Nutrition perspective from the view of pregnant women: their understanding of fetal well-being relative to their diet NUTRITION PERSPECTIVE FROM THE VIEW OF PREGNANT WOMEN

Main Article Content

GÜLDEN AYNACI

Keywords

nutritional knowledge, pregnant women, fetal well-being, dietary recommendation

Abstract

 


Introduction


Nutritionally balanced nutrition assessment, mothers' nutrition motivation, and healthy nutrition information are among the factors that affect infants. Low quality of maternal diet increases the risk of premature birth. Poor maternal nutrition in pregnancy, impaired glucose tolerance, and dyslipidemia may cause increased systemic arterial pressure. The level of relationship between the knowledge and awareness level of pregnant women and their compliance with dietary rules should be determined. Thus, it is possible to shed light on the attempts to reach information in healthy nutrition guides among pregnant women and to improve the nutrition quality in their daily lives. In order to support the safe, healthy, and balanced nutrition of women during pregnancy, it is important to have an idea about factors that affect their dietary behaviors.


Aim


The aim of our study was to evaluate the nutritional habits and healthy nutrition knowledge levels of pregnant women. It was aimed to evaluate whether pregnant women should be included in high quality nutrition programs.


Methods


Our study was performed with volunteer pregnant women who presented to Trakya University obstetrics clinic for routine pregnancy checks. A number of specific questions were included in the first part of the questionnaire to characterize the participants. Additional disease information, gestational week, sociodemographic characteristics, and some information about pregnancies were recorded. The General Knowledge Nutrition Questionnaire (GNKQ) was used in our study, whose validity and reliability have been proven in the literature. For the 4 main areas, knowledge subscales and general nutritional knowledge scores were calculated. In order to protect and improve the health of both the mother and the baby, we tried to determine deficiencies in order to increase the awareness of balanced nutrition.


Results


The study was conducted between March 2018 and April 2019 in Trakya University Women's Diseases and Obstetrics Clinic.  Three hundred sixty-nine volunteer pregnant women participated in our study. However, 31 pregnant women did not fully answer the questions. The study was completed with 338 pregnant women.


The differences in GKNQ scores for the pregnant women in our study were evaluated for the four sections and total scores. For the first section, dietary recommendations, the mean was score was 9.66. For the second section (sources of nutrients), the mean score was 32.92. For the third section (choosing everyday foods), the mean sore was 6.23, and for the fourth section (diet-disease relationships), the mean score was 10.24. The mean total score was 59.10.


There was no statistically significant difference between GNKQ scale total score and sub-scores for the pregnant women who had not diet education, and among the pregnant women who had diet education. It was seen that most of the pregnant women had not received adequate nutrition education before or during pregnancy.


It was observed that some of the pregnant women participated in our study because of the threat of preterm labor and / or premature membrane rupture. The difference between pregnant women without these symptoms in our study was examined. Thirteen (3.84%) were found to have early membrane rupture (EMR) and preterm history. When evaluated with the GNKQ scale, those with a history of EMR were under investigation and treatment due to the threat of preterm labor. Although it was observed that the GNKQ total score and the sources of nutrients, choosing everyday foods, and diet-disease relationships tended to get lower scores, there was not statistical significance between them. In our study, it was seen that patients who were interned in the ward because of gestational hypertension, preeclampsia, and eclampsia GNKQ scores were lower than in the other patients. This result suggests that nutrition may have an effect on the complications of pregnancy.


When the pregnant women were asked as to whether they received regular ≥400 mcg / day folate from the first month of pregnancy, it was observed that those with regular folate intake had higher GNKQ scores. As the level of knowledge in the direction of healthy nutrition increased, the use of folic acid for the protection of fetal health was increased. When pregnant women are evaluated according to the duration of hospitalization, there was a significant difference between GNKQ the total scores of patients who were hospitalized for more than 3 days and those hospitalized for 3 days or less.


Some parameters of the sociodemographic characteristics of the pregnant women in our study were examined. Simply having more education was an important factor regarding high diet knowledge.


The women were asked about where they learned the information about their nutrition. Only 104 (30.76%) of the pregnant women had received information from health personnel. Most of the pregnants reported that they received information from the media (46.15%).


Due to potential health risks, it is important that women comply with the principles of healthy nutrition during pregnancy. Unfortunately, although women reported positive changes in lifestyles during pregnancy, it was shown that their dietary intake and knowledge did not meet the recommended food and nutrient intake for pregnancy.


Discussion


Considering that diet behavior is very complex, attempts to understand this in terms of nutritional knowledge in pregnant women should start with a clear understanding of awareness. Furthermore, they had a wide range of information, but the correct information was not on a systematic basis. These criteria provide a different perspective to research results in pregnant women by looking at the information-behavior relationship in the field of nutrition. In our study, pregnant women stated that they had increased the intake of fruits, vegetables, and iron for healthy eating habits, and that they had reduced the intake of fat and salt. However, their knowledge of meat consumption, vitamin D intake, and glucose consumption was not sufficient. The findings suggest that these nutrients should be targeted in future interventions in this population. Nutritional information is among the determinants that increase the quality of diet. Positive attitudes towards healthy nutrition are constantly associated with high dietary quality. Pregnancy is a life event that triggers a long-term review of nutritional problems. The GNKQ scores tended to decrease as the pregnancy progressed. It is important for health professionals to realize that pregnancy is one of the unique opportunities for women to be informed about nutrition. This increased awareness can benefit maternal, fetal, and baby health. It can also have positive consequences for postnatal nutrition because the gains acquired during pregnancy are of great importance for families and society. In our study, there was a lack of awareness of the need to take folic acid and information about how often the women would be checked. One benefit of raising nutritional awareness is the increased use of folic acid to prevent fetal neural tube defects in pregnant women.


The findings of this study show that there is a need for greater emphasis on nutritional counseling and education in order to optimize the quality of nutritional habits of pregnant women. Primary healthcare providers, family physicians, general practitioners, obstetricians, nurses, and midwives are in a position to reach the community to provide nutritional information. Nutritional knowledge and attitudes were found to be important determinants of diet quality. It has been shown that nutrition interventions that encourage healthy eating habits in pregnant women should focus on developing the determinants of diet behavior. Training and forms should be prepared and put into practical use for pregnant women. In order to contribute to the improvement of fetal and maternal health, it is seen that nutrition education should be given importance in pregnant women.


Conclusion


Our findings show that evaluating pregnant women with the GNKQ and providing nutritional education will be beneficial on pregnancy outcomes. The use of iron, folic acid, and nutritional education in low- and middle-income populations should be encouraged to improve preterm labor, low birth weight, systemic arterial hypertension, and possibly reduce premature births. This study showed that pregnant women had limited knowledge about balanced nutrition rules. Objective-oriented strategies should be developed in order to increase the awareness about the rules of quality nutrition in pregnancy. It is necessary to increase effective nutrition programs and campaigns for pregnant women. Babies should be provided with a healthy start to life and routine nutrition counseling should be promoted as part of pregnancy care.

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