Journal of Food and Nutrition Research, 2017, Vol. 5, No. 9, 689-696
Available online at http://pubs.sciepub.com/jfnr/5/9/9
©Science and Education Publishing
DOI:10.12691/jfnr-5-9-9
Prenatal Nutritional Care Improved Perinatal Outcome
of Pregnant Women in the Context of
Primary Health Care
Beatriz Della Líbera
1,*
, Mirian Ribeiro Baião
2
, Denise Cavalcante de Barros
3
,
Marta Maria Antonieta de Souza Santos
2
, Roberta Gabriela Araújo
3
, Cláudia Saunders
4
1
Graduate Program in Nutrition from Institute of Nutrition Josué de Castro, Rio de Janeiro Federal University, Rio de Janeiro, Brazil
2
Department of Social and Applied Nutrition, Rio de Janeiro Federal University, Rio de Janeiro Brazil
3
Laboratory of Education and Research in Food and Nutrition, Oswaldo Cruz Foundation, Rio de Janeiro Brazil
4
Department of Nutrition and Dietetics. Rio de Janeiro Federal University, Rio de Janeiro Brazil
*Corresponding author
Abstract The aim of the study was to assess the impact of a prenatal nutritional care programme on perinatal
outcome in the context of primary health care. That’s a non-randomised controlled clinical trial developed in a care
unit in Rio de Janeiro, Brazil. 284 pregnant women were allocated into one of two groups: an intervention group
(IG; n = 122), comprising pregnant women who received the intervention of nutritional care through collective
consultations with a nutritionist, and a control group (CG, n = 162) consisting of pregnant women who did not
receive the intervention. There was a higher proportion of pregnancy complications (p=0.000) and abnormal total
gestational weight gain (p=0.031) in the CG. In the final model, it was found that belonging to the CG (adjusted
OR=4.721; CI 95%=1.009-22.090) and living with four or more people in the household (adjusted OR=2.692;
CI 95%=1.021-7.101) were predictors of pregnancy complications, while belonging to the CG (adjusted OR=2.354;
CI 95%=1.063-5.213) and starting prenatal care after 16 weeks (adjusted OR =8.509; CI 95%=1.023-70.784) were
determinants of abnormal pregnancy weight gain. The findings reinforce that the prenatal nutritional care
programme contributed to improving the health of pregnant women.
Keywords: pregnancy, nutrition programmes, prenatal nutrition, primary health care, intervention studies, food
and nutrition education
Cite This Article: Beatriz Della Líbera, Mirian Ribeiro Baião, Denise Cavalcante de Barros, Marta Maria
Antonieta de Souza Santos, Roberta Gabriela Araújo, and Cláudia Saunders, “Prenatal Nutritional Care Improved
Perinatal Outcome of Pregnant Women in the Context of Primary Health Care.” Journal of Food and Nutrition
Research, vol. 5, no. 9 (2017): 689-696. doi: 10.12691/jfnr-5-9-9.
1. Introduction
Maternal morbidity is strongly associated with neonatal
mortality. Adequate prenatal care, with early detection and
intervention during risk situations, as well as good quality
care during labour, are key health indicators related to
mother and child. These indicators have potential to
further reduce the effects of risk factors related to
maternal and neonatal mortality [1,2,3].
Scientific evidence also suggests the importance of
prenatal nutritional care for the woman and her newborn
[4-9]. The World Health Organization [10] highlights
nutritional care as a pre- and post-natal strategy to improve
maternal, newborn and child health. The Brazilian Ministry
of Health provides for the organisation of nutritional care
in the health services, especially in the context of primary
health care (PHC), in order to meet the demands related to
nutrition generated by the most vulnerable people, such as
maternal and child groups [11,12].
Considering the growing number of studies that
confirm the benefits of proper nutrition on pregnancy
outcomes and the need to plan and organise nutritional
care during the different phases of the life course,
including pregnant women, mothers, and children under
two years of age, this study aimed to assess the impact of
a prenatal nutritional care model, focused on PHC, on
perinatal outcomes in a Family Clinic (FC) in the region
of Manguinhos, Rio de Janeiro, Brazil.
2. Materials and Methods
This non-randomised controlled trial is part of the
project entitled "Nutritional Prenatal Care in Primary
Health Care in the area of Manguinhos, Rio de Janeiro,
Brazil". The project studied 284 pregnant and postpartum
women in this region between 2012-2015. The study was
published in the Brazilian Platform of Clinical Trials
Records under the RBR-2x4gm7 registration number.
The inclusion criteria for the pregnant women were:
maternal age not more than 45 years old; singleton
pregnancy; gestational age up to 24 weeks; no history of
chronic diseases; and attending for prenatal care at the
clinic where the study was conducted. Pregnant women