Je Beile 2015

8172019 Je Beile 2015

httpslidepdfcomreaderfullje-beile-2015 148

Accepted Manuscript

A systematic review and meta-analysis of energy intake and weight gain in pregnancy

Hiba Jebeile MNUTRDIET Ms Jovana Mijatovic MNUTRDIET Ms Dr Jimmy Chun

Yu Louie PHD Dr Tania Prvan PHD Dr Jennie C Brand-Miller PHD

PII S0002-9378(15)02653-8

DOI 101016jajog201512049

Reference YMOB 10857

To appear in American Journal of Obstetrics and Gynecology

Received Date 20 July 2015

Revised Date 1 December 2015

Accepted Date 23 December 2015

Please cite this article as Jebeile H Mijatovic J Louie JCY Prvan T Brand-Miller JC A systematic

review and meta-analysis of energy intake and weight gain in pregnancy American Journal of Obstetrics

and Gynecology (2016) doi 101016jajog201512049

This is a PDF file of an unedited manuscript that has been accepted for publication As a service toour customers we are providing this early version of the manuscript The manuscript will undergo

copyediting typesetting and review of the resulting proof before it is published in its final form Please

note that during the production process errors may be discovered which could affect the content and all

legal disclaimers that apply to the journal pertain

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1


Ms Hiba JEBEILE MNUTRDIET Ms Jovana MIJATOVIC MNUTRDIET Dr

Jimmy Chun Yu LOUIE PHD Dr Tania PRVAN PHD Dr Jennie C BRAND-

MILLER PHD

School of Molecular Bioscience and Charles Perkins Centre The University of Sydney

Camperdown 2006 NSW Australia (HJ JM JCYL JCBM)

Department of Statistics Faculty of Science and Engineering Macquarie University Sydney

2109 NSW Australia (TP)

Equal contribution from these authors

Author surnames JEBEILE MIJATOVIC LOUIE PRVAN BRAND-MILLER

Source(s) of support No external funding was required to facilitate this research or

preparation of the manuscript

Conflict of interest statement The authors report no conflict of interest

Corresponding author

Professor Jennie C Brand-Miller

Level 6 West The Hub

D17 Charles Perkins Centre

The University of Sydney NSW 2006

Australia

Ph +61 2 93513759

E jenniebrandmillersydneyeduau

Reprints will not be available Abbreviations BMI body mass index BMR basal metabolic rate GDM gestational

diabetes mellitus GWG gestational weight gain IOM Institute of Medicine PAL physical

activity level RCT randomized controlled trial SD standard deviation SMD standardized

mean difference t time point

Word count Abstract = 333 words Main text = 3480 words

Number of tables and figures 2 and 5 respectively

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2

Condensation Women report little or no change in energy intake during pregnancy

Running head Energy intake and weight gain in pregnancy

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3

ABSTRACT

BACKGROUND Gestational weight gain within the recommended range produces optimal1

pregnancy outcomes yet many women exceed the guidelines Official recommendations to2

increase energy intake by ~ 1000 kJday in pregnancy may be excessive 3

OBJECTIVE To determine by meta-analysis of relevant studies whether greater increments4

in energy intake from early to late pregnancy corresponded to higher or excessive gestational5

weight gain6

DATA SOURCES We systematically searched electronic databases for observational and7

intervention studies published from 1990-present The databases included Ovid Medline8

Cochrane Library Excerpta Medica DataBASE (EMBASE) Cumulative Index to Nursing9

and Allied Health Literature (CINAHL) and Science Direct In addition we hand searched10

reference lists of all identified articles11

STUDY ELIGIBILITY CRIETRIA Studies were included if they reported gestational12

weight gain and energy intake in early and late gestation in women of any age with a13

singleton pregnancy Search also encompassed journals emerging from both developed and14

developing countries15

STUDY APPRAISAL AND SYNTHESIS METHDOS Studies were individually assessed16

for quality based on the Quality Criteria Checklist obtained from the American Dietetic17

Association Evidence Analysis Manual Publication bias was plotted using a funnel plot with18

standard mean difference against standard error Identified studies were meta-analyzed and19

stratified by Body Mass Index study design dietary methodology and country status20

(developeddeveloping) using a random-effects model21

RESULTS Of 2487 articles screened 18 studies met inclusion criteria On average women22

gained 120 (28) kg (Standardized Mean Difference = 1306 P lt 00005) yet reported only a23

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4

small increment in energy intake that did not reach statistical significance (~475 kJday24

Standard Mean Difference = 0266 P = 0016) Irrespective of baseline Body Mass Index25

study design dietary methodology or country status changes in energy intake were not26

significantly correlated to the amount of gestational weight gain (r = 0321 P = 011)27

CONCLUSION Despite rapid physiological weight gain women report little or no change28

in energy intake during pregnancy Current recommendations to increase energy intake by ~29

1000 kJday may therefore encourage excessive weight gain and adverse pregnancy30

outcomes31

KEYWORDS energy intake first trimester gestational weight gain pregnancy third32

trimester33

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5

INTRODUCTION34

In developed nations one third or more of women of childbearing age are overweight or35

obese1-3

Excessive pre-conception body weight is a recognized risk factor for adverse36

pregnancy outcomes including gestational diabetes mellitus (GDM) pregnancy-induced37

hypertension pre-eclampsia and caesarean delivery4 Maternal obesity is also linked with38

increased risk of macrosomia3 stillbirth

5 pre-term birth

6 and congenital malformation

739

Offspring of overweight and obese women are at increased risk of obesity in childhood and40

young adulthood thereby creating an intergenerational vicious cycle8-10

41

Restricting or optimizing gestational weight gain (GWG) is one of the few interventions that42

can reduce adverse pregnancy outcomes11

The Institute of Medicine (IOM) specifies ranges43

of desirable weight gain for underweight normal weight overweight and obese pregnant44

women that have been adopted by other countries12

However many pregnant women gain45

more than is optimal13

and find it difficult to lose the excess weight post-pregnancy14

46

A logical assumption is that additional food intake is required to achieve the desirable rate of47

weight gain in pregnancy Indeed mathematical models have been developed to determine48

the theoretical additional energy costs involved in pregnancy15

The cumulative absolute cost49

for women with a normal BMI and a mean GWG of 120 kg has been estimated to be ~32050

MJ distributed as an additional 0-300 kJday in the first trimester 1000-1500 kJday in the51

second and 1800-2100 kJday in the third16

Nonetheless energy requirements during52

pregnancy will be influenced by multiple factors including pre-pregnancy weight BMI53

maternal age stage of gestation rate of GWG and increases in energy expenditure relating to54

an increase in body mass and hence basal metabolic rate (BMR)1718

55

Despite the theory recent studies suggest that the current generation of women consume very56

little additional food energy to sustain a healthy pregnancy A meta-analysis of 23 studies in57

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6

well-nourished women reported an average increase of only ~140 kJday ie a small fraction58

of the theoretical calculation or current recommendations17

It is conceivable that pregnant59

women now require less energy than earlier generations due to reductions in incidental60

physical activity and increasing sedentariness19

Pregnancy guidelines that recommend an61

additional 2000 kJday in the third trimester may result in excessive GWG and adverse62

pregnancy outcomes63

In this analysis our objective was to determine whether a greater increment in reported64

energy intake from early to late pregnancy corresponded to higher or excessive GWG We65

systematically searched for observational and randomized controlled trials published over the66

past 25 years that reported GWG along with energy intake in early and late pregnancy67

METHODS68

Search Strategy69

A systematic literature search was undertaken in August-October 2014 by 2 independent70

student dietitians (JM and HJ) A starting date of 1990 was specified so that the outcomes71

reflected the current generation of women whose pregnancy advice may have been influenced72

by IOM guidelines20

We searched Ovid Medline Cochrane Library Excerpta Medica73

DataBASE (EMBASE) Cumulative Index to Nursing and Allied Health Literature74

(CINAHL) and Science Direct for studies that reported energy intake in early and late75

pregnancy and GWG in singleton pregnancies in women of any age Randomized controlled76

trials (RCT) and observational cohort and longitudinal studies were eligible for inclusion77

The following search terms were employed ldquopregnantrdquo OR ldquopregnancyrdquo OR ldquopregnant78

womanrdquo OR ldquogestationrdquo OR ldquomaternalrdquo AND ldquoenergy intakerdquo OR ldquomacronutrientrdquo OR79

ldquodietary fatrdquo OR ldquodietary proteinsrdquo OR ldquodietary carbohydraterdquo OR ldquodietary intakerdquo OR80

ldquocalorie intakerdquo OR ldquokilojoule intakerdquo AND ldquoweight gainrdquo OR ldquobody weightrdquo OR ldquoweight81

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7

changerdquo OR ldquobody mass indexrdquo OR ldquoBMIrdquo Hand-searching was conducted to identify82

additional studies Studies reported as withdrawn in the database and retrospective studies83

that preceded 1990 were excluded84

Study Selection85

Full term pregnancy was defined as 37 ndash 42 weeks gestation21

Women were classed as86

underweight normal overweight and obese category according to IOM criteria Countries87

were classified as lsquodevelopedrsquo or lsquodevelopingrsquo based on the United Nations criteria22

In88

relation to energy intake early and later pregnancy were defined by timepoints (t1 and t2) at89

least 12 or more weeks apart where t1 lt18 weeks and t2 gt30 weeks gestation (studies90

reporting data at intervals lt12 weeks were excluded) GWG was recorded as the mean plusmn SD91

where data was collected at lt18 weeks (t1) and gt34 weeks gestation (t2) except in 2 studies92

2324 where the value was calculated as the difference in weight at the 2 timepoints and the SD93

was calculated25

Studies published in a language other than English were excluded if a94

translation was not available In the RCT the control and intervention groups were analyzed95

as separate groups Efforts were made to contact authors for additional data regarding their96

respective studies97

Data extraction98

Data were independently extracted using standardized forms in the Excel spreadsheet which99

collected information on author title study type year published quality rating population100

characteristics (country age number of participants BMI parity) dietary collection method101

weeks gestation at time of data collection energy intake at two time points (t 1 and t2)102

macronutrient intake (g or energy) weight (t1 and t2) and GWG Data were cross-checked103

for accuracy and discrepancies resolved through discussion or involvement of a third party104

(JBM or JCYL)105

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Statistical analysis106

The primary outcome measures were standardized mean difference (SMD) in energy intake107

and GWG from early to late pregnancy Data were meta-analyzed collectively and stratified108

by developed and developing countries BMI (underweight normal overweight and obese)109

study design (observational and RCT) and dietary assessment methodology A random-effect110

model assumed heterogeneity among studies The Moodrsquos median test was used to test the111

equality of medians of SMD for energy intake and weight gain between developed and112

developing countries Because of small sample sizes within each BMI group the median113

GWG and interquartile range were used to assess mean weight gain compared to the IOM114

recommendations To calculate SMDs of mean weight gain between 2 timepoints (t1 and t2) a115

Spearman correlation coefficient of 085 was applied 26

Similarly for the 26 subgroups with116

reported energy intake at t1 and t2 a Spearman correlation coefficient of 074 was assumed For117

the studies which provided a range for weight rather than SD a value was imputed where r =118

085 Analyses were repeated using r = 08 or 09 and r = 07 or 08 for weight and energy119

respectively did not alter findings Data were analyzed using Comprehensive Meta-Analysis120

(CMA) package version 22 (Biostat Englewood New Jersey USA) and presented in the121

form of forest plots P-values of lt 001 were considered statistically significant as 7122

comparisons were made in this study including Body Mass Index countryrsquos economic status123

dietary collection method study type energy intake macronutrient distribution and124

gestational weight gain This was achieved using Bonferroni correction which divides the125

original P = 005 by the number of estimates made producing a new P-value = 0007 which126

was rounded to 001127

Assessment of Risk of Bias128

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Studies were individually assessed at a study level for bias and quality based on the Quality129

Criteria Checklist obtained from the American Dietetic Association Evidence Analysis130

Manual27

Only the studies which obtained a positive or neutral rating were included131

Publication bias was assessed by developing a funnel plot using standard difference in means132

and standard error as x and y-intercepts respectively133

RESULTS134

The electronic search revealed 2440 articles with a further 47 identified by hand-searching135

Of these 2301 did not meet inclusion criteria in the main because they did not report energy136

intake at 2 time points at least 12 weeks apart Three potential studies were excluded because137

of missing data28-30

The screening and selection process resulted in 18 studies of 2644138

women published between 1992 and 2013 (Figure 1) Fourteen studies were observational139

studies232431-42

most conducted in a representative population with a mean BMI in the140

normal range One study41

was in an overweight population and 1 study33

reported data by141

BMI category Of the 4 RCTs43-46

1 was an intervention in an overweight population44

and142

2 in an obese population4346

all aimed at limiting GWG One study45

had a population143

group with a mean BMI in the normal range with interventions comparing pregnancy144

outcomes on a low GI diet vs healthy eating advice145

Of the 18 studies that met inclusion criteria 2 obtained a positive quality rating and 16 were146

neutral (Table 1) Within studies the number of study participants ranged from 10 to 620147

with a mean (SD) age 296 (17) years and BMI 253 (49) kgm2 Seven studies had a148

retention rate of gt8232353638394145

6 ranged 63-78233134424346

1 of 5533

and 3 did149

not report243740

Sixteen subgroups reported total weeks gestation with an average of 396150

(043) weeks Only 6 studies reported parity mean = 18 (232) Dietary data was collected on151

average at 12 (26) weeks and 35 (21) weeks gestation The most frequent dietary collection152

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10

method was a weighed or estimated food record (n = 18) but 3 studies used a food diary 2153

employed repeat 24-hr recall and 2 used a diet history Characteristics of the included studies154

are summarized in Table 2155

Mean reported energy intake in the 18 studies was 8130 (1100) kJday and 8600 (1230)156

kJday in early and late pregnancy respectively The SMD between the 2 was 0266 ( P = 157

0016) a difference equivalent to ~475 kJday which did not reach the a priori level of158

significance (P = 001) (Figure 2) The mean GWG was 120 (28) kg representing a large159

statistically significant increase (SMD = 1306 P lt 00005) (Figure 3) However there was160

no correlation between mean incremental energy intake and GWG (Figure 4A r = 0321 P161

= 011) Only 1 study36

(18 women BMI 217 (3) kgm2) reported a mean increase in energy162

intake in line with pregnancy guidelines ie 1700 kJday (GWG 114 (37) kg)163

When comparing studies from developing (SMD = 0715 P = 0156 n = 4) and developed164

countries (SMD = 0175 P = 0010 n = 22) the change in energy intake did not reach165

statistical level of significance (P = 0277 Moodrsquos median Test) Similarly when comparing166

change in weight in both developed (SMD = 1310 P lt 00005 n = 22) and developing167

countries (SMD = 1297 P lt 00005 n = 4) the difference did not reach statistical168

significance (P = 1000 Mood Median Test)169

There was no difference in incremental energy intake across BMI groupings including obese170

(SMD = 0083 P = 0611 n = 5) underweight (SMD = 0103 P = 0421 n = 1) normal171

(SMD = 0314 P = 0033 n = 16) and overweight (SMD = 0378 P = 0019 n = 4) groups172

In contrast GWG differed significantly among the BMI groups with a downward trend in173

weight gain as BMI increased The largest effect was seen in the underweight group (SMD =174

1658 P lt 00005 n = 1) followed by normal weight (SMD = 1448 P lt 00005 n = 16)175

and overweight (SMD = 1245 P lt 00005 n = 4) The smallest GWG was seen in the obese176

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11

women (SMD = 00845 P lt 00005 n = 5) where all interventions were aimed at reducing177

GWG Despite this the inverse relationship between mean BMI and GWG did not reach178

statistical significance (Figure 4B r = -0363 P = 0068)179

Regardless of mean BMI mean weight gain remained within the range of 10 to 16 kg for the180

majority of studies Comparing GWG to IOM recommendations 1 study population181

classified as underweight did not meet the IOM recommendation of 125-18 kg12

with a182

mean weight gain of 109 kg Nine of 16 studies with a mean BMI in the normal range met183

IOM recommendations for GWG of 115 to 155 kg12

(IQR 113 to 148 kg median 131 kg)184

Two studies exceeded the range 4 studies fell short (102 to 114 kg) and 1 study was far185

below recommendations (61 kg) For overweight women only 1 study met the guidelines of186

a 65 to 115 kg gain12

1 fell short and the remaining 2 studies had a mean weight gain187

exceeding recommendations (IQR 77 to 142 kg median 127 kg) Of the 5 studies in obese188

populations 1 study fell within the guidelines of 50 to 90 kg12

the other 4 exceeded189

recommendations with a mean gain of 98 to 113 kg (IQR 82 to 121 kg median 106 kg)190

Comparing study types RCT showed a lower SMD in energy intake (SMD = 0081 P = 191

0354 n = 9) than observational studies (SMD = 0361 P = 0017 n = 17) but the difference192

was non-significant SMD for weight gain showed a large effect for both study types with193

RCTs showing a lower effect (SMD = 1090 P lt 00005 n = 9) than observational studies194

(SMD = 1431 P lt 00005 n = 17)195

Only when energy intake was assessed with diet history (SMD = 0481 P = 0006 n = 2) an196

increase in intake was observed Neither food records (SMD = 0181 P = 0015 n = 18) nor197

24 hour recalls (SMD = 1024 P = 0204 n = 2) were able to demonstrate a change in energy198

intake Interestingly studies using a food diary or photographs (n = 3) revealed a decrease in199

energy intake from early to late pregnancy (SMD = -0047 P = 0452 n = 3) although did not200

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12

reach statistical significance When analyzed according to macronutrient distribution (201

energy) there was a small but significant increase in carbohydrate intake between early and202

late pregnancy (SMD = 013 P = 0006) but no significant effect on fat or protein intake203

Risk of Bias of Included Studies204

A funnel plot (Figure 5) was produced with an almost even distribution of points to the left205

and right of the solid vertical line in the figure In addition Begg and Mazumdarrsquos rank206

correlation was 0163 (two-tailed p-value = 0252) and Eggerrsquos regression intercept was207

0528 (two-tailed P-value = 0826) which suggests that there is no publication bias in our208

meta-analysis209

COMMENT210

To our knowledge this is the first study to use meta-analysis to explore the relationship211

between changes in food energy intake in pregnancy and maternal weight gain In a212

comprehensive body of literature from developed and developing countries we found no213

relationship between the increment in energy intake from early to late pregnancy and the214

amount of GWG Indeed despite a large highly significant increase in body weight (+120215

kg) there was only a small non-significant increase in reported energy intake (+475 kJday)216

The findings were similar when the intervention arms of the RCT were removed from the217

meta-analysis The average energy intake increment was slightly higher (~650 kJday P =218

0009) but still much lower than the theoretical requirement of 14-19 MJday Furthermore219

weight gain in this sub-group was almost identical to the bigger cohort (+121 kg)220

Others have reported little or no difference in energy intake between pre-pregnancyearly221

pregnancy and late pregnancy47-49

A recently published longitudinal study by Abeysekera222

and colleagues 49 also found that energy intake did not differ between any trimester of223

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13

pregnancy On the other hand a review of 9 prospective studies from a previous generation224

of women (1971-1993)50

reported a mean increase in energy of 300 kJday comparable to225

the present analysis and also well below recommendations for pregnancy16

Unlike the226

present study however the rise in energy intake was not investigated in the light of GWG227

1617 While Streuling et al

11 conducted a systematic review of the literature they did not228

apply meta-analysis to either energy intake or GWG229

It is possible of course that underreporting of food intake explains our findings Higher230

levels of underreporting are more likely among those with a higher BMI and lower education231

levels4751

However underreporting is lower in pregnant women than in the general232

population with recorded rates of 11-33 in the first trimester 16 in the second and 18233

in the third4751

Higher rates during the first trimester may be due to inadequate dietary234

intake as a result of nausea and vomiting that commonly accompanies early gestation rather235

than underreporting itself47

This phenomenon however would inflate the difference in236

energy intake between early and late pregnancy237

We found that studies from developing countries had a higher increment in energy intake238

than those from developed countries although the difference was not significant A potential239

source of between-study variation is the dietary methodology Indeed it is well recognized240

that Food Frequency Questionnaires (FFQs) usually generate higher energy intake than241

dietary record estimates52 Individuals are also likely to alter food intake during their data242

collection period53

In our meta-analysis food records were the predominant dietary243

collection tool when compared to diet history and food diaries making it impossible to draw244

conclusions on the extent of under-reporting for each dietary assessment tool245

The lack of correlation between additional energy intake and GWG suggests that factors246

other than additional food intake may be responsible for the physiological weight gain of247

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14

pregnancy Well-designed studies using objective methodology under free-living conditions248

indicate that women markedly reduce energy expenditure as pregnancy progresses Energy249

savings of ~900 kJday have been documented19

with a reduction in physical activity level250

(PAL) from 19 to 17 in developing (62) and PAL 18 to 16 in developed countries19

This251

is achieved by a shift towards less vigorous activities and greater sedentary time1954

thereby252

counterbalancing a higher BMR55

With up to 60 of the present generation of pregnant253

women already inactive prior to conception54

and greater proportions beginning pregnancy254

overweight or obese declining physical activity and increasing sedentary behavior not255

higher food intake may explain the positive energy deposition of pregnancy256

Studies have also shown that metabolic and behavioral adaptations occur during pregnancy at257

varying levels of pre-pregnancy nutrition Gambian women display a decreased BMR and258

energy sparing adaptations early in pregnancy to allow for weight gain despite severe under-259

nutrition50

Leptin and insulin are important regulators of food intake and energy balance and260

may influence GWG Insulin resistance and leptin concentration increase as pregnancy261

progresses5657

There is a strong positive correlation between BMI and first and third262

trimester insulin and leptin concentrations41

with GWG increasing as baseline leptin263

concentrations rise57

Women with a normal pre-pregnancy BMI and elevated plasma leptin264

concentrations at baseline are predisposed to greater GWG57

265

Although our search strategy revealed almost 2500 potentially relevant studies the majority266

report energy intake at only one time point They are therefore unable to capture the change267

in energy intake or determine the relationship with weight gain over time Hence any single268

measurement may reflect a high pre-pregnancy energy intake rather than an absolute increase269

during pregnancy270

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15

This study has strengths and limitations Strict inclusionexclusion criteria resulted in two271

large pregnancy studies being excluded The Danish Health Cohort58

(n = 47003) and272

Nursesrsquo Health Study II59

(n = 13110) were excluded as dietary data were collected at one273

time point only Most studies were observational in nature and therefore susceptible to the274

effects of bias and confounding as well as the potential for measurement error and under or275

over reporting of dietary intake Effects were minimized by conducting an independent276

assessment of study quality stratifying data according to dietary collection method and study277

type and using the random-effect model in statistical analysis to assume heterogeneity In278

addition only articles published after 1990 were included as they were deemed more279

applicable to current context of high prevalence of overweight and obesity at the time of280

conception281

An important implication of our study is that the current generation of women are unlikely to282

meet the increased micronutrient requirements that are dictated by a growing fetus If dietary283

energy intake is not increased then iron calcium iodine folic acid and other critical284

nutrients will be ingested at levels similar to pre-pregnancy48

Our findings have important285

clinical implications for dietary advice for pregnancy with little or no emphasis on increasing286

food intake and more emphasis on higher dietary quality with richer micronutrient287

composition and recommended supplement use Strict adherence to current energy guidelines288

for pregnancy (+1100 kJday) could well result in excessive GWG with potentially adverse289

consequences for maternal and offspring health These findings call for more case cohort290

studies to evaluate the effect of a reduction of energy intake on gestational weight gain and291


CONCLUSIONS 293

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Despite a period of uniquely rapid weight gain women appear to consume only one quarter294

of the theoretical requirement for additional energy (2000 kJday in trimester 3) during295

pregnancy Given the high prevalence of obesity and excessive GWG in the current296

generation of women of reproductive age dietary guidelines for pregnancy may need to be297

revised298

Acknowledgements299

This research project was undertaken by two students JM and HJ as part of their300

MNUTRDIET degree with special thanks to TP for her work on statistical analysis and to301

supervisors JCYL and JBM for their time guidance and overall contribution in this research302

project303

Authorsrsquo contribution304

JCYL and JBM conceptualized the meta-analysis JM and HJ developed the search strategy305

under the guidance of JCYL and JCBM JM and HJ carried out the systematic search306

screened and reviewed the articles and extracted the data from the included studies JCYL307

and JBM acted as an adjudicating reviewer when required TP performed the meta-analysis308

All authors were involved in the interpretation of the data HJ and JM drafted the manuscript309

All authors have substantial input into the subsequent edits of the manuscript and have read310

and approved the final manuscript311

Conflict of Interest312

The authors declare they have no conflict of interest313

Funding314

The authors received no financial support for the research or authorship of this article315

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4 G983157983141983148983145983150983139983147983160 I D983141983158983148983145983141983143983141983154 983122 B983141983139983147983141983154983155 K 983126983137983150983155983137983150983156 G M983137983156983141983154983150983137983148 983151983138983141983155983145983156983161 983152983154983141983143983150983137983150983139983161 983139983151983149983152983148983145983139983137983156983145983151983150983155

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ACCEPTED MANUSCRIPT

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ACCEPTED MANUSCRIPT

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ACCEPTED MANUSCRIPT

22

Table 1 Assessing the risk of bias in individual studies using the Quality Criteria Checklist

obtained from the American Dietetic Association Evidence Analysis Manual

W a s t h e r e s e a r c h q u e s t i o n c l e a r l y s t a t e d

W a s t h e s e l e c t i o n o f s t u d y s u b j e c t s f r e e

f r o m b i a s

W e r e s t u d y g r o u p s c o m p a r a b l e

W a s m e t h o d o f h a n d l i n g w i t h d r a w a l s

d e s c r i b e d

W a s b l i n d i n g u s e d t o p r e v e n t

i n t r o d u c t i o n o f b i a s

W e r e i n t e r v e n t i o n p r o c e d u r e a n d

c o m p a r i s o n ( s ) d e s c r i b e d i n d e t a i l W h e r e

i n t e r v e n i n g f a c t o r s d e s c r i b e d

W e r e o

u t c o m e s c l e a r l y d e f i n e d a n d t h e

m e a s u r e m e n t s v a l i d a n d r e l i a b l e

W a s t h e s t a t i s t i c a l a n a l y s i s a p p r o p r i a t e

f o r t h e s t u d y d e s i g n a n d t y p e o f o u t c o m e

i n d i c a t o r s

A r e c o n c l u s i o n s s u p p o r t e d b y r e s u l t s

w i t h b i a s e s a n d l i m i t a t i o n s t a k e n i n t o

c o n s i d e

r a t i o n

I s b i a s d u e t o s t u d y rsquo s f u n d i n g o r

s p o n s o r s h i p u n l i k e l y

O v e r a l l Q u a l i t y R a t i n g

Alberti-

Fidanza et

al37

radic (-) (-) radic (x) radic radic radic radic radic Neutral

Carbone

et al34

radic radic radic radic (-) (-) radic (-) (-) radic Neutral

Conway

et al38

radic radic radic radic (-) (-) radic radic radic (-) Neutral

De

Vriese31 radic radic radic (-) (x) (-) radic radic radic radic Neutral

Fung et

al39

radic radic radic radic (-) radic radic radic radic radic Positive

Goodarzi

Khoigani

et al35

radic radic radic (-) (-) (-) radic (-) radic radic Neutral

Guelinckx

et al43

radic radic radic radic (-) (-) radic radic radic radic Neutral

Hronek et

al40

radic radic (-) (x) (x) (-) radic radic radic radic Neutral

Jansson etal41

radic radic radic radic (x) (-) radic radic radic radic Neutral

Kopp

Hoolihan

et al42

radic (-) radic radic (x) (-) radic radic (-) radic Neutral

Korpi

Hyovalti

et al44


Kubota et

al33

radic radic radic (x) (-) (-) (-) (-) radic radic Neutral

Lof et

al

23

radic (-) radic radic (x) (-) radic (-) radic radic Neutral

8172019 Je Beile 2015


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23

W a s t h e r e s e a r c h q u e s t i o n

c l e a r l y s t a t e d

W a s t h e s e l e c t i o n o f s t u d y

s u b j e c t s f r e e

f r o m b i a s


W a s m e t h o d o f h a n d l i n g w

i t h d r a w a l s

d e s c r i b e d



W e r e i n t e r v e n t i o n p r o c e d u

r e a n d

c o m p a r i s o n ( s ) d e s c r i b e d i n

d e t a i l W h e r e


W e r e o u t c o m e s c l e a r l y d e f

i n e d a n d t h e

m e a s u r e m e n t s v a l i d a n d r e

l i a b l e

W a s t h e s t a t i s t i c a l a n a l y s i s

a p p r o p r i a t e


i n d i c a t o r s

A r e c o n c l u s i o n s s u p p o r t e d

b y r e s u l t s

w i t h b i a s e s a n d l i m i t a t i o n s

t a k e n i n t o

c o n s i d e r a t i o n




Martinez

et al32

radic (-) (x) (-) (x) (-) (-) (x) (-) radic Neutral

Moses et

al45

radic radic (-) radic (x) (-) radic radic radic radic Neutral

Piers et

al36

radic (-) radic (-) (x) (-) radic radic (-) radic Neutral

Tabrizi et

al24

radic radic radic (-) (x) (-) (-) (-) radic radic Neutral

Wolff et

al46

radic radic radic radic radic radic radic radic radic radic Positive

Key radic = yes (x) = no (-) = unclear

8172019 Je Beile 2015


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Table 2 Study characteristics values are reported as mean plusmn standard deviation

Observational studies

Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Alberti-Fidanza

et al37

2002

To examine

longitudinally the total

antioxidant capacity

(ToAC) of women

from early pregnancy

to delivery and of their

newborns and relate

the results to the

dietary intake of the

same women during

pregnancy

Italy developed

n = 12

BMI 226 (55)

kgm2

Age 311 (42)

years

Parity 18 (09)

nil smokers

Collected by

qualified and

experienced

dietitians

using the diet

history

method during

the 1st 2

nd and

3rd

trimesters

Not stated It is import

monitor To

during the e

period of pr

and we sug

intakes of f

vegetables

necessary

antioxidant

and pro-vit

supplementregarding th

antioxidant

mothers an

newborns

particularly

preterm m

valuable in

for increasi

chance that

pregnancie

successfull

and achievephysiologic

deliveries

8172019 Je Beile 2015


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Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Carbone et al34

1992

Present patterns of

leukocyte energymetabolism during

normal pregnancy and

puerperium and its

possible relationship to

fetal growth and

maternal nutrient

intake

Spain

developed

n = 33

BMI 227 (22)

kgm2

Age 28 (36)

years

Parity of 1 n =

18 234 n = 15

3-day weight

food recordincluding 1

holiday

completed at

11 19 and 35

weeks

gestation

Gestational age less

than 12 weeks normalmenstrual cycles

before conception no

personal or family

history of metabolic

vascular andor genetic

disorders no apparent

disease present at the

time of visit and

pregnancy

classification as low

risk

There was

correlation proteinDN

and head

circumferen

weeks of ge

Findings m

a relationsh

between the

metabolism

maternal le

and fetal

developme

8172019 Je Beile 2015


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Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Conway et al38

1999

To explore the

relationship betweendietary restraint and

appropriateness of

weight gain during

pregnancy using AIM

criteria and to assess

dietary intake during

pregnancy in relation

to dietary restraint

England

developedRestrainedn = 32

BMI 22 (24)

kgm2

Age 312 (46)

years

Parity of 1 n =

28 2 n = 4

Unrestrainedn = 30

BMI 207 (196)

kgm2

Age 306 (36)

years

Parity of 1 n =

26 2 n = 4

7-day weighed

food record at12 and 30

weeks

gestation

Caucasian women

expecting their first orsecond singleton baby

over 18yrs of age and

free from any medical

condition which might

affect nutrition or fetal

outcomes

Providing p

women witguidance ab

appropriate

gains may b

beneficial

cessation o

during preg

associated w

weight gain

be prudent

accompany

advice abou

smoking dupregnancy

advice abou

and weight

8172019 Je Beile 2015


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Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

De Vriese et

al

31

2001

To determine the

relative validity andusefulness of a Dutch

food frequency

questionnaire (FFQ)

adapted to the Belgian

diet by comparing

dietary fat intake data

collected by this FFQ

with the 7d food

record in pregnant

Belgian women during

the 1st and 3

rd

trimesters

Belgium

developed

n = 26

BMI 22 (176-

293) kgm2

Age 30 (25-37)

years

All pregnant

women were

nulliparous

7-day

estimated foodrecord (EFR)

during the 1st

(median 15

weeks) and 3rd

(median 35

weeks)

trimesters A

FFQ

containing 180

of the most

common fat-

containingfoods was

conducted at

the same

timepoints

Data recorded

was based on

the EFR

First pregnancy

diastolic bloodpressure below 90mm

Hg not diabetic no

proteinuria and not

suffering from renal or

cardiovascular disease

The FFQ in

conjunctionindividual f

compositio

of Belgian

adequate m

reasonably

subjects acc

their dietary

intake

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Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Fung et al39

1997

To determine whether

fractional absorptionof a stable isotope of

zinc from a

standardized meal is

altered in well-

nourished women

followed from before

conception through

lactation and

determine whether the

change in fractional

zinc absorption (ZFA)

is related to indicatorsof maternal zinc status

USA developed

n = 13

BMI 223 (29)

kgm2

Age 30 (29)

years

Parity of 1 n =

10 2 n = 3

3-day weighed

food recordnon-

consecutive

days two

weekdays and

one weekend

at 8-10 weeks

24-26 weeks

and 34-36

weeks

gestation

Aged 22-40yrs body

mass index of 19-26kgm2 non-smoking

non-diabetic non-

vegetarian no drug and

alcohol use and no

previous obstetric or

gynecological

complications

Well-nouri

women meadditional n

zinc during

pregnancy

increasing

and by a 30

increase in

absorption

not signific

increase in

zinc was du

to an increa

intake of daFZA increa

early in the

period pres

an adaptatio

lactation pr

These data

that mechan

regulating z

homeostasi

between pr

and lactatio

8172019 Je Beile 2015


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Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Hronek et al40

2013

To evaluate the dietary

intake of energy andnutrients (DIEN) of

Czech pregnant

women and compare it

with recommended

daily allowances

(RDA)

Czechoslovakia

developed

Participants

were randomly

recruited from

both rural and

city regions

n = 152

BMI 211 (36)

kgm2

Age 289 (36)

years

7-day food

record onconsecutive

days using

scales and

household

measures at 0-

20 weeks 21-

29 weeks 30-

36 weeks and

37-39 weeks

gestation

Nonusers of chronic

medication non-smokers and non-

abusers of alcohol or

drugs and had parity

le2 Subjects were

euthyroid

normoglyceamic and

not anemic

Lower intak

energy andsome nutrie

relative to t

correspond

during preg

Evaluated D

correspond

body size v

Modificatio

intake or al

supplement

recommend

folic acid ivitamin D

iodine and

8172019 Je Beile 2015


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Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Jansson et al41

2008

To identify hormonal

factors that canexplain the link

between early

pregnancy BMI

maternal dietary

intake and birth

weight

Sweden

developing

n = 49

BMI 255 (69)

kgm2

Age 30 (45)

years

Diet history

coveringdietary intake

over a 24hr

period

collected by a

registered

dietitian at 8-

12 weeks and

32-35 weeks

gestation

Inclusion criteria

Scandinavian heritagehealthy and ge20 years

old

Exclusion criteria

smoking

vegetarianism assisted

reproduction

concurrent disease

such as eating disorder

or diabetes

development of

pregnancy

complications such asgestational diabetes

preeclampsia or

intrauterine growth

restriction

High first t

maternal seresistin and

trimester IG

were correl

increased b

weight We

that low ser

concentrati

IGFBP-1 re

link betwee

BMI and in

fetal growth

increasingbioavailabi

IGF-1 regu

placental nu

transport

8172019 Je Beile 2015


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Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Khoigani et

al

35

2012

To assess the

association betweenpreeclampsia risk and

the intake of 40 macro

and micro nutrients

during the first second

and third trimesters

based on demographic

and reproductive

characteristics and

physical activity of

pregnant women

Iran developing

n = 620 (t1 n =

584 t2 n = 510)

BMI 235 (39)

kgm2

Age 256 (44)

years

Parity 158

(076)

48-hour

dietary recallcompleted at

11-15 weeks

26 weeks and

34-37 weeks

gestation

Interviewers

were trained

Pregnant women who

did not have conditionssuch as factors causing

preeclampsia preterm

delivery low birth

weight and factors

which may affect

pregnancy outcomes

such as smoking drug

addiction digestive

and metabolic disease

hemoglobinopathies

eating disorders

allergies mentaldiseases and

malignancy

Mean value

saturated fafirst trimest

subjects wh

experienced

preeclamps

pregnancy

than in othe

women Int

manganese

C vitamin

and carboh

during the t

trimester wsignificantl

among preg

women wh

developed

preeclamps

significant

association

other micro

macro nutri

preeclamps

8172019 Je Beile 2015


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Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Kopp-Hoolihan

et al

42

1999

To assess how well-

nourished womenmeet the energy

demands of pregnancy

and to identify factors

that predict an

individualrsquos metabolic

response

USA developed

n = 10

BMI 231 (21)

kgm2

Age 291 (5)

years

3 day weighed

food recordcompleted

before

pregnancy and

at 8-10 24-26

34-36 weeks

gestation and

4-6 weeks

postpartum

Healthy non-smoking

women

Well-nouri

women useways to me

energy dem

pregnancy

reduction in

induced

thermogene

increased e

intake dep

less fat mas

predicted

8172019 Je Beile 2015


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Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Kubota et al33

2013

To investigate the

associations amongchanges in dietary

intake maternal

bodyweight and fetal

growth during

pregnancy

Japan

developedUnderweightn = 32

BMI 175 (01)

kgm2

Age 297 (52)

years

Normaln = 94

BMI 21 (18)

kgm2

Age 308 (51)

yearsOverweightn = 9

Age 286 (36)

years

BMI 334 (65)

kgm2

Digital images

taken beforeand after

meals on 3

consecutive

days at 14-16

25-27 and 32-

34 weeks

gestation a

dietitian

reviewed

photos and

recorded

intakevalidation of

method not

reported

Singleton pregnant

Japanese women wereincluded those which

had suffered from

obstetrical

complications such as

premature delivery

gestational diabetes

and pre-eclampsia or

did not submit digital

images were excluded

Dietary inta

similar thropregnancy

not correlat

fetal growth

Japanese na

recommend

advising ex

intake

8172019 Je Beile 2015


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Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Lof et al23

2009

Investigate whether

intakes of total dietaryfat types of fat and

weight gain are

associated with

estradiol and

progesterone levels in

plasma during

pregnancy

Sweden

developed

n = 226

BMI 229 (3)

kgm2

Age 32 (4) years

3 day weight

food record onconsecutive

days including

one weekend

at 12 25 and

33 weeks

gestation

Calculations

conducted by

a nutritionist

Women with multi-

fetal pregnanciesmissing data at

baseline questionnaire

or for measurements of

either body weight or

dietary intake were

excluded

No associat

between geweight gain

dietary fat i

(total or sub

and plasma

levels Prog

levels corre

weight gain

pregnancy

Martinez et

al32

1994

To determine how

gestational weight gain

varies according toBMI in a developing

nation Mexico

Mexico

developing

n = 36

BMI 235 (26)

kgm2

Age 31 (54)

years

Diet history

collected by

trainedinterviewers

twice per

month and

reported as

mean first and

third trimester

values

Women with an 18

month old or schooler

7-8 years in the SolisValley who became

pregnant at the time of

initial recruitment

provided that they were

no more than 5 months

pregnant

In this sam

women the

relationshipBMI at con

weight gain

pregnancy

was similar

women in U

States Low

maternal B

predicted sm

birth weigh

through at l

months of l

8172019 Je Beile 2015


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Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Piers et al36

1995

To determine changes

in maternal energymetabolism during

pregnancy and

lactation by comparing

a group of well-

nourished pregnant

and lactating Indian

women at 12 24 and

34 wk gestation and at

12 and 24 wk

postpartum with a

non-pregnant non-

lactating controlgroup

India

developing

n = 18

BMI 217 (24)

kgm2

Age 296 (52)

years

5 day

estimated foodrecord using

household

measures of

known volume

at 12 24 and

34 weeks

gestation and

12 and 24

weeks post-

partum

participants

were trained touse the

measure by a

dietitian who

also checked

all records

Pregnant subjects of

good health were non-smokers had no

appetite affected by

morning sickness

before the initial

metabolic

measurement at 12

weeks gestation

BMR is sig

higher duripregnancy

with non-pr

non-lactatin

and remain

even when

differences

weight are

for Well-n

Indian wom

weight and

similar to th

well-nourisWestern wo

Birth weigh

infants born

to be lower

cost of preg

estimated to

MJ close t

MJ estimat

FAOIWHO

8172019 Je Beile 2015


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Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Tabrizi et al24

2011

To assess the

relationship betweenenergy protein and

mineral intake of

pregnant women and

birth weight of their

neonates

Iran developing

n = 450

BMI 239 (38)

kgm2

Age 261 (58)

years

24 hour Recall

collected atthe end of the

1st 2

nd and 3

rd

trimesters

Qualification

training of

interviewer

not reported

Women of 16 to 40

years whocontinuously visited

health care centers

during the three

trimesters in Khoy city

Maternal en

protein caland zinc int

with higher

serum calci

and zinc in

birth weigh

neonates

Randomized controlled trials

Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

8172019 Je Beile 2015


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Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Guelinckx

et al

43

2010

Study which

degree ofintervention can

improve dietary

habits according to

the National Diet

Recommendations

increase physical

activity level in

obese pregnant

women and

control gestational

weight gain

Belgium

developedrandomly

assigned using

block

randomization

Control(routine)

n =43

BMI 335 (39)

kgm2

Age 294 (44)

yrs

Parity of 1 n = 17Passive (nutrition

and PA

brochure)

n = 37

BMI 334 (31)

kgm2

Age 287 (4) yrs

Parity of 1 n = 15

Active (brochure

+ group dietary

counselling)

n = 42BMI 341 (45)

kgm2

Age 28 (36) yrs

Parity of 1 n = 20

7-day food

recordsincluding both

weighed and

household

measures

during each

trimester of

pregnancy

Records were

checked by a

nutritionist

White women attending

the prenatal clinicbefore 15wks gestation

Exclusion criteria pre-

existing diabetes or

developing gestational

diabetes multiple

pregnancy premature

labor (lt37 wks

gestation) primary

needs for nutritional

advice in case of

metabolic disorder

kidney problems Crohndisease allergic

conditions and

inadequate knowledge

of the Dutch language

because this language

was used for both the

brochure and group

discussions

A lifestyle interv

based on a brochalone or group se

combined with

individual advice

improve dietary h

throughout pregn

in obese women

in the absence of

medical or obstet

complications

maintaining or

increasing PA du

pregnancy is diffTo obtain a signi

decrease in GWG

individually desig

caloric intake res

based on energy

expenditure data

be included

8172019 Je Beile 2015


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Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Korpi-

Hyovalti etal44

2012

To evaluate the

effect of intensivedietary therapy on

quality of diet

weight gain and

birth weight in

women at high risk

of gestational

diabetes mellitus

Finland

developedrandomized into

group 1 or 2

using computed

randomization

Close follow up(general

information on

diet and PA)

n = 27

BMI 255 (34)

kgm2

Lifestyle

intervention (individualized

nutrition advice)

n = 27

BMI 273 (6)

kgm2

4 day weighed


days including

one weekend

completed at

8-12 26-28

and 36-40

weeks

gestation

Records

checked by a

nutritionist

A three-factor

eating

questionnaire

was also used

at the 1st and

3rd

trimester

Women with one or

more risk factors forgestational diabetes

venous plasma glucose

concentration after 12h

overnight fasting was

48-55 mmoll and the

2h oral glucose

tolerance test plasma

glucose lt78 mmoll

were recruited

Women diagnosed with

GDM at 8-12 wks

gestation wereexcluded

There were no cl

differences in satfat and fiber intak

however

polyunsaturated f

increase in the lif

intervention grou

Intensive weight

education led to a

somewhat lower

gain during pregn

and higher birth w

of the infants in

lifestyle intervenbut no difference

macrosomia whe

compared to the c

follow up group

8172019 Je Beile 2015


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Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Moses et al45

2014

To determine

whether offeringlow glycemic

index (LGI) dietary

advice at

the first antenatal

visit would result

in a lower fetal

birth weight

birth percentile

and ponderal index

(PI) than providing

healthy eating

(HE) advice

Australia

developedrandomly

assigned using

computer-

generated

random numbers

1 or 2

Healthy Eating

(counselled to

follow a healthy

diet based on the

AGHE4

) n = 280

BMI 247 (5)

kgm2

Age 299 (5) yrs

Low Glycemic

Index

(individualized

nutrition advice

on a LGI diet)

n = 296

BMI 243 (52)

kgm2 Age 299 (52)

yrs

3 day


household

measures at 16

and 36 weeks

gestation

records

reviewed by a

dietitian

Enrolment at lt 20 wk

of gestation with asingleton pregnancy at

least 18 years old

ability to read and

understand English

language and ability to

comply with visit

schedules Subjects

excluded if they had

diabetes or previous


special dietary needs

the presence of medicalconditions that could

compromise their

metabolic status or the

use of medications that

were likely to influence

body weight

A low intensity d

intervention withcompared with H

in pregnancy did

result in significa

differences in bir

weight fetal perc

of PI

8172019 Je Beile 2015


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Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Wolff et

al

46

2008

To determine

whether a 10 hourdietary

consultations

restricts weight

gain in obese

women and

whether this

restriction impacts

on pregnancy-

induced changes in

glucose

metabolism

Denmark

developedRandomized into

group 1 or 2

using computed

randomization

Control (general

information on

diet and PA)

n = 27

BMI 255 (34)

kgm2

Age 30 (5) yearsIntervention (10

x 1 hour

consultations)

n = 27

BMI 273 (6)

kgm2

Age 28 (4) years

7 day weighed

food record atinclusion (15

plusmn 3 wks) 27

and 36 weeks

gestation

Pregnant obese women

(BMI gt30) in their earlypregnancy were

recruited Exclusion

criteria included

smoking lt18 year old

or gt45 year old

multiple pregnancy or

medical conditions

which impact fetal

growth

Restriction of

gestational weighin obese women

achievable and re

the deterioration

glucose metaboli

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983120983137983143983141 983092983089 983151983142 983092983090

FIGURE LEGENDS

Figure 1 The screening and selection process

Figure 2 Meta-analysis of the standardized mean difference in energy intake between early

and late pregnancy Overall effect shows a small increase in energy intake which is not

significant Data are expressed as standardized mean difference using r = 074 from

Spearmanrsquos correlation coefficient with random effects Study names with an additional

numerical value represent a different population group within the study eg control and

intervention groups in a randomized controlled trial

Figure 3 Meta-analysis of the standardized mean difference in gestational weight gain

throughout pregnancy Overall effect shows a significant increase in maternal weight Data

are expressed as standardized mean difference using r = 085 from Spearmanrsquos correlation

coefficient with random effects Study names with an additional numerical value represent a

different population group within the study for example control and intervention groups in a

randomized controlled trial

Figure 4 A Exploring a correlation between mean difference in energy intake between early

and late pregnancy and gestational weight gain There is no significant correlation between

mean energy increase and mean gestational weight gain at a 1 significance level (r = 0321

P = 0110) B Scatterplot of gestational weight gain (GWG) compared to mean body mass

index (BMI) for each study population Shaded areas represent the Institute of Medicine

guidelines for gestational weight gain (GWG) for each BMI category underweight (BMI lt

185 kgm2 GWG 125 to18 kg) normal (BMI 185 to 249 kgm

2 GWG 115 to 155 kg)

overweight (BMI 250 to 299 kgm2 GWG 65 to 115 kg) and obese (BMI ge 30 kgm

2

GWG 50 to 90 kg)

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983120983137983143983141 983092983090 983151983142 983092983090

Figure 5 Assessing the risk of publication bias using standard error by standard difference in

means from 14 observational studies and 4 randomized controlled trials The solid angled

lines indicate a triangular region where 95 of studies are expected to lie in the absence of

both biases and heterogeneity and solid vertical line represents no intervention effect Begg

and Mazumdarrsquos rank correlation was 0163 (two-tailed p-value = 0252) and Eggerrsquos

regression intercept was 0528 (two-tailed p-value=0826)

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1


Ms Hiba JEBEILE MNUTRDIET Ms Jovana MIJATOVIC MNUTRDIET Dr

Jimmy Chun Yu LOUIE PHD Dr Tania PRVAN PHD Dr Jennie C BRAND-

MILLER PHD

School of Molecular Bioscience and Charles Perkins Centre The University of Sydney

Camperdown 2006 NSW Australia (HJ JM JCYL JCBM)

Department of Statistics Faculty of Science and Engineering Macquarie University Sydney

2109 NSW Australia (TP)

Equal contribution from these authors

Author surnames JEBEILE MIJATOVIC LOUIE PRVAN BRAND-MILLER

Source(s) of support No external funding was required to facilitate this research or

preparation of the manuscript

Conflict of interest statement The authors report no conflict of interest

Corresponding author

Professor Jennie C Brand-Miller

Level 6 West The Hub

D17 Charles Perkins Centre

The University of Sydney NSW 2006

Australia

Ph +61 2 93513759

E jenniebrandmillersydneyeduau

Reprints will not be available Abbreviations BMI body mass index BMR basal metabolic rate GDM gestational

diabetes mellitus GWG gestational weight gain IOM Institute of Medicine PAL physical

activity level RCT randomized controlled trial SD standard deviation SMD standardized

mean difference t time point

Word count Abstract = 333 words Main text = 3480 words

Number of tables and figures 2 and 5 respectively

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ABSTRACT






weight gain6


















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outcomes31


trimester33

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INTRODUCTION34


obese1-3





5 pre-term birth


739



41









46












55



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METHODS68

Search Strategy69




by IOM guidelines20










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7




Study Selection85





In88






was calculated25





Data extraction98







(JBM or JCYL)105

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Manual27




RESULTS134







studies232431-42




reported data by141



and142



had a population143







6 ranged 63-78233134424346

1 of 5533

and 3 did149

not report243740




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with a182
















(SMD = 1431 P lt 00005 n = 17)195






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meta-analysis209

COMMENT210















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of women (1971-1993)50



Unlike the226







levels4751



in the third4751











collection period53






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This251


thereby252










nutrition50



progresses5657







265





during pregnancy270

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(n = 47003) and272










conception281













CONCLUSIONS 293

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revised298

Acknowledgements299




project303











Funding314


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983118983157983156983154983145983156983145983151983150 983122983141983155983141983137983154983139983144 983122983141983158983145983141983159983155 199811(2)231983085253

54 983120983151983157983140983141983158983145983143983150983141 M983123 983119983139983151983150983150983151983154 983120J A 983122983141983158983145983141983159 983151983142 983120983144983161983155983145983139983137983148 A983139983156983145983158983145983156983161 983120983137983156983156983141983154983150983155 983145983150 983120983154983141983143983150983137983150983156 983127983151983149983141983150 983137983150983140

983124983144983141983145983154 983122983141983148983137983156983145983151983150983155983144983145983152 983156983151 983120983155983161983139983144983151983148983151983143983145983139983137983148 H983141983137983148983156983144 983126983151983148 36 C983144983137983149 A983140983145983155 I983150983156983141983154983150983137983156983145983151983150983137983148 20061998308519

55 D983157983142983151983157983154 DL 983122983141983145983150983137 JC 983123983152983157983154983154 GB E983150983141983154983143983161 983145983150983156983137983147983141 983137983150983140 983141983160983152983141983150983140983145983156983157983154983141 983151983142 983142983154983141983141983085983148983145983158983145983150983143 983148983137983139983156983137983156983145983150983143

C983151983148983151983149983138983145983137983150 983159983151983149983141983150 983145983150 983137983150 983157983154983138983137983150 983155983141983156983156983145983150983143 983109983157983154983151983152983141983137983150 983114983151983157983154983150983137983148 983151983142 983107983148983145983150983145983139983137983148 983118983157983156983154983145983156983145983151983150

200256(3)205983085213

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

21

56 L983137983145983150 K983129 C983137983156983137983148983137983150983151 983120M M983141983156983137983138983151983148983145983139 C983144983137983150983143983141983155 983145983150 983120983154983141983143983150983137983150983139983161 983107983148983145983150983145983139983137983148 983151983138983155983156983141983156983154983145983139983155 983137983150983140 983143983161983150983141983139983151983148983151983143983161

200750(4)938983085948

57 983123983156983141983145983150 983124983120 983123983139983144983151983148983148 983124983119 983123983139983144983148983157983156983141983154 MD 983123983139983144983154983151983141983140983141983154 CM 983120983148983137983155983149983137 983148983141983152983156983145983150 983145983150983142983148983157983141983150983139983141983155 983143983141983155983156983137983156983145983151983150983137983148 983159983141983145983143983144983156

983143983137983145983150 983137983150983140 983152983151983155983156983152983137983154983156983157983149 983159983141983145983143983144983156 983154983141983156983141983150983156983145983151983150 983105983149983141983154983145983139983137983150 983114983151983157983154983150983137983148 983151983142 983107983148983145983150983145983139983137983148 983118983157983156983154983145983156983145983151983150

199868(6)12369830851240

58 K983150983157983140983155983141983150 983126K H983141983145983156983149983137983150983150 BL H983137983148983148983140983151983154983155983155983151983150 983124I 983123983151983154983141983150983155983141983150 983124IA 983119983148983155983141983150 983123F M983137983156983141983154983150983137983148 983140983145983141983156983137983154983161983143983148983161983139983137983141983149983145983139 983148983151983137983140 983140983157983154983145983150983143 983152983154983141983143983150983137983150983139983161 983137983150983140 983143983141983155983156983137983156983145983151983150983137983148 983159983141983145983143983144983156 983143983137983145983150 983138983145983154983156983144 983159983141983145983143983144983156 983137983150983140 983152983151983155983156983152983137983154983156983157983149

983159983141983145983143983144983156 983154983141983156983141983150983156983145983151983150 A 983155983156983157983140983161 983159983145983156983144983145983150 983156983144983141 D983137983150983145983155983144 N983137983156983145983151983150983137983148 B983145983154983156983144 C983151983144983151983154983156 983106983154983145983156983145983155983144 983114983151983157983154983150983137983148 983151983142

983118983157983156983154983145983156983145983151983150 2013109(8)14719830851478

59 983130983144983137983150983143 C L983145983157 983123 983123983151983148983151983149983151983150 CG H983157 FB D983145983141983156983137983154983161 983142983145983138983141983154 983145983150983156983137983147983141 983140983145983141983156983137983154983161 983143983148983161983139983141983149983145983139 983148983151983137983140 983137983150983140 983156983144983141 983154983145983155983147

983142983151983154 983143983141983155983156983137983156983145983151983150983137983148 983140983145983137983138983141983156983141983155 983149983141983148983148983145983156983157983155 983108983145983137983138983141983156983141983155 983107983137983154983141 200629(10)22239830852230

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

22





f r o m b i a s



d e s c r i b e d






W e r e o





i n d i c a t o r s



c o n s i d e

r a t i o n




Alberti-

Fidanza et

al37


Carbone

et al34


Conway

et al38


De


Fung et

al39


Goodarzi

Khoigani

et al35


Guelinckx

et al43


Hronek et

al40


Jansson etal41


Kopp

Hoolihan

et al42


Korpi

Hyovalti

et al44


Kubota et

al33


Lof et

al

23


8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

23





f r o m b i a s



i t h d r a w a l s

d e s c r i b e d




r e a n d





i n e d a n d t h e


l i a b l e




i n d i c a t o r s


b y r e s u l t s


t a k e n i n t o





Martinez

et al32


Moses et

al45


Piers et

al36


Tabrizi et

al24


Wolff et

al46



8172019 Je Beile 2015


ACCEPTED MANUSCRIPT



Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Alberti-Fidanza

et al37

2002

To examine



(ToAC) of women



newborns and relate

the results to the


same women during

pregnancy

Italy developed

n = 12

BMI 226 (55)

kgm2

Age 311 (42)

years

Parity 18 (09)

nil smokers

Collected by

qualified and

experienced

dietitians

using the diet

history

method during

the 1st 2

nd and

3rd

trimesters


monitor To

during the e

period of pr

and we sug

intakes of f

vegetables

necessary

antioxidant

and pro-vit


antioxidant

mothers an

newborns

particularly

preterm m

valuable in

for increasi

chance that

pregnancie

successfull


deliveries

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Carbone et al34

1992

Present patterns of



puerperium and its


fetal growth and

maternal nutrient

intake

Spain

developed

n = 33

BMI 227 (22)

kgm2

Age 28 (36)

years

Parity of 1 n =

18 234 n = 15

3-day weight


holiday

completed at

11 19 and 35

weeks

gestation




personal or family





time of visit and

pregnancy


risk

There was


and head

circumferen

weeks of ge

Findings m

a relationsh

between the

metabolism

maternal le

and fetal

developme

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Conway et al38

1999

To explore the


appropriateness of

weight gain during

pregnancy using AIM





England


BMI 22 (24)

kgm2

Age 312 (46)

years

Parity of 1 n =

28 2 n = 4

Unrestrainedn = 30

BMI 207 (196)

kgm2

Age 306 (36)

years

Parity of 1 n =

26 2 n = 4

7-day weighed


weeks

gestation

Caucasian women






outcomes

Providing p


appropriate

gains may b

beneficial

cessation o

during preg

associated w

weight gain

be prudent

accompany

advice abou

smoking dupregnancy

advice abou

and weight

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

De Vriese et

al

31

2001

To determine the


food frequency

questionnaire (FFQ)


diet by comparing



with the 7d food

record in pregnant


the 1st and 3

rd

trimesters

Belgium

developed

n = 26

BMI 22 (176-

293) kgm2

Age 30 (25-37)

years

All pregnant

women were

nulliparous

7-day


during the 1st

(median 15

weeks) and 3rd

(median 35

weeks)

trimesters A

FFQ

containing 180

of the most

common fat-

containingfoods was

conducted at

the same

timepoints

Data recorded

was based on

the EFR

First pregnancy


Hg not diabetic no

proteinuria and not



The FFQ in


compositio

of Belgian

adequate m

reasonably

subjects acc

their dietary

intake

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Fung et al39

1997



zinc from a


altered in well-

nourished women


conception through

lactation and





USA developed

n = 13

BMI 223 (29)

kgm2

Age 30 (29)

years

Parity of 1 n =

10 2 n = 3

3-day weighed

food recordnon-

consecutive

days two

weekdays and

one weekend

at 8-10 weeks

24-26 weeks

and 34-36

weeks

gestation

Aged 22-40yrs body


non-diabetic non-


alcohol use and no


gynecological

complications

Well-nouri


zinc during

pregnancy

increasing

and by a 30

increase in

absorption

not signific

increase in

zinc was du

to an increa


early in the

period pres

an adaptatio

lactation pr

These data

that mechan

regulating z

homeostasi

between pr

and lactatio

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Hronek et al40

2013



Czech pregnant


with recommended

daily allowances

(RDA)

Czechoslovakia

developed

Participants

were randomly

recruited from

both rural and

city regions

n = 152

BMI 211 (36)

kgm2

Age 289 (36)

years

7-day food


days using

scales and

household

measures at 0-

20 weeks 21-

29 weeks 30-

36 weeks and

37-39 weeks

gestation

Nonusers of chronic




le2 Subjects were

euthyroid

normoglyceamic and

not anemic

Lower intak


relative to t

correspond

during preg

Evaluated D

correspond

body size v

Modificatio

intake or al

supplement

recommend


iodine and

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Jansson et al41

2008



between early

pregnancy BMI

maternal dietary

intake and birth

weight

Sweden

developing

n = 49

BMI 255 (69)

kgm2

Age 30 (45)

years

Diet history


over a 24hr

period

collected by a

registered

dietitian at 8-

12 weeks and

32-35 weeks

gestation

Inclusion criteria


old

Exclusion criteria

smoking


reproduction

concurrent disease


or diabetes

development of

pregnancy


preeclampsia or

intrauterine growth

restriction

High first t


trimester IG

were correl

increased b

weight We

that low ser

concentrati

IGFBP-1 re

link betwee

BMI and in

fetal growth


IGF-1 regu

placental nu

transport

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Khoigani et

al

35

2012

To assess the



and micro nutrients




and reproductive

characteristics and


pregnant women

Iran developing

n = 620 (t1 n =

584 t2 n = 510)

BMI 235 (39)

kgm2

Age 256 (44)

years

Parity 158

(076)

48-hour


11-15 weeks

26 weeks and

34-37 weeks

gestation

Interviewers

were trained

Pregnant women who



delivery low birth

weight and factors

which may affect

pregnancy outcomes


addiction digestive


hemoglobinopathies

eating disorders


malignancy

Mean value


subjects wh

experienced

preeclamps

pregnancy

than in othe

women Int

manganese

C vitamin

and carboh

during the t


among preg

women wh

developed

preeclamps

significant

association

other micro

macro nutri

preeclamps

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Kopp-Hoolihan

et al

42

1999

To assess how well-




that predict an


response

USA developed

n = 10

BMI 231 (21)

kgm2

Age 291 (5)

years

3 day weighed


before

pregnancy and

at 8-10 24-26

34-36 weeks

gestation and

4-6 weeks

postpartum

Healthy non-smoking

women

Well-nouri

women useways to me

energy dem

pregnancy

reduction in

induced

thermogene

increased e

intake dep

less fat mas

predicted

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Kubota et al33

2013

To investigate the


intake maternal


growth during

pregnancy

Japan


BMI 175 (01)

kgm2

Age 297 (52)

years

Normaln = 94

BMI 21 (18)

kgm2

Age 308 (51)


Age 286 (36)

years

BMI 334 (65)

kgm2

Digital images


meals on 3

consecutive

days at 14-16

25-27 and 32-

34 weeks

gestation a

dietitian

reviewed

photos and

recorded

intakevalidation of

method not

reported

Singleton pregnant


had suffered from

obstetrical


premature delivery





Dietary inta


not correlat

fetal growth

Japanese na

recommend

advising ex

intake

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Lof et al23

2009

Investigate whether


weight gain are

associated with

estradiol and


plasma during

pregnancy

Sweden

developed

n = 226

BMI 229 (3)

kgm2

Age 32 (4) years

3 day weight


days including

one weekend

at 12 25 and

33 weeks

gestation

Calculations

conducted by

a nutritionist

Women with multi-





dietary intake were

excluded

No associat


dietary fat i

(total or sub

and plasma

levels Prog

levels corre

weight gain

pregnancy

Martinez et

al32

1994

To determine how



nation Mexico

Mexico

developing

n = 36

BMI 235 (26)

kgm2

Age 31 (54)

years

Diet history

collected by

trainedinterviewers

twice per

month and

reported as

mean first and

third trimester

values

Women with an 18




initial recruitment



pregnant

In this sam

women the


weight gain

pregnancy

was similar

women in U

States Low

maternal B

predicted sm

birth weigh

through at l

months of l

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Piers et al36

1995



pregnancy and


a group of well-

nourished pregnant


women at 12 24 and


12 and 24 wk

postpartum with a

non-pregnant non-


India

developing

n = 18

BMI 217 (24)

kgm2

Age 296 (52)

years

5 day


household

measures of

known volume

at 12 24 and

34 weeks

gestation and

12 and 24

weeks post-

partum

participants


measure by a

dietitian who

also checked

all records




morning sickness

before the initial

metabolic

measurement at 12

weeks gestation

BMR is sig


with non-pr

non-lactatin

and remain

even when

differences

weight are

for Well-n

Indian wom

weight and

similar to th


Birth weigh

infants born

to be lower

cost of preg

estimated to

MJ close t

MJ estimat

FAOIWHO

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Tabrizi et al24

2011

To assess the


mineral intake of

pregnant women and


neonates

Iran developing

n = 450

BMI 239 (38)

kgm2

Age 261 (58)

years

24 hour Recall


1st 2

nd and 3

rd

trimesters

Qualification

training of

interviewer

not reported

Women of 16 to 40


health care centers

during the three


Maternal en


with higher

serum calci

and zinc in

birth weigh

neonates


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Guelinckx

et al

43

2010

Study which


improve dietary

habits according to

the National Diet

Recommendations

increase physical

activity level in

obese pregnant

women and

control gestational

weight gain

Belgium

developedrandomly

assigned using

block

randomization

Control(routine)

n =43

BMI 335 (39)

kgm2

Age 294 (44)

yrs


and PA

brochure)

n = 37

BMI 334 (31)

kgm2

Age 287 (4) yrs

Parity of 1 n = 15

Active (brochure

+ group dietary

counselling)

n = 42BMI 341 (45)

kgm2

Age 28 (36) yrs

Parity of 1 n = 20

7-day food


weighed and

household

measures

during each

trimester of

pregnancy

Records were

checked by a

nutritionist






diabetes multiple

pregnancy premature

labor (lt37 wks

gestation) primary


advice in case of

metabolic disorder


conditions and





brochure and group

discussions

A lifestyle interv


combined with

individual advice

improve dietary h

throughout pregn

in obese women

in the absence of

medical or obstet

complications

maintaining or

increasing PA du


decrease in GWG

individually desig

caloric intake res

based on energy

expenditure data

be included

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Korpi-

Hyovalti etal44

2012

To evaluate the


quality of diet

weight gain and

birth weight in

women at high risk

of gestational

diabetes mellitus

Finland


group 1 or 2

using computed

randomization


information on

diet and PA)

n = 27

BMI 255 (34)

kgm2

Lifestyle


nutrition advice)

n = 27

BMI 273 (6)

kgm2

4 day weighed


days including

one weekend

completed at

8-12 26-28

and 36-40

weeks

gestation

Records

checked by a

nutritionist

A three-factor

eating

questionnaire

was also used

at the 1st and

3rd

trimester

Women with one or





48-55 mmoll and the

2h oral glucose


glucose lt78 mmoll

were recruited


GDM at 8-12 wks


There were no cl


however

polyunsaturated f

increase in the lif

intervention grou

Intensive weight

education led to a

somewhat lower

gain during pregn

and higher birth w

of the infants in


macrosomia whe

compared to the c

follow up group

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Moses et al45

2014

To determine


index (LGI) dietary

advice at

the first antenatal

visit would result

in a lower fetal

birth weight

birth percentile

and ponderal index

(PI) than providing

healthy eating

(HE) advice

Australia

developedrandomly

assigned using

computer-

generated

random numbers

1 or 2

Healthy Eating

(counselled to

follow a healthy

diet based on the

AGHE4

) n = 280

BMI 247 (5)

kgm2

Age 299 (5) yrs

Low Glycemic

Index

(individualized

nutrition advice

on a LGI diet)

n = 296

BMI 243 (52)

kgm2 Age 299 (52)

yrs

3 day


household

measures at 16

and 36 weeks

gestation

records

reviewed by a

dietitian



least 18 years old

ability to read and

understand English


comply with visit

schedules Subjects






compromise their




body weight

A low intensity d


in pregnancy did

result in significa

differences in bir

weight fetal perc

of PI

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Wolff et

al

46

2008

To determine


consultations

restricts weight

gain in obese

women and

whether this

restriction impacts

on pregnancy-

induced changes in

glucose

metabolism

Denmark


group 1 or 2

using computed

randomization

Control (general

information on

diet and PA)

n = 27

BMI 255 (34)

kgm2


x 1 hour

consultations)

n = 27

BMI 273 (6)

kgm2

Age 28 (4) years

7 day weighed


plusmn 3 wks) 27

and 36 weeks

gestation



recruited Exclusion

criteria included


or gt45 year old


medical conditions

which impact fetal

growth

Restriction of


achievable and re

the deterioration

glucose metaboli

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983120983137983143983141 983092983089 983151983142 983092983090

