Assessing the Relationship between Individual Level Dietary Intake and the Occurrence of Preeclampsia/Eclampsia and Haemorrhage among Pregnant Women in Eastern Region of Ghana: A Prospective Cohort Study

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DOI: 10.21522/TIJPH.2013.10.01.Art009

Authors : James Atampiiga Avoka, Augustine Ankomah, Agartha Ohemeng, Issah Seidu, Michael Wombeogo, Francis Kwotua Apungu

Abstract:

Pre-eclampsia/eclampsia (PE-E) and haemorrhage are dangerous diseases that occur in pregnancy. This study seeks to assess the relationship between individual-level dietary intake and the occurrence of pre-eclampsia/eclampsia and haemorrhage among pregnant women in the Eastern Region of Ghana. The prospective cohort study involved all pregnant women in their third trimester of pregnancy (>28 weeks gestational age) reporting for antenatal care (ANC) in seven Hospitals in the Eastern Region of Ghana. The study used a 24-hour repeated dietary recall to elicit dietary intake information from pregnant women until delivery. The majority of pregnant women in this study had adequate consumption of phosphorus far above the RDI, coupled with an inadequate intake of calcium, excess intake of sodium, and manganese. The average dietary intake for carbohydrates in this study was rather higher than the RDA. There was a statistically significant association between PE-E and the intake of vitamin C. A statistically significant association exists between the intake of calcium and vitamin A and haemorrhage. The findings show that pregnant women who consumed adequate and excess amounts of vitamin C reduced their odds of developing PE-E by 41.7% and 39.8%, respectively. The results show that pregnant women who had an excess intake of calcium were 6.128 times the odds of developing haemorrhage compared to those who had inadequate intake. Again, pregnant women who had adequate intake of vitamin A were 4.351 times the odds of developing haemorrhage compared to those who had inadequate intake. It is recommended that more nutrition specialists to be trained and posted to counsel pregnant women on nutrition in pregnancy to avert the consequences of PE-E and haemorrhage.

References:

[1] World Health Organization. (2018). WHO recommendations: policy of interventionist versus expectant management of severe pre-eclampsia before term.

[2] Say, L., Chou, D., Gemmill, A., Tunçalp, Ö., Moller, A. B., Daniels, J., Gülmezoglu, A. M., Temmerman, M., & Alkema, L. (2014). Global causes of maternal death: A WHO systematic analysis. The Lancet Global Health, 2(6). https://doi.org/10.1016/S2214-109X(14)70227-X.

[3] Peraçoli et al. (2020). Pre-eclampsia / Eclampsia. 318–332.

[4] Brown et al. (2018). Hypertensive Disorders of Pregnancy. 24–43. https://doi.org/10.1161/hypertensionaha.117.10803.

[5] Sánchez-aranguren, L. C., Prada, C. E., Riaño-medina, C. E., & Lopez, M. (2014). Endothelial dysfunction and preeclampsia : role of oxidative stress. 5(October), 1–11. https://doi.org/10.3389/fphys.2014.00372.

[6] Mannaerts, D., Faes, E., Gielis, J., Craenenbroeck, E. Van, Cos, P., Spaanderman, M., Gyselaers, W., Cornette, J., & Jacquemyn, Y. (2018). Oxidative stress and endothelial function in normal pregnancy versus pre-eclampsia , a combined longitudinal and case-control study. 1–9.

[7] Say, L., Chou, D., Gemmill, A., Tunçalp, Ö., Moller, A., Daniels, J., Gülmezoglu, A. M., Temmerman, M., & Alkema, L. (2006). Global causes of maternal death : a WHO systematic analysis. 323–333. https://doi.org/10.1016/S2214-109X(14)70227-X.

[8] Asamoah, B. O., Moussa, K. M., Stafström, M., & Musinguzi, G. (2011). Distribution of causes of maternal mortality among different socio-demographic groups in Ghana ; a descriptive study.

[9] Moyer, C., Gyasi, R. K., Akosa, A. B., Tettey, Y., Akakpo, P. K., & Anim, J. T. (2013). Pregnancy related causes of deaths in ghana : a 5-year retrospective study. 47(4), 158–163.

[10] Ghana Health Service (GHS) Annual Report, Eastern Region-2020.

[11] GDHS, (2021). Population and Housing Census, 2021 Preliminary Report.

[12] Cochran, W. G. 1963. Sampling Techniques, 2nd Ed., New York: John Wiley and Sons, Inc.

[13] Veena, S. R., Gale, C. R., Krishnaveni, G. V, Kehoe, S. H., Srinivasan, K., & Fall, C. H. D. (2016). Association between maternal nutritional status in pregnancy and offspring cognitive function during childhood and adolescence ; a systematic review. BMC Pregnancy and Childbirth. https://doi.org/10.1186/s12884-016-1011-z.

[14] Grum, T., Hintsa, S., & Hagos, G. (2018). Dietary factors associated with preeclampsia or eclampsia among women in delivery care services in Addis Ababa, Ethiopia : a case-control study. BMC Research Notes, 1–5. https://doi.org/10.1186/s13104-018-3793-8.

[15] Endeshaw, M., Ambaw, F., Aragaw, A., & Ayalew, A. (2014). Effect of Maternal Nutrition and Dietary Habits on Preeclampsia : A Case-Control Study. January. https://doi.org/10.4236/ijcm.2014.521179.

[16] Ram, D., Id, S., Sangroula, R. K., Shakya, N. S., Yadav, R., Chaudhary, N. K., Man, P., & Pradhan, S. (2019). Effect of nutrition education on hemoglobin level in pregnant women : A quasi- experimental study. 1–12.

