# A Scoping Review on Nutrition Knowledge and Nutrition Literacy Among Pregnant Women and the Prevalence of Pregnancy Complications and Adverse Pregnancy Outcomes

## TL;DR

This review finds that pregnant women often lack nutrition knowledge and literacy, with education and income being key factors, but evidence linking this to poor pregnancy outcomes is limited.

## Contribution

The study provides a comprehensive scoping review on the relationship between nutrition knowledge, literacy, and pregnancy outcomes.

## Key findings

- Nutrition knowledge and literacy among pregnant women were generally low.
- Education and income levels were the most significant factors influencing nutrition knowledge.
- Only limited evidence links nutrition knowledge or literacy to adverse pregnancy outcomes.

## Abstract

Background: Proper nutrition supports maternal and fetal health. Gaps in nutritional knowledge (NK) and nutritional literacy (NL) can affect maternal and fetal health. NK refers to knowing facts and processes about nutrition, while NL is a broader component that includes competencies and skills needed to obtain, understand, and apply nutrition information to make dietary decisions. NL and NK limitations may contribute to adverse maternal and neonatal outcomes. This scoping review aims to understand the relationship between NK, NL, and pregnancy outcomes, offering insights into areas for future nutrition-based interventions. Methods: Seven databases were searched for studies assessing NK and NL among pregnant women. A total of 5080 articles were identified, with 4249 retained after removing duplicates. Following title and abstract screening, 18 articles underwent full-text review, and 11 met the inclusion criteria. Data were extracted, analyzed, and categorized into nine key themes. Results: All eleven studies employed survey-based methods; ten focused on NK and one on NL. Overall, NK was generally low. The evidence for an association between NK or NL and pregnancy outcomes was limited. Education, income, occupation, and family influence were identified as key factors influencing the NK and NL of pregnant women. Education and income levels were identified as having the most significant impact on NK overall. Only one study accessed the relationship between NK and adverse birth and neonatal outcomes, and this only included HDP and preterm labor. Also, only one out of the eleven studies was conducted in the US. Conclusions: In this review, we found that NK and NL among pregnant women was generally low, with limited evidence linking it to pregnancy outcomes; education and income emerged as the most influential factors of NK and NL. Future studies in high-income countries are recommended to assess the association between NL and adverse maternal outcomes, especially GDM.