Nutritional and Iron Status of Pregnant Women Attending Antenatal Clinic at the University of Nigeria Teaching Hospital, Ituku Ozalla, Enugu

Abstract

Pregnant and lactating women are nutritionally, the most vulnerable group especially in developing regions of the world. This is because of repeated pregnancies and lactation which are aggravated by food taboos and poor maternal stress. The poor nutrition experienced by these women results to “maternal depletion syndrome”, the most common of which is protein-energy malnutrition (PEM). This study therefore had the following key objectives: (i) to assess the nutritional status of pregnant mothers attending antenatal clinic at the University of Nigeria Teaching Hospital, Ituku, Ozalla, Enugu (ii) to assess the iron status of the mothers and (iii) determine factors that are associated with iron deficiency in pregnant mothers. A retrospective and prospective review of pregnant mothers in the University of Nigeria Teaching Hospital, Ituku/Ozalla, Enugu was carried out to assess their nutritional status using anthropometry, dietary, clinical/physical and biochemical methods. The mothers were enrolled as they came within a period of six months. A total of 405 mothers were enrolled, only those who met the inclusion criteria were selected. Those who were included were in their first or second trimesters, consistent in their visits and were able to do prescribed tests. A total of 263 mothers were qualified to be selected. The results of the study showed that of the 263 pregnant mothers that participated, about 7.6% delivered their babies in a peripheral hospital. The majority (92.4%) of the mothers were married. About 38.4% were within the age range of 27 – 31 years and almost the same number (38.3%) were multiparous. More than a half of the mothers (68.8%) were in their second trimester and 34.2% were in their first trimester. Only 9.1% had no formal education and 18.6% stopped at primary school level. Paleness of the eyes and swollen legs in 61.2% and 29.3% of the subjects were the clinical signs of malnutrition observed . The biochemical analysis showed that 39.5% of the mothers had mild anaemia, 37.3% had moderate anaemia and 10.3% had severe anaemia in their second trimester. Only 12.9% of the mothers had normal haemoglobin. Mothers’ parity, trimester, hours of work and marital status affected their haemoglobin levels. Th mean height of of the mothers was 1.64 ± 0.6m, weight 79.9 ± 10.9kg and age 30.8 ± 3.7 years. Malaria (19.8%) was the main cause of low haemoglobin in the mothers. The 24-hr food recall and food frequency analysis showed that on daily basis, the bulk of the mothers food consisted mainly of starchy roots\tubers, about 19.0% and 28.1% in the first and second trimesters and consumed less of meat\milk products ( 8.0% and 14.4%) in the respective trimesters. About 9.0% and 7.0% of mothers in the first trimester consumed fruits and vegetables and nearly 17.0% and 19.0% of mothers in the second trimester consumed fruits and vegetables. The mothers on weekly basis consumed diets containing adequate foods. The overall nutritional status of the pregnant mothers was poor. Mothers’ occupations, parity and literacy levels significantly (P < 0.05) affected their consumption of vegetables, fruits, legumes and starchy roots/tubers at various levels. The inadequate consumption of these foods may result to micronutrient deficiency (hidden hunger). Women’s under nutrition translates into loss of economic productivity and of lives. Appropriate interventions in addressing maternal nutritional status depend on the factors affecting their status in a particular household and community. A common cause in Nigeria, Enugu in particular is one in which women are underfed and over worked.