埃塞俄比亚孕妇的食物禁忌：规模、驱动因素及其与贫血的关联。
Food taboo among pregnant Ethiopian women: magnitude, drivers, and association with anemia.
机构信息
Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences-International Campus (TUMS-IC), Tehran, Iran.
Unit of Reproductive Health, Addis Ababa City Administration Health Bureau, Addis Ababa, Ethiopia.
出版信息
Nutr J. 2019 Mar 23;18(1):19. doi: 10.1186/s12937-019-0444-4.
BACKGROUND
There are pervasive pregnancy-related food taboos and myths (PRFT) in Ethiopia. The evidence, however, is limited on whether PRFT contributes to the burden of maternal anemia. Thus, this study was aimed to determine the magnitude of PRFT, the reasons for adherence to PRFT, and the association of adherence to PRFT with anemia, among pregnant Ethiopian women.
METHODS
The study was case-control in design and recruited a sample of 592 pregnant women attending antenatal care in four health facilities in Addis Ababa, Ethiopia. Participants were classified into anemic cases (n = 187) and non-anemic controls (n = 405) based on their hemoglobin level. PRFT was assessed by the participants' subjective reporting of avoidance of certain food items during the current pregnancy due to taboo reasons. The specific types of food items avoided and the underlying reasons for the avoidance were also assessed. The relation of PRFT with anemia was evaluated by multiple logistic regression analysis, controlling for covariate factors.
RESULT
Almost a fifth of the study participants (18.2%) avoided one or more food items due to PRFT. Adherence to PRFT was 26.2 and 14.6% among the anemic and the non-anemic individuals, respectively. The food items most avoided due to adherence to PRFT were green chili pepper, organ meat, and dark green leafy vegetables like spinach, lettuce, kale, and broccoli. The underlying reasons for the adherence to PRFT were largely traditionally held beliefs and misconceptions. After controlling for covariates, PRFT was significantly and independently associated with a higher odds of anemia [adjusted odds ratio (AOR) = 2.12, 95% confidence interval (CI) = 1.32-3.42, P = 0.002].
CONCLUSION
PRFT might be contributing to the burden of maternal anemia in Ethiopia. It is time for public health authorities in Ethiopia to recognize PRFT as a public health risk, strengthen maternal nutrition counseling, and create public awareness of the consequences of PRFT.
TRIAL REGISTRATION
ClinicalTrials.gov (NCT03251664), 16 August 2017.
背景
在埃塞俄比亚，存在普遍的与怀孕相关的食物禁忌和神话（PRFT）。然而，关于 PRFT 是否会导致产妇贫血负担，证据有限。因此，本研究旨在确定 PRFT 的严重程度、遵循 PRFT 的原因，以及遵循 PRFT 与贫血之间的关联，对象为埃塞俄比亚的孕妇。
方法
本研究采用病例对照设计，在埃塞俄比亚亚的斯亚贝巴的四家医疗机构招募了 592 名孕妇。根据血红蛋白水平，将参与者分为贫血病例（n=187）和非贫血对照（n=405）。通过参与者主观报告在当前怀孕期间因禁忌原因避免某些食物来评估 PRFT。还评估了避免的具体食物种类和避免的潜在原因。通过多因素逻辑回归分析，控制了协变量因素，评估了 PRFT 与贫血的关系。
结果
研究参与者中近五分之一（18.2%）因 PRFT 而避免食用一种或多种食物。贫血患者和非贫血患者中遵循 PRFT 的比例分别为 26.2%和 14.6%。由于遵循 PRFT 而避免的食物主要是青椒、动物内脏和深绿色叶菜，如菠菜、生菜、羽衣甘蓝和西兰花。遵循 PRFT 的主要原因是传统的信仰和误解。在控制了协变量后，PRFT 与贫血的高风险显著相关（调整后的优势比[AOR]=2.12，95%置信区间[CI]=1.32-3.42，P=0.002）。
结论
PRFT 可能是埃塞俄比亚产妇贫血负担的一个因素。现在是埃塞俄比亚公共卫生当局认识到 PRFT 是公共卫生风险的时候了，应加强孕产妇营养咨询，并提高公众对 PRFT 后果的认识。
试验注册
ClinicalTrials.gov（NCT03251664），2017 年 8 月 16 日。
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