Dietary knowledge, dietary practices, and utilization of antenatal care services among undernourished pregnant women: a cross-sectional study

Authors

  • X. Sangeetha Ramaiah Institute of Nursing Education and Research, M. S. Ramaiah University of Applied Sciences, Bengaluru, India
  • Moonjelly Vijayan Smitha College of Nursing, All India Institute of medical sciences, Bhubaneswar, Odisha, India
  • Geeta Bhardwaj Nursing College, All India Institute of Medical Sciences, Saket Nagar, Bhopal, M. P., India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20260875

Keywords:

Maternal nutrition, Antenatal care utilisation, Dietary knowledge, Dietary practices, Undernourished pregnant women

Abstract

Background: Maternal undernutrition remains a major public health concern in low- and middle-income countries and is associated with adverse maternal and neonatal outcomes. Adequate dietary knowledge and practices during pregnancy are essential for optimal maternal and fetal health. Antenatal care (ANC) services provide an important platform for nutrition counseling and micronutrient supplementation; however, gaps in knowledge, practices, and adherence persist among undernourished pregnant women.

Methods: A cross-sectional study was conducted among 70 undernourished pregnant women (BMI<18.5 kg/m²) attending antenatal clinics in selected health facilities, Bangalore. Data were collected using a structured questionnaire covering socio-demographic characteristics, dietary knowledge, dietary practices, and ANC utilization. Statistical analysis was performed using Jamovi (version 2.5.3) and RStudio. Descriptive statistics, Mann-Whitney U test, Chi-square test, and Fisher’s exact test were applied, with significance set at p<0.05.

Results: The median age was 24 years; most participants had secondary education and were homemakers. Inadequate dietary knowledge (87.1%) and poor practices (71.4%) were prevalent, with no significant association (p=0.265). ANC utilization was high (≥6 visits). Adherence was moderate for folic acid (67%) and calcium (63%), but low for iron (39%). Barriers included nausea, vomiting, and forgetfulness. Income was significantly associated with knowledge and practice levels (p=0.046).

Conclusions: Despite adequate ANC utilization, substantial gaps exist in dietary knowledge and practices among undernourished pregnant women. Strengthening nutrition counseling and addressing adherence barriers and socioeconomic constraints are essential to improve maternal nutrition and pregnancy outcomes.

References

Williamson CS. Nutrition in pregnancy. Nutrition Bulletin 2006;31(1):28-59. DOI: https://doi.org/10.1111/j.1467-3010.2006.00541.x

Shemsu S, Argaw A, Zinab B. Dietary Practice and Nutritional Status Among Pregnant Women Attending Antenatal Care at Mettu Karl Referral Hospital, Southwest Ethiopia. TOPHJ 2020;13(1):538-46. DOI: https://doi.org/10.2174/1874944502013010538

Tafara L, Bikila H, Feyisa I. The prevalence of under nutrition and associated factors among pregnant women attending antenatal care service in public hospitals of western Ethiopia. Marinho CRF. ed. PLoS ONE. 2023;18(1):e0278180. DOI: https://doi.org/10.1371/journal.pone.0278180

World Health Organization. WHO recommendations on antenatal care for a positive pregnancy experience. Geneva: WHO. 2016.

Mithra P, Unnikrishnan B, Rekha T, Nithin K, Mohan K, Kulkarni V. Compliance with iron-folic acid therapy among pregnant women. Afr Health Sci. 2013;13(4):880-885. DOI: https://doi.org/10.4314/ahs.v13i4.3

Gelebo DG, Gebremichael MA, Asale GA, Berbada DA. Prevalence of undernutrition and its associated factors among pregnant women in Konso district, southern Ethiopia: a community-based cross-sectional study. BMC Nutr 2021;7(1):32. DOI: https://doi.org/10.1186/s40795-021-00437-z

Muze M, Yesse M, Kedir S, Abdilmejid M. Prevalence and associated factors of undernutrition among pregnant women visiting ANC clinics in Silte zone, Southern Ethiopia. BMC Pregnancy Childbirth. 2020;20(1):707. DOI: https://doi.org/10.1186/s12884-020-03404-x

International Institute for Population Sciences (IIPS), Ministry of Health and Family Welfare (MoHFW), Government of India. National Family Health Survey (NFHS-5), 2019-21: India Report. Mumbai: IIPS. 2021

Gebremichael MA, Lema TB. Prevalence and Predictors of Knowledge and Attitude on Optimal Nutrition and Health Among Pregnant Women in Their First Trimester of Pregnancy. IJWH 2023;15:1383-95. DOI: https://doi.org/10.2147/IJWH.S415615

Mahmoud NM, Ghaly AS. Dietary Knowledge, Practices and Adequacy among Bedouin Pregnant Women. IJN 2019;7(2):68-83. DOI: https://doi.org/10.15640/ijn.v6n2a7

