SEARCHNARRATIVE_REVIEWobstetrics, gynecology

narrative_review·obstetrics, gynecology, maternal-fetal medicine, nutrition, public health, endocrinology·PMC10108324

Using FIGO Nutrition Checklist counselling in pregnancy: A review to support healthcare professionals

International Journal of Gynaecology and Obstetrics · 21 authors, 26 centres

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TL;DR

This review summarizes global dietary recommendations aligned with the FIGO Nutrition Checklist, a validated tool designed to identify nutritional risks in women before, during, and after pregnancy. The checklist covers dietary practices, body mass index, diet quality, and micronutrients (folic acid, vitamin D, iron), and aims to facilitate nutrition counselling between healthcare providers and women. Implementation of the checklist may help address malnutrition and reduce the intergenerational risk of noncommunicable diseases.

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BACKGROUND

Maternal nutrition is a global health priority linked to multiple Sustainable Development Goals. Many countries face a double or triple burden of malnutrition, with concurrent overnutrition, undernutrition, and micronutrient deficiencies. Most women do not meet dietary guidelines before or during pregnancy, and the COVID-19 pandemic has worsened dietary diversity and calorie intake. Suboptimal diets and high maternal weight increase risks of pregnancy complications and noncommunicable diseases in both mothers and children. International organizations including WHO and FIGO recommend nutrition and weight counselling during pregnancy, yet barriers include lack of nutrition training and resources for healthcare providers. The FIGO Nutrition Checklist was developed to address this gap.

METHODS

This is a narrative review summarizing international dietary recommendations for each component of the FIGO Nutrition Checklist. The authors reviewed freely available and published nutritional guidelines from countries across Asia, Africa, Europe, Oceania, North America, and South America (USA, India, Ireland, Canada, Australia, Kenya, Colombia). The review also incorporates practical insights from countries that have implemented the checklist.

KEY RESULTS

The FIGO Nutrition Checklist covers five food-based components and three micronutrients. For fruit and vegetables, most countries recommend at least 5 servings per day. Dairy recommendations range from 2–5 servings per day. Wholegrain recommendations vary widely: India recommends 9 portions of 30 g per day (50%–55% of total calorie intake), while Ireland recommends 3–5 servings per day. Meat, poultry, or egg recommendations vary from 2 servings per week (Kenya) to 3.5 servings per day (Australia). For micronutrients, folic acid supplementation of 400 μg per day is recommended across most countries, with higher doses (up to 5 mg/day) for those at increased risk of neural tube defects. Vitamin D recommendations range from 400–600 IU per day where specified, though several countries have no specific recommendation. Iron supplementation varies from 16–20 mg per day (Ireland, Canada) to 100 mg elemental iron for 100 days from the 16th week (India). The review notes that in Ireland and Hong Kong, the FIGO Nutrition Checklist identified suboptimal diets in over 80% of women. Saraf et al. found vitamin D deficiency (25[OH]D <50 nmol/L) in 54% of pregnant women globally, ranging from 46% in the Eastern Mediterranean to 87% in Southeast Asia. Iron deficiency anemia affects over one-third of pregnant women globally.

CLINICAL IMPLICATIONS

The FIGO Nutrition Checklist is a validated, freely available tool that can be used across diverse health settings and life stages to identify nutritional deficiencies and facilitate health-promoting conversations. It can be completed before antenatal visits to save clinical time. The checklist is particularly valuable given high rates of unplanned pregnancies and limited access to preconception care. A digital version is under development to improve accessibility via mobile devices. Healthcare providers should follow local dietary and clinical guidelines where available. The review emphasizes that dietary counselling before and during pregnancy improves maternal nutrition knowledge, dietary intakes, and clinical outcomes including anemia, gestational weight gain, and birth weight, with reduced risk of perinatal complications.

