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Abstract：
OBJECTIVE: To identify determinants of diet in pregnancy, by detecting factors in our multiple-determinants life course framework that are associated with dietary patterns, quality or guideline adherence.
METHODS: A systematic review of observational studies, published in English or German, was conducted. Sociodemographic, lifestyle, environmental and pregnancy-related determinants were considered. Four electronic databases were searched in January 2015 and updated in April 2016 and a total of 4368 articles identified. Risk of bias was assessed using adapted Newcastle-Ottawa Scales.
METHODS: High- and upper-middle-income countries.
METHODS: Pregnant or postpartum women reporting their dietary intake during pregnancy.
RESULTS: Seventeen publications of twelve studies were included and compared narratively due to heterogeneity. Diet in pregnancy was patterned along a social gradient and aligned with other health behaviours before and during pregnancy. Few studies investigated the influence of the social and built environment and their findings were inconsistent. Except for parity, pregnancy determinants were rarely assessed even though pregnancy is a physiologically and psychologically unique period. Various less well-researched factors such as the role of ethnicity, pregnancy intendedness, pregnancy ailments and macro-level environment were identified that need to be studied in more detail.
CONCLUSIONS: The framework was supported by the literature identified, but more research of sound methodology is needed in order to conclusively disentangle the interplay of the different determinants. Practitioners should be aware that pregnant women who are young, have a low education or do not follow general health advice appear to be at higher risk of inadequate dietary intake.
METHODS: A systematic review of observational studies, published in English or German, was conducted. Sociodemographic, lifestyle, environmental and pregnancy-related determinants were considered. Four electronic databases were searched in January 2015 and updated in April 2016 and a total of 4368 articles identified. Risk of bias was assessed using adapted Newcastle-Ottawa Scales.
METHODS: High- and upper-middle-income countries.
METHODS: Pregnant or postpartum women reporting their dietary intake during pregnancy.
RESULTS: Seventeen publications of twelve studies were included and compared narratively due to heterogeneity. Diet in pregnancy was patterned along a social gradient and aligned with other health behaviours before and during pregnancy. Few studies investigated the influence of the social and built environment and their findings were inconsistent. Except for parity, pregnancy determinants were rarely assessed even though pregnancy is a physiologically and psychologically unique period. Various less well-researched factors such as the role of ethnicity, pregnancy intendedness, pregnancy ailments and macro-level environment were identified that need to be studied in more detail.
CONCLUSIONS: The framework was supported by the literature identified, but more research of sound methodology is needed in order to conclusively disentangle the interplay of the different determinants. Practitioners should be aware that pregnant women who are young, have a low education or do not follow general health advice appear to be at higher risk of inadequate dietary intake.
摘要：
目的：确定妊娠期饮食的决定因素，通过检测我们的多决定因素生命过程框架中与饮食模式相关的因素，质量或指导方针的遵守。
方法：观察性研究的系统综述，以英语或德语出版，进行了。社会人口统计学，生活方式,考虑了环境和妊娠相关的决定因素.2015年1月搜索了四个电子数据库，并于2016年4月进行了更新，总共确定了4368篇文章。使用适应的纽卡斯尔-渥太华量表评估偏倚风险。
方法：中高收入国家。
方法：孕妇或产后妇女报告她们在怀孕期间的饮食摄入量。
结果：由于异质性，纳入了12项研究的17篇出版物，并进行了叙述比较。怀孕期间的饮食是按照社会梯度进行的，并与怀孕前和怀孕期间的其他健康行为保持一致。很少有研究调查社会和建筑环境的影响，他们的发现是不一致的。除了奇偶校验，即使怀孕是生理和心理上独特的时期，也很少评估怀孕的决定因素。各种研究较少的因素，如种族的作用，怀孕意向，确定了需要更详细研究的妊娠疾病和宏观环境。
结论：该框架得到了文献的支持，但是，需要对合理的方法论进行更多的研究，以便最终解决不同决定因素之间的相互作用。从业者应该意识到年轻的孕妇，受教育程度低或不遵循一般健康建议似乎有更高的饮食摄入不足的风险。
方法：观察性研究的系统综述，以英语或德语出版，进行了。社会人口统计学，生活方式,考虑了环境和妊娠相关的决定因素.2015年1月搜索了四个电子数据库，并于2016年4月进行了更新，总共确定了4368篇文章。使用适应的纽卡斯尔-渥太华量表评估偏倚风险。
方法：中高收入国家。
方法：孕妇或产后妇女报告她们在怀孕期间的饮食摄入量。
结果：由于异质性，纳入了12项研究的17篇出版物，并进行了叙述比较。怀孕期间的饮食是按照社会梯度进行的，并与怀孕前和怀孕期间的其他健康行为保持一致。很少有研究调查社会和建筑环境的影响，他们的发现是不一致的。除了奇偶校验，即使怀孕是生理和心理上独特的时期，也很少评估怀孕的决定因素。各种研究较少的因素，如种族的作用，怀孕意向，确定了需要更详细研究的妊娠疾病和宏观环境。
结论：该框架得到了文献的支持，但是，需要对合理的方法论进行更多的研究，以便最终解决不同决定因素之间的相互作用。从业者应该意识到年轻的孕妇，受教育程度低或不遵循一般健康建议似乎有更高的饮食摄入不足的风险。
