ABSTRACT
Nutrition during pregnancy play a vital role in the wellbeing of the pregnant women and their unborn child and it influence on their health during childhood and adulthood. The problem of malnutrition is the major causes of maternal mortality and it is a major determinant of a successful pregnancy and a healthy well-nourished baby. The study assessed nutrition knowledge and dietary pattern among pregnant women in Umuahia South Local Government Area of Abia state. The study employed the cross sectional survey design. The population was comprised of pregnant women attending antenatal in health centre in Umuahia, the sample was 191 pregnant women. A structured questionnaire was used to collect data for the study. The dietary pattern of the pregnant women were assessed using the food frequency questionnaire, while the nutritional knowledge were assessed using the nutritional knowledge questionnaire. Descriptive statistics such as continuous variables using frequency distribution, proportions, percentages, and measures of central tendency were used to analyse data. The result on socio-economic characteristics revealed that 46.1% attended secondary school, 24.1% were civil servants, 64.9% were married, 49.2% were between the ages of 30-34 years, 71.2% were Christians and 49.2% had 1-2 children. In this study only 64.4% of the pregnant women had good dietary practice indicating that the overall dietary practice of the pregnant women in Umuahia South Local Government Area of Abia State is optimal and the rest 35.6% of the pregnant women reported poor dietary practices. Concerning dietary knowledge, 66.5% of the pregnant women had good dietary knowledge while 15.2% had poor dietary knowledge. In conclusion, maternal dietary practices during pregnancy play an important role in determining the long-term health and nutritional status of both the mother and her growing foetus. Poor dietary practices during pregnancy may result in increased rates of stillbirths, premature birth, and low birth weight, maternal and prenatal death. The study recommends that it is necessary to improve pregnant women knowledge on nutrition through nutrition education and integrating key nutrition messages in already existing strategy should be strengthened.
TABLE OF CONTENTS
Cover Page
Title Page i
Declaration ii
Certification iii
Dedication iv
Acknowledgement vi
Table of contents vii
List of tables x
Abstract xi
CHAPTER 1
INTRODUCTION
1.1 Background of the Study 1
1.2 Statement of Problem 2
1.3 Objective of the Study 4
1.3.1 General objective of the study 4
1.3.2 Specific objective of the study 4
1.4 Significance of the study 4
CHAPTER 2
LITERATURE REVIEW
2.1 Overview of nutrition in pregnancy 6
2.2 Critical periods of pregnancy 7
2.2.1 First Trimester 7
2.2.2 Second Trimester 8
2.2.3 Third Trimester 8
2.3 Physiological changes of concern during pregnancy 8
2.3.1 Morning Sickness 8
2.3.2 Oedema 9
2.3.3 Gestational Diabetes 9
2.3.4 Food Craving and Aversion 10
2.3.5 Non-Food Craving 10
2.3.6 Heartburn, Constipation and Hemorrhoids 10
2.3.7 Anemia in Pregnancy 11
2.3.8 Pregnancy Induced Hypertension 11
2.3.9 Preeclampsia and Eclampsia 12
2.4 changes in body composition and weight gain 13
2.5 Nutrition Pattern 13
2.5.1 Factors That Influence Nutrition Pattern 14
2.5.1.1 Nutrition Knowledge 14
2.5.1.2 Economic Factors of Pregnancy 15
2.5.1.3 Geographical Location 15
2.5.1.4 Religious Belief and Practice 15
2.5.1.5 Culture 15
2.5.1.6 Social Factors 16
2.6 Nutrition related factors affecting pregnancy outcomes 16
2.6.1 Maternal Pre-Pregnancy Weight 16
2.6.2 Maternal Weight Gain 17
2.6.3 Hyperemesesis Gravidarum, Nausea, and Vomiting of Pregnancy (NVP) 18
2.6.4 Food Safety 18
2.6.5 Eating Habits and Diet Quality 19
2.6.6 Young Maternal Age 19
2.6.7 Maternal Lifestyle 20
2.6.8 Maternal Health 21
2.7 Nutrient needs of pregnant women 23
2.7.1 Energy Needs in Pregnancy 24
2.7.2 Protein Needs in Pregnancy 25
2.7.3 Folate/Vitamin B12 Needs in Pregnancy 25
2.7.4 Iron Needs in Pregnancy 26
2.7.5 Zinc Needs in Pregnancy 27
2.7.6 Calcium Needs in Pregnancy 27
2.7.7 Essential Fatty Acids 28
2.7.8 Water Needs in Pregnancy 28
2.7.9 Choline 29
2.8 Nutrient Supplement 29
CHAPTER 3
MATERIALS AND METHODS
3.1 Study Design 30
3.2 Area Of Study 30
3.3 Population Of The Study 31
3.4 Sampling And Sampling Techniques 31
3.4.1 Sample Size 31
3.4.2 Sampling Procedure 32
3.5 Preliminary Activities 33
3.5.1 Preliminary visits 33
3.5.2 Ethical approval 33
3.5.3 Training of research assistant 33
3.6 Data Collection 34
3.6.1 Questionnaires Administration 34
3.6.2 Dietary Pattern 35
3.7 Data Analysis 35
3.7.1 Nutritional Knowledge Assessment 35
3.8 Statistical Analysis 36
CHAPTER 4
RESULTS AND DISCUSSION
4.1 Personal Characteristics of Pregnant Women 37
4.2 Socioeconomic Characteristics of Pregnant Women 40
4.3 Pregnancy Characteristics of Pregnant Women 42
4.4 Nutritional Knowledge of Pregnant Women 46
4.5 Dietary Patterns of Pregnant women 51
4.6 Food Consumption Patterns of Pregnant women 55
CHAPTER 5
CONCLUSION AND RECOMMENDATION
5.1 Conclusion 58
5.2 Recommendations 58
REFERENCES
APPENDIX
LIST OF TABLES
Table 1: Personal Characteristics of Pregnant Women 39
Table 2: Socioeconomic Characteristics of Pregnant Women 41
Table 3: Pregnancy Characteristics of Pregnant Women 45
Table 4: Nutritional Knowledge of Pregnant Women 48
Table 5: Dietary Pattern of Pregnant women 49
Table 6: Food Consumption Patterns of Pregnant women 57
CHAPTER 1
INTRODUCTION
1.1 BACKGROUND OF THE STUDY
According to Elizabeth (2003) pregnancy can be defined as the period during which a woman carries a developing fetus normally in the uterus. The normal duration for pregnant is 280days or 40weeks. Pregnancy is a critical period for meeting the body’s demand for macro and micronutrient (West, 2002). Pregnancy is usually associated with many physiological changes such as increased plasma volume, red blood cell (Women Health, 2003). The world health organization (WHO) estimates that 536,000 women dies of pregnancy related causes annually ,and close to 10 million women suffer complication related to pregnancy or childbirth (WHO, 2007).
