increased by about 2.7%. Conclusions: the study reveals a trend of positive association between the weight of large-for-gestational-age newborns and the consumption of ultra-processed foods by pregnant women, but not for small-for-gestational-age children.

Resumo Objetivos: avaliar a associação entre o consumo de alimentos ultraprocessados por gestantes e o peso de recém-nascidos. Métodos: estudo prospectivo com gestantes (n=214) selecionadas em Unidades Básicas de Saúde em Pinhais, Paraná. Dados socioeconômicos, demográfcos e de saúde foram coletados. Dados de consumo alimentar foram coletados por recordatório de 24-horas físico e entrados no software GloboDiet. O consumo diário relativo de energia proveniente de alimentos ultraprocessados foi estimado e a análise de regressão logística foi utilizada, considerando covariáveis como renda familiar e escolaridade. Resultados: o consumo de alimentos ultraprocessados pelas gestantes representou 26,9% da energia total. Cerca de 5,7% de recém-nascidos foram classifcados como pequenos para idade gestacional (PIG) e 10,7% como grandes para idade gestacional (GIG). Foi observada uma associação estatisticamente signifcativa limítrofe entre o peso dos recém-nascidos GIG e o consumo materno de alimentos ultraprocessados (OR= 1,027; p=0,048). Além disso, a renda familiar esteve associada com o consumo de alimentos ultraprocessados (OR=0,144; p=0,008). A cada 1% adicional de consumo de alimentos ultraprocessados, a probabilidade de as mães terem recém-nascidos GIG aumentou cerca de 2,7%. Conclusões: o estudo revela uma tendência de associação positiva entre o peso de recém-nascidos GIG e o consumo de alimentos ultraprocessados por mulheres grávidas, mas não para crianças PIG.

Mediterranean Diet Quality Index (MDQI) of the pregnant women / Índice de calidad de la dieta mediterránea (MDQI) en mujeres embarazadas

Introduction: This study aimed to determine pregnant women's nutritional status and habits in the middle and low-income groups and the level of compliance with the Mediterranean diet. The Mediterranean diet supports healthy fetal growth and development by providing sufficient nutrients for pregnant women and protecting against the development of obstetrical pathologies.Materials and Methods: One hundred and thirty-two pregnant women aged 17-45 were included. The demographic characteristics and anthropometric measurements, systolic blood pressure, fasting, and postprandial blood glucose values were noted.24-hour recall was determined and The Mediterranean Diet Quality Index (MDQI) developed by Gerber et al. was used to assess nutritional status. Nutritional habits and food attitude changes during gestation were recorded.Results: Overall, 15.2% of the pregnant women had good, 54.5% had medium-good, and %29.5 had medium-poor adherence to MDQI. The dietary macronutrient intakes were close to the daily dietary recommended intakes (DRI); however, micronutrient intakes were below the recommendations. Pre-pregnancy mean BMI was found to be 26.4 kg/m2.Conclusions: According to the mean pre-pregnant BMI, the pregnant women were overweight, and their adherence to the Mediterranean diet needed to be improved. General measures should be taken to improve pregnant women's diets and micronutrient intakes, even in the Mediterranean countries where this diet is the daily nutrition habit of local inhabitant pregnant women. (AU)

Introducción: La dieta mediterránea contribuye a un crecimiento y desarrollo fetal saludable, proporcionando suficientes nutrientes a mujeres embarazadas y protegiendo contra el desarrollo de patologías obstétricas. Este estudio tiene como objetivo determinar el estado nutricional y los hábitos de mujeres embarazadas de grupos de ingresos medios y bajos y su nivel de cumplimiento de la dieta mediterránea.Materiales y métodos: Se incluyeron y siguieron a 132 gestantes de entre 17 y 45 años. Se anotaron sus características demográficas y medidas antropométricas, presión arterial sistólica, y glucemia en ayunas y posprandial. Para evaluar su estado nutricional se utilizaron registros dietéticos de consumo de 24 horas y el indice de calidad de la dieta mediterránea (MDQI). Se registraron los hábitos nutricionales y los cambios de actitud alimentaria durante la gestación.Resultados: En general, la adherencia de las gestantes al MDQI fue buena en el 15,2%, media-buena en el 54.5%, y media-mala en el 29,5% de los casos. Las ingestas dietéticas de macronutrientes se aproximaron a las ingestas diarias recomendadas (IDR); sin embargo, la ingesta de micronutrientes estuvo por debajo de las recomendaciones. El IMC medio antes del embarazo era de 26,4 kg/m2.Conclusiones: De acuerdo con el IMC medio previo al embarazo, las gestantes tenían sobrepeso y debían mejorar su adherencia a la dieta mediterránea. Es necesario tomar medidas generales para mejorar la dieta y la ingesta de micronutrientes de mujeres embarazadas, incluso en países mediterráneo donde esta dieta es el hábito nutricional diario de sus habitantes. (AU)

Determinantes socioeconómicos en la dieta de mujeres embarazadas en zona marginal / Socioeconomic determinants in the diet of pregnant women in a marginal area

Fundamentos: La dieta habitual de embarazadas residentes de zonas con alto grado de marginación, no favorece el mantenimiento de un estado nutricio óptimo. Métodos: Estudio transversal, se analizaron factores socioeconómicos que determinaron la dieta habitual de 71 mujeres embarazadas de un municipio marginal de México. Se aplicaron cuestionarios: sociodemográfico, recordatorio de 24 horas de consumo de alimentos y actividades habituales. Resultados: Más del 80% tuvo consumo dietético insuficiente de múltiples micronutrientes. El ingreso mensual de las mujeres se correlacionó con el nivel educativo (r=0,42, p=0,039), éste se correlacionó con el porcentaje de adecuación de ingesta de energía (r=0.28, p=0,017), carbohidratos (r = -0,32, p = 0,006), proteínas (r= 0,34, p=0,004), lípidos (r=0,30, p =0,012) y vitamina C (r=0,34, p=0,003). El nivel educativo determinó el 8% en la variabilidad de la adecuación de ingesta de energía (r2=0,08, F=5,87, p=0.018). Los indicadores que se correlacionaron con el estado nutricio (p<0,05) fueron, nivel educativo de la pareja, afiliación a un seguro de salud gubernamental, existencia de tiendas de abarrotes y acceso de alimentos en su comunidad. Conclusiones: Las políticas públicas enfocadas en la reducción de la morbilidad materna, deberían considerar como esenciales, el nivel educativo y acceso de variedad de alimentos en estas comunidades. (AU)

