Evaluation of dietary intervention and pregnancy outcomes among food insecure women attending the Montreal Diet Dispensary program
Notice bibliographique
Résumé
Since 1950, the Montreal Diet Dispensary has been aiming to reduce health inequalities among pregnant women with low socio-economic status through a nutritional support program called the Higgins' intervention. In the past, the intervention was shown to be successful in reducing the rate of low-birth weight (LBW) as well as preterm births (PTB). The objective of this thesis was to conduct an outcome evaluation of the Higgins' intervention in a changing demographic population predominantly composed of visible minority and newly immigrated women. The program evaluation was done using an electronic database established in June 2013 where 1387 pregnancies were analyzed. The rate of LBW was 4.18% (95% confidence interval (CI): 3.13, 5.24), small-for-gestational age (SGA) 5.47% (95%CI: 4.28, 6.68) and PTB was 4.76% (95%CI: 3.64, 5.88). The prevalence of these outcomes were considered significantly lower than the Canadian statistics as all CIs did not overlap. Large-for-gestational age rate was 10.60% (95%CI: 8.98, 12.22) which was significantly higher than Montreal but similar to the Canadian rate. Prevalence of maternal outcomes were 17.15% (95%CI: 15.05, 19.25) for gestational diabetes (GDM), anemia was 44.88% (95%CI: 41.90, 47.86) and hypertension (HTN) was 3.82% (95%CI: 2.81, 4.83). Immigrants had similar odds of developing adverse perinatal outcomes as Canadian-born women. Black women were more at risk of having a PTB (adjusted odd ratio (aOR)=1.79, 95%CI: 1.01, 3.19) with African women mostly contributing to the increased risk (aOR=2.67, 95%CI: 1.44, 4.9). Anemia prevalence was also significantly higher in Black women compared to White (aOR=1.74, 95%CI: 1.29, 2.35). Anemia rates were higher among immigrants who were in Canada for more than 5 years (5-10 y aOR=1.99, 95%CI: 1.05, 3.78; > 10 y aOR=2.01, 95%CI: 1.01, 3.99) compared to Canadian-born. Asian women had an increased risk of having a SGA infant (aOR=2.35, 95%CI: 1.21, 4.56;) and GDM (aOR=1.86, 95%CI: 1.17, 2.98) compared to White women. This risk was particularly higher among women from South Asia who had 2.88-times the risk of developing GDM (2.88, 95%CI: 1.03, 8.07) compared to North Americans. The Higgins' intervention supported infant health as evidenced by lower infant complications, but disparities in birth outcomes were still present in this high risk population. As evidenced by high prevalence rates, the late nutritional intervention did not contribute to the prevention of anemia and GDM. Earlier nutritional intervention, prioritization of high risk groups of women and adaptation of the intervention would be needed to further reduce outcomes discrepancies among this vulnerable population.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,005 | 0,012 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».