Department of Human Nutrition and Food Science, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia.
Departement of Nutrition and Dietetics, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia.
PLoS One. 2020 May 8;15(5):e0232712. doi: 10.1371/journal.pone.0232712. eCollection 2020.
The use of excessive caffeine and consumption of alcohol, cigarette, and khat during pregnancy can result in adverse health effects on the fetus. The World Health Organization (WHO) recommends a daily caffeine intake not exceeding 300 mg. Likewise, pregnant women are recommended to avoid alcohol, khat and tobacco use. However, the prevalence's of the use of substances among pregnant women were not well studied in developing countries such as Ethiopia. Therefore, the study aimed to estimate the prevalence of caffeine and alcohol consumption, khat chewing, and tobacco use during pregnancy and identify key factors associated with excess caffeine consumption.
We conducted a community based cross-sectional study and used a random sampling technique to recruit 352 pregnant women. We adapted a questionnaire from Caffeine Consumption Questionnaire-Revised (CCQ-R), Alcohol Use Disorder Identification Test (AUDIT), Global Adult Tobacco Survey (GATS), and Ethiopian Demographic Health Survey 2016 for caffeine, alcohol consumption, tobacco use, and khat chewing assessment, respectively. We conducted non-consecutive two days 24-hour recall to determine the habitual intake of caffeine from caffeinated beverages and foods. Prevalence with 95% confidence interval was estimated for excess caffeine intake per day, alcohol consumption, khat chewing, and passive tobacco smoking. We ran a multivariable binary logistic regression model to identify factors associated with excess caffeine intake.
Almost all pregnant women (98.2%) consumed caffeine as estimated using the 2 days 24-hour average. The median daily caffeine intake was 170.5 mg and ranged from 0.00 mg to 549.8 mg per day. In addition, 17.6% (95% CI: 13.9%, 22.0%) of them had a daily caffeine consumption of 300 mg and above exceeding the WHO recommended daily caffeine intake during pregnancy. The prevalence of alcohol consumption and Khat chewing were 10.0% (95% CI: 7.2%, 13.7%) and 35.8% (95% CI: 30.8, 41.0%) respectively. None of the pregnant women were active tobacco smokers. However, 23.2% (95% CI: 19.0, 28.0%) were passive tobacco smokers. We found that pregnant women in the richest wealth quintile (AOR = 3.66; 95% CI: 1.13, 11.88), and the first trimester of pregnancy (AOR = 4.04; 95% CI: 1.26, 13.05) had higher odds of consuming excessive caffeine.
The study showed a considerable magnitude of substance use among pregnant women in the study area. Given this findings, we recommend, programs and services focusing on pregnant women to consider addressing substance use.
怀孕期间过量摄入咖啡因、饮酒、吸烟和恰特草会对胎儿健康产生不良影响。世界卫生组织（WHO）建议每日咖啡因摄入量不超过 300 毫克。同样，建议孕妇避免饮酒、使用恰特草和吸烟。然而，在埃塞俄比亚等发展中国家，关于孕妇使用这些物质的流行情况并没有得到很好的研究。因此，本研究旨在估计怀孕期间咖啡因和酒精摄入、咀嚼恰特草和吸烟的流行情况，并确定与过量摄入咖啡因相关的关键因素。
我们进行了一项基于社区的横断面研究，并使用随机抽样技术招募了 352 名孕妇。我们改编了咖啡因摄入问卷修订版（CCQ-R）、酒精使用障碍识别测试（AUDIT）、全球成人烟草调查（GATS）和 2016 年埃塞俄比亚人口与健康调查的问卷，分别评估咖啡因、酒精摄入、烟草使用和恰特草咀嚼情况。我们进行了非连续两天的 24 小时回忆，以确定来自含咖啡因饮料和食物的习惯性咖啡因摄入量。每天过量摄入咖啡因的患病率采用 95%置信区间进行估计，包括酒精摄入、咀嚼恰特草和被动吸烟。我们进行了多变量二项逻辑回归模型分析，以确定与过量摄入咖啡因相关的因素。
几乎所有孕妇（98.2%）都摄入了咖啡因，这是通过两天 24 小时的平均摄入量估计的。每日咖啡因摄入量中位数为 170.5 毫克，范围为 0.00 毫克至 549.8 毫克。此外，17.6%（95%CI：13.9%，22.0%）的孕妇每天摄入 300 毫克或以上的咖啡因，超过了 WHO 怀孕期间推荐的每日咖啡因摄入量。酒精摄入和咀嚼恰特草的流行率分别为 10.0%（95%CI：7.2%，13.7%）和 35.8%（95%CI：30.8，41.0%）。没有孕妇是主动吸烟者。然而，23.2%（95%CI：19.0%，28.0%）的孕妇是被动吸烟者。我们发现，最富有财富五分位数的孕妇（AOR=3.66；95%CI：1.13，11.88）和妊娠早期（AOR=4.04；95%CI：1.26，13.05）的孕妇更有可能摄入过量咖啡因。
该研究表明，在研究地区孕妇中存在相当大的物质使用情况。鉴于这一发现，我们建议针对孕妇的方案和服务考虑解决物质使用问题。
