Dietary Practices Of Pregnant Women And Its Associations With Maternal And Prenatal Outcomes In Rural Central Ethiopia

Maternal and child under nutrition is a serious developmental challenge contributing a largernshare to the global disease burden. It is a major reason for increased risk of adverse pregnancyrnoutcomes, poor infant survival, and elevated risks of chronic diseases at later stages of life.rnEthiopia has an unacceptably high burden of malnutrition and its consequences, and yet little isrnknown about the determinants and responses to under nutrition during pregnancy. The few crosssectionalrnstudies and the periodic national surveys are often less appropriate to investigaternnutritional problems during the dynamic periods of pregnancy. Using a mixed-method approach,rnthe present thesis examined the association of maternal nutrition during pregnancy with maternalrnand perinatal outcomes in rural Central Ethiopia. Applying a weighed-record (n= 55), the mostrnfrequently consumed foods were identified, sampled and analyzed for their nutrient compositionrnand nutrient densities estimated. By enrolling pregnant mothers to a prospective cohort study,rnrisk of anemia and adverse pregnancy outcomes were determined. Using a focus-grouprndiscussion (FGD), in-depth interviews (IIs) and passive observations, food consumption-relatedrnbehaviors and perceptions were identified.rnDietary patterns adopted by the pregnant women were largely plant-based, predominantly cerealrnand legume-based. The nutrient-density of the foods were low and the overall dietary diversityrnwas low. The overall incidence of maternal anemia increased from 28.6% to 32.4% during thernivrnfollow-up period and twenty percent of the mothers experienced at least one of the adversernpregnancy outcomes (APO): low birth weight (LBW; 9.1%), preterm (13.6%), and stillbirthrn(4.5%). Mothers who consistently consumed ≥ 4 food groups (out of nine) had a lower risk ofrnanemia [adjusted RR (ARR: 2.29; 95% CI: 1.62, 3.24], LBW (ARR: 2.06; 95% CI: 1.03, 4.11),rnand PTB (ARR: 4.61; 95% CI: 2.31,9.19) but not of stillbirth (ARR: 2.71; 95% CI: 0.88, 8.36)rndeliveries than those who consumed undiversified diets. Low or inconsistent consumption ofrndark green leafy vegetables(adjusted odds ratio (AOR), 2.012; 95% confidence interval (CI):rn1.04; 3.87), dairy products (AOR, 2.64; 95% CI: 1.11; 6.30), and fruits and vegetables (AOR,rn2.92; 95% CI: 1.49; 5.67) were associated with increased risk of APO. The presence ofrnwidespread misconceptions about weight gain during pregnancy, the food taboos among somernpopulation segments, and the relatively low awareness about maternal nutrition may be some ofrnthe underlying reasons.rnTherefore, efforts to enhance maternal awareness about nutrition in general, and promotingrndietary diversity (≥ 4 food groups) to increase animal sources foods (ASF), fruits and vegetablesrnin particular, could help improve maternal nutrition and prevent the associated adverse outcomes.rnPopulation based controlled trials of various options to improve dietary diversity and intake ofrnselected limiting food groups are recommended.rnrnKeywords: Dietary diversity; anemia; low birth weight; preterm; stillbirth food taboo; intakes; women’s nutrition; pregnancy

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