Anthropometric status in children aged 6-36 months, born from intended and unintended pregnancies in vulnerable communities from the Western Cape Province

Holm, Adri (2019-04)

Thesis (MNutr)--Stellenbosch University, 2019.

Thesis

ENGLISH SUMMARY : South Africa has a high rate of unintended pregnancies among vulnerable women. There is a growing body of evidence that shows the importance of the first 1000 days of life (namely, from conception to 2 years old). This time period in the life cycle provides a crucial window of opportunity for proper nutrition, which could improve overall health, cognitive capacity and academic performance, leading to improved health and socio-economic circumstances on an individual and national scale in South Africa. Improving the quality of women’s and girls’ pre-conception nutritional intake, as well as their intake during the period of pregnancy, could boost progressive maternal and child health and development outcomes. This cross-sectional study measured the pregnancy intention of mothers (n=72), aged 15 to 43 years old, retrospectively to analyse the impact thereof on their child’s current nutritional status in two vulnerable peri-urban communities in the Western Cape. Other determinants of health and its effects on children’s nutritional status were also investigated. From the sample population, 39% (n=28) of the pregnancies were categorised as “Unplanned”, 46% (n=33) as “Ambivalent” and only 15% (n=11) as “Planned”. Infants born from ambivalent pregnancy intention had a slightly lower birth weight than those of unplanned and planned pregnancy intention. Pregnancy intention and the current anthropometric status of the child were not associated [CI: -1.86 to 1.86]. A non-linear association was found between the ages of the sample population and their anthropometric status. Children aged 12 to 28 months were more prone to malnutrition.Women receiving their main income from the Child Support Grant had a significantly lower pregnancy intention than those women receiving their main income from either family or the child’s father (Prob > F =0.0038). No literature was previously available on whether there is a link between the high rate of unintended pregnancies in vulnerable communities in South Africa, and malnutrition in young children born from such pregnancies. This research concludes that unintended pregnancies did not contribute to malnutrition in the studied vulnerable peri-urban communities. Hence, even though many of the pregnancies were unintended, it seems as if most of the mothers found a way to care for the child. Improving nutritional quality and the emotional wellbeing of all women of childbearing potential, therefore, presents a key opportunity to improve future generations’ health and mitigate the risk of adverse long-term economic outcomes. Future mothers should be empowered to make decisions in the best interest of their children, regardless of whether the pregnancies were planned or unplanned.

AFRIKAANSE OPSOMMING : Suid-Afrika ondervind ‘n hoë koers van onbeplande swangerskappe onder kwesbare vroue. Daar is toenemende bewyse vir die belangrikheid van die eerste 1000 dae van lewe (naamlik vanaf bevrugting tot twee-jarige ouderdom). Hierdie lewensiklus-fase voorsien ‘n kritieke venster periode vir behoorlike kwaliteit voeding, wat algehele gesondheid, kognitiewe kapasiteit en akademiese prestasie kan verbeter, wat kan lei tot verbeterde gesondheid en sosio-ekonomiese toestande op ‘n individuele en nasionale vlak in Suid-Afrika. Verbetering van meisies en vrouens se voedingsinname voor bevrugting sowel as gedurende die swangerskap, kan dus progressiewe uitkomste vir die moeder en kind se gesondheid en ontwikkeling beteken. Hierdie deursnee-studie het die swangerskap intensies van moeders (n=72), 15 tot 43 jaar oud, in twee kwesbare, buitestedelike gemeenskappe in die Wes-Kaap retrospektief gemeet om sodoende die impak daarvan op hul kinders se huidige voedingstatus te analiseer. Ander faktore wat gesondheid bepaal en die effekte daarvan op kinders se voedingstatus was ook ondersoek. Uit die steekproef bevolking was 39% (n=28) van die swangerskappe gekategoriseer as “Onbepland”, 46% (n=33) as “Ambivalent” en slegs 15% (n=11) as “Beplan”. Kinders gebore uit ambivalente swangerskappe het ‘n effens laer geboortegewig gehad as dié van onbeplande of beplande swangerskappe. Die huidige antropometriese status van die kinders en swangerskap intensie was nie geassosieer nie [CI: -1.86 tot 1.86]. ‘n Nie-liniêre assosiasie was gevind tussen die ouderdomme van die steekproef bevolking en hul antropometriese status. Kinders tussen 12 en 28 maande oud was meer geneig tot wanvoeding. Vrouens wat hul hoofinkomste ontvang het van ‘n Kinderondersteuningstoelae het `n betekenisvolle laer swangerskap intensie gehad as dié vrouens wat hul hoofinkomste ontvang het van hul families of die kinders se vader (Prob > F =0.0038). Geen literatuur was voorheen beskikbaar oor die moontlikheid van ‘n skakel tussen die hoë onbeplande swangerskapskoers in kwesbare gemeenskappe in Suid-Afrika, en wanvoeding in jong kinders gebore uit sulke swangerskappe nie. Hierdie navorsing het tot die gevolgtrekking gekom dat onbeplande swangerskappe nie bygedra het tot wanvoeding in die bestudeerde kwesbare, buitestedelike gemeenskappe nie. Dit blyk dat meeste van die moeders n manier gevind het om na die kind om te sien, ten spyte van die feit dat baie van die swangerskappe onbepland was. Die verbetering van voeding en die emosionele welstand van alle vrouens met die potensiaal om swanger te raak bied dus ‘n gulde geleentheid om die toekomstige generasies se gesondheid te verbeter en die risiko van ongunstige, langtermyn ekonomiese uitkomste te verminder. Toekomstige moeders moet bemagtig word om besluite te maak in die beste belang van hul kinders of die swangerskappe beplan of onbepland was.

Please refer to this item in SUNScholar by using the following persistent URL: http://hdl.handle.net/10019.1/105644
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