Abstract

Background: In the Mount Cameroon area, maternal anemia remains a major public health concern. We hypothesized that nutrient inadequacy may account for the level of anemia in pregnancy. Thus, this study examined the relative effect of dietary diversity on maternal anemia in the study area.Methods: A total of 1,014 consenting pregnant women were enrolled in this cross-sectional study. Information on socio-demographic, antenatal characteristics, malaria and anemia control measures were documented. Dietary diversity (DD) was evaluated using the 24-h recall method and hemoglobin (Hb) levels (g/dl) measured using a portable Hb meter. Malaria parasitaemia was diagnosed by blood microscopy. Anemia status was trimester specific. Logistic regression analysis was used determine predictors of maternal anemia.Results: Among the pregnant women enrolled, the mean DD score was 3.5±0.8 SD and only 10.4% had adequate dietary diversity. Anemia prevalence was 40.9%. Majority of the women consumed starchy staples (99.3%) while least consumed foods were dairy (4.5%), eggs (8.3%), fruits and vegetable (vitamin A-rich) (8.6%). A significant lower prevalence of anemia was associated with intake of dairy (P < 0.001), animal protein (P = 0.006), vitamin A-rich fruits and vegetables (P < 0.001). Furthermore, mean Hb levels were higher (P < 0.001) among women with diverse diets (12.39 ± 1.34) than in those with less diverse diets (10.85 ± 1.33). Predictors of anemia were as follows: study setting [Odd Ratio (OR) = 1.4, 95% CI: 1.07-1.94], occupation (OR = 1.9, 95% CI: 1.16-3.43), number of clinic visits (OR = 1.9, 95% CI: 1.27-2.91), trimester of pregnancy (OR = 3.2, 95% CI: 1.45-7.38), malaria parasitaemia (OR = 1.8, 95% CI: 1.33-2.68), out of home eating (OR = 1.4, 95% CI: 1.03-2.13), and DD (OR = 9.8, 95% CI: 4.56-20.80). The attributable risk of anemia due to dietary diversity was 82.9%.Conclusion: In the study area, DD is a major risk factor for maternal anemia. This finding underscores the importance of content specific nutrition education during clinic visits to improve intake of protein and iron-rich food in anemia prevention.

Highlights

  • Pregnancy is characterized by anatomical, physiological, and biochemical changes in the woman’s body

  • We described diet diversity characteristics and evaluated its contribution to anemia among pregnant women reporting for antenatal care in some medical facilities located in semi-urban and urbanized settings in the Mount Cameroon area

  • 50.2 and 49.8% of the participants were from Tiko health district (THD) and Buea health district (BHD), respectively

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Summary

Introduction

Pregnancy is characterized by anatomical, physiological, and biochemical changes in the woman’s body. These changes are accompanied by an increase in dietary energy and nutrient requirement to support these maternal adaptations during pregnancy as well as for nutrient delivery to the fetus. Notwithstanding, in low- and middle-income countries (LMICs) many women living in under resourced environments, suffer from undernutrition and pregnancy presents an additional burden on the women’s nutritional requirement to meet the needs of both mother and the developing fetus. Consequences of inadequate nutrient intake in pregnancy include; low birth weight, intrauterine growth restriction as well as increased risk of maternal morbidity and mortality [2]. This study examined the relative effect of dietary diversity on maternal anemia in the study area

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