Multiple Micronutrients Versus Iron Folic Acid on Pica and Hemoglobin Levels Among Pregnant Women in Kenya

Betsy Chebet Rono; Yeri Kombe; Anselimo Makokha

doi:doi:10.11648/j.cajph.20180404.11

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Multiple Micronutrients Versus Iron Folic Acid on Pica and Hemoglobin Levels Among Pregnant Women in Kenya

Betsy Chebet Rono, Yeri Kombe, Anselimo Makokha

Published in Central African Journal of Public Health (Volume 4, Issue 4)

Received: 6 July 2018 Accepted: 25 July 2018 Published: 27 August 2018

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Abstract

Pica is an indicator of low micronutrients in a pregnant woman’s health. Low micronutrients pose a great risk to an otherwise healthy pregnancy. A healthy pregnancy, results in a healthy mother and baby; the critical probability in every pregnancy. The aim of the study was to introduce multiple micronutrients to promote maternal nutrition and influence development in pregnancy health outcomes. Sub-populations at risk of nutritional deficiencies and provided opportunities for early intervention to support the known benefit of multiple micronutrients on pregnancy outcomes i.e. up to six weeks (42 days) post delivery. The variations on pregnancy health, pica and hemoglobin levels among the Multiple Micronutrients (MMs) and Iron Folic Acid (IFA) groups. This was a block randomized controlled study. The intervention arm received MMs while the control received the usual care of IFA. A structured questionnaire with open and closed ended questions was used. Focus group discussions were conducted using a semi-structured guide to collect the qualitative data on the effects of prenatal multiple micronutrients among the pregnant women. The study assumed equal variances based on the Levene’s test of >0.10 (f, 0.196, p=0.661). The difference in inter trimester weight gain means was 5.85 kgs for MMs and 5.52 kgs for IFA (t, 0.109, p=0.914), duration to resumption of household work was 7 days for MMs and 14 days for the IFA groups. The hemoglobin level increased by; 1.25 g/dl for MMs, and 0.45 g/dl for the IFA (t, 0.897, p= 0.376). Pica for stones was experienced among 55.6% of pregnant women; however there was no pica within 14 days among MMs enrollment, but persisted in the IFA group. The study demonstrated no significance in the importance of multiple micronutrients in increasing hemoglobin level (P,0.376), reduction of pica craving during pregnancy (P,0.176) and resumption of household duties (P,0.067) post delivery compared to those on Iron Folic Acid.

Published in	Central African Journal of Public Health (Volume 4, Issue 4)
DOI	10.11648/j.cajph.20180404.11
Page(s)	95-101
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2018. Published by Science Publishing Group

