Features of eating behavior in women: experience of observation with an assessment of the risk of predicted complications

   Introduction. Studies show that up to 8 % of pregnant women suffer from eating disorders. Such problems are found everywhere, most often women do not even realize that this may be related to problems. And for pregnant women, this issue is most relevant, since there is a risk of complications of the gestation period, after which it is necessary to prevent unfavorable variants of the course of pregnancy and childbirth.
   Aim. To study the variants of eating disorders in pregnant women to assess the prognosis of pregnancy.

   Materials and methods. We conducted a retrospective analysis of clinical case histories of pregnant women (n = 267), followed by a survey of women on the basis of the State Medical Institution “Maternity Hospital No. 2” in Tyumen. The study period is from 2019–2022. Two groups were identified for the analysis: 1^st  – BMI of 18.5–24.9 kg/m² : 2^nd  – BMI of 25 kg/m²  or more. In order to determine the type of eating disorder, we used various versions of questionnaires.
   Results. Of the total number of women surveyed, overweight (BMI) was determined in 149/267 (55.9 %, 2 group), in 118/267 (44.1 %, 1 group), BMI was within normal values. Risk factors were identified for the groups that could affect the course of the gestational process in the case of an identified eating disorder. When assessing comorbidity, gynecological diseases were detected, pathologies were significantly more common for group 2 62/149 (41.6 %). The dependence of the presence of a violation of any type of eating behavior and the risk of possible complications of pregnancy is not statistically significant.

   Conclusions. To maximize the favorable course of pregnancy and reduce the risk of possible complications, it is necessary to prepare a plan of preventive measures, which will include nutrition planning with a detailed description of solutions for a certain type of eating disorder.

1. Макарова Е. Л. Оценка факторов риска развития избыточной массы тела и ожирения у женщин репродуктивного возраста Анализ риска здоровью / Е.Л. Макарова, А. А. Олина, М. М. Падруль. – 2020. – (2): 38–46. https://doi.org/10.21668/health.risk/2020.2.04. – Makarova E. L., Olina A. A., Padrul’ M. M. Assessment of risk factors for overweight and obesity in women of reproductive age. Health Risk Analysis. 2020; (2): 38–46. (In Russ.) https://doi.org/10.21668/health.risk/2020.2.04.

2. Матейкович Е. А. Неблагоприятные исходы беременности и гестационный сахарный диабет: от исследования НАРО к современным данным / Е. А.Матейкович // Акушерство и гинекология. – 2021. – (2): 13–20. Режим доступа: https://doi.org/10.18565/aig.2021.2.13-20. – Mateykovich E. A. Adverse pregnancy outcomes and gestational diabetes mellitus: from the NARO study to current data. Akusherstvo i Ginekologiya (Russian Federation). 2021; (2): 13–20. (In Russ.) https://doi.org/10.18565/aig.2021.2.13-20.

3. Падруль М. М. Оценка инсулинорезистентности у беременных с ожирением / М. М. Падруль, Ф. Х. Алиева // Уральский медицинский журнал. – 2019. – (15): 51–53. Режим доступа: https://elibrary.ru/item.asp?id=41589636. – Padrul M. M., Alieva F. Kh. Assessing insulin resistance in obese pregnant women. Ural Medical Journal. 2019; (15): 51–53. (In Russ.) Available at: https://elibrary.ru/item.asp?id=41589636.

4. Райлян А. Л. Конституциональный подход к физиологическому обоснованию двигательной активности у беременных с избыточной массой тела / А. Л. Райлян [и др.] // Медицинская наука и образование Урала. – 2018. –(3): 63–66. Режим доступа: https://elibrary.ru/item.asp?id=35686802. – Raylyan A. L., Gordiychuk S. N., Tomilova E. A., Samsonov N. S. Constitutional approach to physiological justification of motor activity in overweight pregnant women. Meditsinskaya Nauka i Obrazovanie Urala. 2018; (3): 63–66. (In Russ.) Available at: https://elibrary.ru/item.asp?id=35686802.

