Malnutrition in Pregnancy

MIP: Medical Nutrition Therapy (2018)

Intervention
Are there beneficial health outcomes associated with MNT by an RD or RDN in pregnant women with malnutrition on gestational weight gain?
- Conclusion
  The evidence reviewed observed lower gestational weight gain in the MNT group among women with mixed BMI status (one out of one study) and women who were overweight or obese (two out of three studies).
- Grade: I
  - Grade I means there is Good/Strong evidence supporting the statement;
  - Grade II is Fair;
  - Grade III is Limited/Weak;
  - Grade IV is Expert Opinion Only;
  - Grade V is Not Assignable.
  - High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
  - Moderate (B) means we are moderately confident in the effect estimate;
  - Low (C) means our confidence in the effect estimate is limited;
  - Very Low (D) means we have very little confidence in the effect estimate.
  - Ungraded means a grade is not assignable.
- Evidence Summary: Are there beneficial health outcomes associated with MNT by an RD or RDN in pregnant women with malnutrition on gestational weight gain?
- Search Plan and Results: MIP: MNT (2014)
Are there beneficial health outcomes associated with MNT by an RD or RDN in pregnant women with malnutrition on markers of glycemic control (glucose, OGTT, insulin use)?
- Conclusion
  The evidence reviewed found no significant differences in fasting, two hours post-prandial serum glucose, or frequency and amount of insulin usage among pregnant women with gestational diabetes or type 2 diabetes (one out of one study) and OGTT among pregnant women who were obese (one out of one study) between MNT intervention and comparison groups.
- Grade: II
  - Grade I means there is Good/Strong evidence supporting the statement;
  - Grade II is Fair;
  - Grade III is Limited/Weak;
  - Grade IV is Expert Opinion Only;
  - Grade V is Not Assignable.
  - High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
  - Moderate (B) means we are moderately confident in the effect estimate;
  - Low (C) means our confidence in the effect estimate is limited;
  - Very Low (D) means we have very little confidence in the effect estimate.
  - Ungraded means a grade is not assignable.
- Evidence Summary: Are there beneficial health outcomes associated with MNT by an RD or RDN in pregnant women with malnutrition on markers of glycemic control (glucose, OGTT and insulin use)?
- Search Plan and Results: MIP: MNT (2014)
Are there beneficial health outcomes associated with MNT by an RD or RDN in pregnant women with malnutrition on maternal complications?
- Conclusion
  The evidence reviewed found no significant differences in maternal complications (gestational diabetes, pre-eclampsia or hypertension) between MNT intervention and control groups among pregnant women with mixed BMI status and those who were either overweight or obese (four out of four studies). However, higher incidence of pre-eclampsia were observed in the control group among pregnant women with gestational diabetes or type 2 diabetes mellitus (one out of one study).
- Grade: I
  - Grade I means there is Good/Strong evidence supporting the statement;
  - Grade II is Fair;
  - Grade III is Limited/Weak;
  - Grade IV is Expert Opinion Only;
  - Grade V is Not Assignable.
  - High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
  - Moderate (B) means we are moderately confident in the effect estimate;
  - Low (C) means our confidence in the effect estimate is limited;
  - Very Low (D) means we have very little confidence in the effect estimate.
  - Ungraded means a grade is not assignable.
- Evidence Summary: Are there beneficial health outcomes associated with MNT by an RD or RDN in pregnant women with malnutrition on maternal complications?
- Search Plan and Results: MIP: MNT (2014)
Are there beneficial health outcomes associated with MNT by an RD or RDN in pregnant women with malnutrition on Caesarean section?
- Conclusion
  The evidence reviewed found no significant differences in the rates of Caesarean section delivery between the intervention and control groups among pregnant women with mixed BMI status or those who were either overweight or obese (three out of four studies).
- Grade: I
  - Grade I means there is Good/Strong evidence supporting the statement;
  - Grade II is Fair;
  - Grade III is Limited/Weak;
  - Grade IV is Expert Opinion Only;
  - Grade V is Not Assignable.
  - High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
  - Moderate (B) means we are moderately confident in the effect estimate;
  - Low (C) means our confidence in the effect estimate is limited;
  - Very Low (D) means we have very little confidence in the effect estimate.
  - Ungraded means a grade is not assignable.
- Evidence Summary: Are there beneficial health outcomes associated with MNT by an RD or RDN in pregnant women with malnutrition on Caesarean section?
