Журнал расстройств питания и терапии

Абстрактный

Конгресс по питанию 2015 г.: Диетические практики беременных женщин в связи с антропометрическим статусом младенцев в возрасте 0–6 недель в округе Вхембе, провинция Лимпопо — Мусафи Л. Ф. — Университет Венда

Мусафи ЛФ

Предыстория: Рацион многих южноафриканцев состоит из каши как основного продукта питания, которую обычно употребляют с овощами, бобовыми и небольшим количеством продуктов животного происхождения. Недостаточное потребление сбалансированной диеты может привести к плохому набору веса во время беременности, увеличивая риск преждевременных родов, низкой массы тела при рождении и врожденных дефектов.

Цель: разработать принципы питания матерей с учетом антропометрических показателей детей в возрасте от 0 до 6 недель.

Место проведения: исследование проводилось в четырех клиниках округа Вхембе, провинция Лимпопо, Южная Африка.

Методы: Кросс-секционное экспрессивное исследование было проведено среди двухсот сорока (240) беременных женщин и их малышей, выбранных удобным образом из четырех клиник в округе Вхембе. Антропометрические измерения проводились по стандартным методикам. Данные о диетических практиках и социально-демографическая информация собирались с помощью анкеты, разрешение и одобрение были получены, а права участников соблюдались.

Это исследование является первым, предоставившим данные о диетических практиках беременных женщин, связи между весом матери во время беременности и весом ее ребенка в сельских деревнях Южной Африки. Результаты показали, что большинство участников текущего исследования были очень молоды. Подростки часто не имеют достаточных знаний о том, что именно необходимо в плане питания во время беременности. Возможно, это можно объяснить тем фактом, что подросткам на этой стадии требуется разнообразное питание, чтобы удовлетворить возросшие потребности в питательных веществах и энергии во время беременности и поддерживать адекватный набор веса. Результаты показали, что большинство участников текущего исследования набрали плохой вес во время беременности. Бедные женщины, как правило, набирают меньше веса во время беременности, получают меньше микроэлементов, и это может иметь пагубные последствия для исхода беременности.

The findings of the study revealed that majority of the participants were unemployed. Surprisingly there is no significant difference between the employment status of the mother and Z-scores of children (WAZ (p=0.700), HAZ (p=0.553) and BAZ (p=0.728). However, women living in low socio economic status are often malnourished before pregnancy due to inadequate food intake putting them at higher risk of having low birth and preterm delivery. Nevertheless, unemployment did not affect the z-scores of the infants in the current study. These findings are congruent with previous study done in Nigeria which indicated that majority of pregnant mothers were unemployed. In addition, poor weight of the pregnant women influenced by the socio-economic status of her family has a direct effect on the birth weight of her child. About 41.7% of the participants in the current study spend R1000-R2000 on food while 36.7% of the participants spend R500-R1000 on food. Perhaps this variation on money spend on food could be attributed to the household income and employment status of the members of household. Studies have shown relationship between dietary diversity, socioeconomic status and demographic characteristics.

The findings of the study revealed that participants ate three meals per day. Regular meals are not expected to be skipped during pregnancy, nutritious foods are directly linked to higher chance of a normal birth weight, improving brain development and reducing the risk of many birth defects. “Post-partum outcomes for mother and infants are linked to maternal consumption habits during pregnancy.

In addition, one of the main meals in the current study comprised of starchy foods. Starchy foods eaten in the present study include porridge, rice, samp and bread. The findings of the current study correlate with the study done in Ethiopia. “Adequate consumption of starchy food during pregnancy is known to support rapid growth of the foetus and also assist in maintaining weight gain during pregnancy”. The participants in the current study ate meat, legumes and dairy product. “Outcome of the pregnancy depends on the mother’s health. Consumption of protein food during pregnancy is vital to support growth of the foetus and this is linked to low risk of neonatal death and birth defects”. These findings are congruent with study done in Nigeria were it was reported that participants ate meat and meat products including those from home owned animals.

The most indigenous vegetables consumed in the current study were Delele, Vowa and Phuri. Access to indigenous food has been shown to be key determinant of dietary adequacy and consumption of these foods high in iron content. “Access to indigenous food has been shown to be key determinant of dietary adequacy therefore consumption of these foods is a key consideration during pregnancy”.

The findings of the study revealed that participants had pica during pregnancy. Consumption of non- food items in large quantities is common among pregnant women in rural villages and this could cause intestinal obstructions interfering with the absorption of essential nutrients which are vital for the growth of the foetus [26]. This is due to the fact that women lack of knowledge concerning the effects of pica on the foetus. Non-food items consumption during pregnancy can lead to malnutrition and deficiencies of vitamins and minerals. These findings are congruent with previous studies which indicated that pregnant women have been practicing pica and this can cause complication during pregnancy.

During pregnancy women are restrict to eat certain food items according to culture and this could result in fewer food consumption which in turn can lead to underweight and overweight. Surprisingly our study indicates negative correlation between mother’s BMI and the infant’s WAZ (r=-0.48; p=0.515). These indicate that the mother’s weight during pregnancy is not only the contributing factor to infant’s weight during birth. Factors such as dietary practices during pregnancy should be considered when studying the relationship between the mother’s weight during pregnancy and their infants during birth. However, women who have poor weight gain during pregnancy face greater risks of delivery preterm babies and their infants set off on a weaker development path, both physically and intellectually.25 Furthermore, Girls born with low birth weight are more likely to become poorly nourished children and poorly grown women and are, therefore, likely to give birth to low birth weight infants resulting in the vicious cycle of malnutrition [14]. In addition, nutritional status of mothers is one of the most important factors of foetal growth and development.

Results: 45 percent of the study participants have eaten carrots, bananas, apples, spinach, cabbage and beetroots during pregnancy while 26.7% of the study participants reported that they need eaten carrots, oranges, bananas, apples, spinach, cabbage and beetroots during pregnancy. The majority of participants (91.7%) received folate and iron supplements while 8.3% received iron, folate and calcium supplements during pregnancy. Half of the participants at the time of pregnancy had normal BMI, 13.3% were underweight, 30% were observed overweight and 6.7% were observed obese. More than third quarter of infants (80%) at birth had normal WAZ (-1SD to ≤+2SD), 6.7% of infants were underweight (<-3SD to <-2SD) while 11.7% of infants were mildly underweight (-2SD to <-1SD). 

Заключение: Возраст матери и диетические привычки во время беременности оказывают значительное влияние на исход родов. Вес матери во время беременности — не единственный фактор, влияющий на вес младенца во время родов. Такие факторы, как диетические привычки во время беременности и социально-экономический статус, необходимо учитывать при изучении связи между весом матери во время беременности и ее младенцами. Распространенность недостаточного веса, истощения и задержки роста обусловлена ​​низким набором веса во время беременности и неправильным питанием матери (несбалансированным питанием). Матери, которые недоедали во время беременности, рожали детей с низким весом при рождении.

Примечание: эта работа частично представлена ​​на 4-й Международной конференции и выставке по питанию, которая прошла 26–28 октября 2015 г. в Чикаго, штат Иллинойс, США.