Effect of Maternal Nutrition Knowledge and Nutritional Status on Pregnancy Outcome in Rural and Urban Areas of Ebonyi State, Nigeria.

Abstract:

The main purpose of this study was to assess the effect of maternal nutrition knowledge and nutritional status on pregnancy outcome in Ebonyi State, Nigeria. Specifically, the study sought to describe the general characteristics of pregnant women in rural and urban areas of Ebonyi State, to assess the nutrition knowledge of the respondents; assess their dietary practices and their perception of the effect of poor nutrition on pregnancy outcome in rural and urban areas of Ebonyi state; determine the mortality rate of neonates in the study area; determine the nutritional status of the respondents and anthropometric indices of their neonates; determine the effect of mother’s nutrition knowledge and nutritional status on pregnancy outcome in Ebonyi State. The population for this study was made up of all the pregnant women attending antenatal clinics in hospitals and maternity homes in Ebonyi State. Ebonyi state was stratified into three strata. Simple random sampling was used to draw four hundred pregnant women who participated in the study. A structured questionnaire was used for data collection. Information from focus group discussion was used to produce the questionnaire. A three day weighed food intake was conducted on a sub-sample of 60 respondents. Their height and weight were also taken and compared with standards. Anthropometric indices of neonates and haemoglobin status of the respondents were collected from their hospital folders (records). Data collected were analysed using mean, standard deviation, correlation and regression analyses. Findings revealed that 70.4% of the respondents were from rural community, while 29.6% were from urban; 22.5% were adolescents, 76.2% were middle aged, while 1.3% were older women. All the respondents were Christians. Majority (90.6%) were married while 9.4% were single. About 86.6% of the respondents were fairly educated. More than half of the respondents (66.5%) were farmers, traders and artisans, while 14.5% were government workers. About 64.5% earned between N30,000 – N100,000; 26.8% and 26.3% earned high and low income, respectively. Twenty percent (20%), 32.9% and 47.1% had poor, fair and good knowledge respectively of the foods that make up an adequate diet; 90.4% and 9.6% had poor and fair knowledge of nutrient sources and deficiencies. More rural respondents skipped their meals because they were not hungry; 98.5% of the respondents ate snacks, while 52.2%, 66.3% and 50.8% ate more in the first, second and third trimesters of their pregnancies. Weight gain was normal for 32.7% while 61.5% of the respondents gained above normal weight. About 86.1% and 13.9% had normal and poor haemoglobin status, respectively. LBW rate was 4.8% (urban 8.5% and rural 3.2%); 95.2%, 63.5%, 79%, 99.1%, 89.9% and 89.9% of the neonates had normal birth weight, birth length, head circumference, chest circumference, abdominal circumference, and placental weight. There was a significant (p= <0.05) relationship between haemoglobin status and placental size; and also between calcium, protein and iron intake and neonatal birth weight and placental weight. Maternal protein intake and riboflavin intake were associated with neonatal abdominal circumference and maternal haemoglobin status, respectively. Maternal nutrition knowledge did not affect neonatal weight. In conclusion, the low prevalence of low LBW recorded in this study is an indication of the effectiveness of maternal and child care programme in Ebonyi State. Also, the early registration and regular antenatal checkups, the use of supplements and some pregnancy adaptations must have contributed to the normal weight gain and Hb levels. The positive relationship between calcium intake and LBW needs to be carefully considered, while the negative relationship protein and riboflavin intakes and LBW need further investigation. The findings of this study support the reactivation and expansion of the mother and child health pragramme and free antenatal care in the State.