STUDY TYPE

narrative_review

SPECIALTY

obstetrics

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ORIGINAL PAPER

PMC10108324

Using FIGO Nutrition Checklist counselling in pregnancy: A review to support healthcare professionals

International Journal of Gynaecology and Obstetrics

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ABSTRACT

Abstract The period before and during pregnancy is increasingly recognized as an important stage for addressing malnutrition. This can help to reduce the risk of noncommunicable diseases in mothers and passage of risk to their infants. The FIGO Nutrition Checklist is a tool designed to address these issues. The checklist contains questions on specific dietary requirements, body mass index, diet quality, and micronutrients. Through answering these questions, awareness is generated, potential risks are identified, and information is collected that can inform health‐promoting conversations between women and their healthcare professionals. The tool can be used across a range of health settings, regions, and life stages. The aim of this review is to summarize nutritional recommendations related to the FIGO Nutrition Checklist to support healthcare providers using it in practice. Included is a selection of global dietary recommendations for each of the components of the checklist and practical insights from countries that have used it. Implementation of the FIGO Nutrition Checklist will help identify potential nutritional deficiencies in women so that they can be addressed by healthcare providers. This has potential longstanding benefits for mothers and their children, across generations.

CITATION EXPORT

Sarah Louise Killeen, Niamh Donnellan, Sharleen L. O'Reilly et al.. Using FIGO Nutrition Checklist counselling in pregnancy: A review to support healthcare professionals. International Journal of Gynaecology and Obstetrics. (2023). https://doi.org/10.1002/ijgo.14539

AUTHORS

21 · 26 CENTRES

Sarah Louise Killeen, Niamh Donnellan, Sharleen L. O'Reilly, Mark A. Hanson, Mary L. Rosser, Virna P. Medina, Chandni Maria Jacob, Hema Divakar, Moshe Hod, Liona C. Poon, Lina Bergman, Patrick O'Brien, Anil Kapur, Bo Jacobsson, Cynthia V. Maxwell, Harold David McIntyre, Lesley Regan, Esraa Algurjia, Ronald C. Ma, Sumaiya Adam, Fionnuala M. McAuliffe

1 UCD Perinatal Research Centre, School of Medicine University College Dublin, National Maternity Hospital Dublin Ireland
2 School of Agriculture and Food Science University College Dublin Dublin Ireland
3 Institute of Developmental Sciences University Hospital Southampton Southampton UK
4 NIHR Southampton Biomedical Research Centre University of Southampton Southampton UK
5 Department of Obstetrics and Gynecology Columbia University Irving Medical Center New York New York USA
6 Department of Obstetrics and Gynecology, Faculty of Health Universidad del Valle, Clínica Imbanaco Quirón Salud, Universidad Libre Cali Colombia
7 Divakar's Specialty Hospital Bengaluru India
8 Helen Schneider Hospital for Women, Rabin Medical Center Petah Tikva Israel
9 Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel
10 Department of Obstetrics and Gynecology Prince of Wales Hospital, The Chinese University of Hong Kong Hong Kong Hong Kong SAR China
11 Department of Obstetrics and Gynecology, Institute of Clinical Sciences Sahlgrenska Academy, University of Gothenburg Gothenburg Sweden
12 Department of Obstetrics and Gynecology Stellenbosch University Cape Town South Africa
13 Department of Women's and Children's Health Uppsala University Uppsala Sweden
14 Institute for Women's Health University College London London UK
15 World Diabetes Foundation Bagsvaerd Denmark
16 Department of Obstetrics and Gynecology Sahlgrenska University Hospital Gothenburg Sweden
17 Department of Genetics and Bioinformatics Domain of Health Data and Digitalization, Institute of Public Health Oslo Norway
18 Maternal Fetal Medicine, Sinai Health and Women's College Hospital University of Toronto Toronto Canada
19 Mater Health University of Queensland, Mater Health Campus South Brisbane Queensland Australia
20 Imperial College London London UK
21 The World Association of Trainees in Obstetrics & Gynecology Paris France
22 Elwya Maternity Hospital Baghdad Iraq
23 Department of Medicine and Therapeutics The Chinese University of Hong Kong Hong Kong Hong Kong SAR China
24 Hong Kong Institute of Diabetes and Obesity The Chinese University of Hong Kong Hong Kong Hong Kong SAR China
25 Department of Obstetrics and Gynecology, School of Medicine, Faculty of Health Sciences University of Pretoria Pretoria South Africa
26 Diabetes Research Centre, Faculty of Health Sciences University of Pretoria Pretoria South Africa