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Thakur GK, Shankar H, Arora TK, Kulkarni B. Role of mineral nutrients other than iron in pregnancy: under recognized opportunities to improve maternal/fetal outcomes: a literature review. Arch Gynecol Obstet 2024; 309:895-905. [PMID: 37698602 DOI: 10.1007/s00404-023-07183-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 08/02/2023] [Indexed: 09/13/2023]
Abstract
BACKGROUND Anemia during pregnancy is an important global health concern, affecting 40% of women worldwide, and iron deficiency shares a significant proportion of the burden. From conception to birth, pregnancy is a period when women undergo metabolic and physiological changes. The nutritional needs are higher during pregnancy; thus, adequate nutrition is essential to maintain fetal growth and development. However, adverse effects due to deficiency in nutrition during pregnancy can result in maternal, fetal and neonatal complications. Despite the multifactorial etiology of anemia, iron deficiency is assumed as the primary cause of anemia during pregnancy and hence, mitigation strategy pivots around it for anemia management. Therefore, excluding other contributors, a single-micronutrient approach with iron supplements remains a myopic approach and this can exacerbate iron deficiency anemia. Micronutrient deficiencies are of particular concern as they may pose a silent threat to the survival and well-being of reproductive-age women and their infants. AIM Micronutrients, especially trace minerals, play a myriad of roles in pregnancy, and the lack of each one causes adverse complications to both the mother and the fetus. In this review paper, we attempt to piece together available information regarding the adverse effects of abnormal trace mineral levels along with iron deficiency on the mother and the fetus. METHOD A non-systematic literature search in PubMed, Google Scholar, and the Cochrane databases, for publications on minerals and vitamins during pregnancy and the possible influence of supplements on pregnancy outcomes. CONCLUSION Micronutrient deficiency exacerbates the pregnancy-induced anemia and other adverse birth outcomes. Micronutrient supplementation during pregnancy can combat anemia as well as reduce a number of adverse pregnancy outcomes in a comprehensive manner.
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Affiliation(s)
- Gaurav Kr Thakur
- RBMCH Division, Indian Council of Medical Research, Ansari Nagar, New Delhi, 110029, India
| | - Hari Shankar
- Central Procurement Cell, Indian Council of Medical Research, Ansari Nagar, New Delhi, 110029, India.
| | - Taruna K Arora
- RBMCH Division, Indian Council of Medical Research, Ansari Nagar, New Delhi, 110029, India.
| | - Bharati Kulkarni
- RBMCH Division, Indian Council of Medical Research, Ansari Nagar, New Delhi, 110029, India
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Seid A, Dugassa Fufa D, Weldeyohannes M, Tadesse Z, Fenta SL, Bitew ZW, Dessie G. Inadequate dietary diversity during pregnancy increases the risk of maternal anemia and low birth weight in Africa: A systematic review and meta-analysis. Food Sci Nutr 2023; 11:3706-3717. [PMID: 37457158 PMCID: PMC10345738 DOI: 10.1002/fsn3.3388] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 04/02/2023] [Accepted: 04/11/2023] [Indexed: 07/18/2023] Open
Abstract
Inadequately diversified food consumption during pregnancy can lead to micronutrient deficiencies, which can affect maternal and newborn health outcomes. Previous studies on maternal dietary diversity have either been limited to a specific geographical region or consist entirely of systematic reviews, without meta-analyses. Thus, this study aimed to determine the pooled estimate of the association between inadequate dietary diversity during pregnancy, maternal anemia, and low birth weight in Africa. A systematic review of observational studies published between January 2000 and April 2022 was undertaken using the Google Scholar, PubMed, and CINAHL databases. The PRISMA checklist was followed to present the results. Microsoft Excel was used to abstract the data. STATA version 17 was used to analyze the data, and a random-effects meta-analysis model was applied to compute the pooled estimates. The study was registered in PROSPERO with protocol number CRD42022320873. A total of 22 publications with 9,696 participants were included in the final meta-analysis. The pooled adjusted odds ratio (AOR) for inadequate dietary diversity and maternal anemia was 2.15 (95% CI, 1.66-2.65), while that for low birth weight was 2.04 (95% CI, 1.46-2.63). The highest pooled estimate of maternal anemia was reported in Cameroon (AOR = 9.8, 95% CI: 1.68-17.92), followed by Ethiopia (AOR = 2.6, 95% CI: 1.95-3.25). Similarly, the pooled estimates of low birth weight were highest in Cameroon (AOR = 3.04, 95% CI: 1.19-4.88) and Ethiopia (AOR = 1.8, 95% CI: 1.29-2.39). In Africa, pregnant mothers with inadequate dietary diversity are two times more likely to develop anemia and low birth weight. Social protection policies that prioritize pregnant women, maternal nutrition promotion in the community, and dietary counseling during antenatal care visits, using national food-based dietary guidelines, should be strengthened.