Background: Diet of pregnant inhabitants of areas with high levels of marginalization does not favor an optimal nutritional status. Methods: This cross-sectional study analyze the socio-economic factors that determine the usual diet of 71 pregnant woman from a marginal municipality in Mexico. Socio-economic questionnaires, 24-hour diet record consumption and regular activities were applied. Results: More than 80% had insufficient dietary intake of multiple micronutrients. Women's monthly income was correlated with education level (r=0.42, p=0.039) which in turn was correlated with the percentage of intake adequacy of energy (r=0.28, p=0.017), carbohydrates (r = -0.32, p = 0.006), proteins (r= 0.34, p=0.004), lipids (r=0.30, p =0.012) and vitamin C (r=0.34, p=0.003). Education level was responsible for 8% of the variability of intake adequacy of energy (r2=0.08, F=5.87, p=0.018). Couple’s education level, enrollment in the government health insurance, presence of grocery stores and geographical access to food were correlated with indicators of nutritional status (p<0.05). Conclusions: Public policies focused to reduce maternal morbidity should consider the educational level and geographical access to a variety of foods in these communities. (AU)

Association between food consumption and the Quality of Diet Index Adapted for pregnant women / Associação entre o consumo alimentar e o Índice de Qualidade da Dieta Adaptado para Gestantes

Abstract Objectives: to investigate the association between the Índice de Qualidade da Dieta Adaptado para Gestantes (IQDAG) (Quality of Diet Index Adapted for Pregnant Women) with food consumption, lifestyle and health information. Methods: cross-sectional study with 110 pregnant women assisted at a public health service. Sociodemographic, nutritional and health data were collected from medical records. Food consumption was investigated through the usual intake, for a nutritional analysis, DietPro® program version 6.1 was used. Quality ofdiet was assessed using the IQDAG. Multinomial logistic regression was used to investigate an association between food consumption and IQDAG. Results: the average total score of the IQDAG was 61.3 (±26.1), this is the best quality of the diet. After adjusting for age, schooling and physical activity, the highest consumption of vitamin A (OR=1.04; CI95% = 1.02-1.07) and B2 (OR=2.63; CI95% = 1.19-5.70) was associated with a greater chance of having a better quality of diet (3rdtertile of the IQDAG). Conclusions: pregnant women with better quality of diet had higher intakes of vitamins A and B2. However, other population-based studies are suggested to more broadly in verify its association with food consumption and its ability to identify adherence to nutritional recommendations.

Resumo Objetivos: investigar a associação entre o Índice de Qualidade da Dieta Adaptado para Gestantes (IQDAG) com o consumo alimentar e hábitos de vida e informações de saúde. Métodos: estudo transversal com 110 gestantes atendidas em um serviço público de saúde. Os dados sociodemográficos, nutricionais e de saúde foram coletados a partir dos prontuários de atendimento. O consumo alimentar foi investigado por meio do recordatório de ingestão habitual, para a análise nutricional foi utilizado o Programa DietPro® versão 6.1. A qualidade da dieta foi avaliada utilizando o IQDAG. A regressão logística multinomial foi usada para investigar a associação entre o consumo alimentar e IQDAG. Resultados: a média da pontuação total do IQDAG foi 61,3 (±26,1), isto é uma melhor qualidade da dieta. Após ajuste por idade, escolaridade e atividade física, o maior consumo de vitamina A (OR=1,04; IC95%= 1,02-1,07) e B2 (OR= 2,63; IC95%= 1,19-5,70) esteve associado a maior chance da gestante apresentar uma melhor qualidade da dieta (3º tercil do IQDAG). Conclusões: gestantes com melhor qualidade da dieta tiveram maior ingestão das vitaminas A e B2. Entretanto, sugere-se outros estudos de base populacional para verificar de forma mais ampla sua associação com o consumo alimentar e sua capacidade de identificar a adesão as recomendações nutricionais.

Insegurança alimentar e situação de saúde de gestantes do semiárido nordestino / Food insecurity and health status among pregnant women in the semiarid region of Northeast Brazil

Introdução: O Brasil enfrenta um cenário de enfraquecimento das políticas públicas em saúde, principalmente as voltadas ao acesso à alimentação, afetando a qualidade de vida da população. Objetivo: Buscou-se investigar a situação de saúde e de segurança alimentar e nutricional de gestantes usuárias da Atenção Primária à Saúde de um município do interior do Rio Grande do Norte. Métodos: Trata-se de um estudo transversal que analisou as condições de acesso aos alimentos por meio da Escala Brasileira de Insegurança Alimentar, além de realizar avaliação antropométrica e de percepção de saúde de gestantes, através de questionário estruturado adaptado para tal fim. Realizou-se o teste de Qui-quadrado de Pearson para verificar a associação entre as variáveis categóricas do estudo, considerando-se estatisticamente significante as associações com valores de p < 0,05. Resultados: Identificou-se alta prevalência de insegurança alimentar (IA) entre a s gestantes (70,6%) e associação entre insegurança alimentar (IA) e doenças crônicas não transmissíveis (p=0,036) e programas sociais assistenciais (p=0,028). Apesar dos avanços enquanto sociedade, ainda há determinantes sociais fortemente relacionados à insegurança alimentar e nutricional da população, principalmente quanto à menor renda e na população beneficiária de programas socioassistenciais. Conclusão: Este estudo ressalta a necessidade de implantação e ampliação de políticas públicas que garantam o Direito Humano à Alimentação Adequada e Saudável de gestantes ­ que se encontra gravemente violado ­, haja vista sua importância para a saúde do binômio.

Introduction: Brazil faces the weakening of public health policies, especially those directed at access to food, which affects the quality of life of the population. Objective: The aim of the present study was to investigate the health status of pregnant women in primary care in a municipality in the state of Rio Grande do Norte, Brazil. Methods: A cross-sectional study was conducted involving an analysis of access to foods using the Brazilian Food Insecurity Scale, anthropometric measures and a questionnaire designed to collect information on the perception of health among pregnant women. The chi-square test was used to investigate associations between categorical variables, with a p-value < 0.05 considered indicative of statistical significance. Results: The prevalence of food insecurity was high among the pregnant women (70.6). Food insecurity was associated with chronic noncommunicable diseases (p=0.036) and being a beneficiary of social assistance programs (p=0.028). Despite advances in society, social determinants remain strongly associated with food and nutritional insecurity in the population, especially individuals with a low income and beneficiaries of social assistance programs. Conclusion: The present findings underscore the need for the implantation and expansion of public policies that ensure the human right to adequate, healthy food among pregnant women, which has been severely violated, considering the importance to the health of the mother-child dyad.