Keywords

Nutrients Deficiencies, Pregnancy Outcomes, Weight Gain, Return to Work

References

[1]	Miao D, Young S L, Golden C D. A meta-analysis of pica and micronutrient status. American Journal of Human Biology 2015 January; 27(1): 84-93. Doi:10.1002/ajhb.22598
[2]	Ezzedin N, Zavosly R, Noroozi M, Sarichloo M E, Jahanihashemi H. The association between postpartum Depression and Pica during pregnancy. Global Journal of Health Science; vol. 8, no. 4; 2016. ISSN 1916-9736. Doi:10.5539/gjhs.v8n4p120
[3]	Lumish R A, Young S L, Looper E, Pressman E, Guillet R, O’Brien K O. Gestational Iron Deficiency is associated with Pica Behaviors in Adolescents. The Journal of Nutrition 144: 1533-1539; 2014. NCT01019902. Doi:10.3945/jn.114.192070.
[4]	Young S L, Khaitan S S, Farag T H, Kavie J A, Ali S M, Hajji H, Rasmussen K M, Pelto R J. Association of pica with anemia and gastrointestinal distress among pregnant women in Zanzibar, Tanzania. Am J. Trop. Medicine and Hygiene. 83(1), 2010, pp 144-151. Doi.10.4269/ajtmh 2010.09.0442
[5]	WHO. The global prevalence of anemia in 2011. Geneva: World Health Organization: 2015.
[6]	Ononge S, Campbell O, Mirembe F. Hemoglobin status and predictors of anemia among pregnant in Mpigi, Uganda. BMC Research Notes 2014, 7:712 http:// www.biomedcentral.com/1756-0500/7/712
[7]	Sukrat B, Wilasrusmee C, Siribumrungwong B, McEnvoy M, Okaschroen C, Attia J, Thakkinstian A. Hemoglobin concentration and pregnancy outcomes: A systematic Review and meta-analysis. Biomed Research International vol. 2013 article Id 769057. http://dx.doi.org/10.1155/2013/769057
[8]	Savajols E, Burguet A, Grimaldi M, Godoy F, Sogot P, Semama D S. Maternal Hemoglobin and short-term Neonatal outcome in preterm neonates. PLoS ONE 9(2):e89530. Doi:10.1371/journal.pone.0089530
[9]	Pena-Rosas J B, De-Regil L M, Daswel T, Viteri F E. Intermittent oral iron supplementation during pregnancy (Review) Cochrane database system Review. Author manuscript: available in PMC 2014, June 13.
[10]	Kenya National Bureau of Statistics. Kenya Demographic and Health Survey 2008-09 https://dhsprogram.com/pubs/pdf/fr229/fr229.pdf
[11]	Kenya National Bureau of Statistics. Kenya Demographic and Health Survey 2014. https://dhsprogram.com/pubs/pdf/fr308/fr308.pdf
[12]	Jwa SC, Fujiwara T, Yamanobe Y, Kozuka K, Sago H. Changes in maternity hemoglobin during pregnancy and birth outcomes. BMC Pregnancy and Childbirth (2015)15:80. Doi.10.1186/s12884-015-0516-1
[13]	Intiful F D, Wiredu E K, Asare G A, Asante M, Adjei D N. Anemia in pregnant adolescent girls with malaria and practicing pica. Pan African Medical Journal 2016; Doi.10.11604/pamj.2016.24.96.9282

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APA Style

Betsy Chebet Rono, Yeri Kombe, Anselimo Makokha. (2018). Multiple Micronutrients Versus Iron Folic Acid on Pica and Hemoglobin Levels Among Pregnant Women in Kenya. Central African Journal of Public Health, 4(4), 95-101. https://doi.org/10.11648/j.cajph.20180404.11

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ACS Style

Betsy Chebet Rono; Yeri Kombe; Anselimo Makokha. Multiple Micronutrients Versus Iron Folic Acid on Pica and Hemoglobin Levels Among Pregnant Women in Kenya. Cent. Afr. J. Public Health 2018, 4(4), 95-101. doi: 10.11648/j.cajph.20180404.11

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AMA Style

Betsy Chebet Rono, Yeri Kombe, Anselimo Makokha. Multiple Micronutrients Versus Iron Folic Acid on Pica and Hemoglobin Levels Among Pregnant Women in Kenya. Cent Afr J Public Health. 2018;4(4):95-101. doi: 10.11648/j.cajph.20180404.11

