Abstract

Adequate knowledge of nutritional status and health of pregnant women is very important because it determines the health of the developing foetus due to the connection between the mother and child. This study was carried out to assess the knowledge and attitude towards adequate diet practices of pregnant women attending ante-natal clinic at University College Hospital and Adeoyo Maternity Hospital. A total of 386 pregnant women were randomly selected from the two (2) hospitals and a well-structured questionnaire was used for collection of data. Descriptive statistics was used for data analysis. More than half (58.8%) of the respondents were within the age group 26-30 years old. Results revealed that 65% of the respondents have fair knowledge of nutritional diet during pregnancy while 35% of them have good knowledge of nutritional diet during pregnancy respectively. Furthermore, most (66.7%) of the respondents have positive attitude towards adequate diet during pregnancy while 33.3% have negative attitude towards adequate diet during pregnancy respectively. The pregnant women were not eating more quantity and variety of foods more than what they normally consume before pregnancy nor took dairy products daily in their meal and also claimed inability to afford sufficient quantity and quality of adequate diet recommended for them. Based on respondents lifestyle, results indicated that majority (69.9%) of the respondents engaged in physical exercise in form of brisk walking and dancing. This study suggest that pregnant women needs to be educated on nutrition and practices of adequate diet during pregnancy.

1. Introduction

In a women’s life, pregnancy is one of the greatest nutritionally demanding periods. Pregnancy is the state at which female carry a developing embryo or foetus within their body. During pregnancy, suitable dietary balance is important to make sure that appropriate energy intake is available for sufficient foetus development without consuming on the mother’s tissues to sustain her pregnancy ¹. Pregnancy condition can be confirmed through blood test, ultrasound, detection of foetal heartbeat or an X-ray and positive results on an over-the-counter urine test. Pregnancy period lasts for about nine months which is calculated starting from the date of the woman's last menstrual period (LMP). State of pregnancy is usually divided into three (3) trimesters, comprises of roughly three months long each ². During pregnancy, suitable nutritional intake has been identified as a vital factor for strong pregnancy and anticipated birth outcomes ^{3, 4}.

Maternal nutrition during pregnancy has been recognized as an essential element of birth weight. According to ⁵, in developing countries, high rate of Low Birth Weight (LBW) has been ascribed to deprived maternal nutrition. Developing foetus consumes a lot of nutrients from the mother to improve psychological growth. Similarly, there is high demand for nutrient by the mother due to developing foetus ⁶. Previous studies shows that individual nutritional knowledge affects food quality intake and choice of healthy food purchased ^{4, 7}.

Furthermore, pregnant women’s food habits are extremely influenced by their occupation and culture. The beliefs concerning food consumption during pregnancy are another reason that determines the nutritional status of pregnant women ⁸. Pregnant women need to be educated on the food consumption and attitude towards food choice during pregnancy. Adequate nutrition knowledge is very vital during pregnancy and good attitude towards the information acquired is essential ⁴. Studies regarding pregnant women’s knowledge towards dietary intake are scanty and more research needs to be carried out to address the issue. Therefore, the objective of this study is to assess the knowledge and attitude towards adequate diet practices of pregnant women attending antenatal clinic in University College Hospital and Adeoyo Maternity Hospital, Ibadan, Oyo State, Nigeria.

2. Materials and Methods

The study was conducted among pregnant women attending ante-natal clinic in University College Hospital and Adeoyo Maternity Hospital, Ibadan, Oyo State. These hospitals were selected because they are the biggest and well-known hospitals in Ibadan. Pregnant women were selected from these hospitals in order to assess their knowledge and attitude towards adequate dietary intake. Pregnant women were identified through positive pregnancy laboratory test in the hospitals. Also, additional selection principles involve women within the range of child bearing age (15-39 years) that were confirmed as pregnant women by the gynaecologist.

