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© Borgis - New Medicine 4/2010, s. 163-165
*Wojciech Chalcarz1, Sylwia Merkiel1, Agnieszka Marzęcka2, Natalia Popierz-Rydlewska1, Renata Godyń-Swędzioł2
Nutritional knowledge of pregnant women from Kraków. Part 2. Influence of nutrition on the course of pregnancy
1Food and Nutrition Department of the Eugeniusz Piasecki
University School of Physical Education in Poznań
Head of the Department: dr hab. Wojciech Chalcarz, prof. nadzw. AWF
2Gabriel Narutowicz City Specialist Hospital in Kraków
Director: dr n. med. Renata Godyń-Swędzioł
Summary
The aim of this study was to assess knowledge about the influence of nutrition on the course of pregnancy among pregnant women from Kraków.
Questionnaires on the influence of nutrition on the course of pregnancy were filled in by 115 pregnant women who were admitted to Gabriel Narutowicz City Specialist Hospital in Kraków. Statistical analysis was carried out by means of the SPSS 12.0 PL for Windows computer programme. The studied population was divided according to the trimester of pregnancy.
Trimester of pregnancy had statistically significant influence on the answers to the question whether taking folic acid supplements before conception and at the beginning of pregnancy can prevent from blood pressure increase during pregnancy. All of the women in the first trimester of pregnancy knew that taking folic acid supplements before conception and at the beginning of pregnancy cannot prevent from blood pressure increase during pregnancy, whereas the percentage of correct answers given by the women in the second and the third trimester was 61.3 and 50.0%, respectively. Women in the first trimester of pregnancy gave the most correct answers to nine questions, including two questions to which the percentage of correct answers was equal to those given by women in the third trimester of pregnancy.
The level of knowledge about the influence of nutrition on the course of pregnancy in the studied pregnant women was insufficient. Knowledge in this issue should be included in the school curricula and should be spread by the mass media.
INTRODUCTION
Nutrition is a very important factor which influences reproduction. Unfortunately, there is lack of direct evidence for the correlation between nutrition and the ability to procreate due to the complexity of this issue and the impact of age, socioeconomic status, mother?s education and health status, as well as using health service by the mother. It has been reported that women with poor nutritional status have more risk factors connected with their life style. There are few studies focused on the influence of nutritional status on reproduction (1, 2). Current studies provide information on the importance of supplementation and nutritional counseling to women with poor nutritional status (3, 4).
AIM
The aim of this study was to assess knowledge about the influence of nutrition on the course of pregnancy among pregnant women from Kraków.
MATERIAL AND METHODS
Questionnaires on the influence of nutrition on the course of pregnancy were filled in by 115 pregnant women who were admitted to Gabriel Narutowicz City Specialist Hospital in Kraków.
This study was approved by the Bioethics Committee of the Poznan University of Medical Sciences.
Statistical analysis was carried out by means of the SPSS 12.0 PL for Windows computer programme.
The studied population was divided according to the trimester of pregnancy. Qualitative variables were presented in contingency tables. Statistical significance was determined using Pearson?s chi-square test, except for the variables with more than 20% of cells with an expected frequency of less than five. In this case, the Kruskal-Wallis H test was used. The level of significance was set at p ? 0.05.
RESULTS
Table 1 shows the correct answers, according to the trimester, given by the studied pregnant women to the questions concerning the influence of nutrition on the course of pregnancy.
Table 1. Correct answers of the studied pregnant women to the questions concerning the influence of nutrition on the course of pregnancy. Results given in (%).
