Preferences of women for web-based nutritional information in pregnancy

doi:10.1016/j.puhe.2016.10.028

Public Health

Volume 143, February 2017, Pages 71-77

https://doi.org/10.1016/j.puhe.2016.10.028 Get rights and content

Highlights

•
Women use a range of unregulated online nutritional resources during pregnancy.
•
There is minimal use of publically funded or academically supported resources.
•
Women are at risk of receiving dietary advice which is not scientifically based.
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This study identified the features women want from a web-based nutrition resource.
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These findings may assist in the design of future evidence-based applications.

Abstract

Objectives

During pregnancy, women are increasingly turning to web-based resources for information. This study examined the use of web-based nutritional information by women during pregnancy and explored their preferences.

Study design

Cross-sectional observational study.

Methods

Women were enrolled at their convenience from a large maternity hospital. Clinical and sociodemographic details were collected and women's use of web-based resources was assessed using a detailed questionnaire.

Results

Of the 101 women, 41.6% were nulliparous and the mean age was 33.1 years (19–47 years). All women had internet access and only 3% did not own a smartphone. Women derived pregnancy-related nutritional information from a range of online resources, most commonly: What to Expect When You're Expecting (15.1%), Babycenter (12.9%), and Eumom (9.7%). However, 24.7% reported using Google searches. There was minimal use of publically funded or academically supported resources. The features women wanted in a web-based application were recipes (88%), exercise advice (71%), personalized dietary feedback (37%), social features (35%), videos (24%) and cooking demonstrations (23%).

Conclusions

This survey highlights the risk that pregnant women may get nutritional information from online resources which are not evidence-based. It also identifies features that women want from a web-based nutritional resource.

Introduction

Maternal nutrition during pregnancy influences the long-term health outcomes of both the woman and her offspring.1, 2 Suboptimal maternal nutrition may result in unfavourable neonatal outcomes, such as fetal growth restriction and neural tube defects. It may also increase the risk of long-term adverse metabolic profiles later in life.3, 4, 5, 6 Research has shown that women are not meeting intake recommendations for key micronutrients in pregnancy such as iron (12.5% compliance), vitamin D (0.3% compliance), iodine (50.5% compliance) and folate (2.1% compliance).⁷ Furthermore, dietetic services and personnel to deliver dietetic advice are an increasingly constrained resource.⁸ In 2014, the Coombe Women and Infants University Hospital (CWIUH) provided dietetic care to just over 25% of women attending the hospital, with many patients seen in group format as the hospital is limited to 1.0 whole-time equivalent (WTE) dietitian.⁹

Web-based technology is a widely accessible and cost effective means of disseminating information to large populations. A systematic review identified web-based technology as a safe and potentially efficacious dietetic tool in pregnancy, although this study cited the need for further supportive data in this area.¹⁰ Studies have also reported high attrition rates which might compromise the overall utility of such tools, and which highlight the requirement to determine what features could improve user retention.¹¹ The increasing evidence supporting the importance of maternal diet in pregnancy, as well as the potential efficacy of web-based tools to deliver evidence-based dietetic interventions, suggest that research in this area is warranted.

Optimal methods of delivering evidence-based nutrition information which engages obstetric populations need to be defined. There is a lack of knowledge to date concerning the features of web-based applications which pregnant women find useful. Furthermore, what evidence-based information pregnant women find interesting and engaging also needs to be determined.

The purpose of this observational study was to examine the use of web-based nutritional information by women attending for prenatal care in a large academic maternity hospital in a developed country.

Section snippets

Methods

A self-administered, paper-based questionnaire was distributed to women attending for antenatal care after confirmation of a healthy, ongoing pregnancy at the CWIUH between June 2015 and August 2015. Women were recruited from booking and antenatal clinics at varying stages of gestation. The CWIUH accepts patients from all socioeconomic groups, and from across the urban-rural divide. It is one of the largest maternity hospitals in the European Union (EU). In 2014, the hospital delivered over

Results

A total of 110 questionnaires were distributed and 101 (91.8%) of these were returned. The study population characteristics are outlined in Table 1. There were no differences in age, parity or health insurance cover between our study population and the hospital population (P > 0.05).⁹ For the calculation of socioeconomic status, 62 of the 101 women provided data on income and deprivation status, which are required to calculate consistent poverty. Individuals can be reluctant to disclose their

Discussion

We found that the majority of pregnant women irrespective of their sociodemographic and clinical circumstances used web-based resources for information on nutrition. However, they used a wide variety of resources, mainly commercial, with little use of publicly-funded or academically-supported resources which raises the possibility of them receiving conflicting or erroneous advice. We identified that women's preferences for content varied with age, health insurance cover and educational level,

Ethical approval

This study received ethical approval from the CWIUH Research Ethic Committee and the Dublin Institute of Technology Research Ethics Committee.

Funding

This work was supported by the Dublin Institute of Technology Fiosraigh Scholarship awarded to DMA McCartney and RAK Kennedy.

Competing interest

None declared.

Author contributions

RAK Kennedy: 1) the conception and the design of the study, acquisition of data, analysis and interpretation of data, 2) drafting the article, 3) final approval of the version to be submitted.

L Mullaney: 1) the

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Original ResearchPreferences of women for web-based nutritional information in pregnancy

Highlights

Abstract

Objectives

Study design

Methods

Results

Conclusions

Introduction

Section snippets

Methods

Results

Discussion

Ethical approval

Funding

Competing interest

Author contributions

J Nutr Educ Behav

Prev Med

J Am Diet Assoc

Effect of Women's nutrition before and during early pregnancy on maternal and infant outcomes: a systematic review

Paediatr Perinat Epidemiol

Pregnancy, obesity and insulin resistance: maternal overnutrition and the target windows of fetal development

Horm Mol Biol Clin Invest

Gestational diabetes: risk factors and recent advances in its genetics and treatment

Br J Nutr

Atlantic diabetes in pregnancy (DIP): the prevalence and outcomes of gestational diabetes mellitus using new diagnostic criteria

Diabetologia

Anaemia, prenatal iron use, and risk of adverse pregnancy outcomes: systematic review and meta-analysis

BMJ

An analysis of folic acid supplementation in women presenting for antenatal care

J Public Health (Oxf)

Maternal dietary patterns and associated nutrient intakes during each trimester of pregnancy

Public Health Nutr

Recommendations for the clinical nutrition service of antenatal patients with diabetes—a summary report for the national diabetes working group

Hospital annual clinical report

Technology-supported dietary and lifestyle interventions in healthy pregnant women: a systematic review

Eur J Clin Nutr

Initial and sustained participation in an internet-delivered long-term worksite health promotion program on physical activity and nutrition

J Med Internet Res

Websites and apps used by women to access infant feeding information

Proc Nutr Soc

The use of digital media by women using the maternity services in a developed country

Ir Med J

Central Statistics Office EU Survey on Income and Living Conditions (EU-SILC) 2011 and revised 2010 results

Original Research
Preferences of women for web-based nutritional information in pregnancy