Inadequate dietary diversity during pregnancy increases the risk of maternal anemia and low birth weight in Africa: A systematic review and meta‐analysis

Abstract

Inadequately diversified food consumption during pregnancy can lead to micronutrient deficiencies, which can affect maternal and newborn health outcomes. Previous studies on maternal dietary diversity have either been limited to a specific geographical region or consist entirely of systematic reviews, without meta‐analyses. Thus, this study aimed to determine the pooled estimate of the association between inadequate dietary diversity during pregnancy, maternal anemia, and low birth weight in Africa. A systematic review of observational studies published between January 2000 and April 2022 was undertaken using the Google Scholar, PubMed, and CINAHL databases. The PRISMA checklist was followed to present the results. Microsoft Excel was used to abstract the data. STATA version 17 was used to analyze the data, and a random‐effects meta‐analysis model was applied to compute the pooled estimates. The study was registered in PROSPERO with protocol number CRD42022320873. A total of 22 publications with 9,696 participants were included in the final meta‐analysis. The pooled adjusted odds ratio (AOR) for inadequate dietary diversity and maternal anemia was 2.15 (95% CI, 1.66–2.65), while that for low birth weight was 2.04 (95% CI, 1.46–2.63). The highest pooled estimate of maternal anemia was reported in Cameroon (AOR = 9.8, 95% CI: 1.68–17.92), followed by Ethiopia (AOR = 2.6, 95% CI: 1.95–3.25). Similarly, the pooled estimates of low birth weight were highest in Cameroon (AOR = 3.04, 95% CI: 1.19–4.88) and Ethiopia (AOR = 1.8, 95% CI: 1.29–2.39). In Africa, pregnant mothers with inadequate dietary diversity are two times more likely to develop anemia and low birth weight. Social protection policies that prioritize pregnant women, maternal nutrition promotion in the community, and dietary counseling during antenatal care visits, using national food‐based dietary guidelines, should be strengthened.

Prevalence and predictors of anemia among six-week-old infants in Kwale County, Kenya: A cross-sectional study

“…In this study, infants in Msambweni Sub-County had significantly higher risk of anemia compared to infants in Matuga Sub-County. While there was no direct measure of diet or other factors leading to this, evidence shows that low diet quality, inadequate dietary diversity and consumption of monotonous diets in Africa among poor populations are important predictors of maternal anemia and poor birth outcomes [31]. The 2017 Kwale County Maternal Infant and Young Child Nutrition (MIYCN) Knowledge, Attitude and Practices (KAP) survey report states that the minimum dietary diversity for women of reproductive age is 45.2%, suggesting a low-quality diet [32].…”

Factors associated with child and maternal dietary diversity in the urban areas of Bangladesh

“…Though DD is one of the four dimensions of a healthy diet (Alkerwi, 2014 ; Kennedy et al., 2020 ), in the Bangladesh context, it would be the most important indicator of nutrient sufficiency, a precondition of an available healthy diet, where the staple food rice constitutes 70% of the daily meals' consumption (Jamadder, 2018 ). While a diverse diet is necessary throughout the life cycle, it is especially critical for children, adolescents, and women of reproductive age, particularly pregnant and lactating mothers (Bitew et al., 2021 ; Fahim et al., 2023 ; FAO, 2016 ; Seid et al., 2023 ). In Bangladesh, women generally do not improve their diet during pregnancy and breastfeeding.…”