Evaluation of pregnancy outcomes among food insecure women attending the Montreal Diet Dispensary program
Notice bibliographique
Résumé
Introduction Prenatal nutrition programs for women of low socio‐economic status, including the Higgins' intervention, have been successful in reducing the rate of low‐birth weight (LBW) as well as preterm births (PTB). Little is known as to the efficacy of such programs among visible minority and/or newly immigrated women of low socio‐economic status. Objective To determine if the Higgins' intervention was as effective at reducing pregnancy complications among women of visible minority compared to White women, as well as among immigrant women compared to those born in Canada. Methods The program evaluation was done using an electronic database from June 2013 to December 2015 with data on 1387 pregnancies available. Demographic information, including country of birth, time of arrival in Canada, marital status and maternal education, were self‐reported at patient's registration at 20.4 ± 7.0 weeks gestation. Pregravida weight was self‐reported, weight was then measured biweekly visit until birth. Anemia, gestational diabetes (GDM) and gestational hypertension were ascertained using copies of medical reports. Infant birth weight was collected from the vaccination booklet and Kramer's growth curve reference was used to assess size at birth. Women who were eligible to participate into the program had lower family income than the budget for basic needs determined by the Dispensary. Results Compared to Canadian‐born women, immigrants had similar odds of developing adverse perinatal outcomes such as preterm births (PTB), small‐for‐gestational age (SGA) and low‐birth‐weight (LBW) infants, gestational diabetes, maternal anemia and gestational hypertension. However, differences between ethnicities and immigration duration were observed. Black women were more at risk of having a PTB (adjusted odd ratio (aOR)=1.79, 95%CI: 1.01, 3.19) compared with White women, with African women mostly contributing to the increased risk (aOR= 2.67, 95%CI: 1.44, 4.90). Black women had higher anemia prevalence and gestational hypertension (aOR= 2.23, 95%CI: 1.18–4.21) than White women. 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. When comparing women by region of birth, 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 (Canada and USA). Anemia rates were also higher among those who immigrated to Canada more than 5 years before the assessment (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. Conclusion The Higgins' intervention supported perinatal health in immigrants, but disparities were still present for Black and Asian women. 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. Support or Funding Information Canadian Foundation for Dietetic Research (CFDR)
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 | 0,002 | 0,006 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,002 | 0,002 |
| 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 | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,004 | 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 ».