Pica In Pregnancy Research Articles

Association of pica with cortisol and inflammation among Latina pregnant women.

Pica, the urge to consume items generally not considered food, such as dirt, raw starch, and ice, are particularly common among pregnant women. However, the biology of pica in pregnancy is not well understood. Therefore, this study aimed to assess how pica relates to endocrine stress and immune biomarkers in a cohort of pregnant Latina women in Southern California. Thirty-four women completed a structured pica questionnaire. Maternal urinary cortisol and plasma cytokine levels were measured between 21 and 31 weeks' gestation. Associations between pica during pregnancy and biomarkers were assessed using linear regression models adjusting for gestational age. Twelve (35.3%) of the pregnant women reported pica (geophagy and amylophagy) during pregnancy. In multivariate models, those who engaged in pica had higher levels of cortisol (β: 0.37, 95% CI: 0.01, 0.073) and lower levels of IL-1β (β: -0.06, 95% CI: -0.11, -0.02), IL-8 (β: -0.30, 95% CI: -0.56, -0.05), IL-21 (β: -0.35, 95% CI: -0.63, -0.08), and type-1 inflammation composite (β: -0.29, 95% CI: -0.44, -0.14) than women who did not engage in pica. These results suggest that biological stress and immune response differ for women with pica compared to those without. This study suggests novel physiological covariates of pica during pregnancy. Further research is needed to better understand the mechanisms and temporality underlying the observed associations between pica and endocrine and immune biomarkers.

Update on the Global Prevalence of Pica in Pregnant Women: A Meta-analysis

Objectives: Pregnancy pica is harmful to the mother and her baby. This study aimed to update the global prevalence of pica in pregnant women. Methods: Scopus, Science Direct, Wiley online, Google Scholar, and PubMed databases were searched for observational studies until July 2021. This search was done with the keywords "pregnancy pica", "prevalence of pica", "pica frequency". After evaluating the extracted studies based on inclusion and exclusion criteria, 45 final articles were selected. Calculations were performed based on STATA software. Publication bias was also assessed. Results: The global prevalence of pica in pregnancy in the final forty-five articles (Sample size: 21267) was 34%. However, the prevalence has decreased since 2015. In the subgroup analysis, rural women, women with lower education, younger women, unemployed women, and women living in the African geographical area had the highest prevalence of pica. Our results also showed that this rate was higher in women in the first trimester of pregnancy and multiparous women. Conclusions: The global prevalence of pica was 34%. Therefore, it is recommended to implement educational programs, empower women and distribute nutritional supplements during pregnancy.

Baking Soda Pica Associated With Rhabdomyolysis and Cardiomyopathy in Pregnancy

Pica is a commonly underappreciated disorder in pregnancy that can lead to several complications, including severe metabolic derangements and other adverse outcomes. We report a case of baking soda pica in pregnancy associated with both rhabdomyolysis and cardiomyopathy. A multigravid woman at 37 weeks of gestation presented with weakness and severe hypokalemia. She subsequently had development of rhabdomyolysis and presumed peripartum cardiomyopathy. After delivery, it was discovered that the patient had a long history of consumption of large quantities of baking soda. Her condition improved with cessation of the pica. Clinicians must have a high index of suspicion for pica in pregnancy because it can lead to complex diagnostic challenges and pregnancy complications. The diagnosis should be considered in a patient with unexplained metabolic abnormalities.

Pica in Pregnancy: New Ideas About an Old Condition

Pica, the purposive consumption of nonfood substances, is a millennia-old nutritional enigma. Its worldwide ubiquity, prevalence among pregnant women and children, and association with both positive and negative health outcomes, especially micronutrient deficiencies, underscore the importance of understanding this behavior. Multiple proposed etiologies of pica are reviewed, including cultural expectations, psychological stress, hunger, dyspepsia, micronutrient deficiencies (Fe, Zn, and Ca), and protection against toxins and pathogens. Currently available data, although limited, best support the protection hypothesis as a cause of most types of pica, although some evidence suggests that pagophagy (ice consumption) may occur during iron deficiency. It is possible that the binding capacity of pica substances explains the association with micronutrient deficiencies; earth, starch, etc. may render micronutrients in ingesta unavailable for absorption. Increased research efforts are warranted and must be hypothesis driven, interdisciplinary, and permit the testing of multiple causal inferences.

Pica practices of pregnant women in Nairobi Kenya

Aim : To establish the prevalence of pica behaviour during pregnancy; to identify the substances commonly ingested and their prevalence; and to determine the characteristics of women who reported practicing pica. Method : Was descriptive, cross sectional study involving use of questionnaire administered in interview format. Study was conducted at Pumwani Maternity Hospital, Nairobi, Kneya. Participants included a convenience sample of 1071 ante natal women with a mean age of 28.1 (I7.3) years. Subjects were selected based on availability, accessibility, and willingness to participate in the study. Results : Seven hundred and ninety three (74.0%) participants reported practicing pica regularly on daily basis. Pica prevalence categorised by substances ingested was as follows: soft stones (odowa), 89.8%; soil, 61.2%; and others, 9.6% and no pica, 26.0%. Majority of women who reported practicing pica (62.5%) ingested more than one substance. Most women who practiced pica reported having experienced strong cravings prior to ingestion of pica items, childhood pica, pica before pregnancy, pica in previous pregnancy and a history of pica in family members and significant others inthe community. Conclusions : Pica prevalence was significantly high among the subjects indicating that pica in pregnancy might be more common and widespread in Kenya than health care providers assume or observe. There is need to routinely screen pregnant women for pica during antenatal visits as this will provide a more systematic and a less expensive way of establishing its epidemiologic status. A nationwide investigation of pica prevalence is also recommended in order to establish possible health consequences of pica on mother and child.

