{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T05:05:38Z","timestamp":1789707938593,"version":"4.0.1"},"reference-count":106,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T00:00:00Z","timestamp":1789603200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T00:00:00Z","timestamp":1789603200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Human Nutrition Diet"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>The coexistence of undernutrition and overweight, obesity, or diet\u2010related noncommunicable diseases and micronutrient deficiency in pregnant women is defined by the WHO as a double burden of malnutrition (DBM). These coexistences are a critical aspect of maternal and antenatal care, especially in low\u2010 and middle\u2010income countries.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To estimate the global prevalence of DBM in pregnant women through a systematic review and meta\u2010analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The systematic review was conducted in accordance with the PRISMA recommendations. Studies that reported prevalence measures of DBM in healthy pregnant women were included. DBM was considered as the coexistence of underweight with gestational diabetes mellitus (GDM), underweight with hypertension, overweight\/obesity with anemia, overweight\/obesity with vitamin D deficiency, overweight\/obesity with vitamin B12 deficiency, and overweight\/obesity with folate deficiency. The meta\u2010analysis used a random\u2010effects model with inverse\u2010variance weighting. Risk of bias was assessed using Joanna Briggs Institute tools, and the certainty of the evidence was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The systematic review included 62 articles totaling 1,386,245 pregnant women, at 8\u201342 gestational weeks and 13\u201345 years of age. The most common DBMs identified were overweight\/obesity and vitamin D deficiency (21%; 95% CI: 14%\u201327%,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200910 studies) and overweight\/obesity and anemia (9%; 95% CI: 7%\u201310%,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200918 studies). A meta\u2010analysis of overweight\/obesity and micronutrient deficiency was not conducted due to the small number of eligible studies. Most studies (66.3%) had high methodological quality; however, GRADE rated the overall certainty of evidence as low.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>A high prevalence of overweight\/obesity with vitamin D deficiency and anemia were observed. These results emphasize the need for stronger public policies to ensure equitable access to healthy diets, evidence\u2010based supplementation, and continuous nutritional monitoring during pregnancy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jhn.70347","type":"journal-article","created":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T04:28:47Z","timestamp":1789705727000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Double Burden of Malnutrition Prevalence in Pregnant Women: Systematic Review and Meta\u2010Analysis"],"prefix":"10.1111","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7326-4782","authenticated-orcid":false,"given":"Amanda","family":"Biete","sequence":"first","affiliation":[{"name":"Graduate Program in Human Nutrition University of Brasilia, Campus Universit\u00e1rio Darcy Ribeiro Bras\u00edlia DF Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-7084-2767","authenticated-orcid":false,"given":"Camila","family":"Biete","sequence":"additional","affiliation":[{"name":"Graduate Program in Human Nutrition University of Brasilia, Campus Universit\u00e1rio Darcy Ribeiro Bras\u00edlia DF Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6893-8263","authenticated-orcid":false,"given":"Vivian S. S.","family":"Gon\u00e7alves","sequence":"additional","affiliation":[{"name":"Graduate Program in Public Health University of Brasilia, Campus Universit\u00e1rio Darcy Ribeiro Bras\u00edlia DF Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erika S. O.","family":"Patriota","sequence":"additional","affiliation":[{"name":"Graduate Program in Public Health University of Brasilia, Campus Universit\u00e1rio Darcy Ribeiro Bras\u00edlia DF Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5858-7076","authenticated-orcid":false,"given":"Nathalia","family":"Pizato","sequence":"additional","affiliation":[{"name":"Graduate Program in Human Nutrition University of Brasilia, Campus Universit\u00e1rio Darcy Ribeiro Bras\u00edlia DF Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,17]]},"reference":[{"key":"e_1_2_10_2_1","article-title":"The Double Burden of Malnutrition","author":"WHO","year":"2017","journal-title":"Policy Brief"},{"key":"e_1_2_10_3_1","unstructured":"Double Burden of Malnutrition. Malnutrition in All Its Forms. [Internet]. Geneva: WHO 2024; [citado 6 de maio de 2025]. 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