FIGURE LEGENDS





















2 GWG 115 to 155 kg)


2

GWG 50 to 90 kg)

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983120983137983143983141 983092983090 983151983142 983092983090







8172019 Je Beile 2015


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8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

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ABSTRACT






weight gain6


















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outcomes31


trimester33

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INTRODUCTION34


obese1-3





5 pre-term birth


739



41









46












55



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METHODS68

Search Strategy69




by IOM guidelines20










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Study Selection85





In88






was calculated25





Data extraction98







(JBM or JCYL)105

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Manual27




RESULTS134







studies232431-42




reported data by141



and142



had a population143







6 ranged 63-78233134424346

1 of 5533

and 3 did149

not report243740




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with a182
















(SMD = 1431 P lt 00005 n = 17)195






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meta-analysis209

COMMENT210















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of women (1971-1993)50



Unlike the226







levels4751



in the third4751











collection period53






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This251


thereby252










nutrition50



progresses5657







265





during pregnancy270

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(n = 47003) and272










conception281













CONCLUSIONS 293

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revised298

Acknowledgements299




project303











Funding314


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ACCEPTED MANUSCRIPT

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55 D983157983142983151983157983154 DL 983122983141983145983150983137 JC 983123983152983157983154983154 GB E983150983141983154983143983161 983145983150983156983137983147983141 983137983150983140 983141983160983152983141983150983140983145983156983157983154983141 983151983142 983142983154983141983141983085983148983145983158983145983150983143 983148983137983139983156983137983156983145983150983143

C983151983148983151983149983138983145983137983150 983159983151983149983141983150 983145983150 983137983150 983157983154983138983137983150 983155983141983156983156983145983150983143 983109983157983154983151983152983141983137983150 983114983151983157983154983150983137983148 983151983142 983107983148983145983150983145983139983137983148 983118983157983156983154983145983156983145983151983150

200256(3)205983085213

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

21

56 L983137983145983150 K983129 C983137983156983137983148983137983150983151 983120M M983141983156983137983138983151983148983145983139 C983144983137983150983143983141983155 983145983150 983120983154983141983143983150983137983150983139983161 983107983148983145983150983145983139983137983148 983151983138983155983156983141983156983154983145983139983155 983137983150983140 983143983161983150983141983139983151983148983151983143983161

200750(4)938983085948

57 983123983156983141983145983150 983124983120 983123983139983144983151983148983148 983124983119 983123983139983144983148983157983156983141983154 MD 983123983139983144983154983151983141983140983141983154 CM 983120983148983137983155983149983137 983148983141983152983156983145983150 983145983150983142983148983157983141983150983139983141983155 983143983141983155983156983137983156983145983151983150983137983148 983159983141983145983143983144983156

983143983137983145983150 983137983150983140 983152983151983155983156983152983137983154983156983157983149 983159983141983145983143983144983156 983154983141983156983141983150983156983145983151983150 983105983149983141983154983145983139983137983150 983114983151983157983154983150983137983148 983151983142 983107983148983145983150983145983139983137983148 983118983157983156983154983145983156983145983151983150

199868(6)12369830851240

58 K983150983157983140983155983141983150 983126K H983141983145983156983149983137983150983150 BL H983137983148983148983140983151983154983155983155983151983150 983124I 983123983151983154983141983150983155983141983150 983124IA 983119983148983155983141983150 983123F M983137983156983141983154983150983137983148 983140983145983141983156983137983154983161983143983148983161983139983137983141983149983145983139 983148983151983137983140 983140983157983154983145983150983143 983152983154983141983143983150983137983150983139983161 983137983150983140 983143983141983155983156983137983156983145983151983150983137983148 983159983141983145983143983144983156 983143983137983145983150 983138983145983154983156983144 983159983141983145983143983144983156 983137983150983140 983152983151983155983156983152983137983154983156983157983149

983159983141983145983143983144983156 983154983141983156983141983150983156983145983151983150 A 983155983156983157983140983161 983159983145983156983144983145983150 983156983144983141 D983137983150983145983155983144 N983137983156983145983151983150983137983148 B983145983154983156983144 C983151983144983151983154983156 983106983154983145983156983145983155983144 983114983151983157983154983150983137983148 983151983142

983118983157983156983154983145983156983145983151983150 2013109(8)14719830851478

59 983130983144983137983150983143 C L983145983157 983123 983123983151983148983151983149983151983150 CG H983157 FB D983145983141983156983137983154983161 983142983145983138983141983154 983145983150983156983137983147983141 983140983145983141983156983137983154983161 983143983148983161983139983141983149983145983139 983148983151983137983140 983137983150983140 983156983144983141 983154983145983155983147

983142983151983154 983143983141983155983156983137983156983145983151983150983137983148 983140983145983137983138983141983156983141983155 983149983141983148983148983145983156983157983155 983108983145983137983138983141983156983141983155 983107983137983154983141 200629(10)22239830852230

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

22





f r o m b i a s



d e s c r i b e d






W e r e o





i n d i c a t o r s



c o n s i d e

r a t i o n




Alberti-

Fidanza et

al37


Carbone

et al34


Conway

et al38


De


Fung et

al39


Goodarzi

Khoigani

et al35


Guelinckx

et al43


Hronek et

al40


Jansson etal41


Kopp

Hoolihan

et al42


Korpi

Hyovalti

et al44


Kubota et

al33


Lof et

al

23


8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

23





f r o m b i a s



i t h d r a w a l s

d e s c r i b e d




r e a n d





i n e d a n d t h e


l i a b l e




i n d i c a t o r s


b y r e s u l t s


t a k e n i n t o





Martinez

et al32


Moses et

al45


Piers et

al36


Tabrizi et

al24


Wolff et

al46



8172019 Je Beile 2015


ACCEPTED MANUSCRIPT



Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Alberti-Fidanza

et al37

2002

To examine



(ToAC) of women



newborns and relate

the results to the


same women during

pregnancy

Italy developed

n = 12

BMI 226 (55)

kgm2

Age 311 (42)

years

Parity 18 (09)

nil smokers

Collected by

qualified and

experienced

dietitians

using the diet

history

method during

the 1st 2

nd and

3rd

trimesters


monitor To

during the e

period of pr

and we sug

intakes of f

vegetables

necessary

antioxidant

and pro-vit


antioxidant

mothers an

newborns

particularly

preterm m

valuable in

for increasi

chance that

pregnancie

successfull


deliveries

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Carbone et al34

1992

Present patterns of



puerperium and its


fetal growth and

maternal nutrient

intake

Spain

developed

n = 33

BMI 227 (22)

kgm2

Age 28 (36)

years

Parity of 1 n =

18 234 n = 15

3-day weight


holiday

completed at

11 19 and 35

weeks

gestation




personal or family





time of visit and

pregnancy


risk

There was


and head

circumferen

weeks of ge

Findings m

a relationsh

between the

metabolism

maternal le

and fetal

developme

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Conway et al38

1999

To explore the


appropriateness of

weight gain during

pregnancy using AIM





England


BMI 22 (24)

kgm2

Age 312 (46)

years

Parity of 1 n =

28 2 n = 4

Unrestrainedn = 30

BMI 207 (196)

kgm2

Age 306 (36)

years

Parity of 1 n =

26 2 n = 4

7-day weighed


weeks

gestation

Caucasian women






outcomes

Providing p


appropriate

gains may b

beneficial

cessation o

during preg

associated w

weight gain

be prudent

accompany

advice abou

smoking dupregnancy

advice abou

and weight

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

De Vriese et

al

31

2001

To determine the


food frequency

questionnaire (FFQ)


diet by comparing



with the 7d food

record in pregnant


the 1st and 3

rd

trimesters

Belgium

developed

n = 26

BMI 22 (176-

293) kgm2

Age 30 (25-37)

years

All pregnant

women were

nulliparous

7-day


during the 1st

(median 15

weeks) and 3rd

(median 35

weeks)

trimesters A

FFQ

containing 180

of the most

common fat-

containingfoods was

conducted at

the same

timepoints

Data recorded

was based on

the EFR

First pregnancy


Hg not diabetic no

proteinuria and not



The FFQ in


compositio

of Belgian

adequate m

reasonably

subjects acc

their dietary

intake

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Fung et al39

1997



zinc from a


altered in well-

nourished women


conception through

lactation and





USA developed

n = 13

BMI 223 (29)

kgm2

Age 30 (29)

years

Parity of 1 n =

10 2 n = 3

3-day weighed

food recordnon-

consecutive

days two

weekdays and

one weekend

at 8-10 weeks

24-26 weeks

and 34-36

weeks

gestation

Aged 22-40yrs body


non-diabetic non-


alcohol use and no


gynecological

complications

Well-nouri


zinc during

pregnancy

increasing

and by a 30

increase in

absorption

not signific

increase in

zinc was du

to an increa


early in the

period pres

an adaptatio

lactation pr

These data

that mechan

regulating z

homeostasi

between pr

and lactatio

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Hronek et al40

2013



Czech pregnant


with recommended

daily allowances

(RDA)

Czechoslovakia

developed

Participants

were randomly

recruited from

both rural and

city regions

n = 152

BMI 211 (36)

kgm2

Age 289 (36)

years

7-day food


days using

scales and

household

measures at 0-

20 weeks 21-

29 weeks 30-

36 weeks and

37-39 weeks

gestation

Nonusers of chronic




le2 Subjects were

euthyroid

normoglyceamic and

not anemic

Lower intak


relative to t

correspond

during preg

Evaluated D

correspond

body size v

Modificatio

intake or al

supplement

recommend


iodine and

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Jansson et al41

2008



between early

pregnancy BMI

maternal dietary

intake and birth

weight

Sweden

developing

n = 49

BMI 255 (69)

kgm2

Age 30 (45)

years

Diet history


over a 24hr

period

collected by a

registered

dietitian at 8-

12 weeks and

32-35 weeks

gestation

Inclusion criteria


old

Exclusion criteria

smoking


reproduction

concurrent disease


or diabetes

development of

pregnancy


preeclampsia or

intrauterine growth

restriction

High first t


trimester IG

were correl

increased b

weight We

that low ser

concentrati

IGFBP-1 re

link betwee

BMI and in

fetal growth


IGF-1 regu

placental nu

transport

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Khoigani et

al

35

2012

To assess the



and micro nutrients




and reproductive

characteristics and


pregnant women

Iran developing

n = 620 (t1 n =

584 t2 n = 510)

BMI 235 (39)

kgm2

Age 256 (44)

years

Parity 158

(076)

48-hour


11-15 weeks

26 weeks and

34-37 weeks

gestation

Interviewers

were trained

Pregnant women who



delivery low birth

weight and factors

which may affect

pregnancy outcomes


addiction digestive


hemoglobinopathies

eating disorders


malignancy

Mean value


subjects wh

experienced

preeclamps

pregnancy

than in othe

women Int

manganese

C vitamin

and carboh

during the t


among preg

women wh

developed

preeclamps

significant

association

other micro

macro nutri

preeclamps

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Kopp-Hoolihan

et al

42

1999

To assess how well-




that predict an


response

USA developed

n = 10

BMI 231 (21)

kgm2

Age 291 (5)

years

3 day weighed


before

pregnancy and

at 8-10 24-26

34-36 weeks

gestation and

4-6 weeks

postpartum

Healthy non-smoking

women

Well-nouri

women useways to me

energy dem

pregnancy

reduction in

induced

thermogene

increased e

intake dep

less fat mas

predicted

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Kubota et al33

2013

To investigate the


intake maternal


growth during

pregnancy

Japan


BMI 175 (01)

kgm2

Age 297 (52)

years

Normaln = 94

BMI 21 (18)

kgm2

Age 308 (51)


Age 286 (36)

years

BMI 334 (65)

kgm2

Digital images


meals on 3

consecutive

days at 14-16

25-27 and 32-

34 weeks

gestation a

dietitian

reviewed

photos and

recorded

intakevalidation of

method not

reported

Singleton pregnant


had suffered from

obstetrical


premature delivery





Dietary inta


not correlat

fetal growth

Japanese na

recommend

advising ex

intake

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Lof et al23

2009

Investigate whether


weight gain are

associated with

estradiol and


plasma during

pregnancy

Sweden

developed

n = 226

BMI 229 (3)

kgm2

Age 32 (4) years

3 day weight


days including

one weekend

at 12 25 and

33 weeks

gestation

Calculations

conducted by

a nutritionist

Women with multi-





dietary intake were

excluded

No associat


dietary fat i

(total or sub

and plasma

levels Prog

levels corre

weight gain

pregnancy

Martinez et

al32

1994

To determine how



nation Mexico

Mexico

developing

n = 36

BMI 235 (26)

kgm2

Age 31 (54)

years

Diet history

collected by

trainedinterviewers

twice per

month and

reported as

mean first and

third trimester

values

Women with an 18




initial recruitment



pregnant

In this sam

women the


weight gain

pregnancy

was similar

women in U

States Low

maternal B

predicted sm

birth weigh

through at l

months of l

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Piers et al36

1995



pregnancy and


a group of well-

nourished pregnant


women at 12 24 and


12 and 24 wk

postpartum with a

non-pregnant non-


India

developing

n = 18

BMI 217 (24)

kgm2

Age 296 (52)

years

5 day


household

measures of

known volume

at 12 24 and

34 weeks

gestation and

12 and 24

weeks post-

partum

participants


measure by a

dietitian who

also checked

all records




morning sickness

before the initial

metabolic

measurement at 12

weeks gestation

BMR is sig


with non-pr

non-lactatin

and remain

even when

differences

weight are

for Well-n

Indian wom

weight and

similar to th


Birth weigh

infants born

to be lower

cost of preg

estimated to

MJ close t

MJ estimat

FAOIWHO

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Tabrizi et al24

2011

To assess the


mineral intake of

pregnant women and


neonates

Iran developing

n = 450

BMI 239 (38)

kgm2

Age 261 (58)

years

24 hour Recall


1st 2

nd and 3

rd

trimesters

Qualification

training of

interviewer

not reported

Women of 16 to 40


health care centers

during the three


Maternal en


with higher

serum calci

and zinc in

birth weigh

neonates


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Guelinckx

et al

43

2010

Study which


improve dietary

habits according to

the National Diet

Recommendations

increase physical

activity level in

obese pregnant

women and

control gestational

weight gain

Belgium

developedrandomly

assigned using

block

randomization

Control(routine)

n =43

BMI 335 (39)

kgm2

Age 294 (44)

yrs


and PA

brochure)

n = 37

BMI 334 (31)

kgm2

Age 287 (4) yrs

Parity of 1 n = 15

Active (brochure

+ group dietary

counselling)

n = 42BMI 341 (45)

kgm2

Age 28 (36) yrs

Parity of 1 n = 20

7-day food


weighed and

household

measures

during each

trimester of

pregnancy

Records were

checked by a

nutritionist






diabetes multiple

pregnancy premature

labor (lt37 wks

gestation) primary


advice in case of

metabolic disorder


conditions and





brochure and group

discussions

A lifestyle interv


combined with

individual advice

improve dietary h

throughout pregn

in obese women

in the absence of

medical or obstet

complications

maintaining or

increasing PA du


decrease in GWG

individually desig

caloric intake res

based on energy

expenditure data

be included

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Korpi-

Hyovalti etal44

2012

To evaluate the


quality of diet

weight gain and

birth weight in

women at high risk

of gestational

diabetes mellitus

Finland


group 1 or 2

using computed

randomization


information on

diet and PA)

n = 27

BMI 255 (34)

kgm2

Lifestyle


nutrition advice)

n = 27

BMI 273 (6)

kgm2

4 day weighed


days including

one weekend

completed at

8-12 26-28

and 36-40

weeks

gestation

Records

checked by a

nutritionist

A three-factor

eating

questionnaire

was also used

at the 1st and

3rd

trimester

Women with one or





48-55 mmoll and the

2h oral glucose


glucose lt78 mmoll

were recruited


GDM at 8-12 wks


There were no cl


however

polyunsaturated f

increase in the lif

intervention grou

Intensive weight

education led to a

somewhat lower

gain during pregn

and higher birth w

of the infants in


macrosomia whe

compared to the c

follow up group

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Moses et al45

2014

To determine


index (LGI) dietary

advice at

the first antenatal

visit would result

in a lower fetal

birth weight

birth percentile

and ponderal index

(PI) than providing

healthy eating

(HE) advice

Australia

developedrandomly

assigned using

computer-

generated

random numbers

1 or 2

Healthy Eating

(counselled to

follow a healthy

diet based on the

AGHE4

) n = 280

BMI 247 (5)

kgm2

Age 299 (5) yrs

Low Glycemic

Index

(individualized

nutrition advice

on a LGI diet)

n = 296

BMI 243 (52)

kgm2 Age 299 (52)

yrs

3 day


household

measures at 16

and 36 weeks

gestation

records

reviewed by a

dietitian



least 18 years old

ability to read and

understand English


comply with visit

schedules Subjects






compromise their




body weight

A low intensity d


in pregnancy did

result in significa

differences in bir

weight fetal perc

of PI

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Wolff et

al

46

2008

To determine


consultations

restricts weight

gain in obese

women and

whether this

restriction impacts

on pregnancy-

induced changes in

glucose

metabolism

Denmark


group 1 or 2

using computed

randomization

Control (general

information on

diet and PA)

n = 27

BMI 255 (34)

kgm2


x 1 hour

consultations)

n = 27

BMI 273 (6)

kgm2

Age 28 (4) years

7 day weighed


plusmn 3 wks) 27

and 36 weeks

gestation



recruited Exclusion

criteria included


or gt45 year old


medical conditions

which impact fetal

growth

Restriction of


achievable and re

the deterioration

glucose metaboli

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

41

983120983137983143983141 983092983089 983151983142 983092983090

FIGURE LEGENDS





















2 GWG 115 to 155 kg)


2

GWG 50 to 90 kg)

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

42

983120983137983143983141 983092983090 983151983142 983092983090







8172019 Je Beile 2015


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8172019 Je Beile 2015


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8172019 Je Beile 2015


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8172019 Je Beile 2015


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8172019 Je Beile 2015


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8172019 Je Beile 2015


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8172019 Je Beile 2015


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3

ABSTRACT






weight gain6


















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outcomes31


trimester33

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INTRODUCTION34


obese1-3





5 pre-term birth


739



41









46












55



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METHODS68

Search Strategy69




by IOM guidelines20










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Study Selection85





In88






was calculated25





Data extraction98







(JBM or JCYL)105

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Manual27




RESULTS134







studies232431-42




reported data by141



and142



had a population143







6 ranged 63-78233134424346

1 of 5533

and 3 did149

not report243740




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with a182
















(SMD = 1431 P lt 00005 n = 17)195






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meta-analysis209

COMMENT210















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of women (1971-1993)50



Unlike the226







levels4751



in the third4751











collection period53






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This251


thereby252










nutrition50



progresses5657







265





during pregnancy270

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(n = 47003) and272










conception281













CONCLUSIONS 293

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revised298

Acknowledgements299




project303











Funding314


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ACCEPTED MANUSCRIPT

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56 L983137983145983150 K983129 C983137983156983137983148983137983150983151 983120M M983141983156983137983138983151983148983145983139 C983144983137983150983143983141983155 983145983150 983120983154983141983143983150983137983150983139983161 983107983148983145983150983145983139983137983148 983151983138983155983156983141983156983154983145983139983155 983137983150983140 983143983161983150983141983139983151983148983151983143983161

200750(4)938983085948

57 983123983156983141983145983150 983124983120 983123983139983144983151983148983148 983124983119 983123983139983144983148983157983156983141983154 MD 983123983139983144983154983151983141983140983141983154 CM 983120983148983137983155983149983137 983148983141983152983156983145983150 983145983150983142983148983157983141983150983139983141983155 983143983141983155983156983137983156983145983151983150983137983148 983159983141983145983143983144983156

983143983137983145983150 983137983150983140 983152983151983155983156983152983137983154983156983157983149 983159983141983145983143983144983156 983154983141983156983141983150983156983145983151983150 983105983149983141983154983145983139983137983150 983114983151983157983154983150983137983148 983151983142 983107983148983145983150983145983139983137983148 983118983157983156983154983145983156983145983151983150

199868(6)12369830851240

58 K983150983157983140983155983141983150 983126K H983141983145983156983149983137983150983150 BL H983137983148983148983140983151983154983155983155983151983150 983124I 983123983151983154983141983150983155983141983150 983124IA 983119983148983155983141983150 983123F M983137983156983141983154983150983137983148 983140983145983141983156983137983154983161983143983148983161983139983137983141983149983145983139 983148983151983137983140 983140983157983154983145983150983143 983152983154983141983143983150983137983150983139983161 983137983150983140 983143983141983155983156983137983156983145983151983150983137983148 983159983141983145983143983144983156 983143983137983145983150 983138983145983154983156983144 983159983141983145983143983144983156 983137983150983140 983152983151983155983156983152983137983154983156983157983149

983159983141983145983143983144983156 983154983141983156983141983150983156983145983151983150 A 983155983156983157983140983161 983159983145983156983144983145983150 983156983144983141 D983137983150983145983155983144 N983137983156983145983151983150983137983148 B983145983154983156983144 C983151983144983151983154983156 983106983154983145983156983145983155983144 983114983151983157983154983150983137983148 983151983142

983118983157983156983154983145983156983145983151983150 2013109(8)14719830851478

59 983130983144983137983150983143 C L983145983157 983123 983123983151983148983151983149983151983150 CG H983157 FB D983145983141983156983137983154983161 983142983145983138983141983154 983145983150983156983137983147983141 983140983145983141983156983137983154983161 983143983148983161983139983141983149983145983139 983148983151983137983140 983137983150983140 983156983144983141 983154983145983155983147

983142983151983154 983143983141983155983156983137983156983145983151983150983137983148 983140983145983137983138983141983156983141983155 983149983141983148983148983145983156983157983155 983108983145983137983138983141983156983141983155 983107983137983154983141 200629(10)22239830852230

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

22





f r o m b i a s



d e s c r i b e d






W e r e o





i n d i c a t o r s



c o n s i d e

r a t i o n




Alberti-

Fidanza et

al37


Carbone

et al34


Conway

et al38


De


Fung et

al39


Goodarzi

Khoigani

et al35


Guelinckx

et al43


Hronek et

al40


Jansson etal41


Kopp

Hoolihan

et al42


Korpi

Hyovalti

et al44


Kubota et

al33


Lof et

al

23


8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

23





f r o m b i a s



i t h d r a w a l s

d e s c r i b e d




r e a n d





i n e d a n d t h e


l i a b l e




i n d i c a t o r s


b y r e s u l t s


t a k e n i n t o





Martinez

et al32


Moses et

al45


Piers et

al36


Tabrizi et

al24


Wolff et

al46



8172019 Je Beile 2015


ACCEPTED MANUSCRIPT



Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Alberti-Fidanza

et al37

2002

To examine



(ToAC) of women



newborns and relate

the results to the


same women during

pregnancy

Italy developed

n = 12

BMI 226 (55)

kgm2

Age 311 (42)

years

Parity 18 (09)

nil smokers

Collected by

qualified and

experienced

dietitians

using the diet

history

method during

the 1st 2

nd and

3rd

trimesters


monitor To

during the e

period of pr

and we sug

intakes of f

vegetables

necessary

antioxidant

and pro-vit


antioxidant

mothers an

newborns

particularly

preterm m

valuable in

for increasi

chance that

pregnancie

successfull


deliveries

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Carbone et al34

1992

Present patterns of



puerperium and its


fetal growth and

maternal nutrient

intake

Spain

developed

n = 33

BMI 227 (22)

kgm2

Age 28 (36)

years

Parity of 1 n =

18 234 n = 15

3-day weight


holiday

completed at

11 19 and 35

weeks

gestation




personal or family





time of visit and

pregnancy


risk

There was


and head

circumferen

weeks of ge

Findings m

a relationsh

between the

metabolism

maternal le

and fetal

developme

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Conway et al38

1999

To explore the


appropriateness of

weight gain during

pregnancy using AIM





England


BMI 22 (24)

kgm2

Age 312 (46)

years

Parity of 1 n =

28 2 n = 4

Unrestrainedn = 30

BMI 207 (196)

kgm2

Age 306 (36)

years

Parity of 1 n =

26 2 n = 4

7-day weighed


weeks

gestation

Caucasian women






outcomes

Providing p


appropriate

gains may b

beneficial

cessation o

during preg

associated w

weight gain

be prudent

accompany

advice abou

smoking dupregnancy

advice abou

and weight

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

De Vriese et

al

31

2001

To determine the


food frequency

questionnaire (FFQ)


diet by comparing



with the 7d food

record in pregnant


the 1st and 3

rd

trimesters

Belgium

developed

n = 26

BMI 22 (176-

293) kgm2

Age 30 (25-37)

years

All pregnant

women were

nulliparous

7-day


during the 1st

(median 15

weeks) and 3rd

(median 35

weeks)

trimesters A

FFQ

containing 180

of the most

common fat-

containingfoods was

conducted at

the same

timepoints

Data recorded

was based on

the EFR

First pregnancy


Hg not diabetic no

proteinuria and not



The FFQ in


compositio

of Belgian

adequate m

reasonably

subjects acc

their dietary

intake

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Fung et al39

1997



zinc from a


altered in well-

nourished women


conception through

lactation and





USA developed

n = 13

BMI 223 (29)

kgm2

Age 30 (29)

years

Parity of 1 n =

10 2 n = 3

3-day weighed

food recordnon-

consecutive

days two

weekdays and

one weekend

at 8-10 weeks

24-26 weeks

and 34-36

weeks

gestation

Aged 22-40yrs body


non-diabetic non-


alcohol use and no


gynecological

complications

Well-nouri


zinc during

pregnancy

increasing

and by a 30

increase in

absorption

not signific

increase in

zinc was du

to an increa


early in the

period pres

an adaptatio

lactation pr

These data

that mechan

regulating z

homeostasi

between pr

and lactatio

8172019 Je Beile 2015


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Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Hronek et al40

2013



Czech pregnant


with recommended

daily allowances

(RDA)

Czechoslovakia

developed

Participants

were randomly

recruited from

both rural and

city regions

n = 152

BMI 211 (36)

kgm2

Age 289 (36)

years

7-day food


days using

scales and

household

measures at 0-

20 weeks 21-

29 weeks 30-

36 weeks and

37-39 weeks

gestation

Nonusers of chronic




le2 Subjects were

euthyroid

normoglyceamic and

not anemic

Lower intak


relative to t

correspond

during preg

Evaluated D

correspond

body size v

Modificatio

intake or al

supplement

recommend


iodine and

8172019 Je Beile 2015


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Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Jansson et al41

2008



between early

pregnancy BMI

maternal dietary

intake and birth

weight

Sweden

developing

n = 49

BMI 255 (69)

kgm2

Age 30 (45)

years

Diet history


over a 24hr

period

collected by a

registered

dietitian at 8-

12 weeks and

32-35 weeks

gestation

Inclusion criteria


old

Exclusion criteria

smoking


reproduction

concurrent disease


or diabetes

development of

pregnancy


preeclampsia or

intrauterine growth

restriction

High first t


trimester IG

were correl

increased b

weight We

that low ser

concentrati

IGFBP-1 re

link betwee

BMI and in

fetal growth


IGF-1 regu

placental nu

transport

8172019 Je Beile 2015


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Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Khoigani et

al

35

2012

To assess the



and micro nutrients




and reproductive

characteristics and


pregnant women

Iran developing

n = 620 (t1 n =

584 t2 n = 510)

BMI 235 (39)

kgm2

Age 256 (44)

years

Parity 158

(076)

48-hour


11-15 weeks

26 weeks and

34-37 weeks

gestation

Interviewers

were trained

Pregnant women who



delivery low birth

weight and factors

which may affect

pregnancy outcomes


addiction digestive


hemoglobinopathies

eating disorders


malignancy

Mean value


subjects wh

experienced

preeclamps

pregnancy

than in othe

women Int

manganese

C vitamin

and carboh

during the t


among preg

women wh

developed

preeclamps

significant

association

other micro

macro nutri

preeclamps

8172019 Je Beile 2015


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Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Kopp-Hoolihan

et al

42

1999

To assess how well-




that predict an


response

USA developed

n = 10

BMI 231 (21)

kgm2

Age 291 (5)

years

3 day weighed


before

pregnancy and

at 8-10 24-26

34-36 weeks

gestation and

4-6 weeks

postpartum

Healthy non-smoking

women

Well-nouri

women useways to me

energy dem

pregnancy

reduction in

induced

thermogene

increased e

intake dep

less fat mas

predicted

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Kubota et al33

2013

To investigate the


intake maternal


growth during

pregnancy

Japan


BMI 175 (01)

kgm2

Age 297 (52)

years

Normaln = 94

BMI 21 (18)

kgm2

Age 308 (51)


Age 286 (36)

years

BMI 334 (65)

kgm2

Digital images


meals on 3

consecutive

days at 14-16

25-27 and 32-

34 weeks

gestation a

dietitian

reviewed

photos and

recorded

intakevalidation of

method not

reported

Singleton pregnant


had suffered from

obstetrical


premature delivery





Dietary inta


not correlat

fetal growth

Japanese na

recommend

advising ex

intake

8172019 Je Beile 2015


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Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Lof et al23

2009

Investigate whether


weight gain are

associated with

estradiol and


plasma during

pregnancy

Sweden

developed

n = 226

BMI 229 (3)

kgm2

Age 32 (4) years

3 day weight


days including

one weekend

at 12 25 and

33 weeks

gestation

Calculations

conducted by

a nutritionist

Women with multi-





dietary intake were

excluded

No associat


dietary fat i

(total or sub

and plasma

levels Prog

levels corre

weight gain

pregnancy

Martinez et

al32

1994

To determine how



nation Mexico

Mexico

developing

n = 36

BMI 235 (26)

kgm2

Age 31 (54)

years

Diet history

collected by

trainedinterviewers

twice per

month and

reported as

mean first and

third trimester

values

Women with an 18




initial recruitment



pregnant

In this sam

women the


weight gain

pregnancy

was similar

women in U

States Low

maternal B

predicted sm

birth weigh

through at l

months of l

8172019 Je Beile 2015


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Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Piers et al36

1995



pregnancy and


a group of well-

nourished pregnant


women at 12 24 and


12 and 24 wk

postpartum with a

non-pregnant non-


India

developing

n = 18

BMI 217 (24)

kgm2

Age 296 (52)

years

5 day


household

measures of

known volume

at 12 24 and

34 weeks

gestation and

12 and 24

weeks post-

partum

participants


measure by a

dietitian who

also checked

all records




morning sickness

before the initial

metabolic

measurement at 12

weeks gestation

BMR is sig


with non-pr

non-lactatin

and remain

even when

differences

weight are

for Well-n

Indian wom

weight and

similar to th


Birth weigh

infants born

to be lower

cost of preg

estimated to

MJ close t

MJ estimat

FAOIWHO

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Tabrizi et al24

2011

To assess the


mineral intake of

pregnant women and


neonates

Iran developing

n = 450

BMI 239 (38)

kgm2

Age 261 (58)

years

24 hour Recall


1st 2

nd and 3

rd

trimesters

Qualification

training of

interviewer

not reported

Women of 16 to 40


health care centers

during the three


Maternal en


with higher

serum calci

and zinc in

birth weigh

neonates


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Guelinckx

et al

43

2010

Study which


improve dietary

habits according to

the National Diet

Recommendations

increase physical

activity level in

obese pregnant

women and

control gestational

weight gain

Belgium

developedrandomly

assigned using

block

randomization

Control(routine)

n =43

BMI 335 (39)

kgm2

Age 294 (44)

yrs


and PA

brochure)

n = 37

BMI 334 (31)

kgm2

Age 287 (4) yrs

Parity of 1 n = 15

Active (brochure

+ group dietary

counselling)

n = 42BMI 341 (45)

kgm2

Age 28 (36) yrs

Parity of 1 n = 20

7-day food


weighed and

household

measures

during each

trimester of

pregnancy

Records were

checked by a

nutritionist






diabetes multiple

pregnancy premature

labor (lt37 wks

gestation) primary


advice in case of

metabolic disorder


conditions and





brochure and group

discussions

A lifestyle interv


combined with

individual advice

improve dietary h

throughout pregn

in obese women

in the absence of

medical or obstet

complications

maintaining or

increasing PA du


decrease in GWG

individually desig

caloric intake res

based on energy

expenditure data

be included

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Korpi-

Hyovalti etal44

2012

To evaluate the


quality of diet

weight gain and

birth weight in

women at high risk

of gestational

diabetes mellitus

Finland


group 1 or 2

using computed

randomization


information on

diet and PA)

n = 27

BMI 255 (34)

kgm2

Lifestyle


nutrition advice)

n = 27

BMI 273 (6)

kgm2

4 day weighed


days including

one weekend

completed at

8-12 26-28

and 36-40

weeks

gestation

Records

checked by a

nutritionist

A three-factor

eating

questionnaire

was also used

at the 1st and

3rd

trimester

Women with one or





48-55 mmoll and the

2h oral glucose


glucose lt78 mmoll

were recruited


GDM at 8-12 wks


There were no cl


however

polyunsaturated f

increase in the lif

intervention grou

Intensive weight

education led to a

somewhat lower

gain during pregn

and higher birth w

of the infants in


macrosomia whe

compared to the c

follow up group

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Moses et al45

2014

To determine


index (LGI) dietary

advice at

the first antenatal

visit would result

in a lower fetal

birth weight

birth percentile

and ponderal index

(PI) than providing

healthy eating

(HE) advice

Australia

developedrandomly

assigned using

computer-

generated

random numbers

1 or 2

Healthy Eating

(counselled to

follow a healthy

diet based on the

AGHE4

) n = 280

BMI 247 (5)

kgm2

Age 299 (5) yrs

Low Glycemic

Index

(individualized

nutrition advice

on a LGI diet)

n = 296

BMI 243 (52)

kgm2 Age 299 (52)

yrs

3 day


household

measures at 16

and 36 weeks

gestation

records

reviewed by a

dietitian



least 18 years old

ability to read and

understand English


comply with visit

schedules Subjects






compromise their




body weight

A low intensity d


in pregnancy did

result in significa

differences in bir

weight fetal perc

of PI

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Wolff et

al

46

2008

To determine


consultations

restricts weight

gain in obese

women and

whether this

restriction impacts

on pregnancy-

induced changes in

glucose

metabolism

Denmark


group 1 or 2

using computed

randomization

Control (general

information on

diet and PA)

n = 27

BMI 255 (34)

kgm2


x 1 hour

consultations)

n = 27

BMI 273 (6)

kgm2

Age 28 (4) years

7 day weighed


plusmn 3 wks) 27

and 36 weeks

gestation



recruited Exclusion

criteria included


or gt45 year old


medical conditions

which impact fetal

growth

Restriction of


achievable and re

the deterioration

glucose metaboli

8172019 Je Beile 2015


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41

983120983137983143983141 983092983089 983151983142 983092983090

FIGURE LEGENDS





















2 GWG 115 to 155 kg)


2

GWG 50 to 90 kg)

8172019 Je Beile 2015


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42

983120983137983143983141 983092983090 983151983142 983092983090







8172019 Je Beile 2015


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8172019 Je Beile 2015


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8172019 Je Beile 2015


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8172019 Je Beile 2015


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8172019 Je Beile 2015


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8172019 Je Beile 2015


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8172019 Je Beile 2015


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4








outcomes31


trimester33

8172019 Je Beile 2015


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5

INTRODUCTION34


obese1-3





5 pre-term birth


739



41









46












55



8172019 Je Beile 2015


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6













METHODS68

Search Strategy69




by IOM guidelines20










8172019 Je Beile 2015


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7




Study Selection85





In88






was calculated25





Data extraction98







(JBM or JCYL)105

8172019 Je Beile 2015


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8

























8172019 Je Beile 2015


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9



Manual27




RESULTS134







studies232431-42




reported data by141



and142



had a population143







6 ranged 63-78233134424346

1 of 5533

and 3 did149

not report243740




8172019 Je Beile 2015


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10


























8172019 Je Beile 2015


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11







with a182
















(SMD = 1431 P lt 00005 n = 17)195






8172019 Je Beile 2015


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12









meta-analysis209

COMMENT210















8172019 Je Beile 2015


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13


of women (1971-1993)50



Unlike the226







levels4751



in the third4751











collection period53






8172019 Je Beile 2015


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14






This251


thereby252










nutrition50



progresses5657







265





during pregnancy270

8172019 Je Beile 2015


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15



(n = 47003) and272










conception281













CONCLUSIONS 293

8172019 Je Beile 2015


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16





revised298

Acknowledgements299




project303











Funding314


8172019 Je Beile 2015


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18

REFERENCES

1 D983137983158983145983155 E 983119983148983155983151983150 C 983119983138983141983155983145983156983161 983145983150 983120983154983141983143983150983137983150983139983161 983120983154983145983149983137983154983161 983107983137983154983141 983107983148983145983150983145983139983155 983145983150 983119983142983142983145983139983141 983120983154983137983139983156983145983139983141

200936(2)341983085356

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ACCEPTED MANUSCRIPT

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ACCEPTED MANUSCRIPT

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ACCEPTED MANUSCRIPT

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199868(6)12369830851240

58 K983150983157983140983155983141983150 983126K H983141983145983156983149983137983150983150 BL H983137983148983148983140983151983154983155983155983151983150 983124I 983123983151983154983141983150983155983141983150 983124IA 983119983148983155983141983150 983123F M983137983156983141983154983150983137983148 983140983145983141983156983137983154983161983143983148983161983139983137983141983149983145983139 983148983151983137983140 983140983157983154983145983150983143 983152983154983141983143983150983137983150983139983161 983137983150983140 983143983141983155983156983137983156983145983151983150983137983148 983159983141983145983143983144983156 983143983137983145983150 983138983145983154983156983144 983159983141983145983143983144983156 983137983150983140 983152983151983155983156983152983137983154983156983157983149

983159983141983145983143983144983156 983154983141983156983141983150983156983145983151983150 A 983155983156983157983140983161 983159983145983156983144983145983150 983156983144983141 D983137983150983145983155983144 N983137983156983145983151983150983137983148 B983145983154983156983144 C983151983144983151983154983156 983106983154983145983156983145983155983144 983114983151983157983154983150983137983148 983151983142

983118983157983156983154983145983156983145983151983150 2013109(8)14719830851478

59 983130983144983137983150983143 C L983145983157 983123 983123983151983148983151983149983151983150 CG H983157 FB D983145983141983156983137983154983161 983142983145983138983141983154 983145983150983156983137983147983141 983140983145983141983156983137983154983161 983143983148983161983139983141983149983145983139 983148983151983137983140 983137983150983140 983156983144983141 983154983145983155983147

983142983151983154 983143983141983155983156983137983156983145983151983150983137983148 983140983145983137983138983141983156983141983155 983149983141983148983148983145983156983157983155 983108983145983137983138983141983156983141983155 983107983137983154983141 200629(10)22239830852230

8172019 Je Beile 2015


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22





f r o m b i a s



d e s c r i b e d






W e r e o





i n d i c a t o r s



c o n s i d e

r a t i o n




Alberti-

Fidanza et

al37


Carbone

et al34


Conway

et al38


De


Fung et

al39


Goodarzi

Khoigani

et al35


Guelinckx

et al43


Hronek et

al40


Jansson etal41


Kopp

Hoolihan

et al42


Korpi

Hyovalti

et al44


Kubota et

al33


Lof et

al

23


8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

23





f r o m b i a s



i t h d r a w a l s

d e s c r i b e d




r e a n d





i n e d a n d t h e


l i a b l e




i n d i c a t o r s


b y r e s u l t s


t a k e n i n t o





Martinez

et al32


Moses et

al45


Piers et

al36


Tabrizi et

al24


Wolff et

al46



8172019 Je Beile 2015


ACCEPTED MANUSCRIPT



Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Alberti-Fidanza

et al37

2002

To examine



(ToAC) of women



newborns and relate

the results to the


same women during

pregnancy

Italy developed

n = 12

BMI 226 (55)

kgm2

Age 311 (42)

years

Parity 18 (09)

nil smokers

Collected by

qualified and

experienced

dietitians

using the diet

history

method during

the 1st 2

nd and

3rd

trimesters


monitor To

during the e

period of pr

and we sug

intakes of f

vegetables

necessary

antioxidant

and pro-vit


antioxidant

mothers an

newborns

particularly

preterm m

valuable in

for increasi

chance that

pregnancie

successfull


deliveries

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Carbone et al34

1992

Present patterns of



puerperium and its


fetal growth and

maternal nutrient

intake

Spain

developed

n = 33

BMI 227 (22)

kgm2

Age 28 (36)

years

Parity of 1 n =

18 234 n = 15

3-day weight


holiday

completed at

11 19 and 35

weeks

gestation




personal or family





time of visit and

pregnancy


risk

There was


and head

circumferen

weeks of ge

Findings m

a relationsh

between the

metabolism

maternal le

and fetal

developme

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Conway et al38

1999

To explore the


appropriateness of

weight gain during

pregnancy using AIM





England


BMI 22 (24)

kgm2

Age 312 (46)

years

Parity of 1 n =

28 2 n = 4

Unrestrainedn = 30

BMI 207 (196)

kgm2

Age 306 (36)

years

Parity of 1 n =

26 2 n = 4

7-day weighed


weeks

gestation

Caucasian women






outcomes

Providing p


appropriate

gains may b

beneficial

cessation o

during preg

associated w

weight gain

be prudent

accompany

advice abou

smoking dupregnancy

advice abou

and weight

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

De Vriese et

al

31

2001

To determine the


food frequency

questionnaire (FFQ)


diet by comparing



with the 7d food

record in pregnant


the 1st and 3

rd

trimesters

Belgium

developed

n = 26

BMI 22 (176-

293) kgm2

Age 30 (25-37)

years

All pregnant

women were

nulliparous

7-day


during the 1st

(median 15

weeks) and 3rd

(median 35

weeks)

trimesters A

FFQ

containing 180

of the most

common fat-

containingfoods was

conducted at

the same

timepoints

Data recorded

was based on

the EFR

First pregnancy


Hg not diabetic no

proteinuria and not



The FFQ in


compositio

of Belgian

adequate m

reasonably

subjects acc

their dietary

intake

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Fung et al39

1997



zinc from a


altered in well-

nourished women


conception through

lactation and





USA developed

n = 13

BMI 223 (29)

kgm2

Age 30 (29)

years

Parity of 1 n =

10 2 n = 3

3-day weighed

food recordnon-

consecutive

days two

weekdays and

one weekend

at 8-10 weeks

24-26 weeks

and 34-36

weeks

gestation

Aged 22-40yrs body


non-diabetic non-


alcohol use and no


gynecological

complications

Well-nouri


zinc during

pregnancy

increasing

and by a 30

increase in

absorption

not signific

increase in

zinc was du

to an increa


early in the

period pres

an adaptatio

lactation pr

These data

that mechan

regulating z

homeostasi

between pr

and lactatio

8172019 Je Beile 2015


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Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Hronek et al40

2013



Czech pregnant


with recommended

daily allowances

(RDA)

Czechoslovakia

developed

Participants

were randomly

recruited from

both rural and

city regions

n = 152

BMI 211 (36)

kgm2

Age 289 (36)

years

7-day food


days using

scales and

household

measures at 0-

20 weeks 21-

29 weeks 30-

36 weeks and

37-39 weeks

gestation

Nonusers of chronic




le2 Subjects were

euthyroid

normoglyceamic and

not anemic

Lower intak


relative to t

correspond

during preg

Evaluated D

correspond

body size v

Modificatio

intake or al

supplement

recommend


iodine and

8172019 Je Beile 2015


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Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Jansson et al41

2008



between early

pregnancy BMI

maternal dietary

intake and birth

weight

Sweden

developing

n = 49

BMI 255 (69)

kgm2

Age 30 (45)

years

Diet history


over a 24hr

period

collected by a

registered

dietitian at 8-

12 weeks and

32-35 weeks

gestation

Inclusion criteria


old

Exclusion criteria

smoking


reproduction

concurrent disease


or diabetes

development of

pregnancy


preeclampsia or

intrauterine growth

restriction

High first t


trimester IG

were correl

increased b

weight We

that low ser

concentrati

IGFBP-1 re

link betwee

BMI and in

fetal growth


IGF-1 regu

placental nu

transport

8172019 Je Beile 2015


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Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Khoigani et

al

35

2012

To assess the



and micro nutrients




and reproductive

characteristics and


pregnant women

Iran developing

n = 620 (t1 n =

584 t2 n = 510)

BMI 235 (39)

kgm2

Age 256 (44)

years

Parity 158

(076)

48-hour


11-15 weeks

26 weeks and

34-37 weeks

gestation

Interviewers

were trained

Pregnant women who



delivery low birth

weight and factors

which may affect

pregnancy outcomes


addiction digestive


hemoglobinopathies

eating disorders


malignancy

Mean value


subjects wh

experienced

preeclamps

pregnancy

than in othe

women Int

manganese

C vitamin

and carboh

during the t


among preg

women wh

developed

preeclamps

significant

association

other micro

macro nutri

preeclamps

8172019 Je Beile 2015


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Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Kopp-Hoolihan

et al

42

1999

To assess how well-




that predict an


response

USA developed

n = 10

BMI 231 (21)

kgm2

Age 291 (5)

years

3 day weighed


before

pregnancy and

at 8-10 24-26

34-36 weeks

gestation and

4-6 weeks

postpartum

Healthy non-smoking

women

Well-nouri

women useways to me

energy dem

pregnancy

reduction in

induced

thermogene

increased e

intake dep

less fat mas

predicted

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Kubota et al33

2013

To investigate the


intake maternal


growth during

pregnancy

Japan


BMI 175 (01)

kgm2

Age 297 (52)

years

Normaln = 94

BMI 21 (18)

kgm2

Age 308 (51)


Age 286 (36)

years

BMI 334 (65)

kgm2

Digital images


meals on 3

consecutive

days at 14-16

25-27 and 32-

34 weeks

gestation a

dietitian

reviewed

photos and

recorded

intakevalidation of

method not

reported

Singleton pregnant


had suffered from

obstetrical


premature delivery





Dietary inta


not correlat

fetal growth

Japanese na

recommend

advising ex

intake

8172019 Je Beile 2015


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Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Lof et al23

2009

Investigate whether


weight gain are

associated with

estradiol and


plasma during

pregnancy

Sweden

developed

n = 226

BMI 229 (3)

kgm2

Age 32 (4) years

3 day weight


days including

one weekend

at 12 25 and

33 weeks

gestation

Calculations

conducted by

a nutritionist

Women with multi-





dietary intake were

excluded

No associat


dietary fat i

(total or sub

and plasma

levels Prog

levels corre

weight gain

pregnancy

Martinez et

al32

1994

To determine how



nation Mexico

Mexico

developing

n = 36

BMI 235 (26)

kgm2

Age 31 (54)

years

Diet history

collected by

trainedinterviewers

twice per

month and

reported as

mean first and

third trimester

values

Women with an 18




initial recruitment



pregnant

In this sam

women the


weight gain

pregnancy

was similar

women in U

States Low

maternal B

predicted sm

birth weigh

through at l

months of l

8172019 Je Beile 2015


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Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Piers et al36

1995



pregnancy and


a group of well-

nourished pregnant


women at 12 24 and


12 and 24 wk

postpartum with a

non-pregnant non-


India

developing

n = 18

BMI 217 (24)

kgm2

Age 296 (52)

years

5 day


household

measures of

known volume

at 12 24 and

34 weeks

gestation and

12 and 24

weeks post-

partum

participants


measure by a

dietitian who

also checked

all records




morning sickness

before the initial

metabolic

measurement at 12

weeks gestation

BMR is sig


with non-pr

non-lactatin

and remain

even when

differences

weight are

for Well-n

Indian wom

weight and

similar to th


Birth weigh

infants born

to be lower

cost of preg

estimated to

MJ close t

MJ estimat

FAOIWHO

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Tabrizi et al24

2011

To assess the


mineral intake of

pregnant women and


neonates

Iran developing

n = 450

BMI 239 (38)

kgm2

Age 261 (58)

years

24 hour Recall


1st 2

nd and 3

rd

trimesters

Qualification

training of

interviewer

not reported

Women of 16 to 40


health care centers

during the three


Maternal en


with higher

serum calci

and zinc in

birth weigh

neonates


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Guelinckx

et al

43

2010

Study which


improve dietary

habits according to

the National Diet

Recommendations

increase physical

activity level in

obese pregnant

women and

control gestational

weight gain

Belgium

developedrandomly

assigned using

block

randomization

Control(routine)

n =43

BMI 335 (39)

kgm2

Age 294 (44)

yrs


and PA

brochure)

n = 37

BMI 334 (31)

kgm2

Age 287 (4) yrs

Parity of 1 n = 15

Active (brochure

+ group dietary

counselling)

n = 42BMI 341 (45)

kgm2

Age 28 (36) yrs

Parity of 1 n = 20

7-day food


weighed and

household

measures

during each

trimester of

pregnancy

Records were

checked by a

nutritionist






diabetes multiple

pregnancy premature

labor (lt37 wks

gestation) primary


advice in case of

metabolic disorder


conditions and





brochure and group

discussions

A lifestyle interv


combined with

individual advice

improve dietary h

throughout pregn

in obese women

in the absence of

medical or obstet

complications

maintaining or

increasing PA du


decrease in GWG

individually desig

caloric intake res

based on energy

expenditure data

be included

8172019 Je Beile 2015


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Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Korpi-

Hyovalti etal44

2012

To evaluate the


quality of diet

weight gain and

birth weight in

women at high risk

of gestational

diabetes mellitus

Finland


group 1 or 2

using computed

randomization


information on

diet and PA)

n = 27

BMI 255 (34)

kgm2

Lifestyle


nutrition advice)

n = 27

BMI 273 (6)

kgm2

4 day weighed


days including

one weekend

completed at

8-12 26-28

and 36-40

weeks

gestation

Records

checked by a

nutritionist

A three-factor

eating

questionnaire

was also used

at the 1st and

3rd

trimester

Women with one or





48-55 mmoll and the

2h oral glucose


glucose lt78 mmoll

were recruited


GDM at 8-12 wks


There were no cl


however

polyunsaturated f

increase in the lif

intervention grou

Intensive weight

education led to a

somewhat lower

gain during pregn

and higher birth w

of the infants in


macrosomia whe

compared to the c

follow up group

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Moses et al45

2014

To determine


index (LGI) dietary

advice at

the first antenatal

visit would result

in a lower fetal

birth weight

birth percentile

and ponderal index

(PI) than providing

healthy eating

(HE) advice

Australia

developedrandomly

assigned using

computer-

generated

random numbers

1 or 2

Healthy Eating

(counselled to

follow a healthy

diet based on the

AGHE4

) n = 280

BMI 247 (5)

kgm2

Age 299 (5) yrs

Low Glycemic

Index

(individualized

nutrition advice

on a LGI diet)

n = 296

BMI 243 (52)

kgm2 Age 299 (52)

yrs

3 day


household

measures at 16

and 36 weeks

gestation

records

reviewed by a

dietitian



least 18 years old

ability to read and

understand English


comply with visit

schedules Subjects






compromise their




body weight

A low intensity d


in pregnancy did

result in significa

differences in bir

weight fetal perc

of PI

8172019 Je Beile 2015


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Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Wolff et

al

46

2008

To determine


consultations

restricts weight

gain in obese

women and

whether this

restriction impacts

on pregnancy-

induced changes in

glucose

metabolism

Denmark


group 1 or 2

using computed

randomization

Control (general

information on

diet and PA)

n = 27

BMI 255 (34)

kgm2


x 1 hour

consultations)

n = 27

BMI 273 (6)

kgm2

Age 28 (4) years

7 day weighed


plusmn 3 wks) 27

and 36 weeks

gestation



recruited Exclusion

criteria included


or gt45 year old


medical conditions

which impact fetal

growth

Restriction of


achievable and re

the deterioration

glucose metaboli

8172019 Je Beile 2015


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41

983120983137983143983141 983092983089 983151983142 983092983090

FIGURE LEGENDS





















2 GWG 115 to 155 kg)


2

GWG 50 to 90 kg)

8172019 Je Beile 2015


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42

983120983137983143983141 983092983090 983151983142 983092983090







8172019 Je Beile 2015


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8172019 Je Beile 2015


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8172019 Je Beile 2015


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8172019 Je Beile 2015


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8172019 Je Beile 2015


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8172019 Je Beile 2015


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8172019 Je Beile 2015


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5

INTRODUCTION34


obese1-3





5 pre-term birth


739



41









46












55



8172019 Je Beile 2015


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6













METHODS68

Search Strategy69




by IOM guidelines20










8172019 Je Beile 2015


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7




Study Selection85





In88






was calculated25





Data extraction98







(JBM or JCYL)105

8172019 Je Beile 2015


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8

























8172019 Je Beile 2015


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9



Manual27




RESULTS134







studies232431-42




reported data by141



and142



had a population143







6 ranged 63-78233134424346

1 of 5533

and 3 did149

not report243740




8172019 Je Beile 2015


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10


























8172019 Je Beile 2015


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11







with a182
















(SMD = 1431 P lt 00005 n = 17)195






8172019 Je Beile 2015


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12









meta-analysis209

COMMENT210















8172019 Je Beile 2015


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13


of women (1971-1993)50



Unlike the226







levels4751



in the third4751











collection period53






8172019 Je Beile 2015


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14






This251


thereby252










nutrition50



progresses5657







265





during pregnancy270

8172019 Je Beile 2015


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15



(n = 47003) and272










conception281













CONCLUSIONS 293

8172019 Je Beile 2015


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16





revised298

Acknowledgements299




project303











Funding314


8172019 Je Beile 2015


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18

REFERENCES

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3 983119983158983141983155983141983150 983120 983122983137983155983149983157983155983155983141983150 983123 K983141983155983149983151983140983141983148 983125 E983142983142983141983139983156 983151983142 983152983154983141983152983154983141983143983150983137983150983139983161 983149983137983156983141983154983150983137983148 983151983158983141983154983159983141983145983143983144983156 983137983150983140

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ACCEPTED MANUSCRIPT

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ACCEPTED MANUSCRIPT

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ACCEPTED MANUSCRIPT

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199868(6)12369830851240

58 K983150983157983140983155983141983150 983126K H983141983145983156983149983137983150983150 BL H983137983148983148983140983151983154983155983155983151983150 983124I 983123983151983154983141983150983155983141983150 983124IA 983119983148983155983141983150 983123F M983137983156983141983154983150983137983148 983140983145983141983156983137983154983161983143983148983161983139983137983141983149983145983139 983148983151983137983140 983140983157983154983145983150983143 983152983154983141983143983150983137983150983139983161 983137983150983140 983143983141983155983156983137983156983145983151983150983137983148 983159983141983145983143983144983156 983143983137983145983150 983138983145983154983156983144 983159983141983145983143983144983156 983137983150983140 983152983151983155983156983152983137983154983156983157983149

983159983141983145983143983144983156 983154983141983156983141983150983156983145983151983150 A 983155983156983157983140983161 983159983145983156983144983145983150 983156983144983141 D983137983150983145983155983144 N983137983156983145983151983150983137983148 B983145983154983156983144 C983151983144983151983154983156 983106983154983145983156983145983155983144 983114983151983157983154983150983137983148 983151983142

983118983157983156983154983145983156983145983151983150 2013109(8)14719830851478

59 983130983144983137983150983143 C L983145983157 983123 983123983151983148983151983149983151983150 CG H983157 FB D983145983141983156983137983154983161 983142983145983138983141983154 983145983150983156983137983147983141 983140983145983141983156983137983154983161 983143983148983161983139983141983149983145983139 983148983151983137983140 983137983150983140 983156983144983141 983154983145983155983147

983142983151983154 983143983141983155983156983137983156983145983151983150983137983148 983140983145983137983138983141983156983141983155 983149983141983148983148983145983156983157983155 983108983145983137983138983141983156983141983155 983107983137983154983141 200629(10)22239830852230

8172019 Je Beile 2015


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22





f r o m b i a s



d e s c r i b e d






W e r e o





i n d i c a t o r s



c o n s i d e

r a t i o n




Alberti-

Fidanza et

al37


Carbone

et al34


Conway

et al38


De


Fung et

al39


Goodarzi

Khoigani

et al35


Guelinckx

et al43


Hronek et

al40


Jansson etal41


Kopp

Hoolihan

et al42


Korpi

Hyovalti

et al44


Kubota et

al33


Lof et

al

23


8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

23





f r o m b i a s



i t h d r a w a l s

d e s c r i b e d




r e a n d





i n e d a n d t h e


l i a b l e




i n d i c a t o r s


b y r e s u l t s


t a k e n i n t o





Martinez

et al32


Moses et

al45


Piers et

al36


Tabrizi et

al24


Wolff et

al46



8172019 Je Beile 2015


ACCEPTED MANUSCRIPT



Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Alberti-Fidanza

et al37

2002

To examine



(ToAC) of women



newborns and relate

the results to the


same women during

pregnancy

Italy developed

n = 12

BMI 226 (55)

kgm2

Age 311 (42)

years

Parity 18 (09)

nil smokers

Collected by

qualified and

experienced

dietitians

using the diet

history

method during

the 1st 2

nd and

3rd

trimesters


monitor To

during the e

period of pr

and we sug

intakes of f

vegetables

necessary

antioxidant

and pro-vit


antioxidant

mothers an

newborns

particularly

preterm m

valuable in

for increasi

chance that

pregnancie

successfull


deliveries

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Carbone et al34

1992

Present patterns of



puerperium and its


fetal growth and

maternal nutrient

intake

Spain

developed

n = 33

BMI 227 (22)

kgm2

Age 28 (36)

years

Parity of 1 n =

18 234 n = 15

3-day weight


holiday

completed at

11 19 and 35

weeks

gestation




personal or family





time of visit and

pregnancy


risk

There was


and head

circumferen

weeks of ge

Findings m

a relationsh

between the

metabolism

maternal le

and fetal

developme

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Conway et al38

1999

To explore the


appropriateness of

weight gain during

pregnancy using AIM





England


BMI 22 (24)

kgm2

Age 312 (46)

years

Parity of 1 n =

28 2 n = 4

Unrestrainedn = 30

BMI 207 (196)

kgm2

Age 306 (36)

years

Parity of 1 n =

26 2 n = 4

7-day weighed


weeks

gestation

Caucasian women






outcomes

Providing p


appropriate

gains may b

beneficial

cessation o

during preg

associated w

weight gain

be prudent

accompany

advice abou

smoking dupregnancy

advice abou

and weight

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

De Vriese et

al

31

2001

To determine the


food frequency

questionnaire (FFQ)


diet by comparing



with the 7d food

record in pregnant


the 1st and 3

rd

trimesters

Belgium

developed

n = 26

BMI 22 (176-

293) kgm2

Age 30 (25-37)

years

All pregnant

women were

nulliparous

7-day


during the 1st

(median 15

weeks) and 3rd

(median 35

weeks)

trimesters A

FFQ

containing 180

of the most

common fat-

containingfoods was

conducted at

the same

timepoints

Data recorded

was based on

the EFR

First pregnancy


Hg not diabetic no

proteinuria and not



The FFQ in


compositio

of Belgian

adequate m

reasonably

subjects acc

their dietary

intake

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Fung et al39

1997



zinc from a


altered in well-

nourished women


conception through

lactation and





USA developed

n = 13

BMI 223 (29)

kgm2

Age 30 (29)

years

Parity of 1 n =

10 2 n = 3

3-day weighed

food recordnon-

consecutive

days two

weekdays and

one weekend

at 8-10 weeks

24-26 weeks

and 34-36

weeks

gestation

Aged 22-40yrs body


non-diabetic non-


alcohol use and no


gynecological

complications

Well-nouri


zinc during

pregnancy

increasing

and by a 30

increase in

absorption

not signific

increase in

zinc was du

to an increa


early in the

period pres

an adaptatio

lactation pr

These data

that mechan

regulating z

homeostasi

between pr

and lactatio

8172019 Je Beile 2015


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Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Hronek et al40

2013



Czech pregnant


with recommended

daily allowances

(RDA)

Czechoslovakia

developed

Participants

were randomly

recruited from

both rural and

city regions

n = 152

BMI 211 (36)

kgm2

Age 289 (36)

years

7-day food


days using

scales and

household

measures at 0-

20 weeks 21-

29 weeks 30-

36 weeks and

37-39 weeks

gestation

Nonusers of chronic




le2 Subjects were

euthyroid

normoglyceamic and

not anemic

Lower intak


relative to t

correspond

during preg

Evaluated D

correspond

body size v

Modificatio

intake or al

supplement

recommend


iodine and

8172019 Je Beile 2015


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Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Jansson et al41

2008



between early

pregnancy BMI

maternal dietary

intake and birth

weight

Sweden

developing

n = 49

BMI 255 (69)

kgm2

Age 30 (45)

years

Diet history


over a 24hr

period

collected by a

registered

dietitian at 8-

12 weeks and

32-35 weeks

gestation

Inclusion criteria


old

Exclusion criteria

smoking


reproduction

concurrent disease


or diabetes

development of

pregnancy


preeclampsia or

intrauterine growth

restriction

High first t


trimester IG

were correl

increased b

weight We

that low ser

concentrati

IGFBP-1 re

link betwee

BMI and in

fetal growth


IGF-1 regu

placental nu

transport

8172019 Je Beile 2015


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Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Khoigani et

al

35

2012

To assess the



and micro nutrients




and reproductive

characteristics and


pregnant women

Iran developing

n = 620 (t1 n =

584 t2 n = 510)

BMI 235 (39)

kgm2

Age 256 (44)

years

Parity 158

(076)

48-hour


11-15 weeks

26 weeks and

34-37 weeks

gestation

Interviewers

were trained

Pregnant women who



delivery low birth

weight and factors

which may affect

pregnancy outcomes


addiction digestive


hemoglobinopathies

eating disorders


malignancy

Mean value


subjects wh

experienced

preeclamps

pregnancy

than in othe

women Int

manganese

C vitamin

and carboh

during the t


among preg

women wh

developed

preeclamps

significant

association

other micro

macro nutri

preeclamps

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Kopp-Hoolihan

et al

42

1999

To assess how well-




that predict an


response

USA developed

n = 10

BMI 231 (21)

kgm2

Age 291 (5)

years

3 day weighed


before

pregnancy and

at 8-10 24-26

34-36 weeks

gestation and

4-6 weeks

postpartum

Healthy non-smoking

women

Well-nouri

women useways to me

energy dem

pregnancy

reduction in

induced

thermogene

increased e

intake dep

less fat mas

predicted

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Kubota et al33

2013

To investigate the


intake maternal


growth during

pregnancy

Japan


BMI 175 (01)

kgm2

Age 297 (52)

years

Normaln = 94

BMI 21 (18)

kgm2

Age 308 (51)


Age 286 (36)

years

BMI 334 (65)

kgm2

Digital images


meals on 3

consecutive

days at 14-16

25-27 and 32-

34 weeks

gestation a

dietitian

reviewed

photos and

recorded

intakevalidation of

method not

reported

Singleton pregnant


had suffered from

obstetrical


premature delivery





Dietary inta


not correlat

fetal growth

Japanese na

recommend

advising ex

intake

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Lof et al23

2009

Investigate whether


weight gain are

associated with

estradiol and


plasma during

pregnancy

Sweden

developed

n = 226

BMI 229 (3)

kgm2

Age 32 (4) years

3 day weight


days including

one weekend

at 12 25 and

33 weeks

gestation

Calculations

conducted by

a nutritionist

Women with multi-





dietary intake were

excluded

No associat


dietary fat i

(total or sub

and plasma

levels Prog

levels corre

weight gain

pregnancy

Martinez et

al32

1994

To determine how



nation Mexico

Mexico

developing

n = 36

BMI 235 (26)

kgm2

Age 31 (54)

years

Diet history

collected by

trainedinterviewers

twice per

month and

reported as

mean first and

third trimester

values

Women with an 18




initial recruitment



pregnant

In this sam

women the


weight gain

pregnancy

was similar

women in U

States Low

maternal B

predicted sm

birth weigh

through at l

months of l

8172019 Je Beile 2015


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Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Piers et al36

