CHAPTER ONE
INTRODUCTION
- BACKGROUND OF STUDY
Pregnancy is a critical stage of development during which maternal nutrition can strongly influence obstetric and neonatal outcomes (Godfrey et al., 1996; Kramer, 2003). Optimal nutrition is necessary to maintain the health of the mother, to help ensure a normal, healthy delivery, and also to reduce the risk of birth defects, sub-optimal. foetal development and chronic health problems in childhood (American Dietetic Association, 2008).
The World Health Organization (WHO) defines poor nutrition as ‘the cellular imbalance between the supply of nutrients and energy and the body’s demand for them to ensure growth, maintenance, and specific functions’. Contrary to the common use, the term malnutrition refers not only to deficiency states but also to excess and imbalance in the intake of calories, proteins and/or other nutrients.
Poor nutritional status and sub-optimal pre- and antenatal care are common in developing countries, often resulting in pregnancy complications and poor obstetric outcomes (Hampshire et al., 2004). Pregnant women in Sub-Saharan Africa (SSA) are at particular nutritional risk as a result of poverty, food insecurity, political and economic instabilities, frequent infections, and frequent pregnancies (Lartey, 2008). The main nutritional issues impacting these women include maternal under- and over-nutrition and deficiencies of key pregnancy micronutrients, such as iron, folate, calcium, vitamin D and vitamin A. Consequently, poor obstetric outcomes, such as anaemia, neural tube defects (NTDs), rickets, and low birth weight (LBW) and maternal and neonatal mortality are common in Nigeria.
Pregnancy and breastfeeding predispose to under nutrition due to deficient intake of appropriate food requirement as a result of increased nutritional demand or losses. The children of malnourished women are not spared from the havoc of under nutrition. They are more likely to face cognitive impairments, short stature, lower resistance to infections, and a higher risk of disease and death throughout their lives. In general, fetal exposure to malnutrition is associated with congenital anomalies, intrauterine growth restriction, lower birth weight, stunting in childhood, shorter adult height, lower educational attainment, and reduced economic productivity. Stunted women often encounter greater risks during pregnancy such as obstructed labor, while low birth weight babies from malnutrition have been linked to an increased risk of obesity and NCDs in later life.
A balanced amount of nutrients is necessary for the proper functioning of the body system. Nutrition is a fundamental pillar of human life, health and development throughout the entire life span1. Proper food and good nutrition are essential for survival, physical growth, mental development, performance and productivity, health, and wellbeing. However, nutrition requirements vary with age, gender, and during physiological changes such as pregnancy. Pregnancy is such a critical phase in a woman's life when the expecting mother needs optimal nutrients of superior quality to support the developing fetus.
Malnutrition manifests itself as a function of many and complex factors that affect the national child status. It is directly linked to inadequacy in diet and diseases under living conditions factors that include crisis in household food supply, inappropriate childcare and feeding practices, unhealthy place of residence and insufficient basic health services for those in poor socioeconomic situations, cultural beliefs, and lack of parents’ education, especially that of mothers.
Malnutrition is a serious public health challenge which has been directly associated with increased mortality and morbidity rate especially in many parts of developing countries. According to World Health Organization (WHO), 585,000 deaths resulting from pregnancy and childbirth related complications occur globally with about 1,500 deaths recorded daily, however most of these deaths occur in developing countries. In Nigeria, there still remains dearth in the number of published studies showing the exact number of deaths recorded. However, an incidence rate of 10–40% has been reported in a rural community in the northern part of Nigeria. Also 75% of pregnant women from the western part of Nigeria were reported to have had inadequate dietary energy intake. Nevertheless, Poor nutrition in pregnancy negatively affects the woman’s health and that of the unborn child. To the woman, it causes weakness and lethargy, anaemia and loss of life for both the mother and the foetus and also reduces the woman’s lactation performance
An adequate nutritional status of pregnant women is essential for their health and pregnancy outcomes. Due to increased nutritional requirements, pregnancy is a critical period for meeting the body’s demand for macro/ micronutrients. Thus, anemia and vitamin A deficiency (VAD) are common micronutrient deficiencies that affect 53.8 million pregnant women in the world.
