Food habits and Pregnancy outcomes

Food habits and Pregnancy outcomes | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Article Food habits and Pregnancy outcomes Devdatt Pitale This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-132630/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Introduction: Nutrition during pregnancy plays an important role for an optimum outcome of pregnancy. Women may be malnourished even before they become pregnant and this may further adversely affect the pregnancy. Maternal undernutrition can lead to poor intrauterine growth and low weight of the baby at birth. Moreover, the leading causes for maternal deaths like hemorrhage and infection are related directly or indirectly to nutrition. Aim of the Study: To study the impact of existing food habits on pregnancy outcome in a south Indian population. Materials and Methods: This prospective study was conducted at a tertiary health care and research institute in India. From the antenatal clinic, 350 women who satisfied the following inclusion and exclusion criteria were admitted to the study. Results: The majority of pregnant women belonged to the age group of 21-25 yrs (47%) followed by the 26-30 yrs age group (40%).The number of teenage pregnancies was 30 (8%) whereas 5% of pregnant women belong the age group of 31-35 yrs.83% of the study population belonged to the low socioeconomic class. Majority of the babies (66%) had the birth weight in the range of 2.5-2.9 kgs. 29 % of babies had birth weight in the range of 3-3.5 kgs. There was a significant association (p value < 0.05) between the socioeconomic status of the mother, parity and her calorie intake. The present study found a statistically significant association between the maternal nutritional status, the birth weight of the baby and the need for NICU admission (p value < 0.05). Conclusion: Maternal food habits have an impact on the pregnancy outcome. Maternal food habits are influenced by many factors like socioeconomic status, parity, social food taboos and pregnancy itself. The pregnancy outcomes like birth weight, need for NICU admission and postnatal complications are influenced by maternal nutritional status. Nutrition & Dietetics Nutrition Food habits birth weight Figures Figure 1 Introduction An adequate availability of nutrients during gestation is probably the single most important environmental factor influencing pregnancy outcome (1). An inadequate supply will risk the well-being of both mother and the conceptus. A woman with poor nutritional status has an increased risk of complications like anemia and adverse pregnancy outcomes such as postpartum hemorrhage, preterm births and fetal growth retardation which in turn increases the risk of Prematurity and low birth weight. The National Family Health Survey-4 (NFHS) indicates that 20.2% of men and 22.9% of women are undernourished (2). Maternal nutrition is indirectly assessed by her weight gain during pregnancy. According to the guidelines of Institute of Medicine the total weight gain during the course of a singleton pregnancy for a healthy woman averages 11.5-16 kg, with a weight gain of 1-3kgs during first trimester and about 0.35-0.5kgs per week during second and third trimester(3). Mothers are subjected to nutritional stress owing to the nursing process and their health risk is multiplied by frequent pregnancies, pregnancy complications like hyperemesis, coupled with a lack of access to and control over income, inadequate education, and excessive demands on their time, and so on (4) .As in many other countries, there are traditional beliefs in India regarding specific food items a pregnant woman should or should not eat during pregnancy. This leads to misconceptions like the belief of 'eating down' - the belief that pregnant women should eat less than before pregnancy or should not increase the diet during pregnancy quite widespread in India .Foods perceived as 'hot' in Tamil Nadu communities are more in number ( papaya, pineapple, mango, animal foods, wheat and sesame seeds)(5). Awareness of these being myths is not created in women. There is an urgent need to overcome the cultural practices that are traditionally affecting the nutritional and health status of women . There is no doubt that maternal nutrition during pregnancy plays an important role in optimum outcome of pregnancy. The present study was undertaken to study the effects of food habits on pregnancy outcome. Materials And Methods This prospective study was conducted in the Department of Obstetrics and Gynecology of a Multi-specialty Hospital and Research Institute in India. From the antenatal clinic, 350 women who satisfied the following inclusion and exclusion criteria were admitted to the study .A proper informed consent was obtained from all the mothers who were admitted to the study. Inclusion criteria All Pregnant women less than 40 years with gestational age <24 week Women willing to come for regular antenatal checkups and delivery . Willing to participate in the study Exclusion criteria Maternal complications such as diabetes, hypertension and other medical disorders Bad obstetric history Not willing to participate in the study Methodology From the antenatal clinic, 350 women who satisfied the inclusion and exclusion criteria were admitted to the study. At the first visit, a detailed history regarding her present pregnancy was recorded along with a detailed past obstetric history and family history. All pregnant women who participated in the study were interviewed at regular intervals of (14 to 16wks, 24 to 26 wks, 28 to 30wks and 32 to 36 wks of gestational age). During such visits Dietary intake of the subjects was assessed by 24-hour Recall method .Maternal weight, hemoglobin and fetal growth profile was noted during such visits. A general physical and obstetric examination was done at such visits. Nutritive value was calculated for every case . Assessment of food habits In this study the dietary intake of the subjects was assessed by 24-hour Recall method. Follow up All the women who participated in the study were called for regular antenatal check-up and care was provided as per the routine protocol. During the regular antenatal check-ups, maternal weight gain, BMI, hemoglobin and fetal growth profile, was assessed. All the women were counseled about the importance of adequate nutrition. The onset of labor spontaneous or induced, type of delivery whether spontaneous vaginal delivery, instrumental vaginal delivery or LSCS was noted. Perinatal outcome The Perinatal outcome was assessed by the usual parameters of GA, birth weight, Apgar score and presence or absence of congenital anomalies. Statistical analysis: At the end of the study the impact of food habits on pregnancy outcome in terms of mode of delivery, birth weight and NICU admission was assessed and the results were analyzed using appropriate Chi-Square statistical method. Ethical justification: This study did not involve any invasive procedures. However ethical justification was obtained from the ethical committee of the hospital. Data availability Statement- The data that support the findings of the present study are available within the paper. Results This prospective study was conducted to study the effects of food habits on pregnancy outcome . This prospective study was conducted in the Department of Obstetrics and Gynecology, Voluntary Health services, Multi-specialty Hospital and Research Institute, Chennai. The study was carried out between January 2013- July2014. From the antenatal clinic, 350 women who satisfied