Nutrition during pregnancy play a vital role in the wellbeing of the pregnant women and their unborn child and it influence on their health during childhood and adulthood, thus in the course of pregnancy the quality and quantity of nourishment is very important (Harding, 2001). Evidence showed that inadequate nutrition during pregnancy leads to impaired fetal growth, spontaneous abortion, behavioral problem of the offspring as well as poor pregnancy weight gain (Harding, 2001). Maternal diet during pregnancy has gained a lot of attention over the years. This is due to recognition of the increased physiological and demand placed on the pregnant women by her gravidity (Scholl, 2000). The dietary intake of pregnant women needs to provide energy and other nutrient for the mother as well as the developing fetus (King, 2000). Therefore an appropriate eating pattern is very essential throughout the pregnancy to ensure a healthy pregnancy outcome (Pickle et al., 2005).
Nutrition Pattern are the overall diet, the foods, food groups and nutrient included, their combination and variety and the frequency and quantity with which they are habitually consumed (Curropin, 2002).
Knowledge on nutrition is a vital element to ensure positive pregnancy outcome and is the integral to achieve healthy dietary behaviour and improve their diet quality (Zalilah et al., 2008; Mitra et al., 2012) highlight the importance that pregnant women could benefit through nutritional knowledge
As reported by the Recommendation nutrition intake, nutritional knowledge during pregnancy is necessary to ensure optimal gestational weight gain and reduces complication.
Therefore this study is aimed at accessing the nutrition knowledge and dietary pattern of pregnant women living in Umuahia South Local Government Area of Abia state.
1.2 STATEMENT OF PROBLEM
Maternal nutrition during pregnancy has gained interest over the years due to understanding that there is an increased physiological, metabolic, and nutritional demand associated with pregnancy (Godfrey and barker, 2000). This has been regarded as an important determinant of fetal growth.
The problem of malnutrition is the major causes of maternal mortality and it is a major determinant of a successful pregnancy and a healthy well-nourished baby (Hood, 2015). Poor nutritional status has been known to have unfavorable effect. Evidence on World health Organization showed that excessive intake of alcohol during pregnancy can cause fetal alcohol syndrome which lead infant to aggression, anti-social, hyperactivity, anxiety, intellectual disability, slow growth later in life.
Poor nutrition during pregnancy can have consequences for the child later in life increasing their risk for cardiovascular diseases , hypertension, and neurological disorder (Barrasi,2003).
According to WHO (2011), 23.8% of infants worldwide are estimated to be born with lower than optimal weight at birth due to lack of proper nutrition. Poor nutrition on pregnant mother can cause gestational weight gain, increase maternal infection, preeclampsia, anemia, pre term birth (Lassiz et al., 2013).
Poor dietary during pregnancy such as smoking, caffeine using street drugs can negatively and irreversibly affect the development of the child which happened in the early stage of pregnancy (Laura, 2006).
1.3 OBJECTIVE OF THE STUDY
1.3.1 General objective of the study
The general objective of the study is to assess the nutrition knowledge and dietary pattern among pregnant women in Umuahia South Local Government Area of Abia State
1.3.2 Specific objective of the study
The specific objectives of the study are to:
1. determine the socio-economic characteristics of pregnant women.
2. assess the knowledge and dietary pattern of pregnant women using questionnaire.
3. evaluate their dietary pattern of the respondents using food frequency questionnaire .
1.4 SIGNIFICANCE OF THE STUDY
Pregnancy constitute states of considerable physiological stress which increased nutrition demands. If these demands are not adequately met, It may be expected that not only the nutritional pattern of the Pregnant women will be affected but also the course of pregnancy.
The information obtained from this study will serve as a source of enlightenment to pregnant mothers and intending mothers in umuahia South Local Government Area of Abia state and beyond to become nutrition-conscious before during and after pregnancy thereby protecting their health and that of their babies.
The study will help in the assessment, monitoring and elimination of the underlying causes of most maternal related illness and death.
The recommendation from this study can serve as a guideline for health and nutrition workers in creating public health principles, management, and strategies towards the nutrition knowledge of pregnant women.
The data gotten from this study will also provide insight to policy makers/programmers thereby serving as a baseline data for further studies related to nutrition knowledge and dietary pattern among pregnant women.
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