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Affiliation(s)
- Awole Seid
- Department of Adult Health NursingCollege of Medicine and Health Sciences, Bahir Dar UniversityBahir DarEthiopia
- Center for Food Sciences and NutritionAddis Ababa UniversityAddis AbabaEthiopia
| | - Desta Dugassa Fufa
- Center for Food Sciences and NutritionAddis Ababa UniversityAddis AbabaEthiopia
- Haramaya Institute of Technology, Haramaya UniversityDire DawaEthiopia
| | | | - Zuriyash Tadesse
- Department of Nutrition and DieteticsMekelle UniversityMekelleEthiopia
| | - Selamawit Lake Fenta
- Department of MidwiferyCollege of Medicine and Health Sciences, Bahir Dar UniversityBahir DarEthiopia
| | - Zebenay Workneh Bitew
- Center for Food Sciences and NutritionAddis Ababa UniversityAddis AbabaEthiopia
- St. Paul Hospital Millennium Medical CollegeAddis AbabaEthiopia
| | - Getenet Dessie
- Department of Adult Health NursingCollege of Medicine and Health Sciences, Bahir Dar UniversityBahir DarEthiopia
- National Center for Epidemiology and Population HealthAustralian National University, College of Health and MedicineAustralian Capital TerritoryCanberraAustralia
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Young MF, Oaks BM, Rogers HP, Tandon S, Martorell R, Dewey KG, Wendt AS. Maternal low and high hemoglobin concentrations and associations with adverse maternal and infant health outcomes: an updated global systematic review and meta-analysis. BMC Pregnancy Childbirth 2023; 23:264. [PMID: 37076797 PMCID: PMC10114461 DOI: 10.1186/s12884-023-05489-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 03/02/2023] [Indexed: 04/21/2023] Open
Abstract
BACKGROUND Growing evidence suggests low and high maternal hemoglobin (Hb) concentrations may have adverse consequences for maternal and child health. There remain questions on specific Hb thresholds to define anemia and high Hb as well as how cutoffs may vary by anemia etiology and timing of assessment. METHODS We conducted an updated systematic review (using PubMed and Cochrane Review) on low (< 110 g/L) and high (≥ 130 g/L) maternal Hb concentrations and associations with a range of maternal and infant health outcomes. We examined associations by timing of Hb assessment (preconception; first, second, and third trimesters, as well as at any time point in pregnancy), varying cutoffs used for defining low and high hemoglobin concentrations and performed stratified analyses by iron-deficiency anemia. We conducted meta-analyses to obtain odds ratios (OR) and 95% confidence intervals. RESULTS The updated systematic review included 148 studies. Low maternal Hb at any time point in pregnancy was associated with: low birthweight, LBW (OR (95% CI) 1.28 (1.22-1.35)), very low birthweight, VLBW (2.15 (1.47-3.13)), preterm birth, PTB (1.35 (1.29-1.42)), small-for-gestational age, SGA (1.11 (1.02-1.19)), stillbirth 1.43 (1.24-1.65)), perinatal mortality (1.75 (1.28-2.39)), neonatal mortality (1.25 (1.16-1.34), postpartum hemorrhage (1.69 (1.45-1.97)), transfusion (3.68 (2.58-5.26)), pre-eclampsia (1.57 (1.23-2.01)), and prenatal depression (1.44 (1.24-1.68)). For maternal mortality, the OR was higher for Hb < 90 (4.83 (2.17-10.74)) than for Hb < 100 (2.87 (1.08-7.67)). High maternal Hb was associated with: VLBW (1.35 (1.16-1.57)), PTB (1.12 (1.00-1.25)), SGA (1.17 (1.09-1.25)), stillbirth (1.32 (1.09-1.60)), maternal mortality (2.01 (1.12-3.61)), gestational diabetes (1.71 (1.19-2.46)), and pre-eclampsia (1.34 (1.16-1.56)). Stronger associations were noted earlier in pregnancy for low Hb and adverse birth outcomes while the role of timing of high Hb was inconsistent. Lower Hb cutoffs were associated with greater odds of poor outcomes; for high Hb, data were too limited to identify patterns. Information on anemia etiology was limited; relationships did not vary by iron-deficiency anemia. CONCLUSION Both low and high maternal Hb concentrations during pregnancy are strong predictors of adverse maternal and infant health outcomes. Additional research is needed to establish healthy reference ranges and design effective interventions to optimize maternal Hb during pregnancy.
