How to Improve Prenatal Nutrition in the UK - Literature review Example

How to improve prenatal nutrition in the United Kingdom Table of Contents Aim Prenatal nutrition plays a key role in both the mother’s and the child’s health. Inappropriate maternal nutrition has proved to yield adversative birth outcomes and associated maternal complications. “However, it is important to note that the relationship between mother’s nutrition and nature of birth is a complex matter dictated sociological, biological, economic, and demographic factors” (Semba & Bloem, 2008). These factors vary based on different locations and among various populations. “It is vital to understand the relationship between mother’s prenatal nutrition and birth outcome as the knowledge provide a basis for understanding and design of nutritional interventions for the improvement of positive birth results, long term maternal life quality, reduced mortality rates and health care expenses” (Alexander & Cornely, 1987). This review seeks to provide a broad overview on the ways through which prenatal nutrition can be improved in the United Kingdom. The overview of the literature reviews status of maternal nutrition and birth results in the United Kingdom. “Nutrition of an expectant mother is a crucial issue owing to the fact that the kind of diet intake during pregnancy may likely have a positive or a negative impact on the mother’s health as well as the newborn baby” (Duggan, Watkins, & Walker, 2008). These effects manifest in the child’s life early or late in life including adulthood. It is for this reason that the Food Standards Agency in the United Kingdom deems necessary to offer dietary advice for mothers during their gravidity period. The advices offered range from appropriate diet to the undesirable ones. “A number of studies conducted in the United Kingdom show evidence that expectant mothers take insufficient major nutrients” (Langley-Evans, 2009). The studies further reveal that the current state can be improved through various dietary interventions. This review seeks to bring out dietary interventions that can be provided to expectant mothers with a purpose of improving prenatal care and the general improvement of the birth outcomes. Rationale Improved access to quality nutrition among expectant mothers in the United Kingdom has for the last 10 years the government’s headache. The United Kingdom’s department of health has been formulating various prenatal care policies geared at quality nutrition and care for pregnant women that would see reduced risks among the high risk groups. This paper uses numerous literature review works conducted by earlier researchers to answer its research questions. The questions that the paper seeks to answer are, what long term and short-term dietary measures should be devised for prenatal mothers in the United Kingdom. Do they have any effect on the nature of the born baby or the mother’s health? The review samples various nutritional studies all over the world whose populations may have had different nutritional standards from what is currently being experienced in the United Kingdom today. In this regard, the recommendations that this paper presents may not be fully relied upon for purposes of implementation by the UK authorities seeking to improve prenatal health among expectant mothers. “This research paper will analytically review the value of food provision programs towards the improvement of diet for expectant mothers in the UK” (Davis, 2011). It will further review the efficacy of health mediations deliberated to promote the uptake of food enhancements such as folic acid supplements in the first three months of pregnancy. It will finally review the usefulness of reduced alcohol intake during expectancy. Methodology “A research conducted by the University of York in November 2005, using a stepped approach, started its review with a search with a purpose of identifying potential systematic reviews done from the year 2000 onwards” (Balarajan et al., 2012). The study further reviewed randomized studies conducted in the United Kingdom and published within the same period. The researchers between the year 2006 and 2007 conducted a fresh systematic search of literature viewed at answering three key research questions as follows. Firstly, what is the recommended use of oily fish and omega three fatty acids enhancements? In this case, what are the recommended intake levels for the expectant mothers? Secondly, are there intercessions put forth to increase the uptake of food supplements? What are the safety concerns? Thirdly, what Interventions have been put in place to increase allergy prophylaxis advice? The research produced screened full paper copies of the reviews. The results underwent randomized controlled trials and further assessments. The data was then used to answer the questions above. “The research incorporated three literature searches to identify various study types including systematic reviews and random trials” (Balarajan et al., 2012). In this review, the following databases were accessed to identify the various types of study: i. Cochrane database of systematic reviews (CDSR) ii. Cochrane Central Register of Controlled Trials iii. PsycINFO database Two independent reviews were used to screen titles and abstracts to ascertain their relevance and suitability. Two separate reviewers performed the check for inclusion one after the other. Data abstraction and study for quality. “The review was systematic where another independent reviewer checked data assessed by one reviewer” (Alexander &Cornely, 1987). Areas of contentions were resolved through dialogue. “Syntheses of findings were presented through narrative summary, data tables and graphs” (Imdad, Yakoob & Bhutta, 2011). This research paper seeks to answer questions such as, what interpolations are efficient in growing consciousness among expectant women on the recommended folic acid intake supplements. Secondly, what measures are effective in increasing intake of folic acid supplements for expectant mothers? In addition to this, the research seeks to unearth the contributions of various intervention groups aiming to improve prenatal nutrition. The paper seeks to answer the question, “What other interventions, apart from fortification of folic acids on foods, are effective in snowballing nutritional folic acid ingestion for expectant mothers?” (Frank, 2007). Concerning the above question, what measures should be taken to equip a large number of health professionals with