Abstract
Pica is an indicator of low micronutrients in a pregnant woman’s health. Low micronutrients pose a great risk to an otherwise healthy pregnancy. A healthy pregnancy, results in a healthy mother and baby; the critical probability in every pregnancy. The aim of the study was to introduce multiple micronutrients to promote maternal nutrition and influence development in pregnancy health outcomes. Sub-populations at risk of nutritional deficiencies and provided opportunities for early intervention to support the known benefit of multiple micronutrients on pregnancy outcomes i.e. up to six weeks (42 days) post delivery. The variations on pregnancy health, pica and hemoglobin levels among the Multiple Micronutrients (MMs) and Iron Folic Acid (IFA) groups. This was a block randomized controlled study. The intervention arm received MMs while the control received the usual care of IFA. A structured questionnaire with open and closed ended questions was used. Focus group discussions were conducted using a semi-structured guide to collect the qualitative data on the effects of prenatal multiple micronutrients among the pregnant women. The study assumed equal variances based on the Levene’s test of >0.10 (f, 0.196, p=0.661). The difference in inter trimester weight gain means was 5.85 kgs for MMs and 5.52 kgs for IFA (t, 0.109, p=0.914), duration to resumption of household work was 7 days for MMs and 14 days for the IFA groups. The hemoglobin level increased by; 1.25 g/dl for MMs, and 0.45 g/dl for the IFA (t, 0.897, p= 0.376). Pica for stones was experienced among 55.6% of pregnant women; however there was no pica within 14 days among MMs enrollment, but persisted in the IFA group. The study demonstrated no significance in the importance of multiple micronutrients in increasing hemoglobin level (P,0.376), reduction of pica craving during pregnancy (P,0.176) and resumption of household duties (P,0.067) post delivery compared to those on Iron Folic Acid.
Highlights
According to past studies, pica status is a preliminary clinical indicator for micronutrient deficiency. [1] Nutrition and mineral deficiency precipitates pica behavior which can either be: geoghagia, pagophagia or amylophagia
The study was implemented after ethical consideration and approval was sought from the Moi University/Moi Teaching and Referral Hospital Institutional Research and Ethics Committee (IREC) and approval of the study topic by the Board of Postgraduate Studies of Jomo Kenyatta University of Agriculture and Technology (JKUAT)
The average hemoglobin level experienced in this setting was 11.39g/dl which is above the World health Organization recommended non-anemic hemoglobin level of 11.0g/dl
Summary
Pica status is a preliminary clinical indicator for micronutrient deficiency. [1] Nutrition and mineral deficiency precipitates pica behavior which can either be: geoghagia, pagophagia or amylophagia. Pica status is a preliminary clinical indicator for micronutrient deficiency. [1] Nutrition and mineral deficiency precipitates pica behavior which can either be: geoghagia, pagophagia or amylophagia. The causal relationship between pica and micronutrients remains unclear needing further studies. This necessitates investigation into the strength of association which has been inconsistent. Iron and zinc supplementation has been associated with cessation of pica. Pica etiology remains unclear with a prevalence of between 0.02-74% in Iran and 46% among the pregnant adolescents in the USA. The relationship between pica and iron status biomarkers is unknown though it has been in observance since > 2000 years according to Hippocrates in 400BCE. Pica prevalence in Ghana is 9.1%, in Pemba, Tanzania for amylophagia -36.3%, geophagia and
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