the inclusion and exclusion criteria were admitted to the study. Characteristics of the women in the study Age distribution Age distribution of women who participated in this study is shown in the table 1. [Please see the supplementary files section to view the tables.] From the above table it is seen that the maximum number of pregnant women belonged to the age group of 21-25 yrs (47%) followed by the 26-30 yrs age group (40%).The number of teenage pregnancies was 30 (8%) whereas 5% of pregnant women belong the age group of 31-35 yrs. Parity Half of the pregnant women (50%) in the study group were primigravidas and (43.5%) were second gravidas . In this study, 6 % and 0.5 % of pregnant women were third and fourth gravidas respectively. Socio economic status The socio economic status of the respondents as per Kuppuswamy’s classification It is seen from the above table that 83% of the study population belonged to the low socioeconomic class .14 % and 3 % of the study population belonged to the upper lower and middle lower socioeconomic class respectively . Majority of women in this study belong to low socioeconomic class this institute provides medical care especially to the patients belonging to the lower socioeconomic class on par with the upper socioeconomic class patients . Prepregnancy B.M.I [See figure 1] Food habits of pregnant mothers Depending upon the B.M.I, the mothers in this study were divided into three major groups .The food items specifically consumed by the pregnant women who participated in this study is shown in the tables below. The above table shows the food habits of participant mothers belonging to different B.M.I groups. In all the three groups the mothers have added the nutritious food items in their diet. In the mothers with low B.M.I , milk and banana was added by 75% of mothers followed by apple and dates by 50% of mothers. In the mothers with B.M.I within normal range, milk was added by 68% of mothers followed by apples ( 47 %), dates( 50%) and bananas(44%). Eggs were added by 51% mothers in their diet. In the mothers with B.M.I >25 kg/m 2 , 54 % of mothers added milk followed by eggs (60%),dates (60%) and apples by 56% of mothers Association between the socioeconomic status and calorie intake The association between the socioeconomic status and calorie intake of the mothers is shown in the table 4 The above table 4, shows the association between the calorie intake and socioeconomic status . As shown in the above table, there is a significant association between the socio-economic status of the mother and the calorie intake . CALORIE INTAKE The average calorie intake of the mothers belonging to different groups during each visit is shown in table 5 The above table shows us the average calorie intake of the mothers belonging to different B.M.I groups. The highest calorie intake during the first visit (1900 kcal/day) was seen in the mothers belonging to the >25 kg/m 2 B.M.I group, whereas the least calorie intake during the first visit (1640 kcal/day) was seen in the mothers with B.M.I <18.5 kg/m 2 .In the mothers belonging to B.M.I within normal range (18.5-24.9 kg/m 2 ) the calorie intake during the first visit was 1800 kcal/day. In all the three groups there has been a fall in calorie intake during the last visit as compared to the calorie intake in the third visit. The maximum fall in calorie intake was seen in the mothers with B.M.I 25 kg/m 2 was reduced to 2100 kcal/day and 2000 kcal/day respectively. Mode of delivery of participant mothers Maximum number of women (65%) had a normal delivery. About 30% of women underwent a cesarean section. Only 5% of the pregnant women underwent an instrumental delivery . Birth weight The above tables shows the birth weight of the babies in the present study . Majority of the babies (66%) had the birth weight in the range of 2.5-2.9 kgs .29 % of babies had birth weight in the range of 3-3.5 kgs .5% of babies had birth weight in the range of 2-2.49 kgs. Association between the parity and calorie intake Above table shows the association between parity and the calorie intake of the pregnant women. As per the statistical analysis, there is a significant association between parity and calorie intake during the pregnancy. There is a declining trend in the calorie intake especially in multiparous mothers . CALORIE INTAKE AND BIRTH WEIGHT The association between the calorie intake and birth weight of the baby is shown in the table 7 Above table shows the association between the calorie intake of pregnant mother and weight of the baby at birth. As shown in the above table, there is a very significant association between the calorie intake of the mother and birth weight of the baby. Proper calorie intake of the mother has a positive impact on the baby weight. CALORIE INTAKE AND NICU ADMISSION In the present study 3 babies had NICU admission for the fetal distress. The association between the calorie intake of the mother and need for NICU admission for fetal distress is shown in the table 8. Table 8 shows the association between the calorie intake and the (NICU) Neonatal intensive care unit admission at birth for fetal distress. Condition at discharge All the mothers who participated in this study were discharged on third day in case of a normal delivery and on eighth day in case of a cesarean section. All the babies including those admitted in NICU were discharged on day 3 after checking their bilirubin levels. There was no case of neonatal death, postnatal complications like puerperal sepsis and anemia in this study . Discussion An adequate availability of nutrients during gestation is probably the single most important environmental factor influencing pregnancy outcome(1,5). Although physiological adjustments in nutrient utilization and metabolism are geared to improve the utilization of dietary nutrients during pregnancy, these adjustments may be insufficient to meet the demands for pregnancy and lactation if the woman is in poor nutrient status at conception. An adequate supply of nutrients is required to maintain the delicate balance between the needs of the mother and those of the fetus. An inadequate supply will cause a state of biological competition between the mother and the conceptus in which the well-being of both is at serious risk (1). All societies have traditional beliefs regarding harmful and beneficial foods for women during, pregnancy(6,7,8).There are also beliefs regarding the optimal amount of food to be taken during pregnancy for a successful reproductive outcome. These beliefs may or may not conform to the modern biomedical notions about the proper types and amount of food needed by pregnant women to safeguard maternal nutrition, adequate growth of fetus and safe delivery(9,10) .This prospective study was conducted to study the effects of food habits on pregnancy outcome. Factors affecting the maternal nutrition Socioeconomic status In this study majority of the women ( 83%) belonged to lower socioeconomic class as per Kuppuswamy’s classification. 14 % of women belonged to upper lower class and 3% belonged to middle lower socioeconomic class respectively. The present study found a statistically significant association ( p value < 0.05) between the socioeconomic status and calorie intake of the mothers. Ayesha et al (11)reported the impact of maternal socioeconomic limitations on the calorie intake. PARITY The majority of women in this study were primigravida (50%) or second gravida (43.5%) . 