knowledge on the recommendation of folic acid in expectant mothers? What measures are effective in informing expectant mothers on the benefits of taking in their diet appropriate amounts of oily fish and other vegetarian sources of omega three acids? Finally, what measures are effective in reducing the intake of alcohol and alcoholic drinks among expectant women? Results The review found no randomized trials that attempted to promote awareness about the intake of folic acid among expectant mothers. “Control of this acids is crucial especially in the early months of pregnancy as increased intake of folic acids during this period was bound to promote increased neural tube defects” (Alexander &Cornely, 1987). It is therefore important to control the defect within the first trimester of expectancy by taking appropriate amounts of folic acids. “Pregnant women should be informed of this during their pregnancy period through media campaigns, prenatal advisors and caretakers” (Rolfes, Pinna & Whitney, 2009) It is important to note that was no randomized trials conducted in the United Kingdom to measure the amounts of folic acids among expectant women during, before and after an intervention. This was caused by the logistical difficulties that would be involved in the event of random checking of expectant women among its population. “Interventions aimed at promoting the use of appropriate amounts of folate and folic acid supplements has been conducted during the conceptual review of this matter” (Fowles, 2004). It is evident that with increased media consciousness and stipulation of folic acid supplements and advice on the use of these supplements will yield good results. What measures are deemed important in creating more awareness and knowhow among expectant mothers concerning the use and benefits of taking recommended amounts of omega 3 fatty acids and its vegetarian sources during pregnancy? What interventions are recommended in an effort to alter their consumption during pregnancy period? One relevant study was found to address the research question. “Several studies were conducted within a period of 19 weeks of expectancy about the importance of sufficient consumption of oily fish and omega 3 fatty acids” (Raznahan et al., 2012). In this regard, the review did not find any significant impact on birth results when measurements were made. It is important to note that from the observations collected, the study did not find a vital difference in the nature of birth results between expectant women who received counseling and those who did not receive the counseling on the appropriate intake of sea fish within the first 20 weeks of expectancy. In disregard of other interventions, the review had to address the interventions necessary in addressing the problem of alcohol intake among expectant mothers. “Numerous studies conducted have evaluated interventions aimed at reducing the amount of alcohol intake among expectant mothers” (Rathus, 2011). In one of the research study cases, the review found that there was bound to be a reduction in alcohol intakes among expectant mothers as the period of pregnancy progressed towards the last trimesters. “However, a randomized trial conducted in the United States of America evaluated the advices offered by trained clinicians did not prove to yield proper results on alcohol reduction among the drinking population of pregnant mothers” (Alexander, & Cornely, 1987). It is important to note that though the two reviews were independent, both groups proved to cause a drop in alcohol consumption among the expectant mothers. “It is evident from the studies conducted in both the united states of America and Europe that women who get into counseling with a view of seeking help on the reduction of alcohol during expectancy period experience a significantly reduced intake as the pregnancy progresses” (Davis, 2011). This reduction has been found to occur through the implantation of various interventions and control groups. “It has also been found that a brief counseling by a trained clinician counselor reported a fall on the drinking level and alcohol consumption” (Samour & King, 2012). The review has not found a study that appraises different ways intended on giving advises to expectant mothers on matters related to food safety. “A study conducted in the united kingdom in 2003 indicates that increased awareness on the food safety especially the presence mercury contents in some fish species resulted in a drop in fish consumption level among expectant mothers” (Balarajan et al., 2012). Given the importance of food safety during expectancy period, any warning a government authority gives regarding the safety a food type result in a sharp drop in its consumption. Under this review, the review question is what counseling/educational interventions are appropriate in the improvement of nutritional intake among the expectant mothers? In addition, are there counseling/ educational interventions that are aimed at educating specific groups of pregnant mothers on appropriate nutritional intake? It is evident from the review that two research studies attempted to answer the question the van Teijlingen of 1998 and D’Souza et al., 2005. “The studies comprised of two United Kingdom studies, the Frank in 2007and Doyle’s in 1992” (Frank, 2007). The studies found across several reviews varied interventions among varied populations where a good number of these reviews were of low quality and small in content sampling. “The populations in the study were varied as earlier mentioned and included among others Mexican immigrants residing in the United Kingdom, Indians, and the Greek” (Newman & Newman, 2009). In the Anderson’s study of 1995, the population of expectant women sampled received normal prenatal advice, education and care from midwives at the time the study began. “This was followed by the intervention group education given during the 26th week of expectancy” (Burdge et al., 2009). At the beginning of the 30th week, an interview was carried out where they were required to fill in structured questionnaires that asked them about their knowledge about appropriate food intakes, their attitudes and put on record their food intake schedules. Sampled results showed that the intervention groups scored exceedingly on matters related to the knowledge acquired but dismally on feelings about good diet. “Non-randomized control trials conducted in Scotland showed that when expectant mothers are given written educational materials on diet during