Abstract:
Inadequate nutrition during pregnancy can lead to adverse birth outcomes, and more importantly for pregnant adolescents as they require nutrients to meet their needs for their growth and the fetus. The study examined the relationship between nutritional status and birth outcomes among Ghanaian pregnant adolescents in selected districts of the Ashanti Region, Ghana. In this prospective cohort study, we followed 416 pregnant teenagers recruited at health centers during antenatal care until delivery. We measured weight and height to calculate Body Mass Index (BMI), and Mid-Upper Arm Circumference (MUAC), and nutrient intakes using a repeated 24 hr dietary recall were collected. Hemoglobin (Hb), serum levels of ferritin, prealbumin, vitamin A, Total Antioxidant Capacity (TAC), C-reactive protein (CRP), and Zinc Protoporphyrin (ZPP) were analyzed. Birth outcome data of interest were low birth weight (LBW) and preterm births (PTB). About 15.2 % had LBW, 12.5 % had PTB, and 3.1 % neonatal deaths. The majority of the pregnant adolescents consumed below Estimated Average Requirements (EAR) for thiamin (75.7 %), riboflavin (84.6 %), folate (82.9 %), vitamin A (87.3 %), iron (93.5 %), zinc (83.7 %), and calcium (96.9 %) intakes, while energy (96.6 %), protein (84.6 %), and dietary fiber (74.4 %) were below the Recommended Dietary Allowance (RDA). Anemia and wasting prevalences were 57.1 % and 27.8 %. The mean intakes for carbohydrates (p = 0.042) and dietary fiber (p = 0.012) were significantly higher among adolescent mothers with term birth (276.7 � 111.2 g, 23.7 � 11.2 g) than those with PTB (237.3 � 83.7 g, 19.4 � 9.0 g), respectively. Preterm birth proportions were higher in severely wasted (18.8 %) adolescents than moderately wasted (6.2 %) and normal MUAC (14.0 %) adolescents (p = 0.184). LBW proportions were higher among anemic (18.1 %) than the non-anemic (12.1 %), among low (30 %) compared with normal (14.9 %) serum ferritin, among low (15.7 %) compared with normal (0 %) serum prealbumin, and among low (16.2 %) compared with normal (11.1 %) serum vitamin A status pregnant adolescents. Pregnant adolescents with moderate wasting had lower odds (Adjusted odds ratio = 0.2, p = 0.017, 95 % confidence interval = 0.1�0.8) of having LBW infants compared with those with normal MUAC. The odds of preterm births were significantly higher among pregnant adolescents with dietary fiber intake below the RDA (Unadjusted OR = 2.8, p = 0.042, 95 % CI = 1.0�7.3). In conclusion, adverse birth outcomes were associated with poor nutritional status among pregnant adolescents studied. � 2021 The Author(s)
Description:
Gyimah, L.A., Department of Biochemistry and Biotechnology, Faculty of Biosciences, College of Science, Kwame Nkrumah University of Science and Technology, Private Mail Bag, University Post Office, Kumasi, Ghana, Department of Food and Nutrition Education, Faculty of Home Economics Education, University of Education, Winneba, Post Office Box 25, Winneba, Ghana; Annan, R.A., Department of Biochemistry and Biotechnology, Faculty of Biosciences, College of Science, Kwame Nkrumah University of Science and Technology, Private Mail Bag, University Post Office, Kumasi, Ghana; Apprey, C., Department of Biochemistry and Biotechnology, Faculty of Biosciences, College of Science, Kwame Nkrumah University of Science and Technology, Private Mail Bag, University Post Office, Kumasi, Ghana; Asamoah-Boakye, O., Department of Biochemistry and Biotechnology, Faculty of Biosciences, College of Science, Kwame Nkrumah University of Science and Technology, Private Mail Bag, University Post Office, Kumasi, Ghana; Aduku, L.N.E., Department of Biochemistry and Biotechnology, Faculty of Biosciences, College of Science, Kwame Nkrumah University of Science and Technology, Private Mail Bag, University Post Office, Kumasi, Ghana; Azanu, W., Department of Obstetrics and Gynecology, School of Medicine, University of Allied Health Sciences, Ho, PMB 31, Ghana; Lutterodt, H.E., Department of Food Science and Technology, Faculty of Biosciences, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana; Edusei, A.K., Department of Community Health, School of Public Health, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana