Determinants of chronic energy deficiency among non-pregnant and non-lactating women of reproductive age in rural Kebeles of Dera District, North West Ethiopia, 2019: Unmatched case control study

Malnutrition and Anemia Among Particularly Vulnerable Tribal Groups of Odisha, India: Needs for Context-Specific Intervention

Background

As undernutrition and anemia persist to be prevalent in India, the socioeconomically disadvantaged groups continue to take the greater brunt. Odisha is home to the largest number of particularly vulnerable tribal groups (PVTGs) in India. The study aimed to provide a comprehensive report on the undernutrition and anemia status of all the PVTGs of Odisha.

Methods

A community-based cross-sectional study was conducted among (N = 1461, 683 males and 779 females) 13 PVTGs spread across 12 districts of Odisha from August 2018 to February 2019.

Results

Among the under-five children, the prevalence of underweight was observed in 75.26%, stunting in 55.42%, and wasting in 60.00% and all forms of undernutrition were higher among girls. Among children and adolescents belonging to the age group of 5 to 19 years, the prevalence of thinness was 46.7%. In individuals above the age of 20, the prevalence of underweight among males was 37.7% and females was 44.3% and severe anemia was present in 36.5% of females and 35.8% of males. Women in the reproductive age have a higher prevalence of anemia.

Conclusion

The study shows that undernutrition and anemia remain high in the PVTGs, especially among the under-five children and women in the reproductive age. As the country heads toward fulfilling Sustainable Development Goals (SDG) by 2030, national and state health policies need to be designed and implemented, giving special focus to these vulnerable groups.

Determinants of chronic energy deficiency (CED) incidence in pregnant women: A cross-sectional study in Banyumas, Indonesia

Chronic energy deficiency (CED) in pregnant women is a condition of energy and protein deficiency that lasts for years and causes problems in the mother and fetus. Due to its significant consequences, determining the determinants associated with CED incidence is of utmost importance. The aim of this study was to determine the determinants of the incidence of CED in pregnant women in Indonesia. A cross-sectional study was conducted on pregnant women in Banyumas, Central Java, Indonesia, in 2022. Plausible determinants included maternal age, pregnancy interval, parity, educational attainment, nutritional knowledge, employment, frequency of antenatal care (ANC), and nutritional intake. The Chi-squared test followed by multivariate logistic regression were used to determine the factors associated with the incidence of CED. Our data indicated that 32% of the pregnant women had CED. Univariate analysis found that maternal age (p=0.022), pregnancy interval (p=0.009), educational attainment (p=0.012), knowledge of nutrition and CED (p=0.023), frequency of utilization of ANC services (p=0.028), energy intake (p=0.002), protein intake (p=0.006), vitamin C intake (p=0.016), folate intake (p=0.011), and calcium intake (p=0.004) were significantly associated with CED incidence in the pregnant women. Multivariate analysis indicated that extreme maternal age (OR; 3.49; 95%CI: 1.10-11.05), low educational attainment (OR: 4.12; 95%CI: 1.37-12.33), short pregnancy interval (OR; 7.30; 95%CI: 1.84-28.99), low frequency of ANC (OR: 3.06; 95%CI: 1.01-9.19) and low protein intake (OR: 6.80; 95%CI: 1.62-28.59) were associated with CED incidence. This study underscores the importance of increasing nutritional intake, frequency of ANC, and pregnancy interval among pregnant women to reduce the risk of CED and its adverse health outcomes.

Maternal macronutrient and energy intake during pregnancy: a systematic review and meta-analysis

BACKGROUND

Nutritional status during pregnancy can have a significant impact on infant and maternal health outcomes. To maintain maternal homeostasis and support fetal growth, adequate macronutrient and energy intake during pregnancy is essential. Therefore, this study sought to systematically review and meta-analyze macronutrient and energy intakes during pregnancy.

METHODS

A systematic review and meta-analysis was carried out based on the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The required data were collected from four databases including: Web of Sciences, ProQuest, Scopus, and PubMed, from 1 January 1980 to 30 May 2023, by using a combination of search terms (dietary pattern" OR "diet quality" OR "food habits" OR "nutrition surveys" OR "diet surveys" OR "food-frequency questionnaire" OR "diet record" OR "dietary recall") AND ( "pregnancy" OR "reproduction" OR "maternal health" OR "neonatal outcomes") among interventional and observational studies. Excel and STATA version 11 were used for data analysis.