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Affiliation(s)
- Melissa F Young
- Hubert Department of Global Health, Emory University, 1518 Clifton Road NE, 30322, Atlanta, GA, USA.
| | - Brietta M Oaks
- Department of Nutrition and Food Sciences, University of Rhode Island, 02881, Kingston, United States
| | - Hannah Paige Rogers
- Hubert Department of Global Health, Emory University, 1518 Clifton Road NE, 30322, Atlanta, GA, USA
| | - Sonia Tandon
- Hubert Department of Global Health, Emory University, 1518 Clifton Road NE, 30322, Atlanta, GA, USA
| | - Reynaldo Martorell
- Hubert Department of Global Health, Emory University, 1518 Clifton Road NE, 30322, Atlanta, GA, USA
| | - Kathryn G Dewey
- Department of Nutrition, University of California, Davis, 95616, Davis, United States
| | - Amanda S Wendt
- Research Department 2, Potsdam Institute for Climate Impact Research (PIK), Member of the Leibniz Association, PO Box 60 12 03, 14412,, Potsdam, Germany
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Daniali SS, Yazdi M, Heidari-Beni M, Taheri E, Zarean E, Goli P, Kelishadi R. Birth Size Outcomes in Relation to Maternal Blood Levels of Some Essential and Toxic Elements. Biol Trace Elem Res 2023; 201:4-13. [PMID: 35298828 DOI: 10.1007/s12011-022-03121-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Accepted: 01/16/2022] [Indexed: 01/11/2023]
Abstract
Exposures to toxic trace elements and deficiencies of essential trace elements during pregnancy may impact fetal growth. This study was conducted to determine the association between maternal blood levels of essential elements including manganese (Mn), copper (Cu), and zinc (Zn) and toxic elements including arsenic (As), cadmium (Cd), and lead (Pb) at the first trimester with neonatal anthropometric parameters. This cross-sectional study was conducted in 2019-2020 in Isfahan, Iran. Overall, 263 mother-infant pairs were recruited in the first trimester of pregnancy. Maternal whole blood was collected, and essential and toxic elements were determined by mass spectrometry (ICP-MS)-based method. Birth size measurements were performed according to standardized protocols. Geometric means and standard deviations of maternal blood concentrations of Mn, Cu, Zn, As, Cd, and Pb were 3.94 ± 0.82, 5.22 ± 0.57, 7.67 ± 0.58, 2.21 ± 0.77, - 0.59 ± 0.98, and 3.23 ± 0.72 µg/l, respectively. Mean age of mothers was 29.94 ± 5.22 years. Thirty-one (12.1%) neonates were preterm. Maternal blood Pb levels were negatively correlated with birth weight (β = - 0.22 (CI 95%: - 0.38, - 0.05) p = 0.010) and marginally with birth head circumference (β = - 0.14(CI 95%: - 0.29, 0.02), P = 0.094) after adjustment for potential confounder variables. There was no significant association between Mn, Cu, Zn, As, Cd, and birth size measurements. Reverse association was found between maternal blood Pb levels and birth weight and birth head circumference. There is limited evidence related to the association between essential and toxic elements during pregnancy with birth size measurements and pregnancy disorders. More studies are suggested to assess of the effect of the trace elements and birth outcomes.
