Dietary Practices of Pregnant Women and its Associations with Maternal and Prenatal Outcomes in Rural Central Ethiopia
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2015-12
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Abstract
Maternal and child under nutrition is a serious developmental challenge contributing a large
share to the global disease burden. It is a major reason for increased risk of adverse pregnancy
outcomes, poor infant survival, and elevated risks of chronic diseases at later stages of life.
Ethiopia has an unacceptably high burden of malnutrition and its consequences, and yet little is
known about the determinants and responses to under nutrition during pregnancy. The few crosssectional
studies and the periodic national surveys are often less appropriate to investigate
nutritional problems during the dynamic periods of pregnancy. Using a mixed-method approach,
the present thesis examined the association of maternal nutrition during pregnancy with maternal
and perinatal outcomes in rural Central Ethiopia. Applying a weighed-record (n= 55), the most
frequently consumed foods were identified, sampled and analyzed for their nutrient composition
and nutrient densities estimated. By enrolling pregnant mothers to a prospective cohort study,
risk of anemia and adverse pregnancy outcomes were determined. Using a focus-group
discussion (FGD), in-depth interviews (IIs) and passive observations, food consumption-related
behaviors and perceptions were identified.
Dietary patterns adopted by the pregnant women were largely plant-based, predominantly cereal
and legume-based. The nutrient-density of the foods were low and the overall dietary diversity
was low. The overall incidence of maternal anemia increased from 28.6% to 32.4% during the
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follow-up period and twenty percent of the mothers experienced at least one of the adverse
pregnancy outcomes (APO): low birth weight (LBW; 9.1%), preterm (13.6%), and stillbirth
(4.5%). Mothers who consistently consumed ≥ 4 food groups (out of nine) had a lower risk of
anemia [adjusted RR (ARR: 2.29; 95% CI: 1.62, 3.24], LBW (ARR: 2.06; 95% CI: 1.03, 4.11),
and PTB (ARR: 4.61; 95% CI: 2.31,9.19) but not of stillbirth (ARR: 2.71; 95% CI: 0.88, 8.36)
deliveries than those who consumed undiversified diets. Low or inconsistent consumption of
dark green leafy vegetables(adjusted odds ratio (AOR), 2.012; 95% confidence interval (CI):
1.04; 3.87), dairy products (AOR, 2.64; 95% CI: 1.11; 6.30), and fruits and vegetables (AOR,
2.92; 95% CI: 1.49; 5.67) were associated with increased risk of APO. The presence of
widespread misconceptions about weight gain during pregnancy, the food taboos among some
population segments, and the relatively low awareness about maternal nutrition may be some of
the underlying reasons.
Therefore, efforts to enhance maternal awareness about nutrition in general, and promoting
dietary diversity (≥ 4 food groups) to increase animal sources foods (ASF), fruits and vegetables
in particular, could help improve maternal nutrition and prevent the associated adverse outcomes.
Population based controlled trials of various options to improve dietary diversity and intake of
selected limiting food groups are recommended.
Keywords: Dietary diversity; anemia; low birth weight; preterm; stillbirth food taboo; intakes; women’s nutrition; pregnancy
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Keywords
Dietary diversity; anemia; low birth weight; preterm; stillbirth food taboo; intakes; women’s nutrition; pregnancy