1995



pregnancy and


a group of well-

nourished pregnant


women at 12 24 and


12 and 24 wk

postpartum with a

non-pregnant non-


India

developing

n = 18

BMI 217 (24)

kgm2

Age 296 (52)

years

5 day


household

measures of

known volume

at 12 24 and

34 weeks

gestation and

12 and 24

weeks post-

partum

participants


measure by a

dietitian who

also checked

all records




morning sickness

before the initial

metabolic

measurement at 12

weeks gestation

BMR is sig


with non-pr

non-lactatin

and remain

even when

differences

weight are

for Well-n

Indian wom

weight and

similar to th


Birth weigh

infants born

to be lower

cost of preg

estimated to

MJ close t

MJ estimat

FAOIWHO

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Tabrizi et al24

2011

To assess the


mineral intake of

pregnant women and


neonates

Iran developing

n = 450

BMI 239 (38)

kgm2

Age 261 (58)

years

24 hour Recall


1st 2

nd and 3

rd

trimesters

Qualification

training of

interviewer

not reported

Women of 16 to 40


health care centers

during the three


Maternal en


with higher

serum calci

and zinc in

birth weigh

neonates


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Guelinckx

et al

43

2010

Study which


improve dietary

habits according to

the National Diet

Recommendations

increase physical

activity level in

obese pregnant

women and

control gestational

weight gain

Belgium

developedrandomly

assigned using

block

randomization

Control(routine)

n =43

BMI 335 (39)

kgm2

Age 294 (44)

yrs


and PA

brochure)

n = 37

BMI 334 (31)

kgm2

Age 287 (4) yrs

Parity of 1 n = 15

Active (brochure

+ group dietary

counselling)

n = 42BMI 341 (45)

kgm2

Age 28 (36) yrs

Parity of 1 n = 20

7-day food


weighed and

household

measures

during each

trimester of

pregnancy

Records were

checked by a

nutritionist






diabetes multiple

pregnancy premature

labor (lt37 wks

gestation) primary


advice in case of

metabolic disorder


conditions and





brochure and group

discussions

A lifestyle interv


combined with

individual advice

improve dietary h

throughout pregn

in obese women

in the absence of

medical or obstet

complications

maintaining or

increasing PA du


decrease in GWG

individually desig

caloric intake res

based on energy

expenditure data

be included

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Korpi-

Hyovalti etal44

2012

To evaluate the


quality of diet

weight gain and

birth weight in

women at high risk

of gestational

diabetes mellitus

Finland


group 1 or 2

using computed

randomization


information on

diet and PA)

n = 27

BMI 255 (34)

kgm2

Lifestyle


nutrition advice)

n = 27

BMI 273 (6)

kgm2

4 day weighed


days including

one weekend

completed at

8-12 26-28

and 36-40

weeks

gestation

Records

checked by a

nutritionist

A three-factor

eating

questionnaire

was also used

at the 1st and

3rd

trimester

Women with one or





48-55 mmoll and the

2h oral glucose


glucose lt78 mmoll

were recruited


GDM at 8-12 wks


There were no cl


however

polyunsaturated f

increase in the lif

intervention grou

Intensive weight

education led to a

somewhat lower

gain during pregn

and higher birth w

of the infants in


macrosomia whe

compared to the c

follow up group

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Moses et al45

2014

To determine


index (LGI) dietary

advice at

the first antenatal

visit would result

in a lower fetal

birth weight

birth percentile

and ponderal index

(PI) than providing

healthy eating

(HE) advice

Australia

developedrandomly

assigned using

computer-

generated

random numbers

1 or 2

Healthy Eating

(counselled to

follow a healthy

diet based on the

AGHE4

) n = 280

BMI 247 (5)

kgm2

Age 299 (5) yrs

Low Glycemic

Index

(individualized

nutrition advice

on a LGI diet)

n = 296

BMI 243 (52)

kgm2 Age 299 (52)

yrs

3 day


household

measures at 16

and 36 weeks

gestation

records

reviewed by a

dietitian



least 18 years old

ability to read and

understand English


comply with visit

schedules Subjects






compromise their




body weight

A low intensity d


in pregnancy did

result in significa

differences in bir

weight fetal perc

of PI

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Wolff et

al

46

2008

To determine


consultations

restricts weight

gain in obese

women and

whether this

restriction impacts

on pregnancy-

induced changes in

glucose

metabolism

Denmark


group 1 or 2

using computed

randomization

Control (general

information on

diet and PA)

n = 27

BMI 255 (34)

kgm2


x 1 hour

consultations)

n = 27

BMI 273 (6)

kgm2

Age 28 (4) years

7 day weighed


plusmn 3 wks) 27

and 36 weeks

gestation



recruited Exclusion

criteria included


or gt45 year old


medical conditions

which impact fetal

growth

Restriction of


achievable and re

the deterioration

glucose metaboli

8172019 Je Beile 2015


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41

983120983137983143983141 983092983089 983151983142 983092983090

FIGURE LEGENDS





















2 GWG 115 to 155 kg)


2

GWG 50 to 90 kg)

8172019 Je Beile 2015


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42

983120983137983143983141 983092983090 983151983142 983092983090







8172019 Je Beile 2015


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8172019 Je Beile 2015


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8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


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8172019 Je Beile 2015


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8172019 Je Beile 2015


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8172019 Je Beile 2015


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6













METHODS68

Search Strategy69




by IOM guidelines20










8172019 Je Beile 2015


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7




Study Selection85





In88






was calculated25





Data extraction98







(JBM or JCYL)105

8172019 Je Beile 2015


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8

























8172019 Je Beile 2015


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9



Manual27




RESULTS134







studies232431-42




reported data by141



and142



had a population143







6 ranged 63-78233134424346

1 of 5533

and 3 did149

not report243740




8172019 Je Beile 2015


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10


























8172019 Je Beile 2015


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11







with a182
















(SMD = 1431 P lt 00005 n = 17)195






8172019 Je Beile 2015


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12









meta-analysis209

COMMENT210















8172019 Je Beile 2015


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13


of women (1971-1993)50



Unlike the226







levels4751



in the third4751











collection period53






8172019 Je Beile 2015


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14






This251


thereby252










nutrition50



progresses5657







265





during pregnancy270

8172019 Je Beile 2015


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15



(n = 47003) and272










conception281













CONCLUSIONS 293

8172019 Je Beile 2015


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16





revised298

Acknowledgements299




project303











Funding314


8172019 Je Beile 2015


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18

REFERENCES

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200936(2)341983085356

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ACCEPTED MANUSCRIPT

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ACCEPTED MANUSCRIPT

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ACCEPTED MANUSCRIPT

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199868(6)12369830851240

58 K983150983157983140983155983141983150 983126K H983141983145983156983149983137983150983150 BL H983137983148983148983140983151983154983155983155983151983150 983124I 983123983151983154983141983150983155983141983150 983124IA 983119983148983155983141983150 983123F M983137983156983141983154983150983137983148 983140983145983141983156983137983154983161983143983148983161983139983137983141983149983145983139 983148983151983137983140 983140983157983154983145983150983143 983152983154983141983143983150983137983150983139983161 983137983150983140 983143983141983155983156983137983156983145983151983150983137983148 983159983141983145983143983144983156 983143983137983145983150 983138983145983154983156983144 983159983141983145983143983144983156 983137983150983140 983152983151983155983156983152983137983154983156983157983149

983159983141983145983143983144983156 983154983141983156983141983150983156983145983151983150 A 983155983156983157983140983161 983159983145983156983144983145983150 983156983144983141 D983137983150983145983155983144 N983137983156983145983151983150983137983148 B983145983154983156983144 C983151983144983151983154983156 983106983154983145983156983145983155983144 983114983151983157983154983150983137983148 983151983142

983118983157983156983154983145983156983145983151983150 2013109(8)14719830851478

59 983130983144983137983150983143 C L983145983157 983123 983123983151983148983151983149983151983150 CG H983157 FB D983145983141983156983137983154983161 983142983145983138983141983154 983145983150983156983137983147983141 983140983145983141983156983137983154983161 983143983148983161983139983141983149983145983139 983148983151983137983140 983137983150983140 983156983144983141 983154983145983155983147

983142983151983154 983143983141983155983156983137983156983145983151983150983137983148 983140983145983137983138983141983156983141983155 983149983141983148983148983145983156983157983155 983108983145983137983138983141983156983141983155 983107983137983154983141 200629(10)22239830852230

8172019 Je Beile 2015


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22





f r o m b i a s



d e s c r i b e d






W e r e o





i n d i c a t o r s



c o n s i d e

r a t i o n




Alberti-

Fidanza et

al37


Carbone

et al34


Conway

et al38


De


Fung et

al39


Goodarzi

Khoigani

et al35


Guelinckx

et al43


Hronek et

al40


Jansson etal41


Kopp

Hoolihan

et al42


Korpi

Hyovalti

et al44


Kubota et

al33


Lof et

al

23


8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

23





f r o m b i a s



i t h d r a w a l s

d e s c r i b e d




r e a n d





i n e d a n d t h e


l i a b l e




i n d i c a t o r s


b y r e s u l t s


t a k e n i n t o





Martinez

et al32


Moses et

al45


Piers et

al36


Tabrizi et

al24


Wolff et

al46



8172019 Je Beile 2015


ACCEPTED MANUSCRIPT



Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Alberti-Fidanza

et al37

2002

To examine



(ToAC) of women



newborns and relate

the results to the


same women during

pregnancy

Italy developed

n = 12

BMI 226 (55)

kgm2

Age 311 (42)

years

Parity 18 (09)

nil smokers

Collected by

qualified and

experienced

dietitians

using the diet

history

method during

the 1st 2

nd and

3rd

trimesters


monitor To

during the e

period of pr

and we sug

intakes of f

vegetables

necessary

antioxidant

and pro-vit


antioxidant

mothers an

newborns

particularly

preterm m

valuable in

for increasi

chance that

pregnancie

successfull


deliveries

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Carbone et al34

1992

Present patterns of



puerperium and its


fetal growth and

maternal nutrient

intake

Spain

developed

n = 33

BMI 227 (22)

kgm2

Age 28 (36)

years

Parity of 1 n =

18 234 n = 15

3-day weight


holiday

completed at

11 19 and 35

weeks

gestation




personal or family





time of visit and

pregnancy


risk

There was


and head

circumferen

weeks of ge

Findings m

a relationsh

between the

metabolism

maternal le

and fetal

developme

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Conway et al38

1999

To explore the


appropriateness of

weight gain during

pregnancy using AIM





England


BMI 22 (24)

kgm2

Age 312 (46)

years

Parity of 1 n =

28 2 n = 4

Unrestrainedn = 30

BMI 207 (196)

kgm2

Age 306 (36)

years

Parity of 1 n =

26 2 n = 4

7-day weighed


weeks

gestation

Caucasian women






outcomes

Providing p


appropriate

gains may b

beneficial

cessation o

during preg

associated w

weight gain

be prudent

accompany

advice abou

smoking dupregnancy

advice abou

and weight

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

De Vriese et

al

31

2001

To determine the


food frequency

questionnaire (FFQ)


diet by comparing



with the 7d food

record in pregnant


the 1st and 3

rd

trimesters

Belgium

developed

n = 26

BMI 22 (176-

293) kgm2

Age 30 (25-37)

years

All pregnant

women were

nulliparous

7-day


during the 1st

(median 15

weeks) and 3rd

(median 35

weeks)

trimesters A

FFQ

containing 180

of the most

common fat-

containingfoods was

conducted at

the same

timepoints

Data recorded

was based on

the EFR

First pregnancy


Hg not diabetic no

proteinuria and not



The FFQ in


compositio

of Belgian

adequate m

reasonably

subjects acc

their dietary

intake

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Fung et al39

1997



zinc from a


altered in well-

nourished women


conception through

lactation and





USA developed

n = 13

BMI 223 (29)

kgm2

Age 30 (29)

years

Parity of 1 n =

10 2 n = 3

3-day weighed

food recordnon-

consecutive

days two

weekdays and

one weekend

at 8-10 weeks

24-26 weeks

and 34-36

weeks

gestation

Aged 22-40yrs body


non-diabetic non-


alcohol use and no


gynecological

complications

Well-nouri


zinc during

pregnancy

increasing

and by a 30

increase in

absorption

not signific

increase in

zinc was du

to an increa


early in the

period pres

an adaptatio

lactation pr

These data

that mechan

regulating z

homeostasi

between pr

and lactatio

8172019 Je Beile 2015


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Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Hronek et al40

2013



Czech pregnant


with recommended

daily allowances

(RDA)

Czechoslovakia

developed

Participants

were randomly

recruited from

both rural and

city regions

n = 152

BMI 211 (36)

kgm2

Age 289 (36)

years

7-day food


days using

scales and

household

measures at 0-

20 weeks 21-

29 weeks 30-

36 weeks and

37-39 weeks

gestation

Nonusers of chronic




le2 Subjects were

euthyroid

normoglyceamic and

not anemic

Lower intak


relative to t

correspond

during preg

Evaluated D

correspond

body size v

Modificatio

intake or al

supplement

recommend


iodine and

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Jansson et al41

2008



between early

pregnancy BMI

maternal dietary

intake and birth

weight

Sweden

developing

n = 49

BMI 255 (69)

kgm2

Age 30 (45)

years

Diet history


over a 24hr

period

collected by a

registered

dietitian at 8-

12 weeks and

32-35 weeks

gestation

Inclusion criteria


old

Exclusion criteria

smoking


reproduction

concurrent disease


or diabetes

development of

pregnancy


preeclampsia or

intrauterine growth

restriction

High first t


trimester IG

were correl

increased b

weight We

that low ser

concentrati

IGFBP-1 re

link betwee

BMI and in

fetal growth


IGF-1 regu

placental nu

transport

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Khoigani et

al

35

2012

To assess the



and micro nutrients




and reproductive

characteristics and


pregnant women

Iran developing

n = 620 (t1 n =

584 t2 n = 510)

BMI 235 (39)

kgm2

Age 256 (44)

years

Parity 158

(076)

48-hour


11-15 weeks

26 weeks and

34-37 weeks

gestation

Interviewers

were trained

Pregnant women who



delivery low birth

weight and factors

which may affect

pregnancy outcomes


addiction digestive


hemoglobinopathies

eating disorders


malignancy

Mean value


subjects wh

experienced

preeclamps

pregnancy

than in othe

women Int

manganese

C vitamin

and carboh

during the t


among preg

women wh

developed

preeclamps

significant

association

other micro

macro nutri

preeclamps

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Kopp-Hoolihan

et al

42

1999

To assess how well-




that predict an


response

USA developed

n = 10

BMI 231 (21)

kgm2

Age 291 (5)

years

3 day weighed


before

pregnancy and

at 8-10 24-26

34-36 weeks

gestation and

4-6 weeks

postpartum

Healthy non-smoking

women

Well-nouri

women useways to me

energy dem

pregnancy

reduction in

induced

thermogene

increased e

intake dep

less fat mas

predicted

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Kubota et al33

2013

To investigate the


intake maternal


growth during

pregnancy

Japan


BMI 175 (01)

kgm2

Age 297 (52)

years

Normaln = 94

BMI 21 (18)

kgm2

Age 308 (51)


Age 286 (36)

years

BMI 334 (65)

kgm2

Digital images


meals on 3

consecutive

days at 14-16

25-27 and 32-

34 weeks

gestation a

dietitian

reviewed

photos and

recorded

intakevalidation of

method not

reported

Singleton pregnant


had suffered from

obstetrical


premature delivery





Dietary inta


not correlat

fetal growth

Japanese na

recommend

advising ex

intake

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Lof et al23

2009

Investigate whether


weight gain are

associated with

estradiol and


plasma during

pregnancy

Sweden

developed

n = 226

BMI 229 (3)

kgm2

Age 32 (4) years

3 day weight


days including

one weekend

at 12 25 and

33 weeks

gestation

Calculations

conducted by

a nutritionist

Women with multi-





dietary intake were

excluded

No associat


dietary fat i

(total or sub

and plasma

levels Prog

levels corre

weight gain

pregnancy

Martinez et

al32

1994

To determine how



nation Mexico

Mexico

developing

n = 36

BMI 235 (26)

kgm2

Age 31 (54)

years

Diet history

collected by

trainedinterviewers

twice per

month and

reported as

mean first and

third trimester

values

Women with an 18




initial recruitment



pregnant

In this sam

women the


weight gain

pregnancy

was similar

women in U

States Low

maternal B

predicted sm

birth weigh

through at l

months of l

8172019 Je Beile 2015


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Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Piers et al36

1995



pregnancy and


a group of well-

nourished pregnant


women at 12 24 and


12 and 24 wk

postpartum with a

non-pregnant non-


India

developing

n = 18

BMI 217 (24)

kgm2

Age 296 (52)

years

5 day


household

measures of

known volume

at 12 24 and

34 weeks

gestation and

12 and 24

weeks post-

partum

participants


measure by a

dietitian who

also checked

all records




morning sickness

before the initial

metabolic

measurement at 12

weeks gestation

BMR is sig


with non-pr

non-lactatin

and remain

even when

differences

weight are

for Well-n

Indian wom

weight and

similar to th


Birth weigh

infants born

to be lower

cost of preg

estimated to

MJ close t

MJ estimat

FAOIWHO

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Tabrizi et al24

2011

To assess the


mineral intake of

pregnant women and


neonates

Iran developing

n = 450

BMI 239 (38)

kgm2

Age 261 (58)

years

24 hour Recall


1st 2

nd and 3

rd

trimesters

Qualification

training of

interviewer

not reported

Women of 16 to 40


health care centers

during the three


Maternal en


with higher

serum calci

and zinc in

birth weigh

neonates


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Guelinckx

et al

43

2010

Study which


improve dietary

habits according to

the National Diet

Recommendations

increase physical

activity level in

obese pregnant

women and

control gestational

weight gain

Belgium

developedrandomly

assigned using

block

randomization

Control(routine)

n =43

BMI 335 (39)

kgm2

Age 294 (44)

yrs


and PA

brochure)

n = 37

BMI 334 (31)

kgm2

Age 287 (4) yrs

Parity of 1 n = 15

Active (brochure

+ group dietary

counselling)

n = 42BMI 341 (45)

kgm2

Age 28 (36) yrs

Parity of 1 n = 20

7-day food


weighed and

household

measures

during each

trimester of

pregnancy

Records were

checked by a

nutritionist






diabetes multiple

pregnancy premature

labor (lt37 wks

gestation) primary


advice in case of

metabolic disorder


conditions and





brochure and group

discussions

A lifestyle interv


combined with

individual advice

improve dietary h

throughout pregn

in obese women

in the absence of

medical or obstet

complications

maintaining or

increasing PA du


decrease in GWG

individually desig

caloric intake res

based on energy

expenditure data

be included

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Korpi-

Hyovalti etal44

2012

To evaluate the


quality of diet

weight gain and

birth weight in

women at high risk

of gestational

diabetes mellitus

Finland


group 1 or 2

using computed

randomization


information on

diet and PA)

n = 27

BMI 255 (34)

kgm2

Lifestyle


nutrition advice)

n = 27

BMI 273 (6)

kgm2

4 day weighed


days including

one weekend

completed at

8-12 26-28

and 36-40

weeks

gestation

Records

checked by a

nutritionist

A three-factor

eating

questionnaire

was also used

at the 1st and

3rd

trimester

Women with one or





48-55 mmoll and the

2h oral glucose


glucose lt78 mmoll

were recruited


GDM at 8-12 wks


There were no cl


however

polyunsaturated f

increase in the lif

intervention grou

Intensive weight

education led to a

somewhat lower

gain during pregn

and higher birth w

of the infants in


macrosomia whe

compared to the c

follow up group

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Moses et al45

2014

To determine


index (LGI) dietary

advice at

the first antenatal

visit would result

in a lower fetal

birth weight

birth percentile

and ponderal index

(PI) than providing

healthy eating

(HE) advice

Australia

developedrandomly

assigned using

computer-

generated

random numbers

1 or 2

Healthy Eating

(counselled to

follow a healthy

diet based on the

AGHE4

) n = 280

BMI 247 (5)

kgm2

Age 299 (5) yrs

Low Glycemic

Index

(individualized

nutrition advice

on a LGI diet)

n = 296

BMI 243 (52)

kgm2 Age 299 (52)

yrs

3 day


household

measures at 16

and 36 weeks

gestation

records

reviewed by a

dietitian



least 18 years old

ability to read and

understand English


comply with visit

schedules Subjects






compromise their




body weight

A low intensity d


in pregnancy did

result in significa

differences in bir

weight fetal perc

of PI

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Wolff et

al

46

2008

To determine


consultations

restricts weight

gain in obese

women and

whether this

restriction impacts

on pregnancy-

induced changes in

glucose

metabolism

Denmark


group 1 or 2

using computed

randomization

Control (general

information on

diet and PA)

n = 27

BMI 255 (34)

kgm2


x 1 hour

consultations)

n = 27

BMI 273 (6)

kgm2

Age 28 (4) years

7 day weighed


plusmn 3 wks) 27

and 36 weeks

gestation



recruited Exclusion

criteria included


or gt45 year old


medical conditions

which impact fetal

growth

Restriction of


achievable and re

the deterioration

glucose metaboli

8172019 Je Beile 2015


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41

983120983137983143983141 983092983089 983151983142 983092983090

FIGURE LEGENDS





















2 GWG 115 to 155 kg)


2

GWG 50 to 90 kg)

8172019 Je Beile 2015


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42

983120983137983143983141 983092983090 983151983142 983092983090







8172019 Je Beile 2015


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8172019 Je Beile 2015


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8172019 Je Beile 2015


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8172019 Je Beile 2015


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8172019 Je Beile 2015


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8172019 Je Beile 2015


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8172019 Je Beile 2015


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7




Study Selection85





In88






was calculated25





Data extraction98







(JBM or JCYL)105

8172019 Je Beile 2015


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8

























8172019 Je Beile 2015


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9



Manual27




RESULTS134







studies232431-42




reported data by141



and142



had a population143







6 ranged 63-78233134424346

1 of 5533

and 3 did149

not report243740




8172019 Je Beile 2015


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10


























8172019 Je Beile 2015


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11







with a182
















(SMD = 1431 P lt 00005 n = 17)195






8172019 Je Beile 2015


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12









meta-analysis209

COMMENT210















8172019 Je Beile 2015


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13


of women (1971-1993)50



Unlike the226







levels4751



in the third4751











collection period53






8172019 Je Beile 2015


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14






This251


thereby252










nutrition50



progresses5657







265





during pregnancy270

8172019 Je Beile 2015


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15



(n = 47003) and272










conception281













CONCLUSIONS 293

8172019 Je Beile 2015


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16





revised298

Acknowledgements299




project303











Funding314


8172019 Je Beile 2015


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18

REFERENCES

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200936(2)341983085356

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ACCEPTED MANUSCRIPT

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ACCEPTED MANUSCRIPT

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ACCEPTED MANUSCRIPT

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199868(6)12369830851240

58 K983150983157983140983155983141983150 983126K H983141983145983156983149983137983150983150 BL H983137983148983148983140983151983154983155983155983151983150 983124I 983123983151983154983141983150983155983141983150 983124IA 983119983148983155983141983150 983123F M983137983156983141983154983150983137983148 983140983145983141983156983137983154983161983143983148983161983139983137983141983149983145983139 983148983151983137983140 983140983157983154983145983150983143 983152983154983141983143983150983137983150983139983161 983137983150983140 983143983141983155983156983137983156983145983151983150983137983148 983159983141983145983143983144983156 983143983137983145983150 983138983145983154983156983144 983159983141983145983143983144983156 983137983150983140 983152983151983155983156983152983137983154983156983157983149

983159983141983145983143983144983156 983154983141983156983141983150983156983145983151983150 A 983155983156983157983140983161 983159983145983156983144983145983150 983156983144983141 D983137983150983145983155983144 N983137983156983145983151983150983137983148 B983145983154983156983144 C983151983144983151983154983156 983106983154983145983156983145983155983144 983114983151983157983154983150983137983148 983151983142

983118983157983156983154983145983156983145983151983150 2013109(8)14719830851478

59 983130983144983137983150983143 C L983145983157 983123 983123983151983148983151983149983151983150 CG H983157 FB D983145983141983156983137983154983161 983142983145983138983141983154 983145983150983156983137983147983141 983140983145983141983156983137983154983161 983143983148983161983139983141983149983145983139 983148983151983137983140 983137983150983140 983156983144983141 983154983145983155983147

983142983151983154 983143983141983155983156983137983156983145983151983150983137983148 983140983145983137983138983141983156983141983155 983149983141983148983148983145983156983157983155 983108983145983137983138983141983156983141983155 983107983137983154983141 200629(10)22239830852230

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

22





f r o m b i a s



d e s c r i b e d






W e r e o





i n d i c a t o r s



c o n s i d e

r a t i o n




Alberti-

Fidanza et

al37


Carbone

et al34


Conway

et al38


De


Fung et

al39


Goodarzi

Khoigani

et al35


Guelinckx

et al43


Hronek et

al40


Jansson etal41


Kopp

Hoolihan

et al42


Korpi

Hyovalti

et al44


Kubota et

al33


Lof et

al

23


8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

23





f r o m b i a s



i t h d r a w a l s

d e s c r i b e d




r e a n d





i n e d a n d t h e


l i a b l e




i n d i c a t o r s


b y r e s u l t s


t a k e n i n t o





Martinez

et al32


Moses et

al45


Piers et

al36


Tabrizi et

al24


Wolff et

al46



8172019 Je Beile 2015


ACCEPTED MANUSCRIPT



Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Alberti-Fidanza

et al37

2002

To examine



(ToAC) of women



newborns and relate

the results to the


same women during

pregnancy

Italy developed

n = 12

BMI 226 (55)

kgm2

Age 311 (42)

years

Parity 18 (09)

nil smokers

Collected by

qualified and

experienced

dietitians

using the diet

history

method during

the 1st 2

nd and

3rd

trimesters


monitor To

during the e

period of pr

and we sug

intakes of f

vegetables

necessary

antioxidant

and pro-vit


antioxidant

mothers an

newborns

particularly

preterm m

valuable in

for increasi

chance that

pregnancie

successfull


deliveries

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Carbone et al34

1992

Present patterns of



puerperium and its


fetal growth and

maternal nutrient

intake

Spain

developed

n = 33

BMI 227 (22)

kgm2

Age 28 (36)

years

Parity of 1 n =

18 234 n = 15

3-day weight


holiday

completed at

11 19 and 35

weeks

gestation




personal or family





time of visit and

pregnancy


risk

There was


and head

circumferen

weeks of ge

Findings m

a relationsh

between the

metabolism

maternal le

and fetal

developme

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Conway et al38

1999

To explore the


appropriateness of

weight gain during

pregnancy using AIM





England


BMI 22 (24)

kgm2

Age 312 (46)

years

Parity of 1 n =

28 2 n = 4

Unrestrainedn = 30

BMI 207 (196)

kgm2

Age 306 (36)

years

Parity of 1 n =

26 2 n = 4

7-day weighed


weeks

gestation

Caucasian women






outcomes

Providing p


appropriate

gains may b

beneficial

cessation o

during preg

associated w

weight gain

be prudent

accompany

advice abou

smoking dupregnancy

advice abou

and weight

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

De Vriese et

al

31

2001

To determine the


food frequency

questionnaire (FFQ)


diet by comparing



with the 7d food

record in pregnant


the 1st and 3

rd

trimesters

Belgium

developed

n = 26

BMI 22 (176-

293) kgm2

Age 30 (25-37)

years

All pregnant

women were

nulliparous

7-day


during the 1st

(median 15

weeks) and 3rd

(median 35

weeks)

trimesters A

FFQ

containing 180

of the most

common fat-

containingfoods was

conducted at

the same

timepoints

Data recorded

was based on

the EFR

First pregnancy


Hg not diabetic no

proteinuria and not



The FFQ in


compositio

of Belgian

adequate m

reasonably

subjects acc

their dietary

intake

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Fung et al39

1997



zinc from a


altered in well-

nourished women


conception through

lactation and





USA developed

n = 13

BMI 223 (29)

kgm2

Age 30 (29)

years

Parity of 1 n =

10 2 n = 3

3-day weighed

food recordnon-

consecutive

days two

weekdays and

one weekend

at 8-10 weeks

24-26 weeks

and 34-36

weeks

gestation

Aged 22-40yrs body


non-diabetic non-


alcohol use and no


gynecological

complications

Well-nouri


zinc during

pregnancy

increasing

and by a 30

increase in

absorption

not signific

increase in

zinc was du

to an increa


early in the

period pres

an adaptatio

lactation pr

These data

that mechan

regulating z

homeostasi

between pr

and lactatio

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Hronek et al40

2013



Czech pregnant


with recommended

daily allowances

(RDA)

Czechoslovakia

developed

Participants

were randomly

recruited from

both rural and

city regions

n = 152

BMI 211 (36)

kgm2

Age 289 (36)

years

7-day food


days using

scales and

household

measures at 0-

20 weeks 21-

29 weeks 30-

36 weeks and

37-39 weeks

gestation

Nonusers of chronic




le2 Subjects were

euthyroid

normoglyceamic and

not anemic

Lower intak


relative to t

correspond

during preg

Evaluated D

correspond

body size v

Modificatio

intake or al

supplement

recommend


iodine and

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Jansson et al41

2008



between early

pregnancy BMI

maternal dietary

intake and birth

weight

Sweden

developing

n = 49

BMI 255 (69)

kgm2

Age 30 (45)

years

Diet history


over a 24hr

period

collected by a

registered

dietitian at 8-

12 weeks and

32-35 weeks

gestation

Inclusion criteria


old

Exclusion criteria

smoking


reproduction

concurrent disease


or diabetes

development of

pregnancy


preeclampsia or

intrauterine growth

restriction

High first t


trimester IG

were correl

increased b

weight We

that low ser

concentrati

IGFBP-1 re

link betwee

BMI and in

fetal growth


IGF-1 regu

placental nu

transport

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Khoigani et

al

35

2012

To assess the



and micro nutrients




and reproductive

characteristics and


pregnant women

Iran developing

n = 620 (t1 n =

584 t2 n = 510)

BMI 235 (39)

kgm2

Age 256 (44)

years

Parity 158

(076)

48-hour


11-15 weeks

26 weeks and

34-37 weeks

gestation

Interviewers

were trained

Pregnant women who



delivery low birth

weight and factors

which may affect

pregnancy outcomes


addiction digestive


hemoglobinopathies

eating disorders


malignancy

Mean value


subjects wh

experienced

preeclamps

pregnancy

than in othe

women Int

manganese

C vitamin

and carboh

during the t


among preg

women wh

developed

preeclamps

significant

association

other micro

macro nutri

preeclamps

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Kopp-Hoolihan

et al

42

1999

To assess how well-




that predict an


response

USA developed

n = 10

BMI 231 (21)

kgm2

Age 291 (5)

years

3 day weighed


before

pregnancy and

at 8-10 24-26

34-36 weeks

gestation and

4-6 weeks

postpartum

Healthy non-smoking

women

Well-nouri

women useways to me

energy dem

pregnancy

reduction in

induced

thermogene

increased e

intake dep

less fat mas

predicted

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Kubota et al33

2013

To investigate the


intake maternal


growth during

pregnancy

Japan


BMI 175 (01)

kgm2

Age 297 (52)

years

Normaln = 94

BMI 21 (18)

kgm2

Age 308 (51)


Age 286 (36)

years

BMI 334 (65)

kgm2

Digital images


meals on 3

consecutive

days at 14-16

25-27 and 32-

34 weeks

gestation a

dietitian

reviewed

photos and

recorded

intakevalidation of

method not

reported

Singleton pregnant


had suffered from

obstetrical


premature delivery





Dietary inta


not correlat

fetal growth

Japanese na

recommend

advising ex

intake

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Lof et al23

2009

Investigate whether


weight gain are

associated with

estradiol and


plasma during

pregnancy

Sweden

developed

n = 226

BMI 229 (3)

kgm2

Age 32 (4) years

3 day weight


days including

one weekend

at 12 25 and

33 weeks

gestation

Calculations

conducted by

a nutritionist

Women with multi-





dietary intake were

excluded

No associat


dietary fat i

(total or sub

and plasma

levels Prog

levels corre

weight gain

pregnancy

Martinez et

al32

1994

To determine how



nation Mexico

Mexico

developing

n = 36

BMI 235 (26)

kgm2

Age 31 (54)

years

Diet history

collected by

trainedinterviewers

twice per

month and

reported as

mean first and

third trimester

values

Women with an 18




initial recruitment



pregnant

In this sam

women the


weight gain

pregnancy

was similar

women in U

States Low

maternal B

predicted sm

birth weigh

through at l

months of l

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Piers et al36

1995



pregnancy and


a group of well-

nourished pregnant


women at 12 24 and


12 and 24 wk

postpartum with a

non-pregnant non-


India

developing

n = 18

BMI 217 (24)

kgm2

Age 296 (52)

years

5 day


household

measures of

known volume

at 12 24 and

34 weeks

gestation and

12 and 24

weeks post-

partum

participants


measure by a

dietitian who

also checked

all records




morning sickness

before the initial

metabolic

measurement at 12

weeks gestation

BMR is sig


with non-pr

non-lactatin

and remain

even when

differences

weight are

for Well-n

Indian wom

weight and

similar to th


Birth weigh

infants born

to be lower

cost of preg

estimated to

MJ close t

MJ estimat

FAOIWHO

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Tabrizi et al24

2011

To assess the


mineral intake of

pregnant women and


neonates

Iran developing

n = 450

BMI 239 (38)

kgm2

Age 261 (58)

years

24 hour Recall


1st 2

nd and 3

rd

trimesters

Qualification

training of

interviewer

not reported

Women of 16 to 40


health care centers

during the three


Maternal en


with higher

serum calci

and zinc in

birth weigh

neonates


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Guelinckx

et al

43

2010

Study which


improve dietary

habits according to

the National Diet

Recommendations

increase physical

activity level in

obese pregnant

women and

control gestational

weight gain

Belgium

developedrandomly

assigned using

block

randomization

Control(routine)

n =43

BMI 335 (39)

kgm2

Age 294 (44)

yrs


and PA

brochure)

n = 37

BMI 334 (31)

kgm2

Age 287 (4) yrs

Parity of 1 n = 15

Active (brochure

+ group dietary

counselling)

n = 42BMI 341 (45)

kgm2

Age 28 (36) yrs

Parity of 1 n = 20

7-day food


weighed and

household

measures

during each

trimester of

pregnancy

Records were

checked by a

nutritionist






diabetes multiple

pregnancy premature

labor (lt37 wks

gestation) primary


advice in case of

metabolic disorder


conditions and





brochure and group

discussions

A lifestyle interv


combined with

individual advice

improve dietary h

throughout pregn

in obese women

in the absence of

medical or obstet

complications

maintaining or

increasing PA du


decrease in GWG

individually desig

caloric intake res

based on energy

expenditure data

be included

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Korpi-

Hyovalti etal44

2012

To evaluate the


quality of diet

weight gain and

birth weight in

women at high risk

of gestational

diabetes mellitus

Finland


group 1 or 2

using computed

randomization


information on

diet and PA)

n = 27

BMI 255 (34)

kgm2

Lifestyle


nutrition advice)

n = 27

BMI 273 (6)

kgm2

4 day weighed


days including

one weekend

completed at

8-12 26-28

and 36-40

weeks

gestation

Records

checked by a

nutritionist

A three-factor

eating

questionnaire

was also used

at the 1st and

3rd

trimester

Women with one or





48-55 mmoll and the

2h oral glucose


glucose lt78 mmoll

were recruited


GDM at 8-12 wks


There were no cl


however

polyunsaturated f

increase in the lif

intervention grou

Intensive weight

education led to a

somewhat lower

gain during pregn

and higher birth w

of the infants in


macrosomia whe

compared to the c

follow up group

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Moses et al45

2014

To determine


index (LGI) dietary

advice at

the first antenatal

visit would result

in a lower fetal

birth weight

birth percentile

and ponderal index

(PI) than providing

healthy eating

(HE) advice

Australia

developedrandomly

assigned using

computer-

generated

random numbers

1 or 2

Healthy Eating

(counselled to

follow a healthy

diet based on the

AGHE4

) n = 280

BMI 247 (5)

kgm2

Age 299 (5) yrs

Low Glycemic

Index

(individualized

nutrition advice

on a LGI diet)

n = 296

BMI 243 (52)

kgm2 Age 299 (52)

yrs

3 day


household

measures at 16

and 36 weeks

gestation

records

reviewed by a

dietitian



least 18 years old

ability to read and

understand English


comply with visit

schedules Subjects






compromise their




body weight

A low intensity d


in pregnancy did

result in significa

differences in bir

weight fetal perc

of PI

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Wolff et

al

46

2008

To determine


consultations

restricts weight

gain in obese

women and

whether this

restriction impacts

on pregnancy-

induced changes in

glucose

metabolism

Denmark


group 1 or 2

using computed

randomization

Control (general

information on

diet and PA)

n = 27

BMI 255 (34)

kgm2


x 1 hour

consultations)

n = 27

BMI 273 (6)

kgm2

Age 28 (4) years

7 day weighed


plusmn 3 wks) 27

and 36 weeks

gestation



recruited Exclusion

criteria included


or gt45 year old


medical conditions

which impact fetal

growth

Restriction of


achievable and re

the deterioration

glucose metaboli

8172019 Je Beile 2015


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41

983120983137983143983141 983092983089 983151983142 983092983090

FIGURE LEGENDS





















2 GWG 115 to 155 kg)


2

GWG 50 to 90 kg)

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

42

983120983137983143983141 983092983090 983151983142 983092983090







8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


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8172019 Je Beile 2015


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8172019 Je Beile 2015


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8172019 Je Beile 2015


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8

























8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

9



Manual27




RESULTS134







studies232431-42




reported data by141



and142



had a population143







6 ranged 63-78233134424346

1 of 5533

and 3 did149

not report243740




8172019 Je Beile 2015


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10


























8172019 Je Beile 2015


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11







with a182
















(SMD = 1431 P lt 00005 n = 17)195






8172019 Je Beile 2015


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12









meta-analysis209

COMMENT210















8172019 Je Beile 2015


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13


of women (1971-1993)50



Unlike the226







levels4751



in the third4751











collection period53






8172019 Je Beile 2015


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14






This251


thereby252










nutrition50



progresses5657







265





during pregnancy270

8172019 Je Beile 2015


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15



(n = 47003) and272










conception281













CONCLUSIONS 293

8172019 Je Beile 2015


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16





revised298

Acknowledgements299




project303











Funding314


8172019 Je Beile 2015


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18

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200936(2)341983085356

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ACCEPTED MANUSCRIPT

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ACCEPTED MANUSCRIPT

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983118983157983156983154983145983156983145983151983150 2013109(8)14719830851478

59 983130983144983137983150983143 C L983145983157 983123 983123983151983148983151983149983151983150 CG H983157 FB D983145983141983156983137983154983161 983142983145983138983141983154 983145983150983156983137983147983141 983140983145983141983156983137983154983161 983143983148983161983139983141983149983145983139 983148983151983137983140 983137983150983140 983156983144983141 983154983145983155983147

983142983151983154 983143983141983155983156983137983156983145983151983150983137983148 983140983145983137983138983141983156983141983155 983149983141983148983148983145983156983157983155 983108983145983137983138983141983156983141983155 983107983137983154983141 200629(10)22239830852230

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

22





f r o m b i a s



d e s c r i b e d






W e r e o





i n d i c a t o r s



c o n s i d e

r a t i o n




Alberti-

Fidanza et

al37


Carbone

et al34


Conway

et al38


De


Fung et

al39


Goodarzi

Khoigani

et al35


Guelinckx

et al43


Hronek et

al40


Jansson etal41


Kopp

Hoolihan

et al42


Korpi

Hyovalti

et al44


Kubota et

al33


Lof et

al

23


8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

23





f r o m b i a s



i t h d r a w a l s

d e s c r i b e d




r e a n d





i n e d a n d t h e


l i a b l e




i n d i c a t o r s


b y r e s u l t s


t a k e n i n t o





Martinez

et al32


Moses et

al45


Piers et

al36


Tabrizi et

al24


Wolff et

al46



8172019 Je Beile 2015


ACCEPTED MANUSCRIPT



Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Alberti-Fidanza

et al37

2002

To examine



(ToAC) of women



newborns and relate

the results to the


same women during

pregnancy

Italy developed

n = 12

BMI 226 (55)

kgm2

Age 311 (42)

years

Parity 18 (09)

nil smokers

Collected by

qualified and

experienced

dietitians

using the diet

history

method during

the 1st 2

nd and

3rd

trimesters


monitor To

during the e

period of pr

and we sug

intakes of f

vegetables

necessary

antioxidant

and pro-vit


antioxidant

mothers an

newborns

particularly

preterm m

valuable in

for increasi

chance that

pregnancie

successfull


deliveries

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Carbone et al34

1992

Present patterns of



puerperium and its


fetal growth and

maternal nutrient

intake

Spain

developed

n = 33

BMI 227 (22)

kgm2

Age 28 (36)

years

Parity of 1 n =

18 234 n = 15

3-day weight


holiday

completed at

11 19 and 35

weeks

gestation




personal or family





time of visit and

pregnancy


risk

There was


and head

circumferen

weeks of ge

Findings m

a relationsh

between the

metabolism

maternal le

and fetal

developme

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Conway et al38

1999

To explore the


appropriateness of

weight gain during

pregnancy using AIM





England


BMI 22 (24)

kgm2

Age 312 (46)

years

Parity of 1 n =

28 2 n = 4

Unrestrainedn = 30

BMI 207 (196)

kgm2

Age 306 (36)

years

Parity of 1 n =

26 2 n = 4

7-day weighed


weeks

gestation

Caucasian women






outcomes

Providing p


appropriate

gains may b

beneficial

cessation o

during preg

associated w

weight gain

be prudent

accompany

advice abou

smoking dupregnancy

advice abou

and weight

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

De Vriese et

al

31

2001

To determine the


food frequency

questionnaire (FFQ)


diet by comparing



with the 7d food

record in pregnant


the 1st and 3

rd

trimesters

Belgium

developed

n = 26

BMI 22 (176-

293) kgm2

Age 30 (25-37)

years

All pregnant

women were

nulliparous

7-day


during the 1st

(median 15

weeks) and 3rd

(median 35

weeks)

trimesters A

FFQ

containing 180

of the most

common fat-

containingfoods was

conducted at

the same

timepoints

Data recorded

was based on

the EFR

First pregnancy


Hg not diabetic no

proteinuria and not



The FFQ in


compositio

of Belgian

adequate m

reasonably

subjects acc

their dietary

intake

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Fung et al39

1997



zinc from a


altered in well-

nourished women


conception through

lactation and





USA developed

n = 13

BMI 223 (29)

kgm2

Age 30 (29)

years

Parity of 1 n =

10 2 n = 3

3-day weighed

food recordnon-

consecutive

days two

weekdays and

one weekend

at 8-10 weeks

24-26 weeks

and 34-36

weeks

gestation

Aged 22-40yrs body


non-diabetic non-


alcohol use and no


gynecological

complications

Well-nouri


zinc during

pregnancy

increasing

and by a 30

increase in

absorption

not signific

increase in

zinc was du

to an increa


early in the

period pres

an adaptatio

lactation pr

These data

that mechan

regulating z

homeostasi

between pr

and lactatio

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Hronek et al40

2013



Czech pregnant


with recommended

daily allowances

(RDA)

Czechoslovakia

developed

Participants

were randomly

recruited from

both rural and

city regions

n = 152

BMI 211 (36)

kgm2

Age 289 (36)

years

7-day food


days using

scales and

household

measures at 0-

20 weeks 21-

29 weeks 30-

36 weeks and

37-39 weeks

gestation

Nonusers of chronic




le2 Subjects were

euthyroid

normoglyceamic and

not anemic

Lower intak


relative to t

correspond

during preg

Evaluated D

correspond

body size v

Modificatio

intake or al

supplement

recommend


iodine and

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Jansson et al41

2008



between early

pregnancy BMI

maternal dietary

intake and birth

weight

Sweden

developing

n = 49

BMI 255 (69)

kgm2

Age 30 (45)

years

Diet history


over a 24hr

period

collected by a

registered

dietitian at 8-

12 weeks and

32-35 weeks

gestation

Inclusion criteria


old

Exclusion criteria

smoking


reproduction

concurrent disease


or diabetes

development of

pregnancy


preeclampsia or

intrauterine growth

restriction

High first t


trimester IG

were correl

increased b

weight We

that low ser

concentrati

IGFBP-1 re

link betwee

BMI and in

fetal growth


IGF-1 regu

placental nu

transport

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Khoigani et

al

35

2012

To assess the



and micro nutrients




and reproductive

characteristics and


pregnant women

Iran developing

n = 620 (t1 n =

584 t2 n = 510)

BMI 235 (39)

kgm2

Age 256 (44)

years

Parity 158

(076)

48-hour


11-15 weeks

26 weeks and

34-37 weeks

gestation

Interviewers

were trained

Pregnant women who



delivery low birth

weight and factors

which may affect

pregnancy outcomes


addiction digestive


hemoglobinopathies

eating disorders


malignancy

Mean value


subjects wh

experienced

preeclamps

pregnancy

than in othe

women Int

manganese

C vitamin

and carboh

during the t


among preg

women wh

developed

preeclamps

significant

association

other micro

macro nutri

preeclamps

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Kopp-Hoolihan

et al

42

1999

To assess how well-




that predict an


response

USA developed

n = 10

BMI 231 (21)

kgm2

Age 291 (5)

years

3 day weighed


before

pregnancy and

at 8-10 24-26

34-36 weeks

gestation and

4-6 weeks

postpartum

Healthy non-smoking

women

Well-nouri

women useways to me

energy dem

pregnancy

reduction in

induced

thermogene

increased e

intake dep

less fat mas

predicted

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Kubota et al33

2013

To investigate the


intake maternal


growth during

pregnancy

Japan


BMI 175 (01)

kgm2

Age 297 (52)

years

Normaln = 94

BMI 21 (18)

kgm2

Age 308 (51)


Age 286 (36)

years

BMI 334 (65)

kgm2

Digital images


meals on 3

consecutive

days at 14-16

25-27 and 32-

34 weeks

gestation a

dietitian

reviewed

photos and

recorded

intakevalidation of

method not

reported

Singleton pregnant


had suffered from

obstetrical


premature delivery





Dietary inta


not correlat

fetal growth

Japanese na

recommend

advising ex

intake

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Lof et al23

2009

Investigate whether


weight gain are

associated with

estradiol and


plasma during

pregnancy

Sweden

developed

n = 226

BMI 229 (3)

kgm2

Age 32 (4) years

3 day weight


days including

one weekend

at 12 25 and

33 weeks

gestation

Calculations

conducted by

a nutritionist

Women with multi-





dietary intake were

excluded

No associat


dietary fat i

(total or sub

and plasma

levels Prog

levels corre

weight gain

pregnancy

Martinez et

al32

1994

To determine how



nation Mexico

Mexico

developing

n = 36

BMI 235 (26)

kgm2

Age 31 (54)

years

Diet history

collected by

trainedinterviewers

twice per

month and

reported as

mean first and

third trimester

values

Women with an 18




initial recruitment



pregnant

In this sam

women the


weight gain

pregnancy

was similar

women in U

States Low

maternal B

predicted sm

birth weigh

through at l

months of l

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Piers et al36

1995



pregnancy and


a group of well-

nourished pregnant


women at 12 24 and


12 and 24 wk

postpartum with a

non-pregnant non-


India

developing

n = 18

BMI 217 (24)

kgm2

Age 296 (52)

years

5 day


household

measures of

known volume

at 12 24 and

34 weeks

gestation and

12 and 24

weeks post-

partum

participants


measure by a

dietitian who

also checked

all records




morning sickness

before the initial

metabolic

measurement at 12

weeks gestation

BMR is sig


with non-pr

non-lactatin

and remain

even when

differences

weight are

for Well-n

Indian wom

weight and

similar to th


Birth weigh

infants born

to be lower

cost of preg

estimated to

MJ close t

MJ estimat

FAOIWHO

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Tabrizi et al24

2011

To assess the


mineral intake of

pregnant women and


neonates

Iran developing

n = 450

BMI 239 (38)

kgm2

Age 261 (58)

years

24 hour Recall


1st 2

nd and 3

rd

trimesters

Qualification

training of

interviewer

not reported

Women of 16 to 40


health care centers

during the three


Maternal en


with higher

serum calci

and zinc in

birth weigh

neonates


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Guelinckx

et al

43

2010

Study which


improve dietary

habits according to

the National Diet

Recommendations

increase physical

activity level in

obese pregnant

women and

control gestational

weight gain

Belgium

developedrandomly

assigned using

block

randomization

Control(routine)

n =43

BMI 335 (39)

kgm2

Age 294 (44)

yrs


and PA

brochure)

n = 37

BMI 334 (31)

kgm2

Age 287 (4) yrs

Parity of 1 n = 15

Active (brochure

+ group dietary

counselling)

n = 42BMI 341 (45)

kgm2

Age 28 (36) yrs

Parity of 1 n = 20

7-day food


weighed and

household

measures

during each

trimester of

pregnancy

Records were

checked by a

nutritionist






diabetes multiple

pregnancy premature

labor (lt37 wks

gestation) primary


advice in case of

metabolic disorder


conditions and





brochure and group

discussions

A lifestyle interv


combined with

individual advice

improve dietary h

throughout pregn

in obese women

in the absence of

medical or obstet

complications

maintaining or

increasing PA du


decrease in GWG

individually desig

caloric intake res

based on energy

expenditure data

be included

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Korpi-

Hyovalti etal44

2012

To evaluate the


quality of diet

weight gain and

birth weight in

women at high risk

of gestational

diabetes mellitus

Finland


group 1 or 2

using computed

randomization


information on

diet and PA)

n = 27

BMI 255 (34)

kgm2

Lifestyle


nutrition advice)

n = 27

BMI 273 (6)

kgm2

4 day weighed


days including

one weekend

completed at

8-12 26-28

and 36-40

weeks

gestation

Records

checked by a

nutritionist

A three-factor

eating

questionnaire

was also used

at the 1st and

3rd

trimester

Women with one or





48-55 mmoll and the

2h oral glucose


glucose lt78 mmoll

were recruited


GDM at 8-12 wks


There were no cl


however

polyunsaturated f

increase in the lif

intervention grou

Intensive weight

education led to a

somewhat lower

gain during pregn

and higher birth w

of the infants in


macrosomia whe

compared to the c

follow up group

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Moses et al45

2014

To determine


index (LGI) dietary

advice at

the first antenatal

visit would result

in a lower fetal

birth weight

birth percentile

and ponderal index

(PI) than providing

healthy eating

(HE) advice

Australia

developedrandomly

assigned using

computer-

generated

random numbers

1 or 2

Healthy Eating

(counselled to

follow a healthy

diet based on the

AGHE4

) n = 280

BMI 247 (5)

kgm2

Age 299 (5) yrs

Low Glycemic

Index

(individualized

nutrition advice

on a LGI diet)

n = 296

BMI 243 (52)

kgm2 Age 299 (52)

yrs

3 day


household

measures at 16

and 36 weeks

gestation

records

reviewed by a

dietitian



least 18 years old

ability to read and

understand English


comply with visit

schedules Subjects






compromise their




body weight

A low intensity d


in pregnancy did

result in significa

differences in bir

weight fetal perc

of PI

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Wolff et

al

46

2008

To determine


consultations

restricts weight

gain in obese

women and

whether this

restriction impacts

on pregnancy-

induced changes in

glucose

metabolism

Denmark


group 1 or 2

using computed

randomization

Control (general

information on

diet and PA)

n = 27

BMI 255 (34)

kgm2


x 1 hour

consultations)

n = 27

BMI 273 (6)

kgm2

Age 28 (4) years

7 day weighed


plusmn 3 wks) 27

and 36 weeks

gestation



recruited Exclusion

criteria included


or gt45 year old


medical conditions

which impact fetal

growth

Restriction of


achievable and re

the deterioration

glucose metaboli

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

41

983120983137983143983141 983092983089 983151983142 983092983090

FIGURE LEGENDS





















2 GWG 115 to 155 kg)


2

GWG 50 to 90 kg)

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

42

983120983137983143983141 983092983090 983151983142 983092983090







8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


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9



Manual27




RESULTS134







studies232431-42




reported data by141



and142



had a population143







6 ranged 63-78233134424346

1 of 5533

and 3 did149

not report243740




8172019 Je Beile 2015


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10


























8172019 Je Beile 2015


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11







with a182
















(SMD = 1431 P lt 00005 n = 17)195






8172019 Je Beile 2015


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12









meta-analysis209

COMMENT210















8172019 Je Beile 2015


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13


of women (1971-1993)50



Unlike the226







levels4751



in the third4751











collection period53






8172019 Je Beile 2015


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14






This251


thereby252










nutrition50



progresses5657







265





during pregnancy270

8172019 Je Beile 2015


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15



(n = 47003) and272










conception281













CONCLUSIONS 293

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

16





revised298

Acknowledgements299




project303











Funding314


8172019 Je Beile 2015


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18

REFERENCES

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200936(2)341983085356

2 C983144983157 983123983129 K983145983149 983123983129 B983145983155983144 CL 983120983154983141983152983154983141983143983150983137983150983139983161 983151983138983141983155983145983156983161 983152983154983141983158983137983148983141983150983139983141 983145983150 983156983144983141 983125983150983145983156983141983140 983123983156983137983156983141983155 20049830852005

983117983137983156983141983154983150983137983148 983137983150983140 983139983144983145983148983140 983144983141983137983148983156983144 983146983151983157983154983150983137983148 200913(5)614983085620

3 983119983158983141983155983141983150 983120 983122983137983155983149983157983155983155983141983150 983123 K983141983155983149983151983140983141983148 983125 E983142983142983141983139983156 983151983142 983152983154983141983152983154983141983143983150983137983150983139983161 983149983137983156983141983154983150983137983148 983151983158983141983154983159983141983145983143983144983156 983137983150983140

983151983138983141983155983145983156983161 983151983150 983152983154983141983143983150983137983150983139983161 983151983157983156983139983151983149983141 983119983138983155983156983141983156983154983145983139983155 983137983150983140 983143983161983150983141983139983151983148983151983143983161 2011118(2 983120983156 1)305983085312

4 G983157983141983148983145983150983139983147983160 I D983141983158983148983145983141983143983141983154 983122 B983141983139983147983141983154983155 K 983126983137983150983155983137983150983156 G M983137983156983141983154983150983137983148 983151983138983141983155983145983156983161 983152983154983141983143983150983137983150983139983161 983139983151983149983152983148983145983139983137983156983145983151983150983155

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ACCEPTED MANUSCRIPT

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ACCEPTED MANUSCRIPT

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f r o m b i a s



i t h d r a w a l s

d e s c r i b e d




r e a n d





i n e d a n d t h e


l i a b l e




i n d i c a t o r s


b y r e s u l t s


t a k e n i n t o





Martinez

et al32


Moses et

al45


Piers et

al36


Tabrizi et

al24


Wolff et

al46



8172019 Je Beile 2015


ACCEPTED MANUSCRIPT



Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Alberti-Fidanza

et al37

2002

To examine



(ToAC) of women



newborns and relate

the results to the


same women during

pregnancy

Italy developed

n = 12

BMI 226 (55)

kgm2

Age 311 (42)

years

Parity 18 (09)

nil smokers

Collected by

qualified and

experienced

dietitians

using the diet

history

method during

the 1st 2

nd and

3rd

trimesters


monitor To

during the e

period of pr

and we sug

intakes of f

vegetables

necessary

antioxidant

and pro-vit


antioxidant

mothers an

newborns

particularly

preterm m

valuable in

for increasi

chance that

pregnancie

successfull


deliveries

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Carbone et al34

1992

Present patterns of



puerperium and its


fetal growth and

maternal nutrient

intake

Spain

developed

n = 33

BMI 227 (22)

kgm2

Age 28 (36)

years

Parity of 1 n =

18 234 n = 15

3-day weight


holiday

completed at

11 19 and 35

weeks

gestation




personal or family





time of visit and

pregnancy


risk

There was


and head

circumferen

weeks of ge

Findings m

a relationsh

between the

metabolism

maternal le

and fetal

developme

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Conway et al38

1999

To explore the


appropriateness of

weight gain during

pregnancy using AIM





England


BMI 22 (24)

kgm2

Age 312 (46)

years

Parity of 1 n =

28 2 n = 4

Unrestrainedn = 30

BMI 207 (196)

kgm2

Age 306 (36)

years

Parity of 1 n =

26 2 n = 4

7-day weighed


weeks

gestation

Caucasian women






outcomes

Providing p


appropriate

gains may b

beneficial

cessation o

during preg

associated w

weight gain

be prudent

accompany

advice abou

smoking dupregnancy

advice abou

and weight

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

De Vriese et

al

31

2001

To determine the


food frequency

questionnaire (FFQ)


diet by comparing



with the 7d food

record in pregnant


the 1st and 3

rd

trimesters

Belgium

developed

n = 26

BMI 22 (176-

293) kgm2

Age 30 (25-37)

years

All pregnant

women were

nulliparous

7-day


during the 1st

(median 15

weeks) and 3rd

(median 35

weeks)

trimesters A

FFQ

containing 180

of the most

common fat-

containingfoods was

conducted at

the same

timepoints

Data recorded

was based on

the EFR

First pregnancy


Hg not diabetic no

proteinuria and not



The FFQ in


compositio

of Belgian

adequate m

reasonably

subjects acc

their dietary

intake

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Fung et al39

1997



zinc from a


altered in well-

nourished women


conception through

lactation and





USA developed

n = 13

BMI 223 (29)

kgm2

Age 30 (29)

years

Parity of 1 n =

10 2 n = 3

3-day weighed

food recordnon-

consecutive

days two

weekdays and

one weekend

at 8-10 weeks

24-26 weeks

and 34-36

weeks

gestation

Aged 22-40yrs body


non-diabetic non-


alcohol use and no


gynecological

complications

Well-nouri


zinc during

pregnancy

increasing

and by a 30

increase in

absorption

not signific

increase in

zinc was du

to an increa


early in the

period pres

an adaptatio

lactation pr

These data

that mechan

regulating z

homeostasi

between pr

and lactatio

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Hronek et al40

2013



Czech pregnant


with recommended

daily allowances

(RDA)

Czechoslovakia

developed

Participants

were randomly

recruited from

both rural and

city regions

n = 152

BMI 211 (36)

kgm2

Age 289 (36)

years

7-day food


days using

scales and

household

measures at 0-

20 weeks 21-

29 weeks 30-

36 weeks and

37-39 weeks

gestation

Nonusers of chronic




le2 Subjects were

euthyroid

normoglyceamic and

not anemic

Lower intak


relative to t

correspond

during preg

Evaluated D

correspond

body size v

Modificatio

intake or al

supplement

recommend


iodine and

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Jansson et al41

2008



between early

pregnancy BMI

maternal dietary

intake and birth

weight

Sweden

developing

n = 49

BMI 255 (69)

kgm2

Age 30 (45)

years

Diet history


over a 24hr

period

collected by a

registered

dietitian at 8-

12 weeks and

32-35 weeks

gestation

Inclusion criteria


old

Exclusion criteria

smoking


reproduction

concurrent disease


or diabetes

development of

pregnancy


preeclampsia or

intrauterine growth

restriction

High first t


trimester IG

were correl

increased b

weight We

that low ser

concentrati

IGFBP-1 re

link betwee

BMI and in

fetal growth


IGF-1 regu

placental nu

transport

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Khoigani et

al

35

2012

To assess the



and micro nutrients




and reproductive

characteristics and


pregnant women

Iran developing

n = 620 (t1 n =

584 t2 n = 510)

BMI 235 (39)

kgm2

Age 256 (44)

years

Parity 158

(076)

48-hour


11-15 weeks

26 weeks and

34-37 weeks

gestation

Interviewers

were trained

Pregnant women who



delivery low birth

weight and factors

which may affect

pregnancy outcomes


addiction digestive


hemoglobinopathies

eating disorders


malignancy

Mean value


subjects wh

experienced

preeclamps

pregnancy

than in othe

women Int

manganese

C vitamin

and carboh

during the t


among preg

women wh

developed

preeclamps

significant

association

other micro

macro nutri

preeclamps

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Kopp-Hoolihan

et al

42

1999

To assess how well-




that predict an


response

USA developed

n = 10

BMI 231 (21)

kgm2

Age 291 (5)

years

3 day weighed


before

pregnancy and

at 8-10 24-26

34-36 weeks

gestation and

4-6 weeks

postpartum

Healthy non-smoking

women

Well-nouri

women useways to me

energy dem

pregnancy

reduction in

induced

thermogene

increased e

intake dep

less fat mas

predicted

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Kubota et al33

2013

To investigate the


intake maternal


growth during

pregnancy

Japan


BMI 175 (01)

kgm2

Age 297 (52)

years

Normaln = 94

BMI 21 (18)

kgm2

Age 308 (51)


Age 286 (36)

years

BMI 334 (65)

kgm2

Digital images


meals on 3

consecutive

days at 14-16

25-27 and 32-

34 weeks

gestation a

dietitian

reviewed

photos and

recorded

intakevalidation of

method not

reported

Singleton pregnant


had suffered from

obstetrical


premature delivery





Dietary inta


not correlat

fetal growth

Japanese na

recommend

advising ex

intake

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Lof et al23

2009

Investigate whether


weight gain are

associated with

estradiol and


plasma during

pregnancy

Sweden

developed

n = 226

BMI 229 (3)

kgm2

Age 32 (4) years

3 day weight


days including

one weekend

at 12 25 and

33 weeks

gestation

Calculations

conducted by

a nutritionist

Women with multi-





dietary intake were

excluded

No associat


dietary fat i

(total or sub

and plasma

levels Prog

levels corre

weight gain

pregnancy

Martinez et

al32

1994

To determine how



nation Mexico

Mexico

developing

n = 36

BMI 235 (26)

kgm2

Age 31 (54)

years

Diet history

collected by

trainedinterviewers

twice per

month and

reported as

mean first and

third trimester

values

Women with an 18




initial recruitment



pregnant

In this sam

women the


weight gain

pregnancy

was similar

women in U

States Low

maternal B

predicted sm

birth weigh

through at l

months of l

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Piers et al36

1995



pregnancy and


a group of well-

nourished pregnant


women at 12 24 and


12 and 24 wk

postpartum with a

non-pregnant non-


India

developing

n = 18

BMI 217 (24)

kgm2

Age 296 (52)

years

5 day


household

measures of

known volume

at 12 24 and

34 weeks

gestation and

12 and 24

weeks post-

partum

participants


measure by a

dietitian who

also checked

all records




morning sickness

before the initial

metabolic

measurement at 12

weeks gestation

BMR is sig


with non-pr

non-lactatin

and remain

even when

differences

weight are

for Well-n

Indian wom

weight and

similar to th


Birth weigh

infants born

to be lower

cost of preg

estimated to

MJ close t

MJ estimat

FAOIWHO

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Tabrizi et al24

2011

To assess the


mineral intake of

pregnant women and


neonates

Iran developing

n = 450

BMI 239 (38)

kgm2

Age 261 (58)

years

24 hour Recall


1st 2

nd and 3

rd

trimesters

Qualification

training of

interviewer

not reported

Women of 16 to 40


health care centers

during the three


Maternal en


with higher

serum calci

and zinc in

birth weigh

neonates


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Guelinckx

et al

43

2010

Study which


improve dietary

habits according to

the National Diet

Recommendations

increase physical

activity level in

obese pregnant

women and

control gestational

weight gain

Belgium

developedrandomly

assigned using

block

randomization

Control(routine)

n =43

BMI 335 (39)

kgm2

Age 294 (44)

yrs


and PA

brochure)

n = 37

BMI 334 (31)

kgm2

Age 287 (4) yrs

Parity of 1 n = 15

Active (brochure

+ group dietary

counselling)

n = 42BMI 341 (45)

kgm2

Age 28 (36) yrs

Parity of 1 n = 20

7-day food


weighed and

household

measures

during each

trimester of

pregnancy

Records were

checked by a

nutritionist






diabetes multiple

pregnancy premature

labor (lt37 wks

gestation) primary


advice in case of

metabolic disorder


conditions and





brochure and group

discussions

A lifestyle interv


combined with

individual advice

improve dietary h

throughout pregn

in obese women

in the absence of

medical or obstet

complications

maintaining or

increasing PA du


decrease in GWG

individually desig

caloric intake res

based on energy

expenditure data

be included

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Korpi-

Hyovalti etal44

2012

To evaluate the


quality of diet

weight gain and

birth weight in

women at high risk

of gestational

diabetes mellitus

Finland


group 1 or 2

using computed

randomization


information on

diet and PA)

n = 27

BMI 255 (34)

kgm2

Lifestyle


nutrition advice)

n = 27

BMI 273 (6)

kgm2

4 day weighed


days including

one weekend

completed at

8-12 26-28

and 36-40

weeks

gestation

Records

checked by a

nutritionist

A three-factor

eating

questionnaire

was also used

at the 1st and

3rd

trimester

Women with one or





48-55 mmoll and the

2h oral glucose


glucose lt78 mmoll

were recruited


GDM at 8-12 wks


There were no cl


however

polyunsaturated f

increase in the lif

intervention grou

Intensive weight

education led to a

somewhat lower

gain during pregn

and higher birth w

of the infants in


macrosomia whe

compared to the c

follow up group

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Moses et al45

2014

To determine


index (LGI) dietary

advice at

the first antenatal

visit would result

in a lower fetal

birth weight

birth percentile

and ponderal index

(PI) than providing

healthy eating

(HE) advice

Australia

developedrandomly

assigned using

computer-

generated

random numbers

1 or 2

Healthy Eating

(counselled to

follow a healthy

diet based on the

AGHE4

) n = 280

BMI 247 (5)

kgm2

Age 299 (5) yrs

Low Glycemic

Index

(individualized

nutrition advice

on a LGI diet)

n = 296

BMI 243 (52)

kgm2 Age 299 (52)

yrs

3 day


household

measures at 16

and 36 weeks

gestation

records

reviewed by a

dietitian



least 18 years old

ability to read and

understand English


comply with visit

schedules Subjects






compromise their




body weight

A low intensity d


in pregnancy did

result in significa

differences in bir

weight fetal perc

of PI

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Wolff et

al

46

2008

To determine


consultations

restricts weight

gain in obese

women and

whether this

restriction impacts

on pregnancy-

induced changes in

glucose

metabolism

Denmark


group 1 or 2

using computed

randomization

Control (general

information on

diet and PA)

n = 27

BMI 255 (34)

kgm2


x 1 hour

consultations)

n = 27

BMI 273 (6)

kgm2

Age 28 (4) years

7 day weighed


plusmn 3 wks) 27

and 36 weeks

gestation



recruited Exclusion

criteria included


or gt45 year old


medical conditions

which impact fetal

growth

Restriction of


achievable and re

the deterioration

glucose metaboli

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

41

983120983137983143983141 983092983089 983151983142 983092983090

FIGURE LEGENDS





















2 GWG 115 to 155 kg)


2

GWG 50 to 90 kg)