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@article{10.11648/j.cajph.20180404.11,
  author = {Betsy Chebet Rono and Yeri Kombe and Anselimo Makokha},
  title = {Multiple Micronutrients Versus Iron Folic Acid on Pica and Hemoglobin Levels Among Pregnant Women in Kenya},
  journal = {Central African Journal of Public Health},
  volume = {4},
  number = {4},
  pages = {95-101},
  doi = {10.11648/j.cajph.20180404.11},
  url = {https://doi.org/10.11648/j.cajph.20180404.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.cajph.20180404.11},
  abstract = {Pica is an indicator of low micronutrients in a pregnant woman’s health. Low micronutrients pose a great risk to an otherwise healthy pregnancy. A healthy pregnancy, results in a healthy mother and baby; the critical probability in every pregnancy. The aim of the study was to introduce multiple micronutrients to promote maternal nutrition and influence development in pregnancy health outcomes. Sub-populations at risk of nutritional deficiencies and provided opportunities for early intervention to support the known benefit of multiple micronutrients on pregnancy outcomes i.e. up to six weeks (42 days) post delivery. The variations on pregnancy health, pica and hemoglobin levels among the Multiple Micronutrients (MMs) and Iron Folic Acid (IFA) groups. This was a block randomized controlled study. The intervention arm received MMs while the control received the usual care of IFA. A structured questionnaire with open and closed ended questions was used. Focus group discussions were conducted using a semi-structured guide to collect the qualitative data on the effects of prenatal multiple micronutrients among the pregnant women. The study assumed equal variances based on the Levene’s test of >0.10 (f, 0.196, p=0.661). The difference in inter trimester weight gain means was 5.85 kgs for MMs and 5.52 kgs for IFA (t, 0.109, p=0.914), duration to resumption of household work was 7 days for MMs and 14 days for the IFA groups. The hemoglobin level increased by; 1.25 g/dl for MMs, and 0.45 g/dl for the IFA (t, 0.897, p= 0.376). Pica for stones was experienced among 55.6% of pregnant women; however there was no pica within 14 days among MMs enrollment, but persisted in the IFA group. The study demonstrated no significance in the importance of multiple micronutrients in increasing hemoglobin level (P,0.376), reduction of pica craving during pregnancy (P,0.176) and resumption of household duties (P,0.067) post delivery compared to those on Iron Folic Acid.},
 year = {2018}
}

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TY - JOUR
T1 - Multiple Micronutrients Versus Iron Folic Acid on Pica and Hemoglobin Levels Among Pregnant Women in Kenya
AU - Betsy Chebet Rono
AU - Yeri Kombe
AU - Anselimo Makokha
Y1 - 2018/08/27
PY - 2018
N1 - https://doi.org/10.11648/j.cajph.20180404.11
DO - 10.11648/j.cajph.20180404.11
T2 - Central African Journal of Public Health
JF - Central African Journal of Public Health
JO - Central African Journal of Public Health
SP - 95
EP - 101
PB - Science Publishing Group
SN - 2575-5781
UR - https://doi.org/10.11648/j.cajph.20180404.11
AB - Pica is an indicator of low micronutrients in a pregnant woman’s health. Low micronutrients pose a great risk to an otherwise healthy pregnancy. A healthy pregnancy, results in a healthy mother and baby; the critical probability in every pregnancy. The aim of the study was to introduce multiple micronutrients to promote maternal nutrition and influence development in pregnancy health outcomes. Sub-populations at risk of nutritional deficiencies and provided opportunities for early intervention to support the known benefit of multiple micronutrients on pregnancy outcomes i.e. up to six weeks (42 days) post delivery. The variations on pregnancy health, pica and hemoglobin levels among the Multiple Micronutrients (MMs) and Iron Folic Acid (IFA) groups. This was a block randomized controlled study. The intervention arm received MMs while the control received the usual care of IFA. A structured questionnaire with open and closed ended questions was used. Focus group discussions were conducted using a semi-structured guide to collect the qualitative data on the effects of prenatal multiple micronutrients among the pregnant women. The study assumed equal variances based on the Levene’s test of >0.10 (f, 0.196, p=0.661). The difference in inter trimester weight gain means was 5.85 kgs for MMs and 5.52 kgs for IFA (t, 0.109, p=0.914), duration to resumption of household work was 7 days for MMs and 14 days for the IFA groups. The hemoglobin level increased by; 1.25 g/dl for MMs, and 0.45 g/dl for the IFA (t, 0.897, p= 0.376). Pica for stones was experienced among 55.6% of pregnant women; however there was no pica within 14 days among MMs enrollment, but persisted in the IFA group. The study demonstrated no significance in the importance of multiple micronutrients in increasing hemoglobin level (P,0.376), reduction of pica craving during pregnancy (P,0.176) and resumption of household duties (P,0.067) post delivery compared to those on Iron Folic Acid.
VL - 4
IS - 4
ER -

