Israa Mohamed Fadla Alla Elhaj, Fatima Al Zahraa Chokor, Katia AbuShihab, Maryam Alameddine, Hadia Radwan, Farah Naja
This review revealed that several EMR countries lack national DGs for pregnant women, highlighting the importance of encouraging and supporting their development. Few existing guidelines were comprehensive, with key themes like GDM, hydration, and religious fasting often absent. There is a need for more structured, context-specific, and inclusive guidelines across the region.
INTRODUCTION: Maternal nutrition and lifestyle during pregnancy critically influence health outcomes for mother and child. While many countries developed national dietary and lifestyle guidelines (DGs) for pregnant women, in the Eastern Mediterranean Region (EMR), the availability, quality, and coverage of such guidelines remain largely undocumented and inconsistent. This review assesses national DGs for pregnant women in the EMR, identifying gaps, strengths, and opportunities for enhancement.
METHODS: A scoping review was conducted between October 2024 and January 2025, following the PRISMA-ScR framework. Systematic searches were performed across general search engines (Google Search and Google Scholar) and academic databases (PubMed and Scopus). National DGs were included if they addressed nutrition or lifestyle recommendations for pregnant women in any of the 22 EMR countries. Thematic analysis was used to map and evaluate content and structure. Themes were identified inductively from the EMR guidelines and contextualized against established international guidelines.
RESULTS: Eleven EMR countries had DGs targeting pregnant women. Fourteen key themes were identified. Most guidelines covered diet, supplements, and gestational weight gain; meanwhile, hydration, physical activity, food safety, religious fasting, and gestational diabetes (GDM) were partially-addressed or absent. Lebanon and Saudi Arabia had the most comprehensive guidelines, addressing over 11 themes each. Only Lebanon adopted a dietary pattern-based approach. Few guidelines included medical consultation for supplementation or culturally-sensitive messaging.
CONCLUSIONS: This review revealed that several EMR countries lack national DGs for pregnant women, highlighting the importance of encouraging and supporting their development. Few existing guidelines were comprehensive, with key themes like GDM, hydration, and religious fasting often absent. There is a need for more structured, context-specific, and inclusive guidelines across the region.