[17] Stadlmayr, & et al.,. (2012). Table de composition des aliments d´Afrique de l´Ouest West African Food Composition Table.

[18] Saaka, M., & Oladele, J. (2020). Adequacy of nutrient intakes among pregnant women in northern Ghana. 11(1), 145–164.

[19] Ayensu et al. (2020). Prevalence of anaemia and low intake of dietary nutrients in pregnant women living in rural and urban areas in the Ashanti region of Ghana. 1–15. https://doi.org/10.1371/journal.pone.0226026.

[20] Zhao, W., Yu, K., Tan, S., Zheng, Y., Zhao, A., Wang, P., & Zhang, Y. (2017). Dietary diversity scores: An indicator of micronutrient inadequacy instead of obesity for Chinese children. BMC Public Health, 17(1), 1–11. https://doi.org/10.1186/s12889-017-4381-x.

[21] Adikari, A. M. N. T., Sivakanesan, R., Wijesinghe, D. G. N. G., & Liyanage, C. (2016). Assessment of Nutritional Status of Pregnant Women in a Rural Area in Sri Lanka. 27(2), 203–211.

[22] Institute of Medicine (IOM), 2006.

[23] Kominiarek, M. A., & Rajan, P. (2017). HHS Public Access. 100(6), 1199–1215. https://doi.org/10.1016/j.mcna.2016.06.004.Nutrition.

[24] Saaka, M. (2020). Adequacy of nutrient intakes among pregnant women in Northern Ghana. August. https://doi.org/10.26596/wn.2020111145-164.

[25] Lee, S. E., Talegawkar, S. A., Merialdi, M., & Caulfield, L. E. (2013). Dietary intakes of women during pregnancy in low- and middle-income countries. Public Health Nutrition, 16(8), 1340–1353. https://doi.org/10.1017/S1368980012004417.

[26] Nguyen, P. H., Huybregts, L., Sanghvi, T. G., Tran, L. M., Frongillo, E. A., Menon, P., & Ruel, M. T. (2018). Dietary Diversity Predicts the Adequacy of Micronutrient Intake in Pregnant Adolescent Girls and Women in Bangladesh, but Use of the 5-Group Cutoff Poorly Identifies Individuals with Inadequate Intake. https://doi.org/10.1093/jn/nxy045.

[27] Marvin-Dowle, K., Burley, V. J., & Soltani, H. (2016). Nutrient intakes and nutritional biomarkers in pregnant adolescents: A systematic review of studies in developed countries. BMC Pregnancy and Childbirth, 16(1), 1–24. https://doi.org/10.1186/s12884-016-1059-9.

[28] Nove, A., Matthews, Z., Neal, S., & Camacho, A. V. (2014). Maternal mortality in adolescents compared with women of other ages: Evidence from 144 countries. The Lancet Global Health, 2(3), e155–e164. https://doi.org/10.1016/S2214-109X(13)70179-7.

[29] Apungu, F. K. (2019). Nutritional and health status of people living with HIV / AIDS in the eastern region of Ghana. November. https://doi.org/10.1108/NFS-05-2019-0145.

[30] Bobić et al. (2015). Perinatal Epidemiological Risk Factors For Preeclampsia. 54(1), 9–13.

[31] Imdad, A., Jabeen, A., & Bhutta, Z. A. (2011). Role of calcium supplementation during pregnancy in reducing the risk of developing gestational hypertensive disorders : a meta-analysis of studies from developing countries. 11(Suppl 3).


[32] Jabeen, M., Yakoob, M. Y., Imdad, A., & Bhutta, Z. A. (2011). Impact of interventions to prevent and manage preeclampsia and eclampsia on stillbirths. BMC Public Health, 11(SUPPL. 3), S6. https://doi.org/10.1186/1471-2458-11-S3-S6.

[33] Abu-saad, K., & Fraser, D. (2010). Maternal Nutrition and Birth Outcomes. March. https://doi.org/10.1093/epirev/mxq001.

[34] Duley, L., Meher, S., & Abalos, E. (2006). Clinical review Management of pre-eclampsia. box 5.

[35] Torjusen, H., Brantsæter, A. L., Haugen, M., Alexander, J., Bakketeig, L. S., Lieblein, G., Stigum, H., Næs, T., Swartz, J., Holmboe-ottesen, G., Roos, G., & Meltzer, H. M. (2014). Reduced risk of pre-eclampsia with organic vegetable consumption : results from the prospective Norwegian Mother and Child Cohort Study. 1–11. https://doi.org/10.1136/bmjopen-2014-006143.

[36] Agrawal, S., Fledderjohann, J., Vellakkal, S., & Stuckler, D. (2015). Adequately Diversified Dietary Intake and Iron and Folic Acid Supplementation during Pregnancy Is Associated with Reduced Occurrence of Symptoms Suggestive of Pre- Eclampsia or Eclampsia in Indian Women. 1–23. https://doi.org/10.1371/journal.pone.0119120.

[37] Hofmeyr GJ, Lawrie TA, Atallah AN, Duley L, Torloni MR (2014) Calcium supplementation during pregnancy for preventing hypertensive disorders and related problems.Cochrane Database Syst Rev 6: CD001059. doi:10.1002/14651858.CD001059.pub4 PMID: 24960615.

[38] Jain S, Sharma P, Kulshreshtha S, Mohan G, Singh S (2010) The role of calcium, magnesium, and zinc in pre-eclampsia. Biological trace element research 133(2): 162–170. doi:10.1007/s12011-009-8423-9 PMID: 19547932.

[39] World Health Organization. (2020). Calcium supplementation before pregnancy for the prevention of pre-eclampsia and its complications. https://apps.who.int/iris/bitstream/handle/10665/331787/9789240003118-eng.pdf?ua=1.