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Affiliation(s)
- Seyede Shahrbanoo Daniali
- Department of Pediatrics, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Maryam Yazdi
- Department of Pediatrics, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Motahar Heidari-Beni
- Department of Nutrition, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Ensiye Taheri
- Department of Environmental Health Engineering, Environment Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Elaheh Zarean
- Department of Nutrition, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Obstetrics and Gynecology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Parvin Goli
- Department of Pediatrics, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Roya Kelishadi
- Department of Pediatrics, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran.
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Pregnancy as a Fundamental Determinant of Child Health: a Review. Curr Nutr Rep 2022; 11:457-485. [PMID: 35789475 DOI: 10.1007/s13668-022-00416-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/07/2022] [Indexed: 10/17/2022]
Abstract
PURPOSE OF REVIEW Maternal conditions and exposures during pregnancy including over- and undernutrition are associated with poor childbirth outcomes, growth, development and chronic childhood diseases. We examined contemporary pregnancy-related determinants of child health. RECENT FINDINGS While maternal undernutrition remains a major contributor to low birth weight, maternal obesity affects foetal growth, birth weight, survival and is associated with childhood obesity, asthma and autistic spectrum disorders. Emerging evidence suggests that epigenetic changes, the prenatal microbiome and maternal immune activation (MIA), a neuroinflammatory process induced by diet and other exposures cause foetal programming resulting in these chronic childhood diseases. Maternal diet is potentially a modifiable risk factor for controlling low birth weight, obesity and chronic disease in childhood. Further studies are warranted to refine guidance on dietary restriction and physical activity during pregnancy and determine how MIA and prenatal microbiota can be applied to control childhood diseases arising from programming.
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Bilal JA, Rayis DA, AlEed A, Al-Nafeesah A, Adam I. Maternal Undernutrition and Low Birth Weight in a Tertiary Hospital in Sudan: A Cross-Sectional Study. Front Pediatr 2022; 10:927518. [PMID: 35799688 PMCID: PMC9253371 DOI: 10.3389/fped.2022.927518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Accepted: 05/24/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The World Health Organization set a Global Nutrition Target of a 30% reduction in LBW by 2025. Maternal malnutrition/undernutrition is among the most important modifiable risk factors for impaired fetal growth. This study investigates the effect of maternal undernutrition on LBW in Sudan. METHODS A cross-sectional study was conducted at Saad Abuelela Hospital in Khartoum, Sudan, from May to October 2020. The sociodemographic and obstetric data of the women were gathered via questionnaire, and their mid-upper arm circumference (MUAC) was measured. Maternal undernutrition was defined as a MUAC of <23 cm. RESULTS In total, 1,505 pairs of pregnant women and their newborns were enrolled in the study. The medians [interquartile (IQR)] of the age, parity, and gestational age were 27.0 (9.0) years, 1.0 (3.0), and 38.0 (2.0) weeks, respectively. The median (IQR) of the birth weight was 3,028.0 (690.0) g. Of the 1,505 participants, 182 (12.1%) delivered LBW infants. Multivariate logistic regression showed that MUAC [adjusted odds ratio (AOR) = 0.91, 95% confidence interval (CI) = 0.87-0.96] and gestational age (AOR = 0.79, 95% CI = 0.73-0.85) were negatively associated with LBW. The level of antenatal care <2 visits (AOR = 2.10, 95% CI = 1.30-3.57) was associated with LBW. Women with undernutrition were at a higher risk of delivering LBW infants (AOR = 1.66, 95% CI = 1.09-2.53). CONCLUSION LBW is a health problem in Sudan, and women with undernutrition were at a higher risk of delivering LBW infants.