5. Садыкова Г. К. Оценка фактического питания в первом триместре беременности как показатель формирования преморбидного фона / Г. К. Садыкова, А. А. Олина, М. М. Падруль // Журнал акушерства и женских болезней. – 2021. – 70 (2): 63–76. https://doi.org/10.17816/JOWD49965. – Sadykova G. K., Olina A. A., Padrul M. M. Assessment of actual nutrition in the first trimester of pregnancy as an indicator of premorbid background formation. Journal of Obstetrics and Women’s Diseases. 2021; 70; (2): 63–76. (In Russ.) https://doi.org/10.17816/JOWD49965.

6. Ушакова С. А. Анализ различных способов фракционирования жировой массы тела / С.А. Ушакова [и др.] // Морфология. – 2019. – 155 (2): 291–292. Режим доступа: https://www.elibrary.ru/item.asp?id=38174428. – Ushakova S. A., Orlova I. S., Kuznetsova Ya. V., Orlova E. S. Different ways to fractionate body fat mass. Morphology. 2019; 155 (2): 291–292. (In Russ.) Available at: https://www.elibrary.ru/item.asp?id=38174428.

7. Ушакова С. А. Сравнение различных способов определения массы тела / С. А. Ушакова [и др.] // Университетская медицина Урала. – 2018. – 4 (4): 38–40. Режим доступа: https://www.elibrary.ru/item.asp?id=36931553. – Ushakova S. A., Kuznetsova Ya. V., Orlova I. S., Kuzmina A. V. Comparison of different methods for determining body weight. Universitetskaya Meditsina Urala. 2018; 4 (4): 38–40. (In Russ.) Available at: https://www.elibrary.ru/item.asp?id=36931553.

8. Чабанова Н. Б. Проблемы диагностики избыточной массы тела и ожирения во время беременности / Н.Б. Чабанова [и др.] // Здоровье и образование в XXI веке. – 2016. – 18 (2): 176–180. Режим доступа: https://cyberleninka.ru/article/n/problemy-diagnostiki-izbytochnoy-massy-tela-i-ozhireniya-vo-vremya-beremennosti. – Chabanova N. B., Vasil’kova T. N., Shevlyukova T. P., Khasanova V. V. Problems diagnosing overweight and obesity during pregnancy. Health and Education Millennium. 2016; 18 (2): 176–180. (In Russ.) Available at: https://cyberleninka.ru/article/n/problemy-diagnostiki-izbytochnoy-massy-tela-i-ozhireniya-vo-vremya-beremennosti.

9. Макарова Е. Л. Роль комплексной программы прегравидарной подготовки женщин с ожирением в профилактике гестационных осложнений / Е. Л. Макарова, А. А. Олина, Н. А. Терехина // Акушерство и гинекология. – 2020. – (4): 182–188. https://doi.org/10.18565/aig.2020.4.182-188. – Makarova E. L., Olina A. A., Terekhina N. A. Role of a comprehensive pregravidary training program for obese women in the prevention of gestational complications. Akusherstvo i Ginekologiya (Russian Federation). 2020; (4): 182–188. (In Russ.) https://doi.org/10.18565/aig.2020.4.182-188.

10. Радзинский В. Е. Беременность ранних сроков. От прегравидарной подготовки к здоровой гестации / В. Е. Радзинский, А. А. Оразмурадов ; Под ред. А. А. Оразмурадова. – 3-е изд., испр. и доп. – М.: Status Praesens; 2020. – 798 с. Режим доступа: https://praesens.ru/knigi-1/beremennost-rannih-srokov. – Radzinskiy V. E., Orazmuradov A. A. (eds.). Early pregnancy. From pregravidary preparation to healthy gestation. 3 nd ed. Moscow: Status Praesens; 2020. 798 p. (In Russ.) Available at: https://praesens.ru/knigi-1/beremennost-rannih-srokov.

