Effect of nutrition education among pregnant women with low body mass index: a community based intervention

Sherin Daniel; Grana Pu Selvi Gnanaraj; Emershia Sharmine

doi:10.18203/2394-6040.ijcmph20163924

Authors

Sherin Daniel Research and Development, World Vision India, Chennai, Tamil Nadu, India
Grana Pu Selvi Gnanaraj Strategic Lead Child Heath & Nutrition, World Vision India, Chennai, Tamil Nadu, India
Emershia Sharmine Regional Technical Lead Child Heath & Nutrition, World Vision India, Chennai, Tamil Nadu, India

DOI:

https://doi.org/10.18203/2394-6040.ijcmph20163924

Keywords:

AIC, BIC, BMI, GWG, HMIS, IUGR, ICDS, NFHS, SGA

Abstract

Background: Indian women are chronically undernourished (36%) and anemic (55%) which has consequences on women during their adolescence, pregnancy, and lactation (NFHS-3). The main objectives were to assess the effect of nutrition education on dietary awareness and practice among undernourished pregnant women.

Methods: Phase 1 included key informant interview capturing information on food frequency and dietary diversity (24 hour dietary recall). Based on the key informant interview and anecdotal evidences a hypothesis was generated and an experimental study was planned to test the hypotheses. Fifty pregnant women in their first trimester of pregnancy having body mass index (BMI) less than 18.5 were selected from 12 villages to be part of the intervention group. Non-intervention group comprised of age matched women in first trimester with low BMI selected from the neighbouring villages. Phase 2 effect of nutrition education was assessed on mean weight gain in third trimester of pregnancy practice of minimum meal frequency (3 meals a day), adoption of dietary diversity through 24 hour recall method, proportion of change evidenced in hand washing practice were measured.

Results: Women enrolled in the intervention had a mean weight gain of 8.7 kg, with more than 3 ante natal care (ANC) visits having regular monthly attendance at ICDS center for awareness programs. Behavioral modification was evidenced by practicing a minimum of 3 meals or more during pregnancy, with consumption of vegetables, lentils and greens in their daily diet along with cereals. Regular hand washing before the meals and after using the toilet were self-reported by the women.

Conclusions: Prospective weight gain among women in intervention had significance over those in the non- intervention group by 2.1kg. Women in the intervention group reflected behavioral change by practicing minimum meal of 3 or more, proper hand washing before meals and after toilet and adequate rest. However birth weight on other hand is weakly associated with maternal weight gain between the two arms of the study.

Metrics

Metrics Loading ...

References

UNICEF, Child Undernutrition in India: A Gender Issue. http://unicef.in/ Story/ 108/ Child-Undernutrition-in-India-A-Gender-Issue.

The World Bank. Helping India Combat Presistently High Rates of Malnutrition. 2013. http://www.worldbank.org/en/news/feature/2013/05/13/helping-india-combat-persistently-high-rates-of-malnutrition.

Christian P, Jiang T, Khatry SK, LeClerq SC, Shrestha SR, West KP Jr. Antenatal supplementation with micronutrients and biochemical indicators of status and subclinical infection in rural Nepal. Am J Clin Nutr. 2006;83(4):788-94.

Fall DH, Fisher DJ, Osmond C, Margetts BM, Maternal Micronutrient Supplementation Study Group. Multiple micronutrient supplementation during pregnancy in low-income countries: A meta-analysis of effects on birth size and length of gestation. Food Nutr Bull. 2009;30(4 Suppl):S533-46.

Chen A, Klebanoff MA, Basso O. Pre-pregnancy body mass index change between pregnancies and pre term birth in the followung pregnancy. Paediatr Perinat Epidemiol. 2009;23(3):207-15.

Merialdi M, Carroli G, Villar J, Abalos E, Gülmezoglu AM, Kulier R, et al. Nutritional Interventions during pregnancy for the Prevention or Treatment of Impaired Fetal Growth: An Overview of Randomized Controlled Trials. J Nutr. 2003;133(5 Suppl 2):1626S-1631S.

Agarwal S, Agarwal A, Bansal AK, Agarwal DK, Agarwal KN. Birth weight patterns in rural undernourished pregnant women. Indian Pediatr. 2002;39(3):244-53.

Cnattingius S, Bergström R, Lipworth L, Kramer MS. Prepregnancy Weight and the Risk of Adverse Pregnancy Outcomes. N Engl J Med. 1998;338(3):147-52.

Allen LH, Peerson JM, Maternal Micronutrient Supplementation Study Group. Impact of multiple micronutrient versus iron-folic acid supplements on maternal anemia and micronutrient status in pregnancy. Food and Nurtition Bulletin. 2009;30(4 Suppl):S527-32.

Kramer MS, Haas J, Kelly A. Maternal anthropometry-based screening and pregnancy outcome: a decision analysis. Trop Med Int Health. 1998;3(6):447-53.

Wise LA, Palmer JR, Heffner LJ, Rosenberg L. Pre pregnancy body size, gestational weight gain and risk of preterm birth in African-American women Epidemiology. 2010;21(2):243-52.

Lundqvist A, Johansson I, Wennberg A, Hultdin J, Högberg U, Hamberg K, et al. Respond dietary intake in early pregnant compared to non pregnant women- a cross sectional study. BMC Pregnancy Childbirth. 2014;14:373.

Bhutta ZA, Ahmed T, Black RE, Cousens S, Dewey K, Giugliani E, et al.What Works? Intervention for maternal and child undernutrition and survival. Lancet Elsevier. 2008;371(9610):417-40.