No.Correct answersTrimester of pregnancyAll women (n=115)
The first (n=14)The second (n=75)The third (n=26)
1.Inadequate nutrition during pregnancy may be the cause of miscarriage53.854.750.053.5
2.Inadequate nutrition during pregnancy may be the cause of premature birth61.554.761.557.0
3.Nutrition during pregnancy influences health and development of foetus100.096.0100.097.4
4.Iodine supplementation before conception and during pregnancy reduces the risk of goitre30.845.346.243.9
5.Taking folic acid supplements before conception and at the beginning of pregnancy may prevent foetus from neural tube defects100.093.396.294.7
6.Taking folic acid supplements before conception and at the beginning of pregnancy cannot prevent from excess weight gain in a pregnant woman100.077.369.278.1
7.Taking folic acid supplements before conception and at the beginning of pregnancy cannot prevent from blood pressure increase during pregnancy*100.061.350.0 63.2
8.Folic acid deficiency may be the cause of megaloblastic anaemia7.720.011.516.7
9.Folic acid deficiency cannot be the cause of urethra defects30.824.023.124.6
10.Vitamin C and E probably play a significant role in the prevention of preterm rupture of the foetal membranes7.722.719.220.2
11.Antioxidant vitamins, that is C, E and ß-carotene, are particularly important in nutrition of pregnant women because they prevent muscular tissue from lesions caused by oxidative stress46.242.742.343.0
12.Antioxidant vitamins, that is C, E and ß-carotene, do not increase strength during exercise15.48.011.59.6
13.Antioxidant vitamins, that is C, E and ß-carotene, do not cause muscle mass increase30.829.319.227.2
Bold type denotes statistical significance at p ? 0.05.
*Post hoc tests did not show statistically significant differences between the pairs of trimesters.
Trimester of pregnancy had statistically significant influence on the answers to the question whether taking folic acid supplements before conception and at the beginning of pregnancy can prevent from blood pressure increase during pregnancy. All of the women in the first trimester of pregnancy knew that taking folic acid supplements before conception and at the beginning of pregnancy cannot prevent from blood pressure increase during pregnancy, whereas the percentage of correct answers given by the women in the second and the third trimester was 61.3 and 50.0%, respectively.
Women in the first trimester of pregnancy gave the most correct answers to nine questions, including two questions to which the percentage of correct answers was equal to those given by women in the third trimester of pregnancy.
DISCUSSION
Knowledge about the influence of nutrition on the course of pregnancy in the studied pregnant women was insufficient. To seven questions, the percentages of correct answers given by the studied population ranged from only 9.6 to 43.9%. Only to one question correct answer was given by 78.1% of the pregnant women and only to two questions ? by more than 90%.
From 9.6 to 27.2% of the studied women knew that folic acid deficiency may be the cause of megaloblastic anaemia (5) but cannot be the cause of urethra defects, that vitamin C and E probably play a significant role in the prevention of preterm rupture of the foetal membranes (6), and that antioxidant vitamins, that is vitamin C, E and ?-carotene, do not cause either increase of strength during exercise or muscle mass increase (7). The lowest percentage of correct answers, 7.7%, was given by the women in the first trimester of pregnancy to the question about folic acid deficiency as a cause of megaloblastic anaemia and to the question about the role of vitamin C and E in the prevention of preterm rupture of the foetal membranes. The highest percentage of correct answers, 30.8%, was also given by the women in the first trimester of pregnancy to the question whether folic acid deficiency may be the cause of urethra defects and whether antioxidant vitamins cause muscle mass increase.
Among the studied women, 43.0% knew that antioxidant vitamins are particularly important in nutrition of pregnant women because they prevent muscular tissue from lesions caused by oxidative stress (7) and 43.9% of them were aware that iodine supplementation before conception and during pregnancy reduces the risk of goitre (5, 8).
About the fact that inadequate nutrition during pregnancy may be the cause of miscarriage (9) knew 53.5% of the studied women and 57.0% of them were familiar with the fact that inadequate nutrition during pregnancy may be the cause of premature birth (9, 10). This result is similar to the knowledge of pregnant women from the Biała Podlaska region (11), of whom 58.0% knew that adequate nutrition during pregnancy reduces the risk of miscarriage and premature birth.
63.2% of the studied women were aware that taking folic acid supplements before conception and at the beginning of pregnancy cannot prevent from blood pressure increase during pregnancy, whereas 78.1% of the studied population knew that it also cannot prevent from excess weight gain in a pregnant woman (12).
