Malnutrition during the critical period of pregnancy has significant health outcomes for both the mother and her offspring. Medical nutrition therapy (MNT) by a registered dietitian nutritionist (RDN) may help mitigate negative health effects, although studies that support the role of the RDN have not been comprehensively evaluated. The objective was to explore the health effects of MNT by an RDN on maternal and infant outcomes in pregnant women with malnutrition. A systematic review of studies published between 2000 and 2014 that incorporated MNT by an RDN during pregnancy were retrieved from a PubMed search, using criteria established by the Academy of Nutrition and Dietetics Evidence Analysis Process. Among 94 identified studies, five controlled trials met the inclusion criteria. The initial search was extended to include one study published between 2014 and 2019. Outcomes included maternal gestational weight gain, maternal markers of glycemic control, maternal complications such as hypertension, incidence of caesarean section, infant birth weight both in grams and in clinical categories, infant gestational age, and infant complications. There was good/strong evidence that MNT by an RDN decreased gestational weight gain, although there was no effect on maternal complications, caesarean section deliveries, and gestational age among women with mixed body mass index status or those who were overweight/obese. The evidence was deemed fair in support of an effect on glycemic control, infant birth weight, and infant complications. The heterogeneity in the results are due to the variation among populations studied, types of interventions, and inconsistency among outcomes. In addition, the training and educational requirements of the RDN or the international equivalent may vary widely across the four countries in which studies were conducted. There was good evidence for MNT by an RDN during pregnancy on improving gestational weight gain among overweight/obese women. To better support the role of MNT by an RDN in the health care of pregnant women, research that clearly identifies the role of the RDN in the intervention, includes a control group, and studies more heterogeneous populations is needed.

中文翻译：

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与注册营养师营养师对营养不良孕妇进行医学营养治疗相关的母婴健康结果：证据分析中心系统评价

怀孕关键时期的营养不良对母亲及其后代的健康都有重大影响。尽管尚未对支持 RDN 作用的研究进行全面评估，但由注册营养师营养师 (RDN) 进行的医学营养疗法 (MNT) 可能有助于减轻对健康的负面影响。目的是通过 RDN 探讨 MNT 对营养不良孕妇的母婴结局的健康影响。对 2000 年至 2014 年间发表的研究的系统评价，这些研究使用营养与营养学证据分析过程学院建立的标准，从 PubMed 搜索中检索到怀孕期间由 RDN 纳入 MNT 的研究。在确定的 94 项研究中，5 项对照试验符合纳入标准。最初的搜索范围扩大到包括 2014 年至 2019 年间发表的一项研究。 结果包括母亲妊娠期体重增加、母亲血糖控制指标、母亲并发症（如高血压）、剖腹产发生率、婴儿出生体重（克）和临床类别，婴儿胎龄和婴儿并发症。有充分/强有力的证据表明，RDN 的 MNT 减少了孕期体重增加，尽管对混合体重指数状态的妇女或超重/肥胖的妇女的母亲并发症、剖腹产分娩和孕龄没有影响。证据被认为是公平的，支持对血糖控制、婴儿出生体重和婴儿并发症的影响。结果的异质性是由于研究人群之间的差异，干预的类型以及结果之间的不一致。此外，RDN 或国际同等机构的培训和教育要求在进行研究的四个国家之间可能有很大差异。有很好的证据表明怀孕期间 RDN 的 MNT 可以改善超重/肥胖妇女的妊娠期体重增加。为了更好地支持 RDN 在孕妇保健中的作用，需要研究清楚地确定 RDN 在干预中的作用，包括一个对照组，并研究更多异质人群。有很好的证据表明怀孕期间 RDN 的 MNT 可以改善超重/肥胖妇女的妊娠期体重增加。为了更好地支持 RDN 在孕妇保健中的作用，需要研究清楚地确定 RDN 在干预中的作用，包括一个对照组，并研究更多异质人群。有很好的证据表明怀孕期间 RDN 的 MNT 可以改善超重/肥胖妇女的妊娠期体重增加。为了更好地支持 RDN 在孕妇保健中的作用，需要研究清楚地确定 RDN 在干预中的作用，包括一个对照组，并研究更多异质人群。