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Affiliation(s)
- Jalal A Bilal
- Department of Pediatrics, College of Medicine, Shaqra University, Shaqra, Saudi Arabia
| | - Duria A Rayis
- Department of Obstetrics and Gynaecology, Faculty of Medicine, University of Khartoum, Khartoum, Sudan
| | - Ashwaq AlEed
- Department of Pediatrics, Unaizah College of Medicine and Medical Sciences, Qassim University, Unaizah, Saudi Arabia.,Department of Pediatrics, College of Medicine, Qassim University, Buraydah, Saudi Arabia
| | - Abdullah Al-Nafeesah
- Department of Pediatrics, Unaizah College of Medicine and Medical Sciences, Qassim University, Unaizah, Saudi Arabia
| | - Ishag Adam
- Department of Obstetrics and Gynecology, Unaizah College of Medicine and Medical Sciences, Qassim University, Unaizah, Saudi Arabia
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Farag MA, Hamouda S, Gomaa S, Agboluaje AA, Hariri MLM, Yousof SM. Dietary Micronutrients from Zygote to Senility: Updated Review of Minerals' Role and Orchestration in Human Nutrition throughout Life Cycle with Sex Differences. Nutrients 2021; 13:nu13113740. [PMID: 34835995 PMCID: PMC8625354 DOI: 10.3390/nu13113740] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 10/15/2021] [Accepted: 10/20/2021] [Indexed: 12/15/2022] Open
Abstract
Micronutrients such as selenium, fluoride, zinc, iron, and manganese are minerals that are crucial for many body homeostatic processes supplied at low levels. The importance of these micronutrients starts early in the human life cycle and continues across its different stages. Several studies have emphasized the critical role of a well-balanced micronutrient intake. However, the majority of studies looked into or examined such issues in relation to a specific element or life stage, with the majority merely reporting the effect of either excess or deficiency. Herein, in this review, we will look in depth at the orchestration of the main element requirements across the human life cycle beginning from fertility and pregnancy, passing through infancy, childhood, adolescence, and reaching adulthood and senility, with insight on the interactions among them and underlying action mechanisms. Emphasis is given towards approaches to the role of the different minerals in the life cycle, associated symptoms for under- or overdoses, and typical management for each element, with future perspectives. The effect of sex is also discussed for each micronutrient for each life stage as literature suffice to highlight the different daily requirements and or effects.
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Affiliation(s)
- Mohamed A. Farag
- Department of Pharmacognosy, College of Pharmacy, Cairo University, Cairo 11562, Egypt
- Department of Chemistry, School of Sciences & Engineering, the American University in Cairo, New Cairo 11835, Egypt; (S.H.); (S.G.); (A.A.A.); (M.L.M.H.)
- Correspondence: (M.A.F.); (S.M.Y.)
| | - Samia Hamouda
- Department of Chemistry, School of Sciences & Engineering, the American University in Cairo, New Cairo 11835, Egypt; (S.H.); (S.G.); (A.A.A.); (M.L.M.H.)
| | - Suzan Gomaa
- Department of Chemistry, School of Sciences & Engineering, the American University in Cairo, New Cairo 11835, Egypt; (S.H.); (S.G.); (A.A.A.); (M.L.M.H.)
| | - Aishat A. Agboluaje
- Department of Chemistry, School of Sciences & Engineering, the American University in Cairo, New Cairo 11835, Egypt; (S.H.); (S.G.); (A.A.A.); (M.L.M.H.)
| | - Mohamad Louai M. Hariri
- Department of Chemistry, School of Sciences & Engineering, the American University in Cairo, New Cairo 11835, Egypt; (S.H.); (S.G.); (A.A.A.); (M.L.M.H.)
| | - Shimaa Mohammad Yousof
- Department of Medical Physiology, Faculty of Medicine in Rabigh, King Abdulaziz University, Jeddah 21589, Saudi Arabia
- Department of Medical Physiology, Faculty of Medicine, Suez Canal University, Ismailia 41522, Egypt
- Correspondence: (M.A.F.); (S.M.Y.)
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Aringazina R, Kurmanalina G, Bazargaliyev Y, Kononets V, Kurmanalin B, Bekkuzhin A. Impact of Anemia in Pregnant Women on the Neonatal Conditions. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.6751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background. One of the most prevalent illnesses in the world is anemia. Anemia in pregnant women has been a pressing obstetric issue for many years and is one of the most common complications of pregnancy in the world, particularly in developing countries.
Aim. To study the condition of neonates born to women with anemia during pregnancy.
Methods. A retrospective analysis of 230 patients' medical records in maternity and pregnancy pathology departments. The patients were divided into 2 groups: Group 1 consisted of patients suffering from iron deficiency anemia, Group 2 comprised patients without iron deficiency anemia.
