Effect Of Nutritional Education On Essential Micronutrients Deficiencies & Nutritional Status Of Young Pregnant Women: An Interventional Trial

Abstract

Background: Maternal and foetal health is significantly influenced by nutrition, because it is widely acknowledged that a healthy diet in pregnancy is the basis for long-standing health. The objectives of our study were to determine the frequencies of iron, calcium, magnesium deficiencies, malnutrition among young pregnant women and their effects on feto-maternal outcome. The effects of nutritional counselling / education in improving maternal nutrition and comparison between fetal maternal health outcomes at tertiary care hospital were measured. Methodology: Total 191 participants were selected study purpose, 91subjects were labelled study group and 100 were labelled comparison group. Study subjects were provided nutritional / diet plan according to the nutritional status and deficiencies and followed for three months. Pregnancy outcomes were measured and compared with comparison group. Sociodemographic information, anthropometric measure, laboratory investigations and dietary plans were collected and analyzed on SPSS (version 26.0), various tests of significance were applied for association and correlation.

Results: All women were primigravida having age from 18 to 26 years, belonging to both urban and rural areas and majority of participants were from middle class families. Mean gestational age of the study group in their 1^st visit was 26.02 ± 1.92 and in 2^nd visit it was 36.62 ± 1.29 while in comparison group mean gestational age at the time of delivery was 36.15 ± 2.04. Mean weight was 69.12 ± 4.56 for study group and mean weight was 65.51 ± 4.87 for comparison group at the time of delivery (p-value 0.535). Mean gestational weight gain measured was 12.21 ± 1.85 for study group at the time of delivery and mean gestational weight gain was 9.71 ± 1.69 for comparison group at the time of delivery (p-value 0.012). Mean hemoglobin level of study group was 10.74 ± 1.32 mg/dl at their 1^st visit and 12.05 ± 1.39 mg/dl at their 2^nd visit while in comparison group mean hemoglobin level was 10.07 ± 2.06 mg/dl.  Statistical significant values were (p-value 0.024) at 95% confidence level. The study group's mean serum calcium level was 8.86 ± 1.04 mg/dl at the first visit and 9.85 ± 0.72 at the second. The mean serum calcium level for the comparison group was 8.75 ± 1.11. At a 95% confidence level, the statistically significant values were (p-value 0.000). The study group's mean serum Magnesium level was 1.81 ± 0.30 mg/dl at their first visit and 2.15 ± 0.12 mg/dl at their second visit, whereas the comparison group's mean was 1.95 ± 0.35 mg/dl. At a 95% confidence level, statistically significant values were (p-value 0.000).

Proper nutritional counselling and diet plan throughout pregnancy is strongly associated with significantly reduced mortality and morbidity in both mother and neonate. Good and balanced nutrition significantly improved feto-maternal health outcomes. All the parameters under study were improved after intervention. There was a statistically significant correlation between maternal nutrition and health outcomes (p-value 0.003, OR- 1.2), while in comparison group there was increased risk of poor health outcome (p-value 0.749, OR 2.63) from our study data. Correlation between maternal nutritional status and health outcome of the newborn and there was highly statistically significant association b/w maternal nutrition and health outcome of the babies (p-value 0.012, OR- 2.458), while in comparison group there was increased risk of poor health outcome of babies was (p-value 0.749, 0R 6.934). Knowledge of study group was assessed before intervention. It was noted that there was gap between knowledge and nutritional status of the participants. P-value 0.035 was significant at in comparison group.

Conclusion: This study concluded that improving nutritive values, food rich in micronutrients during pregnancy can be implemented that increasing the intake of foods naturally high in iron, calcium, and magnesium. These interventions are available to policy makers interested in boosting healthy food intake notably during pregnancy to prevent feto-maternal morbidity and mortality. There was a gap between nutritional knowledge and behavior in these women. An important predictor of nutrition practices among pregnant women was age, household registry, education level (including pregnant women and their husbands), monthly income, and nutrition awareness.