- STATEMENT OF THE PROBLEM
Maternal mortality is unacceptably high. About 800 women or more die from pregnancy or childbirth-related complications around the world every day.
Furthermore, because of little amount or no nutrients and low energy transferred to the foetus, intrauterine growth restrictions occur and the baby becomes small for his gestational age, and may develop some abnormalities and could be born prematurely with a low birth weight and resultant death in some cases.
Poor nutrition is prevalent in pregnant women residing in rural and low income areas and has been observed to be mostly affected due to high consumption of inadequate amount of micronutrients as a result of resource limitations. Intake of micronutrients less than the recommended values increase women’s risk of micronutrient deficiencies. Therefore, the maintenance of adequate nutrition especially during pregnancy is of utmost importance in order to ensure good health and optimal performance for both mother and her unborn child.
Poor nutrition in pregnancy, in combination with infections, is a common cause of maternal and infant mortality and morbidity, low birth weight and intrauterine growth retardation (IUGR). Malnutrition remains one of the world’s highest priority health issues, not only because its effects are so widespread and long lasting but also because it can be eradicated best at the preventive stage. Maternal malnutrition is influenced not only by lack of adequate nutrition but also influenced by social and psychological factors, nutritional knowledge of mothers, and biological changes that influence perceptions of eating patterns during pregnancies
Finally, many women in Africa suffer from chronic energy deficiency, inadequate weight gain during pregnancy, and poor micronutrient status. Insufficient food intake, high energy expenditure, micronutrient-deficient diets, infections, and the demands of pregnancy and lactation contribute to maternal malnutrition. Thus, research on effect of poor nutrition on pregnant women.
- AIMS AND OBJECTIVES
The main aim of the study is the effect of poor nutrition on pregnant women. Other specific objectives include:
1. to determine the relationship between poor nutrition and pregnant women.
2. to examine the effect of poor nutrition on pregnant women.
3. to identify factors responsible for poor nutrition on women.
4. to investigate ways to improve on the nutritional intake of pregnant women.
- RESEARCH QUESTION
1. what is the relationship between poor nutrition and pregnant women?
2. what is the effect of poor nutrition on pregnant women?
3. what are the factors responsible for poor nutrition on women and ways to enlighten women on the importance of good nutrition for both mother and child?
4. what are the ways to improve on the nutritional intake of pregnant women?
- STATEMENT OF RESEARCH HYPOTHESIS
1. H0: poor nutrition has no significant effect on pregnant women.
2. H1: poor nutrition has a significant effect on pregnant women.
- SIGNIFICANCE OF STUDY
The study will be of benefit to pregnant women especially those in the rural areas on the importance of nutrition to their health and tat of their babies to avoid any form of complication during childbirth and even after.
Poor nutrition can be attributed to a lot of factor, so this study will help women understand the necessary nutrients needed in every meal.
Findings of this study will serve as a wakeup call to medical practitioners and all health workers on the need to inculcate nutrients requirements in the teachings during antenatal and also take a cross examination on these women to be sure they are not malnourished. This will go a long way in curbing the high rate of mortality during child birth.
- SCOPE OF STUDY
The scope of study will cover effect of poor nutrition on pregnant women.
- LIMITATION OF STDUY
1. Financial constraint- Insufficient fund tends to impede the efficiency of the researcher in sourcing for the relevant materials, literature or information and in the process of data collection (internet, questionnaire and interview).
2. Time constraint- The researcher will simultaneously engage in this study with other academic work. This consequently will cut down on the time devoted for the research work.
- DEFINITION OF TERMS
Effect: a change which is a result or consequence of an action or other cause.
Poor nutrition: Malnutrition is a serious condition that happens when your diet does not contain the right amount of nutrients. It means "poor nutrition" and can refer to: under nutrition not getting enough nutrients.
Pregnant women: pregnancy is the condition of having a developing embryo or fetus in the body, after union of an oocyte (ovum) and spermatozoon. The average gestation period for a human pregnancy is 10 lunar months (280 days) from the first day of the last menstrual period. Pregnant women are women carrying fetus in the body.
