Nutritional Status Of Preconception Women In Rural Areas Of Belgaum District A Cross Sectional Study

Abstract

Background and Objectives Preconception under nutrition is the most leading cause of health loss worldwide. Women bear the brunt of the disease burden associated with undernutrtion. The prevalence of underweight (< 45 kg) women are roughly the same relative distributions as stunting, but the overall proportion of underweight women is very much higher - up to about 60% in South Asia. In India, women of the child-bearing age (15 to 49 years) constitute 22.2 percent of the total population. Mothers and children not only constitute large group, but also a vulnerable or special-risk group. Poor health of women has bad implications on self as well as on their families. Women of reproductive age living in resource-poor settings are at high risk of inadequate micronutrient intakes when diets lack diversity and are dominated by staple foods. Based on the dietary and anthropometric results some study showed that malnutrition is a common feature among low income rural women. Preconception health applies to women who have never been pregnant and also to women who could become pregnant again. In recent years preconception care and nutrition has become an important health issue in a many developing countries. With this background, as no study about preconception nutritional status was done in this area, a study to know the nutritional status of preconception women, proxy indicators for the micronutrient adequacy of diets and socio demographic factors associated with preconception maternal nutrition was taken up. Methodology A Community based Cross Sectional Study was undertaken over a period of one year, in 18 villages under 10 Primary Health Centres, in Belgaum District. This study was done in One year from January 2014 to December 2014. A total of 770 reproductive age group women (15-49) who were Non pregnant-non lactating women (NPNL) and Parity 0-3 women who were not following any family planning method were enrolled in the study. Women of primary and secondary sterility,NPNL who were having Hb% less than 7gm/dl and women adopted permanent and temporary method of sterilization were excluded. Data collection was done after identification of women, on socio demographic and food insecurity, laboratory investigations, anthropometry and consumption of 24 hrs.dietary history in half of the women. Results The mean age was 22.5 (SD±3.19) years and the median age was 22 years. Majority of them, 64.8 % belonged to class V according to modified B G Prasad classification, followed by 24.0% to class IV and only 22 (0.8%) belonged to class I category of socio-economic status. The mean age of marriage was 18.2 years (SD + 2.59) and the median age of marriage was 18 years. Amongst the total women 43.9% were having 1 child, 33.5% nulliparous women and 18.3% were having 2 children. In this study, 40.4% had moderate anaemia and 38.2% had mild anaemia. One third of the study participants, 36.6%were of below BMI of 18.5 and 22.7% of women were MUAC below 22cm and about 72.1% were having W/H ratio less than 0.8. Majority of women consumed energy less than 90%of RDA. The consumption of protein was below 50% of RDA in 41.8% of preconception women and 50-70% of RDA in 39.0% women. The median intake of total fat was 44gm more than RDA 20gms. The median intake of vitamin B1 was 0.6933 less than RDA 1mg. The median intake of vitamin B2 was 0.6364 less than RDA 1.1mg. The median intake of vitamin B6 was 0.7042 less than RDA 2mg. The median intake of vitamin dietary folate was 104µg less than RDA. The median intake of vitamin C was 22 less than RDA 40mg. Majority women, 34.0% consumed calcium 50% of RDA and 24.7% consumed 50-70% of RDA. Most of the participants 70.9% were consuming iron less than 50% of RDA and 24.9% consumed 50-70% of RDA. The median intake of zinc was 4.4 less than RDA 10mg. Conclusion Preconception women staying in rural areas had less desired food stuffs which were containing inadequate micronutrients and macronutrients. Low BMI in women showed that food habits of rural women had low macro and micronutrients which could be due to lack of knowledge regarding importance of nutrition. Multiple reasons like poverty, food insecurity, high parity, traditional food habits and dietary diversification could be the cause of undernutrtion in preconception women.