Department of Public Health, College of Medicine and Health Science, Wolkite University, Wolkite, Ethiopia.
School of Public Health, College of Health Science and Medicine, Addis Ababa University, Addis Ababa, Ethiopia.
PLoS One. 2024 Apr 30;19(4):e0300480. doi: 10.1371/journal.pone.0300480. eCollection 2024.
Low birth weight (LBW) is a major public health problem in Ethiopia. Dietary diversity is a key indicator of maternal dietary adequacy that may affect birth weight but little is known about their relationship. Hence, this study aimed to assess the association of suboptimal maternal dietary diversity during pregnancy and low birth weight in Gurage Zone, Ethiopia.
The prospective study was conducted among 1062 pregnant women enrolled consecutively in between 16 to 20 gestational weeks and followed until delivery. The baseline data were collected at recruitment and dietary diversity was assessed using the minimum dietary diversity score for women (MDD-W) tool in three different rounds. The average of three scores was considered to categorize women into optimal (consumed ≥ 5 food groups) and suboptimal (consumed < 5 food groups) dietary diversity groups. The risk of low birth weight among suboptimal dietary diversity was assessed using modified Poisson regression with robust standard error.
Of the 1062 pregnant women recruited, 959 (90.4%) women completed follow-up. Among them, 302 (31.5%) women are having optimal and the rest, 657 (68.5%) women are having suboptimal dietary diversity. The risk of low birth weight was significantly higher among women with sub-optimal dietary diversity than among those with optimal diversity (ARR = 1.89, 95% CI: 1.25, 2.84). Other factors such as rural residence (ARR = 1.61, 95% CI: 1.43, 1.87), age > = 35 years (AAR = 3.94, 95% CI: 2.41, 6.46), being underweight (ARR = 1.81, 95% CI: 1.14, 2.86), height < 150cm (ARR = 4.65, 95% CI: 2.52, 8.59), unwanted pregnancy (ARR = 3.35, 95% CI: 2.23, 5.02), preterm delivery (3.65, 95% CI: 2.27, 5.84) and lack of nutritional counseling (ARR = 1.69, 95% CI: 1.08, 2.67) significantly increased the risk of low birth weight.
Suboptimal dietary diversity associated low birth weight. Promoting dietary diversity by strengthening nutritional education and avoiding unwanted pregnancy particularly among rural residents may help to reduce the incidence of low birth weight.
低出生体重（LBW）是埃塞俄比亚的一个主要公共卫生问题。饮食多样性是衡量孕产妇饮食充足程度的一个关键指标，可能会影响出生体重，但人们对此知之甚少。因此，本研究旨在评估古尔加泽地区孕妇妊娠期间饮食多样性不足与低出生体重之间的关系。
这是一项前瞻性研究，共纳入了 1062 名在妊娠 16 至 20 周期间连续入组并随访至分娩的孕妇。在招募时收集基线数据，并使用女性最低饮食多样性评分（MDD-W）工具在三个不同轮次评估饮食多样性。将三个分数的平均值用于将女性分为饮食多样性最佳（摄入≥5 种食物组）和不足（摄入<5 种食物组）两个组。使用校正后的泊松回归模型和稳健标准差评估亚最佳饮食多样性与低出生体重之间的风险比（ARR）。
在招募的 1062 名孕妇中，有 959 名（90.4%）孕妇完成了随访。其中，302 名（31.5%）孕妇饮食多样性最佳，其余 657 名（68.5%）孕妇饮食多样性不足。与饮食多样性最佳的孕妇相比，饮食多样性不足的孕妇发生低出生体重的风险显著更高（ARR=1.89，95%CI：1.25，2.84）。其他因素，如农村居住（ARR=1.61，95%CI：1.43，1.87）、年龄≥35 岁（AAR=3.94，95%CI：2.41，6.46）、体重过轻（ARR=1.81，95%CI：1.14，2.86）、身高<150cm（ARR=4.65，95%CI：2.52，8.59）、非意愿妊娠（ARR=3.35，95%CI：2.23，5.02）、早产（ARR=3.65，95%CI：2.27，5.84）和缺乏营养咨询（ARR=1.69，95%CI：1.08，2.67）也显著增加了低出生体重的风险。
饮食多样性不足与低出生体重有关。通过加强营养教育和避免农村居民中非意愿妊娠，可以促进饮食多样性，这可能有助于降低低出生体重的发生率。