6% and 0.5 % of women were of birth order 3 and 4 .The present study found a significant association between the parity and maternal calorie intake .Sonneveldt et al reported a statistically significant relationship between the high parity and maternal nutrition(12). Food habits and pregnancy outcome Mode of delivery In the present study 65% of women delivered normally.30 % of women underwent a cesarean section and 5% of women had instrumental deliveries. The present study shows no statistically significant association between the mode of delivery and calorie intake (p value > 0.05). Similar results were found in study conducted by Thilothammal N and et al(13). Birth weight In the present study 66% of the babies had birth weight in the range of 2.5-2.9 kgs.29% of babies had birth weight in the range of 3-3.5 kgs and 5% of babies had birth weight in the range of 2-2.49 kgs respectively. The present study found a very significant association between the maternal calorie intake and birth weight of the baby.M Sumithra and Stephenson et al(14,15) demonstrated maternal nutritional status as a very important determinant of birth weight. NICU ADMISSION In the present study 3 babies had NICU admission for fetal distress. The present study found a statistically significant association between the maternal calorie intake and the NICU admission.P Kalik et al and Minsart et al found similar statistically significant results(16,17). The mothers whose preprgnancy BMI was low were given nutritional advice and it was noted that there was a marginal increase in their caroric intake in subsequent visits. However, this is not sufficient to influence the pregnancy outcome. All these mothers belonging to low SE group are covered under the ICDS scheme and receive nutritional supplement during the entire pregnancy. Conclusions Among the 350 women who participated in this study majority of the women belonged to the age group of 21-30 yrs and to a lower socioeconomic class with the pre-pregnancy B.M.I within normal range of 18.5-24.9 kg/m 2 . The average calorie intake of mothers with normal B.M.I was 2012kcal/day .The average calorie intake of mothers with B.M.I 25 was 1866 kcal/day and 1975 kcal/day respectively. The food items consumed by the mothers during pregnancy consisted of rice, sambhar, milk, idly , fruits like apple, banana, dates, rassam and mutton soups.There was a significant association (p value < 0.05) between the socioeconomic status of the mother,parity and her calorie intake. The present study found a statistically significant association between the maternal nutritional status ,the birth weight of the baby and the need for NICU admission (p value < 0.05). Maternal food habits have an impact on the pregnancy outcome. Nutrition education and awareness generation among the women is needed (18,19).Maternal food ood habits are influenced by many factors like socioeconomic status, parity, social food taboos and pregnancy itself .The pregnancy outcomes like birth weight, need for NICU admission and postnatal complications are influenced by maternal nutritional status. Declarations Conflicts of Interest The author declares no conflicts of interest Author Contributions Principal Author – Dr Devdatt Laxman Pitale. Funding -None. Conflicts- None to declare. This study was approved by the Institutional Ethical committee. References 1. Janet C.King.The risk of maternal nutritional depletion and poor outcomes increases in early or closely spaced pregnancies.JN.2003 2. National Family Health Survey-4.MOHFW.GOI.International institute for population sciences.Mumbai;2015-2016 3 Institute of Medicine.Weight Gain During Pregnancy: Reexamining the Guidelines. Washington, DC: National Academy Press; 2009. 4 Asha K, Salil S. Nutrient Intake of Lactating Mothers from Rural areas and urban areas. Indian J Soc Res. 1998;39:2. 5 Nag, M. (2009). Beliefs and Practices about Food during Pregnancy: Implications for Maternal Nutrition. Economic And Political Weekly, 29(37), 2427–2438. 6 Zeisel H S.(2009).Importance of methyl donors during reproduction.Am J Clin Nutr; 89(2): 673S–677S. 7 Wahid MA, Fathi SA. Nutrition and the unborn baby. Ric Clin Lab. 1987;17(3):199–206. 8 .Manderson L, Mathews M. Vietnamese attitudes towards maternal and infant health.Med J Aust.1981:69–72. 9.Mitchell J, Mackerras D. The traditional humoral food habits of pregnant Vietnamese-Australian women and their effect on birth weight.Aust J Public Health.1995:629–33. 10 J Meghali , S Rekha(2013).TABOOS AND MISCONCEPTIONS ABOUT FOOD DURING PREGNANCY.IJRSSIS;Vol 1:1-6 11.Ayesha et Al.Impact of maternal education and socioeconomic status on maternal nutritional knowledge and practices regarding iron rich foods and iron supplements. Ann Pak Inst Med. Sci. 2012;8:101-5. 12Sonneveldt et al.Linking high parity and maternal and child mortality:what is the impact of lower health services coverage among higher order births.BMC Public Health;13(Supply 3):S7 13Thilotthammal N.Influence if maternal nutritional status on mode of delivery and asphyxia neonatorum.Indian J Pediatr.1992;59(3):325-9 14M Sumithra.Maternal nutrition and low birth weight-what is really important.Indian J Med Res.November 2009;130:600-608 15Stephenson T and Symonds M.Maternal nutrition as a determinant of birth weight.Arch Dis Child Fetal Neonatal Ed.2002;86:F4-F6 16Kalik P et al.Impact of maternal body mass index on neonatal outcome.Eur J Med Res.2009;14(5):216-222 17Minsart et al.Neonatal outcomes in obese mothers: a population-based analysis.BMC pregnancy and Childbirth.2013,13:36. 18 Uzma Eram et al. TABOOS AND MISCONCEPTIONS ASSOCIATED WITH PREGNANCY AMONG RURAL WOMEN IN ALIGARH. International Journal of Information Research and Review, December, 2016 19. EA Ugwa. Nutritional Practices and Taboos Among Pregnant Women Attending Antenatal Care at General Hospital in Kano, Northwest Nigeria. Ann Med Health Sci Res . 2016 Mar-Apr; 6(2): 109–114 Additional Declarations (Not answered) Supplementary Files ResultswithTables.docx Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-132630","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Article","associatedPublications":[],"authors":[{"id":9020301,"identity":"6384ab1d-6bcc-4c2f-a999-bb6da586bba0","order_by":0,"name":"Devdatt Pitale","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA5ElEQVRIie2RvwrCMBCHLwTOJbbrlfrnFQoFcdJnEaGTm5MIKhR8H5fQUQnYRXEVXKw+QQdFN6N2bnQTzDccv+E+kh8HYLH8Iuo1CaAC7KiTcD5VCDjw4KmgUVlC8QwHpGcyKk5aXRNL2hM35uvRZdCpIfDstC9RPOVExDZEpDA61GVffwzDcFCiBEq0iM11Fx0OnuRaEeh/pDSVex16cvqFogOyXCqzorv0270NeQuFoc9kKpAbuji77WqfJxO3kcZZfpfjrluJs3OZom8H0Ju9IxevWbpeKKxQ2M24bbFYLP/IA5rbPXjGcQTKAAAAAElFTkSuQmCC","orcid":"","institution":"INHS ASVINI","correspondingAuthor":true,"submittingAuthor":false,"prefix":"","firstName":"Devdatt","middleName":"","lastName":"Pitale","suffix":""}],"badges":[],"createdAt":"2020-12-20 11:50:28","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-132630/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-132630/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":5304111,"identity":"7ab89ff3-7681-4b99-80e0-0fe7cccc8cde","added_by":"auto","created_at":"2021-01-27 15:47:59","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":16038,"visible":true,"origin":"","legend":"Prepregnancy B.M.I (kg/m2) OF PREGNANT WOMEN","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-132630/v1/f9e0e8126ac2dd15035ca938.png"},{"id":13652627,"identity":"8c267850-faba-4a19-8fd8-fd8bc4794cce","added_by":"auto","created_at":"2021-09-17 09:50:15","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":346041,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-132630/v1/464211f9-9f4d-4349-8b55-aeb94951778f.pdf"},{"id":5304110,"identity":"7adce817-fd14-4566-951d-e5ad2eb3f2e9","added_by":"auto","created_at":"2021-01-27 15:47:59","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":45895,"visible":true,"origin":"","legend":"","description":"","filename":"ResultswithTables.docx","url":"https://assets-eu.researchsquare.com/files/rs-132630/v1/8849a7a0e7e0384856a3a08a.docx"}],"financialInterests":"(Not answered)","formattedTitle":"Food habits and Pregnancy outcomes","fulltext":[{"header":"Introduction","content":"\u003cp\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; An adequate availability of nutrients during gestation is probably the single most important environmental factor influencing pregnancy outcome (1). An inadequate supply will risk the well-being of both mother and the conceptus.