Assessing malnutrition in pregnant women using the Dietary Diversity Score and the Mid-Upper Arm Circumference: A cross-sectional study, Zambia

Abstract

Background One of the easiest and effective ways of predicting under nutrition is to use the Dietary Diversity Score (DDS) and the mid-upper arm circumference (MUAC). The dietary diversity score is a qualitative measure of food consumption reflecting an individual’s access to different food items and therefore is a proxy indicator of the nutritional status. The aim of the study was to assess whether the DDS and MUAC can be used to assess the nutritional status of pregnant women attending antenatal. Methods A cross-sectional survey was conducted at Chilenje level I Hospital in a township located in Lusaka city, Lusaka province. The study employed quantitative methods to collect and analyse data on the dietary patterns and if this can be used to assess the nutritional status of individuals 24 hours preceding the survey. Health facilities were selected using random sampling method and systematic sampling method was used to select a sample of 299 pregnant women. An interview schedule was used to collect data. Logistic regression was used to establish associations between DDS and MUAC. Results In this study, 44% of the women were in the lowest dietary diversity category, which indicates inadequate nutrient intake, 31% in the medium category and 24% in the high intake. Maternal weight was associated with a 0.08 cm increase in MUAC (95% CI; 0.74 – 0.93) and this was statistically significant. Marital status and age (95% CI; 0.83 – 0.93) were significantly associated with an increase in MUAC in the univariate analysis but when adjusted for other confounders this was not significant (95% CI; 0.81 – 1.00). Consumption of organ meat was associated with a 0.21cm increase in MUAC (95% CI; 0.04 - 0.97). Conclusion The study results indicated that 44% of the women had inadequate nutrient intake, indicating that the dietary diversity score can be used to predict malnutrition in pregnant women. The mid upper was negatively correlated with the 24hour dietary diversity score implying that we might not rely on this measurement to assess the nutritional status. Key words Dietary Diversity Score, Malnutrition, Mid Upper Arm Circumference, Pregnant women, Antenatal.