Assessment of Iron, Vitamin a and Anthropometric Status of Pregnant Women in Nsukka Local Government Area of Enugu State, Nigeria.
ABSTRACT
The assessment of iron, vitamin A and anthropometric status of pregnant women in urban and rural communities in Nsukka Local Government Area of Enugu State, Nigeria was undertaken. Selection of the respondents was by random sampling method.
The respondents comprised of 129 pregnant women resident in Nsukka urban and 257 pregnant women resident in Ede-Oballa and Okpuje (rural) communities. Instruments used for data collection were questionnaire, anthropometric measurements, biochemical analysis and food intake study.
A validated structured questionnaire was used to collect information on respondents’ socioeconomic andobstetric characteristics and food consumption patterns. Anthropometric indices of the respondents were collected by measuring the respondents’ height, weight and mid-upper arm circumference (MUAC).
The respondents’ nutrient intakes were assessed using 3-day weighed food intake method. Determinations of haemoglobin concentration (Hb) and serum retinol concentration (SRC) were used to assess therespondents’ iron and vitamin A status, respectively.
The data collected were analysed using the Statistical Package for the Social Sciences software (version 17). Frequency distribution, percentage and mean were adopted for data analysis. Duncan’s New Multiple Range Test was used to separate group means, and T-test and analysis of variance were used to compare the means.
Pearson’s correlation coefficient was used to detect relationship between variables. The results showed that mean height of the respondents was 161±5.36cm. A few (1.5%) of urban and 1.2% of rural respondents had height <150cm. The mid-upper arm circumferences of all the respondents were normal (22.5cm and above).
TABLE OF CONTENT
TITLE PAGE — — — — — — — —i
APPROVAL PAGE — — — — — — — —ii
CERTIFICATION — — — — — — — —iii
DEDICATION — — — — — — — —iv
ACKNOWLEDGEMENTS — — — — — — — —v
LIST OF TABLES — — — — — — — —x
LIST OF FIGURES — — — — — — — —xiii
LIST OF APPENDICES — — — — — — — —xiv
ABSTRACT — — — — — — — —xv
CHAPTER ONE
1.0 INTRODUCTION — — — — — — — —1
1.1 Background to the study — — — — — — —1
1.2 Statement of the problem — — — — — — —2
1.3 Objectives of the study — — — — — — —4
1.4 Significance of the study — — — — — — —5
CHAPTER TWO
2.0 LITERATURE REVIEW — — — — — — —6
2.1 Iron — — — — — — — — — —6
2.1.1 Physiological roles of iron — — — — — — —7
2.1.2 Sources and absorption of iron — — — — — —7
2.1.3 Iron metabolism — — — — — — — —9
2.1.4 Dietary iron requirements — — — — — — —11
2.1.5 Iron deficiency — — — — — — —13
2.1.6 Prevalence of iron deficiency — — — — — — —15
2.1.7 Aetiology of iron deficiency — — — — — — —16
2.1.8 Prevention of iron deficiency — — — — — — —16
2.1.9 Iron overload — — — — — — — —20
2.2 Vitamin A — — — — — — — — —21
2.2.1 Vitamin A in foods — — — — — — — —23
2.2.2 Absorption of vitamin A — — — — — — —27
2.2.3 Metabolism of vitamin A — — — — — — —28
2.2.4 Physiological roles of vitamin A — — — — — —29
2.2.5 Requirements of vitamin A — — — — — — —31
2.2.6 Vitamin A deficiency: prevalence and manifestations — — —34
2.2.7 Aetiology of vitamin A deficiency — — — — — —37
2.2.8 Prevention and control of vitamin A deficiency — — — —39
2.2.9 Toxic effects of excess vitamin A — — — — — —42
2.3 Anthropometric status of pregnant women — — — — —44
2.4 Nutrition during pregnancy — — — — — —46
2.5 Nutritional status of pregnant women — — — — —50
2.6 Factors that influence nutritional status of pregnant women — — —52
2.7 Nutrition and pregnancy outcome — — — — — —55
2.8 Assessment of nutritional status of pregnant women — — — —57
CHAPTER THREE
3.0 METHODOLOGY — — — — — — —61
3.1 Study area — — — — — — — — —61
3.2 Research design — — — — — — — —62
3.3 Population of the study — — — — — — —62
3.4 Sample size calculation — — — — — — —62
3.5 Sampling technique — — — — — — — —63
3.6 Ethical clearance and informed consent — — — — —63
3.7 Advocacy visits to the communities — — — — — —64
3.8 Training of research assistants — — — — — —64
