Revista de trastornos nutricionales y terapia

Abstracto

Congreso de Nutrición 2015: Prácticas alimentarias de mujeres embarazadas en relación con el estado antropométrico de los bebés de 0 a 6 semanas en el distrito de Vhembe, provincia de Limpopo - Mushaphi L F - Universidad de Venda

Mushaphi LF

Antecedentes: La dieta de muchos sudafricanos consiste en avena como alimento básico, que generalmente se consume con verduras, legumbres y una pequeña cantidad de alimentos de origen animal. El consumo deficiente de una dieta equilibrada puede provocar un aumento de peso deficiente durante el embarazo, lo que aumenta el peligro de parto prematuro, bajo peso al nacer y defectos de nacimiento.

Objetivo: determinar las prácticas dietéticas maternas en referencia al estado antropométrico de lactantes de 0 a 6 semanas.

Marco: El estudio se llevó a cabo en cuatro clínicas del distrito de Vhembe, provincia de Limpopo, Sudáfrica.

Métodos: Se realizó un estudio expresivo transversal entre doscientas cuarenta (240) mujeres embarazadas y sus niños pequeños, que fueron nominados por conveniencia de cuatro clínicas en el distrito de Vhembe. Se tomaron medidas antropométricas siguiendo técnicas estándar. Se recogieron datos sobre prácticas dietéticas e información sociodemográfica mediante un cuestionario, se obtuvo permiso y autorización y se respetaron los derechos de las participantes.

Este estudio es el primero en proporcionar datos sobre las prácticas alimentarias de las mujeres embarazadas y la asociación entre el peso de la madre durante el embarazo y el peso de su bebé en las aldeas rurales de Sudáfrica. El hallazgo reveló que la mayoría de los participantes en el estudio actual eran muy jóvenes. Los adolescentes a menudo carecen de conocimientos adecuados sobre exactamente lo que se necesita nutricionalmente durante el embarazo. Quizás esto podría atribuirse al hecho de que los adolescentes en esta etapa requieren una dieta variada para satisfacer los mayores requisitos de nutrientes y energía del embarazo y apoyar un aumento de peso adecuado. Los hallazgos revelaron que la mayoría de los participantes en el estudio actual aumentaron de peso durante el embarazo. Las mujeres pobres tienden a ganar menos peso durante el embarazo, tienen una ingesta menor de micronutrientes y esto podría tener efectos perjudiciales en el resultado del embarazo.

The findings of the study revealed that majority of the participants were unemployed. Surprisingly there is no significant difference between the employment status of the mother and Z-scores of children (WAZ (p=0.700), HAZ (p=0.553) and BAZ (p=0.728). However, women living in low socio economic status are often malnourished before pregnancy due to inadequate food intake putting them at higher risk of having low birth and preterm delivery. Nevertheless, unemployment did not affect the z-scores of the infants in the current study. These findings are congruent with previous study done in Nigeria which indicated that majority of pregnant mothers were unemployed. In addition, poor weight of the pregnant women influenced by the socio-economic status of her family has a direct effect on the birth weight of her child. About 41.7% of the participants in the current study spend R1000-R2000 on food while 36.7% of the participants spend R500-R1000 on food. Perhaps this variation on money spend on food could be attributed to the household income and employment status of the members of household. Studies have shown relationship between dietary diversity, socioeconomic status and demographic characteristics.

The findings of the study revealed that participants ate three meals per day. Regular meals are not expected to be skipped during pregnancy, nutritious foods are directly linked to higher chance of a normal birth weight, improving brain development and reducing the risk of many birth defects. “Post-partum outcomes for mother and infants are linked to maternal consumption habits during pregnancy.

In addition, one of the main meals in the current study comprised of starchy foods. Starchy foods eaten in the present study include porridge, rice, samp and bread. The findings of the current study correlate with the study done in Ethiopia. “Adequate consumption of starchy food during pregnancy is known to support rapid growth of the foetus and also assist in maintaining weight gain during pregnancy”. The participants in the current study ate meat, legumes and dairy product. “Outcome of the pregnancy depends on the mother’s health. Consumption of protein food during pregnancy is vital to support growth of the foetus and this is linked to low risk of neonatal death and birth defects”. These findings are congruent with study done in Nigeria were it was reported that participants ate meat and meat products including those from home owned animals.

The most indigenous vegetables consumed in the current study were Delele, Vowa and Phuri. Access to indigenous food has been shown to be key determinant of dietary adequacy and consumption of these foods high in iron content. “Access to indigenous food has been shown to be key determinant of dietary adequacy therefore consumption of these foods is a key consideration during pregnancy”.

The findings of the study revealed that participants had pica during pregnancy. Consumption of non- food items in large quantities is common among pregnant women in rural villages and this could cause intestinal obstructions interfering with the absorption of essential nutrients which are vital for the growth of the foetus [26]. This is due to the fact that women lack of knowledge concerning the effects of pica on the foetus. Non-food items consumption during pregnancy can lead to malnutrition and deficiencies of vitamins and minerals. These findings are congruent with previous studies which indicated that pregnant women have been practicing pica and this can cause complication during pregnancy.

During pregnancy women are restrict to eat certain food items according to culture and this could result in fewer food consumption which in turn can lead to underweight and overweight. Surprisingly our study indicates negative correlation between mother’s BMI and the infant’s WAZ (r=-0.48; p=0.515). These indicate that the mother’s weight during pregnancy is not only the contributing factor to infant’s weight during birth. Factors such as dietary practices during pregnancy should be considered when studying the relationship between the mother’s weight during pregnancy and their infants during birth. However, women who have poor weight gain during pregnancy face greater risks of delivery preterm babies and their infants set off on a weaker development path, both physically and intellectually.25 Furthermore, Girls born with low birth weight are more likely to become poorly nourished children and poorly grown women and are, therefore, likely to give birth to low birth weight infants resulting in the vicious cycle of malnutrition [14]. In addition, nutritional status of mothers is one of the most important factors of foetal growth and development.

Results: 45 percent of the study participants have eaten carrots, bananas, apples, spinach, cabbage and beetroots during pregnancy while 26.7% of the study participants reported that they need eaten carrots, oranges, bananas, apples, spinach, cabbage and beetroots during pregnancy. The majority of participants (91.7%) received folate and iron supplements while 8.3% received iron, folate and calcium supplements during pregnancy. Half of the participants at the time of pregnancy had normal BMI, 13.3% were underweight, 30% were observed overweight and 6.7% were observed obese. More than third quarter of infants (80%) at birth had normal WAZ (-1SD to ≤+2SD), 6.7% of infants were underweight (<-3SD to <-2SD) while 11.7% of infants were mildly underweight (-2SD to <-1SD). 

Conclusión: La edad materna y las prácticas alimentarias durante el embarazo tienen un impacto significativo en los resultados del parto. El peso de la madre durante el embarazo no es el único factor que contribuye al peso del bebé durante el parto. Factores como las prácticas alimentarias durante el embarazo y el nivel socioeconómico deben tenerse en cuenta al estudiar la asociación entre el peso de la madre durante el embarazo y sus bebés. La prevalencia de bajo peso, emaciación y retraso del crecimiento se debe a un bajo aumento de peso durante el embarazo y una dieta materna inadecuada (dieta desequilibrada). Las madres que estaban desnutridas durante el embarazo habían dado a luz a bebés con bajo peso al nacer.

Nota: Este trabajo se presentó parcialmente en la 4ª Conferencia y Exhibición Internacional sobre Nutrición, celebrada del 26 al 28 de octubre de 2015 en Chicago, Illinois, EE. UU.