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

42

983120983137983143983141 983092983090 983151983142 983092983090







8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

10


























8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

11







with a182
















(SMD = 1431 P lt 00005 n = 17)195






8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

12









meta-analysis209

COMMENT210















8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

13


of women (1971-1993)50



Unlike the226







levels4751



in the third4751











collection period53






8172019 Je Beile 2015


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14






This251


thereby252










nutrition50



progresses5657







265





during pregnancy270

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

15



(n = 47003) and272










conception281













CONCLUSIONS 293

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

16





revised298

Acknowledgements299




project303











Funding314


8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

18

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2 C983144983157 983123983129 K983145983149 983123983129 B983145983155983144 CL 983120983154983141983152983154983141983143983150983137983150983139983161 983151983138983141983155983145983156983161 983152983154983141983158983137983148983141983150983139983141 983145983150 983156983144983141 983125983150983145983156983141983140 983123983156983137983156983141983155 20049830852005

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4 G983157983141983148983145983150983139983147983160 I D983141983158983148983145983141983143983141983154 983122 B983141983139983147983141983154983155 K 983126983137983150983155983137983150983156 G M983137983156983141983154983150983137983148 983151983138983141983155983145983156983161 983152983154983141983143983150983137983150983139983161 983139983151983149983152983148983145983139983137983156983145983151983150983155

983143983141983155983156983137983156983145983151983150983137983148 983159983141983145983143983144983156 983143983137983145983150 983137983150983140 983150983157983156983154983145983156983145983151983150 983119983138983141983155983145983156983161 983154983141983158983145983141983159983155 983137983150 983151983142983142983145983139983145983137983148 983146983151983157983154983150983137983148 983151983142 983156983144983141 983113983150983156983141983154983150983137983156983145983151983150983137983148

983105983155983155983151983139983145983137983156983145983151983150 983142983151983154 983156983144983141 983123983156983157983140983161 983151983142 983119983138983141983155983145983156983161 20089(2)140983085150

5 C983150983137983156983156983145983150983143983145983157983155 983123 B983141983154983143983155983156983154983286983149 983122 L983145983152983159983151983154983156983144 L 983141983156 983137983148 983120983154983141983152983154983141983143983150983137983150983139983161 983127983141983145983143983144983156 983137983150983140 983156983144983141 983122983145983155983147 983151983142 A983140983158983141983154983155983141

983120983154983141983143983150983137983150983139983161 983119983157983156983139983151983149983141983155 983124983144983141 983118983141983159 983109983150983143983148983137983150983140 983146983151983157983154983150983137983148 983151983142 983149983141983140983145983139983145983150983141 1998338(3)147983085152

6 983120983141983154983155983155983151983150 M B983151983150983137983149983161 A983085KE C983150983137983156983156983145983150983143983145983157983155 983123 983141983156 983137983148 M983137983156983141983154983150983137983148 983119983138983141983155983145983156983161 983137983150983140 983122983145983155983147 983151983142 983120983154983141983156983141983154983149

D983141983148983145983158983141983154983161 983114983105983117983105 2013309(22)23629830852370

7 983123983156983151983156983144983137983154983140 KJ 983124983141983150983150983137983150983156 983120983127G B983141983148983148 983122 M983137983156983141983154983150983137983148 983119983158983141983154983159983141983145983143983144983156 983137983150983140 983119983138983141983155983145983156983161 983137983150983140 983156983144983141 983122983145983155983147 983151983142

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ACCEPTED MANUSCRIPT

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ACCEPTED MANUSCRIPT

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200256(3)205983085213

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

21

56 L983137983145983150 K983129 C983137983156983137983148983137983150983151 983120M M983141983156983137983138983151983148983145983139 C983144983137983150983143983141983155 983145983150 983120983154983141983143983150983137983150983139983161 983107983148983145983150983145983139983137983148 983151983138983155983156983141983156983154983145983139983155 983137983150983140 983143983161983150983141983139983151983148983151983143983161

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8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

22





f r o m b i a s



d e s c r i b e d






W e r e o





i n d i c a t o r s



c o n s i d e

r a t i o n




Alberti-

Fidanza et

al37


Carbone

et al34


Conway

et al38


De


Fung et

al39


Goodarzi

Khoigani

et al35


Guelinckx

et al43


Hronek et

al40


Jansson etal41


Kopp

Hoolihan

et al42


Korpi

Hyovalti

et al44


Kubota et

al33


Lof et

al

23


8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

23





f r o m b i a s



i t h d r a w a l s

d e s c r i b e d




r e a n d





i n e d a n d t h e


l i a b l e




i n d i c a t o r s


b y r e s u l t s


t a k e n i n t o





Martinez

et al32


Moses et

al45


Piers et

al36


Tabrizi et

al24


Wolff et

al46



8172019 Je Beile 2015


ACCEPTED MANUSCRIPT



Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Alberti-Fidanza

et al37

2002

To examine



(ToAC) of women



newborns and relate

the results to the


same women during

pregnancy

Italy developed

n = 12

BMI 226 (55)

kgm2

Age 311 (42)

years

Parity 18 (09)

nil smokers

Collected by

qualified and

experienced

dietitians

using the diet

history

method during

the 1st 2

nd and

3rd

trimesters


monitor To

during the e

period of pr

and we sug

intakes of f

vegetables

necessary

antioxidant

and pro-vit


antioxidant

mothers an

newborns

particularly

preterm m

valuable in

for increasi

chance that

pregnancie

successfull


deliveries

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Carbone et al34

1992

Present patterns of



puerperium and its


fetal growth and

maternal nutrient

intake

Spain

developed

n = 33

BMI 227 (22)

kgm2

Age 28 (36)

years

Parity of 1 n =

18 234 n = 15

3-day weight


holiday

completed at

11 19 and 35

weeks

gestation




personal or family





time of visit and

pregnancy


risk

There was


and head

circumferen

weeks of ge

Findings m

a relationsh

between the

metabolism

maternal le

and fetal

developme

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Conway et al38

1999

To explore the


appropriateness of

weight gain during

pregnancy using AIM





England


BMI 22 (24)

kgm2

Age 312 (46)

years

Parity of 1 n =

28 2 n = 4

Unrestrainedn = 30

BMI 207 (196)

kgm2

Age 306 (36)

years

Parity of 1 n =

26 2 n = 4

7-day weighed


weeks

gestation

Caucasian women






outcomes

Providing p


appropriate

gains may b

beneficial

cessation o

during preg

associated w

weight gain

be prudent

accompany

advice abou

smoking dupregnancy

advice abou

and weight

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

De Vriese et

al

31

2001

To determine the


food frequency

questionnaire (FFQ)


diet by comparing



with the 7d food

record in pregnant


the 1st and 3

rd

trimesters

Belgium

developed

n = 26

BMI 22 (176-

293) kgm2

Age 30 (25-37)

years

All pregnant

women were

nulliparous

7-day


during the 1st

(median 15

weeks) and 3rd

(median 35

weeks)

trimesters A

FFQ

containing 180

of the most

common fat-

containingfoods was

conducted at

the same

timepoints

Data recorded

was based on

the EFR

First pregnancy


Hg not diabetic no

proteinuria and not



The FFQ in


compositio

of Belgian

adequate m

reasonably

subjects acc

their dietary

intake

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Fung et al39

1997



zinc from a


altered in well-

nourished women


conception through

lactation and





USA developed

n = 13

BMI 223 (29)

kgm2

Age 30 (29)

years

Parity of 1 n =

10 2 n = 3

3-day weighed

food recordnon-

consecutive

days two

weekdays and

one weekend

at 8-10 weeks

24-26 weeks

and 34-36

weeks

gestation

Aged 22-40yrs body


non-diabetic non-


alcohol use and no


gynecological

complications

Well-nouri


zinc during

pregnancy

increasing

and by a 30

increase in

absorption

not signific

increase in

zinc was du

to an increa


early in the

period pres

an adaptatio

lactation pr

These data

that mechan

regulating z

homeostasi

between pr

and lactatio

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Hronek et al40

2013



Czech pregnant


with recommended

daily allowances

(RDA)

Czechoslovakia

developed

Participants

were randomly

recruited from

both rural and

city regions

n = 152

BMI 211 (36)

kgm2

Age 289 (36)

years

7-day food


days using

scales and

household

measures at 0-

20 weeks 21-

29 weeks 30-

36 weeks and

37-39 weeks

gestation

Nonusers of chronic




le2 Subjects were

euthyroid

normoglyceamic and

not anemic

Lower intak


relative to t

correspond

during preg

Evaluated D

correspond

body size v

Modificatio

intake or al

supplement

recommend


iodine and

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Jansson et al41

2008



between early

pregnancy BMI

maternal dietary

intake and birth

weight

Sweden

developing

n = 49

BMI 255 (69)

kgm2

Age 30 (45)

years

Diet history


over a 24hr

period

collected by a

registered

dietitian at 8-

12 weeks and

32-35 weeks

gestation

Inclusion criteria


old

Exclusion criteria

smoking


reproduction

concurrent disease


or diabetes

development of

pregnancy


preeclampsia or

intrauterine growth

restriction

High first t


trimester IG

were correl

increased b

weight We

that low ser

concentrati

IGFBP-1 re

link betwee

BMI and in

fetal growth


IGF-1 regu

placental nu

transport

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Khoigani et

al

35

2012

To assess the



and micro nutrients




and reproductive

characteristics and


pregnant women

Iran developing

n = 620 (t1 n =

584 t2 n = 510)

BMI 235 (39)

kgm2

Age 256 (44)

years

Parity 158

(076)

48-hour


11-15 weeks

26 weeks and

34-37 weeks

gestation

Interviewers

were trained

Pregnant women who



delivery low birth

weight and factors

which may affect

pregnancy outcomes


addiction digestive


hemoglobinopathies

eating disorders


malignancy

Mean value


subjects wh

experienced

preeclamps

pregnancy

than in othe

women Int

manganese

C vitamin

and carboh

during the t


among preg

women wh

developed

preeclamps

significant

association

other micro

macro nutri

preeclamps

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Kopp-Hoolihan

et al

42

1999

To assess how well-




that predict an


response

USA developed

n = 10

BMI 231 (21)

kgm2

Age 291 (5)

years

3 day weighed


before

pregnancy and

at 8-10 24-26

34-36 weeks

gestation and

4-6 weeks

postpartum

Healthy non-smoking

women

Well-nouri

women useways to me

energy dem

pregnancy

reduction in

induced

thermogene

increased e

intake dep

less fat mas

predicted

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Kubota et al33

2013

To investigate the


intake maternal


growth during

pregnancy

Japan


BMI 175 (01)

kgm2

Age 297 (52)

years

Normaln = 94

BMI 21 (18)

kgm2

Age 308 (51)


Age 286 (36)

years

BMI 334 (65)

kgm2

Digital images


meals on 3

consecutive

days at 14-16

25-27 and 32-

34 weeks

gestation a

dietitian

reviewed

photos and

recorded

intakevalidation of

method not

reported

Singleton pregnant


had suffered from

obstetrical


premature delivery





Dietary inta


not correlat

fetal growth

Japanese na

recommend

advising ex

intake

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Lof et al23

2009

Investigate whether


weight gain are

associated with

estradiol and


plasma during

pregnancy

Sweden

developed

n = 226

BMI 229 (3)

kgm2

Age 32 (4) years

3 day weight


days including

one weekend

at 12 25 and

33 weeks

gestation

Calculations

conducted by

a nutritionist

Women with multi-





dietary intake were

excluded

No associat


dietary fat i

(total or sub

and plasma

levels Prog

levels corre

weight gain

pregnancy

Martinez et

al32

1994

To determine how



nation Mexico

Mexico

developing

n = 36

BMI 235 (26)

kgm2

Age 31 (54)

years

Diet history

collected by

trainedinterviewers

twice per

month and

reported as

mean first and

third trimester

values

Women with an 18




initial recruitment



pregnant

In this sam

women the


weight gain

pregnancy

was similar

women in U

States Low

maternal B

predicted sm

birth weigh

through at l

months of l

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Piers et al36

1995



pregnancy and


a group of well-

nourished pregnant


women at 12 24 and


12 and 24 wk

postpartum with a

non-pregnant non-


India

developing

n = 18

BMI 217 (24)

kgm2

Age 296 (52)

years

5 day


household

measures of

known volume

at 12 24 and

34 weeks

gestation and

12 and 24

weeks post-

partum

participants


measure by a

dietitian who

also checked

all records




morning sickness

before the initial

metabolic

measurement at 12

weeks gestation

BMR is sig


with non-pr

non-lactatin

and remain

even when

differences

weight are

for Well-n

Indian wom

weight and

similar to th


Birth weigh

infants born

to be lower

cost of preg

estimated to

MJ close t

MJ estimat

FAOIWHO

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Tabrizi et al24

2011

To assess the


mineral intake of

pregnant women and


neonates

Iran developing

n = 450

BMI 239 (38)

kgm2

Age 261 (58)

years

24 hour Recall


1st 2

nd and 3

rd

trimesters

Qualification

training of

interviewer

not reported

Women of 16 to 40


health care centers

during the three


Maternal en


with higher

serum calci

and zinc in

birth weigh

neonates


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Guelinckx

et al

43

2010

Study which


improve dietary

habits according to

the National Diet

Recommendations

increase physical

activity level in

obese pregnant

women and

control gestational

weight gain

Belgium

developedrandomly

assigned using

block

randomization

Control(routine)

n =43

BMI 335 (39)

kgm2

Age 294 (44)

yrs


and PA

brochure)

n = 37

BMI 334 (31)

kgm2

Age 287 (4) yrs

Parity of 1 n = 15

Active (brochure

+ group dietary

counselling)

n = 42BMI 341 (45)

kgm2

Age 28 (36) yrs

Parity of 1 n = 20

7-day food


weighed and

household

measures

during each

trimester of

pregnancy

Records were

checked by a

nutritionist






diabetes multiple

pregnancy premature

labor (lt37 wks

gestation) primary


advice in case of

metabolic disorder


conditions and





brochure and group

discussions

A lifestyle interv


combined with

individual advice

improve dietary h

throughout pregn

in obese women

in the absence of

medical or obstet

complications

maintaining or

increasing PA du


decrease in GWG

individually desig

caloric intake res

based on energy

expenditure data

be included

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Korpi-

Hyovalti etal44

2012

To evaluate the


quality of diet

weight gain and

birth weight in

women at high risk

of gestational

diabetes mellitus

Finland


group 1 or 2

using computed

randomization


information on

diet and PA)

n = 27

BMI 255 (34)

kgm2

Lifestyle


nutrition advice)

n = 27

BMI 273 (6)

kgm2

4 day weighed


days including

one weekend

completed at

8-12 26-28

and 36-40

weeks

gestation

Records

checked by a

nutritionist

A three-factor

eating

questionnaire

was also used

at the 1st and

3rd

trimester

Women with one or





48-55 mmoll and the

2h oral glucose


glucose lt78 mmoll

were recruited


GDM at 8-12 wks


There were no cl


however

polyunsaturated f

increase in the lif

intervention grou

Intensive weight

education led to a

somewhat lower

gain during pregn

and higher birth w

of the infants in


macrosomia whe

compared to the c

follow up group

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Moses et al45

2014

To determine


index (LGI) dietary

advice at

the first antenatal

visit would result

in a lower fetal

birth weight

birth percentile

and ponderal index

(PI) than providing

healthy eating

(HE) advice

Australia

developedrandomly

assigned using

computer-

generated

random numbers

1 or 2

Healthy Eating

(counselled to

follow a healthy

diet based on the

AGHE4

) n = 280

BMI 247 (5)

kgm2

Age 299 (5) yrs

Low Glycemic

Index

(individualized

nutrition advice

on a LGI diet)

n = 296

BMI 243 (52)

kgm2 Age 299 (52)

yrs

3 day


household

measures at 16

and 36 weeks

gestation

records

reviewed by a

dietitian



least 18 years old

ability to read and

understand English


comply with visit

schedules Subjects






compromise their




body weight

A low intensity d


in pregnancy did

result in significa

differences in bir

weight fetal perc

of PI

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Wolff et

al

46

2008

To determine


consultations

restricts weight

gain in obese

women and

whether this

restriction impacts

on pregnancy-

induced changes in

glucose

metabolism

Denmark


group 1 or 2

using computed

randomization

Control (general

information on

diet and PA)

n = 27

BMI 255 (34)

kgm2


x 1 hour

consultations)

n = 27

BMI 273 (6)

kgm2

Age 28 (4) years

7 day weighed


plusmn 3 wks) 27

and 36 weeks

gestation



recruited Exclusion

criteria included


or gt45 year old


medical conditions

which impact fetal

growth

Restriction of


achievable and re

the deterioration

glucose metaboli

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

41

983120983137983143983141 983092983089 983151983142 983092983090

FIGURE LEGENDS





















2 GWG 115 to 155 kg)


2

GWG 50 to 90 kg)

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

42

983120983137983143983141 983092983090 983151983142 983092983090







8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

11







with a182
















(SMD = 1431 P lt 00005 n = 17)195






8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

12









meta-analysis209

COMMENT210















8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

13


of women (1971-1993)50



Unlike the226







levels4751



in the third4751











collection period53






8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

14






This251


thereby252










nutrition50



progresses5657







265





during pregnancy270

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

15



(n = 47003) and272










conception281













CONCLUSIONS 293

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

16





revised298

Acknowledgements299




project303











Funding314


8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

18

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4 G983157983141983148983145983150983139983147983160 I D983141983158983148983145983141983143983141983154 983122 B983141983139983147983141983154983155 K 983126983137983150983155983137983150983156 G M983137983156983141983154983150983137983148 983151983138983141983155983145983156983161 983152983154983141983143983150983137983150983139983161 983139983151983149983152983148983145983139983137983156983145983151983150983155

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983105983155983155983151983139983145983137983156983145983151983150 983142983151983154 983156983144983141 983123983156983157983140983161 983151983142 983119983138983141983155983145983156983161 20089(2)140983085150

5 C983150983137983156983156983145983150983143983145983157983155 983123 B983141983154983143983155983156983154983286983149 983122 L983145983152983159983151983154983156983144 L 983141983156 983137983148 983120983154983141983152983154983141983143983150983137983150983139983161 983127983141983145983143983144983156 983137983150983140 983156983144983141 983122983145983155983147 983151983142 A983140983158983141983154983155983141

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6 983120983141983154983155983155983151983150 M B983151983150983137983149983161 A983085KE C983150983137983156983156983145983150983143983145983157983155 983123 983141983156 983137983148 M983137983156983141983154983150983137983148 983119983138983141983155983145983156983161 983137983150983140 983122983145983155983147 983151983142 983120983154983141983156983141983154983149

D983141983148983145983158983141983154983161 983114983105983117983105 2013309(22)23629830852370

7 983123983156983151983156983144983137983154983140 KJ 983124983141983150983150983137983150983156 983120983127G B983141983148983148 983122 M983137983156983141983154983150983137983148 983119983158983141983154983159983141983145983143983144983156 983137983150983140 983119983138983141983155983145983156983161 983137983150983140 983156983144983141 983122983145983155983147 983151983142

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2009301(6)636

8 B983157983140983143983141 H G983150983137983150983137983148983145983150983143983144983137983149 MG G983137983154983140983150983141983154 D983123 M983151983155983156983161983150 A 983123983156983141983152983144983141983150983155983151983150 983124 983123983161983149983151983150983140983155 ME M983137983156983141983154983150983137983148

983150983157983156983154983145983156983145983151983150983137983148 983152983154983151983143983154983137983149983149983145983150983143 983151983142 983142983141983156983137983148 983137983140983145983152983151983155983141 983156983145983155983155983157983141 983140983141983158983141983148983151983152983149983141983150983156 983148983151983150983143983085983156983141983154983149 983139983151983150983155983141983153983157983141983150983139983141983155 983142983151983154

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ACCEPTED MANUSCRIPT

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200256(3)205983085213

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

21

56 L983137983145983150 K983129 C983137983156983137983148983137983150983151 983120M M983141983156983137983138983151983148983145983139 C983144983137983150983143983141983155 983145983150 983120983154983141983143983150983137983150983139983161 983107983148983145983150983145983139983137983148 983151983138983155983156983141983156983154983145983139983155 983137983150983140 983143983161983150983141983139983151983148983151983143983161

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8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

22





f r o m b i a s



d e s c r i b e d






W e r e o





i n d i c a t o r s



c o n s i d e

r a t i o n




Alberti-

Fidanza et

al37


Carbone

et al34


Conway

et al38


De


Fung et

al39


Goodarzi

Khoigani

et al35


Guelinckx

et al43


Hronek et

al40


Jansson etal41


Kopp

Hoolihan

et al42


Korpi

Hyovalti

et al44


Kubota et

al33


Lof et

al

23


8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

23





f r o m b i a s



i t h d r a w a l s

d e s c r i b e d




r e a n d





i n e d a n d t h e


l i a b l e




i n d i c a t o r s


b y r e s u l t s


t a k e n i n t o





Martinez

et al32


Moses et

al45


Piers et

al36


Tabrizi et

al24


Wolff et

al46



8172019 Je Beile 2015


ACCEPTED MANUSCRIPT



Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Alberti-Fidanza

et al37

2002

To examine



(ToAC) of women



newborns and relate

the results to the


same women during

pregnancy

Italy developed

n = 12

BMI 226 (55)

kgm2

Age 311 (42)

years

Parity 18 (09)

nil smokers

Collected by

qualified and

experienced

dietitians

using the diet

history

method during

the 1st 2

nd and

3rd

trimesters


monitor To

during the e

period of pr

and we sug

intakes of f

vegetables

necessary

antioxidant

and pro-vit


antioxidant

mothers an

newborns

particularly

preterm m

valuable in

for increasi

chance that

pregnancie

successfull


deliveries

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Carbone et al34

1992

Present patterns of



puerperium and its


fetal growth and

maternal nutrient

intake

Spain

developed

n = 33

BMI 227 (22)

kgm2

Age 28 (36)

years

Parity of 1 n =

18 234 n = 15

3-day weight


holiday

completed at

11 19 and 35

weeks

gestation




personal or family





time of visit and

pregnancy


risk

There was


and head

circumferen

weeks of ge

Findings m

a relationsh

between the

metabolism

maternal le

and fetal

developme

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Conway et al38

1999

To explore the


appropriateness of

weight gain during

pregnancy using AIM





England


BMI 22 (24)

kgm2

Age 312 (46)

years

Parity of 1 n =

28 2 n = 4

Unrestrainedn = 30

BMI 207 (196)

kgm2

Age 306 (36)

years

Parity of 1 n =

26 2 n = 4

7-day weighed


weeks

gestation

Caucasian women






outcomes

Providing p


appropriate

gains may b

beneficial

cessation o

during preg

associated w

weight gain

be prudent

accompany

advice abou

smoking dupregnancy

advice abou

and weight

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

De Vriese et

al

31

2001

To determine the


food frequency

questionnaire (FFQ)


diet by comparing



with the 7d food

record in pregnant


the 1st and 3

rd

trimesters

Belgium

developed

n = 26

BMI 22 (176-

293) kgm2

Age 30 (25-37)

years

All pregnant

women were

nulliparous

7-day


during the 1st

(median 15

weeks) and 3rd

(median 35

weeks)

trimesters A

FFQ

containing 180

of the most

common fat-

containingfoods was

conducted at

the same

timepoints

Data recorded

was based on

the EFR

First pregnancy


Hg not diabetic no

proteinuria and not



The FFQ in


compositio

of Belgian

adequate m

reasonably

subjects acc

their dietary

intake

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Fung et al39

1997



zinc from a


altered in well-

nourished women


conception through

lactation and





USA developed

n = 13

BMI 223 (29)

kgm2

Age 30 (29)

years

Parity of 1 n =

10 2 n = 3

3-day weighed

food recordnon-

consecutive

days two

weekdays and

one weekend

at 8-10 weeks

24-26 weeks

and 34-36

weeks

gestation

Aged 22-40yrs body


non-diabetic non-


alcohol use and no


gynecological

complications

Well-nouri


zinc during

pregnancy

increasing

and by a 30

increase in

absorption

not signific

increase in

zinc was du

to an increa


early in the

period pres

an adaptatio

lactation pr

These data

that mechan

regulating z

homeostasi

between pr

and lactatio

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Hronek et al40

2013



Czech pregnant


with recommended

daily allowances

(RDA)

Czechoslovakia

developed

Participants

were randomly

recruited from

both rural and

city regions

n = 152

BMI 211 (36)

kgm2

Age 289 (36)

years

7-day food


days using

scales and

household

measures at 0-

20 weeks 21-

29 weeks 30-

36 weeks and

37-39 weeks

gestation

Nonusers of chronic




le2 Subjects were

euthyroid

normoglyceamic and

not anemic

Lower intak


relative to t

correspond

during preg

Evaluated D

correspond

body size v

Modificatio

intake or al

supplement

recommend


iodine and

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Jansson et al41

2008



between early

pregnancy BMI

maternal dietary

intake and birth

weight

Sweden

developing

n = 49

BMI 255 (69)

kgm2

Age 30 (45)

years

Diet history


over a 24hr

period

collected by a

registered

dietitian at 8-

12 weeks and

32-35 weeks

gestation

Inclusion criteria


old

Exclusion criteria

smoking


reproduction

concurrent disease


or diabetes

development of

pregnancy


preeclampsia or

intrauterine growth

restriction

High first t


trimester IG

were correl

increased b

weight We

that low ser

concentrati

IGFBP-1 re

link betwee

BMI and in

fetal growth


IGF-1 regu

placental nu

transport

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Khoigani et

al

35

2012

To assess the



and micro nutrients




and reproductive

characteristics and


pregnant women

Iran developing

n = 620 (t1 n =

584 t2 n = 510)

BMI 235 (39)

kgm2

Age 256 (44)

years

Parity 158

(076)

48-hour


11-15 weeks

26 weeks and

34-37 weeks

gestation

Interviewers

were trained

Pregnant women who



delivery low birth

weight and factors

which may affect

pregnancy outcomes


addiction digestive


hemoglobinopathies

eating disorders


malignancy

Mean value


subjects wh

experienced

preeclamps

pregnancy

than in othe

women Int

manganese

C vitamin

and carboh

during the t


among preg

women wh

developed

preeclamps

significant

association

other micro

macro nutri

preeclamps

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Kopp-Hoolihan

et al

42

1999

To assess how well-




that predict an


response

USA developed

n = 10

BMI 231 (21)

kgm2

Age 291 (5)

years

3 day weighed


before

pregnancy and

at 8-10 24-26

34-36 weeks

gestation and

4-6 weeks

postpartum

Healthy non-smoking

women

Well-nouri

women useways to me

energy dem

pregnancy

reduction in

induced

thermogene

increased e

intake dep

less fat mas

predicted

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Kubota et al33

2013

To investigate the


intake maternal


growth during

pregnancy

Japan


BMI 175 (01)

kgm2

Age 297 (52)

years

Normaln = 94

BMI 21 (18)

kgm2

Age 308 (51)


Age 286 (36)

years

BMI 334 (65)

kgm2

Digital images


meals on 3

consecutive

days at 14-16

25-27 and 32-

34 weeks

gestation a

dietitian

reviewed

photos and

recorded

intakevalidation of

method not

reported

Singleton pregnant


had suffered from

obstetrical


premature delivery





Dietary inta


not correlat

fetal growth

Japanese na

recommend

advising ex

intake

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Lof et al23

2009

Investigate whether


weight gain are

associated with

estradiol and


plasma during

pregnancy

Sweden

developed

n = 226

BMI 229 (3)

kgm2

Age 32 (4) years

3 day weight


days including

one weekend

at 12 25 and

33 weeks

gestation

Calculations

conducted by

a nutritionist

Women with multi-





dietary intake were

excluded

No associat


dietary fat i

(total or sub

and plasma

levels Prog

levels corre

weight gain

pregnancy

Martinez et

al32

1994

To determine how



nation Mexico

Mexico

developing

n = 36

BMI 235 (26)

kgm2

Age 31 (54)

years

Diet history

collected by

trainedinterviewers

twice per

month and

reported as

mean first and

third trimester

values

Women with an 18




initial recruitment



pregnant

In this sam

women the


weight gain

pregnancy

was similar

women in U

States Low

maternal B

predicted sm

birth weigh

through at l

months of l

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Piers et al36

1995



pregnancy and


a group of well-

nourished pregnant


women at 12 24 and


12 and 24 wk

postpartum with a

non-pregnant non-


India

developing

n = 18

BMI 217 (24)

kgm2

Age 296 (52)

years

5 day


household

measures of

known volume

at 12 24 and

34 weeks

gestation and

12 and 24

weeks post-

partum

participants


measure by a

dietitian who

also checked

all records




morning sickness

before the initial

metabolic

measurement at 12

weeks gestation

BMR is sig


with non-pr

non-lactatin

and remain

even when

differences

weight are

for Well-n

Indian wom

weight and

similar to th


Birth weigh

infants born

to be lower

cost of preg

estimated to

MJ close t

MJ estimat

FAOIWHO

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Tabrizi et al24

2011

To assess the


mineral intake of

pregnant women and


neonates

Iran developing

n = 450

BMI 239 (38)

kgm2

Age 261 (58)

years

24 hour Recall


1st 2

nd and 3

rd

trimesters

Qualification

training of

interviewer

not reported

Women of 16 to 40


health care centers

during the three


Maternal en


with higher

serum calci

and zinc in

birth weigh

neonates


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Guelinckx

et al

43

2010

Study which


improve dietary

habits according to

the National Diet

Recommendations

increase physical

activity level in

obese pregnant

women and

control gestational

weight gain

Belgium

developedrandomly

assigned using

block

randomization

Control(routine)

n =43

BMI 335 (39)

kgm2

Age 294 (44)

yrs


and PA

brochure)

n = 37

BMI 334 (31)

kgm2

Age 287 (4) yrs

Parity of 1 n = 15

Active (brochure

+ group dietary

counselling)

n = 42BMI 341 (45)

kgm2

Age 28 (36) yrs

Parity of 1 n = 20

7-day food


weighed and

household

measures

during each

trimester of

pregnancy

Records were

checked by a

nutritionist






diabetes multiple

pregnancy premature

labor (lt37 wks

gestation) primary


advice in case of

metabolic disorder


conditions and





brochure and group

discussions

A lifestyle interv


combined with

individual advice

improve dietary h

throughout pregn

in obese women

in the absence of

medical or obstet

complications

maintaining or

increasing PA du


decrease in GWG

individually desig

caloric intake res

based on energy

expenditure data

be included

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Korpi-

Hyovalti etal44

2012

To evaluate the


quality of diet

weight gain and

birth weight in

women at high risk

of gestational

diabetes mellitus

Finland


group 1 or 2

using computed

randomization


information on

diet and PA)

n = 27

BMI 255 (34)

kgm2

Lifestyle


nutrition advice)

n = 27

BMI 273 (6)

kgm2

4 day weighed


days including

one weekend

completed at

8-12 26-28

and 36-40

weeks

gestation

Records

checked by a

nutritionist

A three-factor

eating

questionnaire

was also used

at the 1st and

3rd

trimester

Women with one or





48-55 mmoll and the

2h oral glucose


glucose lt78 mmoll

were recruited


GDM at 8-12 wks


There were no cl


however

polyunsaturated f

increase in the lif

intervention grou

Intensive weight

education led to a

somewhat lower

gain during pregn

and higher birth w

of the infants in


macrosomia whe

compared to the c

follow up group

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Moses et al45

2014

To determine


index (LGI) dietary

advice at

the first antenatal

visit would result

in a lower fetal

birth weight

birth percentile

and ponderal index

(PI) than providing

healthy eating

(HE) advice

Australia

developedrandomly

assigned using

computer-

generated

random numbers

1 or 2

Healthy Eating

(counselled to

follow a healthy

diet based on the

AGHE4

) n = 280

BMI 247 (5)

kgm2

Age 299 (5) yrs

Low Glycemic

Index

(individualized

nutrition advice

on a LGI diet)

n = 296

BMI 243 (52)

kgm2 Age 299 (52)

yrs

3 day


household

measures at 16

and 36 weeks

gestation

records

reviewed by a

dietitian



least 18 years old

ability to read and

understand English


comply with visit

schedules Subjects






compromise their




body weight

A low intensity d


in pregnancy did

result in significa

differences in bir

weight fetal perc

of PI

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Wolff et

al

46

2008

To determine


consultations

restricts weight

gain in obese

women and

whether this

restriction impacts

on pregnancy-

induced changes in

glucose

metabolism

Denmark


group 1 or 2

using computed

randomization

Control (general

information on

diet and PA)

n = 27

BMI 255 (34)

kgm2


x 1 hour

consultations)

n = 27

BMI 273 (6)

kgm2

Age 28 (4) years

7 day weighed


plusmn 3 wks) 27

and 36 weeks

gestation



recruited Exclusion

criteria included


or gt45 year old


medical conditions

which impact fetal

growth

Restriction of


achievable and re

the deterioration

glucose metaboli

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

41

983120983137983143983141 983092983089 983151983142 983092983090

FIGURE LEGENDS





















2 GWG 115 to 155 kg)


2

GWG 50 to 90 kg)

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

42

983120983137983143983141 983092983090 983151983142 983092983090







8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

12









meta-analysis209

COMMENT210















8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

13


of women (1971-1993)50



Unlike the226







levels4751



in the third4751











collection period53






8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

14






This251


thereby252










nutrition50



progresses5657







265





during pregnancy270

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

15



(n = 47003) and272










conception281













CONCLUSIONS 293

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

16





revised298

Acknowledgements299




project303











Funding314


8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

18

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5 C983150983137983156983156983145983150983143983145983157983155 983123 B983141983154983143983155983156983154983286983149 983122 L983145983152983159983151983154983156983144 L 983141983156 983137983148 983120983154983141983152983154983141983143983150983137983150983139983161 983127983141983145983143983144983156 983137983150983140 983156983144983141 983122983145983155983147 983151983142 A983140983158983141983154983155983141

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6 983120983141983154983155983155983151983150 M B983151983150983137983149983161 A983085KE C983150983137983156983156983145983150983143983145983157983155 983123 983141983156 983137983148 M983137983156983141983154983150983137983148 983119983138983141983155983145983156983161 983137983150983140 983122983145983155983147 983151983142 983120983154983141983156983141983154983149

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983150983157983156983154983145983156983145983151983150983137983148 983152983154983151983143983154983137983149983149983145983150983143 983151983142 983142983141983156983137983148 983137983140983145983152983151983155983141 983156983145983155983155983157983141 983140983141983158983141983148983151983152983149983141983150983156 983148983151983150983143983085983156983141983154983149 983139983151983150983155983141983153983157983141983150983139983141983155 983142983151983154

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ACCEPTED MANUSCRIPT

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ACCEPTED MANUSCRIPT

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50 983120983154983141983150983156983145983139983141 AM 983120983151983152983152983145983156983156 983123D G983151983148983140983138983141983154983143 G983122 983120983154983141983150983156983145983139983141 A A983140983137983152983156983145983158983141 983155983156983154983137983156983141983143983145983141983155 983154983141983143983157983148983137983156983145983150983143 983141983150983141983154983143983161

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51 M983139G983151983159983137983150 CA M983139A983157983148983145983142983142983141 FM M983137983156983141983154983150983137983148 983150983157983156983154983145983141983150983156 983145983150983156983137983147983141983155 983137983150983140 983148983141983158983141983148983155 983151983142 983141983150983141983154983143983161 983157983150983140983141983154983154983141983152983151983154983156983145983150983143983140983157983154983145983150983143 983141983137983154983148983161 983152983154983141983143983150983137983150983139983161 983109983157983154983151983152983141983137983150 983146983151983157983154983150983137983148 983151983142 983139983148983145983150983145983139983137983148 983150983157983156983154983145983156983145983151983150 201266(8)906983085913

52 E983154983147983147983151983148983137 M K983137983154983152983152983145983150983141983150 M J983137983158983137983150983137983145983150983141983150 J 983122983268983155983268983150983141983150 L K983150983145983152 M 983126983145983154983156983137983150983141983150 983123M 983126983137983148983145983140983145983156983161 983137983150983140

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54 983120983151983157983140983141983158983145983143983150983141 M983123 983119983139983151983150983150983151983154 983120J A 983122983141983158983145983141983159 983151983142 983120983144983161983155983145983139983137983148 A983139983156983145983158983145983156983161 983120983137983156983156983141983154983150983155 983145983150 983120983154983141983143983150983137983150983156 983127983151983149983141983150 983137983150983140

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55 D983157983142983151983157983154 DL 983122983141983145983150983137 JC 983123983152983157983154983154 GB E983150983141983154983143983161 983145983150983156983137983147983141 983137983150983140 983141983160983152983141983150983140983145983156983157983154983141 983151983142 983142983154983141983141983085983148983145983158983145983150983143 983148983137983139983156983137983156983145983150983143

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200256(3)205983085213

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

21

56 L983137983145983150 K983129 C983137983156983137983148983137983150983151 983120M M983141983156983137983138983151983148983145983139 C983144983137983150983143983141983155 983145983150 983120983154983141983143983150983137983150983139983161 983107983148983145983150983145983139983137983148 983151983138983155983156983141983156983154983145983139983155 983137983150983140 983143983161983150983141983139983151983148983151983143983161

200750(4)938983085948

57 983123983156983141983145983150 983124983120 983123983139983144983151983148983148 983124983119 983123983139983144983148983157983156983141983154 MD 983123983139983144983154983151983141983140983141983154 CM 983120983148983137983155983149983137 983148983141983152983156983145983150 983145983150983142983148983157983141983150983139983141983155 983143983141983155983156983137983156983145983151983150983137983148 983159983141983145983143983144983156

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199868(6)12369830851240

58 K983150983157983140983155983141983150 983126K H983141983145983156983149983137983150983150 BL H983137983148983148983140983151983154983155983155983151983150 983124I 983123983151983154983141983150983155983141983150 983124IA 983119983148983155983141983150 983123F M983137983156983141983154983150983137983148 983140983145983141983156983137983154983161983143983148983161983139983137983141983149983145983139 983148983151983137983140 983140983157983154983145983150983143 983152983154983141983143983150983137983150983139983161 983137983150983140 983143983141983155983156983137983156983145983151983150983137983148 983159983141983145983143983144983156 983143983137983145983150 983138983145983154983156983144 983159983141983145983143983144983156 983137983150983140 983152983151983155983156983152983137983154983156983157983149

983159983141983145983143983144983156 983154983141983156983141983150983156983145983151983150 A 983155983156983157983140983161 983159983145983156983144983145983150 983156983144983141 D983137983150983145983155983144 N983137983156983145983151983150983137983148 B983145983154983156983144 C983151983144983151983154983156 983106983154983145983156983145983155983144 983114983151983157983154983150983137983148 983151983142

983118983157983156983154983145983156983145983151983150 2013109(8)14719830851478

59 983130983144983137983150983143 C L983145983157 983123 983123983151983148983151983149983151983150 CG H983157 FB D983145983141983156983137983154983161 983142983145983138983141983154 983145983150983156983137983147983141 983140983145983141983156983137983154983161 983143983148983161983139983141983149983145983139 983148983151983137983140 983137983150983140 983156983144983141 983154983145983155983147

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8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

22





f r o m b i a s



d e s c r i b e d






W e r e o





i n d i c a t o r s



c o n s i d e

r a t i o n




Alberti-

Fidanza et

al37


Carbone

et al34


Conway

et al38


De


Fung et

al39


Goodarzi

Khoigani

et al35


Guelinckx

et al43


Hronek et

al40


Jansson etal41


Kopp

Hoolihan

et al42


Korpi

Hyovalti

et al44


Kubota et

al33


Lof et

al

23


8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

23





f r o m b i a s



i t h d r a w a l s

d e s c r i b e d




r e a n d





i n e d a n d t h e


l i a b l e




i n d i c a t o r s


b y r e s u l t s


t a k e n i n t o





Martinez

et al32


Moses et

al45


Piers et

al36


Tabrizi et

al24


Wolff et

al46



8172019 Je Beile 2015


ACCEPTED MANUSCRIPT



Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Alberti-Fidanza

et al37

2002

To examine



(ToAC) of women



newborns and relate

the results to the


same women during

pregnancy

Italy developed

n = 12

BMI 226 (55)

kgm2

Age 311 (42)

years

Parity 18 (09)

nil smokers

Collected by

qualified and

experienced

dietitians

using the diet

history

method during

the 1st 2

nd and

3rd

trimesters


monitor To

during the e

period of pr

and we sug

intakes of f

vegetables

necessary

antioxidant

and pro-vit


antioxidant

mothers an

newborns

particularly

preterm m

valuable in

for increasi

chance that

pregnancie

successfull


deliveries

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Carbone et al34

1992

Present patterns of



puerperium and its


fetal growth and

maternal nutrient

intake

Spain

developed

n = 33

BMI 227 (22)

kgm2

Age 28 (36)

years

Parity of 1 n =

18 234 n = 15

3-day weight


holiday

completed at

11 19 and 35

weeks

gestation




personal or family





time of visit and

pregnancy


risk

There was


and head

circumferen

weeks of ge

Findings m

a relationsh

between the

metabolism

maternal le

and fetal

developme

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Conway et al38

1999

To explore the


appropriateness of

weight gain during

pregnancy using AIM





England


BMI 22 (24)

kgm2

Age 312 (46)

years

Parity of 1 n =

28 2 n = 4

Unrestrainedn = 30

BMI 207 (196)

kgm2

Age 306 (36)

years

Parity of 1 n =

26 2 n = 4

7-day weighed


weeks

gestation

Caucasian women






outcomes

Providing p


appropriate

gains may b

beneficial

cessation o

during preg

associated w

weight gain

be prudent

accompany

advice abou

smoking dupregnancy

advice abou

and weight

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

De Vriese et

al

31

2001

To determine the


food frequency

questionnaire (FFQ)


diet by comparing



with the 7d food

record in pregnant


the 1st and 3

rd

trimesters

Belgium

developed

n = 26

BMI 22 (176-

293) kgm2

Age 30 (25-37)

years

All pregnant

women were

nulliparous

7-day


during the 1st

(median 15

weeks) and 3rd

(median 35

weeks)

trimesters A

FFQ

containing 180

of the most

common fat-

containingfoods was

conducted at

the same

timepoints

Data recorded

was based on

the EFR

First pregnancy


Hg not diabetic no

proteinuria and not



The FFQ in


compositio

of Belgian

adequate m

reasonably

subjects acc

their dietary

intake

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Fung et al39

1997



zinc from a


altered in well-

nourished women


conception through

lactation and





USA developed

n = 13

BMI 223 (29)

kgm2

Age 30 (29)

years

Parity of 1 n =

10 2 n = 3

3-day weighed

food recordnon-

consecutive

days two

weekdays and

one weekend

at 8-10 weeks

24-26 weeks

and 34-36

weeks

gestation

Aged 22-40yrs body


non-diabetic non-


alcohol use and no


gynecological

complications

Well-nouri


zinc during

pregnancy

increasing

and by a 30

increase in

absorption

not signific

increase in

zinc was du

to an increa


early in the

period pres

an adaptatio

lactation pr

These data

that mechan

regulating z

homeostasi

between pr

and lactatio

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Hronek et al40

2013



Czech pregnant


with recommended

daily allowances

(RDA)

Czechoslovakia

developed

Participants

were randomly

recruited from

both rural and

city regions

n = 152

BMI 211 (36)

kgm2

Age 289 (36)

years

7-day food


days using

scales and

household

measures at 0-

20 weeks 21-

29 weeks 30-

36 weeks and

37-39 weeks

gestation

Nonusers of chronic




le2 Subjects were

euthyroid

normoglyceamic and

not anemic

Lower intak


relative to t

correspond

during preg

Evaluated D

correspond

body size v

Modificatio

intake or al

supplement

recommend


iodine and

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Jansson et al41

2008



between early

pregnancy BMI

maternal dietary

intake and birth

weight

Sweden

developing

n = 49

BMI 255 (69)

kgm2

Age 30 (45)

years

Diet history


over a 24hr

period

collected by a

registered

dietitian at 8-

12 weeks and

32-35 weeks

gestation

Inclusion criteria


old

Exclusion criteria

smoking


reproduction

concurrent disease


or diabetes

development of

pregnancy


preeclampsia or

intrauterine growth

restriction

High first t


trimester IG

were correl

increased b

weight We

that low ser

concentrati

IGFBP-1 re

link betwee

BMI and in

fetal growth


IGF-1 regu

placental nu

transport

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Khoigani et

al

35

2012

To assess the



and micro nutrients




and reproductive

characteristics and


pregnant women

Iran developing

n = 620 (t1 n =

584 t2 n = 510)

BMI 235 (39)

kgm2

Age 256 (44)

years

Parity 158

(076)

48-hour


11-15 weeks

26 weeks and

34-37 weeks

gestation

Interviewers

were trained

Pregnant women who



delivery low birth

weight and factors

which may affect

pregnancy outcomes


addiction digestive


hemoglobinopathies

eating disorders


malignancy

Mean value


subjects wh

experienced

preeclamps

pregnancy

than in othe

women Int

manganese

C vitamin

and carboh

during the t


among preg

women wh

developed

preeclamps

significant

association

other micro

macro nutri

preeclamps

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Kopp-Hoolihan

et al

42

1999

To assess how well-




that predict an


response

USA developed

n = 10

BMI 231 (21)

kgm2

Age 291 (5)

years

3 day weighed


before

pregnancy and

at 8-10 24-26

34-36 weeks

gestation and

4-6 weeks

postpartum

Healthy non-smoking

women

Well-nouri

women useways to me

energy dem

pregnancy

reduction in

induced

thermogene

increased e

intake dep

less fat mas

predicted

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Kubota et al33

2013

To investigate the


intake maternal


growth during

pregnancy

Japan


BMI 175 (01)

kgm2

Age 297 (52)

years

Normaln = 94

BMI 21 (18)

kgm2

Age 308 (51)


Age 286 (36)

years

BMI 334 (65)

kgm2

Digital images


meals on 3

consecutive

days at 14-16

25-27 and 32-

34 weeks

gestation a

dietitian

reviewed

photos and

recorded

intakevalidation of

method not

reported

Singleton pregnant


had suffered from

obstetrical


premature delivery





Dietary inta


not correlat

fetal growth

Japanese na

recommend

advising ex

intake

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Lof et al23

2009

Investigate whether


weight gain are

associated with

estradiol and


plasma during

pregnancy

Sweden

developed

n = 226

BMI 229 (3)

kgm2

Age 32 (4) years

3 day weight


days including

one weekend

at 12 25 and

33 weeks

gestation

Calculations

conducted by

a nutritionist

Women with multi-





dietary intake were

excluded

No associat


dietary fat i

(total or sub

and plasma

levels Prog

levels corre

weight gain

pregnancy

Martinez et

al32

1994

To determine how



nation Mexico

Mexico

developing

n = 36

BMI 235 (26)

kgm2

Age 31 (54)

years

Diet history

collected by

trainedinterviewers

twice per

month and

reported as

mean first and

third trimester

values

Women with an 18




initial recruitment



pregnant

In this sam

women the


weight gain

pregnancy

was similar

women in U

States Low

maternal B

predicted sm

birth weigh

through at l

months of l

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Piers et al36

1995



pregnancy and


a group of well-

nourished pregnant


women at 12 24 and


12 and 24 wk

postpartum with a

non-pregnant non-


India

developing

n = 18

BMI 217 (24)

kgm2

Age 296 (52)

years

5 day


household

measures of

known volume

at 12 24 and

34 weeks

gestation and

12 and 24

weeks post-

partum

participants


measure by a

dietitian who

also checked

all records




morning sickness

before the initial

metabolic

measurement at 12

weeks gestation

BMR is sig


with non-pr

non-lactatin

and remain

even when

differences

weight are

for Well-n

Indian wom

weight and

similar to th


Birth weigh

infants born

to be lower

cost of preg

estimated to

MJ close t

MJ estimat

FAOIWHO

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Tabrizi et al24

2011

To assess the


mineral intake of

pregnant women and


neonates

Iran developing

n = 450

BMI 239 (38)

kgm2

Age 261 (58)

years

24 hour Recall


1st 2

nd and 3

rd

trimesters

Qualification

training of

interviewer

not reported

Women of 16 to 40


health care centers

during the three


Maternal en


with higher

serum calci

and zinc in

birth weigh

neonates


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Guelinckx

et al

43

2010

Study which


improve dietary

habits according to

the National Diet

Recommendations

increase physical

activity level in

obese pregnant

women and

control gestational

weight gain

Belgium

developedrandomly

assigned using

block

randomization

Control(routine)

n =43

BMI 335 (39)

kgm2

Age 294 (44)

yrs


and PA

brochure)

n = 37

BMI 334 (31)

kgm2

Age 287 (4) yrs

Parity of 1 n = 15

Active (brochure

+ group dietary

counselling)

n = 42BMI 341 (45)

kgm2

Age 28 (36) yrs

Parity of 1 n = 20

7-day food


weighed and

household

measures

during each

trimester of

pregnancy

Records were

checked by a

nutritionist






diabetes multiple

pregnancy premature

labor (lt37 wks

gestation) primary


advice in case of

metabolic disorder


conditions and





brochure and group

discussions

A lifestyle interv


combined with

individual advice

improve dietary h

throughout pregn

in obese women

in the absence of

medical or obstet

complications

maintaining or

increasing PA du


decrease in GWG

individually desig

caloric intake res

based on energy

expenditure data

be included

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Korpi-

Hyovalti etal44

2012

To evaluate the


quality of diet

weight gain and

birth weight in

women at high risk

of gestational

diabetes mellitus

Finland


group 1 or 2

using computed

randomization


information on

diet and PA)

n = 27

BMI 255 (34)

kgm2

Lifestyle


nutrition advice)

n = 27

BMI 273 (6)

kgm2

4 day weighed


days including

one weekend

completed at

8-12 26-28

and 36-40

weeks

gestation

Records

checked by a

nutritionist

A three-factor

eating

questionnaire

was also used

at the 1st and

3rd

trimester

Women with one or





48-55 mmoll and the

2h oral glucose


glucose lt78 mmoll

were recruited


GDM at 8-12 wks


There were no cl


however

polyunsaturated f

increase in the lif

intervention grou

Intensive weight

education led to a

somewhat lower

gain during pregn

and higher birth w

of the infants in


macrosomia whe

compared to the c

follow up group

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Moses et al45

2014

To determine


index (LGI) dietary

advice at

the first antenatal

visit would result

in a lower fetal

birth weight

birth percentile

and ponderal index

(PI) than providing

healthy eating

(HE) advice

Australia

developedrandomly

assigned using

computer-

generated

random numbers

1 or 2

Healthy Eating

(counselled to

follow a healthy

diet based on the

AGHE4

) n = 280

BMI 247 (5)

kgm2

Age 299 (5) yrs

Low Glycemic

Index

(individualized

nutrition advice

on a LGI diet)

n = 296

BMI 243 (52)

kgm2 Age 299 (52)

yrs

3 day


household

measures at 16

and 36 weeks

gestation

records

reviewed by a

dietitian



least 18 years old

ability to read and

understand English


comply with visit

schedules Subjects






compromise their




body weight

A low intensity d


in pregnancy did

result in significa

differences in bir

weight fetal perc

of PI

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Wolff et

al

46

2008

To determine


consultations

restricts weight

gain in obese

women and

whether this

restriction impacts

on pregnancy-

induced changes in

glucose

metabolism

Denmark


group 1 or 2

using computed

randomization

Control (general

information on

diet and PA)

n = 27

BMI 255 (34)

kgm2


x 1 hour

consultations)

n = 27

BMI 273 (6)

kgm2

Age 28 (4) years

7 day weighed


plusmn 3 wks) 27

and 36 weeks

gestation



recruited Exclusion

criteria included


or gt45 year old


medical conditions

which impact fetal

growth

Restriction of


achievable and re

the deterioration

glucose metaboli

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

41

983120983137983143983141 983092983089 983151983142 983092983090

FIGURE LEGENDS





















2 GWG 115 to 155 kg)


2

GWG 50 to 90 kg)

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

42

983120983137983143983141 983092983090 983151983142 983092983090







8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

13


of women (1971-1993)50



Unlike the226







levels4751



in the third4751











collection period53






8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

14






This251


thereby252










nutrition50



progresses5657







265





during pregnancy270

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

15



(n = 47003) and272










conception281













CONCLUSIONS 293

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

16





revised298

Acknowledgements299




project303











Funding314


8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

18

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ACCEPTED MANUSCRIPT

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983139983144983145983148983140983138983145983154983156983144 201414(1)186

49 A983138983141983161983155983141983147983141983154983137 M983126 M983151983154983154983145983155 JA D983137983158983145983155 GK 983119983123983157983148983148983145983158983137983150 AJ A983148983156983141983154983137983156983145983151983150983155 983145983150 983141983150983141983154983143983161 983144983151983149983141983151983155983156983137983155983145983155 983156983151

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50 983120983154983141983150983156983145983139983141 AM 983120983151983152983152983145983156983156 983123D G983151983148983140983138983141983154983143 G983122 983120983154983141983150983156983145983139983141 A A983140983137983152983156983145983158983141 983155983156983154983137983156983141983143983145983141983155 983154983141983143983157983148983137983156983145983150983143 983141983150983141983154983143983161

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51 M983139G983151983159983137983150 CA M983139A983157983148983145983142983142983141 FM M983137983156983141983154983150983137983148 983150983157983156983154983145983141983150983156 983145983150983156983137983147983141983155 983137983150983140 983148983141983158983141983148983155 983151983142 983141983150983141983154983143983161 983157983150983140983141983154983154983141983152983151983154983156983145983150983143983140983157983154983145983150983143 983141983137983154983148983161 983152983154983141983143983150983137983150983139983161 983109983157983154983151983152983141983137983150 983146983151983157983154983150983137983148 983151983142 983139983148983145983150983145983139983137983148 983150983157983156983154983145983156983145983151983150 201266(8)906983085913

52 E983154983147983147983151983148983137 M K983137983154983152983152983145983150983141983150 M J983137983158983137983150983137983145983150983141983150 J 983122983268983155983268983150983141983150 L K983150983145983152 M 983126983145983154983156983137983150983141983150 983123M 983126983137983148983145983140983145983156983161 983137983150983140

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53 M983137983139983140983145983137983154983149983145983140 J B983148983157983150983140983141983148983148 J A983155983155983141983155983155983145983150983143 983140983145983141983156983137983154983161 983145983150983156983137983147983141 983127983144983151 983159983144983137983156 983137983150983140 983159983144983161 983151983142 983157983150983140983141983154983085983154983141983152983151983154983156983145983150983143

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54 983120983151983157983140983141983158983145983143983150983141 M983123 983119983139983151983150983150983151983154 983120J A 983122983141983158983145983141983159 983151983142 983120983144983161983155983145983139983137983148 A983139983156983145983158983145983156983161 983120983137983156983156983141983154983150983155 983145983150 983120983154983141983143983150983137983150983156 983127983151983149983141983150 983137983150983140

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55 D983157983142983151983157983154 DL 983122983141983145983150983137 JC 983123983152983157983154983154 GB E983150983141983154983143983161 983145983150983156983137983147983141 983137983150983140 983141983160983152983141983150983140983145983156983157983154983141 983151983142 983142983154983141983141983085983148983145983158983145983150983143 983148983137983139983156983137983156983145983150983143

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200256(3)205983085213

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

21

56 L983137983145983150 K983129 C983137983156983137983148983137983150983151 983120M M983141983156983137983138983151983148983145983139 C983144983137983150983143983141983155 983145983150 983120983154983141983143983150983137983150983139983161 983107983148983145983150983145983139983137983148 983151983138983155983156983141983156983154983145983139983155 983137983150983140 983143983161983150983141983139983151983148983151983143983161

200750(4)938983085948

57 983123983156983141983145983150 983124983120 983123983139983144983151983148983148 983124983119 983123983139983144983148983157983156983141983154 MD 983123983139983144983154983151983141983140983141983154 CM 983120983148983137983155983149983137 983148983141983152983156983145983150 983145983150983142983148983157983141983150983139983141983155 983143983141983155983156983137983156983145983151983150983137983148 983159983141983145983143983144983156

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199868(6)12369830851240

58 K983150983157983140983155983141983150 983126K H983141983145983156983149983137983150983150 BL H983137983148983148983140983151983154983155983155983151983150 983124I 983123983151983154983141983150983155983141983150 983124IA 983119983148983155983141983150 983123F M983137983156983141983154983150983137983148 983140983145983141983156983137983154983161983143983148983161983139983137983141983149983145983139 983148983151983137983140 983140983157983154983145983150983143 983152983154983141983143983150983137983150983139983161 983137983150983140 983143983141983155983156983137983156983145983151983150983137983148 983159983141983145983143983144983156 983143983137983145983150 983138983145983154983156983144 983159983141983145983143983144983156 983137983150983140 983152983151983155983156983152983137983154983156983157983149

983159983141983145983143983144983156 983154983141983156983141983150983156983145983151983150 A 983155983156983157983140983161 983159983145983156983144983145983150 983156983144983141 D983137983150983145983155983144 N983137983156983145983151983150983137983148 B983145983154983156983144 C983151983144983151983154983156 983106983154983145983156983145983155983144 983114983151983157983154983150983137983148 983151983142

983118983157983156983154983145983156983145983151983150 2013109(8)14719830851478

59 983130983144983137983150983143 C L983145983157 983123 983123983151983148983151983149983151983150 CG H983157 FB D983145983141983156983137983154983161 983142983145983138983141983154 983145983150983156983137983147983141 983140983145983141983156983137983154983161 983143983148983161983139983141983149983145983139 983148983151983137983140 983137983150983140 983156983144983141 983154983145983155983147

983142983151983154 983143983141983155983156983137983156983145983151983150983137983148 983140983145983137983138983141983156983141983155 983149983141983148983148983145983156983157983155 983108983145983137983138983141983156983141983155 983107983137983154983141 200629(10)22239830852230

8172019 Je Beile 2015


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22





f r o m b i a s



d e s c r i b e d






W e r e o





i n d i c a t o r s



c o n s i d e

r a t i o n




Alberti-

Fidanza et

al37


Carbone

et al34


Conway

et al38


De


Fung et

al39


Goodarzi

Khoigani

et al35


Guelinckx

et al43


Hronek et

al40


Jansson etal41


Kopp

Hoolihan

et al42


Korpi

Hyovalti

et al44


Kubota et

al33


Lof et

al

23


8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

23





f r o m b i a s



i t h d r a w a l s

d e s c r i b e d




r e a n d





i n e d a n d t h e


l i a b l e




i n d i c a t o r s


b y r e s u l t s


t a k e n i n t o





Martinez

et al32


Moses et

al45


Piers et

al36


Tabrizi et

al24


Wolff et

al46



8172019 Je Beile 2015


ACCEPTED MANUSCRIPT



Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Alberti-Fidanza

et al37

2002

To examine



(ToAC) of women



newborns and relate

the results to the


same women during

pregnancy

Italy developed

n = 12

BMI 226 (55)

kgm2

Age 311 (42)

years

Parity 18 (09)

nil smokers

Collected by

qualified and

experienced

dietitians

using the diet

history

method during

the 1st 2

nd and

3rd

trimesters


monitor To

during the e

period of pr

and we sug

intakes of f

vegetables

necessary

antioxidant

and pro-vit


antioxidant

mothers an

newborns

particularly

preterm m

valuable in

for increasi

chance that

pregnancie

successfull


deliveries

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Carbone et al34

1992

Present patterns of



puerperium and its


fetal growth and

maternal nutrient

intake

Spain

developed

n = 33

BMI 227 (22)

kgm2

Age 28 (36)

years

Parity of 1 n =

18 234 n = 15

3-day weight


holiday

completed at

11 19 and 35

weeks

gestation




personal or family





time of visit and

pregnancy


risk

There was


and head

circumferen

weeks of ge

Findings m

a relationsh

between the

metabolism

maternal le

and fetal

developme

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Conway et al38

1999

To explore the


appropriateness of

weight gain during

pregnancy using AIM





England


BMI 22 (24)

kgm2

Age 312 (46)

years

Parity of 1 n =

28 2 n = 4

Unrestrainedn = 30

BMI 207 (196)

kgm2

Age 306 (36)

years

Parity of 1 n =

26 2 n = 4

7-day weighed


weeks

gestation

Caucasian women






outcomes

Providing p


appropriate

gains may b

beneficial

cessation o

during preg

associated w

weight gain

be prudent

accompany

advice abou

smoking dupregnancy

advice abou

and weight

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

De Vriese et

al

31

2001

To determine the


food frequency

questionnaire (FFQ)


diet by comparing



with the 7d food

record in pregnant


the 1st and 3

rd

trimesters

Belgium

developed

n = 26

BMI 22 (176-

293) kgm2

Age 30 (25-37)

years

All pregnant

women were

nulliparous

7-day


during the 1st

(median 15

weeks) and 3rd

(median 35

weeks)

trimesters A

FFQ

containing 180

of the most

common fat-

containingfoods was

conducted at

the same

timepoints

Data recorded

was based on

the EFR

First pregnancy


Hg not diabetic no

proteinuria and not



The FFQ in


compositio

of Belgian

adequate m

reasonably

subjects acc

their dietary

intake

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Fung et al39

1997



zinc from a


altered in well-

nourished women


conception through

lactation and





USA developed

n = 13

BMI 223 (29)

kgm2

Age 30 (29)

years

Parity of 1 n =

10 2 n = 3

3-day weighed

food recordnon-

consecutive

days two

weekdays and

one weekend

at 8-10 weeks

24-26 weeks

and 34-36

weeks

gestation

Aged 22-40yrs body


non-diabetic non-


alcohol use and no


gynecological

complications

Well-nouri


zinc during

pregnancy

increasing

and by a 30

increase in

absorption

not signific

increase in

zinc was du

to an increa


early in the

period pres

an adaptatio

lactation pr

These data

that mechan

regulating z

homeostasi

between pr

and lactatio

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Hronek et al40

2013



Czech pregnant


with recommended

daily allowances

(RDA)

Czechoslovakia

developed

Participants

were randomly

recruited from

both rural and

city regions

n = 152

BMI 211 (36)

kgm2

Age 289 (36)

years

7-day food


days using

scales and

household

measures at 0-

20 weeks 21-

29 weeks 30-

36 weeks and

37-39 weeks

gestation

Nonusers of chronic




le2 Subjects were

euthyroid

normoglyceamic and

not anemic

Lower intak


relative to t

correspond

during preg

Evaluated D

correspond

body size v

Modificatio

intake or al

supplement

recommend


iodine and

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Jansson et al41

2008



between early

pregnancy BMI

maternal dietary

intake and birth

weight

Sweden

developing

n = 49

BMI 255 (69)

kgm2

Age 30 (45)

years

Diet history


over a 24hr

period

collected by a

registered

dietitian at 8-

12 weeks and

32-35 weeks

gestation

Inclusion criteria


old

Exclusion criteria

smoking


reproduction

concurrent disease


or diabetes

development of

pregnancy


preeclampsia or

intrauterine growth

restriction

High first t


trimester IG

were correl

increased b

weight We

that low ser

concentrati

IGFBP-1 re

link betwee

BMI and in

fetal growth


IGF-1 regu

placental nu

transport

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Khoigani et

al

35

2012

To assess the



and micro nutrients




and reproductive

characteristics and


pregnant women

Iran developing

n = 620 (t1 n =

584 t2 n = 510)

BMI 235 (39)

kgm2

Age 256 (44)

years

Parity 158

(076)

48-hour


11-15 weeks

26 weeks and

34-37 weeks

gestation

Interviewers

were trained

Pregnant women who



delivery low birth

weight and factors

which may affect

pregnancy outcomes


addiction digestive


hemoglobinopathies

eating disorders


malignancy

Mean value


subjects wh

experienced

preeclamps

pregnancy

than in othe

women Int

manganese

C vitamin

and carboh

during the t


among preg

women wh

developed

preeclamps

significant

association

other micro

macro nutri

preeclamps

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Kopp-Hoolihan

et al

42

1999

To assess how well-




that predict an


response

USA developed

n = 10

BMI 231 (21)

kgm2

Age 291 (5)

years

3 day weighed


before

pregnancy and

at 8-10 24-26

34-36 weeks

gestation and

4-6 weeks

postpartum

Healthy non-smoking

women

Well-nouri

women useways to me

energy dem

pregnancy

reduction in

induced

thermogene

increased e

intake dep

less fat mas

predicted

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Kubota et al33

2013

To investigate the


intake maternal


growth during

pregnancy

Japan


BMI 175 (01)

kgm2

Age 297 (52)

years

Normaln = 94

BMI 21 (18)

kgm2

Age 308 (51)