The impact of docosahexaenoic acid on maternal mental health: scoping review / El impacto del ácido docosahexaenoico en la salud mental materna: revisión sistematizada de la literatura

Docosahexaenoic acid (DHA) is a polyunsaturated essential fatty acid from the omega-3 series that appears to be key to perinatal mental health. For this, the aim of this review is to evaluate the effect of DHA on maternal mental health during pregnancy and lactation with respect to depression and anxiety. The present scoping review was carried out following the methodology of Arksey and O’Malley (2005). The selection of studies was carried out in accordance with PRISMA by means of systematic searches in the PubMed, Scopus, PsycINFO and Medline databases. The results classified according to the effectiveness of DHA. In most (n = 9) of the 14 studies finally included, DHA plasma levels with or without other polyunsaturated omega-3 fatty acids were significantly lower in pregnant women with depressive and anxiety symptoms. However, no study reported a beneficial effect of DHA on mental health during the postpartum period. The majority used detection method was the Edinburgh Postpartum Depression Scale (n = 11). The prevalence of depressive symptoms ranged between 5.9 % and 50 %. As a conclusion, although more research is needed in this area, these exploratory results suggest that DHA could play an important role in preventing the pathogenesis of depression and anxiety during gestation.(AU)

El ácido docosahexaenoico (DHA) es un ácido graso esencial poliinsaturado de la serie omega-3 que parece ser clave para la salud mental perinatal. Por ello, el objetivo de esta revisión es evaluar el efecto del DHA sobre la salud mental materna durante el embarazo y la lactancia con respecto a la depresión y la ansiedad. La presente revisión se llevó a cabo siguiendo la metodología de Arksey y O’Malley (2005). La selección de estudios se realizó de acuerdo con PRISMA mediante búsquedas sistemáticas en las bases de datos PubMed, Scopus, PsycINFO y Medline. Los resultados se catalogaron según la eficacia del DHA. En la mayoría (n = 9) de los 14 estudios finalmente incluidos, los niveles plasmáticos de DHA con o sin otros ácidos grasos omega-3 poliinsaturados fueron significativamente más bajos en mujeres embarazadas con síntomas de depresión y ansiedad. Sin embargo, ningún estudio informó un efecto beneficioso del DHA sobre la salud mental durante el periodo posparto. El método de detección más utilizado fue la Escala de Depresión Posparto de Edimburgo (n = 11). La prevalencia de síntomas depresivos osciló entre el 5,9 % y el 50 %. Como conclusión, aunque se necesita más investigación en este ámbito, los resultados exploratorios parecen indicar que el DHA juega un papel importante en la prevención de la patogenia de la depresión y la ansiedad durante el periodo de gestación.(AU)

Intervenções psicológicas necessárias: a prática como residente no serviço de medicina fetal / Necessary psychological interventions: the practice as a resident in the fetal medicine service / Intervenciones psicológicas necesarias: la práctica como residente en el servicio de medicina fetal

Com os avanços tecnológicos e o aprimoramento da prática médica via ultrassonografia, já é possível detectar possíveis problemas no feto desde a gestação. O objetivo deste estudo foi analisar a prática do psicólogo no contexto de gestações que envolvem riscos fetais. Trata-se de um estudo qualitativo sob formato de relato de experiência como psicólogo residente no Serviço de Medicina Fetal da Maternidade Escola da Universidade Federal do Rio de Janeiro (UFRJ). Os registros, feitos por observação participante e diário de campo, foram analisados em dois eixos temáticos: 1) intervenções psicológicas no trabalho em equipe em consulta de pré-natal, exame de ultrassonografia e procedimento de amniocentese; e 2) intervenções psicológicas em casos de bebês incompatíveis com a vida. Os resultados indicaram que o psicólogo nesse serviço é essencial para atuar de forma multiprofissional na assistência pré-natal para gravidezes de alto risco fetal. Ademais, a preceptoria do residente é relevante para sua formação e treinamento para atuação profissional no campo da psicologia perinatal.(AU)

Face to the technological advances and the improvement of medical practice via ultrasound, it is already possible to detect possible problems in the fetus since pregnancy. The objective of this study was to analyze the psychologist's practice in the context of pregnancies which involve fetal risks. It is a qualitative study based on an experience report as a psychologist trainee at the Fetal Medicine Service of the Maternity School of UFRJ. The records, based on the participant observation and field diary, were analyzed in two thematic axes: 1) psychological interventions in the teamwork in the prenatal attendance, ultrasound examination and amniocentesis procedure; and 2) psychological interventions in cases of babies incompatible to the life. The results indicated that the psychologist in this service is essential to work in a multidisciplinary way at the prenatal care for high fetal risk pregnancies. Furthermore, the resident's preceptorship is relevant to their education and training for professional performance in the field of Perinatal Psychology.(AU)

Con los avances tecnológicos y la mejora de la práctica médica a través de la ecografía, ya se puede detectar posibles problemas en el feto desde el embarazo. El objetivo de este estudio fue analizar la práctica del psicólogo en el contexto de embarazos de riesgos fetal. Es un estudio cualitativo basado en un relato de experiencia como residente de psicología en el Servicio de Medicina Fetal de la Escuela de Maternidad de la Universidade Federal do Rio de Janeiro (UFRJ). Los registros, realizados en la observación participante y el diario de campo, se analizaron en dos ejes temáticos: 1) intervenciones psicológicas en el trabajo en equipo, en la consulta prenatal, ecografía y los procedimientos de amniocentesis; y 2) intervenciones psicológicas en casos de bebés incompatibles con la vida. Los resultados señalaron como fundamental la presencia del psicólogo en este servicio trabajando de forma multidisciplinar en la atención prenatal en el contexto de embarazos de alto riesgo fetal. Además, la tutela del residente es relevante para su educación y formación para el desempeño profesional en el campo de la Psicología Perinatal.(AU)

Variables maternas relacionadas con la condición trófica al nacer / Maternal variables related to the trophic condition at birth

RESUMEN Introducción: El crecimiento y desarrollo prenatal tiene su expresión en el peso al nacer, que adquiere gran importancia por su relación con la morbilidad y mortalidad en cualquier etapa de la vida. Objetivo: Identificar las asociaciones de variables maternas con la condición trófica del recién nacido. Métodos: Se realizó un estudio descriptivo, en tres áreas de salud del municipio Santa Clara, en el periodo comprendido de enero 2013 a diciembre 2020. De una población de 6035 recién nacidos se seleccionó una muestra aleatoria de 2454. De los libros de genética se obtuvo la información de variables maternas y del neonato. Se aplicaron las pruebas no paramétricas de independencia basada en la distribución chi cuadrado y Kruskal Wallis en el análisis estadístico. Resultados: A excepción de la edad, las variables estudiadas mostraron relación con la condición trófica al nacer. El estado nutricional deficiente fue más frecuente en nacimientos pequeños y el obeso en los grandes. En nacimientos grandes se observó mayores porcentajes de gestantes con riesgo de diabetes gestacional. Los trastornos hipertensivos, la anemia, la infección del tracto urinario, la sepsis vaginal y el hábito de fumar se presentaron en mayores porcentajes en gestantes cuyos recién nacidos fueron pequeños. Conclusiones: De las variables estudiadas el riesgo de diabetes gestacional y los trastornos hipertensivos mostraron la mayor fuerza de asociación con la condición trófica al nacer.

