Food Intake and Nutritional Status of Pregnant Women in a Poor Urban Community and the respective Birth Weights of their Infants

Abstract

Some workers have found that birth weights increased as the quality of the diet, height, weight gain during pregnancy, age, and parity of the mother increased) while others found contrary results. One objective of the study was to obtain information on food intake and nutritional status of the pregnant women. The other was to find the relationship between weight gained during pregnancy, height, age and party of the mother on birth weights of their infants. This study was done in a slum (shanty) area of Nairobi, Kenya, with a population of about 80-100,000 people. A sample of 138 pregnant women and a control of 41 non-pregnant/ non-lactating women were selected by visiting every house in the three sampled villages and examining every woman of child bearing age The nutritional status was assessed by methods described by Jelliffe (1966), and the food intake of the women was assessed by weighing method. The sample comprised two main ethnic groups, namely, Nilotics and Bantus. Two-thirds of the women were married, and half were illiterate. Over three-quarters of the women were occupied with housework, as well as rearing children. The husbands were either self-employed or semi-skilled workers. Parity ranged from 0-9 and age from 15-44 years. The principle constituent of the diet was maize meal and dark green vegetables. With the exception of fruit, the women in the control group ate significantly more food than the pregnant women. Only energy and vitamin C intake were sufficient for both pregnant and non-pregnant women. Maize meal was the staple food and was the chief contributor of all nutrients, except vitamin A and C. Kale, which was also mostly consumed, contributed vitamin A and C. Animal proteins were rarely consumed. The mean weights and mean weights-for-height remained good during pregnancy. The mean upper arm circumference (UAC) fell below 5tandard and the mean UAC for the control was significantly greater than for the pregnant. There was no significant change in UACduring the course of pregnancy. The mean height of the women was about 158 cm. Weight changes per month during the second and third trimesters ranged from 0.2 kg to 1.1 kg. The average total weight gain was 6.5 kg. The total mean weight gain during the second and third trimester was 2.0 kg. One-fifth of the women had a weight loss or no weight change at all, i.e. their weights remained constant, while one-thi; gained less than half of the reference standard according to Jelliffe (1966), Thomson and Bil1ewicz (1957), Hytten wid Leitch (1971). No haemoglobin levels fell below the standard 11.0 gm% and clinical signs of malnutrition were not very prevalent. A total of 78 birth weights were recorded; 52 (67%) infants were born in hospital and the rest at home. The average birth weight was 3.1 kg and 12.8% of .the infants were low birth weights ( <.2500). The mean birth weights increased with parity, length of gestation, and height of the mother but not with age, weight gain during pregnancy or the weight-for-height of the mothers. The low consumption of dry legumes and maize could be explained by their greater consumption of fuel while cooking, while low consumption of other low cost foods was, perhaps, due to the ignorance, of their nutritive value or the way to cook them. The decreased food intake during pregnancy explained the high rate of deficiencies' in nutrient intakes of pregnant women in view of their higher recommended intakes. The results from the study showed that women were well-nourished before pregnancy. Therefore, though there was no increase in food intake or weight during pregnancy they were probably able to draw from their reserves and through physiological adaptation meet the nutritional demands of their infants and thus delivered infants whose: mean birth weight was 91.1% the Harvard standard. The total weight gain of 6.5 kg, though higher than that recorded for Indians, was lower than that recorded for the well-nourished European and American mothers. Well-fed women from developed countries gain about 15-25% of their pre-gravid weight. Mathare women gained 12% of their pre-gravid weight which is the same as found by Jansen•(1980) for pregnant rural Kenya women. On average taller mothers delivered heavier babies and birth weigh rose with parity which was in conformity with other findings. Consumption of locally available and cheap foods coupled with education on methods of food preparation and budgeting are recommended In addition, greater attention should be paid to primiparae and women less than 150 cm. tall at antenatal clinics. Despite their low economic status the performance during pregnancy was encouraging. Much more research needs to be done to elucidate the intricate relationship between food intake, nutritional status of the mother, and the outcome of pregnancy.