Prevalence and factors associated with undernutrition among pregnant women attending the antenatal clinic at Kawempe Referral Hospital

Abstract

Background: Maternal undernutrition in Africa remains a challenge and is associated with poor pregnancy outcomes such as anemia, poor fetal development, preterm delivery and low birth weight leading to increased infant morbidity and mortality. The prevalence of maternal undernutrition in Africa remains above 10%. Despite the multiple complications associated with maternal undernutrition, there is paucity of data regarding nutritional studies among pregnant women in Uganda. This study investigated the prevalence and factors associated with undernutrition among pregnant women attending the antenatal clinic at Kawempe Referral Hospital. Methods: We conducted a facility based cross-sectional study in June and July 2021. A total of 970 pregnant women were enrolled and assessed for undernutrition using their MUAC. Interviewer administered questionnaires were used to collect data on participants’ individual, house-hold, community, health and nutritional information. Categorical data was summarized using percentages while continuous variables were summarized by calculating the mean, standard deviation, median, range. Differences between groups for categorical variables were assessed using chi-squared or Fisher's exact tests depending on the numbers. Associations between undernutrition and independent variables were explored using a binary logistic regression model. A p-value of less than 0.05 was considered significant at 95% level of confidence. Independent variables with a p-value of less than 0.2 were assessed for interaction, confounding using multivariate analysis. Results: Of the 970 pregnant women that were recruited, majority were aged 20-29 years, had completed secondary education, were married and lived in urban areas. The prevalence of undernutrition among pregnant women was 4.9% (95%CI 3.58 – 6.39). Salaried employment (aOR = 2.53, 95%CI 1.05 - 6.10, p value = 0.039) and house-holds headed by relatives (aOR = 3.3, 95%CI 1.52 – 7.32, p value = 0.003) were independently associated with undernutrition. In addition, women having 1 to 2 children were less likely to have undernutrition (aOR = 0.21, 95%CI 0.08 - 0.55, p value = 0.002) compared to those without children. Conclusion: The prevalence of undernutrition among pregnant women in this study is lower than most studies in Africa. Pregnant women with salaried employment, living in households headed by relatives and having no children were factors associated with undernutrition. Nutritional education should be offered to pregnant women with the above risk factors.