Nutritional and Psychological Implications of Low Micro-Nutrient Status of Pregnant Women in Imo State, Nigeria

Article excerpt

INTRODUCTION

Micro-nutrient malnutrition has become a global problem of immense proportions (ACC/SCN, 1992). Deficiency of iron, vitamin A and iodine is associated with increased mortality rates amongst most poor women, infants and children. It has been suggested that vitamin A status of pregnant women can affect vitamin A source in the liver of the foetus (Underwood, 1994).

The likelihood of a normal labour is better in women brought up in good circumstances, who have eaten a satisfactory diet from birth to maturity (FAO\ WHO, 1994), received good medical care, and continue to have these advantages during pregnancy than those women of the poorer socio-economic classes (Davidson et al., 1990). Hence poor maternal nutrition, before and during pregnancy, is a major cause of poor pregnancy outcomes especially in developing countries (WHO, 1995; Kramer, 2003). Micronutrient deficiency during pregnancy contributes to poor maternal weight gain which affects the birth weight of babies. Weight gain during pregnancy is widely used as an indicator of the adequacy of nutrition during pregnancy and has been associated with infant outcome such as mortality, prematurity and low birth weight (WHO, 1995; Caulifield et al., 1998).

Poor nutrition and inadequate micronutrient's intake during pregnancy often begin in uterus and extend throughout the life cycle (Schroll et al., 1997). Under nutrition manifests in decreased maternal height (stunting), and below normal maternal pregnancy weight and pregnancy weight gain (Prentice et al., 2001). Infants born with low birth weight (IBW) suffer extremely low weight, morbidity and mortality from infectious and diseases and are underweight, stunted or wasted beginning in the neonatal period and through childhood (ACC/SCN 2000). Infants weighing 2.0-25kg at birth are more likely to die during their first 28 days of life than infants who weigh 2.5-3.0kg and 3.0-3.5kg at birth (Gulmezo in et al., 1997). Death of infants, especially among Nigerians who highly value children, goes with numerous psychological challenges such as depression, guilt, spouse abuse and divorce (Uwaoma et al, 2011).

Low birth weight is associated with impaired immune function, poor cognitive development and risk of developing acute diarrhea or pneumonia (Baker and Osmond, 1986). It is postulated that almost half of infant deaths from pneumonia and diarrhea could have been prevented if low birth weights as a result of low nutrient status of their mothers were eliminated (Baker and Osmond, 1986). Infants born with LBW face an increased risk of chronic diseases including high blood pressure, non insulin dependent diabetes mellitus, coronary heart diseases and stroke in adulthood. Again these diseases are killers among rural and poor folks in developing nations and often create opportunities for allied illnesses among children, infants, and adults.

EMPIRICAL REVIEW

Maternal under-nutrition is widely recognized as a major public health issue in the developing world and it is estimated that between 10% and 19% of women in many countries of the developing world are undernourished with a Body Mass Index (BMI) of less than 18.5 (Black et al., 2008). Studies in Dietary intake and micronutrient s tatus s how that maternal micronutrient deficiency in iron, vitamin A, zinc and vitamin B12, iodine and folate are widespread and have a negative impact on pregnancy outcome (Sunawarg et al., 2009). Thus, it is established that micronutrient deficiency plays a major role in increasing morbidity and mortality (Bhutta et al., 2008). Poor cognitive development, marasmus, poor psychomotor development, growth retardation and inadequate nutritional balance are some of the adverse consequences of low pregnant mothers' micronutrients status (Afam-Anene, 2008).

Micronutrients have important influences on health of pregnant women and the growing fetus (Allen, 1997). Iron deficiency results in anemia which may increase the risk of death from hemorrhage during delivery. …