RESULTS

Among 7081 published articles, 54 studies were included in the review. Most of the 33 (61%) studies were cohort studies and a total of 135,566 pregnant women were included. The overall average of energy, carbohydrate, fat, and protein intake was 2036.10 kcal/day, 262.17 gr/day, 74.17 gr/day, and 78.21 gr/day, respectively. Also, energy intake during pregnancy was higher in American (2228.31 kcal/day, CI95%: 2135.06-2325.63) and Eastern Mediterranean regions (2226.70 kcal/day, CI95%: 2077.23-2386.92) than other regions (P < 0.001). Energy intake was higher in the third trimester than others (2115.64 kcal/day, CI95%: 1974.15-2267.27). Furthermore, based on the findings, there was a significant difference between energy intake in different World Health Organization (WHO) regions (P < 0.05).

CONCLUSIONS

According to the results of meta-analysis, the average total energy was below than average total energy required during pregnancy. More efforts are needed to encourage women to adopt healthy eating habits during pregnancy to support healthy fetal and infant development.

Multi-Level Correlates of the Nutritional Status of Nigerian Women of Reproductive Age

Poor nutrition compromises the capacity of women to perform their vital roles as mothers and productive workers in their families, communities and society. Using a conceptual framework developed by the United Nations Children's Fund, this study determines individual-, household- and community-level factors associated with the nutritional status of Nigerian women of reproductive age. A secondary analysis of pooled data from the Nigeria Demographic and Health Survey (NDHS) for 2003, 2008, 2013 and 2018 was conducted involving 82,734 non-pregnant women aged 15-49 years. Multinomial logistic regression was used to determine predictors of nutritional status. Study results show that a significant proportion of the women had poor nutritional status; the prevalence of underweight, overweight and obesity were 12.1%, 16.8% and 7.2% respectively. Statistically significant factors associated with poor nutritional status were found at all three levels, highlighting the need for effective multidimensional, multisectoral policy interventions to address the double burden of malnutrition among women in Nigeria.

The association of intimate Partner violence and decision making power on nutritional status of married women in Ethiopia: a multilevel mixed-effect analysis

BACKGROUND

A growing body of research has established a link between intimate partner violence (IPV) and decision-making autonomy on women's mental, physical, and reproductive health consequences, as well as child nutritional status. However, there is a scarcity of research on the effects of IPV and decision-making autonomy on women's nutritional status. To date, no research has been conducted in Ethiopia to investigate the impact of IPV and decision-making autonomy on women's nutritional status. Therefore, the purpose of this study was to investigate the relationship between IPV and decision-making power at both the individual and community levels on women's nutritional status.

METHODS

We analyzed data from the 2016 Ethiopian demographic and health survey. Our study focused on 3,660 married non-pregnant women of reproductive age. We used the chi-squared test and spearman correlation coefficients for bivariate analysis. The relationship between IPV and decision making power with nutritional status was evaluated using multilevel binary logistic regression models while controlling other determinants.

RESULTS

Around 28% of women reported at least one of the four types of IPV. Approximately 32% of women had no decision-making power at home. About 27.1% of women were underweight (BMI < 18.5), while 10.6% were overweight/obese (BMI ≥ 25). Women who had sexual IPV had a higher chance of being underweight (AOR = 2.97; 95% CI: 2.02-4.38) than women who had no sexual IPV. While women who had decision-making power at home were at lower odds of being underweight (AOR = 0.83; 95% CI: 0.69-0.98) than their counterparts. The findings also revealed a negative relationship between being overweight/obese and community-level women's decision-making autonomy (AOR = 0.75; 95% CI 0.34-0.89).

CONCLUSIONS

Our findings show the presence of a significant association between IPV & decision-making autonomy with women's nutritional status. Therefore, effective policies and programs to end violence against women and encourage women to participate in decision-making are required. This will help to improve the nutritional status of women as well as the nutritional outcomes of their families. This study suggests that efforts to achieve Sustainable Development Goal (SDG5) may have an impact on other SDGs particularly SDG2.

Nutrient intakes of pregnant and lactating women in Indonesia and Malaysia: Systematic review and meta-analysis

Introduction

Optimizing dietary intake during pregnancy and lactation is crucial to the growth and development of children and their lifelong health. We performed a systematic review and meta-analysis to describe the nutrient intakes of pregnant and lactating women in Indonesia and Malaysia, countries that are experiencing rapid nutrition transition in Southeast Asia.