Age 286 (36)

years

BMI 334 (65)

kgm2

Digital images


meals on 3

consecutive

days at 14-16

25-27 and 32-

34 weeks

gestation a

dietitian

reviewed

photos and

recorded

intakevalidation of

method not

reported

Singleton pregnant


had suffered from

obstetrical


premature delivery





Dietary inta


not correlat

fetal growth

Japanese na

recommend

advising ex

intake

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Lof et al23

2009

Investigate whether


weight gain are

associated with

estradiol and


plasma during

pregnancy

Sweden

developed

n = 226

BMI 229 (3)

kgm2

Age 32 (4) years

3 day weight


days including

one weekend

at 12 25 and

33 weeks

gestation

Calculations

conducted by

a nutritionist

Women with multi-





dietary intake were

excluded

No associat


dietary fat i

(total or sub

and plasma

levels Prog

levels corre

weight gain

pregnancy

Martinez et

al32

1994

To determine how



nation Mexico

Mexico

developing

n = 36

BMI 235 (26)

kgm2

Age 31 (54)

years

Diet history

collected by

trainedinterviewers

twice per

month and

reported as

mean first and

third trimester

values

Women with an 18




initial recruitment



pregnant

In this sam

women the


weight gain

pregnancy

was similar

women in U

States Low

maternal B

predicted sm

birth weigh

through at l

months of l

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Piers et al36

1995



pregnancy and


a group of well-

nourished pregnant


women at 12 24 and


12 and 24 wk

postpartum with a

non-pregnant non-


India

developing

n = 18

BMI 217 (24)

kgm2

Age 296 (52)

years

5 day


household

measures of

known volume

at 12 24 and

34 weeks

gestation and

12 and 24

weeks post-

partum

participants


measure by a

dietitian who

also checked

all records




morning sickness

before the initial

metabolic

measurement at 12

weeks gestation

BMR is sig


with non-pr

non-lactatin

and remain

even when

differences

weight are

for Well-n

Indian wom

weight and

similar to th


Birth weigh

infants born

to be lower

cost of preg

estimated to

MJ close t

MJ estimat

FAOIWHO

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Tabrizi et al24

2011

To assess the


mineral intake of

pregnant women and


neonates

Iran developing

n = 450

BMI 239 (38)

kgm2

Age 261 (58)

years

24 hour Recall


1st 2

nd and 3

rd

trimesters

Qualification

training of

interviewer

not reported

Women of 16 to 40


health care centers

during the three


Maternal en


with higher

serum calci

and zinc in

birth weigh

neonates


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Guelinckx

et al

43

2010

Study which


improve dietary

habits according to

the National Diet

Recommendations

increase physical

activity level in

obese pregnant

women and

control gestational

weight gain

Belgium

developedrandomly

assigned using

block

randomization

Control(routine)

n =43

BMI 335 (39)

kgm2

Age 294 (44)

yrs


and PA

brochure)

n = 37

BMI 334 (31)

kgm2

Age 287 (4) yrs

Parity of 1 n = 15

Active (brochure

+ group dietary

counselling)

n = 42BMI 341 (45)

kgm2

Age 28 (36) yrs

Parity of 1 n = 20

7-day food


weighed and

household

measures

during each

trimester of

pregnancy

Records were

checked by a

nutritionist






diabetes multiple

pregnancy premature

labor (lt37 wks

gestation) primary


advice in case of

metabolic disorder


conditions and





brochure and group

discussions

A lifestyle interv


combined with

individual advice

improve dietary h

throughout pregn

in obese women

in the absence of

medical or obstet

complications

maintaining or

increasing PA du


decrease in GWG

individually desig

caloric intake res

based on energy

expenditure data

be included

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Korpi-

Hyovalti etal44

2012

To evaluate the


quality of diet

weight gain and

birth weight in

women at high risk

of gestational

diabetes mellitus

Finland


group 1 or 2

using computed

randomization


information on

diet and PA)

n = 27

BMI 255 (34)

kgm2

Lifestyle


nutrition advice)

n = 27

BMI 273 (6)

kgm2

4 day weighed


days including

one weekend

completed at

8-12 26-28

and 36-40

weeks

gestation

Records

checked by a

nutritionist

A three-factor

eating

questionnaire

was also used

at the 1st and

3rd

trimester

Women with one or





48-55 mmoll and the

2h oral glucose


glucose lt78 mmoll

were recruited


GDM at 8-12 wks


There were no cl


however

polyunsaturated f

increase in the lif

intervention grou

Intensive weight

education led to a

somewhat lower

gain during pregn

and higher birth w

of the infants in


macrosomia whe

compared to the c

follow up group

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Moses et al45

2014

To determine


index (LGI) dietary

advice at

the first antenatal

visit would result

in a lower fetal

birth weight

birth percentile

and ponderal index

(PI) than providing

healthy eating

(HE) advice

Australia

developedrandomly

assigned using

computer-

generated

random numbers

1 or 2

Healthy Eating

(counselled to

follow a healthy

diet based on the

AGHE4

) n = 280

BMI 247 (5)

kgm2

Age 299 (5) yrs

Low Glycemic

Index

(individualized

nutrition advice

on a LGI diet)

n = 296

BMI 243 (52)

kgm2 Age 299 (52)

yrs

3 day


household

measures at 16

and 36 weeks

gestation

records

reviewed by a

dietitian



least 18 years old

ability to read and

understand English


comply with visit

schedules Subjects






compromise their




body weight

A low intensity d


in pregnancy did

result in significa

differences in bir

weight fetal perc

of PI

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Wolff et

al

46

2008

To determine


consultations

restricts weight

gain in obese

women and

whether this

restriction impacts

on pregnancy-

induced changes in

glucose

metabolism

Denmark


group 1 or 2

using computed

randomization

Control (general

information on

diet and PA)

n = 27

BMI 255 (34)

kgm2


x 1 hour

consultations)

n = 27

BMI 273 (6)

kgm2

Age 28 (4) years

7 day weighed


plusmn 3 wks) 27

and 36 weeks

gestation



recruited Exclusion

criteria included


or gt45 year old


medical conditions

which impact fetal

growth

Restriction of


achievable and re

the deterioration

glucose metaboli

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

41

983120983137983143983141 983092983089 983151983142 983092983090

FIGURE LEGENDS





















2 GWG 115 to 155 kg)


2

GWG 50 to 90 kg)

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

42

983120983137983143983141 983092983090 983151983142 983092983090







8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

14






This251


thereby252










nutrition50



progresses5657







265





during pregnancy270

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

15



(n = 47003) and272










conception281













CONCLUSIONS 293

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

16





revised298

Acknowledgements299




project303











Funding314


8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

18

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983120983154983141983143983150983137983150983139983161 983119983157983156983139983151983149983141983155 983124983144983141 983118983141983159 983109983150983143983148983137983150983140 983146983151983157983154983150983137983148 983151983142 983149983141983140983145983139983145983150983141 1998338(3)147983085152

6 983120983141983154983155983155983151983150 M B983151983150983137983149983161 A983085KE C983150983137983156983156983145983150983143983145983157983155 983123 983141983156 983137983148 M983137983156983141983154983150983137983148 983119983138983141983155983145983156983161 983137983150983140 983122983145983155983147 983151983142 983120983154983141983156983141983154983149

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7 983123983156983151983156983144983137983154983140 KJ 983124983141983150983150983137983150983156 983120983127G B983141983148983148 983122 M983137983156983141983154983150983137983148 983119983158983141983154983159983141983145983143983144983156 983137983150983140 983119983138983141983155983145983156983161 983137983150983140 983156983144983141 983122983145983155983147 983151983142

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8 B983157983140983143983141 H G983150983137983150983137983148983145983150983143983144983137983149 MG G983137983154983140983150983141983154 D983123 M983151983155983156983161983150 A 983123983156983141983152983144983141983150983155983151983150 983124 983123983161983149983151983150983140983155 ME M983137983156983141983154983150983137983148

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9 C983137983148983148983137983159983137983161 LK 983120983154983145983150983155 JB C983144983137983150983143 AM M983139I983150983156983161983154983141 HD 983124983144983141 983152983154983141983158983137983148983141983150983139983141 983137983150983140 983145983149983152983137983139983156 983151983142 983151983158983141983154983159983141983145983143983144983156 983137983150983140

983151983138983141983155983145983156983161 983145983150 983137983150 A983157983155983156983154983137983148983145983137983150 983151983138983155983156983141983156983154983145983139 983152983151983152983157983148983137983156983145983151983150 983124983144983141 983117983141983140983145983139983137983148 983146983151983157983154983150983137983148 983151983142 983105983157983155983156983154983137983148983145983137

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ACCEPTED MANUSCRIPT

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983138983137983148983137983150983139983141 983145983150 983144983157983149983137983150 983152983154983141983143983150983137983150983139983161 983112983157983149983137983150 983154983141983152983154983151983140983157983139983156983145983151983150 983157983152983140983137983156983141 19951(2)149983085161

51 M983139G983151983159983137983150 CA M983139A983157983148983145983142983142983141 FM M983137983156983141983154983150983137983148 983150983157983156983154983145983141983150983156 983145983150983156983137983147983141983155 983137983150983140 983148983141983158983141983148983155 983151983142 983141983150983141983154983143983161 983157983150983140983141983154983154983141983152983151983154983156983145983150983143983140983157983154983145983150983143 983141983137983154983148983161 983152983154983141983143983150983137983150983139983161 983109983157983154983151983152983141983137983150 983146983151983157983154983150983137983148 983151983142 983139983148983145983150983145983139983137983148 983150983157983156983154983145983156983145983151983150 201266(8)906983085913

52 E983154983147983147983151983148983137 M K983137983154983152983152983145983150983141983150 M J983137983158983137983150983137983145983150983141983150 J 983122983268983155983268983150983141983150 L K983150983145983152 M 983126983145983154983156983137983150983141983150 983123M 983126983137983148983145983140983145983156983161 983137983150983140

983154983141983152983154983151983140983157983139983145983138983145983148983145983156983161 983151983142 983137 983142983151983151983140 983142983154983141983153983157983141983150983139983161 983153983157983141983155983156983145983151983150983150983137983145983154983141 983142983151983154 983152983154983141983143983150983137983150983156 F983145983150983150983145983155983144 983159983151983149983141983150 983105983149983141983154983145983139983137983150

983114983151983157983154983150983137983148 983151983142 983109983152983145983140983141983149983145983151983148983151983143983161 2001154(5)466983085476

53 M983137983139983140983145983137983154983149983145983140 J B983148983157983150983140983141983148983148 J A983155983155983141983155983155983145983150983143 983140983145983141983156983137983154983161 983145983150983156983137983147983141 983127983144983151 983159983144983137983156 983137983150983140 983159983144983161 983151983142 983157983150983140983141983154983085983154983141983152983151983154983156983145983150983143

983118983157983156983154983145983156983145983151983150 983122983141983155983141983137983154983139983144 983122983141983158983145983141983159983155 199811(2)231983085253

54 983120983151983157983140983141983158983145983143983150983141 M983123 983119983139983151983150983150983151983154 983120J A 983122983141983158983145983141983159 983151983142 983120983144983161983155983145983139983137983148 A983139983156983145983158983145983156983161 983120983137983156983156983141983154983150983155 983145983150 983120983154983141983143983150983137983150983156 983127983151983149983141983150 983137983150983140

983124983144983141983145983154 983122983141983148983137983156983145983151983150983155983144983145983152 983156983151 983120983155983161983139983144983151983148983151983143983145983139983137983148 H983141983137983148983156983144 983126983151983148 36 C983144983137983149 A983140983145983155 I983150983156983141983154983150983137983156983145983151983150983137983148 20061998308519

55 D983157983142983151983157983154 DL 983122983141983145983150983137 JC 983123983152983157983154983154 GB E983150983141983154983143983161 983145983150983156983137983147983141 983137983150983140 983141983160983152983141983150983140983145983156983157983154983141 983151983142 983142983154983141983141983085983148983145983158983145983150983143 983148983137983139983156983137983156983145983150983143

C983151983148983151983149983138983145983137983150 983159983151983149983141983150 983145983150 983137983150 983157983154983138983137983150 983155983141983156983156983145983150983143 983109983157983154983151983152983141983137983150 983114983151983157983154983150983137983148 983151983142 983107983148983145983150983145983139983137983148 983118983157983156983154983145983156983145983151983150

200256(3)205983085213

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

21

56 L983137983145983150 K983129 C983137983156983137983148983137983150983151 983120M M983141983156983137983138983151983148983145983139 C983144983137983150983143983141983155 983145983150 983120983154983141983143983150983137983150983139983161 983107983148983145983150983145983139983137983148 983151983138983155983156983141983156983154983145983139983155 983137983150983140 983143983161983150983141983139983151983148983151983143983161

200750(4)938983085948

57 983123983156983141983145983150 983124983120 983123983139983144983151983148983148 983124983119 983123983139983144983148983157983156983141983154 MD 983123983139983144983154983151983141983140983141983154 CM 983120983148983137983155983149983137 983148983141983152983156983145983150 983145983150983142983148983157983141983150983139983141983155 983143983141983155983156983137983156983145983151983150983137983148 983159983141983145983143983144983156

983143983137983145983150 983137983150983140 983152983151983155983156983152983137983154983156983157983149 983159983141983145983143983144983156 983154983141983156983141983150983156983145983151983150 983105983149983141983154983145983139983137983150 983114983151983157983154983150983137983148 983151983142 983107983148983145983150983145983139983137983148 983118983157983156983154983145983156983145983151983150

199868(6)12369830851240

58 K983150983157983140983155983141983150 983126K H983141983145983156983149983137983150983150 BL H983137983148983148983140983151983154983155983155983151983150 983124I 983123983151983154983141983150983155983141983150 983124IA 983119983148983155983141983150 983123F M983137983156983141983154983150983137983148 983140983145983141983156983137983154983161983143983148983161983139983137983141983149983145983139 983148983151983137983140 983140983157983154983145983150983143 983152983154983141983143983150983137983150983139983161 983137983150983140 983143983141983155983156983137983156983145983151983150983137983148 983159983141983145983143983144983156 983143983137983145983150 983138983145983154983156983144 983159983141983145983143983144983156 983137983150983140 983152983151983155983156983152983137983154983156983157983149

983159983141983145983143983144983156 983154983141983156983141983150983156983145983151983150 A 983155983156983157983140983161 983159983145983156983144983145983150 983156983144983141 D983137983150983145983155983144 N983137983156983145983151983150983137983148 B983145983154983156983144 C983151983144983151983154983156 983106983154983145983156983145983155983144 983114983151983157983154983150983137983148 983151983142

983118983157983156983154983145983156983145983151983150 2013109(8)14719830851478

59 983130983144983137983150983143 C L983145983157 983123 983123983151983148983151983149983151983150 CG H983157 FB D983145983141983156983137983154983161 983142983145983138983141983154 983145983150983156983137983147983141 983140983145983141983156983137983154983161 983143983148983161983139983141983149983145983139 983148983151983137983140 983137983150983140 983156983144983141 983154983145983155983147

983142983151983154 983143983141983155983156983137983156983145983151983150983137983148 983140983145983137983138983141983156983141983155 983149983141983148983148983145983156983157983155 983108983145983137983138983141983156983141983155 983107983137983154983141 200629(10)22239830852230

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

22





f r o m b i a s



d e s c r i b e d






W e r e o





i n d i c a t o r s



c o n s i d e

r a t i o n




Alberti-

Fidanza et

al37


Carbone

et al34


Conway

et al38


De


Fung et

al39


Goodarzi

Khoigani

et al35


Guelinckx

et al43


Hronek et

al40


Jansson etal41


Kopp

Hoolihan

et al42


Korpi

Hyovalti

et al44


Kubota et

al33


Lof et

al

23


8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

23





f r o m b i a s



i t h d r a w a l s

d e s c r i b e d




r e a n d





i n e d a n d t h e


l i a b l e




i n d i c a t o r s


b y r e s u l t s


t a k e n i n t o





Martinez

et al32


Moses et

al45


Piers et

al36


Tabrizi et

al24


Wolff et

al46



8172019 Je Beile 2015


ACCEPTED MANUSCRIPT



Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Alberti-Fidanza

et al37

2002

To examine



(ToAC) of women



newborns and relate

the results to the


same women during

pregnancy

Italy developed

n = 12

BMI 226 (55)

kgm2

Age 311 (42)

years

Parity 18 (09)

nil smokers

Collected by

qualified and

experienced

dietitians

using the diet

history

method during

the 1st 2

nd and

3rd

trimesters


monitor To

during the e

period of pr

and we sug

intakes of f

vegetables

necessary

antioxidant

and pro-vit


antioxidant

mothers an

newborns

particularly

preterm m

valuable in

for increasi

chance that

pregnancie

successfull


deliveries

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Carbone et al34

1992

Present patterns of



puerperium and its


fetal growth and

maternal nutrient

intake

Spain

developed

n = 33

BMI 227 (22)

kgm2

Age 28 (36)

years

Parity of 1 n =

18 234 n = 15

3-day weight


holiday

completed at

11 19 and 35

weeks

gestation




personal or family





time of visit and

pregnancy


risk

There was


and head

circumferen

weeks of ge

Findings m

a relationsh

between the

metabolism

maternal le

and fetal

developme

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Conway et al38

1999

To explore the


appropriateness of

weight gain during

pregnancy using AIM





England


BMI 22 (24)

kgm2

Age 312 (46)

years

Parity of 1 n =

28 2 n = 4

Unrestrainedn = 30

BMI 207 (196)

kgm2

Age 306 (36)

years

Parity of 1 n =

26 2 n = 4

7-day weighed


weeks

gestation

Caucasian women






outcomes

Providing p


appropriate

gains may b

beneficial

cessation o

during preg

associated w

weight gain

be prudent

accompany

advice abou

smoking dupregnancy

advice abou

and weight

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

De Vriese et

al

31

2001

To determine the


food frequency

questionnaire (FFQ)


diet by comparing



with the 7d food

record in pregnant


the 1st and 3

rd

trimesters

Belgium

developed

n = 26

BMI 22 (176-

293) kgm2

Age 30 (25-37)

years

All pregnant

women were

nulliparous

7-day


during the 1st

(median 15

weeks) and 3rd

(median 35

weeks)

trimesters A

FFQ

containing 180

of the most

common fat-

containingfoods was

conducted at

the same

timepoints

Data recorded

was based on

the EFR

First pregnancy


Hg not diabetic no

proteinuria and not



The FFQ in


compositio

of Belgian

adequate m

reasonably

subjects acc

their dietary

intake

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Fung et al39

1997



zinc from a


altered in well-

nourished women


conception through

lactation and





USA developed

n = 13

BMI 223 (29)

kgm2

Age 30 (29)

years

Parity of 1 n =

10 2 n = 3

3-day weighed

food recordnon-

consecutive

days two

weekdays and

one weekend

at 8-10 weeks

24-26 weeks

and 34-36

weeks

gestation

Aged 22-40yrs body


non-diabetic non-


alcohol use and no


gynecological

complications

Well-nouri


zinc during

pregnancy

increasing

and by a 30

increase in

absorption

not signific

increase in

zinc was du

to an increa


early in the

period pres

an adaptatio

lactation pr

These data

that mechan

regulating z

homeostasi

between pr

and lactatio

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Hronek et al40

2013



Czech pregnant


with recommended

daily allowances

(RDA)

Czechoslovakia

developed

Participants

were randomly

recruited from

both rural and

city regions

n = 152

BMI 211 (36)

kgm2

Age 289 (36)

years

7-day food


days using

scales and

household

measures at 0-

20 weeks 21-

29 weeks 30-

36 weeks and

37-39 weeks

gestation

Nonusers of chronic




le2 Subjects were

euthyroid

normoglyceamic and

not anemic

Lower intak


relative to t

correspond

during preg

Evaluated D

correspond

body size v

Modificatio

intake or al

supplement

recommend


iodine and

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Jansson et al41

2008



between early

pregnancy BMI

maternal dietary

intake and birth

weight

Sweden

developing

n = 49

BMI 255 (69)

kgm2

Age 30 (45)

years

Diet history


over a 24hr

period

collected by a

registered

dietitian at 8-

12 weeks and

32-35 weeks

gestation

Inclusion criteria


old

Exclusion criteria

smoking


reproduction

concurrent disease


or diabetes

development of

pregnancy


preeclampsia or

intrauterine growth

restriction

High first t


trimester IG

were correl

increased b

weight We

that low ser

concentrati

IGFBP-1 re

link betwee

BMI and in

fetal growth


IGF-1 regu

placental nu

transport

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Khoigani et

al

35

2012

To assess the



and micro nutrients




and reproductive

characteristics and


pregnant women

Iran developing

n = 620 (t1 n =

584 t2 n = 510)

BMI 235 (39)

kgm2

Age 256 (44)

years

Parity 158

(076)

48-hour


11-15 weeks

26 weeks and

34-37 weeks

gestation

Interviewers

were trained

Pregnant women who



delivery low birth

weight and factors

which may affect

pregnancy outcomes


addiction digestive


hemoglobinopathies

eating disorders


malignancy

Mean value


subjects wh

experienced

preeclamps

pregnancy

than in othe

women Int

manganese

C vitamin

and carboh

during the t


among preg

women wh

developed

preeclamps

significant

association

other micro

macro nutri

preeclamps

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Kopp-Hoolihan

et al

42

1999

To assess how well-




that predict an


response

USA developed

n = 10

BMI 231 (21)

kgm2

Age 291 (5)

years

3 day weighed


before

pregnancy and

at 8-10 24-26

34-36 weeks

gestation and

4-6 weeks

postpartum

Healthy non-smoking

women

Well-nouri

women useways to me

energy dem

pregnancy

reduction in

induced

thermogene

increased e

intake dep

less fat mas

predicted

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Kubota et al33

2013

To investigate the


intake maternal


growth during

pregnancy

Japan


BMI 175 (01)

kgm2

Age 297 (52)

years

Normaln = 94

BMI 21 (18)

kgm2

Age 308 (51)


Age 286 (36)

years

BMI 334 (65)

kgm2

Digital images


meals on 3

consecutive

days at 14-16

25-27 and 32-

34 weeks

gestation a

dietitian

reviewed

photos and

recorded

intakevalidation of

method not

reported

Singleton pregnant


had suffered from

obstetrical


premature delivery





Dietary inta


not correlat

fetal growth

Japanese na

recommend

advising ex

intake

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Lof et al23

2009

Investigate whether


weight gain are

associated with

estradiol and


plasma during

pregnancy

Sweden

developed

n = 226

BMI 229 (3)

kgm2

Age 32 (4) years

3 day weight


days including

one weekend

at 12 25 and

33 weeks

gestation

Calculations

conducted by

a nutritionist

Women with multi-





dietary intake were

excluded

No associat


dietary fat i

(total or sub

and plasma

levels Prog

levels corre

weight gain

pregnancy

Martinez et

al32

1994

To determine how



nation Mexico

Mexico

developing

n = 36

BMI 235 (26)

kgm2

Age 31 (54)

years

Diet history

collected by

trainedinterviewers

twice per

month and

reported as

mean first and

third trimester

values

Women with an 18




initial recruitment



pregnant

In this sam

women the


weight gain

pregnancy

was similar

women in U

States Low

maternal B

predicted sm

birth weigh

through at l

months of l

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Piers et al36

1995



pregnancy and


a group of well-

nourished pregnant


women at 12 24 and


12 and 24 wk

postpartum with a

non-pregnant non-


India

developing

n = 18

BMI 217 (24)

kgm2

Age 296 (52)

years

5 day


household

measures of

known volume

at 12 24 and

34 weeks

gestation and

12 and 24

weeks post-

partum

participants


measure by a

dietitian who

also checked

all records




morning sickness

before the initial

metabolic

measurement at 12

weeks gestation

BMR is sig


with non-pr

non-lactatin

and remain

even when

differences

weight are

for Well-n

Indian wom

weight and

similar to th


Birth weigh

infants born

to be lower

cost of preg

estimated to

MJ close t

MJ estimat

FAOIWHO

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Tabrizi et al24

2011

To assess the


mineral intake of

pregnant women and


neonates

Iran developing

n = 450

BMI 239 (38)

kgm2

Age 261 (58)

years

24 hour Recall


1st 2

nd and 3

rd

trimesters

Qualification

training of

interviewer

not reported

Women of 16 to 40


health care centers

during the three


Maternal en


with higher

serum calci

and zinc in

birth weigh

neonates


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Guelinckx

et al

43

2010

Study which


improve dietary

habits according to

the National Diet

Recommendations

increase physical

activity level in

obese pregnant

women and

control gestational

weight gain

Belgium

developedrandomly

assigned using

block

randomization

Control(routine)

n =43

BMI 335 (39)

kgm2

Age 294 (44)

yrs


and PA

brochure)

n = 37

BMI 334 (31)

kgm2

Age 287 (4) yrs

Parity of 1 n = 15

Active (brochure

+ group dietary

counselling)

n = 42BMI 341 (45)

kgm2

Age 28 (36) yrs

Parity of 1 n = 20

7-day food


weighed and

household

measures

during each

trimester of

pregnancy

Records were

checked by a

nutritionist






diabetes multiple

pregnancy premature

labor (lt37 wks

gestation) primary


advice in case of

metabolic disorder


conditions and





brochure and group

discussions

A lifestyle interv


combined with

individual advice

improve dietary h

throughout pregn

in obese women

in the absence of

medical or obstet

complications

maintaining or

increasing PA du


decrease in GWG

individually desig

caloric intake res

based on energy

expenditure data

be included

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Korpi-

Hyovalti etal44

2012

To evaluate the


quality of diet

weight gain and

birth weight in

women at high risk

of gestational

diabetes mellitus

Finland


group 1 or 2

using computed

randomization


information on

diet and PA)

n = 27

BMI 255 (34)

kgm2

Lifestyle


nutrition advice)

n = 27

BMI 273 (6)

kgm2

4 day weighed


days including

one weekend

completed at

8-12 26-28

and 36-40

weeks

gestation

Records

checked by a

nutritionist

A three-factor

eating

questionnaire

was also used

at the 1st and

3rd

trimester

Women with one or





48-55 mmoll and the

2h oral glucose


glucose lt78 mmoll

were recruited


GDM at 8-12 wks


There were no cl


however

polyunsaturated f

increase in the lif

intervention grou

Intensive weight

education led to a

somewhat lower

gain during pregn

and higher birth w

of the infants in


macrosomia whe

compared to the c

follow up group

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Moses et al45

2014

To determine


index (LGI) dietary

advice at

the first antenatal

visit would result

in a lower fetal

birth weight

birth percentile

and ponderal index

(PI) than providing

healthy eating

(HE) advice

Australia

developedrandomly

assigned using

computer-

generated

random numbers

1 or 2

Healthy Eating

(counselled to

follow a healthy

diet based on the

AGHE4

) n = 280

BMI 247 (5)

kgm2

Age 299 (5) yrs

Low Glycemic

Index

(individualized

nutrition advice

on a LGI diet)

n = 296

BMI 243 (52)

kgm2 Age 299 (52)

yrs

3 day


household

measures at 16

and 36 weeks

gestation

records

reviewed by a

dietitian



least 18 years old

ability to read and

understand English


comply with visit

schedules Subjects






compromise their




body weight

A low intensity d


in pregnancy did

result in significa

differences in bir

weight fetal perc

of PI

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Wolff et

al

46

2008

To determine


consultations

restricts weight

gain in obese

women and

whether this

restriction impacts

on pregnancy-

induced changes in

glucose

metabolism

Denmark


group 1 or 2

using computed

randomization

Control (general

information on

diet and PA)

n = 27

BMI 255 (34)

kgm2


x 1 hour

consultations)

n = 27

BMI 273 (6)

kgm2

Age 28 (4) years

7 day weighed


plusmn 3 wks) 27

and 36 weeks

gestation



recruited Exclusion

criteria included


or gt45 year old


medical conditions

which impact fetal

growth

Restriction of


achievable and re

the deterioration

glucose metaboli

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

41

983120983137983143983141 983092983089 983151983142 983092983090

FIGURE LEGENDS





















2 GWG 115 to 155 kg)


2

GWG 50 to 90 kg)

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

42

983120983137983143983141 983092983090 983151983142 983092983090







8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

15



(n = 47003) and272










conception281













CONCLUSIONS 293

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

16





revised298

Acknowledgements299




project303











Funding314


8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

18

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8 B983157983140983143983141 H G983150983137983150983137983148983145983150983143983144983137983149 MG G983137983154983140983150983141983154 D983123 M983151983155983156983161983150 A 983123983156983141983152983144983141983150983155983151983150 983124 983123983161983149983151983150983140983155 ME M983137983156983141983154983150983137983148

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11 983123983156983154983141983157983148983145983150983143 I B983141983161983141983154983148983141983145983150 A 983122983151983155983141983150983142983141983148983140 E 983123983139983144983157983147983137983156 B 983158983151983150 K983154983145983141983155 983122 983127983141983145983143983144983156 983143983137983145983150 983137983150983140 983140983145983141983156983137983154983161 983145983150983156983137983147983141

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12 983122983137983155983149983157983155983155983141983150 KM 983129A 983127983141983145983143983144983156 983111983137983145983150 983108983157983154983145983150983143 983120983154983141983143983150983137983150983139983161 983122983141983141983160983137983149983145983150983145983150983143 983156983144983141 983111983157983145983140983141983148983145983150983141983155 2009 I983123BN983085

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983118983157983156983154983145983156983145983151983150 983122983141983155983141983137983154983139983144 983122983141983158983145983141983159983155 199811(2)231983085253

54 983120983151983157983140983141983158983145983143983150983141 M983123 983119983139983151983150983150983151983154 983120J A 983122983141983158983145983141983159 983151983142 983120983144983161983155983145983139983137983148 A983139983156983145983158983145983156983161 983120983137983156983156983141983154983150983155 983145983150 983120983154983141983143983150983137983150983156 983127983151983149983141983150 983137983150983140

983124983144983141983145983154 983122983141983148983137983156983145983151983150983155983144983145983152 983156983151 983120983155983161983139983144983151983148983151983143983145983139983137983148 H983141983137983148983156983144 983126983151983148 36 C983144983137983149 A983140983145983155 I983150983156983141983154983150983137983156983145983151983150983137983148 20061998308519

55 D983157983142983151983157983154 DL 983122983141983145983150983137 JC 983123983152983157983154983154 GB E983150983141983154983143983161 983145983150983156983137983147983141 983137983150983140 983141983160983152983141983150983140983145983156983157983154983141 983151983142 983142983154983141983141983085983148983145983158983145983150983143 983148983137983139983156983137983156983145983150983143

C983151983148983151983149983138983145983137983150 983159983151983149983141983150 983145983150 983137983150 983157983154983138983137983150 983155983141983156983156983145983150983143 983109983157983154983151983152983141983137983150 983114983151983157983154983150983137983148 983151983142 983107983148983145983150983145983139983137983148 983118983157983156983154983145983156983145983151983150

200256(3)205983085213

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

21

56 L983137983145983150 K983129 C983137983156983137983148983137983150983151 983120M M983141983156983137983138983151983148983145983139 C983144983137983150983143983141983155 983145983150 983120983154983141983143983150983137983150983139983161 983107983148983145983150983145983139983137983148 983151983138983155983156983141983156983154983145983139983155 983137983150983140 983143983161983150983141983139983151983148983151983143983161

200750(4)938983085948

57 983123983156983141983145983150 983124983120 983123983139983144983151983148983148 983124983119 983123983139983144983148983157983156983141983154 MD 983123983139983144983154983151983141983140983141983154 CM 983120983148983137983155983149983137 983148983141983152983156983145983150 983145983150983142983148983157983141983150983139983141983155 983143983141983155983156983137983156983145983151983150983137983148 983159983141983145983143983144983156

983143983137983145983150 983137983150983140 983152983151983155983156983152983137983154983156983157983149 983159983141983145983143983144983156 983154983141983156983141983150983156983145983151983150 983105983149983141983154983145983139983137983150 983114983151983157983154983150983137983148 983151983142 983107983148983145983150983145983139983137983148 983118983157983156983154983145983156983145983151983150

199868(6)12369830851240

58 K983150983157983140983155983141983150 983126K H983141983145983156983149983137983150983150 BL H983137983148983148983140983151983154983155983155983151983150 983124I 983123983151983154983141983150983155983141983150 983124IA 983119983148983155983141983150 983123F M983137983156983141983154983150983137983148 983140983145983141983156983137983154983161983143983148983161983139983137983141983149983145983139 983148983151983137983140 983140983157983154983145983150983143 983152983154983141983143983150983137983150983139983161 983137983150983140 983143983141983155983156983137983156983145983151983150983137983148 983159983141983145983143983144983156 983143983137983145983150 983138983145983154983156983144 983159983141983145983143983144983156 983137983150983140 983152983151983155983156983152983137983154983156983157983149

983159983141983145983143983144983156 983154983141983156983141983150983156983145983151983150 A 983155983156983157983140983161 983159983145983156983144983145983150 983156983144983141 D983137983150983145983155983144 N983137983156983145983151983150983137983148 B983145983154983156983144 C983151983144983151983154983156 983106983154983145983156983145983155983144 983114983151983157983154983150983137983148 983151983142

983118983157983156983154983145983156983145983151983150 2013109(8)14719830851478

59 983130983144983137983150983143 C L983145983157 983123 983123983151983148983151983149983151983150 CG H983157 FB D983145983141983156983137983154983161 983142983145983138983141983154 983145983150983156983137983147983141 983140983145983141983156983137983154983161 983143983148983161983139983141983149983145983139 983148983151983137983140 983137983150983140 983156983144983141 983154983145983155983147

983142983151983154 983143983141983155983156983137983156983145983151983150983137983148 983140983145983137983138983141983156983141983155 983149983141983148983148983145983156983157983155 983108983145983137983138983141983156983141983155 983107983137983154983141 200629(10)22239830852230

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

22





f r o m b i a s



d e s c r i b e d






W e r e o





i n d i c a t o r s



c o n s i d e

r a t i o n




Alberti-

Fidanza et

al37


Carbone

et al34


Conway

et al38


De


Fung et

al39


Goodarzi

Khoigani

et al35


Guelinckx

et al43


Hronek et

al40


Jansson etal41


Kopp

Hoolihan

et al42


Korpi

Hyovalti

et al44


Kubota et

al33


Lof et

al

23


8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

23





f r o m b i a s



i t h d r a w a l s

d e s c r i b e d




r e a n d





i n e d a n d t h e


l i a b l e




i n d i c a t o r s


b y r e s u l t s


t a k e n i n t o





Martinez

et al32


Moses et

al45


Piers et

al36


Tabrizi et

al24


Wolff et

al46



8172019 Je Beile 2015


ACCEPTED MANUSCRIPT



Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Alberti-Fidanza

et al37

2002

To examine



(ToAC) of women



newborns and relate

the results to the


same women during

pregnancy

Italy developed

n = 12

BMI 226 (55)

kgm2

Age 311 (42)

years

Parity 18 (09)

nil smokers

Collected by

qualified and

experienced

dietitians

using the diet

history

method during

the 1st 2

nd and

3rd

trimesters


monitor To

during the e

period of pr

and we sug

intakes of f

vegetables

necessary

antioxidant

and pro-vit


antioxidant

mothers an

newborns

particularly

preterm m

valuable in

for increasi

chance that

pregnancie

successfull


deliveries

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Carbone et al34

1992

Present patterns of



puerperium and its


fetal growth and

maternal nutrient

intake

Spain

developed

n = 33

BMI 227 (22)

kgm2

Age 28 (36)

years

Parity of 1 n =

18 234 n = 15

3-day weight


holiday

completed at

11 19 and 35

weeks

gestation




personal or family





time of visit and

pregnancy


risk

There was


and head

circumferen

weeks of ge

Findings m

a relationsh

between the

metabolism

maternal le

and fetal

developme

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Conway et al38

1999

To explore the


appropriateness of

weight gain during

pregnancy using AIM





England


BMI 22 (24)

kgm2

Age 312 (46)

years

Parity of 1 n =

28 2 n = 4

Unrestrainedn = 30

BMI 207 (196)

kgm2

Age 306 (36)

years

Parity of 1 n =

26 2 n = 4

7-day weighed


weeks

gestation

Caucasian women






outcomes

Providing p


appropriate

gains may b

beneficial

cessation o

during preg

associated w

weight gain

be prudent

accompany

advice abou

smoking dupregnancy

advice abou

and weight

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

De Vriese et

al

31

2001

To determine the


food frequency

questionnaire (FFQ)


diet by comparing



with the 7d food

record in pregnant


the 1st and 3

rd

trimesters

Belgium

developed

n = 26

BMI 22 (176-

293) kgm2

Age 30 (25-37)

years

All pregnant

women were

nulliparous

7-day


during the 1st

(median 15

weeks) and 3rd

(median 35

weeks)

trimesters A

FFQ

containing 180

of the most

common fat-

containingfoods was

conducted at

the same

timepoints

Data recorded

was based on

the EFR

First pregnancy


Hg not diabetic no

proteinuria and not



The FFQ in


compositio

of Belgian

adequate m

reasonably

subjects acc

their dietary

intake

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Fung et al39

1997



zinc from a


altered in well-

nourished women


conception through

lactation and





USA developed

n = 13

BMI 223 (29)

kgm2

Age 30 (29)

years

Parity of 1 n =

10 2 n = 3

3-day weighed

food recordnon-

consecutive

days two

weekdays and

one weekend

at 8-10 weeks

24-26 weeks

and 34-36

weeks

gestation

Aged 22-40yrs body


non-diabetic non-


alcohol use and no


gynecological

complications

Well-nouri


zinc during

pregnancy

increasing

and by a 30

increase in

absorption

not signific

increase in

zinc was du

to an increa


early in the

period pres

an adaptatio

lactation pr

These data

that mechan

regulating z

homeostasi

between pr

and lactatio

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Hronek et al40

2013



Czech pregnant


with recommended

daily allowances

(RDA)

Czechoslovakia

developed

Participants

were randomly

recruited from

both rural and

city regions

n = 152

BMI 211 (36)

kgm2

Age 289 (36)

years

7-day food


days using

scales and

household

measures at 0-

20 weeks 21-

29 weeks 30-

36 weeks and

37-39 weeks

gestation

Nonusers of chronic




le2 Subjects were

euthyroid

normoglyceamic and

not anemic

Lower intak


relative to t

correspond

during preg

Evaluated D

correspond

body size v

Modificatio

intake or al

supplement

recommend


iodine and

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Jansson et al41

2008



between early

pregnancy BMI

maternal dietary

intake and birth

weight

Sweden

developing

n = 49

BMI 255 (69)

kgm2

Age 30 (45)

years

Diet history


over a 24hr

period

collected by a

registered

dietitian at 8-

12 weeks and

32-35 weeks

gestation

Inclusion criteria


old

Exclusion criteria

smoking


reproduction

concurrent disease


or diabetes

development of

pregnancy


preeclampsia or

intrauterine growth

restriction

High first t


trimester IG

were correl

increased b

weight We

that low ser

concentrati

IGFBP-1 re

link betwee

BMI and in

fetal growth


IGF-1 regu

placental nu

transport

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Khoigani et

al

35

2012

To assess the



and micro nutrients




and reproductive

characteristics and


pregnant women

Iran developing

n = 620 (t1 n =

584 t2 n = 510)

BMI 235 (39)

kgm2

Age 256 (44)

years

Parity 158

(076)

48-hour


11-15 weeks

26 weeks and

34-37 weeks

gestation

Interviewers

were trained

Pregnant women who



delivery low birth

weight and factors

which may affect

pregnancy outcomes


addiction digestive


hemoglobinopathies

eating disorders


malignancy

Mean value


subjects wh

experienced

preeclamps

pregnancy

than in othe

women Int

manganese

C vitamin

and carboh

during the t


among preg

women wh

developed

preeclamps

significant

association

other micro

macro nutri

preeclamps

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Kopp-Hoolihan

et al

42

1999

To assess how well-




that predict an


response

USA developed

n = 10

BMI 231 (21)

kgm2

Age 291 (5)

years

3 day weighed


before

pregnancy and

at 8-10 24-26

34-36 weeks

gestation and

4-6 weeks

postpartum

Healthy non-smoking

women

Well-nouri

women useways to me

energy dem

pregnancy

reduction in

induced

thermogene

increased e

intake dep

less fat mas

predicted

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Kubota et al33

2013

To investigate the


intake maternal


growth during

pregnancy

Japan


BMI 175 (01)

kgm2

Age 297 (52)

years

Normaln = 94

BMI 21 (18)

kgm2

Age 308 (51)


Age 286 (36)

years

BMI 334 (65)

kgm2

Digital images


meals on 3

consecutive

days at 14-16

25-27 and 32-

34 weeks

gestation a

dietitian

reviewed

photos and

recorded

intakevalidation of

method not

reported

Singleton pregnant


had suffered from

obstetrical


premature delivery





Dietary inta


not correlat

fetal growth

Japanese na

recommend

advising ex

intake

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Lof et al23

2009

Investigate whether


weight gain are

associated with

estradiol and


plasma during

pregnancy

Sweden

developed

n = 226

BMI 229 (3)

kgm2

Age 32 (4) years

3 day weight


days including

one weekend

at 12 25 and

33 weeks

gestation

Calculations

conducted by

a nutritionist

Women with multi-





dietary intake were

excluded

No associat


dietary fat i

(total or sub

and plasma

levels Prog

levels corre

weight gain

pregnancy

Martinez et

al32

1994

To determine how



nation Mexico

Mexico

developing

n = 36

BMI 235 (26)

kgm2

Age 31 (54)

years

Diet history

collected by

trainedinterviewers

twice per

month and

reported as

mean first and

third trimester

values

Women with an 18




initial recruitment



pregnant

In this sam

women the


weight gain

pregnancy

was similar

women in U

States Low

maternal B

predicted sm

birth weigh

through at l

months of l

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Piers et al36

1995



pregnancy and


a group of well-

nourished pregnant


women at 12 24 and


12 and 24 wk

postpartum with a

non-pregnant non-


India

developing

n = 18

BMI 217 (24)

kgm2

Age 296 (52)

years

5 day


household

measures of

known volume

at 12 24 and

34 weeks

gestation and

12 and 24

weeks post-

partum

participants


measure by a

dietitian who

also checked

all records




morning sickness

before the initial

metabolic

measurement at 12

weeks gestation

BMR is sig


with non-pr

non-lactatin

and remain

even when

differences

weight are

for Well-n

Indian wom

weight and

similar to th


Birth weigh

infants born

to be lower

cost of preg

estimated to

MJ close t

MJ estimat

FAOIWHO

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Tabrizi et al24

2011

To assess the


mineral intake of

pregnant women and


neonates

Iran developing

n = 450

BMI 239 (38)

kgm2

Age 261 (58)

years

24 hour Recall


1st 2

nd and 3

rd

trimesters

Qualification

training of

interviewer

not reported

Women of 16 to 40


health care centers

during the three


Maternal en


with higher

serum calci

and zinc in

birth weigh

neonates


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Guelinckx

et al

43

2010

Study which


improve dietary

habits according to

the National Diet

Recommendations

increase physical

activity level in

obese pregnant

women and

control gestational

weight gain

Belgium

developedrandomly

assigned using

block

randomization

Control(routine)

n =43

BMI 335 (39)

kgm2

Age 294 (44)

yrs


and PA

brochure)

n = 37

BMI 334 (31)

kgm2

Age 287 (4) yrs

Parity of 1 n = 15

Active (brochure

+ group dietary

counselling)

n = 42BMI 341 (45)

kgm2

Age 28 (36) yrs

Parity of 1 n = 20

7-day food


weighed and

household

measures

during each

trimester of

pregnancy

Records were

checked by a

nutritionist






diabetes multiple

pregnancy premature

labor (lt37 wks

gestation) primary


advice in case of

metabolic disorder


conditions and





brochure and group

discussions

A lifestyle interv


combined with

individual advice

improve dietary h

throughout pregn

in obese women

in the absence of

medical or obstet

complications

maintaining or

increasing PA du


decrease in GWG

individually desig

caloric intake res

based on energy

expenditure data

be included

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Korpi-

Hyovalti etal44

2012

To evaluate the


quality of diet

weight gain and

birth weight in

women at high risk

of gestational

diabetes mellitus

Finland


group 1 or 2

using computed

randomization


information on

diet and PA)

n = 27

BMI 255 (34)

kgm2

Lifestyle


nutrition advice)

n = 27

BMI 273 (6)

kgm2

4 day weighed


days including

one weekend

completed at

8-12 26-28

and 36-40

weeks

gestation

Records

checked by a

nutritionist

A three-factor

eating

questionnaire

was also used

at the 1st and

3rd

trimester

Women with one or





48-55 mmoll and the

2h oral glucose


glucose lt78 mmoll

were recruited


GDM at 8-12 wks


There were no cl


however

polyunsaturated f

increase in the lif

intervention grou

Intensive weight

education led to a

somewhat lower

gain during pregn

and higher birth w

of the infants in


macrosomia whe

compared to the c

follow up group

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Moses et al45

2014

To determine


index (LGI) dietary

advice at

the first antenatal

visit would result

in a lower fetal

birth weight

birth percentile

and ponderal index

(PI) than providing

healthy eating

(HE) advice

Australia

developedrandomly

assigned using

computer-

generated

random numbers

1 or 2

Healthy Eating

(counselled to

follow a healthy

diet based on the

AGHE4

) n = 280

BMI 247 (5)

kgm2

Age 299 (5) yrs

Low Glycemic

Index

(individualized

nutrition advice

on a LGI diet)

n = 296

BMI 243 (52)

kgm2 Age 299 (52)

yrs

3 day


household

measures at 16

and 36 weeks

gestation

records

reviewed by a

dietitian



least 18 years old

ability to read and

understand English


comply with visit

schedules Subjects






compromise their




body weight

A low intensity d


in pregnancy did

result in significa

differences in bir

weight fetal perc

of PI

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Wolff et

al

46

2008

To determine


consultations

restricts weight

gain in obese

women and

whether this

restriction impacts

on pregnancy-

induced changes in

glucose

metabolism

Denmark


group 1 or 2

using computed

randomization

Control (general

information on

diet and PA)

n = 27

BMI 255 (34)

kgm2


x 1 hour

consultations)

n = 27

BMI 273 (6)

kgm2

Age 28 (4) years

7 day weighed


plusmn 3 wks) 27

and 36 weeks

gestation



recruited Exclusion

criteria included


or gt45 year old


medical conditions

which impact fetal

growth

Restriction of


achievable and re

the deterioration

glucose metaboli

8172019 Je Beile 2015


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41

983120983137983143983141 983092983089 983151983142 983092983090

FIGURE LEGENDS





















2 GWG 115 to 155 kg)


2

GWG 50 to 90 kg)

8172019 Je Beile 2015


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42

983120983137983143983141 983092983090 983151983142 983092983090







8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

16





revised298

Acknowledgements299




project303











Funding314


8172019 Je Beile 2015


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18

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8172019 Je Beile 2015


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ACCEPTED MANUSCRIPT

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200750(4)938983085948

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983143983137983145983150 983137983150983140 983152983151983155983156983152983137983154983156983157983149 983159983141983145983143983144983156 983154983141983156983141983150983156983145983151983150 983105983149983141983154983145983139983137983150 983114983151983157983154983150983137983148 983151983142 983107983148983145983150983145983139983137983148 983118983157983156983154983145983156983145983151983150

199868(6)12369830851240

58 K983150983157983140983155983141983150 983126K H983141983145983156983149983137983150983150 BL H983137983148983148983140983151983154983155983155983151983150 983124I 983123983151983154983141983150983155983141983150 983124IA 983119983148983155983141983150 983123F M983137983156983141983154983150983137983148 983140983145983141983156983137983154983161983143983148983161983139983137983141983149983145983139 983148983151983137983140 983140983157983154983145983150983143 983152983154983141983143983150983137983150983139983161 983137983150983140 983143983141983155983156983137983156983145983151983150983137983148 983159983141983145983143983144983156 983143983137983145983150 983138983145983154983156983144 983159983141983145983143983144983156 983137983150983140 983152983151983155983156983152983137983154983156983157983149

983159983141983145983143983144983156 983154983141983156983141983150983156983145983151983150 A 983155983156983157983140983161 983159983145983156983144983145983150 983156983144983141 D983137983150983145983155983144 N983137983156983145983151983150983137983148 B983145983154983156983144 C983151983144983151983154983156 983106983154983145983156983145983155983144 983114983151983157983154983150983137983148 983151983142

983118983157983156983154983145983156983145983151983150 2013109(8)14719830851478

59 983130983144983137983150983143 C L983145983157 983123 983123983151983148983151983149983151983150 CG H983157 FB D983145983141983156983137983154983161 983142983145983138983141983154 983145983150983156983137983147983141 983140983145983141983156983137983154983161 983143983148983161983139983141983149983145983139 983148983151983137983140 983137983150983140 983156983144983141 983154983145983155983147

983142983151983154 983143983141983155983156983137983156983145983151983150983137983148 983140983145983137983138983141983156983141983155 983149983141983148983148983145983156983157983155 983108983145983137983138983141983156983141983155 983107983137983154983141 200629(10)22239830852230

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

22





f r o m b i a s



d e s c r i b e d






W e r e o





i n d i c a t o r s



c o n s i d e

r a t i o n




Alberti-

Fidanza et

al37


Carbone

et al34


Conway

et al38


De


Fung et

al39


Goodarzi

Khoigani

et al35


Guelinckx

et al43


Hronek et

al40


Jansson etal41


Kopp

Hoolihan

et al42


Korpi

Hyovalti

et al44


Kubota et

al33


Lof et

al

23


8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

23





f r o m b i a s



i t h d r a w a l s

d e s c r i b e d




r e a n d





i n e d a n d t h e


l i a b l e




i n d i c a t o r s


b y r e s u l t s


t a k e n i n t o





Martinez

et al32


Moses et

al45


Piers et

al36


Tabrizi et

al24


Wolff et

al46



8172019 Je Beile 2015


ACCEPTED MANUSCRIPT



Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Alberti-Fidanza

et al37

2002

To examine



(ToAC) of women



newborns and relate

the results to the


same women during

pregnancy

Italy developed

n = 12

BMI 226 (55)

kgm2

Age 311 (42)

years

Parity 18 (09)

nil smokers

Collected by

qualified and

experienced

dietitians

using the diet

history

method during

the 1st 2

nd and

3rd

trimesters


monitor To

during the e

period of pr

and we sug

intakes of f

vegetables

necessary

antioxidant

and pro-vit


antioxidant

mothers an

newborns

particularly

preterm m

valuable in

for increasi

chance that

pregnancie

successfull


deliveries

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Carbone et al34

1992

Present patterns of



puerperium and its


fetal growth and

maternal nutrient

intake

Spain

developed

n = 33

BMI 227 (22)

kgm2

Age 28 (36)

years

Parity of 1 n =

18 234 n = 15

3-day weight


holiday

completed at

11 19 and 35

weeks

gestation




personal or family





time of visit and

pregnancy


risk

There was


and head

circumferen

weeks of ge

Findings m

a relationsh

between the

metabolism

maternal le

and fetal

developme

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Conway et al38

1999

To explore the


appropriateness of

weight gain during

pregnancy using AIM





England


BMI 22 (24)

kgm2

Age 312 (46)

years

Parity of 1 n =

28 2 n = 4

Unrestrainedn = 30

BMI 207 (196)

kgm2

Age 306 (36)

years

Parity of 1 n =

26 2 n = 4

7-day weighed


weeks

gestation

Caucasian women






outcomes

Providing p


appropriate

gains may b

beneficial

cessation o

during preg

associated w

weight gain

be prudent

accompany

advice abou

smoking dupregnancy

advice abou

and weight

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

De Vriese et

al

31

2001

To determine the


food frequency

questionnaire (FFQ)


diet by comparing



with the 7d food

record in pregnant


the 1st and 3

rd

trimesters

Belgium

developed

n = 26

BMI 22 (176-

293) kgm2

Age 30 (25-37)

years

All pregnant

women were

nulliparous

7-day


during the 1st

(median 15

weeks) and 3rd

(median 35

weeks)

trimesters A

FFQ

containing 180

of the most

common fat-

containingfoods was

conducted at

the same

timepoints

Data recorded

was based on

the EFR

First pregnancy


Hg not diabetic no

proteinuria and not



The FFQ in


compositio

of Belgian

adequate m

reasonably

subjects acc

their dietary

intake

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Fung et al39

1997



zinc from a


altered in well-

nourished women


conception through

lactation and





USA developed

n = 13

BMI 223 (29)

kgm2

Age 30 (29)

years

Parity of 1 n =

10 2 n = 3

3-day weighed

food recordnon-

consecutive

days two

weekdays and

one weekend

at 8-10 weeks

24-26 weeks

and 34-36

weeks

gestation

Aged 22-40yrs body


non-diabetic non-


alcohol use and no


gynecological

complications

Well-nouri


zinc during

pregnancy

increasing

and by a 30

increase in

absorption

not signific

increase in

zinc was du

to an increa


early in the

period pres

an adaptatio

lactation pr

These data

that mechan

regulating z

homeostasi

between pr

and lactatio

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Hronek et al40

2013



Czech pregnant


with recommended

daily allowances

(RDA)

Czechoslovakia

developed

Participants

were randomly

recruited from

both rural and

city regions

n = 152

BMI 211 (36)

kgm2

Age 289 (36)

years

7-day food


days using

scales and

household

measures at 0-

20 weeks 21-

29 weeks 30-

36 weeks and

37-39 weeks

gestation

Nonusers of chronic




le2 Subjects were

euthyroid

normoglyceamic and

not anemic

Lower intak


relative to t

correspond

during preg

Evaluated D

correspond

body size v

Modificatio

intake or al

supplement

recommend


iodine and

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Jansson et al41

2008



between early

pregnancy BMI

maternal dietary

intake and birth

weight

Sweden

developing

n = 49

BMI 255 (69)

kgm2

Age 30 (45)

years

Diet history


over a 24hr

period

collected by a

registered

dietitian at 8-

12 weeks and

32-35 weeks

gestation

Inclusion criteria


old

Exclusion criteria

smoking


reproduction

concurrent disease


or diabetes

development of

pregnancy


preeclampsia or

intrauterine growth

restriction

High first t


trimester IG

were correl

increased b

weight We

that low ser

concentrati

IGFBP-1 re

link betwee

BMI and in

fetal growth


IGF-1 regu

placental nu

transport

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Khoigani et

al

35

2012

To assess the



and micro nutrients




and reproductive

characteristics and


pregnant women

Iran developing

n = 620 (t1 n =

584 t2 n = 510)

BMI 235 (39)

kgm2

Age 256 (44)

years

Parity 158

(076)

48-hour


11-15 weeks

26 weeks and

34-37 weeks

gestation

Interviewers

were trained

Pregnant women who



delivery low birth

weight and factors

which may affect

pregnancy outcomes


addiction digestive


hemoglobinopathies

eating disorders


malignancy

Mean value


subjects wh

experienced

preeclamps

pregnancy

than in othe

women Int

manganese

C vitamin

and carboh

during the t


among preg

women wh

developed

preeclamps

significant

association

other micro

macro nutri

preeclamps

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Kopp-Hoolihan

et al

42

1999

To assess how well-




that predict an


response

USA developed

n = 10

BMI 231 (21)

kgm2

Age 291 (5)

years

3 day weighed


before

pregnancy and

at 8-10 24-26

34-36 weeks

gestation and

4-6 weeks

postpartum

Healthy non-smoking

women

Well-nouri

women useways to me

energy dem

pregnancy

reduction in

induced

thermogene

increased e

intake dep

less fat mas

predicted

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Kubota et al33

2013

To investigate the


intake maternal


growth during

pregnancy

Japan


BMI 175 (01)

kgm2

Age 297 (52)

years

Normaln = 94

BMI 21 (18)

kgm2

Age 308 (51)


Age 286 (36)

years

BMI 334 (65)

kgm2

Digital images


meals on 3

consecutive

days at 14-16

25-27 and 32-

34 weeks

gestation a

dietitian

reviewed

photos and

recorded

intakevalidation of

method not

reported

Singleton pregnant


had suffered from

obstetrical


premature delivery





Dietary inta


not correlat

fetal growth

Japanese na

recommend

advising ex

intake

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Lof et al23

2009

Investigate whether


weight gain are

associated with

estradiol and


plasma during

pregnancy

Sweden

developed

n = 226

BMI 229 (3)

kgm2

Age 32 (4) years

3 day weight


days including

one weekend

at 12 25 and

33 weeks

gestation

Calculations

conducted by

a nutritionist

Women with multi-





dietary intake were

excluded

No associat


dietary fat i

(total or sub

and plasma

levels Prog

levels corre

weight gain

pregnancy

Martinez et

al32

1994

To determine how



nation Mexico

Mexico

developing

n = 36

BMI 235 (26)

kgm2

Age 31 (54)

years

Diet history

collected by

trainedinterviewers

twice per

month and

reported as

mean first and

third trimester

values

Women with an 18




initial recruitment



pregnant

In this sam

women the


weight gain

pregnancy

was similar

women in U

States Low

maternal B

predicted sm

birth weigh

through at l

months of l

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Piers et al36

1995



pregnancy and


a group of well-

nourished pregnant


women at 12 24 and


12 and 24 wk

postpartum with a

non-pregnant non-


India

developing

n = 18

BMI 217 (24)

kgm2

Age 296 (52)

years

5 day


household

measures of

known volume

at 12 24 and

34 weeks

gestation and

12 and 24

weeks post-

partum

participants


measure by a

dietitian who

also checked

all records




morning sickness

before the initial

metabolic

measurement at 12

weeks gestation

BMR is sig


with non-pr

non-lactatin

and remain

even when

differences

weight are

for Well-n

Indian wom

weight and

similar to th


Birth weigh

infants born

to be lower

cost of preg

estimated to

MJ close t

MJ estimat

FAOIWHO

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Tabrizi et al24

2011

To assess the


mineral intake of

pregnant women and


neonates

Iran developing

n = 450

BMI 239 (38)

kgm2

Age 261 (58)

years

24 hour Recall


1st 2

nd and 3

rd

trimesters

Qualification

training of

interviewer

not reported

Women of 16 to 40


health care centers

during the three


Maternal en


with higher

serum calci

and zinc in

birth weigh

neonates


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Guelinckx

et al

43

2010

Study which


improve dietary

habits according to

the National Diet

Recommendations

increase physical

activity level in

obese pregnant

women and

control gestational

weight gain

Belgium

developedrandomly

assigned using

block

randomization

Control(routine)

n =43

BMI 335 (39)

kgm2

Age 294 (44)

yrs


and PA

brochure)

n = 37

BMI 334 (31)

kgm2

Age 287 (4) yrs

Parity of 1 n = 15

Active (brochure

+ group dietary

counselling)

n = 42BMI 341 (45)

kgm2

Age 28 (36) yrs

Parity of 1 n = 20

7-day food


weighed and

household

measures

during each

trimester of

pregnancy

Records were

checked by a

nutritionist






diabetes multiple

pregnancy premature

labor (lt37 wks

gestation) primary


advice in case of

metabolic disorder


conditions and





brochure and group

discussions

A lifestyle interv


combined with

individual advice

improve dietary h

throughout pregn

in obese women

in the absence of

medical or obstet

complications

maintaining or

increasing PA du


decrease in GWG

individually desig

caloric intake res

based on energy

expenditure data

be included

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Korpi-

Hyovalti etal44

2012

To evaluate the


quality of diet

weight gain and

birth weight in

women at high risk

of gestational

diabetes mellitus

Finland


group 1 or 2

using computed

randomization


information on

diet and PA)

n = 27

BMI 255 (34)

kgm2

Lifestyle


nutrition advice)

n = 27

BMI 273 (6)

kgm2

4 day weighed


days including

one weekend

completed at

8-12 26-28

and 36-40

weeks

gestation

Records

checked by a

nutritionist

A three-factor

eating

questionnaire

was also used

at the 1st and

3rd

trimester

Women with one or





48-55 mmoll and the

2h oral glucose


glucose lt78 mmoll

were recruited


GDM at 8-12 wks


There were no cl


however

polyunsaturated f

increase in the lif

intervention grou

Intensive weight

education led to a

somewhat lower

gain during pregn

and higher birth w

of the infants in


macrosomia whe

compared to the c

follow up group

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Moses et al45

2014

To determine


index (LGI) dietary

advice at

the first antenatal

visit would result

in a lower fetal

birth weight

birth percentile

and ponderal index

(PI) than providing

healthy eating

(HE) advice

Australia

developedrandomly

assigned using

computer-

generated

random numbers

1 or 2

Healthy Eating

(counselled to

follow a healthy

diet based on the

AGHE4

) n = 280

BMI 247 (5)

kgm2

Age 299 (5) yrs

Low Glycemic

Index

(individualized

nutrition advice

on a LGI diet)

n = 296

BMI 243 (52)

kgm2 Age 299 (52)

yrs

3 day


household

measures at 16

and 36 weeks

gestation

records

reviewed by a

dietitian



least 18 years old

ability to read and

understand English


comply with visit

schedules Subjects






compromise their




body weight

A low intensity d


in pregnancy did

result in significa

differences in bir

weight fetal perc

of PI

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Wolff et

al

46

2008

To determine


consultations

restricts weight

gain in obese

women and

whether this

restriction impacts

on pregnancy-

induced changes in

glucose

metabolism

Denmark


group 1 or 2

using computed

randomization

Control (general

information on

diet and PA)

n = 27

BMI 255 (34)

kgm2


x 1 hour

consultations)

n = 27

BMI 273 (6)

kgm2

Age 28 (4) years

7 day weighed


plusmn 3 wks) 27

and 36 weeks

gestation



recruited Exclusion

criteria included


or gt45 year old


medical conditions

which impact fetal

growth

Restriction of


achievable and re

the deterioration

glucose metaboli

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

41

983120983137983143983141 983092983089 983151983142 983092983090

FIGURE LEGENDS





















2 GWG 115 to 155 kg)


2

GWG 50 to 90 kg)

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

42

983120983137983143983141 983092983090 983151983142 983092983090







8172019 Je Beile 2015


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8172019 Je Beile 2015


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8172019 Je Beile 2015


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8172019 Je Beile 2015


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8172019 Je Beile 2015


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8172019 Je Beile 2015


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8172019 Je Beile 2015


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18

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ACCEPTED MANUSCRIPT

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ACCEPTED MANUSCRIPT

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983118983157983156983154983145983156983145983151983150 2013109(8)14719830851478

59 983130983144983137983150983143 C L983145983157 983123 983123983151983148983151983149983151983150 CG H983157 FB D983145983141983156983137983154983161 983142983145983138983141983154 983145983150983156983137983147983141 983140983145983141983156983137983154983161 983143983148983161983139983141983149983145983139 983148983151983137983140 983137983150983140 983156983144983141 983154983145983155983147

983142983151983154 983143983141983155983156983137983156983145983151983150983137983148 983140983145983137983138983141983156983141983155 983149983141983148983148983145983156983157983155 983108983145983137983138983141983156983141983155 983107983137983154983141 200629(10)22239830852230

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

22





f r o m b i a s



d e s c r i b e d






W e r e o





i n d i c a t o r s



c o n s i d e

r a t i o n




Alberti-

Fidanza et

al37


Carbone

et al34


Conway

et al38


De


Fung et

al39


Goodarzi

Khoigani

et al35


Guelinckx

et al43


Hronek et

al40


Jansson etal41


Kopp

Hoolihan

et al42


Korpi

Hyovalti

et al44


Kubota et

al33


Lof et

al

23


8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

23





f r o m b i a s



i t h d r a w a l s

d e s c r i b e d




r e a n d





i n e d a n d t h e


l i a b l e




i n d i c a t o r s


b y r e s u l t s


t a k e n i n t o





Martinez

et al32


Moses et

al45


Piers et

al36


Tabrizi et

al24


Wolff et

al46



8172019 Je Beile 2015


ACCEPTED MANUSCRIPT



Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Alberti-Fidanza

et al37

2002

To examine



(ToAC) of women



newborns and relate

the results to the


same women during

pregnancy

Italy developed

n = 12

BMI 226 (55)

kgm2

Age 311 (42)

years

Parity 18 (09)

nil smokers

Collected by

qualified and

experienced

dietitians

using the diet

history

method during

the 1st 2

nd and

3rd

trimesters


monitor To

during the e

period of pr

and we sug

intakes of f

vegetables

necessary

antioxidant

and pro-vit


antioxidant

mothers an

newborns

particularly

preterm m

valuable in

for increasi

chance that

pregnancie

successfull


deliveries

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Carbone et al34

1992

Present patterns of



puerperium and its


fetal growth and

maternal nutrient

intake

Spain

developed

n = 33

BMI 227 (22)

kgm2

Age 28 (36)

years

Parity of 1 n =

18 234 n = 15

3-day weight


holiday

completed at

11 19 and 35

weeks

gestation




personal or family





time of visit and

pregnancy


risk

There was


and head

circumferen

weeks of ge

Findings m

a relationsh

between the

metabolism

maternal le

and fetal

developme

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Conway et al38

1999

To explore the


appropriateness of

weight gain during

pregnancy using AIM





England


BMI 22 (24)

kgm2

Age 312 (46)

years

Parity of 1 n =

28 2 n = 4

Unrestrainedn = 30

BMI 207 (196)

kgm2

Age 306 (36)

years

Parity of 1 n =

26 2 n = 4

7-day weighed


weeks

gestation

Caucasian women






outcomes

Providing p


appropriate

gains may b

beneficial

cessation o

during preg

associated w

weight gain

be prudent

accompany

advice abou

smoking dupregnancy

advice abou

and weight

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

De Vriese et

al

31

2001

To determine the


food frequency

questionnaire (FFQ)


diet by comparing



with the 7d food

record in pregnant


the 1st and 3

rd

trimesters

Belgium

developed

n = 26

BMI 22 (176-

293) kgm2

Age 30 (25-37)

years

All pregnant

women were

nulliparous

7-day


during the 1st

(median 15

weeks) and 3rd

(median 35

weeks)

trimesters A

FFQ

containing 180

of the most

common fat-

containingfoods was

conducted at

the same

timepoints

Data recorded

was based on

the EFR

First pregnancy


Hg not diabetic no

proteinuria and not



The FFQ in


compositio

of Belgian

adequate m

reasonably

subjects acc

their dietary

intake

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Fung et al39

1997



zinc from a


altered in well-

nourished women


conception through

lactation and





USA developed

n = 13

BMI 223 (29)

kgm2

Age 30 (29)

years

Parity of 1 n =

10 2 n = 3

3-day weighed

food recordnon-

consecutive

days two

weekdays and

one weekend

at 8-10 weeks

24-26 weeks

and 34-36

weeks

gestation

Aged 22-40yrs body


non-diabetic non-


alcohol use and no


gynecological

complications

Well-nouri


zinc during

pregnancy

increasing

and by a 30

increase in

absorption

not signific

increase in

zinc was du

to an increa


early in the

period pres

an adaptatio

lactation pr

These data

that mechan

regulating z

homeostasi

between pr

and lactatio

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Hronek et al40

2013



Czech pregnant


with recommended

daily allowances

(RDA)