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; A woman with poor nutritional status has an increased risk of complications like anemia and adverse pregnancy outcomes such as postpartum hemorrhage, preterm births and fetal growth retardation which in turn increases the risk of\u0026nbsp; Prematurity and low birth weight. The National Family Health Survey-4 (NFHS) indicates that 20.2% of men and 22.9% of women are undernourished (2).\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; Maternal nutrition is indirectly assessed by her weight gain during pregnancy. According to the guidelines of Institute of Medicine the total weight gain during the course of a singleton pregnancy for a healthy woman averages 11.5-16 kg,\u0026nbsp;\u0026nbsp; with a weight gain of 1-3kgs during first trimester and about 0.35-0.5kgs per week during second and third trimester(3).\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; Mothers are subjected to nutritional stress owing to the nursing process and their health risk is multiplied by frequent pregnancies, pregnancy complications like hyperemesis, coupled with a lack of access to and control over income, inadequate education, and excessive demands on their time, and so on (4) .As in many other countries, there are traditional beliefs in India regarding specific food items a pregnant woman should or should not eat during pregnancy. This leads to misconceptions like the belief of 'eating down' - the belief that pregnant women should eat less than before pregnancy or should not increase the diet during pregnancy quite widespread in India .Foods perceived as 'hot' in Tamil Nadu communities are more in number ( papaya, pineapple, mango,\u0026nbsp; animal foods, wheat and sesame seeds)(5). Awareness of these being myths is not created in women.\u0026nbsp; There is an urgent need to overcome the cultural practices that are traditionally affecting the nutritional and health status of women\u003csup\u003e.\u003c/sup\u003e\u0026nbsp;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; There is no doubt that maternal nutrition during pregnancy plays an important role in optimum outcome of pregnancy. The present study was undertaken to study the effects of food habits on pregnancy outcome."},{"header":"Materials And Methods","content":"\u003cp\u003e\u0026nbsp; This prospective study was conducted in the Department of Obstetrics and Gynecology of a Multi-specialty Hospital and Research Institute in India. From the antenatal clinic, 350 women who satisfied the following inclusion and exclusion criteria were admitted to the study .A proper informed consent was obtained from all the mothers who were admitted to the study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eInclusion criteria\u003c/strong\u003e\u003c/p\u003e\n\u003col\u003e\n\u003cli\u003eAll Pregnant women less than 40 years with gestational age \u0026lt;24 week\u003c/li\u003e\n\u003c/ol\u003e\n\u003col start=\"2\"\u003e\n\u003cli\u003eWomen willing to come for regular antenatal checkups and delivery .\u003c/li\u003e\n\u003c/ol\u003e\n\u003col start=\"3\"\u003e\n\u003cli\u003eWilling to participate in the study\u003c/li\u003e\n\u003c/ol\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eExclusion criteria\u003c/strong\u003e\u003c/p\u003e\n\u003col\u003e\n\u003cli\u003eMaternal complications such as diabetes, hypertension and other medical disorders\u003c/li\u003e\n\u003c/ol\u003e\n\u003col start=\"2\"\u003e\n\u003cli\u003eBad obstetric history\u003c/li\u003e\n\u003c/ol\u003e\n\u003col start=\"3\"\u003e\n\u003cli\u003eNot willing to participate in the study\u003c/li\u003e\n\u003c/ol\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethodology\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; \u003c/strong\u003e\u0026nbsp;From the antenatal clinic, 350 women who satisfied the inclusion and exclusion criteria were admitted to the study. At the first visit, a detailed history regarding her present pregnancy was recorded along with a detailed past obstetric history and family history. All pregnant women who participated in the study were interviewed at regular intervals of (14 to 16wks, 24 to 26 wks, 28 to 30wks and 32 to 36 wks of gestational age). During such visits Dietary intake of the subjects was assessed by 24-hour Recall method .Maternal weight, hemoglobin and fetal growth profile was noted during such visits. A general physical and obstetric examination was done at such visits. Nutritive value was calculated for every case .\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003cstrong\u003eAssessment of food habits\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u0026nbsp; In this study the dietary intake of the subjects was assessed by 24-hour Recall method.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFollow up\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; All the women who participated in the study were called for regular antenatal check-up and care was provided as per the routine protocol. During the regular antenatal check-ups, maternal weight gain, BMI, hemoglobin and fetal growth profile, was assessed.\u0026nbsp; All the women were counseled about the importance of adequate nutrition. The onset of labor spontaneous or induced, type of delivery whether spontaneous vaginal delivery, instrumental vaginal delivery or LSCS was noted.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePerinatal outcome\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u0026nbsp; \u003c/strong\u003eThe Perinatal outcome was assessed by the usual parameters of GA, birth weight, Apgar score and presence or absence of congenital anomalies.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStatistical analysis:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; At the end of the study the impact of food habits on pregnancy outcome in terms of mode of delivery, birth weight and NICU admission was assessed and the results were analyzed using appropriate Chi-Square statistical method.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthical justification: \u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u0026nbsp; \u003c/strong\u003e\u0026nbsp;This study did not involve any invasive procedures. However ethical justification was obtained from the ethical committee of the hospital.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData availability Statement-\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp; \u003c/strong\u003eThe data that support the findings of the present study are available within the paper.