Magnitude and Determinants of Undernutrition among Pregnant Women Attending a Public Hospital in Kenya

Abstract

Background: Undernutrition during pregnancy in the developing countries is a major public health problem due to its strong association with maternal and child morbidity and mortality. The available data on the extent and determinants of under-nutrition among pregnant women in Kenya is scant. This main objective of the study is to establish the extent and determinants of undernutrition in pregnant women attending a public hospital in Kenya. Methods: A cross-sectional study was conducted among 162 randomly selected pregnant women who attended antenatal clinic at Pumwani Maternity Hospital, a well-known public health facility in Nairobi. A semi-structured questionnaire was used to collect the data. Nutritional status of the pregnant mothers was determined using mid-upper arm circumference measurement. Hemoglobin level was extracted from the maternal antenatal card to determine their anemic status. Descriptive and inferential analyses were done using SPSS Software (version 22.0). Frequencies and proportions were generated for categorical variables. While mean and standard deviation were computed for continuous variables. The chi-square test of independence was employed to establish the relationship between the independent variables and dependent variable. Multivariable logistic regression analysis was used to identify the variables independently linked to maternal undernutrition. Results: The overall prevalence of undernutrition and anemia among the pregnant women was 27% and 39.7%, respectively. Multivariable logistic analysis showed that being single [AOR = 4.27; 95% CI = 2.21 - 8.32, P = 0.001], divorced/separated [AOR = 2.25; 95% CI = 1.13 - 4.87; P = 0.021], self-employed [AOR = 4.27; 95% CI = 2.21 - 8.32; P = 0.022], illiterate [AOR = 4.31; 95% CI = 2.55 - 8.20; P = 0.007), having short birth interval (Conclusions: Our findings show that the burden of undernutrition during pregnancy is still high in Kenya which requires urgent attention. Pregnant women who were never married, divorced/separated, self-employed, illiterate, and those with short birth interval were at increased risk of undernutrition. Nutrition intervention targeting social determinants of maternal undernutrition may result in positive outcomes. This will significantly help achieve the SDGs by reducing maternal child mortality.