Bayked EM, Yimer EM, Gelaw T, Abdu SM, Nigusie AM. Dietary knowledge, attitude, practice, and associated factors among pregnant mothers in Ethiopia: a systematic review and meta-analysis. Front Public Health. 2024;12:1393764. DOI: https://doi.org/10.3389/fpubh.2024.1393764

Girma A, Genetu A, Ayalew E, Dawit G. Determinants of dietary practice among pregnant women at the public hospitals in Bench-Sheko and Kaffa Zones, Southwest Ethiopia. BMC Nutr 2022;8(1):88. DOI: https://doi.org/10.1186/s40795-022-00588-7

Ghosh-Jerath S, Devasenapathy N, Singh A, Anuraj S, Sanjay Z. Ante natal care (ANC) utilization, dietary practices and nutritional outcomes in pregnant and recently delivered women in urban slums of Delhi, India: an exploratory cross-sectional study. Reprod Health. 2015;12(1):20. DOI: https://doi.org/10.1186/s12978-015-0008-9

Yalewdeg M, Birhane M, Adissu Y. Dietary Practices and Their Determinants Among Pregnant Women in Gedeo Zone, Southern Ethiopia: A Community-Based Cross-Sectional Study. NDS. 2020;12:267-75. DOI: https://doi.org/10.2147/NDS.S267453

Getaneh T, Negesse A, Dessie G. Predictors of malnutrition among pregnant women in Ethiopia: A systematic review and meta-analysis. Human Nutrit Metabol. 2021;26:200131. DOI: https://doi.org/10.1016/j.hnm.2021.200131

Rustagi R, Basu S, Garg S. Utilization of antenatal care services and its sociodemographic correlates in urban and rural areas in Delhi, India. Eur J Midwifery. 2021;5(9):1-5. DOI: https://doi.org/10.18332/ejm/140459

Sangwan KS, Kshirsagar VD, Parande MA. Knowledge, attitude and practices regarding nutrition among pregnant females visiting the antenatal care outpatient department of a tertiary care hospital, Pune. Int J Community Med Public Health. 2022;9(2):902. DOI: https://doi.org/10.18203/2394-6040.ijcmph20220064

Diddana TZ. Factors associated with dietary practice and nutritional status of pregnant women in Dessie town, northeastern Ethiopia: a community-based cross-sectional study. BMC Pregnancy Childbirth. 2019;19(1):517. DOI: https://doi.org/10.1186/s12884-019-2649-0

Lincetto O, Mothebesoane-Anoh S, Gomez P, Munjanja S. Antenatal care. In: Opportunities for Africa’s newborns. Geneva: WHO. 2006.

Black RE, Victora CG, Walker SP, Bhutta ZA, Christian P, de Onis M, et al. Maternal and child undernutrition and overweight in low-income and middle-income countries. Lancet. 2013;382(9890):427-51. DOI: https://doi.org/10.1016/S0140-6736(13)60937-X

Abu-Saad K, Fraser D. Maternal nutrition and birth outcomes. Epidemiol Rev. 2010;32(1):5-25. DOI: https://doi.org/10.1093/epirev/mxq001

Girard AW, Olude O. Nutrition education and counselling provided during pregnancy: effects on maternal, neonatal and child health outcomes. Paediatr Perinat Epidemiol. 2012;26(1):191-204. DOI: https://doi.org/10.1111/j.1365-3016.2012.01278.x

Sharma S, Mahajan H, Bedi N. Dietary habits and nutritional status of pregnant women attending antenatal clinics. J Family Med Prim Care. 2020;9(5):2386-91.

Olloqui-Mundet MJ, Cavia MDM, Alonso-Torre SR. Dietary Habits and Nutritional Knowledge of Pregnant Women: The Importance of Nutrition Education. Foods. 2024;13(19):3189. DOI: https://doi.org/10.3390/foods13193189

Nguyen PH, Sanghvi T, Kim SS. Factors influencing maternal nutrition practices in Southeast Asia. Maternal Child Nutr. 2017;13(S2):e12403. DOI: https://doi.org/10.1111/mcn.12406

Saaka M, Oladele J, Larbi A, Hoeschle-Zeledon I. Dietary diversity and maternal nutrition among pregnant women. J Nutr Metab. 2017;2017:1-8. DOI: https://doi.org/10.1155/2017/8497892

Downloads

Published

2026-03-27

How to Cite

Sangeetha, X., Smitha, M. V., & Bhardwaj, G. (2026). Dietary knowledge, dietary practices, and utilization of antenatal care services among undernourished pregnant women: a cross-sectional study. International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 15(4), 1211–1219. https://doi.org/10.18203/2320-1770.ijrcog20260875

Issue

Section

Original Research Articles