\u003c/p\u003e"},{"header":"Results","content":"\u003cp style=\"margin-bottom: 10.0pt; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 14.0pt; line-height: 150%;\"\u003e\u0026nbsp;This prospective study was conducted to study the effects of food habits on pregnancy outcome . This prospective study was conducted in the Department of Obstetrics and Gynecology, Voluntary Health services, Multi-specialty Hospital and Research Institute, Chennai. The study was carried out between January 2013- July2014. From the antenatal clinic, 350 women who satisfied the inclusion and exclusion criteria were admitted to the study.\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"margin-bottom: 10.0pt; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 14.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"margin-bottom: 10.0pt; line-height: 150%;\"\u003e\u003cstrong\u003e\u003cu\u003e\u003cspan style=\"font-size: 14.0pt; line-height: 150%;\"\u003eCharacteristics of the women in the study \u003c/span\u003e\u003c/u\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp style=\"margin-bottom: 10.0pt; line-height: 150%;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 14.0pt; line-height: 150%;\"\u003eAge distribution\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp style=\"margin-bottom: 10.0pt; line-height: 150%;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 14.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp; \u003c/span\u003e\u003c/strong\u003e\u003cspan style=\"font-size: 14.0pt; line-height: 150%;\"\u003eAge distribution of women who participated in this study is shown in the table 1.\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"margin-bottom: 10.0pt; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 14.0pt; line-height: 150%;\"\u003e[Please see the supplementary files section to view the tables.]\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"margin-bottom: 10.0pt; line-height: 150%;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 14.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; \u003c/span\u003e\u003c/strong\u003e\u003cspan style=\"font-size: 14.0pt; line-height: 150%;\"\u003eFrom the above table it is seen that the maximum number of pregnant women belonged to the age group of 21-25 yrs (47%) followed by the 26-30 yrs age group (40%).The number of teenage pregnancies was 30 (8%) whereas 5% of pregnant women belong the age group of 31-35 yrs.\u003cstrong\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; \u003c/strong\u003e\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"margin-bottom: 10.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp style=\"margin-bottom: 10.0pt; line-height: 150%;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 14.0pt; line-height: 150%;\"\u003eParity\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp style=\"margin-bottom: 10.0pt; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 14.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; Half of the\u0026nbsp; pregnant women (50%) in the study group were primigravidas and\u0026nbsp; (43.5%) were\u0026nbsp; second\u0026nbsp; gravidas . In this study, 6 % and 0.5 % of pregnant women were third and fourth gravidas respectively.\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"margin-bottom: 10.0pt; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 14.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"margin-bottom: 10.0pt; line-height: 150%;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 14.0pt; line-height: 150%;\"\u003eSocio economic status\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp style=\"margin-bottom: 10.0pt; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 14.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; The socio economic status of the respondents as per Kuppuswamy\u0026rsquo;s classification\u003cstrong\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp; \u003c/strong\u003e\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"margin-bottom: 10.0pt; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 14.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; It is seen from the above table that\u0026nbsp; 83% of the study\u0026nbsp; population belonged to the low socioeconomic\u0026nbsp; class .14 % and 3 %\u0026nbsp; of the study population belonged to the upper lower and middle lower socioeconomic class respectively . Majority of women in this study belong to low socioeconomic class this institute provides medical care especially to the patients belonging to the\u0026nbsp; lower socioeconomic class on par with the upper\u0026nbsp; socioeconomic class patients .\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"margin-bottom: 10.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp style=\"margin-bottom: 10.0pt; line-height: 150%;\"\u003e\u003cstrong\u003e\u003cu\u003e\u003cspan style=\"font-size: 14.0pt; line-height: 150%;\"\u003ePrepregnancy B.M.I\u003c/span\u003e\u003c/u\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp style=\"margin-bottom: 10.0pt; line-height: 150%;\"\u003e\u003cstrong\u003e[See figure 1]\u003c/strong\u003e\u003c/p\u003e\n\u003cp style=\"margin-bottom: 10.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp style=\"margin-bottom: 10.0pt; line-height: 150%;\"\u003e\u003cstrong\u003e\u003cu\u003e\u003cspan style=\"font-size: 14.0pt; line-height: 150%;\"\u003eFood\u0026nbsp; habits of\u0026nbsp; pregnant mothers\u003c/span\u003e\u003c/u\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp style=\"margin-bottom: 10.0pt; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 14.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; Depending upon the B.M.I, the mothers in this study were divided into three major groups .The\u0026nbsp; food items specifically consumed\u0026nbsp; by the\u0026nbsp; pregnant women who participated in this study is shown in the tables below.\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"margin-bottom: 10.0pt; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 14.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u0026nbsp; The above table shows the food habits of participant mothers belonging to different B.M.I groups. In all the three groups the mothers have added the nutritious food items in their diet.\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"margin-bottom: 10.0pt; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 14.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; In the mothers with low B.M.I , milk and banana was added by 75% of mothers followed by apple and dates by 50% of mothers.\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"margin-bottom: 10.0pt; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 14.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; In the mothers with B.M.I within normal range, milk was added by 68% of mothers followed by apples (\u0026nbsp; 47 %), dates( 50%) \u0026nbsp;and\u0026nbsp; bananas(44%). Eggs were added by 51% mothers in their diet.\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"margin-bottom: 10.0pt; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 14.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u0026nbsp; In\u0026nbsp; the mothers with B.M.I \u0026gt;25 kg/m\u003csup\u003e2\u003c/sup\u003e, 54 % of mothers added milk followed by eggs (60%),dates (60%) and apples by 56% of mothers\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"margin-bottom: 10.0pt; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 14.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"margin-bottom: 10.0pt; line-height: 150%;\"\u003e\u003cstrong\u003e\u003cu\u003e\u003cspan style=\"font-size: 14.0pt; line-height: 150%;\"\u003eAssociation between the socioeconomic status and calorie intake\u003c/span\u003e\u003c/u\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp style=\"margin-bottom: 10.0pt; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 14.