Czechoslovakia

developed

Participants

were randomly

recruited from

both rural and

city regions

n = 152

BMI 211 (36)

kgm2

Age 289 (36)

years

7-day food


days using

scales and

household

measures at 0-

20 weeks 21-

29 weeks 30-

36 weeks and

37-39 weeks

gestation

Nonusers of chronic




le2 Subjects were

euthyroid

normoglyceamic and

not anemic

Lower intak


relative to t

correspond

during preg

Evaluated D

correspond

body size v

Modificatio

intake or al

supplement

recommend


iodine and

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Jansson et al41

2008



between early

pregnancy BMI

maternal dietary

intake and birth

weight

Sweden

developing

n = 49

BMI 255 (69)

kgm2

Age 30 (45)

years

Diet history


over a 24hr

period

collected by a

registered

dietitian at 8-

12 weeks and

32-35 weeks

gestation

Inclusion criteria


old

Exclusion criteria

smoking


reproduction

concurrent disease


or diabetes

development of

pregnancy


preeclampsia or

intrauterine growth

restriction

High first t


trimester IG

were correl

increased b

weight We

that low ser

concentrati

IGFBP-1 re

link betwee

BMI and in

fetal growth


IGF-1 regu

placental nu

transport

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Khoigani et

al

35

2012

To assess the



and micro nutrients




and reproductive

characteristics and


pregnant women

Iran developing

n = 620 (t1 n =

584 t2 n = 510)

BMI 235 (39)

kgm2

Age 256 (44)

years

Parity 158

(076)

48-hour


11-15 weeks

26 weeks and

34-37 weeks

gestation

Interviewers

were trained

Pregnant women who



delivery low birth

weight and factors

which may affect

pregnancy outcomes


addiction digestive


hemoglobinopathies

eating disorders


malignancy

Mean value


subjects wh

experienced

preeclamps

pregnancy

than in othe

women Int

manganese

C vitamin

and carboh

during the t


among preg

women wh

developed

preeclamps

significant

association

other micro

macro nutri

preeclamps

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Kopp-Hoolihan

et al

42

1999

To assess how well-




that predict an


response

USA developed

n = 10

BMI 231 (21)

kgm2

Age 291 (5)

years

3 day weighed


before

pregnancy and

at 8-10 24-26

34-36 weeks

gestation and

4-6 weeks

postpartum

Healthy non-smoking

women

Well-nouri

women useways to me

energy dem

pregnancy

reduction in

induced

thermogene

increased e

intake dep

less fat mas

predicted

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Kubota et al33

2013

To investigate the


intake maternal


growth during

pregnancy

Japan


BMI 175 (01)

kgm2

Age 297 (52)

years

Normaln = 94

BMI 21 (18)

kgm2

Age 308 (51)


Age 286 (36)

years

BMI 334 (65)

kgm2

Digital images


meals on 3

consecutive

days at 14-16

25-27 and 32-

34 weeks

gestation a

dietitian

reviewed

photos and

recorded

intakevalidation of

method not

reported

Singleton pregnant


had suffered from

obstetrical


premature delivery





Dietary inta


not correlat

fetal growth

Japanese na

recommend

advising ex

intake

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Lof et al23

2009

Investigate whether


weight gain are

associated with

estradiol and


plasma during

pregnancy

Sweden

developed

n = 226

BMI 229 (3)

kgm2

Age 32 (4) years

3 day weight


days including

one weekend

at 12 25 and

33 weeks

gestation

Calculations

conducted by

a nutritionist

Women with multi-





dietary intake were

excluded

No associat


dietary fat i

(total or sub

and plasma

levels Prog

levels corre

weight gain

pregnancy

Martinez et

al32

1994

To determine how



nation Mexico

Mexico

developing

n = 36

BMI 235 (26)

kgm2

Age 31 (54)

years

Diet history

collected by

trainedinterviewers

twice per

month and

reported as

mean first and

third trimester

values

Women with an 18




initial recruitment



pregnant

In this sam

women the


weight gain

pregnancy

was similar

women in U

States Low

maternal B

predicted sm

birth weigh

through at l

months of l

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Piers et al36

1995



pregnancy and


a group of well-

nourished pregnant


women at 12 24 and


12 and 24 wk

postpartum with a

non-pregnant non-


India

developing

n = 18

BMI 217 (24)

kgm2

Age 296 (52)

years

5 day


household

measures of

known volume

at 12 24 and

34 weeks

gestation and

12 and 24

weeks post-

partum

participants


measure by a

dietitian who

also checked

all records




morning sickness

before the initial

metabolic

measurement at 12

weeks gestation

BMR is sig


with non-pr

non-lactatin

and remain

even when

differences

weight are

for Well-n

Indian wom

weight and

similar to th


Birth weigh

infants born

to be lower

cost of preg

estimated to

MJ close t

MJ estimat

FAOIWHO

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Tabrizi et al24

2011

To assess the


mineral intake of

pregnant women and


neonates

Iran developing

n = 450

BMI 239 (38)

kgm2

Age 261 (58)

years

24 hour Recall


1st 2

nd and 3

rd

trimesters

Qualification

training of

interviewer

not reported

Women of 16 to 40


health care centers

during the three


Maternal en


with higher

serum calci

and zinc in

birth weigh

neonates


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Guelinckx

et al

43

2010

Study which


improve dietary

habits according to

the National Diet

Recommendations

increase physical

activity level in

obese pregnant

women and

control gestational

weight gain

Belgium

developedrandomly

assigned using

block

randomization

Control(routine)

n =43

BMI 335 (39)

kgm2

Age 294 (44)

yrs


and PA

brochure)

n = 37

BMI 334 (31)

kgm2

Age 287 (4) yrs

Parity of 1 n = 15

Active (brochure

+ group dietary

counselling)

n = 42BMI 341 (45)

kgm2

Age 28 (36) yrs

Parity of 1 n = 20

7-day food


weighed and

household

measures

during each

trimester of

pregnancy

Records were

checked by a

nutritionist






diabetes multiple

pregnancy premature

labor (lt37 wks

gestation) primary


advice in case of

metabolic disorder


conditions and





brochure and group

discussions

A lifestyle interv


combined with

individual advice

improve dietary h

throughout pregn

in obese women

in the absence of

medical or obstet

complications

maintaining or

increasing PA du


decrease in GWG

individually desig

caloric intake res

based on energy

expenditure data

be included

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Korpi-

Hyovalti etal44

2012

To evaluate the


quality of diet

weight gain and

birth weight in

women at high risk

of gestational

diabetes mellitus

Finland


group 1 or 2

using computed

randomization


information on

diet and PA)

n = 27

BMI 255 (34)

kgm2

Lifestyle


nutrition advice)

n = 27

BMI 273 (6)

kgm2

4 day weighed


days including

one weekend

completed at

8-12 26-28

and 36-40

weeks

gestation

Records

checked by a

nutritionist

A three-factor

eating

questionnaire

was also used

at the 1st and

3rd

trimester

Women with one or





48-55 mmoll and the

2h oral glucose


glucose lt78 mmoll

were recruited


GDM at 8-12 wks


There were no cl


however

polyunsaturated f

increase in the lif

intervention grou

Intensive weight

education led to a

somewhat lower

gain during pregn

and higher birth w

of the infants in


macrosomia whe

compared to the c

follow up group

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Moses et al45

2014

To determine


index (LGI) dietary

advice at

the first antenatal

visit would result

in a lower fetal

birth weight

birth percentile

and ponderal index

(PI) than providing

healthy eating

(HE) advice

Australia

developedrandomly

assigned using

computer-

generated

random numbers

1 or 2

Healthy Eating

(counselled to

follow a healthy

diet based on the

AGHE4

) n = 280

BMI 247 (5)

kgm2

Age 299 (5) yrs

Low Glycemic

Index

(individualized

nutrition advice

on a LGI diet)

n = 296

BMI 243 (52)

kgm2 Age 299 (52)

yrs

3 day


household

measures at 16

and 36 weeks

gestation

records

reviewed by a

dietitian



least 18 years old

ability to read and

understand English


comply with visit

schedules Subjects






compromise their




body weight

A low intensity d


in pregnancy did

result in significa

differences in bir

weight fetal perc

of PI

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Wolff et

al

46

2008

To determine


consultations

restricts weight

gain in obese

women and

whether this

restriction impacts

on pregnancy-

induced changes in

glucose

metabolism

Denmark


group 1 or 2

using computed

randomization

Control (general

information on

diet and PA)

n = 27

BMI 255 (34)

kgm2


x 1 hour

consultations)

n = 27

BMI 273 (6)

kgm2

Age 28 (4) years

7 day weighed


plusmn 3 wks) 27

and 36 weeks

gestation



recruited Exclusion

criteria included


or gt45 year old


medical conditions

which impact fetal

growth

Restriction of


achievable and re

the deterioration

glucose metaboli

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

41

983120983137983143983141 983092983089 983151983142 983092983090

FIGURE LEGENDS





















2 GWG 115 to 155 kg)


2

GWG 50 to 90 kg)

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

42

983120983137983143983141 983092983090 983151983142 983092983090







8172019 Je Beile 2015


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8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


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8172019 Je Beile 2015


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8172019 Je Beile 2015


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8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

19

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A983139983137983140983141983149983161 983120983154983141983155983155 1990

21 983123983152983151983150983143 C983129 D983141983142983145983150983145983150983143 983156983141983154983149 983152983154983141983143983150983137983150983139983161 983154983141983139983151983149983149983141983150983140983137983156983145983151983150983155 983142983154983151983149 983156983144983141 D983141983142983145983150983145983150983143 983124983141983154983149

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ACCEPTED MANUSCRIPT

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200256(3)205983085213

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f r o m b i a s



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i n d i c a t o r s



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23


8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

23





f r o m b i a s



i t h d r a w a l s

d e s c r i b e d




r e a n d





i n e d a n d t h e


l i a b l e




i n d i c a t o r s


b y r e s u l t s


t a k e n i n t o





Martinez

et al32


Moses et

al45


Piers et

al36


Tabrizi et

al24


Wolff et

al46



8172019 Je Beile 2015


ACCEPTED MANUSCRIPT



Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Alberti-Fidanza

et al37

2002

To examine



(ToAC) of women



newborns and relate

the results to the


same women during

pregnancy

Italy developed

n = 12

BMI 226 (55)

kgm2

Age 311 (42)

years

Parity 18 (09)

nil smokers

Collected by

qualified and

experienced

dietitians

using the diet

history

method during

the 1st 2

nd and

3rd

trimesters


monitor To

during the e

period of pr

and we sug

intakes of f

vegetables

necessary

antioxidant

and pro-vit


antioxidant

mothers an

newborns

particularly

preterm m

valuable in

for increasi

chance that

pregnancie

successfull


deliveries

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Carbone et al34

1992

Present patterns of



puerperium and its


fetal growth and

maternal nutrient

intake

Spain

developed

n = 33

BMI 227 (22)

kgm2

Age 28 (36)

years

Parity of 1 n =

18 234 n = 15

3-day weight


holiday

completed at

11 19 and 35

weeks

gestation




personal or family





time of visit and

pregnancy


risk

There was


and head

circumferen

weeks of ge

Findings m

a relationsh

between the

metabolism

maternal le

and fetal

developme

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Conway et al38

1999

To explore the


appropriateness of

weight gain during

pregnancy using AIM





England


BMI 22 (24)

kgm2

Age 312 (46)

years

Parity of 1 n =

28 2 n = 4

Unrestrainedn = 30

BMI 207 (196)

kgm2

Age 306 (36)

years

Parity of 1 n =

26 2 n = 4

7-day weighed


weeks

gestation

Caucasian women






outcomes

Providing p


appropriate

gains may b

beneficial

cessation o

during preg

associated w

weight gain

be prudent

accompany

advice abou

smoking dupregnancy

advice abou

and weight

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

De Vriese et

al

31

2001

To determine the


food frequency

questionnaire (FFQ)


diet by comparing



with the 7d food

record in pregnant


the 1st and 3

rd

trimesters

Belgium

developed

n = 26

BMI 22 (176-

293) kgm2

Age 30 (25-37)

years

All pregnant

women were

nulliparous

7-day


during the 1st

(median 15

weeks) and 3rd

(median 35

weeks)

trimesters A

FFQ

containing 180

of the most

common fat-

containingfoods was

conducted at

the same

timepoints

Data recorded

was based on

the EFR

First pregnancy


Hg not diabetic no

proteinuria and not



The FFQ in


compositio

of Belgian

adequate m

reasonably

subjects acc

their dietary

intake

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Fung et al39

1997



zinc from a


altered in well-

nourished women


conception through

lactation and





USA developed

n = 13

BMI 223 (29)

kgm2

Age 30 (29)

years

Parity of 1 n =

10 2 n = 3

3-day weighed

food recordnon-

consecutive

days two

weekdays and

one weekend

at 8-10 weeks

24-26 weeks

and 34-36

weeks

gestation

Aged 22-40yrs body


non-diabetic non-


alcohol use and no


gynecological

complications

Well-nouri


zinc during

pregnancy

increasing

and by a 30

increase in

absorption

not signific

increase in

zinc was du

to an increa


early in the

period pres

an adaptatio

lactation pr

These data

that mechan

regulating z

homeostasi

between pr

and lactatio

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Hronek et al40

2013



Czech pregnant


with recommended

daily allowances

(RDA)

Czechoslovakia

developed

Participants

were randomly

recruited from

both rural and

city regions

n = 152

BMI 211 (36)

kgm2

Age 289 (36)

years

7-day food


days using

scales and

household

measures at 0-

20 weeks 21-

29 weeks 30-

36 weeks and

37-39 weeks

gestation

Nonusers of chronic




le2 Subjects were

euthyroid

normoglyceamic and

not anemic

Lower intak


relative to t

correspond

during preg

Evaluated D

correspond

body size v

Modificatio

intake or al

supplement

recommend


iodine and

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Jansson et al41

2008



between early

pregnancy BMI

maternal dietary

intake and birth

weight

Sweden

developing

n = 49

BMI 255 (69)

kgm2

Age 30 (45)

years

Diet history


over a 24hr

period

collected by a

registered

dietitian at 8-

12 weeks and

32-35 weeks

gestation

Inclusion criteria


old

Exclusion criteria

smoking


reproduction

concurrent disease


or diabetes

development of

pregnancy


preeclampsia or

intrauterine growth

restriction

High first t


trimester IG

were correl

increased b

weight We

that low ser

concentrati

IGFBP-1 re

link betwee

BMI and in

fetal growth


IGF-1 regu

placental nu

transport

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Khoigani et

al

35

2012

To assess the



and micro nutrients




and reproductive

characteristics and


pregnant women

Iran developing

n = 620 (t1 n =

584 t2 n = 510)

BMI 235 (39)

kgm2

Age 256 (44)

years

Parity 158

(076)

48-hour


11-15 weeks

26 weeks and

34-37 weeks

gestation

Interviewers

were trained

Pregnant women who



delivery low birth

weight and factors

which may affect

pregnancy outcomes


addiction digestive


hemoglobinopathies

eating disorders


malignancy

Mean value


subjects wh

experienced

preeclamps

pregnancy

than in othe

women Int

manganese

C vitamin

and carboh

during the t


among preg

women wh

developed

preeclamps

significant

association

other micro

macro nutri

preeclamps

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Kopp-Hoolihan

et al

42

1999

To assess how well-




that predict an


response

USA developed

n = 10

BMI 231 (21)

kgm2

Age 291 (5)

years

3 day weighed


before

pregnancy and

at 8-10 24-26

34-36 weeks

gestation and

4-6 weeks

postpartum

Healthy non-smoking

women

Well-nouri

women useways to me

energy dem

pregnancy

reduction in

induced

thermogene

increased e

intake dep

less fat mas

predicted

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Kubota et al33

2013

To investigate the


intake maternal


growth during

pregnancy

Japan


BMI 175 (01)

kgm2

Age 297 (52)

years

Normaln = 94

BMI 21 (18)

kgm2

Age 308 (51)


Age 286 (36)

years

BMI 334 (65)

kgm2

Digital images


meals on 3

consecutive

days at 14-16

25-27 and 32-

34 weeks

gestation a

dietitian

reviewed

photos and

recorded

intakevalidation of

method not

reported

Singleton pregnant


had suffered from

obstetrical


premature delivery





Dietary inta


not correlat

fetal growth

Japanese na

recommend

advising ex

intake

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Lof et al23

2009

Investigate whether


weight gain are

associated with

estradiol and


plasma during

pregnancy

Sweden

developed

n = 226

BMI 229 (3)

kgm2

Age 32 (4) years

3 day weight


days including

one weekend

at 12 25 and

33 weeks

gestation

Calculations

conducted by

a nutritionist

Women with multi-





dietary intake were

excluded

No associat


dietary fat i

(total or sub

and plasma

levels Prog

levels corre

weight gain

pregnancy

Martinez et

al32

1994

To determine how



nation Mexico

Mexico

developing

n = 36

BMI 235 (26)

kgm2

Age 31 (54)

years

Diet history

collected by

trainedinterviewers

twice per

month and

reported as

mean first and

third trimester

values

Women with an 18




initial recruitment



pregnant

In this sam

women the


weight gain

pregnancy

was similar

women in U

States Low

maternal B

predicted sm

birth weigh

through at l

months of l

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Piers et al36

1995



pregnancy and


a group of well-

nourished pregnant


women at 12 24 and


12 and 24 wk

postpartum with a

non-pregnant non-


India

developing

n = 18

BMI 217 (24)

kgm2

Age 296 (52)

years

5 day


household

measures of

known volume

at 12 24 and

34 weeks

gestation and

12 and 24

weeks post-

partum

participants


measure by a

dietitian who

also checked

all records




morning sickness

before the initial

metabolic

measurement at 12

weeks gestation

BMR is sig


with non-pr

non-lactatin

and remain

even when

differences

weight are

for Well-n

Indian wom

weight and

similar to th


Birth weigh

infants born

to be lower

cost of preg

estimated to

MJ close t

MJ estimat

FAOIWHO

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Tabrizi et al24

2011

To assess the


mineral intake of

pregnant women and


neonates

Iran developing

n = 450

BMI 239 (38)

kgm2

Age 261 (58)

years

24 hour Recall


1st 2

nd and 3

rd

trimesters

Qualification

training of

interviewer

not reported

Women of 16 to 40


health care centers

during the three


Maternal en


with higher

serum calci

and zinc in

birth weigh

neonates


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Guelinckx

et al

43

2010

Study which


improve dietary

habits according to

the National Diet

Recommendations

increase physical

activity level in

obese pregnant

women and

control gestational

weight gain

Belgium

developedrandomly

assigned using

block

randomization

Control(routine)

n =43

BMI 335 (39)

kgm2

Age 294 (44)

yrs


and PA

brochure)

n = 37

BMI 334 (31)

kgm2

Age 287 (4) yrs

Parity of 1 n = 15

Active (brochure

+ group dietary

counselling)

n = 42BMI 341 (45)

kgm2

Age 28 (36) yrs

Parity of 1 n = 20

7-day food


weighed and

household

measures

during each

trimester of

pregnancy

Records were

checked by a

nutritionist






diabetes multiple

pregnancy premature

labor (lt37 wks

gestation) primary


advice in case of

metabolic disorder


conditions and





brochure and group

discussions

A lifestyle interv


combined with

individual advice

improve dietary h

throughout pregn

in obese women

in the absence of

medical or obstet

complications

maintaining or

increasing PA du


decrease in GWG

individually desig

caloric intake res

based on energy

expenditure data

be included

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Korpi-

Hyovalti etal44

2012

To evaluate the


quality of diet

weight gain and

birth weight in

women at high risk

of gestational

diabetes mellitus

Finland


group 1 or 2

using computed

randomization


information on

diet and PA)

n = 27

BMI 255 (34)

kgm2

Lifestyle


nutrition advice)

n = 27

BMI 273 (6)

kgm2

4 day weighed


days including

one weekend

completed at

8-12 26-28

and 36-40

weeks

gestation

Records

checked by a

nutritionist

A three-factor

eating

questionnaire

was also used

at the 1st and

3rd

trimester

Women with one or





48-55 mmoll and the

2h oral glucose


glucose lt78 mmoll

were recruited


GDM at 8-12 wks


There were no cl


however

polyunsaturated f

increase in the lif

intervention grou

Intensive weight

education led to a

somewhat lower

gain during pregn

and higher birth w

of the infants in


macrosomia whe

compared to the c

follow up group

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Moses et al45

2014

To determine


index (LGI) dietary

advice at

the first antenatal

visit would result

in a lower fetal

birth weight

birth percentile

and ponderal index

(PI) than providing

healthy eating

(HE) advice

Australia

developedrandomly

assigned using

computer-

generated

random numbers

1 or 2

Healthy Eating

(counselled to

follow a healthy

diet based on the

AGHE4

) n = 280

BMI 247 (5)

kgm2

Age 299 (5) yrs

Low Glycemic

Index

(individualized

nutrition advice

on a LGI diet)

n = 296

BMI 243 (52)

kgm2 Age 299 (52)

yrs

3 day


household

measures at 16

and 36 weeks

gestation

records

reviewed by a

dietitian



least 18 years old

ability to read and

understand English


comply with visit

schedules Subjects






compromise their




body weight

A low intensity d


in pregnancy did

result in significa

differences in bir

weight fetal perc

of PI

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Wolff et

al

46

2008

To determine


consultations

restricts weight

gain in obese

women and

whether this

restriction impacts

on pregnancy-

induced changes in

glucose

metabolism

Denmark


group 1 or 2

using computed

randomization

Control (general

information on

diet and PA)

n = 27

BMI 255 (34)

kgm2


x 1 hour

consultations)

n = 27

BMI 273 (6)

kgm2

Age 28 (4) years

7 day weighed


plusmn 3 wks) 27

and 36 weeks

gestation



recruited Exclusion

criteria included


or gt45 year old


medical conditions

which impact fetal

growth

Restriction of


achievable and re

the deterioration

glucose metaboli

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

41

983120983137983143983141 983092983089 983151983142 983092983090

FIGURE LEGENDS





















2 GWG 115 to 155 kg)


2

GWG 50 to 90 kg)

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

42

983120983137983143983141 983092983090 983151983142 983092983090







8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


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8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

20

38 C983151983150983159983137983161 983122 983122983141983140983140983161 983123 D983137983158983145983141983155 J D983145983141983156983137983154983161 983154983141983155983156983154983137983145983150983156 983137983150983140 983159983141983145983143983144983156 983143983137983145983150 983140983157983154983145983150983143 983152983154983141983143983150983137983150983139983161 983109983157983154983151983152983141983137983150

983114983151983157983154983150983137983148 983151983142 983107983148983145983150983145983139983137983148 983118983157983156983154983145983156983145983151983150 199953(11)849983085853

39 F983157983150983143 EB 983122983145983156983139983144983145983141 LD 983127983151983151983140983144983151983157983155983141 L983122 983122983151983141983144983148 983122 K983145983150983143 JC 983130983145983150983139 983137983138983155983151983154983152983156983145983151983150 983145983150 983159983151983149983141983150 983140983157983154983145983150983143

983152983154983141983143983150983137983150983139983161 983137983150983140 983148983137983139983156983137983156983145983151983150 983137 983148983151983150983143983145983156983157983140983145983150983137983148 983155983156983157983140983161 983124983144983141 983105983149983141983154983145983139983137983150 983146983151983157983154983150983137983148 983151983142 983139983148983145983150983145983139983137983148 983150983157983156983154983145983156983145983151983150

199766(1)80

40 H983154983151983150983141983147 M D983151983157983138983147983151983158983137 983120 H983154983150983139983145983137983154983145983147983151983158983137 D 983130983137983140983137983147 983130 D983145983141983156983137983154983161 983145983150983156983137983147983141 983151983142 983141983150983141983154983143983161 983137983150983140 983150983157983156983154983145983141983150983156983155 983145983150983154983141983148983137983156983145983151983150 983156983151 983154983141983155983156983145983150983143 983141983150983141983154983143983161 983141983160983152983141983150983140983145983156983157983154983141 983137983150983140 983137983150983156983144983154983151983152983151983149983141983156983154983145983139 983152983137983154983137983149983141983156983141983154983155 983151983142 C983162983141983139983144 983152983154983141983143983150983137983150983156

983159983151983149983141983150 983109983157983154983151983152983141983137983150 983114983151983157983154983150983137983148 983151983142 983118983157983156983154983145983156983145983151983150 201352(1)117983085125

41 J983137983150983155983155983151983150 N N983145983148983155983142983141983148983156 A G983141983148983148983141983154983155983156983141983140983156 M 983141983156 983137983148 M983137983156983141983154983150983137983148 983144983151983154983149983151983150983141983155 983148983145983150983147983145983150983143 983149983137983156983141983154983150983137983148 983138983151983140983161 983149983137983155983155

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200887(6)17439830851749

42 K983151983152983152983085H983151983151983148983145983144983137983150 LE 983158983137983150 L983151983137983150 MD 983127983151983150983143 983127983127 K983145983150983143 JC L983151983150983143983145983156983157983140983145983150983137983148 983137983155983155983141983155983155983149983141983150983156 983151983142 983141983150983141983154983143983161

983138983137983148983137983150983139983141 983145983150 983159983141983148983148983085983150983151983157983154983145983155983144983141983140 983152983154983141983143983150983137983150983156 983159983151983149983141983150 983145983150983139983148983157983140983145983150983143 983139983151983149983149983141983150983156983137983154983161 983138983161 983120983145983156983147983145983150 983122M

983131983139983151983154983154983141983139983156983141983140983133 983131983152983157983138983148983145983155983144983141983140 983141983154983154983137983156983157983149 983137983152983152983141983137983154983155 983145983150 AM J CLIN N983125983124983122 2000 J983137983150 71(1) 157983133 983105983149983141983154983145983139983137983150

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200256(3)205983085213

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

21

56 L983137983145983150 K983129 C983137983156983137983148983137983150983151 983120M M983141983156983137983138983151983148983145983139 C983144983137983150983143983141983155 983145983150 983120983154983141983143983150983137983150983139983161 983107983148983145983150983145983139983137983148 983151983138983155983156983141983156983154983145983139983155 983137983150983140 983143983161983150983141983139983151983148983151983143983161

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8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

22





f r o m b i a s



d e s c r i b e d






W e r e o





i n d i c a t o r s



c o n s i d e

r a t i o n




Alberti-

Fidanza et

al37


Carbone

et al34


Conway

et al38


De


Fung et

al39


Goodarzi

Khoigani

et al35


Guelinckx

et al43


Hronek et

al40


Jansson etal41


Kopp

Hoolihan

et al42


Korpi

Hyovalti

et al44


Kubota et

al33


Lof et

al

23


8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

23





f r o m b i a s



i t h d r a w a l s

d e s c r i b e d




r e a n d





i n e d a n d t h e


l i a b l e




i n d i c a t o r s


b y r e s u l t s


t a k e n i n t o





Martinez

et al32


Moses et

al45


Piers et

al36


Tabrizi et

al24


Wolff et

al46



8172019 Je Beile 2015


ACCEPTED MANUSCRIPT



Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Alberti-Fidanza

et al37

2002

To examine



(ToAC) of women



newborns and relate

the results to the


same women during

pregnancy

Italy developed

n = 12

BMI 226 (55)

kgm2

Age 311 (42)

years

Parity 18 (09)

nil smokers

Collected by

qualified and

experienced

dietitians

using the diet

history

method during

the 1st 2

nd and

3rd

trimesters


monitor To

during the e

period of pr

and we sug

intakes of f

vegetables

necessary

antioxidant

and pro-vit


antioxidant

mothers an

newborns

particularly

preterm m

valuable in

for increasi

chance that

pregnancie

successfull


deliveries

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Carbone et al34

1992

Present patterns of



puerperium and its


fetal growth and

maternal nutrient

intake

Spain

developed

n = 33

BMI 227 (22)

kgm2

Age 28 (36)

years

Parity of 1 n =

18 234 n = 15

3-day weight


holiday

completed at

11 19 and 35

weeks

gestation




personal or family





time of visit and

pregnancy


risk

There was


and head

circumferen

weeks of ge

Findings m

a relationsh

between the

metabolism

maternal le

and fetal

developme

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Conway et al38

1999

To explore the


appropriateness of

weight gain during

pregnancy using AIM





England


BMI 22 (24)

kgm2

Age 312 (46)

years

Parity of 1 n =

28 2 n = 4

Unrestrainedn = 30

BMI 207 (196)

kgm2

Age 306 (36)

years

Parity of 1 n =

26 2 n = 4

7-day weighed


weeks

gestation

Caucasian women






outcomes

Providing p


appropriate

gains may b

beneficial

cessation o

during preg

associated w

weight gain

be prudent

accompany

advice abou

smoking dupregnancy

advice abou

and weight

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

De Vriese et

al

31

2001

To determine the


food frequency

questionnaire (FFQ)


diet by comparing



with the 7d food

record in pregnant


the 1st and 3

rd

trimesters

Belgium

developed

n = 26

BMI 22 (176-

293) kgm2

Age 30 (25-37)

years

All pregnant

women were

nulliparous

7-day


during the 1st

(median 15

weeks) and 3rd

(median 35

weeks)

trimesters A

FFQ

containing 180

of the most

common fat-

containingfoods was

conducted at

the same

timepoints

Data recorded

was based on

the EFR

First pregnancy


Hg not diabetic no

proteinuria and not



The FFQ in


compositio

of Belgian

adequate m

reasonably

subjects acc

their dietary

intake

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Fung et al39

1997



zinc from a


altered in well-

nourished women


conception through

lactation and





USA developed

n = 13

BMI 223 (29)

kgm2

Age 30 (29)

years

Parity of 1 n =

10 2 n = 3

3-day weighed

food recordnon-

consecutive

days two

weekdays and

one weekend

at 8-10 weeks

24-26 weeks

and 34-36

weeks

gestation

Aged 22-40yrs body


non-diabetic non-


alcohol use and no


gynecological

complications

Well-nouri


zinc during

pregnancy

increasing

and by a 30

increase in

absorption

not signific

increase in

zinc was du

to an increa


early in the

period pres

an adaptatio

lactation pr

These data

that mechan

regulating z

homeostasi

between pr

and lactatio

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Hronek et al40

2013



Czech pregnant


with recommended

daily allowances

(RDA)

Czechoslovakia

developed

Participants

were randomly

recruited from

both rural and

city regions

n = 152

BMI 211 (36)

kgm2

Age 289 (36)

years

7-day food


days using

scales and

household

measures at 0-

20 weeks 21-

29 weeks 30-

36 weeks and

37-39 weeks

gestation

Nonusers of chronic




le2 Subjects were

euthyroid

normoglyceamic and

not anemic

Lower intak


relative to t

correspond

during preg

Evaluated D

correspond

body size v

Modificatio

intake or al

supplement

recommend


iodine and

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Jansson et al41

2008



between early

pregnancy BMI

maternal dietary

intake and birth

weight

Sweden

developing

n = 49

BMI 255 (69)

kgm2

Age 30 (45)

years

Diet history


over a 24hr

period

collected by a

registered

dietitian at 8-

12 weeks and

32-35 weeks

gestation

Inclusion criteria


old

Exclusion criteria

smoking


reproduction

concurrent disease


or diabetes

development of

pregnancy


preeclampsia or

intrauterine growth

restriction

High first t


trimester IG

were correl

increased b

weight We

that low ser

concentrati

IGFBP-1 re

link betwee

BMI and in

fetal growth


IGF-1 regu

placental nu

transport

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Khoigani et

al

35

2012

To assess the



and micro nutrients




and reproductive

characteristics and


pregnant women

Iran developing

n = 620 (t1 n =

584 t2 n = 510)

BMI 235 (39)

kgm2

Age 256 (44)

years

Parity 158

(076)

48-hour


11-15 weeks

26 weeks and

34-37 weeks

gestation

Interviewers

were trained

Pregnant women who



delivery low birth

weight and factors

which may affect

pregnancy outcomes


addiction digestive


hemoglobinopathies

eating disorders


malignancy

Mean value


subjects wh

experienced

preeclamps

pregnancy

than in othe

women Int

manganese

C vitamin

and carboh

during the t


among preg

women wh

developed

preeclamps

significant

association

other micro

macro nutri

preeclamps

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Kopp-Hoolihan

et al

42

1999

To assess how well-




that predict an


response

USA developed

n = 10

BMI 231 (21)

kgm2

Age 291 (5)

years

3 day weighed


before

pregnancy and

at 8-10 24-26

34-36 weeks

gestation and

4-6 weeks

postpartum

Healthy non-smoking

women

Well-nouri

women useways to me

energy dem

pregnancy

reduction in

induced

thermogene

increased e

intake dep

less fat mas

predicted

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Kubota et al33

2013

To investigate the


intake maternal


growth during

pregnancy

Japan


BMI 175 (01)

kgm2

Age 297 (52)

years

Normaln = 94

BMI 21 (18)

kgm2

Age 308 (51)


Age 286 (36)

years

BMI 334 (65)

kgm2

Digital images


meals on 3

consecutive

days at 14-16

25-27 and 32-

34 weeks

gestation a

dietitian

reviewed

photos and

recorded

intakevalidation of

method not

reported

Singleton pregnant


had suffered from

obstetrical


premature delivery





Dietary inta


not correlat

fetal growth

Japanese na

recommend

advising ex

intake

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Lof et al23

2009

Investigate whether


weight gain are

associated with

estradiol and


plasma during

pregnancy

Sweden

developed

n = 226

BMI 229 (3)

kgm2

Age 32 (4) years

3 day weight


days including

one weekend

at 12 25 and

33 weeks

gestation

Calculations

conducted by

a nutritionist

Women with multi-





dietary intake were

excluded

No associat


dietary fat i

(total or sub

and plasma

levels Prog

levels corre

weight gain

pregnancy

Martinez et

al32

1994

To determine how



nation Mexico

Mexico

developing

n = 36

BMI 235 (26)

kgm2

Age 31 (54)

years

Diet history

collected by

trainedinterviewers

twice per

month and

reported as

mean first and

third trimester

values

Women with an 18




initial recruitment



pregnant

In this sam

women the


weight gain

pregnancy

was similar

women in U

States Low

maternal B

predicted sm

birth weigh

through at l

months of l

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Piers et al36

1995



pregnancy and


a group of well-

nourished pregnant


women at 12 24 and


12 and 24 wk

postpartum with a

non-pregnant non-


India

developing

n = 18

BMI 217 (24)

kgm2

Age 296 (52)

years

5 day


household

measures of

known volume

at 12 24 and

34 weeks

gestation and

12 and 24

weeks post-

partum

participants


measure by a

dietitian who

also checked

all records




morning sickness

before the initial

metabolic

measurement at 12

weeks gestation

BMR is sig


with non-pr

non-lactatin

and remain

even when

differences

weight are

for Well-n

Indian wom

weight and

similar to th


Birth weigh

infants born

to be lower

cost of preg

estimated to

MJ close t

MJ estimat

FAOIWHO

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Tabrizi et al24

2011

To assess the


mineral intake of

pregnant women and


neonates

Iran developing

n = 450

BMI 239 (38)

kgm2

Age 261 (58)

years

24 hour Recall


1st 2

nd and 3

rd

trimesters

Qualification

training of

interviewer

not reported

Women of 16 to 40


health care centers

during the three


Maternal en


with higher

serum calci

and zinc in

birth weigh

neonates


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Guelinckx

et al

43

2010

Study which


improve dietary

habits according to

the National Diet

Recommendations

increase physical

activity level in

obese pregnant

women and

control gestational

weight gain

Belgium

developedrandomly

assigned using

block

randomization

Control(routine)

n =43

BMI 335 (39)

kgm2

Age 294 (44)

yrs


and PA

brochure)

n = 37

BMI 334 (31)

kgm2

Age 287 (4) yrs

Parity of 1 n = 15

Active (brochure

+ group dietary

counselling)

n = 42BMI 341 (45)

kgm2

Age 28 (36) yrs

Parity of 1 n = 20

7-day food


weighed and

household

measures

during each

trimester of

pregnancy

Records were

checked by a

nutritionist






diabetes multiple

pregnancy premature

labor (lt37 wks

gestation) primary


advice in case of

metabolic disorder


conditions and





brochure and group

discussions

A lifestyle interv


combined with

individual advice

improve dietary h

throughout pregn

in obese women

in the absence of

medical or obstet

complications

maintaining or

increasing PA du


decrease in GWG

individually desig

caloric intake res

based on energy

expenditure data

be included

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Korpi-

Hyovalti etal44

2012

To evaluate the


quality of diet

weight gain and

birth weight in

women at high risk

of gestational

diabetes mellitus

Finland


group 1 or 2

using computed

randomization


information on

diet and PA)

n = 27

BMI 255 (34)

kgm2

Lifestyle


nutrition advice)

n = 27

BMI 273 (6)

kgm2

4 day weighed


days including

one weekend

completed at

8-12 26-28

and 36-40

weeks

gestation

Records

checked by a

nutritionist

A three-factor

eating

questionnaire

was also used

at the 1st and

3rd

trimester

Women with one or





48-55 mmoll and the

2h oral glucose


glucose lt78 mmoll

were recruited


GDM at 8-12 wks


There were no cl


however

polyunsaturated f

increase in the lif

intervention grou

Intensive weight

education led to a

somewhat lower

gain during pregn

and higher birth w

of the infants in


macrosomia whe

compared to the c

follow up group

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Moses et al45

2014

To determine


index (LGI) dietary

advice at

the first antenatal

visit would result

in a lower fetal

birth weight

birth percentile

and ponderal index

(PI) than providing

healthy eating

(HE) advice

Australia

developedrandomly

assigned using

computer-

generated

random numbers

1 or 2

Healthy Eating

(counselled to

follow a healthy

diet based on the

AGHE4

) n = 280

BMI 247 (5)

kgm2

Age 299 (5) yrs

Low Glycemic

Index

(individualized

nutrition advice

on a LGI diet)

n = 296

BMI 243 (52)

kgm2 Age 299 (52)

yrs

3 day


household

measures at 16

and 36 weeks

gestation

records

reviewed by a

dietitian



least 18 years old

ability to read and

understand English


comply with visit

schedules Subjects






compromise their




body weight

A low intensity d


in pregnancy did

result in significa

differences in bir

weight fetal perc

of PI

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Wolff et

al

46

2008

To determine


consultations

restricts weight

gain in obese

women and

whether this

restriction impacts

on pregnancy-

induced changes in

glucose

metabolism

Denmark


group 1 or 2

using computed

randomization

Control (general

information on

diet and PA)

n = 27

BMI 255 (34)

kgm2


x 1 hour

consultations)

n = 27

BMI 273 (6)

kgm2

Age 28 (4) years

7 day weighed


plusmn 3 wks) 27

and 36 weeks

gestation



recruited Exclusion

criteria included


or gt45 year old


medical conditions

which impact fetal

growth

Restriction of


achievable and re

the deterioration

glucose metaboli

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

41

983120983137983143983141 983092983089 983151983142 983092983090

FIGURE LEGENDS





















2 GWG 115 to 155 kg)


2

GWG 50 to 90 kg)

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

42

983120983137983143983141 983092983090 983151983142 983092983090







8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

21

56 L983137983145983150 K983129 C983137983156983137983148983137983150983151 983120M M983141983156983137983138983151983148983145983139 C983144983137983150983143983141983155 983145983150 983120983154983141983143983150983137983150983139983161 983107983148983145983150983145983139983137983148 983151983138983155983156983141983156983154983145983139983155 983137983150983140 983143983161983150983141983139983151983148983151983143983161

200750(4)938983085948

57 983123983156983141983145983150 983124983120 983123983139983144983151983148983148 983124983119 983123983139983144983148983157983156983141983154 MD 983123983139983144983154983151983141983140983141983154 CM 983120983148983137983155983149983137 983148983141983152983156983145983150 983145983150983142983148983157983141983150983139983141983155 983143983141983155983156983137983156983145983151983150983137983148 983159983141983145983143983144983156

983143983137983145983150 983137983150983140 983152983151983155983156983152983137983154983156983157983149 983159983141983145983143983144983156 983154983141983156983141983150983156983145983151983150 983105983149983141983154983145983139983137983150 983114983151983157983154983150983137983148 983151983142 983107983148983145983150983145983139983137983148 983118983157983156983154983145983156983145983151983150

199868(6)12369830851240

58 K983150983157983140983155983141983150 983126K H983141983145983156983149983137983150983150 BL H983137983148983148983140983151983154983155983155983151983150 983124I 983123983151983154983141983150983155983141983150 983124IA 983119983148983155983141983150 983123F M983137983156983141983154983150983137983148 983140983145983141983156983137983154983161983143983148983161983139983137983141983149983145983139 983148983151983137983140 983140983157983154983145983150983143 983152983154983141983143983150983137983150983139983161 983137983150983140 983143983141983155983156983137983156983145983151983150983137983148 983159983141983145983143983144983156 983143983137983145983150 983138983145983154983156983144 983159983141983145983143983144983156 983137983150983140 983152983151983155983156983152983137983154983156983157983149

983159983141983145983143983144983156 983154983141983156983141983150983156983145983151983150 A 983155983156983157983140983161 983159983145983156983144983145983150 983156983144983141 D983137983150983145983155983144 N983137983156983145983151983150983137983148 B983145983154983156983144 C983151983144983151983154983156 983106983154983145983156983145983155983144 983114983151983157983154983150983137983148 983151983142

983118983157983156983154983145983156983145983151983150 2013109(8)14719830851478

59 983130983144983137983150983143 C L983145983157 983123 983123983151983148983151983149983151983150 CG H983157 FB D983145983141983156983137983154983161 983142983145983138983141983154 983145983150983156983137983147983141 983140983145983141983156983137983154983161 983143983148983161983139983141983149983145983139 983148983151983137983140 983137983150983140 983156983144983141 983154983145983155983147

983142983151983154 983143983141983155983156983137983156983145983151983150983137983148 983140983145983137983138983141983156983141983155 983149983141983148983148983145983156983157983155 983108983145983137983138983141983156983141983155 983107983137983154983141 200629(10)22239830852230

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

22





f r o m b i a s



d e s c r i b e d






W e r e o





i n d i c a t o r s



c o n s i d e

r a t i o n




Alberti-

Fidanza et

al37


Carbone

et al34


Conway

et al38


De


Fung et

al39


Goodarzi

Khoigani

et al35


Guelinckx

et al43


Hronek et

al40


Jansson etal41


Kopp

Hoolihan

et al42


Korpi

Hyovalti

et al44


Kubota et

al33


Lof et

al

23


8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

23





f r o m b i a s



i t h d r a w a l s

d e s c r i b e d




r e a n d





i n e d a n d t h e


l i a b l e




i n d i c a t o r s


b y r e s u l t s


t a k e n i n t o





Martinez

et al32


Moses et

al45


Piers et

al36


Tabrizi et

al24


Wolff et

al46



8172019 Je Beile 2015


ACCEPTED MANUSCRIPT



Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Alberti-Fidanza

et al37

2002

To examine



(ToAC) of women



newborns and relate

the results to the


same women during

pregnancy

Italy developed

n = 12

BMI 226 (55)

kgm2

Age 311 (42)

years

Parity 18 (09)

nil smokers

Collected by

qualified and

experienced

dietitians

using the diet

history

method during

the 1st 2

nd and

3rd

trimesters


monitor To

during the e

period of pr

and we sug

intakes of f

vegetables

necessary

antioxidant

and pro-vit


antioxidant

mothers an

newborns

particularly

preterm m

valuable in

for increasi

chance that

pregnancie

successfull


deliveries

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Carbone et al34

1992

Present patterns of



puerperium and its


fetal growth and

maternal nutrient

intake

Spain

developed

n = 33

BMI 227 (22)

kgm2

Age 28 (36)

years

Parity of 1 n =

18 234 n = 15

3-day weight


holiday

completed at

11 19 and 35

weeks

gestation




personal or family





time of visit and

pregnancy


risk

There was


and head

circumferen

weeks of ge

Findings m

a relationsh

between the

metabolism

maternal le

and fetal

developme

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Conway et al38

1999

To explore the


appropriateness of

weight gain during

pregnancy using AIM





England


BMI 22 (24)

kgm2

Age 312 (46)

years

Parity of 1 n =

28 2 n = 4

Unrestrainedn = 30

BMI 207 (196)

kgm2

Age 306 (36)

years

Parity of 1 n =

26 2 n = 4

7-day weighed


weeks

gestation

Caucasian women






outcomes

Providing p


appropriate

gains may b

beneficial

cessation o

during preg

associated w

weight gain

be prudent

accompany

advice abou

smoking dupregnancy

advice abou

and weight

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

De Vriese et

al

31

2001

To determine the


food frequency

questionnaire (FFQ)


diet by comparing



with the 7d food

record in pregnant


the 1st and 3

rd

trimesters

Belgium

developed

n = 26

BMI 22 (176-

293) kgm2

Age 30 (25-37)

years

All pregnant

women were

nulliparous

7-day


during the 1st

(median 15

weeks) and 3rd

(median 35

weeks)

trimesters A

FFQ

containing 180

of the most

common fat-

containingfoods was

conducted at

the same

timepoints

Data recorded

was based on

the EFR

First pregnancy


Hg not diabetic no

proteinuria and not



The FFQ in


compositio

of Belgian

adequate m

reasonably

subjects acc

their dietary

intake

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Fung et al39

1997



zinc from a


altered in well-

nourished women


conception through

lactation and





USA developed

n = 13

BMI 223 (29)

kgm2

Age 30 (29)

years

Parity of 1 n =

10 2 n = 3

3-day weighed

food recordnon-

consecutive

days two

weekdays and

one weekend

at 8-10 weeks

24-26 weeks

and 34-36

weeks

gestation

Aged 22-40yrs body


non-diabetic non-


alcohol use and no


gynecological

complications

Well-nouri


zinc during

pregnancy

increasing

and by a 30

increase in

absorption

not signific

increase in

zinc was du

to an increa


early in the

period pres

an adaptatio

lactation pr

These data

that mechan

regulating z

homeostasi

between pr

and lactatio

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Hronek et al40

2013



Czech pregnant


with recommended

daily allowances

(RDA)

Czechoslovakia

developed

Participants

were randomly

recruited from

both rural and

city regions

n = 152

BMI 211 (36)

kgm2

Age 289 (36)

years

7-day food


days using

scales and

household

measures at 0-

20 weeks 21-

29 weeks 30-

36 weeks and

37-39 weeks

gestation

Nonusers of chronic




le2 Subjects were

euthyroid

normoglyceamic and

not anemic

Lower intak


relative to t

correspond

during preg

Evaluated D

correspond

body size v

Modificatio

intake or al

supplement

recommend


iodine and

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Jansson et al41

2008



between early

pregnancy BMI

maternal dietary

intake and birth

weight

Sweden

developing

n = 49

BMI 255 (69)

kgm2

Age 30 (45)

years

Diet history


over a 24hr

period

collected by a

registered

dietitian at 8-

12 weeks and

32-35 weeks

gestation

Inclusion criteria


old

Exclusion criteria

smoking


reproduction

concurrent disease


or diabetes

development of

pregnancy


preeclampsia or

intrauterine growth

restriction

High first t


trimester IG

were correl

increased b

weight We

that low ser

concentrati

IGFBP-1 re

link betwee

BMI and in

fetal growth


IGF-1 regu

placental nu

transport

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Khoigani et

al

35

2012

To assess the



and micro nutrients




and reproductive

characteristics and


pregnant women

Iran developing

n = 620 (t1 n =

584 t2 n = 510)

BMI 235 (39)

kgm2

Age 256 (44)

years

Parity 158

(076)

48-hour


11-15 weeks

26 weeks and

34-37 weeks

gestation

Interviewers

were trained

Pregnant women who



delivery low birth

weight and factors

which may affect

pregnancy outcomes


addiction digestive


hemoglobinopathies

eating disorders


malignancy

Mean value


subjects wh

experienced

preeclamps

pregnancy

than in othe

women Int

manganese

C vitamin

and carboh

during the t


among preg

women wh

developed

preeclamps

significant

association

other micro

macro nutri

preeclamps

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Kopp-Hoolihan

et al

42

1999

To assess how well-




that predict an


response

USA developed

n = 10

BMI 231 (21)

kgm2

Age 291 (5)

years

3 day weighed


before

pregnancy and

at 8-10 24-26

34-36 weeks

gestation and

4-6 weeks

postpartum

Healthy non-smoking

women

Well-nouri

women useways to me

energy dem

pregnancy

reduction in

induced

thermogene

increased e

intake dep

less fat mas

predicted

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Kubota et al33

2013

To investigate the


intake maternal


growth during

pregnancy

Japan


BMI 175 (01)

kgm2

Age 297 (52)

years

Normaln = 94

BMI 21 (18)

kgm2

Age 308 (51)


Age 286 (36)

years

BMI 334 (65)

kgm2

Digital images


meals on 3

consecutive

days at 14-16

25-27 and 32-

34 weeks

gestation a

dietitian

reviewed

photos and

recorded

intakevalidation of

method not

reported

Singleton pregnant


had suffered from

obstetrical


premature delivery





Dietary inta


not correlat

fetal growth

Japanese na

recommend

advising ex

intake

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Lof et al23

2009

Investigate whether


weight gain are

associated with

estradiol and


plasma during

pregnancy

Sweden

developed

n = 226

BMI 229 (3)

kgm2

Age 32 (4) years

3 day weight


days including

one weekend

at 12 25 and

33 weeks

gestation

Calculations

conducted by

a nutritionist

Women with multi-





dietary intake were

excluded

No associat


dietary fat i

(total or sub

and plasma

levels Prog

levels corre

weight gain

pregnancy

Martinez et

al32

1994

To determine how



nation Mexico

Mexico

developing

n = 36

BMI 235 (26)

kgm2

Age 31 (54)

years

Diet history

collected by

trainedinterviewers

twice per

month and

reported as

mean first and

third trimester

values

Women with an 18




initial recruitment



pregnant

In this sam

women the


weight gain

pregnancy

was similar

women in U

States Low

maternal B

predicted sm

birth weigh

through at l

months of l

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Piers et al36

1995



pregnancy and


a group of well-

nourished pregnant


women at 12 24 and


12 and 24 wk

postpartum with a

non-pregnant non-


India

developing

n = 18

BMI 217 (24)

kgm2

Age 296 (52)

years

5 day


household

measures of

known volume

at 12 24 and

34 weeks

gestation and

12 and 24

weeks post-

partum

participants


measure by a

dietitian who

also checked

all records




morning sickness

before the initial

metabolic

measurement at 12

weeks gestation

BMR is sig


with non-pr

non-lactatin

and remain

even when

differences

weight are

for Well-n

Indian wom

weight and

similar to th


Birth weigh

infants born

to be lower

cost of preg

estimated to

MJ close t

MJ estimat

FAOIWHO

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Tabrizi et al24

2011

To assess the


mineral intake of

pregnant women and


neonates

Iran developing

n = 450

BMI 239 (38)

kgm2

Age 261 (58)

years

24 hour Recall


1st 2

nd and 3

rd

trimesters

Qualification

training of

interviewer

not reported

Women of 16 to 40


health care centers

during the three


Maternal en


with higher

serum calci

and zinc in

birth weigh

neonates


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Guelinckx

et al

43

2010

Study which


improve dietary

habits according to

the National Diet

Recommendations

increase physical

activity level in

obese pregnant

women and

control gestational

weight gain

Belgium

developedrandomly

assigned using

block

randomization

Control(routine)

n =43

BMI 335 (39)

kgm2

Age 294 (44)

yrs


and PA

brochure)

n = 37

BMI 334 (31)

kgm2

Age 287 (4) yrs

Parity of 1 n = 15

Active (brochure

+ group dietary

counselling)

n = 42BMI 341 (45)

kgm2

Age 28 (36) yrs

Parity of 1 n = 20

7-day food


weighed and

household

measures

during each

trimester of

pregnancy

Records were

checked by a

nutritionist






diabetes multiple

pregnancy premature

labor (lt37 wks

gestation) primary


advice in case of

metabolic disorder


conditions and





brochure and group

discussions

A lifestyle interv


combined with

individual advice

improve dietary h

throughout pregn

in obese women

in the absence of

medical or obstet

complications

maintaining or

increasing PA du


decrease in GWG

individually desig

caloric intake res

based on energy

expenditure data

be included

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Korpi-

Hyovalti etal44

2012

To evaluate the


quality of diet

weight gain and

birth weight in

women at high risk

of gestational

diabetes mellitus

Finland


group 1 or 2

using computed

randomization


information on

diet and PA)

n = 27

BMI 255 (34)

kgm2

Lifestyle


nutrition advice)

n = 27

BMI 273 (6)

kgm2

4 day weighed


days including

one weekend

completed at

8-12 26-28

and 36-40

weeks

gestation

Records

checked by a

nutritionist

A three-factor

eating

questionnaire

was also used

at the 1st and

3rd

trimester

Women with one or





48-55 mmoll and the

2h oral glucose


glucose lt78 mmoll

were recruited


GDM at 8-12 wks


There were no cl


however

polyunsaturated f

increase in the lif

intervention grou

Intensive weight

education led to a

somewhat lower

gain during pregn

and higher birth w

of the infants in


macrosomia whe

compared to the c

follow up group

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Moses et al45

2014

To determine


index (LGI) dietary

advice at

the first antenatal

visit would result

in a lower fetal

birth weight

birth percentile

and ponderal index

(PI) than providing

healthy eating

(HE) advice

Australia

developedrandomly

assigned using

computer-

generated

random numbers

1 or 2

Healthy Eating

(counselled to

follow a healthy

diet based on the

AGHE4

) n = 280

BMI 247 (5)

kgm2

Age 299 (5) yrs

Low Glycemic

Index

(individualized

nutrition advice

on a LGI diet)

n = 296

BMI 243 (52)

kgm2 Age 299 (52)

yrs

3 day


household

measures at 16

and 36 weeks

gestation

records

reviewed by a

dietitian



least 18 years old

ability to read and

understand English


comply with visit

schedules Subjects






compromise their




body weight

A low intensity d


in pregnancy did

result in significa

differences in bir

weight fetal perc

of PI

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Wolff et

al

46

2008

To determine


consultations

restricts weight

gain in obese

women and

whether this

restriction impacts

on pregnancy-

induced changes in

glucose

metabolism

Denmark


group 1 or 2

using computed

randomization

Control (general

information on

diet and PA)

n = 27

BMI 255 (34)

kgm2


x 1 hour

consultations)

n = 27

BMI 273 (6)

kgm2

Age 28 (4) years

7 day weighed


plusmn 3 wks) 27

and 36 weeks

gestation



recruited Exclusion

criteria included


or gt45 year old


medical conditions

which impact fetal

growth

Restriction of


achievable and re

the deterioration

glucose metaboli

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

41

983120983137983143983141 983092983089 983151983142 983092983090

FIGURE LEGENDS





















2 GWG 115 to 155 kg)


2

GWG 50 to 90 kg)

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

42

983120983137983143983141 983092983090 983151983142 983092983090







8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

22





f r o m b i a s



d e s c r i b e d






W e r e o





i n d i c a t o r s



c o n s i d e

r a t i o n




Alberti-

Fidanza et

al37


Carbone

et al34


Conway

et al38


De


Fung et

al39


Goodarzi

Khoigani

et al35


Guelinckx

et al43


Hronek et

al40


Jansson etal41


Kopp

Hoolihan

et al42


Korpi

Hyovalti

et al44


Kubota et

al33


Lof et

al

23


8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

23





f r o m b i a s



i t h d r a w a l s

d e s c r i b e d




r e a n d





i n e d a n d t h e


l i a b l e




i n d i c a t o r s


b y r e s u l t s


t a k e n i n t o





Martinez

et al32


Moses et

al45


Piers et

al36


Tabrizi et

al24


Wolff et

al46



8172019 Je Beile 2015


ACCEPTED MANUSCRIPT



Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Alberti-Fidanza

et al37

2002

To examine



(ToAC) of women



newborns and relate

the results to the


same women during

pregnancy

Italy developed

n = 12

BMI 226 (55)

kgm2

Age 311 (42)

years

Parity 18 (09)

nil smokers

Collected by

qualified and

experienced

dietitians

using the diet

history

method during

the 1st 2

nd and

3rd

trimesters


monitor To

during the e

period of pr

and we sug

intakes of f

vegetables

necessary

antioxidant

and pro-vit


antioxidant

mothers an

newborns

particularly

preterm m

valuable in

for increasi

chance that

pregnancie

successfull


deliveries

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Carbone et al34

1992

Present patterns of



puerperium and its


fetal growth and

maternal nutrient

intake

Spain

developed

n = 33

BMI 227 (22)

kgm2

Age 28 (36)

years

Parity of 1 n =

18 234 n = 15

3-day weight


holiday

completed at

11 19 and 35

weeks

gestation




personal or family





time of visit and

pregnancy


risk

There was


and head

circumferen

weeks of ge

Findings m

a relationsh

between the

metabolism

maternal le

and fetal

developme

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Conway et al38

1999

To explore the


appropriateness of

weight gain during

pregnancy using AIM





England


BMI 22 (24)

kgm2

Age 312 (46)

years

Parity of 1 n =

28 2 n = 4

Unrestrainedn = 30

BMI 207 (196)

kgm2

Age 306 (36)

years

Parity of 1 n =

26 2 n = 4

7-day weighed


weeks

gestation

Caucasian women






outcomes

Providing p


appropriate

gains may b

beneficial

cessation o

during preg

associated w

weight gain

be prudent

accompany

advice abou

smoking dupregnancy

advice abou

and weight

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

De Vriese et

al

31

2001

To determine the


food frequency

questionnaire (FFQ)


diet by comparing



with the 7d food

record in pregnant


the 1st and 3

rd

trimesters

Belgium

developed

n = 26

BMI 22 (176-

293) kgm2

Age 30 (25-37)

years

All pregnant

women were

nulliparous

7-day


during the 1st

(median 15

weeks) and 3rd

(median 35

weeks)

trimesters A

FFQ

containing 180

of the most

common fat-

containingfoods was

conducted at

the same

timepoints

Data recorded

was based on

the EFR

First pregnancy


Hg not diabetic no

proteinuria and not



The FFQ in


compositio

of Belgian

adequate m

reasonably

subjects acc

their dietary

intake

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Fung et al39

1997



zinc from a


altered in well-

nourished women


conception through

lactation and





USA developed

n = 13

BMI 223 (29)

kgm2

Age 30 (29)

years

Parity of 1 n =

10 2 n = 3

3-day weighed

food recordnon-

consecutive

days two

weekdays and

one weekend

at 8-10 weeks

24-26 weeks

and 34-36

weeks

gestation

Aged 22-40yrs body


non-diabetic non-


alcohol use and no


gynecological

complications

Well-nouri


zinc during

pregnancy

increasing

and by a 30

increase in

absorption

not signific

increase in

zinc was du

to an increa


early in the

period pres

an adaptatio

lactation pr

These data

that mechan

regulating z

homeostasi

between pr

and lactatio

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Hronek et al40

2013



Czech pregnant


with recommended

daily allowances

(RDA)

Czechoslovakia

developed

Participants

were randomly

recruited from

both rural and

city regions

n = 152

BMI 211 (36)

kgm2

Age 289 (36)

years

7-day food


days using

scales and

household

measures at 0-

20 weeks 21-

29 weeks 30-

36 weeks and

37-39 weeks

gestation

Nonusers of chronic




le2 Subjects were

euthyroid

normoglyceamic and

not anemic

Lower intak


relative to t

correspond

during preg

Evaluated D

correspond

body size v

Modificatio

intake or al

supplement

recommend


iodine and

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Jansson et al41

2008



between early

pregnancy BMI

maternal dietary

intake and birth

weight

Sweden

developing

n = 49

BMI 255 (69)

kgm2

Age 30 (45)

years

Diet history


over a 24hr

period

collected by a

registered

dietitian at 8-

12 weeks and

32-35 weeks

gestation

Inclusion criteria


old

Exclusion criteria

smoking


reproduction

concurrent disease


or diabetes

development of

pregnancy


preeclampsia or

intrauterine growth

restriction

High first t


trimester IG

were correl

increased b

weight We

that low ser

concentrati

IGFBP-1 re

link betwee

BMI and in

fetal growth


IGF-1 regu

placental nu

transport

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Khoigani et

al

35

2012

To assess the



and micro nutrients




and reproductive

characteristics and


pregnant women

Iran developing

n = 620 (t1 n =

584 t2 n = 510)

BMI 235 (39)

kgm2

Age 256 (44)

years

Parity 158

(076)

48-hour


11-15 weeks

26 weeks and

34-37 weeks

gestation

Interviewers

were trained

Pregnant women who



delivery low birth

weight and factors

which may affect

pregnancy outcomes


addiction digestive


hemoglobinopathies

eating disorders


malignancy

Mean value


subjects wh

experienced

preeclamps

pregnancy

than in othe

women Int

manganese

C vitamin

and carboh

during the t


among preg

women wh

developed

preeclamps

significant

association

other micro

macro nutri

preeclamps

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Kopp-Hoolihan

et al

42

1999

To assess how well-




that predict an


response

USA developed

n = 10

BMI 231 (21)

kgm2

Age 291 (5)

years

3 day weighed


before

pregnancy and

at 8-10 24-26

34-36 weeks

gestation and

4-6 weeks

postpartum

Healthy non-smoking

women

Well-nouri

women useways to me

energy dem

pregnancy

reduction in

induced

thermogene

increased e

intake dep

less fat mas

predicted

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Kubota et al33

2013

To investigate the


intake maternal


growth during

pregnancy

Japan


BMI 175 (01)

kgm2

Age 297 (52)

years

Normaln = 94

BMI 21 (18)

kgm2

Age 308 (51)


Age 286 (36)

years

BMI 334 (65)

kgm2

Digital images


meals on 3

consecutive

days at 14-16

25-27 and 32-

34 weeks

gestation a

dietitian

reviewed

photos and

recorded

intakevalidation of

method not

reported

Singleton pregnant


had suffered from

obstetrical


premature delivery





Dietary inta


not correlat

fetal growth

Japanese na

recommend

advising ex

intake

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Lof et al23

2009

Investigate whether


weight gain are

associated with

estradiol and


plasma during

pregnancy

Sweden

developed

n = 226

BMI 229 (3)

kgm2

Age 32 (4) years

3 day weight


days including

one weekend

at 12 25 and

33 weeks

gestation

Calculations

conducted by

a nutritionist

Women with multi-





dietary intake were

excluded

No associat


dietary fat i

(total or sub

and plasma

levels Prog

levels corre

weight gain

pregnancy

Martinez et

al32

1994

To determine how



nation Mexico

Mexico

developing

n = 36

BMI 235 (26)

kgm2

Age 31 (54)

years

Diet history

collected by

trainedinterviewers

twice per

month and

reported as

mean first and

third trimester

values

Women with an 18




initial recruitment



pregnant

In this sam

women the


weight gain

pregnancy

was similar

women in U

States Low

maternal B

predicted sm

birth weigh

through at l

months of l

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Piers et al36

1995



pregnancy and


a group of well-

nourished pregnant


women at 12 24 and


12 and 24 wk

postpartum with a

non-pregnant non-


India

developing

n = 18

BMI 217 (24)

kgm2

Age 296 (52)

years

5 day


household

measures of

known volume

at 12 24 and

34 weeks

gestation and

12 and 24

weeks post-

partum

participants


measure by a

dietitian who

also checked

all records




morning sickness

before the initial

metabolic

measurement at 12

weeks gestation

BMR is sig


with non-pr

non-lactatin

and remain

even when

differences

weight are

for Well-n

Indian wom

weight and

similar to th


Birth weigh

infants born

to be lower

cost of preg

estimated to

MJ close t

MJ estimat

FAOIWHO

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Tabrizi et al24

2011

To assess the


mineral intake of

pregnant women and


neonates

Iran developing

n = 450

BMI 239 (38)

kgm2

Age 261 (58)

years

24 hour Recall


1st 2

nd and 3

rd

trimesters

Qualification

training of

interviewer

not reported

Women of 16 to 40


health care centers

during the three


Maternal en


with higher

serum calci

and zinc in

birth weigh

neonates


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Guelinckx

et al

43

2010

Study which


improve dietary

habits according to

the National Diet

Recommendations

increase physical

activity level in

obese pregnant

women and

control gestational

weight gain

Belgium

developedrandomly

assigned using

block

randomization

Control(routine)

n =43

BMI 335 (39)

kgm2

Age 294 (44)

yrs


and PA

brochure)

n = 37

BMI 334 (31)

kgm2

Age 287 (4) yrs

Parity of 1 n = 15

Active (brochure

+ group dietary

counselling)

n = 42BMI 341 (45)

kgm2

Age 28 (36) yrs

Parity of 1 n = 20

7-day food


weighed and

household

measures

during each

trimester of

pregnancy

Records were

checked by a

nutritionist






diabetes multiple

pregnancy premature

labor (lt37 wks

gestation) primary


advice in case of

metabolic disorder


conditions and





brochure and group

discussions

A lifestyle interv


combined with

individual advice

improve dietary h

throughout pregn

in obese women

in the absence of

medical or obstet

complications

maintaining or

increasing PA du


decrease in GWG

individually desig

caloric intake res

based on energy

expenditure data

be included

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Korpi-

Hyovalti etal44

2012

To evaluate the


quality of diet

weight gain and

birth weight in

women at high risk

of gestational

diabetes mellitus

Finland


group 1 or 2

using computed

randomization


information on

diet and PA)

n = 27

BMI 255 (34)

kgm2

Lifestyle


nutrition advice)

n = 27

BMI 273 (6)

kgm2

4 day weighed


days including

one weekend

completed at

8-12 26-28

and 36-40

weeks

gestation

Records

checked by a

nutritionist

A three-factor

eating

questionnaire

was also used

at the 1st and

3rd

trimester

Women with one or





48-55 mmoll and the

2h oral glucose


glucose lt78 mmoll

were recruited


GDM at 8-12 wks


There were no cl


however

polyunsaturated f

increase in the lif

intervention grou

Intensive weight

education led to a

somewhat lower

gain during pregn

and higher birth w

of the infants in


macrosomia whe

compared to the c

follow up group

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Moses et al45

2014

To determine


index (LGI) dietary

advice at

the first antenatal

visit would result

in a lower fetal

birth weight

birth percentile

and ponderal index

(PI) than providing

healthy eating

(HE) advice

Australia

developedrandomly

assigned using

computer-

generated

random numbers

1 or 2

Healthy Eating

(counselled to

follow a healthy

diet based on the

AGHE4

) n = 280

BMI 247 (5)

kgm2

Age 299 (5) yrs

Low Glycemic

Index

(individualized

nutrition advice

on a LGI diet)

n = 296

BMI 243 (52)

kgm2 Age 299 (52)

yrs

3 day


household

measures at 16

and 36 weeks

gestation

records

reviewed by a

dietitian



least 18 years old

ability to read and

understand English


comply with visit

schedules Subjects






compromise their




body weight

A low intensity d


in pregnancy did

result in significa

differences in bir

weight fetal perc

of PI

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Wolff et

al

46

2008

To determine


consultations

restricts weight

gain in obese

women and

whether this

restriction impacts

on pregnancy-

induced changes in

glucose

metabolism

Denmark


group 1 or 2

using computed

randomization

Control (general

information on

diet and PA)

n = 27

BMI 255 (34)

kgm2


x 1 hour

consultations)

n = 27

BMI 273 (6)

kgm2

Age 28 (4) years

7 day weighed


plusmn 3 wks) 27

and 36 weeks

gestation



recruited Exclusion

criteria included


or gt45 year old


medical conditions

which impact fetal

growth

Restriction of


achievable and re

the deterioration

glucose metaboli

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

41

983120983137983143983141 983092983089 983151983142 983092983090

FIGURE LEGENDS





















2 GWG 115 to 155 kg)


2

GWG 50 to 90 kg)