Results. The height-to-weight ratio in the group of neonates born to mothers with anemia statistically was significantly lower compared to the control group. The proportion of neonates with hypotrophy in the group born to mothers with anemia statistically was significantly higher. Body length and birth condition indices assessed according to the APGAR scale were virtually identical across the groups.
Conclusions. Anemia during pregnancy affects the trophism of a fetus, which is largely reflected in the health of neonates. Treating maternal anemia is important to prevent or decrease the incidence of underweight in infants at birth.
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Annan RA, Gyimah LA, Apprey C, Asamoah-Boakye O, Aduku LNE, Azanu W, Luterodt HE, Edusei AK. Predictors of adverse birth outcomes among pregnant adolescents in Ashanti Region, Ghana. J Nutr Sci 2021; 10:e67. [PMID: 34527225 DOI: 10.1016/j.hnm.2021.200130] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 07/19/2021] [Accepted: 07/22/2021] [Indexed: 05/27/2023] Open
Abstract
Adolescent pregnancy is associated with adverse birth outcomes. However, the determinants of these outcomes are understudied. The present study sought to identify the predictors of adverse birth outcomes among pregnant adolescents in Ghana. In this prospective health centre-based study, 416 pregnant adolescents, aged 13-19 years old, were followed, and 270 birth outcomes were evaluated. We collected data on socio-demographic variables, eating behaviour, household hunger scale (HHS), lived poverty index (LPI) and compliance to antenatal interventions. The prevalence of low birth weight (LBW) and preterm births (PTB) were 15⋅2 and 12⋅5 %, respectively. Pregnant adolescents with no formal education (AOR 9⋅0; P = 0⋅004; 95 % CI 2⋅1, 39⋅8), those who experienced illness (AOR 3⋅0; P = 0⋅011; 95 % CI 1⋅3, 7⋅0), those who experienced hunger (OR 2⋅9; P = 0⋅010; 95 % CI 1⋅3, 6⋅5) and those with high LPI (OR 2⋅5; P = 0⋅014; 95 % CI 1⋅2, 5⋅3) presented increased odds of delivering preterm babies compared with those who have had secondary education, did not experience any illness, were not hungry or having low LPI, respectively. Pregnant adolescents who used insecticide-treated net (ITN) (AOR 0⋅4; P = 0⋅013; 95 % CI 0⋅2, 0⋅9) presented reduced odds LBW children; while those who experienced illness (AOR 2⋅7; P = 0⋅020; 95 % CI 1⋅2, 6⋅0), poorer pregnant adolescents (OR 2⋅5; P = 0⋅014; 95 % CI 1⋅1, 4⋅8) and those who experienced hunger (AOR 3⋅0; P = 0⋅028; 95 % CI 1⋅1, 8⋅1) presented increased odds of LBW children compared with those who used ITN, were not ill, were not poor or did not experience hunger. Adverse birth outcomes were associated with ANC compliance and socioeconomic factors of the pregnant adolescents. Hence, strengthening antenatal uptake and compliance by pregnant adolescents, promoting their livelihood and socioeconomic status, and interventions to prevent teenage pregnancies are strongly recommended.