the initial stages of pregnancy, produced small but still noteworthy upsurge in women’s knowledge on nutrition” (Bloomfield, 2011). It however fails to produce positive results in attitude towards diet during pregnancy period. “Another study conducted in London to compare various intervention groups that gave a controlled group of expectant mothers dietary counseling while offering two different food supplement types during the second and third trimester found that there was no significant upsurge in weight gain, gestation period, the size of the baby’s head and length” (Alexander, &Cornely, 1987). It however found a small but significant upsurge in the mean birth weights for women in the control group as compared to children born of women outside the control group. Nutrition during pregnancy is a key aspect that needs attention due to associated adverse effects such as minimal birth weight and premature births. “This is because the effects can have a long term effect in the health of the unborn baby in terms of development, quality of health and costs incurred in treatment of after birth complications” (Alexander, &Cornely, 1987). Low birth mass of as low as 2.5 kilograms can easily lead to preterm delivery, intrauterine development catastrophe and general growth disruption. “In fact, research shows that children born with low birth weight constitute about 50%-80% of newborn deaths” (Davis, 2011). This is a global figure of which close to 98% of these cases occur in unindustrialized nations. It is evident from the research that most of the low birth weights cases reported in developing and developed countries are associated by perinatal illness and augmented danger of long-term incapacity. Deliveries occurring below 37 weeks lapse are regarded as premature births. Such births contribute majorly to low birth mass and a leading case of infant mortality in the world today. These effects also contribute to a substantial amount of expenses incurred in after birth care caused by preterm born babies and low birth weight interventions. A research conducted in countries which have advanced medical structures show that the cost incurred in neonatal care and treatment for every low birth weight and preterm deliveries increase as the number of infants born prematurely increase. “In another study conducted in California, the cost incurred in caring for a prematurely born infant for the first ten years of his or her life was between 4 and 10 times the costs incurred in care and treatment of a normal baby” (Tulchinsky & Varavikova, 2009). Similarly, the costs incurred in educating and offering social development services to these children was found to be about 2 -10 times the costs for children born with mature weights and term. The health costs incurred is due to increased risks and disorders such neurologic, learning, psychiatric, and mental disorders. Hypothesis show that numerous adulthood diseases such heart diseases, hypertension, and type 2 diabetes are caused due to impaired intrauterine growth disorders and development combined with excessive weight gain in an effort to recover low birth weights during birth. This research paper seeks to answer the question behind dietary provision programs and support in the purchase of certain foods aimed at improving nutritional intake among pregnant mothers. “An evaluation from an organization in the united states of America which conducted a research on the same matter in 1988 produced results that cannot be relied on as they were flawed and biased” (Tulchinsky & Varavikova, 2009). First, a quarter of the sampled groups of expectant mothers were not included in the final analysis of research. “Secondly, the information collected from the health institution records shows that 25 percent of the study population was missing” (Alexander, &Cornely, 1987). These flaws graded the research with a minus since the result of the selection group could not be unearthed. “In a study conducted on two groups of women who were prevalent with low weight and overweight babies carried at the same period, showed from the results obtained during birth that expectant mothers who fed on milk, cheese and eggs had an increased maternal birth weight as compared with the women in control population” (Bloomfield, 2011). However, this did not alter the mean low and high weight gain. The study took a group comprising of women at the second trimester of pregnancy in order to avoid the results of the group being influenced by food initiatives during the entire pregnancy period. From these findings, it is evident that no weighty impact was recorded in the mean delivery mass. “It is also evident that the low birth weight babies born to mothers enrolled into initiative groups during their median pregnancy was significantly reduced” (Muscati, Gray-Donald, & Koski, 1996). These results are based on comparative study to mothers in a control group who received no nutritional enhancements. Conclusion In conclusion, nutrition during pregnancy is a vital component in influencing growth and development of the fetus and birth results. “The public health sectors worldwide invests heavily in maternal nutrition and other efforts in aimed at limiting negative birth outcomes especially among the low income earning populations” (Balarajan et al., 2012). Intervention studies by various groups have in most cases been based on single nutrient intervention which though the research has been done for a short period, the results have yielded positive results. However, the results obtained by these groups have had inconsistent results. “This is caused by logistical constraints such as sample sizing, costs involved in the intervention, and timing” (Alexander, &Cornely, 1987). Owing to the present limitations, this research paper relies mostly on observational and experimental studies. “These studies incorporate multi-nutrient status in addition to maternal nutrition from preconception period through a single reproductive cycle” (Harnisch, 2012).  Whereas the relationship between maternal nutrition, biological, sociological and the nature of birth outcomes have been studied separately, they are intertwined. It is therefore imperative that new approaches be adopted to further our understanding on the influence of the above variables on birth outcome and hence come up with solutions to combat negative birth results among expectant mothers in the United Kingdom. References Alexander, G. R., & Cornely, D. A. 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