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

42

983120983137983143983141 983092983090 983151983142 983092983090







8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

23





f r o m b i a s



i t h d r a w a l s

d e s c r i b e d




r e a n d





i n e d a n d t h e


l i a b l e




i n d i c a t o r s


b y r e s u l t s


t a k e n i n t o





Martinez

et al32


Moses et

al45


Piers et

al36


Tabrizi et

al24


Wolff et

al46



8172019 Je Beile 2015


ACCEPTED MANUSCRIPT



Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Alberti-Fidanza

et al37

2002

To examine



(ToAC) of women



newborns and relate

the results to the


same women during

pregnancy

Italy developed

n = 12

BMI 226 (55)

kgm2

Age 311 (42)

years

Parity 18 (09)

nil smokers

Collected by

qualified and

experienced

dietitians

using the diet

history

method during

the 1st 2

nd and

3rd

trimesters


monitor To

during the e

period of pr

and we sug

intakes of f

vegetables

necessary

antioxidant

and pro-vit


antioxidant

mothers an

newborns

particularly

preterm m

valuable in

for increasi

chance that

pregnancie

successfull


deliveries

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Carbone et al34

1992

Present patterns of



puerperium and its


fetal growth and

maternal nutrient

intake

Spain

developed

n = 33

BMI 227 (22)

kgm2

Age 28 (36)

years

Parity of 1 n =

18 234 n = 15

3-day weight


holiday

completed at

11 19 and 35

weeks

gestation




personal or family





time of visit and

pregnancy


risk

There was


and head

circumferen

weeks of ge

Findings m

a relationsh

between the

metabolism

maternal le

and fetal

developme

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Conway et al38

1999

To explore the


appropriateness of

weight gain during

pregnancy using AIM





England


BMI 22 (24)

kgm2

Age 312 (46)

years

Parity of 1 n =

28 2 n = 4

Unrestrainedn = 30

BMI 207 (196)

kgm2

Age 306 (36)

years

Parity of 1 n =

26 2 n = 4

7-day weighed


weeks

gestation

Caucasian women






outcomes

Providing p


appropriate

gains may b

beneficial

cessation o

during preg

associated w

weight gain

be prudent

accompany

advice abou

smoking dupregnancy

advice abou

and weight

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

De Vriese et

al

31

2001

To determine the


food frequency

questionnaire (FFQ)


diet by comparing



with the 7d food

record in pregnant


the 1st and 3

rd

trimesters

Belgium

developed

n = 26

BMI 22 (176-

293) kgm2

Age 30 (25-37)

years

All pregnant

women were

nulliparous

7-day


during the 1st

(median 15

weeks) and 3rd

(median 35

weeks)

trimesters A

FFQ

containing 180

of the most

common fat-

containingfoods was

conducted at

the same

timepoints

Data recorded

was based on

the EFR

First pregnancy


Hg not diabetic no

proteinuria and not



The FFQ in


compositio

of Belgian

adequate m

reasonably

subjects acc

their dietary

intake

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Fung et al39

1997



zinc from a


altered in well-

nourished women


conception through

lactation and





USA developed

n = 13

BMI 223 (29)

kgm2

Age 30 (29)

years

Parity of 1 n =

10 2 n = 3

3-day weighed

food recordnon-

consecutive

days two

weekdays and

one weekend

at 8-10 weeks

24-26 weeks

and 34-36

weeks

gestation

Aged 22-40yrs body


non-diabetic non-


alcohol use and no


gynecological

complications

Well-nouri


zinc during

pregnancy

increasing

and by a 30

increase in

absorption

not signific

increase in

zinc was du

to an increa


early in the

period pres

an adaptatio

lactation pr

These data

that mechan

regulating z

homeostasi

between pr

and lactatio

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Hronek et al40

2013



Czech pregnant


with recommended

daily allowances

(RDA)

Czechoslovakia

developed

Participants

were randomly

recruited from

both rural and

city regions

n = 152

BMI 211 (36)

kgm2

Age 289 (36)

years

7-day food


days using

scales and

household

measures at 0-

20 weeks 21-

29 weeks 30-

36 weeks and

37-39 weeks

gestation

Nonusers of chronic




le2 Subjects were

euthyroid

normoglyceamic and

not anemic

Lower intak


relative to t

correspond

during preg

Evaluated D

correspond

body size v

Modificatio

intake or al

supplement

recommend


iodine and

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Jansson et al41

2008



between early

pregnancy BMI

maternal dietary

intake and birth

weight

Sweden

developing

n = 49

BMI 255 (69)

kgm2

Age 30 (45)

years

Diet history


over a 24hr

period

collected by a

registered

dietitian at 8-

12 weeks and

32-35 weeks

gestation

Inclusion criteria


old

Exclusion criteria

smoking


reproduction

concurrent disease


or diabetes

development of

pregnancy


preeclampsia or

intrauterine growth

restriction

High first t


trimester IG

were correl

increased b

weight We

that low ser

concentrati

IGFBP-1 re

link betwee

BMI and in

fetal growth


IGF-1 regu

placental nu

transport

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Khoigani et

al

35

2012

To assess the



and micro nutrients




and reproductive

characteristics and


pregnant women

Iran developing

n = 620 (t1 n =

584 t2 n = 510)

BMI 235 (39)

kgm2

Age 256 (44)

years

Parity 158

(076)

48-hour


11-15 weeks

26 weeks and

34-37 weeks

gestation

Interviewers

were trained

Pregnant women who



delivery low birth

weight and factors

which may affect

pregnancy outcomes


addiction digestive


hemoglobinopathies

eating disorders


malignancy

Mean value


subjects wh

experienced

preeclamps

pregnancy

than in othe

women Int

manganese

C vitamin

and carboh

during the t


among preg

women wh

developed

preeclamps

significant

association

other micro

macro nutri

preeclamps

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Kopp-Hoolihan

et al

42

1999

To assess how well-




that predict an


response

USA developed

n = 10

BMI 231 (21)

kgm2

Age 291 (5)

years

3 day weighed


before

pregnancy and

at 8-10 24-26

34-36 weeks

gestation and

4-6 weeks

postpartum

Healthy non-smoking

women

Well-nouri

women useways to me

energy dem

pregnancy

reduction in

induced

thermogene

increased e

intake dep

less fat mas

predicted

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Kubota et al33

2013

To investigate the


intake maternal


growth during

pregnancy

Japan


BMI 175 (01)

kgm2

Age 297 (52)

years

Normaln = 94

BMI 21 (18)

kgm2

Age 308 (51)


Age 286 (36)

years

BMI 334 (65)

kgm2

Digital images


meals on 3

consecutive

days at 14-16

25-27 and 32-

34 weeks

gestation a

dietitian

reviewed

photos and

recorded

intakevalidation of

method not

reported

Singleton pregnant


had suffered from

obstetrical


premature delivery





Dietary inta


not correlat

fetal growth

Japanese na

recommend

advising ex

intake

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Lof et al23

2009

Investigate whether


weight gain are

associated with

estradiol and


plasma during

pregnancy

Sweden

developed

n = 226

BMI 229 (3)

kgm2

Age 32 (4) years

3 day weight


days including

one weekend

at 12 25 and

33 weeks

gestation

Calculations

conducted by

a nutritionist

Women with multi-





dietary intake were

excluded

No associat


dietary fat i

(total or sub

and plasma

levels Prog

levels corre

weight gain

pregnancy

Martinez et

al32

1994

To determine how



nation Mexico

Mexico

developing

n = 36

BMI 235 (26)

kgm2

Age 31 (54)

years

Diet history

collected by

trainedinterviewers

twice per

month and

reported as

mean first and

third trimester

values

Women with an 18




initial recruitment



pregnant

In this sam

women the


weight gain

pregnancy

was similar

women in U

States Low

maternal B

predicted sm

birth weigh

through at l

months of l

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Piers et al36

1995



pregnancy and


a group of well-

nourished pregnant


women at 12 24 and


12 and 24 wk

postpartum with a

non-pregnant non-


India

developing

n = 18

BMI 217 (24)

kgm2

Age 296 (52)

years

5 day


household

measures of

known volume

at 12 24 and

34 weeks

gestation and

12 and 24

weeks post-

partum

participants


measure by a

dietitian who

also checked

all records




morning sickness

before the initial

metabolic

measurement at 12

weeks gestation

BMR is sig


with non-pr

non-lactatin

and remain

even when

differences

weight are

for Well-n

Indian wom

weight and

similar to th


Birth weigh

infants born

to be lower

cost of preg

estimated to

MJ close t

MJ estimat

FAOIWHO

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Tabrizi et al24

2011

To assess the


mineral intake of

pregnant women and


neonates

Iran developing

n = 450

BMI 239 (38)

kgm2

Age 261 (58)

years

24 hour Recall


1st 2

nd and 3

rd

trimesters

Qualification

training of

interviewer

not reported

Women of 16 to 40


health care centers

during the three


Maternal en


with higher

serum calci

and zinc in

birth weigh

neonates


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Guelinckx

et al

43

2010

Study which


improve dietary

habits according to

the National Diet

Recommendations

increase physical

activity level in

obese pregnant

women and

control gestational

weight gain

Belgium

developedrandomly

assigned using

block

randomization

Control(routine)

n =43

BMI 335 (39)

kgm2

Age 294 (44)

yrs


and PA

brochure)

n = 37

BMI 334 (31)

kgm2

Age 287 (4) yrs

Parity of 1 n = 15

Active (brochure

+ group dietary

counselling)

n = 42BMI 341 (45)

kgm2

Age 28 (36) yrs

Parity of 1 n = 20

7-day food


weighed and

household

measures

during each

trimester of

pregnancy

Records were

checked by a

nutritionist






diabetes multiple

pregnancy premature

labor (lt37 wks

gestation) primary


advice in case of

metabolic disorder


conditions and





brochure and group

discussions

A lifestyle interv


combined with

individual advice

improve dietary h

throughout pregn

in obese women

in the absence of

medical or obstet

complications

maintaining or

increasing PA du


decrease in GWG

individually desig

caloric intake res

based on energy

expenditure data

be included

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Korpi-

Hyovalti etal44

2012

To evaluate the


quality of diet

weight gain and

birth weight in

women at high risk

of gestational

diabetes mellitus

Finland


group 1 or 2

using computed

randomization


information on

diet and PA)

n = 27

BMI 255 (34)

kgm2

Lifestyle


nutrition advice)

n = 27

BMI 273 (6)

kgm2

4 day weighed


days including

one weekend

completed at

8-12 26-28

and 36-40

weeks

gestation

Records

checked by a

nutritionist

A three-factor

eating

questionnaire

was also used

at the 1st and

3rd

trimester

Women with one or





48-55 mmoll and the

2h oral glucose


glucose lt78 mmoll

were recruited


GDM at 8-12 wks


There were no cl


however

polyunsaturated f

increase in the lif

intervention grou

Intensive weight

education led to a

somewhat lower

gain during pregn

and higher birth w

of the infants in


macrosomia whe

compared to the c

follow up group

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Moses et al45

2014

To determine


index (LGI) dietary

advice at

the first antenatal

visit would result

in a lower fetal

birth weight

birth percentile

and ponderal index

(PI) than providing

healthy eating

(HE) advice

Australia

developedrandomly

assigned using

computer-

generated

random numbers

1 or 2

Healthy Eating

(counselled to

follow a healthy

diet based on the

AGHE4

) n = 280

BMI 247 (5)

kgm2

Age 299 (5) yrs

Low Glycemic

Index

(individualized

nutrition advice

on a LGI diet)

n = 296

BMI 243 (52)

kgm2 Age 299 (52)

yrs

3 day


household

measures at 16

and 36 weeks

gestation

records

reviewed by a

dietitian



least 18 years old

ability to read and

understand English


comply with visit

schedules Subjects






compromise their




body weight

A low intensity d


in pregnancy did

result in significa

differences in bir

weight fetal perc

of PI

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Wolff et

al

46

2008

To determine


consultations

restricts weight

gain in obese

women and

whether this

restriction impacts

on pregnancy-

induced changes in

glucose

metabolism

Denmark


group 1 or 2

using computed

randomization

Control (general

information on

diet and PA)

n = 27

BMI 255 (34)

kgm2


x 1 hour

consultations)

n = 27

BMI 273 (6)

kgm2

Age 28 (4) years

7 day weighed


plusmn 3 wks) 27

and 36 weeks

gestation



recruited Exclusion

criteria included


or gt45 year old


medical conditions

which impact fetal

growth

Restriction of


achievable and re

the deterioration

glucose metaboli

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

41

983120983137983143983141 983092983089 983151983142 983092983090

FIGURE LEGENDS





















2 GWG 115 to 155 kg)


2

GWG 50 to 90 kg)

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

42

983120983137983143983141 983092983090 983151983142 983092983090







8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT



Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Alberti-Fidanza

et al37

2002

To examine



(ToAC) of women



newborns and relate

the results to the


same women during

pregnancy

Italy developed

n = 12

BMI 226 (55)

kgm2

Age 311 (42)

years

Parity 18 (09)

nil smokers

Collected by

qualified and

experienced

dietitians

using the diet

history

method during

the 1st 2

nd and

3rd

trimesters


monitor To

during the e

period of pr

and we sug

intakes of f

vegetables

necessary

antioxidant

and pro-vit


antioxidant

mothers an

newborns

particularly

preterm m

valuable in

for increasi

chance that

pregnancie

successfull


deliveries

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Carbone et al34

1992

Present patterns of



puerperium and its


fetal growth and

maternal nutrient

intake

Spain

developed

n = 33

BMI 227 (22)

kgm2

Age 28 (36)

years

Parity of 1 n =

18 234 n = 15

3-day weight


holiday

completed at

11 19 and 35

weeks

gestation




personal or family





time of visit and

pregnancy


risk

There was


and head

circumferen

weeks of ge

Findings m

a relationsh

between the

metabolism

maternal le

and fetal

developme

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Conway et al38

1999

To explore the


appropriateness of

weight gain during

pregnancy using AIM





England


BMI 22 (24)

kgm2

Age 312 (46)

years

Parity of 1 n =

28 2 n = 4

Unrestrainedn = 30

BMI 207 (196)

kgm2

Age 306 (36)

years

Parity of 1 n =

26 2 n = 4

7-day weighed


weeks

gestation

Caucasian women






outcomes

Providing p


appropriate

gains may b

beneficial

cessation o

during preg

associated w

weight gain

be prudent

accompany

advice abou

smoking dupregnancy

advice abou

and weight

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

De Vriese et

al

31

2001

To determine the


food frequency

questionnaire (FFQ)


diet by comparing



with the 7d food

record in pregnant


the 1st and 3

rd

trimesters

Belgium

developed

n = 26

BMI 22 (176-

293) kgm2

Age 30 (25-37)

years

All pregnant

women were

nulliparous

7-day


during the 1st

(median 15

weeks) and 3rd

(median 35

weeks)

trimesters A

FFQ

containing 180

of the most

common fat-

containingfoods was

conducted at

the same

timepoints

Data recorded

was based on

the EFR

First pregnancy


Hg not diabetic no

proteinuria and not



The FFQ in


compositio

of Belgian

adequate m

reasonably

subjects acc

their dietary

intake

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Fung et al39

1997



zinc from a


altered in well-

nourished women


conception through

lactation and





USA developed

n = 13

BMI 223 (29)

kgm2

Age 30 (29)

years

Parity of 1 n =

10 2 n = 3

3-day weighed

food recordnon-

consecutive

days two

weekdays and

one weekend

at 8-10 weeks

24-26 weeks

and 34-36

weeks

gestation

Aged 22-40yrs body


non-diabetic non-


alcohol use and no


gynecological

complications

Well-nouri


zinc during

pregnancy

increasing

and by a 30

increase in

absorption

not signific

increase in

zinc was du

to an increa


early in the

period pres

an adaptatio

lactation pr

These data

that mechan

regulating z

homeostasi

between pr

and lactatio

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Hronek et al40

2013



Czech pregnant


with recommended

daily allowances

(RDA)

Czechoslovakia

developed

Participants

were randomly

recruited from

both rural and

city regions

n = 152

BMI 211 (36)

kgm2

Age 289 (36)

years

7-day food


days using

scales and

household

measures at 0-

20 weeks 21-

29 weeks 30-

36 weeks and

37-39 weeks

gestation

Nonusers of chronic




le2 Subjects were

euthyroid

normoglyceamic and

not anemic

Lower intak


relative to t

correspond

during preg

Evaluated D

correspond

body size v

Modificatio

intake or al

supplement

recommend


iodine and

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Jansson et al41

2008



between early

pregnancy BMI

maternal dietary

intake and birth

weight

Sweden

developing

n = 49

BMI 255 (69)

kgm2

Age 30 (45)

years

Diet history


over a 24hr

period

collected by a

registered

dietitian at 8-

12 weeks and

32-35 weeks

gestation

Inclusion criteria


old

Exclusion criteria

smoking


reproduction

concurrent disease


or diabetes

development of

pregnancy


preeclampsia or

intrauterine growth

restriction

High first t


trimester IG

were correl

increased b

weight We

that low ser

concentrati

IGFBP-1 re

link betwee

BMI and in

fetal growth


IGF-1 regu

placental nu

transport

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Khoigani et

al

35

2012

To assess the



and micro nutrients




and reproductive

characteristics and


pregnant women

Iran developing

n = 620 (t1 n =

584 t2 n = 510)

BMI 235 (39)

kgm2

Age 256 (44)

years

Parity 158

(076)

48-hour


11-15 weeks

26 weeks and

34-37 weeks

gestation

Interviewers

were trained

Pregnant women who



delivery low birth

weight and factors

which may affect

pregnancy outcomes


addiction digestive


hemoglobinopathies

eating disorders


malignancy

Mean value


subjects wh

experienced

preeclamps

pregnancy

than in othe

women Int

manganese

C vitamin

and carboh

during the t


among preg

women wh

developed

preeclamps

significant

association

other micro

macro nutri

preeclamps

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Kopp-Hoolihan

et al

42

1999

To assess how well-




that predict an


response

USA developed

n = 10

BMI 231 (21)

kgm2

Age 291 (5)

years

3 day weighed


before

pregnancy and

at 8-10 24-26

34-36 weeks

gestation and

4-6 weeks

postpartum

Healthy non-smoking

women

Well-nouri

women useways to me

energy dem

pregnancy

reduction in

induced

thermogene

increased e

intake dep

less fat mas

predicted

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Kubota et al33

2013

To investigate the


intake maternal


growth during

pregnancy

Japan


BMI 175 (01)

kgm2

Age 297 (52)

years

Normaln = 94

BMI 21 (18)

kgm2

Age 308 (51)


Age 286 (36)

years

BMI 334 (65)

kgm2

Digital images


meals on 3

consecutive

days at 14-16

25-27 and 32-

34 weeks

gestation a

dietitian

reviewed

photos and

recorded

intakevalidation of

method not

reported

Singleton pregnant


had suffered from

obstetrical


premature delivery





Dietary inta


not correlat

fetal growth

Japanese na

recommend

advising ex

intake

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Lof et al23

2009

Investigate whether


weight gain are

associated with

estradiol and


plasma during

pregnancy

Sweden

developed

n = 226

BMI 229 (3)

kgm2

Age 32 (4) years

3 day weight


days including

one weekend

at 12 25 and

33 weeks

gestation

Calculations

conducted by

a nutritionist

Women with multi-





dietary intake were

excluded

No associat


dietary fat i

(total or sub

and plasma

levels Prog

levels corre

weight gain

pregnancy

Martinez et

al32

1994

To determine how



nation Mexico

Mexico

developing

n = 36

BMI 235 (26)

kgm2

Age 31 (54)

years

Diet history

collected by

trainedinterviewers

twice per

month and

reported as

mean first and

third trimester

values

Women with an 18




initial recruitment



pregnant

In this sam

women the


weight gain

pregnancy

was similar

women in U

States Low

maternal B

predicted sm

birth weigh

through at l

months of l

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Piers et al36

1995



pregnancy and


a group of well-

nourished pregnant


women at 12 24 and


12 and 24 wk

postpartum with a

non-pregnant non-


India

developing

n = 18

BMI 217 (24)

kgm2

Age 296 (52)

years

5 day


household

measures of

known volume

at 12 24 and

34 weeks

gestation and

12 and 24

weeks post-

partum

participants


measure by a

dietitian who

also checked

all records




morning sickness

before the initial

metabolic

measurement at 12

weeks gestation

BMR is sig


with non-pr

non-lactatin

and remain

even when

differences

weight are

for Well-n

Indian wom

weight and

similar to th


Birth weigh

infants born

to be lower

cost of preg

estimated to

MJ close t

MJ estimat

FAOIWHO

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Tabrizi et al24

2011

To assess the


mineral intake of

pregnant women and


neonates

Iran developing

n = 450

BMI 239 (38)

kgm2

Age 261 (58)

years

24 hour Recall


1st 2

nd and 3

rd

trimesters

Qualification

training of

interviewer

not reported

Women of 16 to 40


health care centers

during the three


Maternal en


with higher

serum calci

and zinc in

birth weigh

neonates


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Guelinckx

et al

43

2010

Study which


improve dietary

habits according to

the National Diet

Recommendations

increase physical

activity level in

obese pregnant

women and

control gestational

weight gain

Belgium

developedrandomly

assigned using

block

randomization

Control(routine)

n =43

BMI 335 (39)

kgm2

Age 294 (44)

yrs


and PA

brochure)

n = 37

BMI 334 (31)

kgm2

Age 287 (4) yrs

Parity of 1 n = 15

Active (brochure

+ group dietary

counselling)

n = 42BMI 341 (45)

kgm2

Age 28 (36) yrs

Parity of 1 n = 20

7-day food


weighed and

household

measures

during each

trimester of

pregnancy

Records were

checked by a

nutritionist






diabetes multiple

pregnancy premature

labor (lt37 wks

gestation) primary


advice in case of

metabolic disorder


conditions and





brochure and group

discussions

A lifestyle interv


combined with

individual advice

improve dietary h

throughout pregn

in obese women

in the absence of

medical or obstet

complications

maintaining or

increasing PA du


decrease in GWG

individually desig

caloric intake res

based on energy

expenditure data

be included

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Korpi-

Hyovalti etal44

2012

To evaluate the


quality of diet

weight gain and

birth weight in

women at high risk

of gestational

diabetes mellitus

Finland


group 1 or 2

using computed

randomization


information on

diet and PA)

n = 27

BMI 255 (34)

kgm2

Lifestyle


nutrition advice)

n = 27

BMI 273 (6)

kgm2

4 day weighed


days including

one weekend

completed at

8-12 26-28

and 36-40

weeks

gestation

Records

checked by a

nutritionist

A three-factor

eating

questionnaire

was also used

at the 1st and

3rd

trimester

Women with one or





48-55 mmoll and the

2h oral glucose


glucose lt78 mmoll

were recruited


GDM at 8-12 wks


There were no cl


however

polyunsaturated f

increase in the lif

intervention grou

Intensive weight

education led to a

somewhat lower

gain during pregn

and higher birth w

of the infants in


macrosomia whe

compared to the c

follow up group

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Moses et al45

2014

To determine


index (LGI) dietary

advice at

the first antenatal

visit would result

in a lower fetal

birth weight

birth percentile

and ponderal index

(PI) than providing

healthy eating

(HE) advice

Australia

developedrandomly

assigned using

computer-

generated

random numbers

1 or 2

Healthy Eating

(counselled to

follow a healthy

diet based on the

AGHE4

) n = 280

BMI 247 (5)

kgm2

Age 299 (5) yrs

Low Glycemic

Index

(individualized

nutrition advice

on a LGI diet)

n = 296

BMI 243 (52)

kgm2 Age 299 (52)

yrs

3 day


household

measures at 16

and 36 weeks

gestation

records

reviewed by a

dietitian



least 18 years old

ability to read and

understand English


comply with visit

schedules Subjects






compromise their




body weight

A low intensity d


in pregnancy did

result in significa

differences in bir

weight fetal perc

of PI

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Wolff et

al

46

2008

To determine


consultations

restricts weight

gain in obese

women and

whether this

restriction impacts

on pregnancy-

induced changes in

glucose

metabolism

Denmark


group 1 or 2

using computed

randomization

Control (general

information on

diet and PA)

n = 27

BMI 255 (34)

kgm2


x 1 hour

consultations)

n = 27

BMI 273 (6)

kgm2

Age 28 (4) years

7 day weighed


plusmn 3 wks) 27

and 36 weeks

gestation



recruited Exclusion

criteria included


or gt45 year old


medical conditions

which impact fetal

growth

Restriction of


achievable and re

the deterioration

glucose metaboli

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

41

983120983137983143983141 983092983089 983151983142 983092983090

FIGURE LEGENDS





















2 GWG 115 to 155 kg)


2

GWG 50 to 90 kg)

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

42

983120983137983143983141 983092983090 983151983142 983092983090







8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Carbone et al34

1992

Present patterns of



puerperium and its


fetal growth and

maternal nutrient

intake

Spain

developed

n = 33

BMI 227 (22)

kgm2

Age 28 (36)

years

Parity of 1 n =

18 234 n = 15

3-day weight


holiday

completed at

11 19 and 35

weeks

gestation




personal or family





time of visit and

pregnancy


risk

There was


and head

circumferen

weeks of ge

Findings m

a relationsh

between the

metabolism

maternal le

and fetal

developme

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Conway et al38

1999

To explore the


appropriateness of

weight gain during

pregnancy using AIM





England


BMI 22 (24)

kgm2

Age 312 (46)

years

Parity of 1 n =

28 2 n = 4

Unrestrainedn = 30

BMI 207 (196)

kgm2

Age 306 (36)

years

Parity of 1 n =

26 2 n = 4

7-day weighed


weeks

gestation

Caucasian women






outcomes

Providing p


appropriate

gains may b

beneficial

cessation o

during preg

associated w

weight gain

be prudent

accompany

advice abou

smoking dupregnancy

advice abou

and weight

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

De Vriese et

al

31

2001

To determine the


food frequency

questionnaire (FFQ)


diet by comparing



with the 7d food

record in pregnant


the 1st and 3

rd

trimesters

Belgium

developed

n = 26

BMI 22 (176-

293) kgm2

Age 30 (25-37)

years

All pregnant

women were

nulliparous

7-day


during the 1st

(median 15

weeks) and 3rd

(median 35

weeks)

trimesters A

FFQ

containing 180

of the most

common fat-

containingfoods was

conducted at

the same

timepoints

Data recorded

was based on

the EFR

First pregnancy


Hg not diabetic no

proteinuria and not



The FFQ in


compositio

of Belgian

adequate m

reasonably

subjects acc

their dietary

intake

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Fung et al39

1997



zinc from a


altered in well-

nourished women


conception through

lactation and





USA developed

n = 13

BMI 223 (29)

kgm2

Age 30 (29)

years

Parity of 1 n =

10 2 n = 3

3-day weighed

food recordnon-

consecutive

days two

weekdays and

one weekend

at 8-10 weeks

24-26 weeks

and 34-36

weeks

gestation

Aged 22-40yrs body


non-diabetic non-


alcohol use and no


gynecological

complications

Well-nouri


zinc during

pregnancy

increasing

and by a 30

increase in

absorption

not signific

increase in

zinc was du

to an increa


early in the

period pres

an adaptatio

lactation pr

These data

that mechan

regulating z

homeostasi

between pr

and lactatio

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Hronek et al40

2013



Czech pregnant


with recommended

daily allowances

(RDA)

Czechoslovakia

developed

Participants

were randomly

recruited from

both rural and

city regions

n = 152

BMI 211 (36)

kgm2

Age 289 (36)

years

7-day food


days using

scales and

household

measures at 0-

20 weeks 21-

29 weeks 30-

36 weeks and

37-39 weeks

gestation

Nonusers of chronic




le2 Subjects were

euthyroid

normoglyceamic and

not anemic

Lower intak


relative to t

correspond

during preg

Evaluated D

correspond

body size v

Modificatio

intake or al

supplement

recommend


iodine and

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Jansson et al41

2008



between early

pregnancy BMI

maternal dietary

intake and birth

weight

Sweden

developing

n = 49

BMI 255 (69)

kgm2

Age 30 (45)

years

Diet history


over a 24hr

period

collected by a

registered

dietitian at 8-

12 weeks and

32-35 weeks

gestation

Inclusion criteria


old

Exclusion criteria

smoking


reproduction

concurrent disease


or diabetes

development of

pregnancy


preeclampsia or

intrauterine growth

restriction

High first t


trimester IG

were correl

increased b

weight We

that low ser

concentrati

IGFBP-1 re

link betwee

BMI and in

fetal growth


IGF-1 regu

placental nu

transport

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Khoigani et

al

35

2012

To assess the



and micro nutrients




and reproductive

characteristics and


pregnant women

Iran developing

n = 620 (t1 n =

584 t2 n = 510)

BMI 235 (39)

kgm2

Age 256 (44)

years

Parity 158

(076)

48-hour


11-15 weeks

26 weeks and

34-37 weeks

gestation

Interviewers

were trained

Pregnant women who



delivery low birth

weight and factors

which may affect

pregnancy outcomes


addiction digestive


hemoglobinopathies

eating disorders


malignancy

Mean value


subjects wh

experienced

preeclamps

pregnancy

than in othe

women Int

manganese

C vitamin

and carboh

during the t


among preg

women wh

developed

preeclamps

significant

association

other micro

macro nutri

preeclamps

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Kopp-Hoolihan

et al

42

1999

To assess how well-




that predict an


response

USA developed

n = 10

BMI 231 (21)

kgm2

Age 291 (5)

years

3 day weighed


before

pregnancy and

at 8-10 24-26

34-36 weeks

gestation and

4-6 weeks

postpartum

Healthy non-smoking

women

Well-nouri

women useways to me

energy dem

pregnancy

reduction in

induced

thermogene

increased e

intake dep

less fat mas

predicted

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Kubota et al33

2013

To investigate the


intake maternal


growth during

pregnancy

Japan


BMI 175 (01)

kgm2

Age 297 (52)

years

Normaln = 94

BMI 21 (18)

kgm2

Age 308 (51)


Age 286 (36)

years

BMI 334 (65)

kgm2

Digital images


meals on 3

consecutive

days at 14-16

25-27 and 32-

34 weeks

gestation a

dietitian

reviewed

photos and

recorded

intakevalidation of

method not

reported

Singleton pregnant


had suffered from

obstetrical


premature delivery





Dietary inta


not correlat

fetal growth

Japanese na

recommend

advising ex

intake

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Lof et al23

2009

Investigate whether


weight gain are

associated with

estradiol and


plasma during

pregnancy

Sweden

developed

n = 226

BMI 229 (3)

kgm2

Age 32 (4) years

3 day weight


days including

one weekend

at 12 25 and

33 weeks

gestation

Calculations

conducted by

a nutritionist

Women with multi-





dietary intake were

excluded

No associat


dietary fat i

(total or sub

and plasma

levels Prog

levels corre

weight gain

pregnancy

Martinez et

al32

1994

To determine how



nation Mexico

Mexico

developing

n = 36

BMI 235 (26)

kgm2

Age 31 (54)

years

Diet history

collected by

trainedinterviewers

twice per

month and

reported as

mean first and

third trimester

values

Women with an 18




initial recruitment



pregnant

In this sam

women the


weight gain

pregnancy

was similar

women in U

States Low

maternal B

predicted sm

birth weigh

through at l

months of l

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Piers et al36

1995



pregnancy and


a group of well-

nourished pregnant


women at 12 24 and


12 and 24 wk

postpartum with a

non-pregnant non-


India

developing

n = 18

BMI 217 (24)

kgm2

Age 296 (52)

years

5 day


household

measures of

known volume

at 12 24 and

34 weeks

gestation and

12 and 24

weeks post-

partum

participants


measure by a

dietitian who

also checked

all records




morning sickness

before the initial

metabolic

measurement at 12

weeks gestation

BMR is sig


with non-pr

non-lactatin

and remain

even when

differences

weight are

for Well-n

Indian wom

weight and

similar to th


Birth weigh

infants born

to be lower

cost of preg

estimated to

MJ close t

MJ estimat

FAOIWHO

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Tabrizi et al24

2011

To assess the


mineral intake of

pregnant women and


neonates

Iran developing

n = 450

BMI 239 (38)

kgm2

Age 261 (58)

years

24 hour Recall


1st 2

nd and 3

rd

trimesters

Qualification

training of

interviewer

not reported

Women of 16 to 40


health care centers

during the three


Maternal en


with higher

serum calci

and zinc in

birth weigh

neonates


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Guelinckx

et al

43

2010

Study which


improve dietary

habits according to

the National Diet

Recommendations

increase physical

activity level in

obese pregnant

women and

control gestational

weight gain

Belgium

developedrandomly

assigned using

block

randomization

Control(routine)

n =43

BMI 335 (39)

kgm2

Age 294 (44)

yrs


and PA

brochure)

n = 37

BMI 334 (31)

kgm2

Age 287 (4) yrs

Parity of 1 n = 15

Active (brochure

+ group dietary

counselling)

n = 42BMI 341 (45)

kgm2

Age 28 (36) yrs

Parity of 1 n = 20

7-day food


weighed and

household

measures

during each

trimester of

pregnancy

Records were

checked by a

nutritionist






diabetes multiple

pregnancy premature

labor (lt37 wks

gestation) primary


advice in case of

metabolic disorder


conditions and





brochure and group

discussions

A lifestyle interv


combined with

individual advice

improve dietary h

throughout pregn

in obese women

in the absence of

medical or obstet

complications

maintaining or

increasing PA du


decrease in GWG

individually desig

caloric intake res

based on energy

expenditure data

be included

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Korpi-

Hyovalti etal44

2012

To evaluate the


quality of diet

weight gain and

birth weight in

women at high risk

of gestational

diabetes mellitus

Finland


group 1 or 2

using computed

randomization


information on

diet and PA)

n = 27

BMI 255 (34)

kgm2

Lifestyle


nutrition advice)

n = 27

BMI 273 (6)

kgm2

4 day weighed


days including

one weekend

completed at

8-12 26-28

and 36-40

weeks

gestation

Records

checked by a

nutritionist

A three-factor

eating

questionnaire

was also used

at the 1st and

3rd

trimester

Women with one or





48-55 mmoll and the

2h oral glucose


glucose lt78 mmoll

were recruited


GDM at 8-12 wks


There were no cl


however

polyunsaturated f

increase in the lif

intervention grou

Intensive weight

education led to a

somewhat lower

gain during pregn

and higher birth w

of the infants in


macrosomia whe

compared to the c

follow up group

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Moses et al45

2014

To determine


index (LGI) dietary

advice at

the first antenatal

visit would result

in a lower fetal

birth weight

birth percentile

and ponderal index

(PI) than providing

healthy eating

(HE) advice

Australia

developedrandomly

assigned using

computer-

generated

random numbers

1 or 2

Healthy Eating

(counselled to

follow a healthy

diet based on the

AGHE4

) n = 280

BMI 247 (5)

kgm2

Age 299 (5) yrs

Low Glycemic

Index

(individualized

nutrition advice

on a LGI diet)

n = 296

BMI 243 (52)

kgm2 Age 299 (52)

yrs

3 day


household

measures at 16

and 36 weeks

gestation

records

reviewed by a

dietitian



least 18 years old

ability to read and

understand English


comply with visit

schedules Subjects






compromise their




body weight

A low intensity d


in pregnancy did

result in significa

differences in bir

weight fetal perc

of PI

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Wolff et

al

46

2008

To determine


consultations

restricts weight

gain in obese

women and

whether this

restriction impacts

on pregnancy-

induced changes in

glucose

metabolism

Denmark


group 1 or 2

using computed

randomization

Control (general

information on

diet and PA)

n = 27

BMI 255 (34)

kgm2


x 1 hour

consultations)

n = 27

BMI 273 (6)

kgm2

Age 28 (4) years

7 day weighed


plusmn 3 wks) 27

and 36 weeks

gestation



recruited Exclusion

criteria included


or gt45 year old


medical conditions

which impact fetal

growth

Restriction of


achievable and re

the deterioration

glucose metaboli

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

41

983120983137983143983141 983092983089 983151983142 983092983090

FIGURE LEGENDS





















2 GWG 115 to 155 kg)


2

GWG 50 to 90 kg)

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

42

983120983137983143983141 983092983090 983151983142 983092983090







8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Conway et al38

1999

To explore the


appropriateness of

weight gain during

pregnancy using AIM





England


BMI 22 (24)

kgm2

Age 312 (46)

years

Parity of 1 n =

28 2 n = 4

Unrestrainedn = 30

BMI 207 (196)

kgm2

Age 306 (36)

years

Parity of 1 n =

26 2 n = 4

7-day weighed


weeks

gestation

Caucasian women






outcomes

Providing p


appropriate

gains may b

beneficial

cessation o

during preg

associated w

weight gain

be prudent

accompany

advice abou

smoking dupregnancy

advice abou

and weight

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

De Vriese et

al

31

2001

To determine the


food frequency

questionnaire (FFQ)


diet by comparing



with the 7d food

record in pregnant


the 1st and 3

rd

trimesters

Belgium

developed

n = 26

BMI 22 (176-

293) kgm2

Age 30 (25-37)

years

All pregnant

women were

nulliparous

7-day


during the 1st

(median 15

weeks) and 3rd

(median 35

weeks)

trimesters A

FFQ

containing 180

of the most

common fat-

containingfoods was

conducted at

the same

timepoints

Data recorded

was based on

the EFR

First pregnancy


Hg not diabetic no

proteinuria and not



The FFQ in


compositio

of Belgian

adequate m

reasonably

subjects acc

their dietary

intake

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Fung et al39

1997



zinc from a


altered in well-

nourished women


conception through

lactation and





USA developed

n = 13

BMI 223 (29)

kgm2

Age 30 (29)

years

Parity of 1 n =

10 2 n = 3

3-day weighed

food recordnon-

consecutive

days two

weekdays and

one weekend

at 8-10 weeks

24-26 weeks

and 34-36

weeks

gestation

Aged 22-40yrs body


non-diabetic non-


alcohol use and no


gynecological

complications

Well-nouri


zinc during

pregnancy

increasing

and by a 30

increase in

absorption

not signific

increase in

zinc was du

to an increa


early in the

period pres

an adaptatio

lactation pr

These data

that mechan

regulating z

homeostasi

between pr

and lactatio

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Hronek et al40

2013



Czech pregnant


with recommended

daily allowances

(RDA)

Czechoslovakia

developed

Participants

were randomly

recruited from

both rural and

city regions

n = 152

BMI 211 (36)

kgm2

Age 289 (36)

years

7-day food


days using

scales and

household

measures at 0-

20 weeks 21-

29 weeks 30-

36 weeks and

37-39 weeks

gestation

Nonusers of chronic




le2 Subjects were

euthyroid

normoglyceamic and

not anemic

Lower intak


relative to t

correspond

during preg

Evaluated D

correspond

body size v

Modificatio

intake or al

supplement

recommend


iodine and

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Jansson et al41

2008



between early

pregnancy BMI

maternal dietary

intake and birth

weight

Sweden

developing

n = 49

BMI 255 (69)

kgm2

Age 30 (45)

years

Diet history


over a 24hr

period

collected by a

registered

dietitian at 8-

12 weeks and

32-35 weeks

gestation

Inclusion criteria


old

Exclusion criteria

smoking


reproduction

concurrent disease


or diabetes

development of

pregnancy


preeclampsia or

intrauterine growth

restriction

High first t


trimester IG

were correl

increased b

weight We

that low ser

concentrati

IGFBP-1 re

link betwee

BMI and in

fetal growth


IGF-1 regu

placental nu

transport

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Khoigani et

al

35

2012

To assess the



and micro nutrients




and reproductive

characteristics and


pregnant women

Iran developing

n = 620 (t1 n =

584 t2 n = 510)

BMI 235 (39)

kgm2

Age 256 (44)

years

Parity 158

(076)

48-hour


11-15 weeks

26 weeks and

34-37 weeks

gestation

Interviewers

were trained

Pregnant women who



delivery low birth

weight and factors

which may affect

pregnancy outcomes


addiction digestive


hemoglobinopathies

eating disorders


malignancy

Mean value


subjects wh

experienced

preeclamps

pregnancy

than in othe

women Int

manganese

C vitamin

and carboh

during the t


among preg

women wh

developed

preeclamps

significant

association

other micro

macro nutri

preeclamps

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Kopp-Hoolihan

et al

42

1999

To assess how well-




that predict an


response

USA developed

n = 10

BMI 231 (21)

kgm2

Age 291 (5)

years

3 day weighed


before

pregnancy and

at 8-10 24-26

34-36 weeks

gestation and

4-6 weeks

postpartum

Healthy non-smoking

women

Well-nouri

women useways to me

energy dem

pregnancy

reduction in

induced

thermogene

increased e

intake dep

less fat mas

predicted

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Kubota et al33

2013

To investigate the


intake maternal


growth during

pregnancy

Japan


BMI 175 (01)

kgm2

Age 297 (52)

years

Normaln = 94

BMI 21 (18)

kgm2

Age 308 (51)


Age 286 (36)

years

BMI 334 (65)

kgm2

Digital images


meals on 3

consecutive

days at 14-16

25-27 and 32-

34 weeks

gestation a

dietitian

reviewed

photos and

recorded

intakevalidation of

method not

reported

Singleton pregnant


had suffered from

obstetrical


premature delivery





Dietary inta


not correlat

fetal growth

Japanese na

recommend

advising ex

intake

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Lof et al23

2009

Investigate whether


weight gain are

associated with

estradiol and


plasma during

pregnancy

Sweden

developed

n = 226

BMI 229 (3)

kgm2

Age 32 (4) years

3 day weight


days including

one weekend

at 12 25 and

33 weeks

gestation

Calculations

conducted by

a nutritionist

Women with multi-





dietary intake were

excluded

No associat


dietary fat i

(total or sub

and plasma

levels Prog

levels corre

weight gain

pregnancy

Martinez et

al32

1994

To determine how



nation Mexico

Mexico

developing

n = 36

BMI 235 (26)

kgm2

Age 31 (54)

years

Diet history

collected by

trainedinterviewers

twice per

month and

reported as

mean first and

third trimester

values

Women with an 18




initial recruitment



pregnant

In this sam

women the


weight gain

pregnancy

was similar

women in U

States Low

maternal B

predicted sm

birth weigh

through at l

months of l

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Piers et al36

1995



pregnancy and


a group of well-

nourished pregnant


women at 12 24 and


12 and 24 wk

postpartum with a

non-pregnant non-


India

developing

n = 18

BMI 217 (24)

kgm2

Age 296 (52)

years

5 day


household

measures of

known volume

at 12 24 and

34 weeks

gestation and

12 and 24

weeks post-

partum

participants


measure by a

dietitian who

also checked

all records




morning sickness

before the initial

metabolic

measurement at 12

weeks gestation

BMR is sig


with non-pr

non-lactatin

and remain

even when

differences

weight are

for Well-n

Indian wom

weight and

similar to th


Birth weigh

infants born

to be lower

cost of preg

estimated to

MJ close t

MJ estimat

FAOIWHO

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Tabrizi et al24

2011

To assess the


mineral intake of

pregnant women and


neonates

Iran developing

n = 450

BMI 239 (38)

kgm2

Age 261 (58)

years

24 hour Recall


1st 2

nd and 3

rd

trimesters

Qualification

training of

interviewer

not reported

Women of 16 to 40


health care centers

during the three


Maternal en


with higher

serum calci

and zinc in

birth weigh

neonates


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Guelinckx

et al

43

2010

Study which


improve dietary

habits according to

the National Diet

Recommendations

increase physical

activity level in

obese pregnant

women and

control gestational

weight gain

Belgium

developedrandomly

assigned using

block

randomization

Control(routine)

n =43

BMI 335 (39)

kgm2

Age 294 (44)

yrs


and PA

brochure)

n = 37

BMI 334 (31)

kgm2

Age 287 (4) yrs

Parity of 1 n = 15

Active (brochure

+ group dietary

counselling)

n = 42BMI 341 (45)

kgm2

Age 28 (36) yrs

Parity of 1 n = 20

7-day food


weighed and

household

measures

during each

trimester of

pregnancy

Records were

checked by a

nutritionist






diabetes multiple

pregnancy premature

labor (lt37 wks

gestation) primary


advice in case of

metabolic disorder


conditions and





brochure and group

discussions

A lifestyle interv


combined with

individual advice

improve dietary h

throughout pregn

in obese women

in the absence of

medical or obstet

complications

maintaining or

increasing PA du


decrease in GWG

individually desig

caloric intake res

based on energy

expenditure data

be included

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Korpi-

Hyovalti etal44

2012

To evaluate the


quality of diet

weight gain and

birth weight in

women at high risk

of gestational

diabetes mellitus

Finland


group 1 or 2

using computed

randomization


information on

diet and PA)

n = 27

BMI 255 (34)

kgm2

Lifestyle


nutrition advice)

n = 27

BMI 273 (6)

kgm2

4 day weighed


days including

one weekend

completed at

8-12 26-28

and 36-40

weeks

gestation

Records

checked by a

nutritionist

A three-factor

eating

questionnaire

was also used

at the 1st and

3rd

trimester

Women with one or





48-55 mmoll and the

2h oral glucose


glucose lt78 mmoll

were recruited


GDM at 8-12 wks


There were no cl


however

polyunsaturated f

increase in the lif

intervention grou

Intensive weight

education led to a

somewhat lower

gain during pregn

and higher birth w

of the infants in


macrosomia whe

compared to the c

follow up group

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Moses et al45

2014

To determine


index (LGI) dietary

advice at

the first antenatal

visit would result

in a lower fetal

birth weight

birth percentile

and ponderal index

(PI) than providing

healthy eating

(HE) advice

Australia

developedrandomly

assigned using

computer-

generated

random numbers

1 or 2

Healthy Eating

(counselled to

follow a healthy

diet based on the

AGHE4

) n = 280

BMI 247 (5)

kgm2

Age 299 (5) yrs

Low Glycemic

Index

(individualized

nutrition advice

on a LGI diet)

n = 296

BMI 243 (52)

kgm2 Age 299 (52)

yrs

3 day


household

measures at 16

and 36 weeks

gestation

records

reviewed by a

dietitian



least 18 years old

ability to read and

understand English


comply with visit

schedules Subjects






compromise their




body weight

A low intensity d


in pregnancy did

result in significa

differences in bir

weight fetal perc

of PI

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Wolff et

al

46

2008

To determine


consultations

restricts weight

gain in obese

women and

whether this

restriction impacts

on pregnancy-

induced changes in

glucose

metabolism

Denmark


group 1 or 2

using computed

randomization

Control (general

information on

diet and PA)

n = 27

BMI 255 (34)

kgm2


x 1 hour

consultations)

n = 27

BMI 273 (6)

kgm2

Age 28 (4) years

7 day weighed


plusmn 3 wks) 27

and 36 weeks

gestation



recruited Exclusion

criteria included


or gt45 year old


medical conditions

which impact fetal

growth

Restriction of


achievable and re

the deterioration

glucose metaboli

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

41

983120983137983143983141 983092983089 983151983142 983092983090

FIGURE LEGENDS





















2 GWG 115 to 155 kg)


2

GWG 50 to 90 kg)

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

42

983120983137983143983141 983092983090 983151983142 983092983090







8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

De Vriese et

al

31

2001

To determine the


food frequency

questionnaire (FFQ)


diet by comparing



with the 7d food

record in pregnant


the 1st and 3

rd

trimesters

Belgium

developed

n = 26

BMI 22 (176-

293) kgm2

Age 30 (25-37)

years

All pregnant

women were

nulliparous

7-day


during the 1st

(median 15

weeks) and 3rd

(median 35

weeks)

trimesters A

FFQ

containing 180

of the most

common fat-

containingfoods was

conducted at

the same

timepoints

Data recorded

was based on

the EFR

First pregnancy


Hg not diabetic no

proteinuria and not



The FFQ in


compositio

of Belgian

adequate m

reasonably

subjects acc

their dietary

intake

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Fung et al39

1997



zinc from a


altered in well-

nourished women


conception through

lactation and





USA developed

n = 13

BMI 223 (29)

kgm2

Age 30 (29)

years

Parity of 1 n =

10 2 n = 3

3-day weighed

food recordnon-

consecutive

days two

weekdays and

one weekend

at 8-10 weeks

24-26 weeks

and 34-36

weeks

gestation

Aged 22-40yrs body


non-diabetic non-


alcohol use and no


gynecological

complications

Well-nouri


zinc during

pregnancy

increasing

and by a 30

increase in

absorption

not signific

increase in

zinc was du

to an increa


early in the

period pres

an adaptatio

lactation pr

These data

that mechan

regulating z

homeostasi

between pr

and lactatio

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Hronek et al40

2013



Czech pregnant


with recommended

daily allowances

(RDA)

Czechoslovakia

developed

Participants

were randomly

recruited from

both rural and

city regions

n = 152

BMI 211 (36)

kgm2

Age 289 (36)

years

7-day food


days using

scales and

household

measures at 0-

20 weeks 21-

29 weeks 30-

36 weeks and

37-39 weeks

gestation

Nonusers of chronic




le2 Subjects were

euthyroid

normoglyceamic and

not anemic

Lower intak


relative to t

correspond

during preg

Evaluated D

correspond

body size v

Modificatio

intake or al

supplement

recommend


iodine and

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Jansson et al41

2008



between early

pregnancy BMI

maternal dietary

intake and birth

weight

Sweden

developing

n = 49

BMI 255 (69)

kgm2

Age 30 (45)

years

Diet history


over a 24hr

period

collected by a

registered

dietitian at 8-

12 weeks and

32-35 weeks

gestation

Inclusion criteria


old

Exclusion criteria

smoking


reproduction

concurrent disease


or diabetes

development of

pregnancy


preeclampsia or

intrauterine growth

restriction

High first t


trimester IG

were correl

increased b

weight We

that low ser

concentrati

IGFBP-1 re

link betwee

BMI and in

fetal growth


IGF-1 regu

placental nu

transport

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Khoigani et

al

35

2012

To assess the



and micro nutrients




and reproductive

characteristics and


pregnant women

Iran developing

n = 620 (t1 n =

584 t2 n = 510)

BMI 235 (39)

kgm2

Age 256 (44)

years

Parity 158

(076)

48-hour


11-15 weeks

26 weeks and

34-37 weeks

gestation

Interviewers

were trained

Pregnant women who



delivery low birth

weight and factors

which may affect

pregnancy outcomes


addiction digestive


hemoglobinopathies

eating disorders


malignancy

Mean value


subjects wh

experienced

preeclamps

pregnancy

than in othe

women Int

manganese

C vitamin

and carboh

during the t


among preg

women wh

developed

preeclamps

significant

association

other micro

macro nutri

preeclamps

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Kopp-Hoolihan

et al

42

1999

To assess how well-




that predict an


response

USA developed

n = 10

BMI 231 (21)

kgm2

Age 291 (5)

years

3 day weighed


before

pregnancy and

at 8-10 24-26

34-36 weeks

gestation and

4-6 weeks

postpartum

Healthy non-smoking

women

Well-nouri

women useways to me

energy dem

pregnancy

reduction in

induced

thermogene

increased e

intake dep

less fat mas

predicted

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Kubota et al33

2013

To investigate the


intake maternal


growth during

pregnancy

Japan


BMI 175 (01)

kgm2

Age 297 (52)

years

Normaln = 94

BMI 21 (18)

kgm2

Age 308 (51)


Age 286 (36)

years

BMI 334 (65)

kgm2

Digital images


meals on 3

consecutive

days at 14-16

25-27 and 32-

34 weeks

gestation a

dietitian

reviewed

photos and

recorded

intakevalidation of

method not

reported

Singleton pregnant


had suffered from

obstetrical


premature delivery





Dietary inta


not correlat

fetal growth

Japanese na

recommend

advising ex

intake

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Lof et al23

2009

Investigate whether


weight gain are

associated with

estradiol and


plasma during

pregnancy

Sweden

developed

n = 226

BMI 229 (3)

kgm2

Age 32 (4) years

3 day weight


days including

one weekend

at 12 25 and

33 weeks

gestation

Calculations

conducted by

a nutritionist

Women with multi-





dietary intake were

excluded

No associat


dietary fat i

(total or sub

and plasma

levels Prog

levels corre

weight gain

pregnancy

Martinez et

al32

1994

To determine how



nation Mexico

Mexico

developing

n = 36

BMI 235 (26)

kgm2

Age 31 (54)

years

Diet history

collected by

trainedinterviewers

twice per

month and

reported as

mean first and

third trimester

values

Women with an 18




initial recruitment



pregnant

In this sam

women the


weight gain

pregnancy

was similar

women in U

States Low

maternal B

predicted sm

birth weigh

through at l

months of l

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Piers et al36

1995



pregnancy and


a group of well-

nourished pregnant


women at 12 24 and


12 and 24 wk

postpartum with a

non-pregnant non-


India

developing

n = 18

BMI 217 (24)

kgm2

Age 296 (52)

years

5 day


household

measures of

known volume

at 12 24 and

34 weeks

gestation and

12 and 24

weeks post-

partum

participants


measure by a

dietitian who

also checked

all records




morning sickness

before the initial

metabolic

measurement at 12

weeks gestation

BMR is sig


with non-pr

non-lactatin

and remain

even when

differences

weight are

for Well-n

Indian wom

weight and

similar to th


Birth weigh

infants born

to be lower

cost of preg

estimated to

MJ close t

MJ estimat

FAOIWHO

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Tabrizi et al24

2011

To assess the


mineral intake of

pregnant women and


neonates

Iran developing

n = 450

BMI 239 (38)

kgm2

Age 261 (58)

years

24 hour Recall


1st 2

nd and 3

rd

trimesters

Qualification

training of

interviewer

not reported

Women of 16 to 40


health care centers

during the three


Maternal en


with higher

serum calci

and zinc in

birth weigh

neonates


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Guelinckx

et al

43

2010

Study which


improve dietary

habits according to

the National Diet

Recommendations

increase physical

activity level in

obese pregnant

women and

control gestational

weight gain

Belgium

developedrandomly

assigned using

block

randomization

Control(routine)

n =43

BMI 335 (39)

kgm2

Age 294 (44)

yrs


and PA

brochure)

n = 37

BMI 334 (31)

kgm2

Age 287 (4) yrs

Parity of 1 n = 15

Active (brochure

+ group dietary

counselling)

n = 42BMI 341 (45)

kgm2

Age 28 (36) yrs

Parity of 1 n = 20

7-day food


weighed and

household

measures

during each

trimester of

pregnancy

Records were

checked by a

nutritionist






diabetes multiple

pregnancy premature

labor (lt37 wks

gestation) primary


advice in case of

metabolic disorder


conditions and





brochure and group

discussions

A lifestyle interv


combined with

individual advice

improve dietary h

throughout pregn

in obese women

in the absence of

medical or obstet

complications

maintaining or

increasing PA du


decrease in GWG

individually desig

caloric intake res

based on energy

expenditure data

be included

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Korpi-

Hyovalti etal44

2012

To evaluate the


quality of diet

weight gain and

birth weight in

women at high risk

of gestational

diabetes mellitus

Finland


group 1 or 2

using computed

randomization


information on

diet and PA)

n = 27

BMI 255 (34)

kgm2

Lifestyle


nutrition advice)

n = 27

BMI 273 (6)

kgm2

4 day weighed


days including

one weekend

completed at

8-12 26-28

and 36-40

weeks

gestation

Records

checked by a

nutritionist

A three-factor

eating

questionnaire

was also used

at the 1st and

3rd

trimester

Women with one or





48-55 mmoll and the

2h oral glucose


glucose lt78 mmoll

were recruited


GDM at 8-12 wks


There were no cl


however

polyunsaturated f

increase in the lif

intervention grou

Intensive weight

education led to a

somewhat lower

gain during pregn

and higher birth w

of the infants in


macrosomia whe

compared to the c

follow up group

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Moses et al45

2014

To determine


index (LGI) dietary

advice at

the first antenatal

visit would result

in a lower fetal

birth weight

birth percentile

and ponderal index

(PI) than providing

healthy eating

(HE) advice

Australia

developedrandomly

assigned using

computer-

generated

random numbers

1 or 2

Healthy Eating

(counselled to

follow a healthy

diet based on the

AGHE4

) n = 280

BMI 247 (5)

kgm2

Age 299 (5) yrs

Low Glycemic

Index

(individualized

nutrition advice

on a LGI diet)

n = 296

BMI 243 (52)

kgm2 Age 299 (52)

yrs

3 day


household

measures at 16

and 36 weeks

gestation

records

reviewed by a

dietitian



least 18 years old

ability to read and

understand English


comply with visit

schedules Subjects






compromise their




body weight

A low intensity d


in pregnancy did

result in significa

differences in bir

weight fetal perc

of PI

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Wolff et

al

46

2008

To determine


consultations

restricts weight

gain in obese

women and

whether this

restriction impacts

on pregnancy-

induced changes in

glucose

metabolism

Denmark


group 1 or 2

using computed

randomization

Control (general

information on

diet and PA)

n = 27

BMI 255 (34)

kgm2


x 1 hour

consultations)

n = 27

BMI 273 (6)

kgm2

Age 28 (4) years

7 day weighed


plusmn 3 wks) 27

and 36 weeks

gestation



recruited Exclusion

criteria included


or gt45 year old


medical conditions

which impact fetal

growth

Restriction of


achievable and re

the deterioration

glucose metaboli

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

41

983120983137983143983141 983092983089 983151983142 983092983090

FIGURE LEGENDS





















2 GWG 115 to 155 kg)


2

GWG 50 to 90 kg)

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

42

983120983137983143983141 983092983090 983151983142 983092983090







8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Fung et al39

1997



zinc from a


altered in well-

nourished women


conception through

lactation and





USA developed

n = 13

BMI 223 (29)

kgm2

Age 30 (29)

years

Parity of 1 n =

10 2 n = 3

3-day weighed

food recordnon-

consecutive

days two

weekdays and

one weekend

at 8-10 weeks

24-26 weeks

and 34-36

weeks

gestation

Aged 22-40yrs body


non-diabetic non-


alcohol use and no


gynecological

complications

Well-nouri


zinc during

pregnancy

increasing

and by a 30

increase in

absorption

not signific

increase in

zinc was du

to an increa


early in the

period pres

an adaptatio

lactation pr

These data

that mechan

regulating z

homeostasi

between pr

and lactatio

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Hronek et al40

2013



Czech pregnant


with recommended

daily allowances

(RDA)

Czechoslovakia

developed

Participants

were randomly

recruited from

both rural and

city regions

n = 152

BMI 211 (36)

kgm2

Age 289 (36)

years

7-day food


days using

scales and

household

measures at 0-

20 weeks 21-

29 weeks 30-

36 weeks and

37-39 weeks

gestation

Nonusers of chronic




le2 Subjects were

euthyroid

normoglyceamic and

not anemic

Lower intak


relative to t

correspond

during preg

Evaluated D

correspond

body size v

Modificatio

intake or al

supplement

recommend


iodine and

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Jansson et al41

2008



between early

pregnancy BMI

maternal dietary

intake and birth

weight

Sweden

developing

n = 49

BMI 255 (69)

kgm2

Age 30 (45)

years

Diet history


over a 24hr

period

collected by a

registered

dietitian at 8-

12 weeks and

32-35 weeks

gestation

Inclusion criteria


old

Exclusion criteria

smoking


reproduction

concurrent disease


or diabetes

development of

pregnancy


preeclampsia or

intrauterine growth

restriction

High first t


trimester IG

were correl

increased b

weight We

that low ser

concentrati

IGFBP-1 re

link betwee

BMI and in

fetal growth


IGF-1 regu

placental nu

transport

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Khoigani et

al

35

2012

To assess the



and micro nutrients




and reproductive

characteristics and


pregnant women

Iran developing

n = 620 (t1 n =

584 t2 n = 510)

BMI 235 (39)

kgm2

Age 256 (44)

years

Parity 158

(076)

48-hour


11-15 weeks

26 weeks and

34-37 weeks

gestation

Interviewers

were trained

Pregnant women who



delivery low birth

weight and factors

which may affect

pregnancy outcomes


addiction digestive


hemoglobinopathies

eating disorders


malignancy

Mean value


subjects wh

experienced

preeclamps

pregnancy

than in othe

women Int

manganese

C vitamin

and carboh

during the t


among preg

women wh

developed

preeclamps

significant

association

other micro

macro nutri

preeclamps

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Kopp-Hoolihan

et al

42

1999

To assess how well-




that predict an


response

USA developed

n = 10

BMI 231 (21)

kgm2

Age 291 (5)

years

3 day weighed


before

pregnancy and

at 8-10 24-26

34-36 weeks

gestation and

4-6 weeks

postpartum

Healthy non-smoking

women

Well-nouri

women useways to me

energy dem

pregnancy

reduction in

induced

thermogene

increased e

intake dep

less fat mas

predicted

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Kubota et al33

2013

To investigate the


intake maternal


growth during

pregnancy

Japan


BMI 175 (01)

kgm2

Age 297 (52)

years

Normaln = 94

BMI 21 (18)

kgm2

Age 308 (51)


Age 286 (36)

years

BMI 334 (65)

kgm2

Digital images


meals on 3

consecutive

days at 14-16

25-27 and 32-

34 weeks

gestation a

dietitian

reviewed

photos and

recorded

intakevalidation of

method not

reported

Singleton pregnant


had suffered from

obstetrical


premature delivery





Dietary inta


not correlat

fetal growth

Japanese na

recommend

advising ex

intake

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Lof et al23

2009

Investigate whether


weight gain are

associated with

estradiol and


plasma during

pregnancy

Sweden

developed

n = 226

BMI 229 (3)

kgm2

Age 32 (4) years

3 day weight


days including

one weekend

at 12 25 and

33 weeks

gestation

Calculations

conducted by

a nutritionist

Women with multi-





dietary intake were

excluded

No associat


dietary fat i

(total or sub

and plasma

levels Prog

levels corre

weight gain

pregnancy

Martinez et

al32

1994

To determine how



nation Mexico

Mexico

developing

n = 36

BMI 235 (26)

kgm2

Age 31 (54)

years

Diet history

collected by

trainedinterviewers

twice per

month and

reported as

mean first and

third trimester

values

Women with an 18




initial recruitment



pregnant

In this sam

women the


weight gain

pregnancy

was similar

women in U

States Low

maternal B

predicted sm

birth weigh

through at l

months of l

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Piers et al36

1995



pregnancy and


a group of well-

nourished pregnant


women at 12 24 and


12 and 24 wk

postpartum with a

non-pregnant non-


India

developing

n = 18

BMI 217 (24)

kgm2

Age 296 (52)

years

5 day


household

measures of

known volume

at 12 24 and

34 weeks

gestation and

12 and 24

weeks post-

partum

participants


measure by a

dietitian who

also checked

all records




morning sickness

before the initial

metabolic

measurement at 12

weeks gestation

BMR is sig


with non-pr

non-lactatin

and remain

even when

differences

weight are

for Well-n

Indian wom

weight and

similar to th


Birth weigh

infants born

to be lower

cost of preg

estimated to

MJ close t

MJ estimat

FAOIWHO

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Tabrizi et al24

2011

To assess the


mineral intake of

pregnant women and


neonates

Iran developing

n = 450

BMI 239 (38)

kgm2

Age 261 (58)

years

24 hour Recall


1st 2

nd and 3

rd

trimesters

Qualification

training of

interviewer

not reported

Women of 16 to 40


health care centers

during the three


Maternal en


with higher

serum calci

and zinc in

birth weigh

neonates


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Guelinckx

et al

43

2010

Study which


improve dietary

habits according to

the National Diet

Recommendations

increase physical

activity level in

obese pregnant

women and

control gestational

weight gain

Belgium

developedrandomly

assigned using

block

randomization

Control(routine)

n =43

BMI 335 (39)

kgm2

Age 294 (44)

yrs


and PA

brochure)

n = 37

BMI 334 (31)

kgm2

Age 287 (4) yrs

Parity of 1 n = 15

Active (brochure

+ group dietary

counselling)

n = 42BMI 341 (45)

kgm2

Age 28 (36) yrs

Parity of 1 n = 20

7-day food


weighed and

household

measures

during each

trimester of

pregnancy

Records were

checked by a

nutritionist






diabetes multiple

pregnancy premature

labor (lt37 wks

gestation) primary


advice in case of

metabolic disorder


conditions and





brochure and group

discussions

A lifestyle interv


combined with

individual advice

improve dietary h

throughout pregn

in obese women

in the absence of

medical or obstet

complications

maintaining or

increasing PA du


decrease in GWG

individually desig

caloric intake res

based on energy

expenditure data

be included

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Korpi-

Hyovalti etal44

2012

To evaluate the


quality of diet

weight gain and

birth weight in

women at high risk

of gestational

diabetes mellitus

Finland


group 1 or 2

using computed

randomization


information on

diet and PA)

n = 27

BMI 255 (34)

kgm2

Lifestyle


nutrition advice)

n = 27

BMI 273 (6)

kgm2

4 day weighed


days including

one weekend

completed at

8-12 26-28

and 36-40

weeks

gestation

Records

checked by a

nutritionist

A three-factor

eating

questionnaire

was also used

at the 1st and

3rd

trimester

Women with one or





48-55 mmoll and the

2h oral glucose


glucose lt78 mmoll

were recruited


GDM at 8-12 wks


There were no cl


however

polyunsaturated f

increase in the lif

intervention grou

Intensive weight

education led to a

somewhat lower

gain during pregn

and higher birth w

of the infants in


macrosomia whe

compared to the c

follow up group

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Moses et al45

2014

To determine


index (LGI) dietary

advice at

the first antenatal

visit would result

in a lower fetal

birth weight

birth percentile

and ponderal index

(PI) than providing

healthy eating

(HE) advice

Australia

developedrandomly

assigned using

computer-

generated

random numbers

1 or 2

Healthy Eating

(counselled to

follow a healthy

diet based on the

AGHE4

) n = 280

BMI 247 (5)

kgm2

Age 299 (5) yrs

Low Glycemic

Index

(individualized

nutrition advice

on a LGI diet)

n = 296

BMI 243 (52)

kgm2 Age 299 (52)

yrs

3 day


household

measures at 16

and 36 weeks

gestation

records

reviewed by a

dietitian



least 18 years old

ability to read and

understand English


comply with visit

schedules Subjects






compromise their




body weight

A low intensity d


in pregnancy did

result in significa

differences in bir

weight fetal perc

of PI

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Wolff et

al

46

2008

To determine


consultations

restricts weight

gain in obese

women and

whether this

restriction impacts

on pregnancy-

induced changes in

glucose

metabolism

Denmark


group 1 or 2

using computed

randomization

Control (general

information on

diet and PA)

n = 27

BMI 255 (34)

kgm2


x 1 hour

consultations)

n = 27

BMI 273 (6)

kgm2

Age 28 (4) years

7 day weighed


plusmn 3 wks) 27

and 36 weeks

gestation



recruited Exclusion

criteria included


or gt45 year old


medical conditions

which impact fetal

growth

Restriction of


achievable and re

the deterioration

glucose metaboli

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

41

983120983137983143983141 983092983089 983151983142 983092983090

FIGURE LEGENDS





















2 GWG 115 to 155 kg)


2

GWG 50 to 90 kg)