11. Савельева И. В. Особенности прегравидарной подготовки у женщин с ожирением / И. В. Савельева [и др.] // Вопросы гинекологии, акушерства и перинатологии. – 2018. – 17 (5): 29–34. https://doi.org/10.20953/1726-1678-2018-5-29-34. – Saveleva I. V., Barinov S. V., Blauman S. I., Bukharova E. А., Shirokova О. V., Krasnikova E. P. et al. Features of pre-gravidary training in obese women. Gynecology, Obstetrics and Perinatology. 2018; 17 (5): 29–34. (In Russ.) https://doi.org/10.20953/1726-1678-2018-5-29-34.

12. Кравченко Е. Н. Значение прегравидарной подготовки и репродуктивных установок женщин г. Омска / Е. Н. Кравченко, Р. А. Моргунова // Гинекология. – 2018. – 20 (6): 48–52. Режим доступа: https://journals.eco-vector.com/2079-5831/article/view/30116/pdf. – Kravchenko E. N., Morgunov R. A. Significance of pre-gravidary training and reproductive attitudes of Omsk women. Gynecology. 2018; 20 (6): 48–52. (In Russ.) Available at: https://journals.eco-vector.com/2079-5831/article/view/30116/pdf.

13. Олина А. А. Оценка пищевого потребления цинка во время беременности как управляемый фактор риска развития акушерских осложнений / А. А. Олина, Г. К. Садыкова, Н. М. Пирожникова // Медицинская наука и образование Урала. – 2021. – 22 (4): 67–72. Режим доступа: https://elibrary.ru/item.asp?id=47880982. – Olina A. A., Sadykova G. K., Pirozhnikova N. M. Assessment of dietary zinc intake during pregnancy, as a manageable risk factor for obstetric complications. Meditsinskaya Nauka i Obrazovanie Urala. 2021; 22 (4): 67–72. (In Russ.) Available at: https://elibrary.ru/item.asp?id=47880982.

14. Садыкова Г. К. Анализ фактического питания женщин молодого репродуктивного возраста как этапа прегравидарной подготовки / Г. К. Садыкова [и др.] // Медицинская наука и образование Урала. – 2021. –22 (4): 112–118. Режим доступа: https://elibrary.ru/item.asp?id=47880993. – Sadykova G. K., Meteleva T. A., Olina A. A., Shirikina E. V. Analysis of the actual nutrition of young women of reproductive age, as a stage of pre-gravidary training. Meditsinskaya Nauka i Obrazovanie Urala. 2021; 22 (4): 112–118. (In Russ.) Available at: https://elibrary.ru/item.asp?id=47880993.

15. Синдюкова Е. Г. Гестационный сахарный диабет: исходы беременности и родов / Е. Г. Синдюкова [и др.] // Медицинская наука и образование Урала. – 2020. –22 (4): 119–125. Режим доступа: https://elibrary.ru/item.asp?id=47880994. – Syundyukova E. G., Medvedeva B. I., Chulkov V. S., Ryabkina M. G., Tarasova L. B., Filippova N. A., Yakovleva Yu. A. Gestational diabetes mellitus: pregnancy and childbirth outcomes. Meditsinskaya Nauka i Obrazovanie Urala. 2021; 22 (4): 126–129. (In Russ.) Available at: https://elibrary.ru/item.asp?id=47880994.

16. Iordachescu A. C., Cirstoiu M. M., Zugravu C. A., Teodor O. M., Turcan N., Ducu I., Bohiltea R. E. Dietary behavior during pregnancy. Exp Ther Med. 2020; 20 (3): 2460–2464. https://doi.org/10.3892/etm.2020.8804.

17. Kebbe M., Flanagan E. W., Sparks J. R., Redman L. M. Eating Behaviors and Dietary Patterns of Women during Pregnancy: Optimizing the Universal ‘Teachable Moment’. Nutrients. 2021; 13 (9): 3298. https://doi.org/10.3390/nu13093298.

18. Versele V., Stok F. M., Aerenhouts D., Deforche B., Bogaerts A., Devlieger R. et al. Determinants of changes in women’s and men’s eating behavior across the transition to parenthood: a focus group study. Int J Behav Nutr Phys Act. 2021; 18 (1): 95. https://doi.org/10.1186/s12966-021-01137-4.