ABSTRACT Introduction: prenatal growth and development have their expression in birth weight, which acquires great importance due to its relationship with morbidity and mortality at any stage of life. Objective: to identify the associations of maternal variables with the trophic condition of the newborn. Methods: a descriptive study was carried out in three health areas from Santa Clara municipality between January 2013 and December 2020. A random sample of 2,454 was selected from a population of 6,035 newborns. Information on maternal and newborn variables was obtained. Non-parametric tests of independence based on the Chi-square distribution and Kruskal Wallis were applied in the statistical analysis. Results: the variables studied showed a relationship with the trophic condition at birth, except for age. Poor nutritional status was more frequent in small births and obesity in large ones. In large births, higher percentages of pregnant women at risk of gestational diabetes were observed. Hypertensive disorders, anemia, urinary tract infection, vaginal sepsis and smoking were present in higher percentages in pregnant women whose newborns were small. Conclusions: from the studied variables, the risk of gestational diabetes and hypertensive disorders showed the strongest association with the trophic status at birth.

Maternal Vitamin D Status and Its Associated Environmental Factors: A Cross-Sectional Study

Vitamin D deficiency is common among women during pregnancy. This study aims to determine the prevalence of vitamin D deficiency and their shared modifiable environmental factors among pregnant women in Indonesia and Malaysia. METHODS: Blood samples of 844 third-trimester pregnant women (Indonesians: 311; Malaysians: 533) were collected to determine their serum 25(OH) D levels. Information on sun exposure and sun protection behaviours were obtained through face-to-face interviews. Dietary vitamin D intake was assessed by using a semiquantitative food frequency questionnaire. RESULTS: The prevalence of vitamin D deficiency (<30 nmol/L) among Indonesian and Malaysian pregnant women were 42.4% and 72.0%, respectively. Percentage of exposed body surface area was inversely associated with vitamin D deficiency among Indonesian pregnant women (OR = 0.21, 95% CI = 0.09-0.48). Among Malaysian pregnant women, higher intakes of dietary vitamin D were associated with lower risk of vitamin D deficiency (OR = 0.48, 95% CI = 0.29-0.81). Analysis of the combined cohorts revealed a lower risk of vitamin D deficiency among pregnant women who had a daily intake of at least 15 mcg vitamin D (OR = 0.58, 95% CI = 0.38-0.88) and exposure of more than 27% body surface area to the sunlight (OR = 0.30, 95% CI = 0.16-0.60). CONCLUSION: Despite abundant sunshine, vitamin D deficiency is prevalent among pregnant women in tropical countries. The present study suggests that nutrition education on vitamin D intake and sun exposure during pregnancy is necessary for primary prevention of vitamin D deficiency in pregnant women living in the tropical countries

Alimentación en gestantes adolescentes con hipertensión: Cuidados y Cultura / Diet in pregnant teenagers with hypertension: Care and Culture

Introducción: La gestación en adolescentes es una realidad que enfrentan cada día la familia, comunidad y sociedad; además puede tener complicaciones como la hipertensión, por lo tanto, los cuidados son fundamentales y pueden variar según la cultura. Objetivo: Describir las prácticas de cuidados culturales relacionadas con la alimentación de las gestantes adolescentes con hipertensión, hospitalizadas en una institución de III Nivel de Atención en Salud del municipio de Sincelejo. Materiales y Métodos: Investigación cualitativa etnográfica. Se aplicaron entrevistas semiestructuradas a profundidad a trece participantes. El análisis etnográfico permitió identificar términos, dominios, taxonomías y relaciones semánticas. Resultados: Se observó un alto consumo de alimentos tradicionales de la región Caribe y productos procesados; emergieron prácticas de cuidados referentes a los cambios en la alimentación y su significado cultural, en las subcategorías, alimentos saludables y alimentos relacionados con hipertensión. Conclusiones: Las prácticas de cuidados en la alimentación, evidencian la diversidad de significado cultural en las participantes, conocimiento esencial para brindar cuidados de enfermería coherentes y humanizados. Asimismo, conlleva a la implementación de programas de intervención a nivel domiciliario e institucional en esta población.

Introduction: Pregnancy in adolescents is a common reality faced by family, community and society, which can also bring health complications such as hypertension. Therefore, care of these teenagers is fundamental and can vary according to cultural contexts. Objective: To describe cultural care practices related to diet in pregnant adolescents with hypertension, who are inpatients in a Level III health care institution in Sincelejo (Colombia). Materials and methods: Qualitative ethnographic research. In-depth semi-structured interviews were done with thirteen participants. The ethnographic assessment facilitated the identification of terms, domains, taxonomies, and semantic relationships. Results: High consumption of traditional Caribbean food and processed products was observed. Care practices related to diet changes and their cultural meaning were common in subcategories such as healthy food and hypertension related diet. Conclusions: Diet care practices show diversity in terms of the cultural significance given by participants, which is an essential knowledge to provide coherent and humanized nursing care. Likewise, it is necessary to implement intervention programs to treat these patients both at home as well as at health care institutions.

The contribution of prenatal care in the dietary patterns of high-risk pregnant women / A contribuição do acompanhamento pré-natal nos padrões alimentares de gestantes de alto risco

Abstract Objectives: investigate whether prenatal characteristics were associated with dietary pattern of pregnant women. Methods: we studied 200 high-risk pregnant women in Fortaleza, Ceará. The identification of dietary patterns was performed through principal component analysis with the orthogonal Varimax rotation. Poisson regression was used to estimate prevalence ratios (PR) and respective confidence intervals (CI95%). Results: three major dietary patterns were identified: 'common Brazilian', 'healthy' and 'energy-dense'. After adjustments conducted with multivariate analysis, pregnant women who had not received dietary guidance in prenatal consultations (34%) were less likely to adhere to the 'healthy' pattern (PR = 0,81; CI95%= 0,67-0,95). Pregnant women who attended an appropriate number of consultations (≥ 6 consultations) (41%) showed greater adherence to the 'healthy' pattern (PR = 1,15; CI95%= 1,01-1,32) and lower adherence to the 'energy-dense' pattern (PR = 0,85; CI95%= 0,74-0,99). Conclusion: it was observed that the high-risk pregnant women who attended an adequate number of consultations during the prenatal care had a higher chance to adhere to the 'healthy' pattern and a lower chance to adhere to the 'energy-dense' pattern. Not receiving guidelines on prenatal nutrition was inversely associated with the healthy pattern. Thus, the importance of high-risk pregnant women undergoing an appropriate prenatal care is reinforced.