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u0026nbsp; The association between the socioeconomic status and calorie intake of the mothers is shown in the table 4\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"margin-bottom: 10.0pt; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 14.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; The above table 4, shows the association between the calorie intake and socioeconomic status . As shown in the above table,\u0026nbsp;\u0026nbsp; there is a significant association between the socio-economic status of the mother\u0026nbsp; and the calorie intake . \u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"margin-bottom: 10.0pt; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 14.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"margin-bottom: 10.0pt; line-height: 150%;\"\u003e\u003cstrong\u003e\u003cu\u003e\u003cspan style=\"font-size: 14.0pt; line-height: 150%;\"\u003eCALORIE INTAKE\u003c/span\u003e\u003c/u\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp style=\"margin-bottom: 10.0pt; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 14.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; The average calorie intake of\u0026nbsp; the mothers belonging to different groups\u0026nbsp; during each visit is shown in table 5\u0026nbsp;\u0026nbsp;\u0026nbsp; \u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"margin-bottom: 10.0pt; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 14.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; The above table shows us the average calorie intake of the mothers belonging to different B.M.I groups. The highest calorie intake during the first visit (1900 kcal/day) was seen in the mothers belonging to the \u0026gt;25 kg/m\u003csup\u003e2 \u003c/sup\u003eB.M.I group, whereas the least calorie intake during the first visit (1640 kcal/day) was seen in the mothers with B.M.I \u0026lt;18.5 kg/m\u003csup\u003e2\u003c/sup\u003e .In the mothers belonging to B.M.I within normal range (18.5-24.9 kg/m\u003csup\u003e2\u003c/sup\u003e) the calorie intake during the first visit was 1800 kcal/day.\u0026nbsp; \u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"margin-bottom: 10.0pt; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 14.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; In all the three groups there has been a fall in calorie intake during the last visit as compared to the calorie intake in the third visit. The maximum fall in calorie intake was seen in the mothers with B.M.I \u0026lt;18.5 kg/m\u003csup\u003e2\u003c/sup\u003e (1950kcal/day). The calorie intake in the mothers with B.M.I within normal range and mothers with B.M.I \u0026gt;25 kg/m\u003csup\u003e2\u003c/sup\u003e was reduced to 2100 kcal/day and 2000 kcal/day respectively. \u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"margin-bottom: 10.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp style=\"margin-bottom: 10.0pt; line-height: 150%;\"\u003e\u003cstrong\u003e\u003cu\u003e\u003cspan style=\"font-size: 14.0pt; line-height: 150%;\"\u003eMode of delivery of participant mothers\u003c/span\u003e\u003c/u\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp style=\"margin-bottom: 10.0pt; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 14.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp; Maximum number of women (65%) had a normal delivery. About 30% of women underwent a cesarean section. Only 5% of the pregnant women underwent an instrumental delivery .\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"margin-bottom: 10.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp style=\"margin-bottom: 10.0pt; line-height: 150%;\"\u003e\u003cstrong\u003e\u003cu\u003e\u003cspan style=\"font-size: 14.0pt; line-height: 150%;\"\u003eBirth weight \u003c/span\u003e\u003c/u\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp style=\"margin-bottom: 10.0pt; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 14.0pt; line-height: 150%;\"\u003eThe above tables shows the birth weight of the babies in the present study . Majority of the babies (66%) had the birth weight in the range of 2.5-2.9 kgs .29 % of babies had birth weight in the range of 3-3.5 kgs .5% of babies had birth weight in the range of 2-2.49 kgs.\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"margin-bottom: 10.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp style=\"margin-bottom: 10.0pt; line-height: 150%;\"\u003e\u003cstrong\u003e\u003cu\u003e\u003cspan style=\"font-size: 14.0pt; line-height: 150%;\"\u003eAssociation between the parity and calorie intake\u003c/span\u003e\u003c/u\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp style=\"margin-bottom: 10.0pt; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 14.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; Above table shows the association between parity and the calorie intake of the pregnant women. As per the statistical analysis, there is a significant association between parity and calorie intake during the pregnancy. There is a declining trend in the calorie intake especially in multiparous mothers .\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"margin-bottom: 10.0pt; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 14.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"margin-bottom: 10.0pt; line-height: 150%;\"\u003e\u003cstrong\u003e\u003cu\u003e\u003cspan style=\"font-size: 14.0pt; line-height: 150%;\"\u003eCALORIE INTAKE AND BIRTH WEIGHT\u003c/span\u003e\u003c/u\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp style=\"margin-bottom: 10.0pt; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 14.0pt; line-height: 150%;\"\u003e\u0026nbsp; \u003cstrong\u003e\u0026nbsp;\u003c/strong\u003eThe association between the calorie intake and birth weight of the baby is shown in the table 7\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"margin-bottom: 10.0pt; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 14.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; Above table shows the association between the calorie intake of pregnant mother and weight of the baby at birth. As shown in the above table, there is a very significant association between the calorie intake of the mother and birth weight of the baby. Proper calorie intake of the mother has a positive impact on the baby weight.\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"margin-bottom: 10.0pt; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 14.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"margin-bottom: 10.0pt; line-height: 150%;\"\u003e\u003cstrong\u003e\u003cu\u003e\u003cspan style=\"font-size: 14.0pt; line-height: 150%;\"\u003eCALORIE INTAKE AND NICU ADMISSION\u003c/span\u003e\u003c/u\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp style=\"margin-bottom: 10.0pt; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 14.0pt; line-height: 150%;\"\u003eIn the present study 3 babies had NICU admission for the fetal distress.\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"margin-bottom: 10.0pt; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 14.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; The association between the calorie intake of the mother and need for NICU admission for fetal distress is shown in the table 8.\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"margin-bottom: 10.0pt; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 14.