Prevalence and Associated Factors of Zinc Deficiency Among Pregnant Women Attending Antenatal Care at Gambella Hospital, Gambella, Ethiopia, 2018
American Journal of Life Sciences
Volume 7, Issue 5, October 2019, Pages: 91-99
Received: May 30, 2019;
Accepted: Oct. 21, 2019;
Published: Oct. 30, 2019
Views 167 Downloads 70
Ataguade Mekonnen, Department of Human Nutrition and Dietetics, School of Public Health, Gambella of Health Sciences, Gambella, Ethiopia
Wondwossen Terefe, Department of Human Nutrition and Dietetics, School of Public Health, Mekelle University, Mekelle, Ethiopia
Abate Bekele Belachew, Department of Human Nutrition and Dietetics, School of Public Health, Mekelle University, Mekelle, Ethiopia
Amaha Kahsay Adhanu, Department of Human Nutrition and Dietetics, School of Public Health, Mekelle University, Mekelle, Ethiopia
Kebede Embaye Gezae, Department of Human Nutrition and Dietetics, School of Public Health, Mekelle University, Mekelle, Ethiopia
It has been evidenced that zinc deficiency has an adverse effect on both mother and fetus, and subsequent birth outcomes and child survival. However, data on the prevalence and determinants of zinc deficiency among pregnant women are scanty in the country. Thus, this study was aimed to assess the prevalence of zinc deficiency and its associated factors among pregnant mothers attending antenatal care in the study setting in particular and the country in general. Hospital based cross-sectional study was done in Gambella Hospital, Southwest Ethiopia from January to March, 2016. A randomly selected 246 pregnant women were included in this study. Blood samples were collected to analyze biochemical indicators of zinc deficiency. A multivariable logistic regression analysis was done to assess the effect of various explanatory variables on the serum zinc level. The mean serum zinc concentration was 58.75μg/dl (95%CI: 56.10-61.41). The overall prevalence of zinc deficiency among pregnant women was 55.3% (95% CI: 50.0-61.3). Zinc deficiency was positively associated with short birth interval (AOR=2.6; 95% CI: 1.08-6.27), the third trimester (AOR=3.76; 95% CI: 1.49-9.49), failure to consume diet of animal source (AOR=2.4; 95% CI: 1.01-5.74), inadequate dietary diversity (AOR=3.59; 95% CI: 1.45-8.96), low serum albumin level (AOR=3.05; 95%CI: 1.31-7.08), and anemia (AOR=3.09; 95%CI: 1.19-7.95). More than half (55.3%) of pregnant women had biochemical evidence of zinc deficiency. Moreover, the magnitude of zinc deficiency was pronounced among pregnant mothers with short birth interval, advanced gestational age, minimal intake of animal food sources, inadequate dietary diversity score, low serum albumin level, and low hemoglobin level (anemia). Therefore, effort should be made to encourage pregnant mothers to consume balanced diet including animal food sources particularly in their third trimester, to monitor their hemoglobin and serum albumin levels, and strengthening family planning implementations to prevent the occurrence of zinc deficiency.
Abate Bekele Belachew,
Amaha Kahsay Adhanu,
Kebede Embaye Gezae,
Prevalence and Associated Factors of Zinc Deficiency Among Pregnant Women Attending Antenatal Care at Gambella Hospital, Gambella, Ethiopia, 2018, American Journal of Life Sciences.
Vol. 7, No. 5,
2019, pp. 91-99.
Hambidge M. Zinc and Health: Current status and future directions. Journal of Nutrition. 2000; 130: 1344S-1349S.
NairK M, Choudhury DR. Zinc nutrition in health and diseases. Journal of SAT Agricultural. 2013.
Brown KH, Rivera JA, Bhutta Z, Gibson RS, King JC, Lönnerdal B, Ruel MT, Sandtröm B, Wasantwisut E, Hotz C, de Romaña DL. International Zinc Nutrition Consultative Group (IZiNCG) technical document# 1. Assessment of the risk of zinc deficiency in populations and options for its control. Food and nutrition bulletin. 2004; 25 (1 Suppl 2).
Joint FAO and WHO. Vitamin and mineral requirements in human nutrition. 2005.
