Micronutritional Status of Yemeni Pregnant Women & Its Effects on the Outcome of Pregnancy

Abstract

Background: Nutrition plays a crucial role in the prevention, reduction of risk factors and management of chronic diseases. Pregnancy is associated with increased demand for all micronutrients. Altered plasma levels of iron, zinc and vitamin A during pregnancy are known to have profound effects on pregnant women and their newborns. The status and effects of these micronutrients is not known in pregnant women in Yemen. Objective: This study aimed to assess micronutritional status of vit.A, iron, and zinc of Yemeni pregnant women and their newborns and to examine the relationship of maternal micronutritional status to the outcome of pregnancy. The study was also to investigate the relationship between maternal socioeconomic status and micronutrients level. Materials & Methods: This is a descriptive cross sectional study that was carried at Al-Sabeen maternal referral hospital in Sana'a. It included 184 subjects, 92 Yemeni pregnant women coming for delivery and their newborns after taking their consent. A questionnaire was used to collect personal, socioeconomic data and dietetic history. Blood samples from mothers and umbilical cord were analyzed for hemoglobin, serum iron, ferritin, total iron binding capacity (TIBC), zinc and vitamin A (vit.A). Results: Most of the mothers (91.3%) were housewives; 34.78% of them were illiterate. Dietetic history showed that carbohydrates were the predominant nutrients. Thirty four mothers (36.96%) used vitamins and mineral supplements. Qat chewing was only practiced by 30 mothers (32.61%) and it was not statistically related to their parameters or their newborns’. Seventy three mothers (79.35%) drink tea with or immediately after meals. It was significantly related to mothers' hemoglobin and serum iron levels and to newborns' hemoglobin & serum vit.A levels. Child marriage (<18yrs) was observed in 23.91% and it was significantly related to their hemoglobin. VI The mean hemoglobin concentration of mothers was 11.78 ± 1.32 g/dL and that of their newborns was 14.69 ± 1.25 g/dL. Sixty seven mothers (72.8%) had normal hemoglobin, while 25 (27.2%) were anaemic. Forty four mothers (50%) had serum iron levels less than normal range. Mean serum TIBC for the mothers was 468.40 ± 318.84 μg/dL; while that of their newborns was 309.81± 152.17 μg/dL. Fifty nine mothers (67.82%) and 76 of newborns (93.83%) had normal serum ferritin levels. Fifty four mothers (60.67%) and 45 (53.57%) of newborns had normal serum zinc levels. Most of the mothers (96.67%) and their newborns had normal serum vit.A levels. Micronutrient status of newborns was found to be significantly correlated to their mothers' micronutrient status in all studied biochemical parameters. Regarding the pregnancy outcome, the number of pregnancies was significantly related to maternal serum iron and their newborns' hemoglobin levels. The mean of the newborns' weight was 2.8 ±0.47 kg. Most of the newborns (n=75, 81.52%) had normal birth weight. It was significantly related only to their mothers' hemoglobin and serum zinc levels. Neonatal assessment revealed that 90 of the newborns (97.83%) had normal Apgar score. Conclusions: These results indicated that maternal drinking of tea with or immediately after meals was significantly related to mothers' hemoglobin and serum iron levels and to newborns' hemoglobin and serum vit.A levels. Early marriage was related to mothers’ hemoglobin. Micronutrient status of newborns was found to be correlated to their mothers' micronutrient status. Most of the mothers and new borns had normal vit.A levels. Serum zinc was low in about 44% of newborns; this may be a reflection of low zinc among a large number of mothers (34%). Supplementation, nutritional education and counseling may improve dietary intake and habits which is crucial for maternal and newborn health.