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Selenium, Zinc and Iron Status of Pregnant Women and Zinc Content of Selected Traditional Foods in Obio-Akpor L.G.A Rivers State, Nigeria

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Selenium, Zinc and Iron Status of Pregnant Women and Zinc Content of Selected Traditional Foods in Obio-Akpor L.G.A Rivers State, Nigeria.

ABSTRACT

The study was designed to have both survey and biochemical components. Three communities were selected randomly from twelve communities in the Obio-Akpor local government area.

The sample size was calculated using the maternal mortality ratio for pregnant women in Nigeria which was 30%.

Two hundred pregnant women were purposively selected from health care centers, public and private clinics providing ante-natal care, and from traditional birth attendants and local delivery homes.

The survey component assessed the socio-economic and demographic characteristics of the respondents using a structured questionnaire to collect information on mothers’ age, pregnancy age, number of deliveries, education, occupation, food frequency consumption, weighed food intake, and clinical signs of malnutrition.

The biochemical assessment was carried out using standard procedures in assessing iron, selenium, and zinc status of pregnant women and zinc content of selected traditional foods consumed in Obio-Akpor LGA.

Serum iron, selenium, and zinc were determined using atomic absorption spectrometry model number Buck 210/11. The analytical procedures of the Association of the Official Analytical Chemists were used for the proximate composition and mineral composition of the traditional foods.

The questionnaire was coded and entered into the computer using the Statistical Package for Social Sciences (SPSS) version 16.

The data were analyzed using descriptive statistics. Chi-square analysis and Pearson’s correlation were used to identify variables that had a significant role in influencing micronutrient (iron, selenium, and zinc) status.

The study showed that 40% of the pregnant women were iron deficient and 97.3% were zinc deficient. No case of selenium deficiency was identified in the present study.

Occupation of women, pregnancy age, and ‘‘who receives the best portion of food” had a significant (P<0.05) association with the iron and zinc status of the pregnant women.

There was a significant (P<0.05) association between iron status and signs and symptoms of iron deficiency namely weakness and reduced physical activity.

There was a significant (c2 = 39.304; P= 0.05) association between education and occupation. Educational
status significantly (c2 =44.475; P=0.05) differed with age at marriage. Educational status and number of children was equally highly significant (c2 =32.024; P=0.05).

There was a positive association between income and availability of money to purchase food (c2 =17.240; P= 0.05). Occupation and availability of money to purchase food also had a positive relationship (c2=16.808; P=0.05).

There was a positive association between weakness and fatigue (r=0.355; P<0.05); weakness and reduced physical activity (r=0.351; P< 0.05) in relation to iron: loss of appetite and diarrhea (r=0.157; P<0.05) in relation to zinc.

The mineral composition of zinc in the foods ranged from figures 4.37mg/100g (shark fish) to 55.55mg/100g (oysters).

The iron contents of the foods ranged from shark fish (2.91mg/100g) to sardine fish (14.93mg/100g). When compared with FAO/WHO requirement values, the pregnant women had lower dietary intakes of nutrients crucial in pregnancy such as zinc (72.9%), niacin (74.11%), thiamin (78.567%), riboflavin (87.85%), and calcium (96.99%).

There were differences in food consumption patterns among pregnant women, indicating that the foods consumed were determined by availability, affordability, and seasonality.

TABLE OF CONTENT

TITLE PAGE————————————————————————-i
APPROVAL PAGE—————————————————————–ii
CERTIFICATION PAGE——————————————————– -iii
DEDICATION———————————————————————–iv
ACKNOWLEDGMENTS———————————————————–v
LIST OF TABLES——————————————————————-x
LIST OF FIGURES—————————————————————-xii
ABSTRACT———————————————————————–xiii

CHAPTER ONE

1.0 INTRODUCTION————————————————————– 1
1.1 Background to the study—————————————————— 1
1.2 Statement of problem——————————————————— 3
1.3 Objectives———————————————————————- 5
1.4 Significance of the study—————————————————– 5

CHAPTER TWO

2.0 LITERATURE REVIEW —————————————————- 7
2.1 Nutrition and pregnancy—————————————————- 7
2.1.1 Improving pregnancy outcomes through nutrition———————– 8
2.1.2 Importance of micronutrient nutrition in reproductive health———- 9
2.2 Micronutrients and pregnancy——————————————— 10
2.3 Maternal morbidity ———————————————————- 11
2.3.1 Maternal mortality ———————————————————– 13
2.3.2 Distribution of maternal mortality —————————————– 14
2.3.3 Causes of maternal deaths ————————————————– 16
2.3.4 Effect of Nutrition on Maternal morbidity and mortality—————- 16
2.4 Nutrition throughout the life cycle—————————————– 18
2.5.0 Iron—————————————————————————– 19
2.5.1 Dietary sources of iron——————————————————- 20
2.5.2 Absorption and utilization of iron—————————————— 20
2.5.3 Iron requirements in pregnancy——————————————– 21
2.5.4 Iron deficiency————————————————————— 22
2.6.0 Anaemia and maternal mortality——————————————- 23
2.7.0 Selenium ———————————————————————- 25
2.7.1 Dietary sources of selenium————————————————- 26
2.7.2 Absorption and utilization of selenium———————————— 26
2.7.3 Selenium requirements in pregnancy————————————– 27
2.7.4 Selenium deficiency——————————————————— 27
2.8.0 Zinc—————————————————————————- 28
2.8.1 Dietary sources of zinc——————————————————- 28
2.8.2 Absorption and utilization of zinc—————————————— 29
2.8.3 Zinc requirements in pregnancy——————————————– 30
2.8.4 Zinc deficiency—————————————————————- 30
2.9.0 Prevalence of micronutrient deficiencies (iron, selenium and zinc in
Pregnant women) ————————————————————– 31
2.9.1 Nutrition assessment of pregnant women———————————– 32
2.9.2 Anthropometric evaluation————————————————— 32
2.9.3 Biochemical assessment—————————————————— 32
2.9.4 Clinical evaluation———————————————————— 33
2.9.5 Dietary assessment———————————————————— 33
2.9.6 Indicators of iron, selenium and zinc deficiencies————————- 35