Bales CW, Ritchie CS, editors. Handbook of clinical nutrition and aging. New York, NY, USA: Humana Press. 2009.
Karimi A, Bagheri S, Nematy M, Saeidi M. Zinc Deficiency in Pregnancy and Fetal-Neonatal Outcomes and Impact of the Supplements on Pregnancy Outcomes. Iranian Journal of Neonatology (IJN). 2012; 3 (2): 77-83.
Shah D, Sachdev HP. Effect of gestational zinc deficiency on pregnancy outcomes: Summary of observation studies and zinc supplementation trials. British Journal of Nutrition. 2001; 85 (2): 101-108.
CaulfieldLE, Black RE. Zinc deficiency: Comparative quantification of health risks: global and regional burden of disease attributable to selected major risk factors. Geneva. 2004: 257-279.
Tamura T, Goldenberg RL, Johnston KE, Dubard M. Maternal plasma zinc concentrations and pregnancy outcome. The American journal of clinical nutrition. 2000; 71 (1): 109-113.
Ugwuja EI, Akubugwo EI, Ibiam UA, Obidoa O. Maternal socio-demographic parameters: impact on trace element status and pregnancy outcomes in Nigerian women. Journal of health, population, and nutrition. 2011; 29 (2): 156.
Getahun Z, Urga K, Ganebo T, Nigatu A. Review of the status of malnutrition and trends in Ethiopia. The Ethiopian Journal of Health Development (EJHD). 2017; 15 (2).
Kumera G, Awoke T, Melese T, Eshetie S, Mekuria G, Feleke M, Ewunetu T, Gedle D. Prevalence of zinc deficiency and its association with dietary, serum albumin and intestinal parasitic infection among pregnant women attending antenatal care at the University of Gondar Hospital, Gondar, Northwest Ethiopia. BMC Nutrition. 2015; 1 (1): 31.
Woteki CE, Earl R, editors. Iron deficiency anemia: recommended guidelines for the prevention, detection, and management among US children and women of childbearing age. National Academies Press. 1994.
Be WK, Kerkkamp HE, Booij LH. Hemocue--a new haemoglobinometer in the clinic. European journal of anaesthesiology. 1991; 8 (1): 55-58.
Lambein F, Haque R, Khan JK, Kebede N, Kuo YH. From soil to brain: zinc deficiency increases the neurotoxicity of Lathyrus sativus and may affect the susceptibility for the motorneurone disease neurolathyrism. Toxicon. 1994; 32 (4): 461-466.
Gebremedhin S, Enquselassie F, Umeta, M. Enquselassie, and M. Umeta, Prevalence of prenatal zinc deficiency and its association with socio-demographic, dietary and health care related factors in Rural Sidama, Southern Ethiopia: A cross-sectional study. BMC public health. 2011; 11 (1): 898.
Pathak P, Kapil U, Kapoor S, Dwivedi S, Singh R. Magnitude of zinc deficiency among nulliparous nonpregnant women in a rural community of Haryana State, India. Food and nutrition bulletin. 2003; 24 (4): 368-371.
Ma AG, Chen XC, Xu RX, Zheng MC, Wang Y, Li JS. Comparison of serum levels of iron, zinc and copper in anemic and non-anemic pregnant women in China. Asia Pacific journal of clinical nutrition. 2004; 13 (4).
Gibson RS, Abebe Y, Stabler S, Robert H, Allen R, Westcott J, Stoecker B, Krebs N, Hambidge K. Zinc, Gravid, infection, and iron, but vitamin B-12 or foliate status, predict hemoglobin during pregnancy in southern Ethiopia. Journal of nutrition. Journal of nutrition. 2008; 138 (3): 538-586.
Abebe Y, Bogale A, Hambidge KM, Stoecker BJ, Arbide I, Teshome A, Krebs NF, Westcott JE, Bailey KB, Gibson RS. Inadequate intakes of dietary zinc among pregnant women from subsistence households in Sidama, Southern Ethiopia. Public health nutrition. 2008; 11 (4): 379-386.
Kassu A, Yabutani T, Mulu A, Tesema B, Ota F. Serum zinc, copper, selenium, calcium, and magnesium levels in pregnant and non-pregnant women in Gondar, Northwest Ethiopia. Biological trace element research. 2008; 122 (2): 97.