Among the studied pregnant women, 94.7% knew that taking folic acid supplements before conception and at the beginning of pregnancy may prevent foetus from neural tube defects (6, 14), thus the level of knowledge about this fact in the studied population was higher than in pregnant women from Warszawa (13).
As many as 97.4% of the studied women were aware of the fact that nutrition during pregnancy influences health and development of foetus (15).
CONCLUSIONS
1. The level of knowledge about the influence of nutrition on the course of pregnancy in the studied pregnant women was insufficient.
2. Knowledge in this issue should be included in the school curricula and should be spread by the mass media.
Piśmiennictwo
1. Kesmodel US et al.: Lifestyle during pregnancy: neurodevelopmental effects at 5 years of age. The design and implementation of a prospective follow-up study. Scand J Public Health 2010; 38(2): 208-219. 2. Mook-Kanamori DO et al.: Risk factors and outcomes associated with first-trimester fetal growth restriction. JAMA 2010; 303(6): 527-534. 3. Dondorp W et al.: Lifestyle-related factors and access to medically assisted reproduction. Hum Reprod 2010; 25(3): 578-583. 4. Shirazian T: Lifestyle modification program decreases pregnancy weight gain in obese women. Am J Perinatol 2010; 27(5): 411-414.
5. Karowicz-Bylińska A et al.: Stanowisko Zespołu Ekspertów Polskiego Towarzystwa Ginekologicznego na temat suplementacji kobiet ciężarnych i karmiących w zakresie witamin i mikroelementów. Ginekol Pol 2010; 81(2): 144-148. 6. Szostak-Węgierek D, Cichocka A: Żywienie kobiet w ciąży. Wydawnictwo Lekarskie PZWL, Warszawa 2005.
7. McGinley C, Shafat A, Donnelly AE: Does antioxidant vitamin supplementation protect against muscle damage? Sports Med 2009; 39(12): 1011-1032. 8. Raczyński P, Kubik P, Niemiec T: Zalecenia dotyczące suplementacji diety u kobiet podczas planowania ciąży, w ciąży i w czasie karmienia piersią. Ginekol Prakt 2006; 14(4): 2-7. 9. Kaim I et al.: Stan odżywienia kobiet ciężarnych a cechy rozwoju somatycznego noworodków. Prz Lek 2009; 66(4): 176-180. 10. Karczewski J, Szczerbiński R: Częstość spożywania wybranych produktów spożywczych w okresie poprzedzającym ciążę. Żyw Człow Metab 2009; 36(1): 239-245.
11. Józwiak A et al.: Wiedza kobiet na temat zachowań prozdrowotnych w ciąży. Polska Medycyna Rodzinna 2004; 6(1): 377-381. 12. Chivu CM et al.: A systematic review of interventions to increase awareness, knowledge, and folic acid consumption before and during pregnancy. Am J Health Promot 2008; 22(4): 237-245. 13. Kozłowska-Wojciechowska M, Makarewicz-Wujec M: Wiedza i zachowanie kobiet ciężarnych. Roczn PZH 2002; 53(2): 167-175. 14. Spaczyński M: Rekomendacje Polskiego Towarzystwa Ginekologicznego w zakresie opieki przedporodowej w ciąży o prawidłowym przebiegu. Ginekol Pol 2005; 76(7): 517-527. 15. Williamson CS: Nutrition in pregnancy. Nutrition Bulletin 2006; 31(1): 28-59.
otrzymano: 2010-11-10
zaakceptowano do druku: 2010-12-15

Adres do korespondencji:
*Wojciech Chalcarz
Zakład Żywności i Żywienia
Akademii Wychowania Fizycznego w Poznaniu
ul. Droga Dębińska 7, 61-555 Poznań
tel.: +48 61 835 52 87
e-mail: chalcarz@awf.poznan.pl

New Medicine 4/2010
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