CHAPTER THREE

3.0 MATERIALS AND METHODS———————————————— 37
3.1 Study area———————————————————————– 37
3.2 Sample population————————————————————– 37
3.3 Study design——————————————————————— 37
3.4 Sample size and size calculation———————————————- 38
3.5 Sampling technique————————————————————- 38
3.6.0 Data collection instrumentations and methods—————————– 38
3.6.1 Questionnaire—————————————————————— 38
3.6.2 Collection of blood samples————————————————- 39
3.6.3 Biochemical analysis of iron, selenium, and zinc ————————– 39
3.6.4 Clinical assessment of pregnant women———————————— 40
3.6.5 Dietary assessment using weighed food intake—————————- 41
3.6.6 Dietary assessment using food frequency questionnaire —————— 41
3.6.7 Proximate analysis of zinc content of traditional foods—————— 41
3.7 Ethical clearance and consent form——————————————- 42
3.8 Data analysis——————————————————————– 42

CHAPTER FOUR

4.0 RESULTS————————————————————————- 43
4.1 Background information of the women studied—————————— 43
4.2 Household food security and feeding patterns of respondents————- 45
4.2.1 Obstetrics characteristics of the respondents studied———————– 48
4.3 Factors that influence nutritional status of respondents ——————– 50
4.4 Food frequency consumption and weighed food intake of the
respondents ———————————————————————- 55
4.5 Signs and symptoms of iron, selenium, and zinc deficiency in
respondents ———————————————————————- 62
4.6 Nutrient compositions of some selected traditional foods consumed
in Rivers State. ——————————————————————- 65
4.7 Biochemical assessment of micronutrients (iron, selenium, and zinc)
in the respondents studied——————————————————- 67
4.8 Relationship between socioeconomic and demographic variables and
the prevalence of micronutrient deficiency in the respondents————- 68
4.9 Relationship between signs and symptoms and the prevalence
of iron, selenium, and zinc in the respondents studied———————— 82
4.9.1 Correlation of relationships among the variables—————————– 84

CHAPTER FIVE

5.0 DISCUSSION—————————————————————— 89
5.1 Socioeconomic characteristics of the respondents studied—————- 89
5.2 Household food security and feeding patterns of the pregnant
women studied——————————————————————- 90
5.3 Food frequency consumption————————————————- 91
5.4 Clinical signs of iron, selenium, and zinc in the respondents
studied————————————————————————— 93
5.5 Nutrient composition of some selected traditional foods in
Rivers State———————————————————————- 93
5.6 Micronutrients (iron, selenium, and zinc) status of the respondents
studied and their determinants———————————————— 95
CONCLUSION————————————————————————- 99
RECOMMENDATIONS————————————————————— 101
REFERENCES————————————————————————- 102

INTRODUCTION

1.1 Background to the Study

Micronutrients encompass vitamins and minerals which are essential for human development and functioning. They are needed in small amounts. Micronutrients are well known to play an important role in the maintenance of health.

Alterations in the maternal-fetal disposition of some essential nutrients could be a potential health risk for the mothers as well as the fetus.

Micronutrient malnutrition is primarily related to inadequate dietary intake and pregnancy places women at risk of nutritional problems due to an increased need for both macro and micronutrients during pregnancy.

Deficiencies of micronutrients (iron, selenium, and zinc) during pregnancy continue to be a problem of considerable magnitude in most developing countries of the world.

Childbirth remains one of the biggest health risks for women, especially in developing countries. Fifteen hundred women (1,500), die every day during delivery, which is half a million mothers every year (UNICEF, 2009).

The WHO, (2007) estimated that about 80% of maternal deaths are due to direct causes which are hemorrhage, sepsis, eclampsia, and unsafe abortion. About 20% are due to indirect causes including anemia, malaria, and heart disease (WHO, 2007).

The micronutrient status of mothers can affect hemorrhage, anemia, eclampsia, sepsis, and perhaps malaria. In addition, micronutrients can reduce morbidity.

Adequate micronutrient nutrition for pregnant women is critical for the health and survival prospects of both mothers and newborns. Micronutrient deficiencies of mothers increase their health risks as well as that of their babies.

REFERENCES

Agett, P.J., & Favier, A. (1993). Zinc. International Journal of Vitamin Nutrition Research, 63, 247-316.
ACC/SCN (2000). Fourth Report on the World Nutrition Situation: Nutrition throughout the life cycle. Pp 1:14. United Nations Standing Committee, Geneva, in collaboration with the International Food Policy Research Institute, Washington.
ACC/SCN (2004). Fifth Report on the World Nutrition Situation: Nutrition for improved development outcomes. United Nations Standing Committee, Geneva.
Alauddin, M. (1986). Maternal Mortality in rural Bangladesh: The Tangail district. Studies in family Planning, 17, 13-21. (Medline).
Al-Saleh, E. (2005). Maternal-fetal status of Copper, Iron, Molybdenum, Selenium and zinc in insulin-dependent diabetic pregnancies. Archives of Gynecology Obstetrics, 271,212-7.
Andrews, N.C. (1999). Disorders of iron metabolism. New England Journal of Medicine, 341.

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