Table 3 Sample size, participant characteristics, study design, quality appraisal, and exposure and outcome variables
From: Maternal diet, nutritional status and infant birth weight in Malaysia: a scoping review
Study (year) | Sample size | Participant characteristics | Study design | Quality Appraisal (out of 4) | Exposure | Outcome | Results | ||
|---|---|---|---|---|---|---|---|---|---|
Method of data collection | Variables examined | Timing | Variable | ||||||
Boo et al. (2008) [13] | 350 cases; 350 controls | Pregnant women delivered live births, Negeri Sembilan; mean age 28 years; Malay (63%), Chinese (12%), Indian (20%), others (5%) | Case-control study | 2 = moderate; Study design = 1, sample size =1 | Retrospectively retrieved from medical records | - Pre-pregnancy weight (kg) based on measured weight in the first trimester or recalled weight at late booking; - blood pressure | Birth | LBW < 2.5 kg vs. birth weight ≥ 2.5 kg | Higher pre-pregnancy weight was associated with lower odds of LBW. |
Rahman et al. (2008) [14] | 312 cases; 312 controls | Healthy pregnant women with singleton live births, Kedah; age < 20y (2%), 20-34y (80%), ≥35y (18%); Malay (75%), Chinese (10%), Indian (14%), others (1%) | Case-control study | 2 = moderate; Study design = 1, sample size =1 | Retrospectively retrieved from medical records | - GWG (< 10, 10–12, > 12 kg) based on difference between measured weight at last antenatal visit and recalled pre-pregnancy weight; - blood pressure | Birth | LBW < 2.5 kg vs. birth weight 2.5–4.0 kg | Low GWG was associated with higher odds of LBW. |
Tan et al. (2009) [15] | 1368 | Pregnant women with singleton births, Kuala Lumpur; mean age 30y; Malay (62%), Chinese (18%), Indian (15%), others (5%) | Cross-sectional study | 2 = moderate; Study design = 1, sample size =1 | Retrospectively retrieved from medical records | - GCT positive if 1-h plasma glucose ≥7.2 mmol/l.; - GCT false-positive (GCT positive & GTT negative); GDM (GCT & GTT positive), diagnosed based on WHO 1999 | Birth | Birth weight; LBW (< 2.5 kg); macrosomia (> 4.0 kg); | GCT false-positive status was associated with higher odds of PTB. GDM was associated with higher odds of macrosomia babies, labour induction and caesarean section. |
Rozlan et al. (2012) [16] | 436 | Singleton pregnancy women, 4 BMI groups; Underweight (< 18.5 kg/m2), Normal (18.5–24.9 kg/m2), Overweight (25–30 kg/m2), Obese (30 kg/m2) *according to WHO | Retrospective study | 1 = poor; Study design =1 | Pre-pregnancy until prior to birth | - Maternal data of height and weight gain obtained by phone called interview. | Birth | Birth weight | Normal BMI with low GWG was associated with higher odds of PTB and LBW. |
Loy et al. (2013) [17] | 121 | Malay healthy pregnant women with singleton full-term births, Kelantan; age 19–40 years | Cross-sectional study | 2 = moderate; Study design = 1, valid data collection method =1 | Throughout pregnancy | Energy and nutrient intake (unit/day); fruit and vegetable intake (g/day) based on semi-quantitative food frequency questionnaire | Birth | Birth weight | Greater leafy vegetable intake was associated with larger head circumference (HC). Greater tuber vegetable intake was associated with higher birth length and larger HC. Greater fruit intake was associated with higher birth weight, birth length and HC. |
Kampan et al. (2013) [18] | 400 cases; 400 controls | Pregnant women with diabetes and healthy control, Kuala Lumpur; age < 25y (8%), 25-35y (73%), >35y (19%),; Malay (69%), Chinese (25%), Indian (5%), − others (1%) | Case-control study | 2 = moderate;; Study design = 1, sample size =1 | Retrospectively retrieved from medical records | Diabetes in pregnancy (Type 1/ 2 diabetes) and GDM (insulin; diet control). Diabetes in pregnancy diagnosis based on fasting glucose ≥6.0 mmol/l and 2-h post-load 75 g glucose ≥7.8 mmol/l. GDM diagnosis criteria not specified. | Birth | IUGR; macrosomia (> 4.0 kg); | Women with diabetes on insulin had higher odds PTB. Higher rates of macrosomia, low Apgar score, NICU admission, hypoglycaemia and RSD were shown in women with diabetes, especially in those on insulin. Higher rates of NICU admission, macrosomia and RDS were shown in women with higher HbA1c. |
Ismail et al. (2013) [19] | 279 | Pregnant women at risk of diabetes with singleton births, Kuala Lumpur; mean age 31.1y; Malay (76%), Chinese (21%) Indian (3%) | Prospective cohort study | 2 = moderate; Study design = 1, valid data collection method =1 | Not specified | GDM diagnosis based on fasting glucose ≥6 mmol/l or 2 h post-load 75 g glucose ≥7.8 mmol/l; maternal fasting serum insulin and HOMA-IR score | Birth | Macrosomia (> 4.0 kg) | High HOMA-IR score (≥2.92 vs. < 2.92) was associated with higher rates of neonatal hypoglycaemia and caesarean section in GDM women. |
Yadav and Lee (2013) [20] | 666 | Healthy pregnant women with singleton live births, Negeri Sembilan; age < 24y (18%), 25-29y (41%), 30-34y (24.8%), ≥35y (17.0); Malay (68%), Chinese (14%), Indian (14%) | Cross-sectional study | 2 = moderate; Study design = 1, sample size =1 | Retrospectively retrieved from medical records | Pre-pregnancy BMI (< 20, 20–24.9, ≥25 kg/m2) based on first booking measured weight and height; blood pressure | Birth | LBW < 2.5 kg | Low pre-pregnancy BMI (< 20 vs. 20–24.9 kg/m2) was associated with higher odds of LBW. |