- Search Plan and Results: MIP: MNT (2014)
Are there beneficial health outcomes associated with MNT by an RD or RDN in pregnant women with malnutrition on birth weight (in grams)?
- Conclusion
  The evidence reviewed found no significant differences in birth weight (three out of three studies) among pregnant women with gestational diabetes or type 2 diabetes mellitus or those who were obese.
- Grade: II
  - Grade I means there is Good/Strong evidence supporting the statement;
  - Grade II is Fair;
  - Grade III is Limited/Weak;
  - Grade IV is Expert Opinion Only;
  - Grade V is Not Assignable.
  - High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
  - Moderate (B) means we are moderately confident in the effect estimate;
  - Low (C) means our confidence in the effect estimate is limited;
  - Very Low (D) means we have very little confidence in the effect estimate.
  - Ungraded means a grade is not assignable.
- Evidence Summary: Are there beneficial health outcomes associated with MNT by an RD or RDN in pregnant women with malnutrition on birth weight (in grams)?
- Search Plan and Results: MIP: MNT (2014)
Are there beneficial health outcomes associated with MNT by an RD or RDN in pregnant women with malnutrition on birth weight (in categories)?
- Conclusion
  The evidence reviewed found no significant differences in large for gestational age (one out of two studies), macrosomia (two out of three studies), low birth weight (one out of one study), or small for gestational age (one out of one study) among pregnant women with gestational diabetes or type 2 diabetes mellitus, or those who were either overweight or obese
- Grade: II
  - Grade I means there is Good/Strong evidence supporting the statement;
  - Grade II is Fair;
  - Grade III is Limited/Weak;
  - Grade IV is Expert Opinion Only;
  - Grade V is Not Assignable.
  - High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
  - Moderate (B) means we are moderately confident in the effect estimate;
  - Low (C) means our confidence in the effect estimate is limited;
  - Very Low (D) means we have very little confidence in the effect estimate.
  - Ungraded means a grade is not assignable.
- Evidence Summary: Are there beneficial health outcomes associated with MNT by an RD or RDN in pregnant women with malnutrition on birth weight (in categories)?
- Search Plan and Results: MIP: MNT (2014)
Are there beneficial health outcomes associated with MNT by an RD or RDN in pregnant women with malnutrition on pre-term delivery or gestational age?
- Conclusion
  The evidence reviewed found no significant differences in pre-term delivery or gestational age between MNT intervention and control groups among pregnant women with gestational diabetes or type 2 diabetes mellitus and those who were either overweight or obese (four out of four studies).
- Grade: I
  - Grade I means there is Good/Strong evidence supporting the statement;
  - Grade II is Fair;
  - Grade III is Limited/Weak;
  - Grade IV is Expert Opinion Only;
  - Grade V is Not Assignable.
  - High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
  - Moderate (B) means we are moderately confident in the effect estimate;
  - Low (C) means our confidence in the effect estimate is limited;
  - Very Low (D) means we have very little confidence in the effect estimate.
  - Ungraded means a grade is not assignable.
- Evidence Summary: Are there beneficial health outcomes associated with MNT by an RD or RDN in pregnant women with malnutrition on preterm delivery or gestational age?
- Search Plan and Results: MIP: MNT (2014)
Are there beneficial health outcomes associated with MNT by an RD or RDN in pregnant women with malnutrition on infant illnesses or complications – perinatal mortality, NICU admissions, congenital malformations rate?
- Conclusion
  The evidence reviewed found no significant differences in infant illnesses — NICU admission (two out of three studies), congenital malformation rate (one out of one study) and perinatal death (one out of one study) — among pregnant women with gestational diabetes or type 2 diabetes mellitus, or those who were either overweight or obese.
- Grade: II
  - Grade I means there is Good/Strong evidence supporting the statement;
  - Grade II is Fair;
  - Grade III is Limited/Weak;
  - Grade IV is Expert Opinion Only;
  - Grade V is Not Assignable.
  - High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
  - Moderate (B) means we are moderately confident in the effect estimate;
  - Low (C) means our confidence in the effect estimate is limited;
  - Very Low (D) means we have very little confidence in the effect estimate.
  - Ungraded means a grade is not assignable.
- Evidence Summary: Are there beneficial health outcomes associated with MNT by an RD or RDN in pregnant women with malnutrition on infant illnesses or complications: Perinatal mortality, NICU admissions, congenital malformations rate?
- Search Plan and Results: MIP: MNT (2014)