The nutritional condition of a mother at the time of conception, during pregnancy and breastfeeding plays an important role in determining her health and well-being, as well as that of her newborn.

Objective: This study assessed practice of proper nutrition during pregnancy to ensure a healthier pregnancy journey.

Methodology: This was an observational prospective hospital based study, conducted in Enugu State University Teaching Hospital. Two hundred pregnant women participated in the study. Self-administered questionnaire was used to ascertain information on socio-demographic and reproductive characteristics, dietary practice/knowledge of nutrition required during pregnancy and factors associated with dietary practices. Data collected were analysis with Statistical Package for Social Sciences software (IBM Chicago) version 28. Categorical variables were presented in frequencies and percentages while symmetrical continuous variables were presented using mean and standard deviations with 95% confidence intervals around the point estimates.

Result: The result revealed that, out of the two hundred participants in the study, only 44 (22%) of pregnant women had good dietary practice. Also, mother’s educational status, monthly income, marital status and dietary knowledge were significantly association with good dietary practice.

Conclusion and recommendation: The number of participants with good dietary practice from this study is 44(22%). This finding shows that majority of the participants lacked in knowledge of nutritional requirements in pregnancy and this poses a serious threat to pregnant women and their unborn babies. Therefore, advocacy and awareness creation on good nutritional / dietary practice among pregnant women are indicated.

Keywords: dietary practice, pregnant women, Hospital, South-East

The nutritional condition of a mother at the time of conception, during pregnancy and breastfeeding plays an important role in determining her health and well-being, as well as that of her newborn. Poor maternal nutrition during pregnancy were associated with higher risk of having a preterm labour, low birth-weight, intrauterine growth restrictions and threat to mothers wellbeing and survival.^1,2 Widespread global micronutrient deficiencies (MNDs) and their consequences exist with pregnant women and under 5‑year‑old children at the highest risk.^3–6 The reproductive period is a critical time for establishing risks of chronic diseases in offspring later in life.⁷ Malnutrition is among the most severe health problems affecting children and their mothers and malnourished mothers face higher risks during pregnancy and childbirth.⁸ Deficiency of nutrients on the other hand increases the risk for intrauterine growth retardation (IUGR) which usually predicts early life growth curves and survival, besides age and sex.⁹ Maternal undernutrition ranges from 10% to 19% in most countries in sub‑Saharan Africa, south‑central, and south‑eastern Asia. Most pregnant women in Nigeria have been shown to consume vegetables but almost half of them still avoid eggs, fish, meat, and chocolate beverage which are high in protein needed by the fetus because of taboos.^10,11 Malnutrition determines survival, poverty, and development.^12–14 Malnutrition due to dietary habits is higher during pregnancy than at any other stage of the life cycle.¹³ A pregnant woman’s nutritional intake plays a major role in determining fetal health, predisposition to some diseases(more than genetic factors), and influences the fetus for the rest of its life. Hence, high dietary diversity is important as good sources of nutrients to support proper growth and development.¹⁵

Comprehensive guidelines detailing nutritional needs of women throughout reproduction from preconception through pregnancy and lactation are lacking even in the phase of the guidelines for antenatal care by World Health Organization (WHO).¹⁶

Maternal health is of the utmost importance during pregnancy, not just for the mother but also for the developing fetus. Pregnancy brings significant changes to the body, necessitating increased nutritional support for both the developing fetus and the mother’s health.¹⁷

Therefore, it is crucial to enhance education and awareness of proper nutrition during pregnancy to ensure a healthier pregnancy journey for both the mother and the baby. By providing accurate information and guidance, expectant mothers can bridge this knowledge gap and make informed decisions about their diet and supplement choices

Study design and setting

This was a prospective hospital based study conducted in Enugu State University Teaching Hospital. Enugu State University Teaching Hospital is a tertiary health facility in the capital of Enugu State, South-East Nigeria with different cadres of professionals. It is located in the metropolis of Enugu and serves as a training Centre for undergraduate medical students and postgraduate resident doctors as well as a referral center for secondary health care centers and other government owned and private Hospitals in Enugu and neighboring States. Its central location and efficient medical services delivery in the hospital made it an institution of choice for many patients in the state and its environs.

Study participants

Participants were pregnant women that attended antenatal care in Enugu State University Teaching Hospital. Daily antenatal care is conducted in the hospital from Monday to Friday and average of 80 clients are attended to daily.

Systematic Sampling method, involving the recruitment of the first and every other 4^th woman each day until the 5^th antenatal day was employed in selecting the 200 pregnant women involved in the study.
Variables of the study

Dietary practice was the dependent variable while social, demographic, socioeconomic, gravidity and dietary knowledge were the independent variables.

Sample size calculation

The sample size for this study was calculated using single population proportion formula and was calculated relying on the finding of 39.9% as the, prevalence of good nutritional practices during pregnancy from previous research in Guto Gida woreda.¹⁸
Measurement
a structured self-administered questionnaire was used to ascertain information on socio-demographic and reproductive characteristics, dietary knowledge of nutrition required during pregnancy and factors associated with dietary practices

Pretest was done on 20% (40) of pregnant mothers prior to the actual study period. Cronbatch’s alpha score of 85 was calculated after pre-testing the questionnaire which confirmed the internal consistency or reliability of the items (questions) on the questionnaire.
Operational definition

Practices: The actions of pregnant women that could affect her meal frequency per day.