Methods

We screened 2,258 studies published between January 1980 and March 2021. The nutrient intakes of pregnant and lactating women were quantitatively analyzed to calculate the percentage of adequacy using national recommended daily allowances or nutrient intakes (RDA/RNI) and estimated average requirements (EAR) for micronutrients. Standardized mean differences (SMD) between dietary intake and RDA/RNI were determined for selected nutrients.

Results

Fifty-three studies were included and showed that energy and macronutrient intakes among pregnant and lactating women in both countries were below the RDA/RNI. In addition, most studies reported that women failed to meet the EAR for vitamin D (&lt;70% EAR), vitamin E (&lt;50% EAR), and water-soluble vitamins (&lt;80% EAR) except for vitamin C and A among Malaysians. Moreover, calcium, potassium, and iron intakes of pregnant women were &lt;60% EAR in Indonesia and &lt;80% EAR in Malaysia. Phosphorus intake among pregnant women in both countries and sodium intake among Malaysian pregnant women exceeded 100% EAR. Indonesian lactating women had &lt;60% EAR for calcium and potassium intakes, while Malaysian women had more than 100% EAR. For 21 studies reporting overall protein intakes, the standard mean difference (SMD) was −2.26 (95% CI; −2.98, −1.54) below the RDA/RNI for pregnant women and −0.67 SMD (95% CI −15.7, −11.5) for lactating women. When the four studies from Malaysia were analyzed separately, protein intakes of pregnant women were above the RNI. Moreover, low intakes of vitamin D, vitamin C, calcium, and iron, but sufficient intakes in vitamin A, zinc, and phosphorus were observed in pregnant women in both countries.

Conclusion

Dietary intakes of energy, macronutrients, and micronutrients (vitamin D, vitamin E, water-soluble vitamins, calcium, and iron) of pregnant and lactating women in Indonesia and Malaysia were below the recommendations. Important heterogeneities were observed even between these two countries for specific essential nutrient intakes. Innovative research and targeted programs to address specific deficiencies should be prioritized.

Systematic review registration

https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021252204, identifier: CRD42021252204.

Serum concentration of zinc, copper, iron, and its associated factors among pregnant women of small-scale farming in western Ethiopia

Micro-nutrients are required in small amounts to maintain growth and cell functioning to complete the life cycle through reproductions. However, pregnant women in developing countries like Ethiopia are vulnerable to multiple micro-nutrient deficiencies. Therefore, this study aimed at assessing the serum level of metals and associated factors like dietary diversity, and health-related problems in pregnant women among small-scale farming in Kellem Wellega, western Ethiopia. A cross-sectional laboratory-based study was conducted from June to August 2021 on 417 pregnant women attending antenatal care at rural healthcare facilities. Data was collected by using per-tested structured questionnaires via face-to-face interviews. The data analysis was conducted using SPSS version 24.0, and multivariate logistic regression analysis was performed to determine the association between predictor and outcome variables. A statistically significant was considered at p value < 0.05 for all the analyses. Our study findings showed that 62.1, 80.9, and 71.9% of the participants were deficient in iron, zinc, and copper micro-nutrient levels, respectively. Pregnant women who could not have formal education were 3.24 (AOR = 3.24, 95% CI 1.33-7.91) and 3.98 (AOR = 3.98, 95% CI 1.2-13.15) times more likely to show zinc and copper deficiency than those who attended secondary school and above, respectively. Furthermore, pregnant women involved only in farming activities were 0.57 (AOR = 0.57, 95% CI 0.36-0.91) and 4.33 (AOR = 5.72, 95% CI 2.34-13.97) times more likely to be exposed to iron and zinc deficiency than those who were engaged in other activities. This study revealed that pregnant women with low income were 6.36 times more likely to be exposed to zinc micro-nutrient deficiencies than those with high-income participants (AOR = 6.36, 95% CI 1.47-27.61). Additionally, those participants who ate a varied diet between 1 and 4 items per day were 2.26 (AOR = 2.26, 95% CI 1.43-3.59) and 2.77 (AOR = 2.77, 95% CI 1.6-4.61) times more likely to suffer zinc and copper micro-nutrient insufficiency than those who consumed 5-10 items per day. Finally, pregnant women who developed diarrhea in the past three months were 1.82 (AOR = 2.77, 95% CI 1.14-2.92) and 2.52 (AOR = 2.52, 95% CI 1.3-4.91) times more likely to be exposed to iron and copper deficiency than those who never show the symptoms, respectively. This study identified low concentrations of zinc, iron, and copper in the blood serum of pregnant women of small-scale farmers.