Resumo Objetivos: investigar o efeito potencial das características de acompanhamento do pré-natal em padrões alimentares identificados em gestantes de alto risco. Métodos: foram estudadas 200 gestantes de alto-risco de Fortaleza, Ceará. Os padrões alimentares foram identificados pela análise de componentes principais seguida de rotação ortogonal Varimax. Utilizou-se Regressão de Poisson para estimar as razões de prevalência (RP) e os intervalos de confança (IC95%). Resultados: três padrões alimentares foram identificados: 'comum brasileiro', 'saudável' e 'denso em energia'. Após a realização de ajuste com análise multivariada, as gestantes que não receberam orientação sobre alimentação nas consultas do pré-natal (34%) apresentaram menores chances de adesão ao padrão 'saudável' (RP = 0.81, IC95%= 0.67-0.95). Aquelas que realizaram um número de consultas adequado (≥ 6 consultas) (41%) apresentaram maior adesão ao padrão 'saudável' (RP = 1.15, IC95%= 1.01-1.32) e menor adesão ao padrão 'denso em energia' (RP = 0.85, IC95%= 0.74-0.99). Conclusão: observou-se que as gestantes de alto risco que compareceram a um número adequado de consultas no pré-natal tiveram maior chance de aderir ao padrão 'saudável' e menor chance de aderir ao padrão 'denso em energia'. Não receber orientações sobre nutrição durante o pré-natal foi inversamente associado ao padrão 'saudável'. Reforçando a importância das gestantes de alto risco realizarem um pré-natal adequado.

Quality of the diet of pregnant women in the scope of Primary Health Care / Qualidade da dieta de gestantes no âmbito da Atenção Primária à Saúde

ABSTRACT Objective To evaluate the quality of the diet of the pregnant women monitored by the Family Health Strategy teams and associated factors. Methods This is a population-based cross-sectional study, carried out with 1244 pregnant women between 2018 and 2019. The Diet Quality Index Adapted for Pregnant Women was used to measure the quality of the diet and associate it with risk factors (sociodemographic, obstetric, clinical, behavioral, nutritional status) during the pregnancy. A hierarchical model composed of three blocks was used. A multinomial logistic regression was applied. Results The general average of this Diet Quality Index was 72.75 points, the average of the 1st tercile was 56.06 points, the average of the 2nd tercile was 73.71 points and the average of the 3rd was 88.51 points. The worst diet quality was related to pregnant women with lower education (OR=2.36; 95% CI=1.39-4.01), sedentary women (OR=1.37; 95% CI=1.17-2, 61), those who had a negative self-perception of food (OR=2.00; 95% CI=1.45-2.76) and who had 3 to 5 meals a day (OR=1.83; 95% CI=1.26-2.77), and less than 3 (OR=2.64; 95% CI=1.13-6.18). Conclusion The present study identified that pregnant women with less education, sedentary, and with inadequate nutritional characteristics presented worse diet qualities.

RESUMO Objetivo Avaliar a qualidade da dieta das gestantes acompanhadas pelas equipes da Estratégia da Saúde da Familia e fatores associados. Métodos Trata-se de um estudo tranversal de base populacional, realizado com 1244 gestantes entre 2018 e 2019. O Índice de Qualidade da Dieta Adaptado para Gestantes foi utilizado para mensurar a qualidade da dieta adotada pelas gestantes e associá-la a fatores de risco (sociodemográficos, obstétricos, clínicos, comportamentais, estado nutricional) durante a gravidez. Utilizou-se um modelo hierárquico composto por três blocos. Aplicou-se a regressão logística multinomial. Resultados Observou-se que a média geral do Índice de Qualidade da Dieta foi de 72,75 pontos, sendo que a média do 1º tercil foi de 56,06 pontos; a média do 2º tercil foi de 73,71 pontos e que a do 3º tercil foi de 88,51 pontos. A dieta de pior qualidade esteve relacionada a gestantes com menor escolaridade (OR=2,36; 95% IC=1,39-4,01), sedentárias (OR=1,37 95% IC=1,17-2,61), que apresentavam autopercepção negativa da alimentação (OR=2,00; 95% IC=1,45-2,76) e que faziam de três a cinco refeições ao dia (OR=1,83; 95% IC=1,26-2,77) e menos de três (OR=2,64 ; 95% IC=1,13-6,18). Conclusão O presente estudo identificou que gestantes com menor escolaridade, sedentárias e com características nutricionais inadequadas apresentaram dieta de pior qualidade.

Efectividad de las sesiones demostrativas para mejorar el conocimiento en la prevención de la anemia en gestantes, madres lactantes De niños menores de 3 años. Centro de salud Aparicio Pomares. Huánuco ­ perú / Effectiveness of demonstration sessions to improve knowledge in the prevention of anemia in pregnant women, nursing mothers of children under 3 years. Aparicio pomares health center. Huánuco ­ Peru

El problema de la anemia está muy relacionado a los índices de pobreza, falta de cuidado de la salud y educación de la población, pero principalmente a la falta de conocimientos sobre alimentación y nutrición infantil por parte de las madres. Objetivo: Determinar la efectividad de las sesiones demostrativas para mejorar el conocimiento en la prevención de la anemia en gestantes, madres lactantes de niños menores de 3 años. Materiales y Métodos: El estudio fue de tipo experimental, descriptivo y de nivel observacional, explicativo y analítico. La población de estudio estuvo conformada por 200 gestantes, obteniendo una muestra de 30 gestantes y 20 madres lactantes de niños menores de 3 años, haciendo un total de 50 pacientes, se utilizó el cuestionario para la recolección de datos, aplicado en dos momentos; antes y después de las sesiones demostrativas, con la finalidad de comparar los resultados. Resultados: El nivel de conocimiento teórico de las madres, luego de la aplicación de las sesiones demostrativas se incrementó su nivel a un conocimiento alto. Respecto a los conocimientos prácticos luego de la aplicación de las sesiones, se logró un conocimiento alto. Conclusiones: La técnica de sesiones demostrativas en el incremento de conocimientos es efectiva(AU)

