Maternal health behaviors during pregnancy in rural Northwestern China

Dietary Diversity and Its Contribution to the Magnitude of Anaemia among Pregnant Women: Evidence from Rural Areas of Western China

BACKGROUND

Prenatal anaemia causes serious consequences for both mother and foetus, and dietary factors are suggested to be associated with anaemia. However, research in pregnant women living in rural areas is limited. We aim to assess the contribution of dietary diversity to the magnitude of prenatal anaemia in rural China and identify the interactions between dietary diversity and several sociodemographic and maternal characteristics in relation to anaemia.

METHODS

A multi-stage random cluster sampling method was used to select pregnant women in rural western China. The Woman's Dietary Diversity Score was created to measure dietary diversity, which was recoded into terciles. Multinomial logistic regression models were used to assess the associations between dietary diversity score terciles and the magnitude of prenatal anaemia. Multiplicative interactions were tested by adding the product term of dietary diversity and several sociodemographic and maternal characteristics into the regression models.

RESULTS

Out of 969 participants, 54.3% were measured as anaemic, with 28.6% mildly anaemic and 25.7% moderately to severely anaemic. There was an absence of agreement between self-reported and measured anaemia status (κ = 0.28, 95% CI [0.22-0.34]). Participants in the highest dietary diversity score tercile had lower odds of being moderately to severely anaemic after adjusting for potential confounders (RRR = 0.65, 95% CI [0.44, 0.98]). In participants with moderate to severe anaemia, significant interactions were found between dietary diversity score terciles, age, and parity (p for interaction < 0.05).

CONCLUSIONS

The prevalence of prenatal anaemia in rural China remains high, and pregnant women living in these areas are insufficiently aware of their anaemia status. Improving dietary diversity is needed to manage prenatal anaemia in rural areas.

Structural Determinants of Child Health in Rural China: The Challenge of Creating Health Equity

Over the past two decades, the literature has shown a clear gradient between child health and wealth. The same health-wealth gradient is also observed among children in China, with a large gap in health between rural and urban children. However, there are still unanswered questions about the main causes of China's rural-urban child health inequality. This paper aims to review the major factors that have led to the relatively poor levels of health among China's rural children. In addition to the direct income effect on children's health, children in rural areas face disadvantages compared with their urban counterparts from the beginning of life: Prenatal care and infant health outcomes are worse in rural areas; rural caregivers have poor health outcomes and lack knowledge and support to provide adequate nurturing care to young children; there are large disparities in access to quality health care between rural and urban areas; and rural families are more likely to lack access to clean water and sanitation. In order to inform policies that improve health outcomes for the poor, there is a critical need for research that identifies the causal drivers of health outcomes among children. Strengthening the pediatric training and workforce in rural areas is essential to delivering quality health care for rural children. Other potential interventions include addressing the health needs of mothers and grandparent caregivers, improving parenting knowledge and nurturing care, improving access to clean water and sanitation for remote families, and most importantly, targeting poverty itself.

Health-related behaviours and weight status of expectant fathers

OBJECTIVE

Little attention has been given to the health status and lifestyle behaviours of expectant fathers. This study aimed to examine health-related variables in a cohort of expectant fathers to identify potential focus areas for interventions designed to optimise health and wellbeing outcomes in this group.

METHODS

Partners of pregnant women who accessed antenatal services at a large maternity unit in a Western Australian hospital were recruited as part of the ORIGINS Project. Analyses were conducted on data from 498 expectant fathers who were primarily of mid and high socioeconomic status.

RESULTS

Participants reported relatively low levels of smoking and alcohol consumption and higher physical activity compared to national averages. Weight status was consistent with population norms for adult males: 76% were overweight or obese and 62% had a waist girth ≥94cm.

CONCLUSIONS

Expectant fathers may benefit from health interventions, especially in relation to managing their weight during this phase of their lives and beyond.

IMPLICATIONS FOR PUBLIC HEALTH

Pregnancy represents a valuable opportunity to engage fathers-to-be in health interventions. Given identified links between paternal weight status and offspring outcomes, interventions focusing on achieving and maintaining a healthy weight among expectant fathers could be beneficial for families.