Written approval was gotten from the management in-charge of the ante-natal clinics of the two hospitals. Sampling frame of pregnant women in their first, second and third trimesters was collected from the ante-natal clinic. Random sampling was used to select 420 pregnant women that gave their consent to participate in the research but due to incomplete response from the respondents, 386 questionnaires were used for the purpose of this study. For the purpose of adequate data collection, ante-natal clinic was visited on the ante-natal days in order to meet the respondents. Questionnaire was validated first through pilot study by selecting 30 respondents from the list provided from the hospital. The purpose of validation is to be sure that respondents understand the content of the question and to ensure that the items explains the construct. After the validity test, questionnaire was used for data collection from the pregnant women for a period of three (3) months. The questionnaire used was divided into four sections; demographic factors, lifestyle of respondents, 24-hour dietary recall to asses food quality intakes and practice of adequate diet during pregnancy.

Data collected was analyzed using Statistical Package for Social Sciences (SPSS) version 24.0 software. Descriptive statistics such as mean, standard deviation, frequency and percentage was used to examine demographic factors of respondents, knowledge of pregnant women towards adequate diet intake during pregnancy, attitude of pregnant women towards adequate diet during pregnancy and practice of adequate diet during pregnancy.

3. Results

Table 1 shows the demographic factors of respondents. Almost 60% of the respondents were within the age group of 26-30 years old, followed by 32.9% respondents between ages 21-25 years and 1.6% of respondents were above 35 years respectively. Majority (98.4%) of the respondents were married and few (0.8%) of them were single and widowed respectively. Most of the respondents’ occupation was artisan (46.9%) and civil servant (46.6%) respectively.

Descriptive statistics of lifestyle of respondents is shown in Table 2. Majority (61.7%) of the respondents were moderately active, 21.2% were sedentary and 17.1% were active respectively. Furthermore, 69.9% of the respondents were engaged in physical exercise band while 30.1% do not participate in physical exercise. Results revealed that out of 69.9% that engage in physical exercise, most (56.9%) of them engaged in daily exercise while 38.7% engaged in exercise once a week respectively. Majority (71.2%) of the respondents do not take alcoholic beverage and 100% of them do not smoke cigarettes respectively.

Table 3 shows the descriptive statistics of knowledge of pregnant women towards adequate diet intake during pregnancy. Majority (94.5%) of the respondents claimed that nutrients intakes increased during pregnancy, 100% claimed that adequate diet is important during pregnancy; adequate diet include proteinous food during pregnancy; adequate diet include minerals, milk and green leafy vegetable; adequate diet include vitamins, fruits and green leafy vegetable; during pregnancy green leafy vegetables and fruits should be taken regularly; eating well will make mother and baby healthy; eat clean and safe foods; wash fruits and vegetables before eating and fish, poultry, egg and meat will make baby grow well respectively. Furthermore, majority (85.6%) of the respondents claimed that adequate diet should include energy rich food during pregnancy; adequate diet should include palm oil and vegetable oil during pregnancy; 95.2% stated that eating of variety of food is important during pregnancy; 93.8% claimed that pregnant women should consume more of animal protein than plant protein; 71.9% claimed that pregnant women should take prenatal vitamins and minerals as prescribed; 82.2% claimed that food eaten during pregnancy should be eaten; 91.8% claimed that pregnant women needs to eat well so as not to fall sick; 98.6% claimed that nutrition is crucial for the growth of the baby; 99.3% claimed that pregnant women should wash cooking utensils before cooking; 76.7% claimed that pregnant women should boil water before drinking during pregnancy; 64.4% claimed that pregnant women should eat at least two pieces of meat daily during pregnancy; 83.6% claimed that pregnant women should take at least 5-8 dessert spoons of green leafy vegetables daily; 93.8% claimed that pregnant women should take 2 pieces of yellow fruits daily to keep healthy respectively. However, 94.5% claimed that it is not important to take some milk in daily meals.

Table 4 and Table 5 shows the respondents attitude towards adequate diet during pregnancy. Respondents attitude was classified as positive and negative response in Table 5. Most (67%) of the respondents has positive attitude towards adequate diet during pregnancy while 33.3% has negative attitude.

Table 6 shows the descriptive statistics of respondents practice of adequate diet during pregnancy. From the findings of the result, most (52.6%) of the respondents cannot afford sufficient quality of food daily. Also, majority (93.0%) of the respondents do not eat more than the normal food when they are not pregnant while 73.8% of them take green leafy vegetables as a source of fibre.