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; Table 8 shows the association between the calorie intake and the (NICU) Neonatal intensive care unit admission at birth for fetal distress. \u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"margin-bottom: 10.0pt; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 14.0pt; line-height: 150%;\"\u003e\u0026nbsp; \u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"margin-bottom: 10.0pt; line-height: 150%;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 14.0pt; line-height: 150%;\"\u003eCondition at discharge\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp style=\"margin-bottom: 10.0pt; line-height: 150%;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 14.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u0026nbsp; \u003c/span\u003e\u003c/strong\u003e\u003cspan style=\"font-size: 14.0pt; line-height: 150%;\"\u003e\u0026nbsp;All the mothers who participated in this study were discharged on third day in case of a normal delivery and on eighth day\u0026nbsp; in case of a cesarean section.\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"margin-bottom: 10.0pt; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 14.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u0026nbsp; All the babies including those admitted in NICU were discharged on day 3 after checking their bilirubin levels.\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"margin-bottom: 10.0pt; line-height: 150%;\"\u003e\u003cspan style=\"font-size: 14.0pt; line-height: 150%;\"\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; There was no case of neonatal death, postnatal complications like puerperal sepsis and anemia in this study .\u003c/span\u003e\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp; An adequate availability of nutrients during gestation is probably the single most important environmental factor influencing pregnancy outcome(1,5). Although physiological adjustments in nutrient utilization and metabolism are geared to improve the utilization of dietary nutrients during pregnancy, these adjustments may be insufficient to meet the demands for pregnancy and lactation if the woman is in poor nutrient status at conception. An adequate supply of nutrients is required to maintain the delicate balance between the needs of the mother and those of the fetus. An inadequate supply will cause a state of biological competition between the mother and the conceptus in which the well-being of both\u0026nbsp; is at serious risk (1).\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; All societies have traditional beliefs regarding harmful and beneficial foods for women during, pregnancy(6,7,8).There are also beliefs regarding the optimal amount of food to be taken during pregnancy for a successful reproductive outcome. These beliefs may or may not conform to the modern biomedical notions about the proper types and amount of food needed by pregnant women to safeguard maternal nutrition, adequate growth of fetus and safe delivery(9,10) .This prospective study was conducted to study the effects of food habits on pregnancy outcome.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFactors affecting the maternal nutrition\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSocioeconomic status\u0026nbsp; \u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; \u003c/strong\u003eIn this study majority of the women ( 83%) belonged to lower socioeconomic class as per Kuppuswamy\u0026rsquo;s classification. 14 % of women belonged to upper lower class and\u0026nbsp; 3% belonged to middle lower socioeconomic class respectively.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; The present study found a statistically significant association ( p value \u0026lt; 0.05) between the socioeconomic status and calorie intake of the mothers. Ayesha et al (11)reported the impact of maternal socioeconomic limitations on the calorie intake.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePARITY\u0026nbsp; \u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; \u003c/strong\u003eThe majority of women in this study were\u0026nbsp; primigravida (50%) or\u0026nbsp; second gravida (43.5%) . 6% and 0.5 % of women were of birth order 3 and 4 .The present study found a significant association between the parity and\u0026nbsp; maternal calorie intake .Sonneveldt et al reported a statistically significant relationship between the high parity and maternal nutrition(12).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFood habits and pregnancy outcome\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMode of delivery \u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; \u003c/strong\u003eIn the present study 65% of women delivered normally.30 % of women underwent a cesarean section and 5% of women had instrumental deliveries. The present study shows no statistically significant association between the mode of delivery and calorie intake (p value \u0026gt; 0.05). Similar results were found in study conducted by Thilothammal N and et al(13).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eBirth weight \u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp; \u003c/strong\u003eIn the present study 66% of the babies had birth weight in the range of 2.5-2.9 kgs.29% of babies had birth weight in the range of 3-3.5 kgs and 5% of babies had birth weight in the range of 2-2.49 kgs respectively.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; The present study found a very significant association between the maternal calorie intake and\u0026nbsp; birth weight of the baby.M Sumithra and Stephenson et al(14,15) demonstrated maternal nutritional status as a very important determinant of birth weight.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eNICU ADMISSION\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u0026nbsp; \u003c/strong\u003eIn the present study 3 babies had NICU admission for fetal distress. The present study found a statistically significant association between the maternal calorie intake and the NICU admission.P Kalik et al and Minsart et al found similar statistically significant results(16,17).\u003c/p\u003e\n\u003cp\u003eThe mothers whose preprgnancy BMI was low were given nutritional advice and it was noted that there was a marginal increase in their caroric intake in subsequent visits. However, this is not sufficient to influence the pregnancy outcome.\u003c/p\u003e\n\u003cp\u003eAll these mothers belonging to low SE group are covered under the ICDS scheme and receive nutritional supplement during the entire pregnancy.\u003c/p\u003e"},{"header":"Conclusions","content":"\u003cp\u003e\u0026nbsp; Among the 350 women who participated in this study majority of the women belonged to the age group of 21-30 yrs and\u0026nbsp; to a lower socioeconomic class with the pre-pregnancy B.M.I\u0026nbsp; within normal range of 18.5-24.9 kg/m\u003csup\u003e2\u003c/sup\u003e.\u003c/p\u003e\n\u003cp\u003eThe average calorie intake of mothers with normal B.M.I was 2012kcal/day .The average calorie intake of mothers with B.M.I \u0026lt;18.5 kg/m\u003csup\u003e2\u003c/sup\u003e and mothers with B.M.I \u0026gt;25 was 1866 kcal/day and 1975 kcal/day respectively.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;The food items consumed by the mothers during pregnancy consisted of rice, sambhar, milk, idly , fruits like apple, banana, dates, rassam and mutton soups.There was a significant association (p value \u0026lt; 0.05) between the\u0026nbsp; socioeconomic status of the mother,parity\u0026nbsp; and her calorie intake. The present study found a statistically significant association between the maternal nutritional status ,the birth weight of the baby and the need for NICU admission (p value \u0026lt; 0.05).