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Affiliation(s)
- Reginald Adjetey Annan
- Human Nutrition and Dietetics Unit, Department of Biochemistry and Biotechnology, Faculty of Biosciences, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Linda Afriyie Gyimah
- Human Nutrition and Dietetics Unit, Department of Biochemistry and Biotechnology, Faculty of Biosciences, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Charles Apprey
- Human Nutrition and Dietetics Unit, Department of Biochemistry and Biotechnology, Faculty of Biosciences, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Odeafo Asamoah-Boakye
- Human Nutrition and Dietetics Unit, Department of Biochemistry and Biotechnology, Faculty of Biosciences, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Linda Nana Esi Aduku
- Human Nutrition and Dietetics Unit, Department of Biochemistry and Biotechnology, Faculty of Biosciences, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Wisdom Azanu
- Department of Obstetrics and Gynecology, University of Allied Health Sciences, Ho, Ghana
| | - Herman E Luterodt
- Department of Food Science and Technology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Anthony K Edusei
- Department of Community Health, School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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Hemoglobin Level and Associated Factors among Pregnant Women in Rural Southwest Ethiopia. BIOMED RESEARCH INTERNATIONAL 2021; 2021:9922370. [PMID: 34104652 PMCID: PMC8159627 DOI: 10.1155/2021/9922370] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 05/04/2021] [Accepted: 05/08/2021] [Indexed: 12/13/2022]
Abstract
Background Anemia is a situation in which the number and size of red blood cells, or the concentration of hemoglobin, fall below established cut-off values. Low hemoglobin level during pregnancy favors the alteration of placental angiogenesis and resulted in restricting the availability of nutrients to the fetus and consequently causing fetal growth retardation and low weight at birth. This study is aimed at assessing the hemoglobin level and associated factors among pregnant women in rural communities of Jimma zone, Southwest Ethiopia. Methods A community-based cross-sectional study design was carried out among 367 pregnant women from June 1 to 30, 2020. Systematic random sampling was used to select study subjects. Hemoglobin level was measured by using HemoCue HB 301. An interviewer-administered structured questionnaire was used to collect the data. Descriptive statistics were used to describe the study subjects. A multivariable linear regression model was employed after the linearity, normality, multicollinearity, and homoscedasticity assumptions were checked. The unstandardized beta (β) coefficient along with a 95% confidence interval was computed to estimate the association between explanatory and dependant variables. Statistical significance was declared at P value < 0.05. Results The mean (± SD) hemoglobin level of the respondents was 12.66 (±1.44) g/dl. The overall magnitude of anemia (hemoglobin level < 11 g/dl) among pregnant women was found to be 85 [23.16%, (95% CI: 18.3%-27.5%)]. Meal frequency [β = 0.40, (95% CI: 0.12, 0.69), P = 0.005], interpregnancy interval [β = 0.08, (95% CI: 0.02, 0.15), P = 0.007], mid-upper arm circumference measurement [β = 0.13, (95% CI: 0.07, 0.20), P ≤ 0.001], own fruits/vegetable [β = 0.55, (95% CI: 0.79, 0.31), P ≤ 0.001], coffee consumption [β = −1.00, (95% CI: -1.31, -0.68), P ≤ 0.001], and having history of still birth [β = −0.63, (95% CI: -1.06, -0.20), P = 0.004] were significantly associated with the hemoglobin level of pregnant women. Conclusions Anemia was identified to be a moderate public health problem in the study area. Therefore, nutritional counseling should focus on the necessity of at least one extra meal, promotion of fruits/vegetable consumption, and improving the nutritional status of the women during antenatal care follow-up. Moreover, early screening and management of women with a history of stillbirth for anemia are also essential.
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Maternal dietary diversity during pregnancy and risk of low birth weight in newborns: a systematic review. Public Health Nutr 2021; 24:4671-4681. [PMID: 33472725 DOI: 10.1017/s1368980021000276] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
OBJECTIVE Maternal nutrition during pregnancy is a key factor influencing birth outcome. Dietary diversity is a proxy for multiple macro- and/or micronutrient sufficiency of an individual's diet. This systematic review aimed to summarise the findings on the association between maternal dietary diversity during pregnancy and the risk of low birth weight (LBW) in newborns. DESIGN This is a systematic review study. SETTING Google and the PubMed, Scopus and Google Scholar databases were searched to extract original studies on humans published until June 2020, without date restrictions. There was no limitation regarding geographic region or economic condition of countries. Duplicated and irrelevant studies were screened out and data were obtained through critical analysis. PARTICIPANTS Articles that examined the association between maternal dietary diversity during pregnancy and the risk of LBW in infants were included. RESULTS Of the ninety-eight studies retrieved, fifteen articles were included in the final review. All included articles represent low- and middle-income countries. Eighty percentage of the studies (n 12) indicated that low maternal dietary diversity during pregnancy is associated with an increased risk of LBW infants. Three studies that included a small number of LBW infants and did not take into account factors which may bias study results failed to show this association. CONCLUSION The results suggest that low maternal dietary diversity during pregnancy may be associated with the risk of LBW, more specifically in developing countries. Dietary diversity might be a valuable predictor of maternal nutrition during pregnancy and the chance of giving birth to a LBW infant.
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