Pica practice during pregnancy is associated with low maternal haemoglobin levels and gestational age among women in the Cape Coast Metropolis, Ghana

Abstract

Background: Pica during pregnancy poses substantial harm to the mother and the unborn baby. This study aimed to determine the prevalence of pica practice and its associations with pregnancy and birth outcomes among mothers in Cape Coast, Ghana. Methods: A cross-sectional study involving 580 nursing mothers receiving postnatal care in three health facilities in the Cape Coast Metropolis was undertaken from July to September 2021. A semi-structured questionnaire was used to obtain data on pica prevalence, knowledge of pica, pica practice, and pregnancy and birth outcomes. Results: The mean age of the participants was 28.63 ± 5.97 years. Prevalence of pica was 42.9%. White clay and ice were the most commonly consumed pica items. Statistically significant associations were found between pica behaviour and maternal haemoglobin levels at the first ANC visit (X2 =13.568; p<0.001), 28th week (X2 =36.103; p<0.001) and 36th week (X2 =65.022; p<0.001) of pregnancy; infants’ gestational age (X2 = 23.697; p = 0.004); maternal age (X2 = 13.15; p = 0.004); occupation (X2 = 10.50; p = 0.015); and maternal knowledge of pica and its effects (X2 = 8.26; p = 0.004). Regression analysis revealed that pregnant women who practiced pica were more likely to have low haemoglobin levels at the first ANC visit (OR =1.878; 95% CI 1.341 -2.631, p<0.001), 28th week (OR =2.853; 95% CI 2.018 - 4.032, p<0.001) and 36th week of pregnancy (OR =4.255; 95% CI 2.967- 6.101, p<0.001). M mothers who practiced pica were more likely to deliver before 37 weeks of gestation (OR =2.404; 95% CI 1.682 – 3.436, p<0.001). Conclusion: Pica is a common practice among the study participants and was significantly associated with lower maternal haemoglobin levels and gestational age. Counselling and education on pica and its effects should be intensified and prioritized during the prenatal period.