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; \u003c/strong\u003eMaternal food habits have an impact on the pregnancy outcome. Nutrition education and awareness generation among the women is needed (18,19).Maternal food ood habits are influenced by many factors like socioeconomic status, parity, social food taboos and pregnancy itself .The pregnancy outcomes like birth weight, need for NICU admission and postnatal complications are influenced by maternal nutritional status.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eConflicts of Interest\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe author declares no conflicts of interest\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor Contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003ePrincipal Author \u0026ndash; Dr Devdatt Laxman Pitale.\u003c/p\u003e\n\u003cp\u003eFunding -None.\u003c/p\u003e\n\u003cp\u003eConflicts- None to declare.\u003c/p\u003e\n\u003cp\u003eThis study was approved by the Institutional Ethical committee.\u003c/p\u003e"},{"header":"References","content":"\u003cp\u003e1. Janet C.King.The risk of maternal nutritional depletion and poor outcomes increases in early or closely spaced pregnancies.JN.2003\u003c/p\u003e\n\u003cp\u003e2. National Family Health Survey-4.MOHFW.GOI.International institute for population sciences.Mumbai;2015-2016\u003c/p\u003e\n\u003cp\u003e3 Institute of Medicine.Weight Gain During Pregnancy: Reexamining the Guidelines. Washington, DC: National Academy Press; 2009.\u003c/p\u003e\n\u003cp\u003e4 Asha K, Salil S. Nutrient Intake of Lactating Mothers from Rural areas and urban areas. Indian J Soc Res. 1998;39:2.\u003c/p\u003e\n\u003cp\u003e5 Nag, M. (2009). Beliefs and Practices about Food during Pregnancy: Implications for Maternal Nutrition. Economic And Political Weekly, 29(37), 2427\u0026ndash;2438.\u003c/p\u003e\n\u003cp\u003e6 Zeisel H S.(2009).Importance of methyl donors during reproduction.Am J Clin Nutr; 89(2): 673S\u0026ndash;677S.\u003c/p\u003e\n\u003cp\u003e7 Wahid MA, Fathi SA. Nutrition and the unborn baby. Ric Clin Lab. 1987;17(3):199\u0026ndash;206.\u003c/p\u003e\n\u003cp\u003e8 .Manderson L, Mathews M. Vietnamese attitudes towards maternal and infant health.Med J Aust.1981:69\u0026ndash;72.\u003c/p\u003e\n\u003cp\u003e9.Mitchell J, Mackerras D. The traditional humoral food habits of pregnant Vietnamese-Australian women and their effect on birth weight.Aust J Public Health.1995:629\u0026ndash;33.\u003c/p\u003e\n\u003cp\u003e10\u0026nbsp; J Meghali , S Rekha(2013).TABOOS AND MISCONCEPTIONS ABOUT FOOD DURING PREGNANCY.IJRSSIS;Vol 1:1-6\u003c/p\u003e\n\u003cp\u003e11.Ayesha et Al.Impact of maternal \u003cbr /\u003e education and socioeconomic status on maternal nutritional knowledge and practices regarding iron rich foods and iron supplements. Ann Pak Inst Med. Sci. 2012;8:101-5.\u003c/p\u003e\n\u003cp\u003e12Sonneveldt et al.Linking high parity and maternal and child mortality:what is the impact of lower health services coverage among higher order births.BMC Public Health;13(Supply 3):S7\u003c/p\u003e\n\u003cp\u003e13Thilotthammal N.Influence if maternal nutritional status on mode of delivery and asphyxia neonatorum.Indian J Pediatr.1992;59(3):325-9\u003c/p\u003e\n\u003cp\u003e14M Sumithra.Maternal nutrition and low birth weight-what is really important.Indian J Med Res.November 2009;130:600-608\u003c/p\u003e\n\u003cp\u003e15Stephenson T and Symonds M.Maternal nutrition as a determinant of birth weight.Arch Dis Child Fetal Neonatal Ed.2002;86:F4-F6\u003c/p\u003e\n\u003cp\u003e16Kalik P et al.Impact of maternal body mass index on neonatal outcome.Eur J Med Res.2009;14(5):216-222\u003c/p\u003e\n\u003cp\u003e17Minsart et al.Neonatal outcomes in obese mothers: a population-based analysis.BMC pregnancy and Childbirth.2013,13:36.\u003c/p\u003e\n\u003cp\u003e18 Uzma Eram et al. TABOOS AND MISCONCEPTIONS ASSOCIATED WITH PREGNANCY AMONG RURAL WOMEN IN ALIGARH. International Journal of Information Research and Review, December, 2016\u003c/p\u003e\n\u003cp\u003e19. EA Ugwa. Nutritional Practices and Taboos Among Pregnant Women Attending Antenatal Care at General Hospital in Kano, Northwest Nigeria. \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4866363/?report=classic\"\u003eAnn Med Health Sci Res\u003c/a\u003e. 2016 Mar-Apr; 6(2): 109\u0026ndash;114\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Nutrition, Food habits, birth weight","lastPublishedDoi":"10.21203/rs.3.rs-132630/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-132630/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eIntroduction: Nutrition during pregnancy plays an important role for an optimum outcome of pregnancy. Women may be malnourished even before they become pregnant and this may further adversely affect the pregnancy. Maternal undernutrition can lead to poor intrauterine growth and low weight of the baby at birth. Moreover, the leading causes for maternal deaths like hemorrhage and infection are related directly or indirectly to nutrition. \u003c/p\u003e\u003cp\u003eAim of the Study: To study the impact of existing food habits on pregnancy outcome in a south Indian population. \u003c/p\u003e\u003cp\u003eMaterials and Methods: This prospective study was conducted at a tertiary health care and research institute in India. From the antenatal clinic, 350 women who satisfied the following inclusion and exclusion criteria were admitted to the study. \u003c/p\u003e\u003cp\u003eResults: The majority of pregnant women belonged to the age group of 21-25 yrs (47%) followed by the 26-30 yrs age group (40%).The number of teenage pregnancies was 30 (8%) whereas 5% of pregnant women belong the age group of 31-35 yrs.83% of the study population belonged to the low socioeconomic class. Majority of the babies (66%) had the birth weight in the range of 2.5-2.9 kgs. 29 % of babies had birth weight in the range of 3-3.5 kgs. There was a significant association (p value \u0026lt; 0.05) between the socioeconomic status of the mother, parity and her calorie intake. The present study found a statistically significant association between the maternal nutritional status, the birth weight of the baby and the need for NICU admission (p value \u0026lt; 0.05). \u003c/p\u003e\u003cp\u003eConclusion: Maternal food habits have an impact on the pregnancy outcome. Maternal food habits are influenced by many factors like socioeconomic status, parity, social food taboos and pregnancy itself. The pregnancy outcomes like birth weight, need for NICU admission and postnatal complications are influenced by maternal nutritional status.\u003c/p\u003e","manuscriptTitle":"Food habits and Pregnancy outcomes","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2021-01-27 15:47:57","doi":"10.21203/rs.3.rs-132630/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"9b1c7136-64dc-4357-9759-48d45c8e7fdc","owner":[],"postedDate":"January 27th, 2021","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":2092723,"name":"Nutrition \u0026 Dietetics"}],"tags":[],"updatedAt":"2021-01-27T15:47:57+00:00","versionOfRecord":[],"versionCreatedAt":"2021-01-27 15:47:57","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-132630","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-132630","identity":"rs-132630","version":["v1"]},"buildId":"FbvkV6FR0MCFSLy54lSbu","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}