The problem of anemia is closely related to the rates of poverty, lack of care of the health and education of the population, but mainly to the lack of knowledge about food and infant nutrition by mothers. Objective: To determine the effectiveness of the demonstration sessions to improve knowledge in the prevention of anemia in pregnant women, nursing mothers of minor children 3 years old Materials and methods: The study was of type, experimental, descriptive and observational level, explanatory and analytical. The study population consisted of 200 pregnant women, obtaining a sample of 30 pregnant women and 20 lactating mothers of children under 3 years of age, making a total of 50 patients, the questionnaire was used for data collection, applied in two moments; before and after demonstration sessions, in order to compare the results. Results: The level of theoretical knowledge of the mothers, after the application of the demonstrative sessions their level to high knowledge. Regarding the practical knowledge after the application of the sessions, high knowledge was achieved. Conclusions: The technique of demonstrative sessions in the increase of knowledge is effective(AU)

Suplementación prenatal con omega 3 y su efecto en complicaciones durante el embarazo / Effect of prenatal omega 3 supplementation on pregnancy outcomes

Durante los últimos años se ha incentivado la suplementación con omega 3 durante el embarazo principalmente debido a la evidencia que mostraría beneficios en el desarrollo neuronal y visual del hijo en gestación, y a la prevención de patologías obstétricas asociadas a un aumento de la morbi-mortalidad perinatal. Los ácidos grasos poliinsaturados (PUFAs) omega 3, específicamente el ácido eicosapentaenoico (EPA) y el ácido docosahexaenoico (DHA), poseen propiedades antiinflamatorias, vasodilatadoras, además de propiedades anti-agregantes, las cuales han estimulado el uso de PUFAs en la prevención de enfermedades cardiovasculares. En esta revisión detallamos los efectos de la suplementación con omega 3 en diferentes aspectos del embarazo tales como la prevención del parto prematuro, preeclampsia, depresión post-parto y mejora del metabolismo durante la diabetes gestacional. Si bien existen diversos ensayos clínicos randomizados que estudian la suplementación con omega 3 durante la gestación, la evidencia sigue siendo no concluyente, debido a la variabilidad de las dosis y tiempo de administración. Ciertamente, un mayor número de estudios de calidad son necesarios para determinar el real impacto de la suplementación con omega 3 durante la gestación en la prevención de patologías obstétricas(AU)

During pregnancy, omega 3 supplementation has raised its popularity due to evidence that it would show not only benefits in the neural and visual development of the unborn child, but also in the prevention of obstetrical pathologies associated with of perinatal morbidity and mortality. Omega 3 polyunsaturated fatty acids (PUFAs), specifically, docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), possess anti-inflammatory, vasodilatory and anti-aggregating properties, which have led to the use of PUFAs in the prevention of cardiovascular diseases. In this review, we detail the effects of omega 3 supplementation on different aspects of pregnancy such as prevention of preterm birth, pre-eclampsia, postpartum depression, and improved metabolism during gestational diabetes. Although there are several randomized clinical trials using omega-3 supplementation during pregnancy, the evidence remains inconclusive, due to variability in dosage and administration time. Certainly, a greater number of high-quality studies including randomized clinical trials are necessary to determine the impact of omega 3 supplementation during pregnancy in the prevention of obstetric pathologies(AU)

Association between ultra-processed food consumption and nutrient intake among low-risk pregnant women / Associação entre o consumo de alimentos ultraprocessados e a ingestão de nutrientes em gestantes de risco habitual

Abstract Objectives: to analyze the ultra-processed foods (UPF) consumption in pregnant women's diets associated with nutrient intake. Methods: a cross-sectional study using socioeconomic, anthropometric and food consumption data from low-risk pregnant women. Consumption of energy, macro and micronutrient were obtained through two 24-hour recalls (R24h). The UPF were identified using the NOVA classification, and the percentage of energy from this food was classified in quartiles and associated with nutrient intake. So, the ANCOVA test adjusted for age and per capita income were adopted. Results: a total of 60 pregnant women with a mean of age of 28.44 (CI95%=27.20-29.69) years old were evaluated. The average percentage of UPF in the diet was 20.68 (CI95%=17.88-23.47). Pregnant women in the highest quartile of UPF consumption had lower protein intake (13.48g vs. 18.84g; p=0.031) and lower zinc intake (4.52mg vs. 6.18mg; p=0.045) when compared to those in the lowest quartile. Conclusions: the results showed a negative relationship between the participation of UPF in pregnant women's diets and the intake of protein and zinc, important nutrients for the gestational period. Such findings reinforce the importance of promoting healthy eating habits during pregnancy to ensure an adequate supply of nutrients in this phase.

Resumo Objetivos: analisar o consumo de alimentos ultraprocessados (AUP) e sua associação com a ingestão de nutrientes entre gestantes de risco habitual. Métodos: estudo transversal com dados socioeconômicos, antropométricos e de consumo alimentar de gestantes de risco habitual. O consumo de energia, macro e micronutrientes foi obtido através de dois Recordatórios 24 horas (R24h). Os AUP foram identificados através da classificação NOVA, e o percentual de calorias proveniente destes alimentos foi classificado em quartis e associado à ingestão de nutrientes. Para tal, adotou-se o teste ANCOVA ajustado segundo a idade e a renda per capita. Resultados: foram avaliadas 60 gestantes com média de idade de 28,44 (IC95%=27,20-29,69) anos. O percentual médio de AUP na dieta foi de 20,68 (IC95%=17,88-23,47). Gestantes no maior quartil de consumo de AUP apresentaram menor ingestão de proteína (13,48g vs. 18,84g; p=0,031) e zinco (4,52mg vs. 6,18mg; p=0,045) quando comparadas ao menor quartil. Conclusão: os resultados evidenciaram uma relação desfavorável entre a participação de AUP na dieta e a ingestão de proteínas e zinco, nutrientes importantes para o período gestacional. Tais achados reforçam a importância da promoção de hábitos alimentares saudáveis durante a gestação para garantir o aporte adequado de nutrientes nessa fase.

Development and Validation of a Protocol for Pregnant Women Based on the Brazilian Dietary Guidelines / Desenvolvimento e validação de um protocolo para orientação de gestantes baseado no guia alimentar para a população brasileira

Abstract Objective To develop and validate a protocol for the use of the Dietary Guidelines for the Brazilian Population (DGBP) in the individual dietary advice for pregnant women assisted in primary healthcare (PHC). Methods Methodological study that involved the elaboration of a protocol in six steps: definition of the format, definition of the instrument to evaluate food consumption, systematization of evidence on food and nutrition needs of pregnant women, extraction of DGBP recommendations, development of messages of dietary guidelines and content, and face validity. The analyses of the validation steps were carried out by calculating the Content Validity Index (CVI) and thematic content analysis. Results As products of the steps, the protocol structure was defined and the dietary advice for pregnant women were elaborated, considering physiological changes, food consumption, nutritional and health needs, and socioeconomic conditions of this population. The protocol was well evaluated by experts and health professionals in terms of clarity, relevance (CVI > 0.8), and applicability. In addition, the participants made some suggestions to improve the clarity of the messages and to expand the applicability of the instrument with Brazilian pregnant women. Conclusion The instrument developed fills a gap in clinical protocols on dietary advice for pregnant women focused on promoting a healthy diet, contributing to a healthy pregnancy. In addition, it demonstrates potential to contribute to the qualification of PHC professionals and to the implementation of the DGBP recommendations.