Manaf et.al (2014) [21] | 236 | Pregnant women, Underweight (12.7%) Normal (55.1%) Overweight (25%) Obese (7.2%) | Cross Sectional | 2 = moderate; Study design = 1, sample size =1 | Throughout pregnancy | Nutritional knowledge and dietary intake | Prior to Birth | Micronutrient intake | One-third of respondents were anaemic. Most of the participants did not achieve RNI for calcium, folic acid, niacin and vitamin D. |
Jan Mohamed et.al (2014) [22] | 102 | Pregnant women aged 19–40 years. | Prospective cohort study | 2 = moderate; Study design = 1, sample size =1 | 14–24 gw; ≥32 gw | Blood and breast milk vitamin D levels; Dietary intake | 14–24 weeks; ≥32 gw | Dietary calcium intake | Vitamin D deficiency [25(OH) D < 50 nmol/L] was detected in 60 and 37% of women in the second and third trimesters of pregnancy, respectively. Higher maternal serum vitamin D level in the second trimester of pregnancy was associated with an elevated level of vitamin D in breast milk at delivery (β = 0.002, p = 0.026). |
Yadav and Lee (2014) [23] | 2332 | Pregnant women with singleton full-term births, Negeri Sembilan; Malay (67%), Chinese (14%), Indian (15%), others (4%) | Cross-sectional study | 3 = high; study design = 1; sample size =1; valid data instrument = 1 | Retrospectively retrieved from medical records | Pre-pregnancy BMI (< 20, 20–24.9, ≥25 kg/m2) based on first booking measured weight and height, GWG (< 10, ≥10 kg), diabetes in pregnancy | Birth | Macrosomia > 4.0 kg | High pre-pregnancy BMI (≥25 vs. < 20 kg/m2) was associated with higher odds of macrosomic babies. High GWG (≥10 vs. < 10 kg) was associated with higher odds of macrosomic babies. Diabetes in pregnancy was associated with higher odds of macrosomic babies. |
Yeop et.al (2018) [24] | 396 | Pregnant women aged 18–40 years | Cross-sectional study | 3 = high; study design = 1; sample size =1; valid data instrument = 1 | First trimester. | Milk intake and prevalence of hypocalcaemia on serum calcium | First trimester pregnancy | Calcium intake | Hypocalcemia was present in 26% of pregnant women. Median calcium intake in food was 625.53 mg/day. Pregnant women who consumed less than two glasses of milk per day had two times higher risk of developing hypocalcaemia. |
Kaur et al. (2019) [25] | 437 | Pregnant women at ≥20 gw in urban and rural | Prospective cohort study | 3 = high; study design = 1; sample size =1; valid data instrument = 1 | During pregnancy and followed up after they had given birth. | Questionnaires on sociodemographic characteristics and physical activity. Weight and middle-upper arm circumference were measured. | Birth | LBW | Rural women had more LBW infants than urban women. Rural women were less sedentary and participated in more household/caregiving activities, sports activities and less occupational activity than urban women. Older age, low parity and low MUAC increased the risk of LBW infants in rural, but not in urban women |
Edi (2021) [26] | 483 | Pregnant women with singleton full-term births, Kuala Lumpur and Selangor; ≥ 18 years, ≥ 28 weeks of gestations. | Cross-sectional study | 3 = high; study design = 1; sample size =1; valid data instrument = 1 | During pregnancy and follow up after they had given birth. | Pre-pregnancy BMI obtained from maternal medical records; Total gestational weight gain; prenatal care visit history; maternal smoking and SHS exposure during pregnancy | Birth | Birth weight | Inadequate GWG and exposure to SHS at home were significant predictors of LBW. |
Hasneezah et al. (2020) [27] | 162 | Anaemic pregnant women with haemoglobin (Hb) level between 7. 0 g/dl and 11.0 g/dl, singleton pregnancy; Malay (72.8%), Chinese (5.6%), Indian (16.0%) and others (4.9%). | Quasi-experimental study | 3 = high; study design = 1; sample size =1; valid data instrument = 1 | Second and third trimester | Haemoglobin level, knowledge score, Health Belief Model construct score, dietary intake | 35–37 weeks | Dietary iron intake | The dietary iron intake of respondents at pre- and post-test was below the Malaysian recommended iron intake for pregnant women. Low intake of iron could be due to the lower protein intake limited by economic status |
Yong et al. (2020) [28] | 2193 | Healthy, non-diabetic women, singleton pregnancy; Malay (83.7%), Chinese (4.7%), Indian and others (11.6%). | Retrospective cohort study | 2 = moderate; study design =1; sample size = 1 | Throughout pregnancy | Rate of gestational weight gain and total gestational weight gain | Birth | Birth weight | Higher GWG as well as increasing GWG trajectories was associated with higher risk of PTB and LBW. Women with maintained rate of GWG at an average of 0·58 kg/week had lower risk of having SGA infants. |
Woon et al. 2019 [29] | 535 | Pregnant women with singleton pregnancy, ≥ 18 years, ≥ 28 weeks of gestation. | Prospective cohort study | 3 = high; study design = 1; sample size =1; valid data instrument = 1 | Third trimester | Serum 25(OH) D level, maternal vitamin D intake and supplementation, and sun exposure. | Prior to Birth | Vitamin D intake | Three-quarters of respondents did not achieve the RNI for vitamin D. Food sources, namely fish and fish products accounted for major source of vitamin D. |