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Author Information

Betsy Chebet Rono

Department of Public Health, School of Public Health, Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya
Yeri Kombe

Center for Public Health Research, Kenya Medical Research Institute, Nairobi, Kenya
Anselimo Makokha

Department of Food Science and Technology, Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya

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APA Style

Betsy Chebet Rono, Yeri Kombe, Anselimo Makokha. (2018). Multiple Micronutrients Versus Iron Folic Acid on Pica and Hemoglobin Levels Among Pregnant Women in Kenya. Central African Journal of Public Health, 4(4), 95-101. https://doi.org/10.11648/j.cajph.20180404.11

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ACS Style

Betsy Chebet Rono; Yeri Kombe; Anselimo Makokha. Multiple Micronutrients Versus Iron Folic Acid on Pica and Hemoglobin Levels Among Pregnant Women in Kenya. Cent. Afr. J. Public Health 2018, 4(4), 95-101. doi: 10.11648/j.cajph.20180404.11

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AMA Style

Betsy Chebet Rono, Yeri Kombe, Anselimo Makokha. Multiple Micronutrients Versus Iron Folic Acid on Pica and Hemoglobin Levels Among Pregnant Women in Kenya. Cent Afr J Public Health. 2018;4(4):95-101. doi: 10.11648/j.cajph.20180404.11

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@article{10.11648/j.cajph.20180404.11,
  author = {Betsy Chebet Rono and Yeri Kombe and Anselimo Makokha},
  title = {Multiple Micronutrients Versus Iron Folic Acid on Pica and Hemoglobin Levels Among Pregnant Women in Kenya},
  journal = {Central African Journal of Public Health},
  volume = {4},
  number = {4},
  pages = {95-101},
  doi = {10.11648/j.cajph.20180404.11},
  url = {https://doi.org/10.11648/j.cajph.20180404.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.cajph.20180404.11},
  abstract = {Pica is an indicator of low micronutrients in a pregnant woman’s health. Low micronutrients pose a great risk to an otherwise healthy pregnancy. A healthy pregnancy, results in a healthy mother and baby; the critical probability in every pregnancy. The aim of the study was to introduce multiple micronutrients to promote maternal nutrition and influence development in pregnancy health outcomes. Sub-populations at risk of nutritional deficiencies and provided opportunities for early intervention to support the known benefit of multiple micronutrients on pregnancy outcomes i.e. up to six weeks (42 days) post delivery. The variations on pregnancy health, pica and hemoglobin levels among the Multiple Micronutrients (MMs) and Iron Folic Acid (IFA) groups. This was a block randomized controlled study. The intervention arm received MMs while the control received the usual care of IFA. A structured questionnaire with open and closed ended questions was used. Focus group discussions were conducted using a semi-structured guide to collect the qualitative data on the effects of prenatal multiple micronutrients among the pregnant women. The study assumed equal variances based on the Levene’s test of >0.10 (f, 0.196, p=0.661). The difference in inter trimester weight gain means was 5.85 kgs for MMs and 5.52 kgs for IFA (t, 0.109, p=0.914), duration to resumption of household work was 7 days for MMs and 14 days for the IFA groups. The hemoglobin level increased by; 1.25 g/dl for MMs, and 0.45 g/dl for the IFA (t, 0.897, p= 0.376). Pica for stones was experienced among 55.6% of pregnant women; however there was no pica within 14 days among MMs enrollment, but persisted in the IFA group. The study demonstrated no significance in the importance of multiple micronutrients in increasing hemoglobin level (P,0.376), reduction of pica craving during pregnancy (P,0.176) and resumption of household duties (P,0.067) post delivery compared to those on Iron Folic Acid.},
 year = {2018}
}

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