Resumo Objetivo Desenvolver e validar um protocolo para uso do Guia Alimentar para a População Brasileira (GAPB) na orientação alimentar individual de gestantes atendidas na atenção primária à saúde (APS). Métodos Estudo metodológico que envolveu a elaboração de um protocolo em seis etapas: definição do formato do documento, definição do instrumento de avaliação do consumo alimentar, sistematização de evidências sobre necessidades de alimentação e nutrição de gestantes, extração das recomendações do GAPB, desenvolvimento de mensagens de orientação alimentar e validação de conteúdo e validação aparente. As análises das etapas de validação foram realizadas através do cálculo do índice de validade de conteúdo e análise temática de conteúdo. Resultados Como produtos das etapas, a estrutura do protocolo foi definida e as orientações alimentares de gestantes foram elaboradas, considerando as alterações fisiológicas, consumo alimentar, necessidades nutricionais e de saúde e condições socioeconômicas desta população. O protocolo foi bem avaliado por especialistas e profissionais de saúde nos critérios de clareza, pertinência (índice de validade de conteúdo > 0,8) e aplicabilidade. Além disso, os participantes deram sugestões para melhoria da clareza das mensagens e para ampliar a aplicabilidade do instrumento em gestantes brasileiras. Conclusão O instrumento desenvolvido preenche uma lacuna sobre protocolos clínicos de orientação alimentar para gestantes focado na promoção da alimentação saudável, contribuindo para uma gestação saudável. Além disso, o instrumento demonstra potencial para contribuir na qualificação de profissionais da APS e implementação das recomendações do GAPB.

Estado nutricional de las gestantes a la captación del embarazo / Nutritional State of Pregnant Women at the First Gestational Visit

Introducción: Un buen estado nutricional, tanto preconcepcional como durante el embarazo, es de vital importancia por igual para la madre como para el producto de la gestación. Objetivo: Evaluar el estado nutricional de las embarazadas en el momento de la captación del municipio Regla. Métodos: Estudio descriptivo, transversal en 81 gestantes, aparentemente sanas a la captación, en el área de salud Lidia y Clodomira, en el período comprendido de enero a mayo del 2019. Las variables a estudiar fueron: sociodemográficas, antecedente obstétrico y estado nutricional. Se utilizó el SPSS-22 para Windows para la estadística. Resultados: La edad materna más frecuente se encontró en el grupo de edades de 20 a 35 años, en su mayoría amas de casa con un alto nivel escolar, y baja paridad. El 56,8 por ciento presentó un estado nutricional adecuado (79 por ciento sin anemia), aun así, el resto mostró alteraciones del peso (por defecto o exceso). No todas las mujeres realizaban las 6 frecuencias alimentarías recomendadas ni consumían diariamente los alimentos de los 7 grupos básicos. Conclusiones: La mayoría de las gestantes tenían un estado nutricional adecuado a la captación del embarazo: expresión del estado nutricional pregestacional. Sin embargo, presentaban hábitos alimentarios no saludables durante esta etapa de la vida, en la cual la alimentación es fundamental para la madre y el producto de la concepción(AU)

Introduction: A good nutritional state, both in the preconception stage and during pregnancy, is of vital importance for the mother as well as for the product of pregnancy. Objective: To assess the nutritional status of pregnant women from Regla Municipality at the first gestational visit. Methods: Descriptive and cross-sectional study carried out, in the period from January to May 2019, with 81 pregnant women, apparently healthy in the first gestational visit, from the health area belonging to Lidia and Clodomira Polyclinic. The study variables were sociodemographic ones, obstetric history and nutritional state. SPSS-22 for Windows was used for statistics. Results: The most frequent maternal age was found in the age group of 20 to 35 years, mostly housewives, with a high educational level and low parity. 56.8 percent presented an adequate nutritional status (79 percent without anemia), yet the rest showed weight alterations (by default or excess). Not all the women did the six recommended food frequencies nor did they consume the foods from the seven basic groups daily. Conclusions: Most of the pregnant women had an adequate nutritional state in the first gestational visit, which is consistent with the nutritional state before pregnancy. However, they presented unhealthy eating habits during this stage of life, in which food is essential for the mother and the product of conception(AU)

Saúde da mulher: manutenção da gravidez em gestantes / Women's health: maintenance of pregnancy in pregnant women / Salud de la mujer: mantenimiento del embarazo em mujeres embarazadas

Objetivo: revisar e analisar, através da literatura, as principais alterações fisiológicas e patológicas da gestação, bem como as recomendações para preveni-las. Método: trata-se de um estudo de análise bibliográfica, descritivo, tipo revisão de literatura, com buscas realizadas durante o período de 01 a 17 de abril de 2020 nas bibliotecas virtuais Scientific Electronic Library Online (SciELO) e Biblioteca Virtual em Saúde (BVS). Selecionaram-se 19 artigos, os dados foram processados no software IRAMUTEQ® e analisados descritivamente pelo método de Reinert. Resultados: organizaram-se sete classes, destas emergiram quatro categorias: Classe 1, 4 e 7 - Alterações fisiológicas no peso e a avaliação nutricional na gestação; Classes 2 e 3 ­ Processo Educativo sobre a pirâmide nutricional para um desfecho saudável da gestação; Classe 6 ­ A importância das alterações hematológicas durante a gestação; Classe 5 ­ Benefícios da vitamina D na saúde da gestante ao longo do ciclo gravídico e puerperal. Conclusão: Identificou-se, que é fundamental o conhecimento das mudanças fisiológicas e patológicas para que seja ofertado as condições assistenciais necessárias, com intuito de prevenir complicações.(AU)

Objective: to review and analyze, through the literature, the main physiological and pathological changes in pregnancy, as well as the recommendations to prevent them. Method: this is a descriptive, literature review-type study of bibliographic analysis, with searches carried out during the period from April 1st to 17th, 2020 in the Scientific Electronic Library Online (SciELO) and Virtual Health Library (VHL) virtual libraries. Nineteen articles were selected, the data were processed in the IRAMUTEQ® software and descriptively analyzed using the Reinert method. Results: seven classes were organized, from which four categories emerged: Class 1, 4 and 7 - Physiological changes in weight and nutritional assessment during pregnancy; Classes 2 and 3 ­ Educational Process on the nutritional pyramid for a healthy pregnancy outcome; Class 6 ­ The importance of hematological changes during pregnancy; Class 5 ­ Benefits of vitamin D on the health of pregnant women throughout the pregnancy and puerperal cycle. Conclusion: It was identified that it is essential to know the physiological and pathological changes so that the necessary care conditions can be offered, in order to prevent complications.(AU)

