Nutrition related risk factors in pregnancy in Siaya District Kenya

Abstract

A hospital based 3 months prospective study was carried out on 160, randomly selected, pregnant mothers in four health facilities in Siaya District. The study aimed at establishing which of the selected risk factors, namely, parity, reproductive age, birth intervals, income, food intake, morbidity during pregnancy and related factors were significantly impinging on maternal nutritional status. Data was collected using a structured questionnaire while blood and fecal specimens were obtained from the pregnant mothers for determination of haemoglobin levels and parasitic infestations. Nutritional status during pregnancy was determined usmg mid-upper arm circumference, subscapular skinfold thickness and haemoglobin levels. Nutrient adequacy of the diets consumed by the mothers was computed using different combinations of responses to calculate indices of proteins, vitamins, carbohydrates and fats consumption. These indices were then compared to the Daily Food Guide which provides the recommended number of servings of various foods per day considered adequate. The results showed that the participants were young ( mean age 25 years) and had their first child at a mean age of 18 years. Mean parity was low (2) with a mean birth interval of 4 years. Majority, (90%), were married and 80% had attained primary school education. About 46% of the study mothers were employed and 80%, earned less than Ksh 2000 per month (equivalent to $ 36). The diets consumed by the mothers were deficient in carbohydrates and were relatively adequate in proteins and vitamins. Cravings, aversions and pica were reported in 51 %,59% and 40% of the mothers respectively. The morbidity prevalence was 83% among the study mothers with stomach pains being the most prevalent condition. Prevalence of intestinal helminths was 68 % with ascaris being the most prevalent infestation (34 %). Malarial parasites were detected in only 28% of the mothers. A significant proportion, (59%) of the study mothers, were malnourished (MUAC < 28.5cm) and 72 % had haemoglobin levels less than llgm/dl. Mean weight gain of the mothers fell far below the recommended gain of O.4kg per week and ranged between 0.14 - 0.22kg per week. The factors that were negatively associated (p <0.05) with nutritional status and hence could be described as risk factors were maternal morbidity (specifically malaria), duration of the illness and seeking no medical care when one was sick. The recommendation is that seeking proper medical attention from qualified medical personnel during illness would lead to improvement of maternal nutritional status and in the long run reduce maternal morbidity and mortality.