Nutritional Habits of Pregnant Ghanaian Women and Effects on Pregnancy Outcome

Abstract

Reduction of infant and maternal mortality is a part of the WHO/UNICEF goals set in 1991 to be achieved by the year 2000. Maternal and infant mortality can be reduced by ensuring favourable outcome of pregnancy. This study sought to assess the effects of nutrition and health habits of pregnant women on pregnancy outcome. A total of 502 pregnant women attending ante-natal clinics in the Greater Accra region participated in an epidemiological study, which involved a study of food habits, pica practice, alcohol intake, parity, preference for infant size at birth, ante-natal care, oedema and nausea during pregnancy. A sub-sample of 128 pregnant women participated in a longitudinal study which assessed maternal nutrient intake, height, weight gain and nutrient supplementation during pregnancy, infant birth-weight and maternal haemoglobin levels. Results showed that women who experienced nausea during pregnancy had infants of lower birth-weights. Oedema was present in about 40% of the women and this correlated with higher birth-weights. Mothers who have had three or four previous pregnancies had infants of higher birth-weights than nulliparous (first-delivery) mothers and those with seven or more previous pregnancies. Pregnant women who received ante-natal care in the first trimester had infants of higher birth weight than those who received it in the second or third trimesters. About 48% of the pregnant women practiced pica. Eating clay was the major form of pica among the pregnant women. It correlated negatively with maternal haemoglobin level but had no effect on infant birth weight and maternal weight-gain. The prevalence of alcohol intake among the pregnant women was 9.36%. A substantial number- 62.35%, of the subjects avoided some kind of food during the pregnancy. Majority of the women, 72.71%, did not increase their dietary intake during pregnancy. Dietary intakes were lower where nausea occurred. To avoid difficult labour, 40.60% of mothers preferred small infants, and about 10% of these mothers reduced their food intake in order to achieve this. Among the 502 pregnant women, the prevalence of low birth-weight delivery was 8.4%. In the longitudinal study, maternal weight-gain and haemoglobin levels were lower for women who experienced nausea. Maternal height was positively associated with infant birth-weight and maternal weight-gain. The average maternal weight-gain of the 128 mothers was 10.531 ± 1.681kg. Mothers who have had three or four previous pregnancies had higher maternal weight-gain than nulliparous mothers and those with seven or more previous pregnancies. Oedema had no significant effect on maternal weight-gain. The daily intakes of energy, and iron were lower than the recommended amounts for pregnant women. However mean protein intake met the recommended allowance. Energy and protein intakes had positive effects on infant birth-weight and maternal weight-gain. High dietary iron intake was associated with high maternal weight-gain and haemoglobin level but had no effect on infant birth weight. Mineral and vitamin supplementation during pregnancy had:little effect on overall haemoglobin levels of the mothers. It however helped mothers to have infants of higher birth-weight. The mean monthly maternal haemoglobin level was 11.503 ± 0.603g/dl. (WHO standard for pregnant women: ll.Og/dl; Tomkins and Watson, 1991) From the total of 12 8 pregnant women, about 2 0% were anaemic throughout pregnancy. Recommendations include the need for early ante-natal care for pregnant women, education against the practice of pica, intensification of mass education on good nutrition and health practices, during pregnancy and the need for more health posts to encourage ante-natal attendance..