Objetivo: revisar y analizar, a través de la literatura, los principales cambios fisiológicos y patológicos del embarazo, así como las recomendaciones para prevenirlos. Método: se trata de un análisis bibliográfico, estudio descriptivo, tipo revisión de la literatura, con búsquedas realizadas durante el período del 1 al 17 de abril de 2020 en las bibliotecas virtuales de la Biblioteca Científica Electrónica en Línea (SciELO) y la Biblioteca Virtual en Salud (BVS). Se seleccionaron 19 artículos, los datos se procesaron en el software IRAMUTEQ® y se analizaron descriptivamente mediante el método Reinert. Resultados: se organizaron siete clases, de las cuales surgieron cuatro categorías: Clase 1, 4 y 7 - Cambios fisiológicos en el peso y valoración nutricional durante el embarazo; Clases 2 y 3 - Proceso educativo sobre la pirámide nutricional para un resultado de embarazo saludable; Clase 6: la importancia de los cambios hematológicos durante el embarazo; Clase 5 - Beneficios de la vitamina D sobre la salud de la gestante durante todo el embarazo y ciclo puerperal. Conclusión: Se identificó que es fundamental conocer los cambios fisiológicos y patológicos para que se puedan brindar las condiciones de atención necesarias, a fin de prevenir complicaciones.(AU)

Crecimiento en niños y en hijos de madres que adhieren a dietas vegetarianas: revisión de la literatura / Growth in children and in the offspring whose mothers adhere to vegetarian diets: Literature review

Introducción. La prevalencia del vegetarianismo aumenta a nivel mundial y no hay consenso acerca de si este tipo de alimentación es adecuado durante el período de crecimiento. Objetivo. Se realizó una revisión descriptiva de la literatura con el objetivo de conocer si los niños e hijos de madres que siguen dietas vegetarianas crecen de manera diferente a los niños con dietas omnívoras. Métodos. Se incluyen 25 artículos publicados entre los años 1995-2020, que describen el crecimiento prenatal, postnatal y desarrollo puberal en niños vegetarianos e hijos de madres vegetarianas. Conclusión. La escasez de estudios longitudinales y resultados en el largo plazo, la heterogeneidad en la clasificación y el registro de las dietas, además de deficiencias metodológicas, no permiten concluir que el crecimiento de estos niños sea diferente al de los niños que siguen dietas omnívoras. Se requieren estudios longitudinales en el largo plazo para contribuir a dirimir esta controversia

The prevalence of vegetarianism is rising worldwide and there is no consensus about whether it is adequate during the growth period. The objective of this descriptive review is to find out if vegetarian children and children born from mothers who follow vegetarian diets, grow different from those who follow omnivorous diets. Results. 25 articles published between 1995 and 2020 were included describing prenatal and postnatal growth and pubertal development in vegetarian children and children of vegetarian mothers. Conclusion. The scarcity of longitudinal studies and long-term results, the heterogeneity in the classification and registration of the diets, in addition to methodological deficiencies, do not allow to conclude that the growth of these children is different from children on omnivorous diets. Long-term longitudinal studies are required to help to solve this controversy

Influence of ultra-processed foods consumption during pregnancy on baby's anthropometric measurements, from birth to the first year of life: a systematic review / Influência do consumo de alimentos ultraprocessados durante a gestação nas medidas antropométricas do bebê, do nascimento ao primeiro ano de vida: uma revisão sistemática

Abstract Objectives: to perform a systematic review of studies that investigated the influence of ultra-processed foods (UPF) consumption during pregnancy on child's anthropometric parameters up to one year of life. Methods: cohort and cross-sectional studies were researched in BVS, Cinahl, Cochrane, Embase, Pubmed, Scopus and Web of Science databases until March 2020, and the main descriptors were: "Pregnant Women", "Ultra-processed foods", "Birth Weight", "Smallfor Gestational Age", "Infant", "Newborn". Results: seventeen articles were considered eligible and evaluated the associations between the exposures: ultra-processed dietary patterns; soft drinks, sugar-sweetened beverages, artificially sweetened beverages; fast food, junk food, sweets, snacks and the outcomes: birth weight and its classifications; length and head circumference at birth; birth weight adjustments according to gestational age; weight/age, length/age, body mass index/age and weight/length indices. The results showed: 36 non-significant associations between the exposures and the outcomes; 13 direct associations (outcomes versus ultraprocessed dietary patterns, soft drinks, artificially sweetened beverages, sweets, junk food) and 5 inverse associations (outcomes versus ultra-processed dietary patterns, soft drinks). Conclusions: most of the evaluated literature did not demonstrate the influence of UPF consumption during pregnancy on the newborn's anthropometric measurements up to one year of life and denoted a smaller number of direct and inverse associations between the exposures and the outcomes.

Resumo Objetivos: realizar uma revisão sistemática de estudos que investigaram a influência do consumo de alimentos ultraprocessados (AUP) na gestação nas medidas antropométricas do recém-nascido até um ano de idade. Métodos: foram pesquisados estudos de coorte e transversais nas bases BVS, Cinahl, Cochrane, Embase, Pubmed, Scopus e Web of Science até março de 2020, tendo como principais descritores: "Pregnant women", "Ultra-processed foods", "Birth weight", "Small for Gestational Age", "Infant", "Newborn". Resultados: dezessete artigos foram considerados elegíveis e avaliaram as associações entre as exposições: padrões alimentares ultraprocessados; refrigerantes, sugar-sweetened beverages ou artificially sweetened beverages; fastfood, junkfood, doces e snacks e os desfe-chos:peso ao nascer e suas classificações; comprimento e perímetro cefálico ao nascimento; adequações do peso ao nascer segundo idade gestacional; e índices peso/idade, compri-mento/idade, índice de massa corporal/idade e peso/comprimento. Foram encontradas: 36 associações nulas entre exposições e desfechos avaliados; 13 diretas (desfechos versus padrões alimentares ultraprocessados, refrigerantes, artificially sweetened beverages, doces e junkfood) e 5 inversas (desfechos versus padrões alimentares ultraprocessados e refrigerantes). Conclusões: a maioria da literatura avaliada não demonstrou influência do consumo de AUP na gestação nas medidas antropométricas do recém-nascido até um ano de vida e apontou um menor número de associações diretas e inversas entre as exposições e os desfechos analisados.