19. Tran N. T., Nguyen L. T., Berde Y., Low Y. L., Tey S. L., Huynh D. T. T. Maternal nutritional adequacy and gestational weight gain and their associations with birth outcomes among Vietnamese women. BMC Pregnancy Childbirth. 2019; 19 (1): 468. https://doi.org/10.1186/s12884-019-2643-6.

20. Super S., Beulen Y. H., Koelen M. A., Wagemakers A. Opportunities for dietitians to promote a healthy dietary intake in pregnant women with a low socio-economic status within antenatal care practices in the Netherlands: a qualitative study. J Health Popul Nutr. 2021;40(1):35. https://doi.org/10.1186/s41043-021-00260-z.

21. Garmendia M. L., Corvalan C., Araya M., Casanello P., Kusanovic J. P., Uauy R. Effectiveness of a normative nutrition intervention in Chilean pregnant women on maternal and neonatal outcomes: the CHiMINCs study. Am J Clin Nutr. 2020; 112 (4): 991–1001. https://doi.org/10.1093/ajcn/nqaa185.

22. Wang Y., Li R., Liu D., Dai Z., Liu J., Zhang J. et al. Evaluation of the dietary quality by diet balance index for pregnancy among pregnant women. Wei Sheng Yan Jiu. 2016; 45 (2): 211–216. Available at: https://pubmed.ncbi.nlm.nih.gov/27301216.

23. Kozlowska A., Jagielska A. M., Okreglicka K. M., Dabrowski F., Kanecki K., Nitsch-Osuch A. et al. Dietary macronutrients and fluid intakes in a sample of pregnant women with eithergestational diabetes or type 1 diabetes mellitus, assessed in comparison with Polish nutritional guidelines. Ginekol Pol. 2018; 89 (12): 659–666. https://doi.org/10.5603/GP.a2018.0111.

24. Lee A., Newton M., Radcliffe J. Belski R. Pregnancy nutrition knowledge and experiences of pregnant women and antenatal care clinicians: A mixed methods approach. Women Birth. 2018; 31 (4): 269–277. https://doi.org/10.1016/j.wombi.2017.10.010.

25. Nikièma L., Huybregts L., Martin- Prevel Y., Donnen P., Lanou H., Grosemans J. et al. Effectiveness of facility-based personalized maternal nutrition coun-seling in improving child growth and morbidity up to 18 months: A cluster-randomized controlled trial in rural Burkina Faso. PLoS ONE. 2017; 12 (5): e0177839. https://doi.org/10.1371/journal.pone.0177839.

26. Olmedo-Requena R., Gómez-Fernández J., Mozas-Moreno J., Lewis-Mikhael A. M., Bueno-Cavanillas A., Jiménez-Moleón J. J. Factors associated with adherence to nutritional recommendations before and during pregnancy. Women Health. 2018; 58 (10): 1094–1111. https://doi.org/10.1080/03630242.2017.1388332.

27. Shi Y., Shi H., Ma X., Tan L., Zhang Y., Wang L. Gestational stress on dietary preferences in late pregnancy. Wei Sheng Yan Jiu. 2020; 49 (1): 1–18. (In Chinese) https://doi.org/10.19813/j.cnki.weishengyanjiu.2020.01.001.

28. Diddana T. Z. Factors associated with dietary practice and nutritional status of pregnant women in Dessie town, northeastern Ethiopia: a community- based cross-sectional study. BMC Pregnancy Childbirth. 2019; 19 (1): 517. https://doi.org/10.1186/s12884-019-2649-0.

29. Horan M. K., McGowan C. A., Gibney E. R., Byrne J., Donnelly J. M., McAuliffe F. M. Maternal Nutrition and Glycaemic Index during Pregnancy Impacts on Offspring Adiposity at 6 Months of Age – Analysis from the ROLO Randomised Controlled Trial. Nutrients. 2016; 8 (1): 7. https://doi.org/10.3390/nu8010007.