Most (69.7%) of them include fruits in their meals daily while 30.3% do not include fruits in their meals daily. Furthermore, 76.2% of the respondents take dairy products (milk) in their meal daily and 28.8% do not take dairy products in their meal daily. Almost (97.9%) all of the respondents increase food intake during pregnancy per meal daily while 92.7% of them take at least two pieces of carrot, orange or water melon daily. Almost all (98.3%) of the respondents do not reduce their food intake during pregnancy and do not follow weight reduction therapy respectively.

4. Discussions

The results of this study shows that majority (58.8%) of the respondents fall within the age group of 26-30 years. This age group is within the child bearing age with less complication and is in accordance with ⁶ work where respondents falls within age group of 15-20 years. Majority (98.4%) of the respondents were married while most (46.9%, 46.6%) of the respondents were artisan and civil servant by occupation. This findings is not in accordance with ^{6, 9} studies. Their studies shows that 62.6% and 67.3% of the respondents were housewives respectively. Based on the income level, 94.3% of the respondents earn above ₦10,000. Results indicated that most (47.4%) of the respondents have tertiary education, 28.8% have primary education while 23.8% have secondary education respectively.

Despite high level of education among the respondents, results revealed that 65% of the respondents have fair knowledge of nutritional diet during pregnancy and 35% of them have good knowledge of nutritional diet during pregnancy respectively. According to ⁶ studies, 65.4% of the respondents showed high knowledge of dietary practices during pregnancy while 34.6% indicated low knowledge of dietary practices during pregnancy. Adequate knowledge is the most important factor which determine the nutritional habits of pregnant women. According to ⁷, knowledge during pregnancy period is enough to encourage pregnant women to practice healthy dietary behaviour.

Findings revealed that majority (67.1%) of the respondents strongly agree that nutrients intakes need to be increased during pregnancy. However, majority (66.7%) of the respondents have positive attitude towards adequate diet during pregnancy while 33.3% have negative attitude towards adequate diet during pregnancy respectively. Studies from ¹⁰ suggested that knowledge, attitude and belief are related to healthy eating, health maintenance and nutritional behavioural change. The knowledge and positive attitude change must mediate adequate dietary process. In this study, a high proportion of the respondents claimed to have some knowledge of what they should eat during pregnancy. However, their knowledge and attitude to the recommended diet was generally assessed as being fair.

The pregnant women were not eating more quantity and variety of foods more than what they normally eats before pregnancy nor consume dairy products in their meal daily and also claimed inability to afford sufficient quantity and quality of adequate diet recommended for them. Based on respondents lifestyle, results indicated that majority (69.9%) of the respondents engaged in physical exercise in form of brisk walking and dancing. Most (56.9%) of them engaged in daily exercise while 38.7% engaged in exercise once a week respectively. This findings is in line with ¹¹ who stated that physical exercise is helpful for pregnant women because it reduces risks during delivery. However, findings revealed that knowledge of adequate nutrition and practices of adequate diet during pregnancy is significantly related.

5. Conclusion

Pregnancy is a period of remarkable physiological changes that require healthy dietary intake and lifestyle choices. During pregnancy, demand for nutrient increase by the mother due to growing foetus. The results indicated that majority of the pregnant women attending UCH and Adeoyo ante-natal clinics were artisan and civil servant. It was observed that most of them have tertiary education which implies that they are literate. Most of the pregnant women engaged in physical exercise to make them fit during pregnancy. This study revealed that pregnant women should consume adequate diet with essential micronutrients especially in calcium, zinc, folate, iron and vitamin B12. The pregnant women’s knowledge and attitude towards adequate diet during pregnancy was rated fair while their practices of adequate diet was poor. Therefore, there is need to educate the pregnant women at the community level on attitude towards adequate diet during pregnancy period and benefit attached to practices of adequate diet.

Acknowledgements

The researchers of this study appreciate the respondents and all those that contributed in one way or the other to the success of this research.

References