Pica practices of pregnant women in Nairobi, Kenya

To establish the prevalence of pica behaviour during pregnancy; to identify the substances commonly ingested and their prevalence; and to determine the characteristics of women who reported practising pica. Descriptive, cross sectional study involving use of questionnaire administered in interview format. Pumwani Maternity Hospital, Nairobi, Kenya. One hundred and seventy one antenatal women with a mean age of 28.1 (+/-7.3) years. Subjects were selected based on availability; accessibility and willingness to participate in the study. Seven hundred and ninety three (74.0%) participants reported practising pica regularly on daily basis. Pica prevalence categorised by substances ingested was as follows: soft stones (odowa); 89.8%; soil, 61.2%; and others, 9.6% and no pica, 26.0%. Majority of women who reported practising pica (62.5%) ingested more than one substance. Most women who practised pica reported having experienced strong cravings prior to ingestion of pica items, childhood pica, pica before pregnancy, pica in previous pregnancy and a history of pica in family members and significant others in the community. Pica prevalence was significantly high among the subjects indicating that pica in pregnancy might be more common and independent in Kenya than health care providers assume or observe. There is need to routinely screen pregnant women for pica during antenatal visits as this will provide a more systematic and a less expensive way of establishing its epidemiological status. A nation-wide investigation of pica prevalence is also recommended in order to establish pica prevalence at national level and among different socio-economic groups. Further studies are also needed to establish possible health consequences of pica on mother and child.

Craving More Than Food: The Implications of Pica in Pregnancy

Craving More Than Food: The Implications of Pica in Pregnancy

Pica in Pregnancy in a Privileged Population: Myth or Reality

The term pica refers to the ingestion of nonnutritive substances. It can be a feature of severe anemia and also reportedly is frequent in pregnant women. Pica is especially common in certain geographic areas such as sub-Saharan Africa and, in Western societies, it seems to be particularly prevalent in African-Americans, foreign-bom women, and less privileged groups. Among the substances most commonly craved and eaten are clay, laundry starch, soap, and chalk. One meta-analysis found that 30% of 50% of pregnant women had pica (Homer RD et al. J Am Diet Assoc 1991,91:34) The investigators prospectively determined the frequency of pica in 100,000 pregnant women registered in the Danish National Birth Cohort in the years 1996-2002, who represented approximately one-third of all pregnant women in Denmark. Food frequency questionnaires were sent during the 25th week of gestation, and 70% were returned. Participants had an average age of 29 years and were generally of high socioeconomic status. Only 14 respondents, 0.02% of the total, reported having eaten substances that were clearly not foods. Substances mentioned more than once included clay or soil, toothpaste, and chalk. Individual respondents reported eating things as diverse as coffee grounds, toilet paper, soft sponge, lavender flowers, and roses. The authors conclude that, at least in well-nourished populations like the Danish, pica during pregnancy is more a myth than a reality.

Pica in pregnancy in a privileged population: myth or reality

In the literature pica is reported to be prevalent in pregnant women. Most studies have focused on less privileged populations, but is pica prevalent among privileged pregnant women? 100,000 pregnant women in the Danish National Birth Cohort were asked about pica in a food frequency questionnaire mailed in gestation week 25. The response rate of the questionnaire was 70% of Danish National Birth Cohort participants. Only 14 women reported to have eaten substances that were clearly not foods, i.e. 0.02% had pica in this cohort of well nourished Danish women. It seems that, in privileged populations, pica is more a myth than a reality.

Pica in pregnancy: does it affect pregnancy outcomes?

To discover the prevalence of pica, the documentation of pica on medical records, and any relationship of pica to pregnancy outcomes in rural socioeconomically disadvantaged pregnant women. Prospective, descriptive, correlational investigation with 128 women who sought prenatal care from two rural community health agencies. Demographic and sociocultural variables, pica practices, pica substances ingested, and pregnancy outcomes were collected. Thirty-eight percent of these pregnant women practiced pica. African-American women reported practicing pica more often than other ethnicities. Substances ingested included ice (>1 cup/day), freezer frost, laundry starch, cornstarch, clay dirt, and baked clay dirt. Polypica (ingestion of more than one substance) was practiced by 11 women. Women practicing pica were more likely to have been underweight prior to pregnancy, and smoked fewer cigarettes. Women reporting daily pica practice were significantly more likely to have lower prenatal hematocrits than women who did not practice pica, or who practiced pica less frequently than daily. No specific pregnancy complication was associated with the practice of pica. Pica exists, and might be more common than healthcare providers assume. Although this study did not show specific pregnancy complications associated with pica, other studies have shown anemia and lead poisoning among women who practice pica. It is not clear that patients volunteer information about pica, so it would be helpful if nurses queried patients at each prenatal visit regarding pica practice. Discussion of pica practices should be based on a nonjudgmental model, for pica may have strong cultural implications, and may be practiced for cultural reasons unknown to the nurse.

CE Test: Pica in Pregnancy: Does It Affect Pregnancy Outcomes?

MCN, The American Journal of Maternal/Child Nursing: May 2003 - Volume 28 - Issue 3 - p 190-191

What about pica?

Summary Pica in pregnancy is a prevalent practice that has its roots in antiquity. The nurse-midwife needs to be aware that each patient she sees may practice pica. It is essential that she get a complete dietary and social history to screen for possible pica patients. Once the practice of pica is identified, the nurse-midwife provides nutritional and educational counseling to meet the specific needs of her patiant. Community health programs should include a discussion of pica and its deleterious effects. With the proper education of adolescents the nurse-midwife has the opportunity to break the cycle of pica. The nurse-midwife's unique skill at establishing close patient relationships makes her the appropriate person to work with the pregnant pica patient.