Good dietary practices: Pregnant women who scored > 75% (answered 5 questions yes or correctly) of the dietary practice question which were seven in number.

Poor Dietary practices: Pregnant women who scored < 75% (answered 5 questions yes or correctly) of dietary practice question.⁷

Good dietary knowledge: Pregnant women who scored ≥ 75% of dietary practice question.

Poor dietary knowledge: Pregnant women who scored < 75% of dietary practice question.¹⁹
Data analysis

Data collected were analysis with Statistical Package for Social Sciences software (IBM Chicago) version 28. Categorical variables were presented in frequencies and percentages while symmetrical continuous variables were presented using mean and standard deviations with 95% confidence intervals around the point estimates. P-value of less than 0.05 was considered statistically significant.

Ethical clearance for the study was obtained from the Ethics Committee of the hospital

Two hundred pregnant women participated in the study with majority (32%) in the age range of 25 to 29 years. The mean age of the respondents was 26.45 years with± 4.34 SD. Most of the respondents had secondary level of education (41.5), 95% were married and 32.5% civil servants. Majority of the research participants were Christians (98.5%) who also had up to 2-4 deliveries in the past (67%) (Table 1).

Dietary practices result of the research participants showed that 84.5% of the respondents craved for consumption of unusual materials. Lesser number, 38.5% had aversion to some food materials mainly to avoid fetal macrosomia (32.5%). More than half of the respondents (61%) agreed to have consumed more of carbohydrate rich meal basically due to poor income (59%). Majority of the pregnant women also ate only one to two times in a day 109(54.5%) as seen in Table 2 below. In all, only forty –four respondents had good dietary practice compared to one hundred and fifty-six who had poor dietary practice.

Mothers educational status, monthly income, marital status and dietary knowledge were significantly association with good dietary practices. Respondents with secondary and tertiary level of education had better good dietary practice than those with no formal education or primary level of education. The study participants who earned fifty and hundred naira per month had good dietary practice when compared with those who earned less than ten thousand naira and between ten thousand naira and fifty thousand naira (χ^{2 =} 10.26). Those of them who also had good dietary knowledge were more likely to have good dietary practice and vice versa. Out of forty-four participants who had good dietary practice, forty had good dietary knowledge while only four participants had poor dietary knowledge. Majority of the participants who had poor dietary practice (156) had poor dietary knowledge (135) (Table 3).

The nutritional condition of a mother at the time of conception, during pregnancy and breastfeeding plays an important role in determining her health and well-being, as well as that of her newborn. Two hundred pregnant women participated in this study that assessed practice and knowledge of awareness of proper nutrition during pregnancy to ensure a healthier pregnancy journey for both the mother and the baby, amounting to 100% recruitment rate. The study revealed that, out of the two hundred that participated in the study, only 44 (22%) of pregnant women had good dietary practices. This poor dietary practice of 22% was similar to 21.6% noted by Kuche PS²⁰ and 26.9 % by Tolera B,²¹ but lower than 31.4 % by Yoseph in Dale Woreda,²² 33.9% by Daba G in Guto Gida¹⁸ and 31.2% by Yisma.²³ The difference in the finding could be due to variation in environmental factor, cultural differences and sample size used for the study. Mothers educational status, monthly income, marital status and dietary knowledge were significantly association with good dietary practices. In a study conducted in America, similar high mothers education was also found to improve their dietary knowledge and practice compared to low and moderate educational level.²⁴

The impact of high monthly income in busting dietary knowledge and practice as noted was similar with the finding of Yismaw, WS.²³ This may be due to direct effect of increase in health seeking behavior, attendance to antenatal care and compliance to recommended diet which are usually associated with increase in ones income as documented in literature.¹⁹ Good knowledge about nutrients was found to have good correlation with dietary practice and this was also supported by the results of the previous studies.²⁵ In a study done in Lagos, Nigeria to access dietary habits, diversity, and predictors among pregnant women attending primary health care centers for antenatal care, the results showed that only 16.7% of respondents consumed five servings of fruits and vegetables daily while carbohydrate (rice) was the most frequent meal taken (45.4%). Meat was the commonest animal protein (20.3%) and only 30.8% had a high dietary diversity score (DDS). High DDS was significantly associated with parity of 1–3, living in a duplex or detached house, completion of at least secondary school education, and highly skilled professionals.²⁶ The findings were similar to the observation in the present study that found low dietary habits/practice and low dietary diversity (DDS) amongst the pregnant women attending antenatal care in Enugu.

The number of participants with good dietary practice from this study is 44(22%). This finding shows that majority of the pregnant women are lacking in the knowledge of nutritional requirements in pregnancy and this poses a serious threat to pregnant women and their unborn babies. Therefore, we recommend advocacy and awareness creation on good nutritional/dietary practices among pregnant women using media, community partnership and fliers

None.

None.

Authors have no competing interests.

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