3.9 Instruments used for data collection — — — — — —64
3.10 Methods of data collection — — — — — — —64
3.10.1 Questionnaire — — — — — — — — —64
3.10.2 Anthropometric measurements — — — — — —65
3.10.3 Food intake study — — — — — — — —66
3.10.4 Biochemical analysis of blood samples — — — — —67
3.11 Statistical analysis — — — — — — — —69
CHAPTER FOUR
4.0 RESULTS — — — — — — — —70
4.1 Characteristics of the respondents — — — — — —70
4.1.1 Socio-economic characteristics of the respondents — — — —70
4.1.2 Socio-economic characteristics of the respondents’ families — — —73
4.1.3 Obstetric profile of the respondents — —- — — — —76
4.2 Anthropometric status of the respondents — —- —- — —80
4.3 Dietary consumption patterns of the respondents — —- — —82
4.4 Food intake study — — — — — — — —94
4.5 Iron status of the respondents — — — — — — —99
4.6 Vitamin A status of the respondents — — — — — —100
4.7 Factors that influenced nutritional status of the respondents — — —102
4.8 Correlation between variables — — — — — — —105
CHAPTER FIVE
5.0 DISCUSSION — — — — — — —107
5.1 Characteristics of the respondents — — — — — —107
5.1.1 Socio-economic characteristics of the respondents — — — —107
5.1.2 Obstetric profile of the respondents — — — — — —109
5.2 Anthropometric status of the respondents — — — — —111
5.3 Dietary consumption patterns of the respondents — — — —112
5.4 Food intake study — — — — — — — —115
5.5 Iron status of the respondents — — — — — — —117
5.6 Vitamin A status of the respondents — — — — — —119
5.7 Factors that influenced nutritional status of the respondents — — —119
5.8 Conclusion — — — — — — — — —123
5.9 Recommendation — — — — — — — —125
REFERENCES — — — — — — — —126
APPENDICES — — — — — — — —141
INTRODUCTION
Malnutrition is one of the major problems in the developing world today. It perpetuates itself generation by generation. Globally, malnutrition is the most important risk factor for illness and death, and affects millions of pregnant women and young children in particular. Many population groups suffer from multiple nutrient deficiencies.
The clustering of iron and vitamin A deficiencies has been observed (Administrative Committee on Coordination/ Subcommittee on Nutrition [ACC/SCN], 2000). The risks of deficiencies of these micronutrients increase during periods of growth: infancy, preschool age, adolescence and pregnancy.
In addition to protein and energy deficiencies, these micronutrient deficiencies result in growth retardation with consequent illness, debility and death (ACC/SCN, 2000). Iron deficiency, the commonest nutritional disorder in both developed and developing countries, affects over 3.5 billion people in the developing world (ACC/SCN, 2000).
Iron deficiency has serious impact particularly on women of child-bearing age and pre-school children. If uncorrected, the deficiency leads to anaemia of increasing severity, with increased risks of death (ACC/SCN, 1991a). The results of the 2001 – 2003 Nigeria food consumption and nutrition survey showed that approximately 35.3% of pregnant women had varying degrees of iron deficiency (Maxiya – Dixon et al., 2004).
Federal Government of Nigeria [FGN] / United Nations International Children’s Emergency Fund [UNICEF] (1993) reported that among Nigerian women, South-eastern Nigeria had the highest prevalence of iron deficiency anaemia (61%). Iron deficiency in pregnancy, increases the risks of premature delivery and low birth weight (Allen, 2000).
REFERENCES
ACC/SCN (1987). Delivery of oral doses of vitamin A to prevent vitamin A deficiency and nutritional blindness. Nutrition Policy Discussion Paper No. 2.
Geneva: ACC/SCN. ACC/SCN (1989). Women’s role in food chain activities and the implications for nutrition. Nutrition Policy Discussion Paper No. 4. Geneva: ACC/SCN.
ACC/SCN (1990). Women and nutrition. Nutrition Policy Discussion Paper No. 6. Geneva: ACC/SCN.
ACC/SCN (1991a). Controlling iron deficiency. Nutrition Policy Discussion Paper No. 9. Geneva: ACC/SCN.
ACC/SCN (1991b). Nutrition Relevant Actions. Nutrition Policy Discussion Paper No 10. Geneva: ACC/SCN.
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