ASSESSMENT OF DIETARY DIVERSITY AND NUTRITIONAL STATUS OF PREGNANT WOMEN IN ISLAMABAD, PAKISTAN
AbstractBackground: Maternal under-nutrition is one of the most important causes of maternal morbidity and mortality, particularly in the developing countries. Maternal nutrition has direct association with foetal nutrition. This study aimed to identify dietary diversity and determine any relationship of dietary diversity with nutritional status of pregnant women belonging to different socioeconomic conditions in Rawalpindi Islamabad region. Methods: It was a cross sectional survey involving 350 pregnant women in their second and third trimesters, conducted in outpatient department of Maternal and Child health centre at Pakistan Institute of Medical Sciences (PIMS) Islamabad. A semi qualitative questionnaire was used that contained structured questions regarding socio-demographic features, socioeconomic status, nutritional status, and three day dietary recall. A second section comprising of questions regarding dietary perceptions was also Results: Out of total, 47% of pregnant women had normal pre-gestational BMI while, 22% were overweight, 17% obese, and only 12% of pregnant women were under weight. Similarly 28.1% were anaemic. Medium dietary diversity was observed in 89% of pregnant women, while only 5% showed low, and high dietary diversity. Dietary diversity was not associated with socio-demographic, or socioeconomic status of pregnant women. Even though weight gain during second (p=0.2 ) and third trimesters (p=0.049) had a positive relationship with dietary diversity, more than 74% of pregnant women gained less than recommended level of weight gain. No association could be proven between haemoglobin and dietary diversity (p=0.51). Conclusion: Dietary diversity is a good proxy indicator for micronutrient adequacy in pregnant women, however if quantity of food consumed is added it can give better indication of determinants of nutritional status of pregnant women.Keywords: Dietary diversity, Nutritional assessment, Pregnancy, Maternal nutrition
Tomkins A. Nutrition and maternal morbidity and mortality. Br J Nutr 2001;85(S2):S93-S9
Abu-Saad K, Fraser D. Maternal nutrition and birth outcomes. Epidemiol Rev. 2010;32(1):5–25.
Wu G, Bazer FW, Cudd TA, Meininger CJ, Spencer TE. Maternal nutrition and fetal development. J Nutr 2004;134(9):2169–72.
Black RE, Allen LH, Bhutta ZA, Caulfield LE, de Onis M, Ezzati M, et al. Maternal and child undernutrition: global and regional exposures and health consequences. Lancet 2008;371(9608):243–60.
FAO. Guidelines for measuring individual and household dietary diversity. 2011.
Wen LM, Flood VM, Simpson JM, Rissel C, Baur LA. Dietary behaviours during pregnancy: findings from first-time mothers in southwest Sydney, Australia. Int J Behav Nutr Phys Act 2010;7(13):1–7.
Northstone K, Emmett P, Rogers I. Dietary patterns in pregnancy and associations with socio-demographic and lifestyle factors. Eur J Clin Nutr 2007;62(4):471–9.
Horton R. Maternal and child undernutrition: an urgent opportunity. Lancet 2008;371(9608):179.
National Nutrition Survey of Pakistan. Aga Khan University, Pakistan Medical Research Council. Islamabad: Nutrition Wing, Cabinet Division, Government of Pakistan, 2012.
Baig-Ansari N, Badruddin SH, Karmaliani R, Harris H, Jehan I, Pasha O, et al. Anemia prevalence and risk factors in pregnant women in an urban area of Pakistan. Food and Nutr Bull 2008;29(2):132–9.
Neggers Y, Goldenberg RL. Some thoughts on body mass index, micronutrient intakes and pregnancy outcome. J Nutr 2003;133(5 Suppl 2):1737S-40S.
Patil R, Mittal A, Vedapriya D, Khan MI, Raghavia M. Taboos and misconceptions about food during pregnancy among rural population of Pondicherry. Calicut Med J 2010;8(2):e4.
Meena G. Associations Between Maternal Nutritional Characteristics and the Anthropometric Indices of Their Full-term and Pre-term Newborns. Pak J Nutr 2012;4(11):343–9.
Zobairi SE, Freitas ML, Wasti SA. Diet and nutrition: a knowledge, attitude and practice study of pregnant women in Karachi. Australian and New Zealand journal of obstetrics and gynaecology. 1998;38(2):188-93.
Branca F, Mahy L, Mustafa TS. The lack of progress in reducing anaemia among women: the inconvenient truth. Bulletin of the World Health Organization. 2014;92(4):231.
Torheim L, Ouattara F, Diarra MM, Thiam F, Barikmo I, Hatløy A, et al. Nutrient adequacy and dietary diversity in rural Mali: association and determinants. Eur J Clin Nutr 2004;58(4):594–604.
Savy M, Martin-Prevel Y, Danel P, Traissac P, Dabiré H, Delpeuch F. Are dietary diversity scores related to the socio-economic and anthropometric status of women living in an urban area in Burkina Faso? Public Health Nutr 2008;11(02):132–41.
Munim S, Maheen H. Association of gestational weight gain and pre-pregnancy body mass index with adverse pregnancy outcome. J Coll Physicians Surg Pak 2012;22:694–8.
Yakoob MY, Bhutta ZA. Effect of routine iron supplementation with or without folic acid on anemia during pregnancy. BMC Public Health 2011;11(Suppl 3):S21
Kemunto ML. Dietary Diversity and Nutritional Status of Pregnant Women Aged 15-49 Years Attending Kapenguria District Hospital West Pokot County, Kenya. kenayatta University Institutional Repository 2013