Maternal Dietary Intakes in the Third Trimester and Pregnancy Outcomes

Abstract

Background: Maternal nutrition during pregnancy is a major determinant for birth outcomes and consequently, offspring health outcomes in later life. Poor maternal nutrition, particularly during the third trimester is a major cause of low birth weight (LBW) in developing countries.Inadequate intakes of specific nutrients such as iron and folate in pregnancy have been reported to lead to a variety of poor maternal and infant outcomes including anemia and preterm birth respectively. The pregnant woman is tasked to prioritize her nutritional needs and practice good dietary habits to achieve optimum birth outcomes. Aim: To assess the dietary intake and pregnancy outcomes of women in their third trimester attending antenatal clinics at the Korle-Bu Teaching Hospital. Methods: A cohort design was employed for this study. The cohort design recruited third trimester pregnant women (N=81) between the ages of 18-49 years from Korle-Bu Teaching Hospital in the Greater Accra Region. Dietary intake data were obtained based on a 52-item quantitative food frequency questionnaire. Daily supplement dosages of participants were recorded. Serum concentrations of iron (ferritin) and folate were respectively determined using the AccuBind ELISA microwells. Data obtained were analyzed using IBM SPSS version 25 and nutrients analysis was done using West Africa Foods Analysis (WAFUDS). One-way anova test was used to determine differences among mean weights of the participants. Spearman’s rank correlation test was used to determine the strength and relationship between dietary intakes and birth outcomes as well as ferritin and folate sera levels of participants and birth outcomes. Means, median, mode and standard deviations were used to summarize continuous and categorical variables. A p-value of ≤0.05 was considered statistically significant.

Results: A total of 81 participants were involved in this study. Their mean age was 32.22 (±6.00) years. A greater percentage (82.7%) of them was married and almost all (92.6%) the participants were formally educated with the majority (67.9%) involved in either trading or a vocation. The vast (76.9%; 100%; 86.4%) proportion of the participants were not involved in pica practice, consuming alcohol and skipping meals in the day during the 3rd trimester respectively. Majority (60.5%) of the participants ate thrice in the day with a substantial proportion (28.4%) also eating 4-5 times per day in the 3rd trimester. A sizeable proportion (11.1%) experienced some difficulties in food intakes during the 3rd trimester. Mean nutrients intake of dietary iron and folate were 13.54 (±8.30) mg and 331.16 (±113.97) mcg respectively. Mean intake of iron and folic acid supplement were 42.70 (±48.80) mg and 5.50 (±11.10) mg respectively. Majority (74.1%; 86.4%) of the participants did not meet recommendations for daily total iron and folate respectively. Most of the participants, however, had serum ferritin and folate levels in the normal range (82.7% and 87.7% respectively). In this study, almost all the participants obtained positive birth outcomes and the significant predictor of birth outcome was total dietary iron (p=0.041). Conclusion: The study showed that, the participants’ dietary habits were generally good. However, the amount of food consumed by majority was suboptimal which might have led to a greater percentage not meeting the dietary recommendations for both nutrients (folate and iron). Adherence to supplement intake was generally good which might have resorted to the normal serum ferritin and folate levels obtained. The good dietary habits and normal serum levels obtained could be a major contributing factor to the positive birth outcomes observed in the study.