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

42

983120983137983143983141 983092983090 983151983142 983092983090







8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Hronek et al40

2013



Czech pregnant


with recommended

daily allowances

(RDA)

Czechoslovakia

developed

Participants

were randomly

recruited from

both rural and

city regions

n = 152

BMI 211 (36)

kgm2

Age 289 (36)

years

7-day food


days using

scales and

household

measures at 0-

20 weeks 21-

29 weeks 30-

36 weeks and

37-39 weeks

gestation

Nonusers of chronic




le2 Subjects were

euthyroid

normoglyceamic and

not anemic

Lower intak


relative to t

correspond

during preg

Evaluated D

correspond

body size v

Modificatio

intake or al

supplement

recommend


iodine and

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Jansson et al41

2008



between early

pregnancy BMI

maternal dietary

intake and birth

weight

Sweden

developing

n = 49

BMI 255 (69)

kgm2

Age 30 (45)

years

Diet history


over a 24hr

period

collected by a

registered

dietitian at 8-

12 weeks and

32-35 weeks

gestation

Inclusion criteria


old

Exclusion criteria

smoking


reproduction

concurrent disease


or diabetes

development of

pregnancy


preeclampsia or

intrauterine growth

restriction

High first t


trimester IG

were correl

increased b

weight We

that low ser

concentrati

IGFBP-1 re

link betwee

BMI and in

fetal growth


IGF-1 regu

placental nu

transport

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Khoigani et

al

35

2012

To assess the



and micro nutrients




and reproductive

characteristics and


pregnant women

Iran developing

n = 620 (t1 n =

584 t2 n = 510)

BMI 235 (39)

kgm2

Age 256 (44)

years

Parity 158

(076)

48-hour


11-15 weeks

26 weeks and

34-37 weeks

gestation

Interviewers

were trained

Pregnant women who



delivery low birth

weight and factors

which may affect

pregnancy outcomes


addiction digestive


hemoglobinopathies

eating disorders


malignancy

Mean value


subjects wh

experienced

preeclamps

pregnancy

than in othe

women Int

manganese

C vitamin

and carboh

during the t


among preg

women wh

developed

preeclamps

significant

association

other micro

macro nutri

preeclamps

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Kopp-Hoolihan

et al

42

1999

To assess how well-




that predict an


response

USA developed

n = 10

BMI 231 (21)

kgm2

Age 291 (5)

years

3 day weighed


before

pregnancy and

at 8-10 24-26

34-36 weeks

gestation and

4-6 weeks

postpartum

Healthy non-smoking

women

Well-nouri

women useways to me

energy dem

pregnancy

reduction in

induced

thermogene

increased e

intake dep

less fat mas

predicted

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Kubota et al33

2013

To investigate the


intake maternal


growth during

pregnancy

Japan


BMI 175 (01)

kgm2

Age 297 (52)

years

Normaln = 94

BMI 21 (18)

kgm2

Age 308 (51)


Age 286 (36)

years

BMI 334 (65)

kgm2

Digital images


meals on 3

consecutive

days at 14-16

25-27 and 32-

34 weeks

gestation a

dietitian

reviewed

photos and

recorded

intakevalidation of

method not

reported

Singleton pregnant


had suffered from

obstetrical


premature delivery





Dietary inta


not correlat

fetal growth

Japanese na

recommend

advising ex

intake

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Lof et al23

2009

Investigate whether


weight gain are

associated with

estradiol and


plasma during

pregnancy

Sweden

developed

n = 226

BMI 229 (3)

kgm2

Age 32 (4) years

3 day weight


days including

one weekend

at 12 25 and

33 weeks

gestation

Calculations

conducted by

a nutritionist

Women with multi-





dietary intake were

excluded

No associat


dietary fat i

(total or sub

and plasma

levels Prog

levels corre

weight gain

pregnancy

Martinez et

al32

1994

To determine how



nation Mexico

Mexico

developing

n = 36

BMI 235 (26)

kgm2

Age 31 (54)

years

Diet history

collected by

trainedinterviewers

twice per

month and

reported as

mean first and

third trimester

values

Women with an 18




initial recruitment



pregnant

In this sam

women the


weight gain

pregnancy

was similar

women in U

States Low

maternal B

predicted sm

birth weigh

through at l

months of l

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Piers et al36

1995



pregnancy and


a group of well-

nourished pregnant


women at 12 24 and


12 and 24 wk

postpartum with a

non-pregnant non-


India

developing

n = 18

BMI 217 (24)

kgm2

Age 296 (52)

years

5 day


household

measures of

known volume

at 12 24 and

34 weeks

gestation and

12 and 24

weeks post-

partum

participants


measure by a

dietitian who

also checked

all records




morning sickness

before the initial

metabolic

measurement at 12

weeks gestation

BMR is sig


with non-pr

non-lactatin

and remain

even when

differences

weight are

for Well-n

Indian wom

weight and

similar to th


Birth weigh

infants born

to be lower

cost of preg

estimated to

MJ close t

MJ estimat

FAOIWHO

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Tabrizi et al24

2011

To assess the


mineral intake of

pregnant women and


neonates

Iran developing

n = 450

BMI 239 (38)

kgm2

Age 261 (58)

years

24 hour Recall


1st 2

nd and 3

rd

trimesters

Qualification

training of

interviewer

not reported

Women of 16 to 40


health care centers

during the three


Maternal en


with higher

serum calci

and zinc in

birth weigh

neonates


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Guelinckx

et al

43

2010

Study which


improve dietary

habits according to

the National Diet

Recommendations

increase physical

activity level in

obese pregnant

women and

control gestational

weight gain

Belgium

developedrandomly

assigned using

block

randomization

Control(routine)

n =43

BMI 335 (39)

kgm2

Age 294 (44)

yrs


and PA

brochure)

n = 37

BMI 334 (31)

kgm2

Age 287 (4) yrs

Parity of 1 n = 15

Active (brochure

+ group dietary

counselling)

n = 42BMI 341 (45)

kgm2

Age 28 (36) yrs

Parity of 1 n = 20

7-day food


weighed and

household

measures

during each

trimester of

pregnancy

Records were

checked by a

nutritionist






diabetes multiple

pregnancy premature

labor (lt37 wks

gestation) primary


advice in case of

metabolic disorder


conditions and





brochure and group

discussions

A lifestyle interv


combined with

individual advice

improve dietary h

throughout pregn

in obese women

in the absence of

medical or obstet

complications

maintaining or

increasing PA du


decrease in GWG

individually desig

caloric intake res

based on energy

expenditure data

be included

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Korpi-

Hyovalti etal44

2012

To evaluate the


quality of diet

weight gain and

birth weight in

women at high risk

of gestational

diabetes mellitus

Finland


group 1 or 2

using computed

randomization


information on

diet and PA)

n = 27

BMI 255 (34)

kgm2

Lifestyle


nutrition advice)

n = 27

BMI 273 (6)

kgm2

4 day weighed


days including

one weekend

completed at

8-12 26-28

and 36-40

weeks

gestation

Records

checked by a

nutritionist

A three-factor

eating

questionnaire

was also used

at the 1st and

3rd

trimester

Women with one or





48-55 mmoll and the

2h oral glucose


glucose lt78 mmoll

were recruited


GDM at 8-12 wks


There were no cl


however

polyunsaturated f

increase in the lif

intervention grou

Intensive weight

education led to a

somewhat lower

gain during pregn

and higher birth w

of the infants in


macrosomia whe

compared to the c

follow up group

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Moses et al45

2014

To determine


index (LGI) dietary

advice at

the first antenatal

visit would result

in a lower fetal

birth weight

birth percentile

and ponderal index

(PI) than providing

healthy eating

(HE) advice

Australia

developedrandomly

assigned using

computer-

generated

random numbers

1 or 2

Healthy Eating

(counselled to

follow a healthy

diet based on the

AGHE4

) n = 280

BMI 247 (5)

kgm2

Age 299 (5) yrs

Low Glycemic

Index

(individualized

nutrition advice

on a LGI diet)

n = 296

BMI 243 (52)

kgm2 Age 299 (52)

yrs

3 day


household

measures at 16

and 36 weeks

gestation

records

reviewed by a

dietitian



least 18 years old

ability to read and

understand English


comply with visit

schedules Subjects






compromise their




body weight

A low intensity d


in pregnancy did

result in significa

differences in bir

weight fetal perc

of PI

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Wolff et

al

46

2008

To determine


consultations

restricts weight

gain in obese

women and

whether this

restriction impacts

on pregnancy-

induced changes in

glucose

metabolism

Denmark


group 1 or 2

using computed

randomization

Control (general

information on

diet and PA)

n = 27

BMI 255 (34)

kgm2


x 1 hour

consultations)

n = 27

BMI 273 (6)

kgm2

Age 28 (4) years

7 day weighed


plusmn 3 wks) 27

and 36 weeks

gestation



recruited Exclusion

criteria included


or gt45 year old


medical conditions

which impact fetal

growth

Restriction of


achievable and re

the deterioration

glucose metaboli

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

41

983120983137983143983141 983092983089 983151983142 983092983090

FIGURE LEGENDS





















2 GWG 115 to 155 kg)


2

GWG 50 to 90 kg)

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

42

983120983137983143983141 983092983090 983151983142 983092983090







8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Jansson et al41

2008



between early

pregnancy BMI

maternal dietary

intake and birth

weight

Sweden

developing

n = 49

BMI 255 (69)

kgm2

Age 30 (45)

years

Diet history


over a 24hr

period

collected by a

registered

dietitian at 8-

12 weeks and

32-35 weeks

gestation

Inclusion criteria


old

Exclusion criteria

smoking


reproduction

concurrent disease


or diabetes

development of

pregnancy


preeclampsia or

intrauterine growth

restriction

High first t


trimester IG

were correl

increased b

weight We

that low ser

concentrati

IGFBP-1 re

link betwee

BMI and in

fetal growth


IGF-1 regu

placental nu

transport

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Khoigani et

al

35

2012

To assess the



and micro nutrients




and reproductive

characteristics and


pregnant women

Iran developing

n = 620 (t1 n =

584 t2 n = 510)

BMI 235 (39)

kgm2

Age 256 (44)

years

Parity 158

(076)

48-hour


11-15 weeks

26 weeks and

34-37 weeks

gestation

Interviewers

were trained

Pregnant women who



delivery low birth

weight and factors

which may affect

pregnancy outcomes


addiction digestive


hemoglobinopathies

eating disorders


malignancy

Mean value


subjects wh

experienced

preeclamps

pregnancy

than in othe

women Int

manganese

C vitamin

and carboh

during the t


among preg

women wh

developed

preeclamps

significant

association

other micro

macro nutri

preeclamps

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Kopp-Hoolihan

et al

42

1999

To assess how well-




that predict an


response

USA developed

n = 10

BMI 231 (21)

kgm2

Age 291 (5)

years

3 day weighed


before

pregnancy and

at 8-10 24-26

34-36 weeks

gestation and

4-6 weeks

postpartum

Healthy non-smoking

women

Well-nouri

women useways to me

energy dem

pregnancy

reduction in

induced

thermogene

increased e

intake dep

less fat mas

predicted

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Kubota et al33

2013

To investigate the


intake maternal


growth during

pregnancy

Japan


BMI 175 (01)

kgm2

Age 297 (52)

years

Normaln = 94

BMI 21 (18)

kgm2

Age 308 (51)


Age 286 (36)

years

BMI 334 (65)

kgm2

Digital images


meals on 3

consecutive

days at 14-16

25-27 and 32-

34 weeks

gestation a

dietitian

reviewed

photos and

recorded

intakevalidation of

method not

reported

Singleton pregnant


had suffered from

obstetrical


premature delivery





Dietary inta


not correlat

fetal growth

Japanese na

recommend

advising ex

intake

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Lof et al23

2009

Investigate whether


weight gain are

associated with

estradiol and


plasma during

pregnancy

Sweden

developed

n = 226

BMI 229 (3)

kgm2

Age 32 (4) years

3 day weight


days including

one weekend

at 12 25 and

33 weeks

gestation

Calculations

conducted by

a nutritionist

Women with multi-





dietary intake were

excluded

No associat


dietary fat i

(total or sub

and plasma

levels Prog

levels corre

weight gain

pregnancy

Martinez et

al32

1994

To determine how



nation Mexico

Mexico

developing

n = 36

BMI 235 (26)

kgm2

Age 31 (54)

years

Diet history

collected by

trainedinterviewers

twice per

month and

reported as

mean first and

third trimester

values

Women with an 18




initial recruitment



pregnant

In this sam

women the


weight gain

pregnancy

was similar

women in U

States Low

maternal B

predicted sm

birth weigh

through at l

months of l

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Piers et al36

1995



pregnancy and


a group of well-

nourished pregnant


women at 12 24 and


12 and 24 wk

postpartum with a

non-pregnant non-


India

developing

n = 18

BMI 217 (24)

kgm2

Age 296 (52)

years

5 day


household

measures of

known volume

at 12 24 and

34 weeks

gestation and

12 and 24

weeks post-

partum

participants


measure by a

dietitian who

also checked

all records




morning sickness

before the initial

metabolic

measurement at 12

weeks gestation

BMR is sig


with non-pr

non-lactatin

and remain

even when

differences

weight are

for Well-n

Indian wom

weight and

similar to th


Birth weigh

infants born

to be lower

cost of preg

estimated to

MJ close t

MJ estimat

FAOIWHO

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Tabrizi et al24

2011

To assess the


mineral intake of

pregnant women and


neonates

Iran developing

n = 450

BMI 239 (38)

kgm2

Age 261 (58)

years

24 hour Recall


1st 2

nd and 3

rd

trimesters

Qualification

training of

interviewer

not reported

Women of 16 to 40


health care centers

during the three


Maternal en


with higher

serum calci

and zinc in

birth weigh

neonates


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Guelinckx

et al

43

2010

Study which


improve dietary

habits according to

the National Diet

Recommendations

increase physical

activity level in

obese pregnant

women and

control gestational

weight gain

Belgium

developedrandomly

assigned using

block

randomization

Control(routine)

n =43

BMI 335 (39)

kgm2

Age 294 (44)

yrs


and PA

brochure)

n = 37

BMI 334 (31)

kgm2

Age 287 (4) yrs

Parity of 1 n = 15

Active (brochure

+ group dietary

counselling)

n = 42BMI 341 (45)

kgm2

Age 28 (36) yrs

Parity of 1 n = 20

7-day food


weighed and

household

measures

during each

trimester of

pregnancy

Records were

checked by a

nutritionist






diabetes multiple

pregnancy premature

labor (lt37 wks

gestation) primary


advice in case of

metabolic disorder


conditions and





brochure and group

discussions

A lifestyle interv


combined with

individual advice

improve dietary h

throughout pregn

in obese women

in the absence of

medical or obstet

complications

maintaining or

increasing PA du


decrease in GWG

individually desig

caloric intake res

based on energy

expenditure data

be included

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Korpi-

Hyovalti etal44

2012

To evaluate the


quality of diet

weight gain and

birth weight in

women at high risk

of gestational

diabetes mellitus

Finland


group 1 or 2

using computed

randomization


information on

diet and PA)

n = 27

BMI 255 (34)

kgm2

Lifestyle


nutrition advice)

n = 27

BMI 273 (6)

kgm2

4 day weighed


days including

one weekend

completed at

8-12 26-28

and 36-40

weeks

gestation

Records

checked by a

nutritionist

A three-factor

eating

questionnaire

was also used

at the 1st and

3rd

trimester

Women with one or





48-55 mmoll and the

2h oral glucose


glucose lt78 mmoll

were recruited


GDM at 8-12 wks


There were no cl


however

polyunsaturated f

increase in the lif

intervention grou

Intensive weight

education led to a

somewhat lower

gain during pregn

and higher birth w

of the infants in


macrosomia whe

compared to the c

follow up group

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Moses et al45

2014

To determine


index (LGI) dietary

advice at

the first antenatal

visit would result

in a lower fetal

birth weight

birth percentile

and ponderal index

(PI) than providing

healthy eating

(HE) advice

Australia

developedrandomly

assigned using

computer-

generated

random numbers

1 or 2

Healthy Eating

(counselled to

follow a healthy

diet based on the

AGHE4

) n = 280

BMI 247 (5)

kgm2

Age 299 (5) yrs

Low Glycemic

Index

(individualized

nutrition advice

on a LGI diet)

n = 296

BMI 243 (52)

kgm2 Age 299 (52)

yrs

3 day


household

measures at 16

and 36 weeks

gestation

records

reviewed by a

dietitian



least 18 years old

ability to read and

understand English


comply with visit

schedules Subjects






compromise their




body weight

A low intensity d


in pregnancy did

result in significa

differences in bir

weight fetal perc

of PI

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Wolff et

al

46

2008

To determine


consultations

restricts weight

gain in obese

women and

whether this

restriction impacts

on pregnancy-

induced changes in

glucose

metabolism

Denmark


group 1 or 2

using computed

randomization

Control (general

information on

diet and PA)

n = 27

BMI 255 (34)

kgm2


x 1 hour

consultations)

n = 27

BMI 273 (6)

kgm2

Age 28 (4) years

7 day weighed


plusmn 3 wks) 27

and 36 weeks

gestation



recruited Exclusion

criteria included


or gt45 year old


medical conditions

which impact fetal

growth

Restriction of


achievable and re

the deterioration

glucose metaboli

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

41

983120983137983143983141 983092983089 983151983142 983092983090

FIGURE LEGENDS





















2 GWG 115 to 155 kg)


2

GWG 50 to 90 kg)

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

42

983120983137983143983141 983092983090 983151983142 983092983090







8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Khoigani et

al

35

2012

To assess the



and micro nutrients




and reproductive

characteristics and


pregnant women

Iran developing

n = 620 (t1 n =

584 t2 n = 510)

BMI 235 (39)

kgm2

Age 256 (44)

years

Parity 158

(076)

48-hour


11-15 weeks

26 weeks and

34-37 weeks

gestation

Interviewers

were trained

Pregnant women who



delivery low birth

weight and factors

which may affect

pregnancy outcomes


addiction digestive


hemoglobinopathies

eating disorders


malignancy

Mean value


subjects wh

experienced

preeclamps

pregnancy

than in othe

women Int

manganese

C vitamin

and carboh

during the t


among preg

women wh

developed

preeclamps

significant

association

other micro

macro nutri

preeclamps

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Kopp-Hoolihan

et al

42

1999

To assess how well-




that predict an


response

USA developed

n = 10

BMI 231 (21)

kgm2

Age 291 (5)

years

3 day weighed


before

pregnancy and

at 8-10 24-26

34-36 weeks

gestation and

4-6 weeks

postpartum

Healthy non-smoking

women

Well-nouri

women useways to me

energy dem

pregnancy

reduction in

induced

thermogene

increased e

intake dep

less fat mas

predicted

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Kubota et al33

2013

To investigate the


intake maternal


growth during

pregnancy

Japan


BMI 175 (01)

kgm2

Age 297 (52)

years

Normaln = 94

BMI 21 (18)

kgm2

Age 308 (51)


Age 286 (36)

years

BMI 334 (65)

kgm2

Digital images


meals on 3

consecutive

days at 14-16

25-27 and 32-

34 weeks

gestation a

dietitian

reviewed

photos and

recorded

intakevalidation of

method not

reported

Singleton pregnant


had suffered from

obstetrical


premature delivery





Dietary inta


not correlat

fetal growth

Japanese na

recommend

advising ex

intake

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Lof et al23

2009

Investigate whether


weight gain are

associated with

estradiol and


plasma during

pregnancy

Sweden

developed

n = 226

BMI 229 (3)

kgm2

Age 32 (4) years

3 day weight


days including

one weekend

at 12 25 and

33 weeks

gestation

Calculations

conducted by

a nutritionist

Women with multi-





dietary intake were

excluded

No associat


dietary fat i

(total or sub

and plasma

levels Prog

levels corre

weight gain

pregnancy

Martinez et

al32

1994

To determine how



nation Mexico

Mexico

developing

n = 36

BMI 235 (26)

kgm2

Age 31 (54)

years

Diet history

collected by

trainedinterviewers

twice per

month and

reported as

mean first and

third trimester

values

Women with an 18




initial recruitment



pregnant

In this sam

women the


weight gain

pregnancy

was similar

women in U

States Low

maternal B

predicted sm

birth weigh

through at l

months of l

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Piers et al36

1995



pregnancy and


a group of well-

nourished pregnant


women at 12 24 and


12 and 24 wk

postpartum with a

non-pregnant non-


India

developing

n = 18

BMI 217 (24)

kgm2

Age 296 (52)

years

5 day


household

measures of

known volume

at 12 24 and

34 weeks

gestation and

12 and 24

weeks post-

partum

participants


measure by a

dietitian who

also checked

all records




morning sickness

before the initial

metabolic

measurement at 12

weeks gestation

BMR is sig


with non-pr

non-lactatin

and remain

even when

differences

weight are

for Well-n

Indian wom

weight and

similar to th


Birth weigh

infants born

to be lower

cost of preg

estimated to

MJ close t

MJ estimat

FAOIWHO

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Tabrizi et al24

2011

To assess the


mineral intake of

pregnant women and


neonates

Iran developing

n = 450

BMI 239 (38)

kgm2

Age 261 (58)

years

24 hour Recall


1st 2

nd and 3

rd

trimesters

Qualification

training of

interviewer

not reported

Women of 16 to 40


health care centers

during the three


Maternal en


with higher

serum calci

and zinc in

birth weigh

neonates


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Guelinckx

et al

43

2010

Study which


improve dietary

habits according to

the National Diet

Recommendations

increase physical

activity level in

obese pregnant

women and

control gestational

weight gain

Belgium

developedrandomly

assigned using

block

randomization

Control(routine)

n =43

BMI 335 (39)

kgm2

Age 294 (44)

yrs


and PA

brochure)

n = 37

BMI 334 (31)

kgm2

Age 287 (4) yrs

Parity of 1 n = 15

Active (brochure

+ group dietary

counselling)

n = 42BMI 341 (45)

kgm2

Age 28 (36) yrs

Parity of 1 n = 20

7-day food


weighed and

household

measures

during each

trimester of

pregnancy

Records were

checked by a

nutritionist






diabetes multiple

pregnancy premature

labor (lt37 wks

gestation) primary


advice in case of

metabolic disorder


conditions and





brochure and group

discussions

A lifestyle interv


combined with

individual advice

improve dietary h

throughout pregn

in obese women

in the absence of

medical or obstet

complications

maintaining or

increasing PA du


decrease in GWG

individually desig

caloric intake res

based on energy

expenditure data

be included

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Korpi-

Hyovalti etal44

2012

To evaluate the


quality of diet

weight gain and

birth weight in

women at high risk

of gestational

diabetes mellitus

Finland


group 1 or 2

using computed

randomization


information on

diet and PA)

n = 27

BMI 255 (34)

kgm2

Lifestyle


nutrition advice)

n = 27

BMI 273 (6)

kgm2

4 day weighed


days including

one weekend

completed at

8-12 26-28

and 36-40

weeks

gestation

Records

checked by a

nutritionist

A three-factor

eating

questionnaire

was also used

at the 1st and

3rd

trimester

Women with one or





48-55 mmoll and the

2h oral glucose


glucose lt78 mmoll

were recruited


GDM at 8-12 wks


There were no cl


however

polyunsaturated f

increase in the lif

intervention grou

Intensive weight

education led to a

somewhat lower

gain during pregn

and higher birth w

of the infants in


macrosomia whe

compared to the c

follow up group

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Moses et al45

2014

To determine


index (LGI) dietary

advice at

the first antenatal

visit would result

in a lower fetal

birth weight

birth percentile

and ponderal index

(PI) than providing

healthy eating

(HE) advice

Australia

developedrandomly

assigned using

computer-

generated

random numbers

1 or 2

Healthy Eating

(counselled to

follow a healthy

diet based on the

AGHE4

) n = 280

BMI 247 (5)

kgm2

Age 299 (5) yrs

Low Glycemic

Index

(individualized

nutrition advice

on a LGI diet)

n = 296

BMI 243 (52)

kgm2 Age 299 (52)

yrs

3 day


household

measures at 16

and 36 weeks

gestation

records

reviewed by a

dietitian



least 18 years old

ability to read and

understand English


comply with visit

schedules Subjects






compromise their




body weight

A low intensity d


in pregnancy did

result in significa

differences in bir

weight fetal perc

of PI

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Wolff et

al

46

2008

To determine


consultations

restricts weight

gain in obese

women and

whether this

restriction impacts

on pregnancy-

induced changes in

glucose

metabolism

Denmark


group 1 or 2

using computed

randomization

Control (general

information on

diet and PA)

n = 27

BMI 255 (34)

kgm2


x 1 hour

consultations)

n = 27

BMI 273 (6)

kgm2

Age 28 (4) years

7 day weighed


plusmn 3 wks) 27

and 36 weeks

gestation



recruited Exclusion

criteria included


or gt45 year old


medical conditions

which impact fetal

growth

Restriction of


achievable and re

the deterioration

glucose metaboli

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

41

983120983137983143983141 983092983089 983151983142 983092983090

FIGURE LEGENDS





















2 GWG 115 to 155 kg)


2

GWG 50 to 90 kg)

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

42

983120983137983143983141 983092983090 983151983142 983092983090







8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Kopp-Hoolihan

et al

42

1999

To assess how well-




that predict an


response

USA developed

n = 10

BMI 231 (21)

kgm2

Age 291 (5)

years

3 day weighed


before

pregnancy and

at 8-10 24-26

34-36 weeks

gestation and

4-6 weeks

postpartum

Healthy non-smoking

women

Well-nouri

women useways to me

energy dem

pregnancy

reduction in

induced

thermogene

increased e

intake dep

less fat mas

predicted

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Kubota et al33

2013

To investigate the


intake maternal


growth during

pregnancy

Japan


BMI 175 (01)

kgm2

Age 297 (52)

years

Normaln = 94

BMI 21 (18)

kgm2

Age 308 (51)


Age 286 (36)

years

BMI 334 (65)

kgm2

Digital images


meals on 3

consecutive

days at 14-16

25-27 and 32-

34 weeks

gestation a

dietitian

reviewed

photos and

recorded

intakevalidation of

method not

reported

Singleton pregnant


had suffered from

obstetrical


premature delivery





Dietary inta


not correlat

fetal growth

Japanese na

recommend

advising ex

intake

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Lof et al23

2009

Investigate whether


weight gain are

associated with

estradiol and


plasma during

pregnancy

Sweden

developed

n = 226

BMI 229 (3)

kgm2

Age 32 (4) years

3 day weight


days including

one weekend

at 12 25 and

33 weeks

gestation

Calculations

conducted by

a nutritionist

Women with multi-





dietary intake were

excluded

No associat


dietary fat i

(total or sub

and plasma

levels Prog

levels corre

weight gain

pregnancy

Martinez et

al32

1994

To determine how



nation Mexico

Mexico

developing

n = 36

BMI 235 (26)

kgm2

Age 31 (54)

years

Diet history

collected by

trainedinterviewers

twice per

month and

reported as

mean first and

third trimester

values

Women with an 18




initial recruitment



pregnant

In this sam

women the


weight gain

pregnancy

was similar

women in U

States Low

maternal B

predicted sm

birth weigh

through at l

months of l

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Piers et al36

1995



pregnancy and


a group of well-

nourished pregnant


women at 12 24 and


12 and 24 wk

postpartum with a

non-pregnant non-


India

developing

n = 18

BMI 217 (24)

kgm2

Age 296 (52)

years

5 day


household

measures of

known volume

at 12 24 and

34 weeks

gestation and

12 and 24

weeks post-

partum

participants


measure by a

dietitian who

also checked

all records




morning sickness

before the initial

metabolic

measurement at 12

weeks gestation

BMR is sig


with non-pr

non-lactatin

and remain

even when

differences

weight are

for Well-n

Indian wom

weight and

similar to th


Birth weigh

infants born

to be lower

cost of preg

estimated to

MJ close t

MJ estimat

FAOIWHO

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Tabrizi et al24

2011

To assess the


mineral intake of

pregnant women and


neonates

Iran developing

n = 450

BMI 239 (38)

kgm2

Age 261 (58)

years

24 hour Recall


1st 2

nd and 3

rd

trimesters

Qualification

training of

interviewer

not reported

Women of 16 to 40


health care centers

during the three


Maternal en


with higher

serum calci

and zinc in

birth weigh

neonates


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Guelinckx

et al

43

2010

Study which


improve dietary

habits according to

the National Diet

Recommendations

increase physical

activity level in

obese pregnant

women and

control gestational

weight gain

Belgium

developedrandomly

assigned using

block

randomization

Control(routine)

n =43

BMI 335 (39)

kgm2

Age 294 (44)

yrs


and PA

brochure)

n = 37

BMI 334 (31)

kgm2

Age 287 (4) yrs

Parity of 1 n = 15

Active (brochure

+ group dietary

counselling)

n = 42BMI 341 (45)

kgm2

Age 28 (36) yrs

Parity of 1 n = 20

7-day food


weighed and

household

measures

during each

trimester of

pregnancy

Records were

checked by a

nutritionist






diabetes multiple

pregnancy premature

labor (lt37 wks

gestation) primary


advice in case of

metabolic disorder


conditions and





brochure and group

discussions

A lifestyle interv


combined with

individual advice

improve dietary h

throughout pregn

in obese women

in the absence of

medical or obstet

complications

maintaining or

increasing PA du


decrease in GWG

individually desig

caloric intake res

based on energy

expenditure data

be included

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Korpi-

Hyovalti etal44

2012

To evaluate the


quality of diet

weight gain and

birth weight in

women at high risk

of gestational

diabetes mellitus

Finland


group 1 or 2

using computed

randomization


information on

diet and PA)

n = 27

BMI 255 (34)

kgm2

Lifestyle


nutrition advice)

n = 27

BMI 273 (6)

kgm2

4 day weighed


days including

one weekend

completed at

8-12 26-28

and 36-40

weeks

gestation

Records

checked by a

nutritionist

A three-factor

eating

questionnaire

was also used

at the 1st and

3rd

trimester

Women with one or





48-55 mmoll and the

2h oral glucose


glucose lt78 mmoll

were recruited


GDM at 8-12 wks


There were no cl


however

polyunsaturated f

increase in the lif

intervention grou

Intensive weight

education led to a

somewhat lower

gain during pregn

and higher birth w

of the infants in


macrosomia whe

compared to the c

follow up group

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Moses et al45

2014

To determine


index (LGI) dietary

advice at

the first antenatal

visit would result

in a lower fetal

birth weight

birth percentile

and ponderal index

(PI) than providing

healthy eating

(HE) advice

Australia

developedrandomly

assigned using

computer-

generated

random numbers

1 or 2

Healthy Eating

(counselled to

follow a healthy

diet based on the

AGHE4

) n = 280

BMI 247 (5)

kgm2

Age 299 (5) yrs

Low Glycemic

Index

(individualized

nutrition advice

on a LGI diet)

n = 296

BMI 243 (52)

kgm2 Age 299 (52)

yrs

3 day


household

measures at 16

and 36 weeks

gestation

records

reviewed by a

dietitian



least 18 years old

ability to read and

understand English


comply with visit

schedules Subjects






compromise their




body weight

A low intensity d


in pregnancy did

result in significa

differences in bir

weight fetal perc

of PI

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Wolff et

al

46

2008

To determine


consultations

restricts weight

gain in obese

women and

whether this

restriction impacts

on pregnancy-

induced changes in

glucose

metabolism

Denmark


group 1 or 2

using computed

randomization

Control (general

information on

diet and PA)

n = 27

BMI 255 (34)

kgm2


x 1 hour

consultations)

n = 27

BMI 273 (6)

kgm2

Age 28 (4) years

7 day weighed


plusmn 3 wks) 27

and 36 weeks

gestation



recruited Exclusion

criteria included


or gt45 year old


medical conditions

which impact fetal

growth

Restriction of


achievable and re

the deterioration

glucose metaboli

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

41

983120983137983143983141 983092983089 983151983142 983092983090

FIGURE LEGENDS





















2 GWG 115 to 155 kg)


2

GWG 50 to 90 kg)

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

42

983120983137983143983141 983092983090 983151983142 983092983090







8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Kubota et al33

2013

To investigate the


intake maternal


growth during

pregnancy

Japan


BMI 175 (01)

kgm2

Age 297 (52)

years

Normaln = 94

BMI 21 (18)

kgm2

Age 308 (51)


Age 286 (36)

years

BMI 334 (65)

kgm2

Digital images


meals on 3

consecutive

days at 14-16

25-27 and 32-

34 weeks

gestation a

dietitian

reviewed

photos and

recorded

intakevalidation of

method not

reported

Singleton pregnant


had suffered from

obstetrical


premature delivery





Dietary inta


not correlat

fetal growth

Japanese na

recommend

advising ex

intake

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Lof et al23

2009

Investigate whether


weight gain are

associated with

estradiol and


plasma during

pregnancy

Sweden

developed

n = 226

BMI 229 (3)

kgm2

Age 32 (4) years

3 day weight


days including

one weekend

at 12 25 and

33 weeks

gestation

Calculations

conducted by

a nutritionist

Women with multi-





dietary intake were

excluded

No associat


dietary fat i

(total or sub

and plasma

levels Prog

levels corre

weight gain

pregnancy

Martinez et

al32

1994

To determine how



nation Mexico

Mexico

developing

n = 36

BMI 235 (26)

kgm2

Age 31 (54)

years

Diet history

collected by

trainedinterviewers

twice per

month and

reported as

mean first and

third trimester

values

Women with an 18




initial recruitment



pregnant

In this sam

women the


weight gain

pregnancy

was similar

women in U

States Low

maternal B

predicted sm

birth weigh

through at l

months of l

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Piers et al36

1995



pregnancy and


a group of well-

nourished pregnant


women at 12 24 and


12 and 24 wk

postpartum with a

non-pregnant non-


India

developing

n = 18

BMI 217 (24)

kgm2

Age 296 (52)

years

5 day


household

measures of

known volume

at 12 24 and

34 weeks

gestation and

12 and 24

weeks post-

partum

participants


measure by a

dietitian who

also checked

all records




morning sickness

before the initial

metabolic

measurement at 12

weeks gestation

BMR is sig


with non-pr

non-lactatin

and remain

even when

differences

weight are

for Well-n

Indian wom

weight and

similar to th


Birth weigh

infants born

to be lower

cost of preg

estimated to

MJ close t

MJ estimat

FAOIWHO

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Tabrizi et al24

2011

To assess the


mineral intake of

pregnant women and


neonates

Iran developing

n = 450

BMI 239 (38)

kgm2

Age 261 (58)

years

24 hour Recall


1st 2

nd and 3

rd

trimesters

Qualification

training of

interviewer

not reported

Women of 16 to 40


health care centers

during the three


Maternal en


with higher

serum calci

and zinc in

birth weigh

neonates


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Guelinckx

et al

43

2010

Study which


improve dietary

habits according to

the National Diet

Recommendations

increase physical

activity level in

obese pregnant

women and

control gestational

weight gain

Belgium

developedrandomly

assigned using

block

randomization

Control(routine)

n =43

BMI 335 (39)

kgm2

Age 294 (44)

yrs


and PA

brochure)

n = 37

BMI 334 (31)

kgm2

Age 287 (4) yrs

Parity of 1 n = 15

Active (brochure

+ group dietary

counselling)

n = 42BMI 341 (45)

kgm2

Age 28 (36) yrs

Parity of 1 n = 20

7-day food


weighed and

household

measures

during each

trimester of

pregnancy

Records were

checked by a

nutritionist






diabetes multiple

pregnancy premature

labor (lt37 wks

gestation) primary


advice in case of

metabolic disorder


conditions and





brochure and group

discussions

A lifestyle interv


combined with

individual advice

improve dietary h

throughout pregn

in obese women

in the absence of

medical or obstet

complications

maintaining or

increasing PA du


decrease in GWG

individually desig

caloric intake res

based on energy

expenditure data

be included

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Korpi-

Hyovalti etal44

2012

To evaluate the


quality of diet

weight gain and

birth weight in

women at high risk

of gestational

diabetes mellitus

Finland


group 1 or 2

using computed

randomization


information on

diet and PA)

n = 27

BMI 255 (34)

kgm2

Lifestyle


nutrition advice)

n = 27

BMI 273 (6)

kgm2

4 day weighed


days including

one weekend

completed at

8-12 26-28

and 36-40

weeks

gestation

Records

checked by a

nutritionist

A three-factor

eating

questionnaire

was also used

at the 1st and

3rd

trimester

Women with one or





48-55 mmoll and the

2h oral glucose


glucose lt78 mmoll

were recruited


GDM at 8-12 wks


There were no cl


however

polyunsaturated f

increase in the lif

intervention grou

Intensive weight

education led to a

somewhat lower

gain during pregn

and higher birth w

of the infants in


macrosomia whe

compared to the c

follow up group

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Moses et al45

2014

To determine


index (LGI) dietary

advice at

the first antenatal

visit would result

in a lower fetal

birth weight

birth percentile

and ponderal index

(PI) than providing

healthy eating

(HE) advice

Australia

developedrandomly

assigned using

computer-

generated

random numbers

1 or 2

Healthy Eating

(counselled to

follow a healthy

diet based on the

AGHE4

) n = 280

BMI 247 (5)

kgm2

Age 299 (5) yrs

Low Glycemic

Index

(individualized

nutrition advice

on a LGI diet)

n = 296

BMI 243 (52)

kgm2 Age 299 (52)

yrs

3 day


household

measures at 16

and 36 weeks

gestation

records

reviewed by a

dietitian



least 18 years old

ability to read and

understand English


comply with visit

schedules Subjects






compromise their




body weight

A low intensity d


in pregnancy did

result in significa

differences in bir

weight fetal perc

of PI

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Wolff et

al

46

2008

To determine


consultations

restricts weight

gain in obese

women and

whether this

restriction impacts

on pregnancy-

induced changes in

glucose

metabolism

Denmark


group 1 or 2

using computed

randomization

Control (general

information on

diet and PA)

n = 27

BMI 255 (34)

kgm2


x 1 hour

consultations)

n = 27

BMI 273 (6)

kgm2

Age 28 (4) years

7 day weighed


plusmn 3 wks) 27

and 36 weeks

gestation



recruited Exclusion

criteria included


or gt45 year old


medical conditions

which impact fetal

growth

Restriction of


achievable and re

the deterioration

glucose metaboli

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

41

983120983137983143983141 983092983089 983151983142 983092983090

FIGURE LEGENDS





















2 GWG 115 to 155 kg)


2

GWG 50 to 90 kg)

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

42

983120983137983143983141 983092983090 983151983142 983092983090







8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Lof et al23

2009

Investigate whether


weight gain are

associated with

estradiol and


plasma during

pregnancy

Sweden

developed

n = 226

BMI 229 (3)

kgm2

Age 32 (4) years

3 day weight


days including

one weekend

at 12 25 and

33 weeks

gestation

Calculations

conducted by

a nutritionist

Women with multi-





dietary intake were

excluded

No associat


dietary fat i

(total or sub

and plasma

levels Prog

levels corre

weight gain

pregnancy

Martinez et

al32

1994

To determine how



nation Mexico

Mexico

developing

n = 36

BMI 235 (26)

kgm2

Age 31 (54)

years

Diet history

collected by

trainedinterviewers

twice per

month and

reported as

mean first and

third trimester

values

Women with an 18




initial recruitment



pregnant

In this sam

women the


weight gain

pregnancy

was similar

women in U

States Low

maternal B

predicted sm

birth weigh

through at l

months of l

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Piers et al36

1995



pregnancy and


a group of well-

nourished pregnant


women at 12 24 and


12 and 24 wk

postpartum with a

non-pregnant non-


India

developing

n = 18

BMI 217 (24)

kgm2

Age 296 (52)

years

5 day


household

measures of

known volume

at 12 24 and

34 weeks

gestation and

12 and 24

weeks post-

partum

participants


measure by a

dietitian who

also checked

all records




morning sickness

before the initial

metabolic

measurement at 12

weeks gestation

BMR is sig


with non-pr

non-lactatin

and remain

even when

differences

weight are

for Well-n

Indian wom

weight and

similar to th


Birth weigh

infants born

to be lower

cost of preg

estimated to

MJ close t

MJ estimat

FAOIWHO

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Tabrizi et al24

2011

To assess the


mineral intake of

pregnant women and


neonates

Iran developing

n = 450

BMI 239 (38)

kgm2

Age 261 (58)

years

24 hour Recall


1st 2

nd and 3

rd

trimesters

Qualification

training of

interviewer

not reported

Women of 16 to 40


health care centers

during the three


Maternal en


with higher

serum calci

and zinc in

birth weigh

neonates


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Guelinckx

et al

43

2010

Study which


improve dietary

habits according to

the National Diet

Recommendations

increase physical

activity level in

obese pregnant

women and

control gestational

weight gain

Belgium

developedrandomly

assigned using

block

randomization

Control(routine)

n =43

BMI 335 (39)

kgm2

Age 294 (44)

yrs


and PA

brochure)

n = 37

BMI 334 (31)

kgm2

Age 287 (4) yrs

Parity of 1 n = 15

Active (brochure

+ group dietary

counselling)

n = 42BMI 341 (45)

kgm2

Age 28 (36) yrs

Parity of 1 n = 20

7-day food


weighed and

household

measures

during each

trimester of

pregnancy

Records were

checked by a

nutritionist






diabetes multiple

pregnancy premature

labor (lt37 wks

gestation) primary


advice in case of

metabolic disorder


conditions and





brochure and group

discussions

A lifestyle interv


combined with

individual advice

improve dietary h

throughout pregn

in obese women

in the absence of

medical or obstet

complications

maintaining or

increasing PA du


decrease in GWG

individually desig

caloric intake res

based on energy

expenditure data

be included

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Korpi-

Hyovalti etal44

2012

To evaluate the


quality of diet

weight gain and

birth weight in

women at high risk

of gestational

diabetes mellitus

Finland


group 1 or 2

using computed

randomization


information on

diet and PA)

n = 27

BMI 255 (34)

kgm2

Lifestyle


nutrition advice)

n = 27

BMI 273 (6)

kgm2

4 day weighed


days including

one weekend

completed at

8-12 26-28

and 36-40

weeks

gestation

Records

checked by a

nutritionist

A three-factor

eating

questionnaire

was also used

at the 1st and

3rd

trimester

Women with one or





48-55 mmoll and the

2h oral glucose


glucose lt78 mmoll

were recruited


GDM at 8-12 wks


There were no cl


however

polyunsaturated f

increase in the lif

intervention grou

Intensive weight

education led to a

somewhat lower

gain during pregn

and higher birth w

of the infants in


macrosomia whe

compared to the c

follow up group

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Moses et al45

2014

To determine


index (LGI) dietary

advice at

the first antenatal

visit would result

in a lower fetal

birth weight

birth percentile

and ponderal index

(PI) than providing

healthy eating

(HE) advice

Australia

developedrandomly

assigned using

computer-

generated

random numbers

1 or 2

Healthy Eating

(counselled to

follow a healthy

diet based on the

AGHE4

) n = 280

BMI 247 (5)

kgm2

Age 299 (5) yrs

Low Glycemic

Index

(individualized

nutrition advice

on a LGI diet)

n = 296

BMI 243 (52)

kgm2 Age 299 (52)

yrs

3 day


household

measures at 16

and 36 weeks

gestation

records

reviewed by a

dietitian



least 18 years old

ability to read and

understand English


comply with visit

schedules Subjects






compromise their




body weight

A low intensity d


in pregnancy did

result in significa

differences in bir

weight fetal perc

of PI

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Wolff et

al

46

2008

To determine


consultations

restricts weight

gain in obese

women and

whether this

restriction impacts

on pregnancy-

induced changes in

glucose

metabolism

Denmark


group 1 or 2

using computed

randomization

Control (general

information on

diet and PA)

n = 27

BMI 255 (34)

kgm2


x 1 hour

consultations)

n = 27

BMI 273 (6)

kgm2

Age 28 (4) years

7 day weighed


plusmn 3 wks) 27

and 36 weeks

gestation



recruited Exclusion

criteria included


or gt45 year old


medical conditions

which impact fetal

growth

Restriction of


achievable and re

the deterioration

glucose metaboli

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

41

983120983137983143983141 983092983089 983151983142 983092983090

FIGURE LEGENDS





















2 GWG 115 to 155 kg)


2

GWG 50 to 90 kg)

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

42

983120983137983143983141 983092983090 983151983142 983092983090







8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Piers et al36

1995



pregnancy and


a group of well-

nourished pregnant


women at 12 24 and


12 and 24 wk

postpartum with a

non-pregnant non-


India

developing

n = 18

BMI 217 (24)

kgm2

Age 296 (52)

years

5 day


household

measures of

known volume

at 12 24 and

34 weeks

gestation and

12 and 24

weeks post-

partum

participants


measure by a

dietitian who

also checked

all records




morning sickness

before the initial

metabolic

measurement at 12

weeks gestation

BMR is sig


with non-pr

non-lactatin

and remain

even when

differences

weight are

for Well-n

Indian wom

weight and

similar to th


Birth weigh

infants born

to be lower

cost of preg

estimated to

MJ close t

MJ estimat

FAOIWHO

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Tabrizi et al24

2011

To assess the


mineral intake of

pregnant women and


neonates

Iran developing

n = 450

BMI 239 (38)

kgm2

Age 261 (58)

years

24 hour Recall


1st 2

nd and 3

rd

trimesters

Qualification

training of

interviewer

not reported

Women of 16 to 40


health care centers

during the three


Maternal en


with higher

serum calci

and zinc in

birth weigh

neonates


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Guelinckx

et al

43

2010

Study which


improve dietary

habits according to

the National Diet

Recommendations

increase physical

activity level in

obese pregnant

women and

control gestational

weight gain

Belgium

developedrandomly

assigned using

block

randomization

Control(routine)

n =43

BMI 335 (39)

kgm2

Age 294 (44)

yrs


and PA

brochure)

n = 37

BMI 334 (31)

kgm2

Age 287 (4) yrs

Parity of 1 n = 15

Active (brochure

+ group dietary

counselling)

n = 42BMI 341 (45)

kgm2

Age 28 (36) yrs

Parity of 1 n = 20

7-day food


weighed and

household

measures

during each

trimester of

pregnancy

Records were

checked by a

nutritionist






diabetes multiple

pregnancy premature

labor (lt37 wks

gestation) primary


advice in case of

metabolic disorder


conditions and





brochure and group

discussions

A lifestyle interv


combined with

individual advice

improve dietary h

throughout pregn

in obese women

in the absence of

medical or obstet

complications

maintaining or

increasing PA du


decrease in GWG

individually desig

caloric intake res

based on energy

expenditure data

be included

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Korpi-

Hyovalti etal44

2012

To evaluate the


quality of diet

weight gain and

birth weight in

women at high risk

of gestational

diabetes mellitus

Finland


group 1 or 2

using computed

randomization


information on

diet and PA)

n = 27

BMI 255 (34)

kgm2

Lifestyle


nutrition advice)

n = 27

BMI 273 (6)

kgm2

4 day weighed


days including

one weekend

completed at

8-12 26-28

and 36-40

weeks

gestation

Records

checked by a

nutritionist

A three-factor

eating

questionnaire

was also used

at the 1st and

3rd

trimester

Women with one or





48-55 mmoll and the

2h oral glucose


glucose lt78 mmoll

were recruited


GDM at 8-12 wks


There were no cl


however

polyunsaturated f

increase in the lif

intervention grou

Intensive weight

education led to a

somewhat lower

gain during pregn

and higher birth w

of the infants in


macrosomia whe

compared to the c

follow up group

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Moses et al45

2014

To determine


index (LGI) dietary

advice at

the first antenatal

visit would result

in a lower fetal

birth weight

birth percentile

and ponderal index

(PI) than providing

healthy eating

(HE) advice

Australia

developedrandomly

assigned using

computer-

generated

random numbers

1 or 2

Healthy Eating

(counselled to

follow a healthy

diet based on the

AGHE4

) n = 280

BMI 247 (5)

kgm2

Age 299 (5) yrs

Low Glycemic

Index

(individualized

nutrition advice

on a LGI diet)

n = 296

BMI 243 (52)

kgm2 Age 299 (52)

yrs

3 day


household

measures at 16

and 36 weeks

gestation

records

reviewed by a

dietitian



least 18 years old

ability to read and

understand English


comply with visit

schedules Subjects






compromise their




body weight

A low intensity d


in pregnancy did

result in significa

differences in bir

weight fetal perc

of PI

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Wolff et

al

46

2008

To determine


consultations

restricts weight

gain in obese

women and

whether this

restriction impacts

on pregnancy-

induced changes in

glucose

metabolism

Denmark


group 1 or 2

using computed

randomization

Control (general

information on

diet and PA)

n = 27

BMI 255 (34)

kgm2


x 1 hour

consultations)

n = 27

BMI 273 (6)

kgm2

Age 28 (4) years

7 day weighed


plusmn 3 wks) 27

and 36 weeks

gestation



recruited Exclusion

criteria included


or gt45 year old


medical conditions

which impact fetal

growth

Restriction of


achievable and re

the deterioration

glucose metaboli

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

41

983120983137983143983141 983092983089 983151983142 983092983090

FIGURE LEGENDS





















2 GWG 115 to 155 kg)


2

GWG 50 to 90 kg)

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

42

983120983137983143983141 983092983090 983151983142 983092983090







8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population

Dietary

assessment

method

Inclusion exclusion

criteria

Concl

Tabrizi et al24

2011

To assess the


mineral intake of

pregnant women and


neonates

Iran developing

n = 450

BMI 239 (38)

kgm2

Age 261 (58)

years

24 hour Recall


1st 2

nd and 3

rd

trimesters

Qualification

training of

interviewer

not reported

Women of 16 to 40


health care centers

during the three


Maternal en


with higher

serum calci

and zinc in

birth weigh

neonates


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Guelinckx

et al

43

2010

Study which


improve dietary

habits according to

the National Diet

Recommendations

increase physical

activity level in

obese pregnant

women and

control gestational

weight gain

Belgium

developedrandomly

assigned using

block

randomization

Control(routine)

n =43

BMI 335 (39)

kgm2

Age 294 (44)

yrs


and PA

brochure)

n = 37

BMI 334 (31)

kgm2

Age 287 (4) yrs

Parity of 1 n = 15

Active (brochure

+ group dietary

counselling)

n = 42BMI 341 (45)

kgm2

Age 28 (36) yrs

Parity of 1 n = 20

7-day food


weighed and

household

measures

during each

trimester of

pregnancy

Records were

checked by a

nutritionist






diabetes multiple

pregnancy premature

labor (lt37 wks

gestation) primary


advice in case of

metabolic disorder


conditions and





brochure and group

discussions

A lifestyle interv


combined with

individual advice

improve dietary h

throughout pregn

in obese women

in the absence of

medical or obstet

complications

maintaining or

increasing PA du


decrease in GWG

individually desig

caloric intake res

based on energy

expenditure data

be included

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Korpi-

Hyovalti etal44

2012

To evaluate the


quality of diet

weight gain and

birth weight in

women at high risk

of gestational

diabetes mellitus

Finland


group 1 or 2

using computed

randomization


information on

diet and PA)

n = 27

BMI 255 (34)

kgm2

Lifestyle


nutrition advice)

n = 27

BMI 273 (6)

kgm2

4 day weighed


days including

one weekend

completed at

8-12 26-28

and 36-40

weeks

gestation

Records

checked by a

nutritionist

A three-factor

eating

questionnaire

was also used

at the 1st and

3rd

trimester

Women with one or





48-55 mmoll and the

2h oral glucose


glucose lt78 mmoll

were recruited


GDM at 8-12 wks


There were no cl


however

polyunsaturated f

increase in the lif

intervention grou

Intensive weight

education led to a

somewhat lower

gain during pregn

and higher birth w

of the infants in


macrosomia whe

compared to the c

follow up group

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Moses et al45

2014

To determine


index (LGI) dietary

advice at

the first antenatal

visit would result

in a lower fetal

birth weight

birth percentile

and ponderal index

(PI) than providing

healthy eating

(HE) advice

Australia

developedrandomly

assigned using

computer-

generated

random numbers

1 or 2

Healthy Eating

(counselled to

follow a healthy

diet based on the

AGHE4

) n = 280

BMI 247 (5)

kgm2

Age 299 (5) yrs

Low Glycemic

Index

(individualized

nutrition advice

on a LGI diet)

n = 296

BMI 243 (52)

kgm2 Age 299 (52)

yrs

3 day


household

measures at 16

and 36 weeks

gestation

records

reviewed by a

dietitian



least 18 years old

ability to read and

understand English


comply with visit

schedules Subjects






compromise their




body weight

A low intensity d


in pregnancy did

result in significa

differences in bir

weight fetal perc

of PI

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Wolff et

al

46

2008

To determine


consultations

restricts weight

gain in obese

women and

whether this

restriction impacts

on pregnancy-

induced changes in

glucose

metabolism

Denmark


group 1 or 2

using computed

randomization

Control (general

information on

diet and PA)

n = 27

BMI 255 (34)

kgm2


x 1 hour

consultations)

n = 27

BMI 273 (6)

kgm2

Age 28 (4) years

7 day weighed


plusmn 3 wks) 27

and 36 weeks

gestation



recruited Exclusion

criteria included


or gt45 year old


medical conditions

which impact fetal

growth

Restriction of


achievable and re

the deterioration

glucose metaboli

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

41

983120983137983143983141 983092983089 983151983142 983092983090

FIGURE LEGENDS





















2 GWG 115 to 155 kg)


2

GWG 50 to 90 kg)

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

42

983120983137983143983141 983092983090 983151983142 983092983090







8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Guelinckx

et al

43

2010

Study which


improve dietary

habits according to

the National Diet

Recommendations

increase physical

activity level in

obese pregnant

women and

control gestational

weight gain

Belgium

developedrandomly

assigned using

block

randomization

Control(routine)

n =43

BMI 335 (39)

kgm2

Age 294 (44)

yrs


and PA

brochure)

n = 37

BMI 334 (31)

kgm2

Age 287 (4) yrs

Parity of 1 n = 15

Active (brochure

+ group dietary

counselling)

n = 42BMI 341 (45)

kgm2

Age 28 (36) yrs

Parity of 1 n = 20

7-day food


weighed and

household

measures

during each

trimester of

pregnancy

Records were

checked by a

nutritionist






diabetes multiple

pregnancy premature

labor (lt37 wks

gestation) primary


advice in case of

metabolic disorder


conditions and





brochure and group

discussions

A lifestyle interv


combined with

individual advice

improve dietary h

throughout pregn

in obese women

in the absence of

medical or obstet

complications

maintaining or

increasing PA du


decrease in GWG

individually desig

caloric intake res

based on energy

expenditure data

be included

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Korpi-

Hyovalti etal44

2012

To evaluate the


quality of diet

weight gain and

birth weight in

women at high risk

of gestational

diabetes mellitus

Finland


group 1 or 2

using computed

randomization


information on

diet and PA)

n = 27

BMI 255 (34)

kgm2

Lifestyle


nutrition advice)

n = 27

BMI 273 (6)

kgm2

4 day weighed


days including

one weekend

completed at

8-12 26-28

and 36-40

weeks

gestation

Records

checked by a

nutritionist

A three-factor

eating

questionnaire

was also used

at the 1st and

3rd

trimester

Women with one or





48-55 mmoll and the

2h oral glucose


glucose lt78 mmoll

were recruited


GDM at 8-12 wks


There were no cl


however

polyunsaturated f

increase in the lif

intervention grou

Intensive weight

education led to a

somewhat lower

gain during pregn

and higher birth w

of the infants in


macrosomia whe

compared to the c

follow up group

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Moses et al45

2014

To determine


index (LGI) dietary

advice at

the first antenatal

visit would result

in a lower fetal

birth weight

birth percentile

and ponderal index

(PI) than providing

healthy eating

(HE) advice

Australia

developedrandomly

assigned using

computer-

generated

random numbers

1 or 2

Healthy Eating

(counselled to

follow a healthy

diet based on the

AGHE4

) n = 280

BMI 247 (5)

kgm2

Age 299 (5) yrs

Low Glycemic

Index

(individualized

nutrition advice

on a LGI diet)

n = 296

BMI 243 (52)

kgm2 Age 299 (52)

yrs

3 day


household

measures at 16

and 36 weeks

gestation

records

reviewed by a

dietitian



least 18 years old

ability to read and

understand English


comply with visit

schedules Subjects






compromise their




body weight

A low intensity d


in pregnancy did

result in significa

differences in bir

weight fetal perc

of PI

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Wolff et

al

46

2008

To determine


consultations

restricts weight

gain in obese

women and

whether this

restriction impacts

on pregnancy-

induced changes in

glucose

metabolism

Denmark


group 1 or 2

using computed

randomization

Control (general

information on

diet and PA)

n = 27

BMI 255 (34)

kgm2


x 1 hour

consultations)

n = 27

BMI 273 (6)

kgm2

Age 28 (4) years

7 day weighed


plusmn 3 wks) 27

and 36 weeks

gestation



recruited Exclusion

criteria included


or gt45 year old


medical conditions

which impact fetal

growth

Restriction of


achievable and re

the deterioration

glucose metaboli

8172019 Je Beile 2015


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983120983137983143983141 983092983089 983151983142 983092983090

FIGURE LEGENDS





















2 GWG 115 to 155 kg)


2

GWG 50 to 90 kg)

8172019 Je Beile 2015


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Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Korpi-

Hyovalti etal44

2012

To evaluate the


quality of diet

weight gain and

birth weight in

women at high risk

of gestational

diabetes mellitus

Finland


group 1 or 2

using computed

randomization


information on

diet and PA)

n = 27

BMI 255 (34)

kgm2

Lifestyle


nutrition advice)

n = 27

BMI 273 (6)

kgm2

4 day weighed


days including

one weekend

completed at

8-12 26-28

and 36-40

weeks

gestation

Records

checked by a

nutritionist

A three-factor

eating

questionnaire

was also used

at the 1st and

3rd

trimester

Women with one or





48-55 mmoll and the

2h oral glucose


glucose lt78 mmoll

were recruited


GDM at 8-12 wks


There were no cl


however

polyunsaturated f

increase in the lif

intervention grou

Intensive weight

education led to a

somewhat lower

gain during pregn

and higher birth w

of the infants in


macrosomia whe

compared to the c

follow up group

8172019 Je Beile 2015


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Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Moses et al45

2014

To determine


index (LGI) dietary

advice at

the first antenatal

visit would result

in a lower fetal

birth weight

birth percentile

and ponderal index

(PI) than providing

healthy eating

(HE) advice

Australia

developedrandomly

assigned using

computer-

generated

random numbers

1 or 2

Healthy Eating

(counselled to

follow a healthy

diet based on the

AGHE4

) n = 280

BMI 247 (5)

kgm2

Age 299 (5) yrs

Low Glycemic

Index

(individualized

nutrition advice

on a LGI diet)

n = 296

BMI 243 (52)

kgm2 Age 299 (52)

yrs

3 day


household

measures at 16

and 36 weeks

gestation

records

reviewed by a

dietitian



least 18 years old

ability to read and

understand English


comply with visit

schedules Subjects






compromise their




body weight

A low intensity d


in pregnancy did

result in significa

differences in bir

weight fetal perc

of PI

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Wolff et

al

46

2008

To determine


consultations

restricts weight

gain in obese

women and

whether this

restriction impacts

on pregnancy-

induced changes in

glucose

metabolism

Denmark


group 1 or 2

using computed

randomization

Control (general

information on

diet and PA)

n = 27

BMI 255 (34)

kgm2


x 1 hour

consultations)

n = 27

BMI 273 (6)

kgm2

Age 28 (4) years

7 day weighed


plusmn 3 wks) 27

and 36 weeks

gestation



recruited Exclusion

criteria included


or gt45 year old


medical conditions

which impact fetal

growth

Restriction of


achievable and re

the deterioration

glucose metaboli

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

41

983120983137983143983141 983092983089 983151983142 983092983090

FIGURE LEGENDS





















2 GWG 115 to 155 kg)


2

GWG 50 to 90 kg)

8172019 Je Beile 2015


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8172019 Je Beile 2015


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8172019 Je Beile 2015


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8172019 Je Beile 2015


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8172019 Je Beile 2015


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Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Moses et al45

2014

To determine


index (LGI) dietary

advice at

the first antenatal

visit would result

in a lower fetal

birth weight

birth percentile

and ponderal index

(PI) than providing

healthy eating

(HE) advice

Australia

developedrandomly

assigned using

computer-

generated

random numbers

1 or 2

Healthy Eating

(counselled to

follow a healthy

diet based on the

AGHE4

) n = 280

BMI 247 (5)

kgm2

Age 299 (5) yrs

Low Glycemic

Index

(individualized

nutrition advice

on a LGI diet)

n = 296

BMI 243 (52)

kgm2 Age 299 (52)

yrs

3 day


household

measures at 16

and 36 weeks

gestation

records

reviewed by a

dietitian



least 18 years old

ability to read and

understand English


comply with visit

schedules Subjects






compromise their




body weight

A low intensity d


in pregnancy did

result in significa

differences in bir

weight fetal perc

of PI

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT


Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Wolff et

al

46

2008

To determine


consultations

restricts weight

gain in obese

women and

whether this

restriction impacts

on pregnancy-

induced changes in

glucose

metabolism

Denmark


group 1 or 2

using computed

randomization

Control (general

information on

diet and PA)

n = 27

BMI 255 (34)

kgm2


x 1 hour

consultations)

n = 27

BMI 273 (6)

kgm2

Age 28 (4) years

7 day weighed


plusmn 3 wks) 27

and 36 weeks

gestation



recruited Exclusion

criteria included


or gt45 year old


medical conditions

which impact fetal

growth

Restriction of


achievable and re

the deterioration

glucose metaboli

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

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983120983137983143983141 983092983089 983151983142 983092983090

FIGURE LEGENDS





















2 GWG 115 to 155 kg)


2

GWG 50 to 90 kg)

8172019 Je Beile 2015


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Source Aim Study

population and

intervention

Dietary

assessment

method

Inclusion exclusion

criteria

Conclusion

Wolff et

al

46

2008

To determine


consultations

restricts weight

gain in obese

women and

whether this

restriction impacts

on pregnancy-

induced changes in

glucose

metabolism

Denmark


group 1 or 2

using computed

randomization

Control (general

information on

diet and PA)

n = 27

BMI 255 (34)

kgm2


x 1 hour

consultations)

n = 27

BMI 273 (6)

kgm2

Age 28 (4) years

7 day weighed


plusmn 3 wks) 27

and 36 weeks

gestation



recruited Exclusion

criteria included


or gt45 year old


medical conditions

which impact fetal

growth

Restriction of


achievable and re

the deterioration

glucose metaboli

8172019 Je Beile 2015


ACCEPTED MANUSCRIPT

41

983120983137983143983141 983092983089 983151983142 983092983090

FIGURE LEGENDS





















2 GWG 115 to 155 kg)


2

GWG 50 to 90 kg)

8172019 Je Beile 2015


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983120983137983143983141 983092983089 983151983142 983092983090

FIGURE LEGENDS





















2 GWG 115 to 155 kg)


2

GWG 50 to 90 kg)

8172019 Je Beile 2015


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Je Beile 2015

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