Oguizu AD. Assessment of Iron, Selenium and Zinc Status of Pregnant Women in Obio-Akpor LGA Rivers State. Pakistan Journal of Nutrition. 2015; 14 (1): 1-5.
Mitheko AN. Dietary, socio-economic and demographic factors influencing serum zinc levels of pregnant women at Naivasha level 4 hospital Nakuru County, Kenya. 2013.
Engle-Stone R, Ndjebayi AO, Nankap M, Killilea DW, Brown KH. Stunting Prevalence, Plasma Zinc Concentrations, and Dietary Zinc Intakes in a Nationally Representative Sample Suggest a High Risk of Zinc Deficiency among Women and Young Children in Cameroon–3. The Journal of nutrition. 2013; 144 (3): 382-391.
Açkurt F, Wetherict H, Löker M. Biochemical assessment of nutritional status in pre-and post-natal Turkish women and outcome of pregnancy. European Journal of Clinical Nutrition. 1995; 49 (8): 613-622.
Pathak P, Kapil U, Dwivedi SN, Singh R. Serum zinc levels amongst pregnant women in a rural block of Haryana state, India. Asia Pacific journal of clinical nutrition. 2008; 17 (2): 276-279.
Rathi SS, Srinivas M, Grover JK, Mitra D, Vats V, Sharma JD. Zinc levels in women and newborns. Indian journal of pediatrics. 1999; 66 (5): 681-684.
Walker CF, Ezzati M, Black R. Global and regional child mortality and burden of disease attributable to zinc deficiency. European Journal of Clinical Nutrition. 2009; 63 (5): 591-597.
Haidar J, Umeta M, Kogi-Makau W. Effect of iron supplementation on serum zinc status of lactating women in Addis Ababa, Ethiopia. East African medical journal. 2005; 82 (7): 349-352.
Lutfullah G. Prevalence of zinc deficiency among rural women during childbearing age in Peshawar, Pakistan. Pak. J. Pharm. Sci. 2014; 27 (1): 173-177.
Bushra M, Elhassan M, Naji I, Ali A, Osman E, Khalid H, Bakheit A, Adam I. Anaemia, zinc and copper deficiencies among pregnant women in central Sudan. Biological trace element research. 2010; 137 (3): 255-261.
Shommo S, Zumrawi F, Saeed A. Micronutrients Dietary Intakes of Pregnant Sudanese Women. International Journal of Science and Research. 2013; 4 (4): 2319-7064.
Gibson RS, Huddle JM. Suboptimal zinc status in pregnant Malawian women: its association with low intakes of poorly available zinc, frequent reproductive cycling, and malaria. The American journal of clinical nutrition. 1998; 67 (4): 702-709.
Hanachi P, Golkho S, Norrozi M. The association of serum Zinc levels with socio demographic factors, red and white blood cells count in pregnant women. Journal of Applied Sciences. 2008; 8: 4679-4683.
Roshanravan N, Alizadeh M, Hedayati M, Asghari-Jafarabadi M, Alamdari NM, Anari F, Tarighat-Esfanjani A. Effect of zinc supplementation on insulin resistance, energy and macronutrients intakes in pregnant women with impaired glucose tolerance. Iranian journal of public health. 2015; 44 (2): 211.
Nguyen VQ, Gotot A, Nguyen TVT, Vo KT, Ta TNT, Nguyen TNT, et al. Prevalence and correlates of zinc deficiency in pregnant Vietnamese women in Ho Chi Minh City. Asia Pacific journal of clinical nutrition. 2013; 22 (4): 614-619.
Shamin AA, Merrill RD, Ali AH, Rashid M, Schulze K. Plasma zinc, vitamin B 12 and α-tocopherol are positively and plasma γ-tocopherol is negatively associated with Hb concentration in early pregnancy in north-west Bangladesh. Public health nutrition. 2013; 16 (8): 1354-1361.
Severi C, Hambidge M, Krebs N, Alonso R, Atalah E. Zinc in plasma and breast milk in adolescents and adults in pregnancy and pospartum: a cohort study in Uruguay. Nutrición Hospitalaria. 2013; 28 (1).
King JC. Determinants of maternal zinc status during pregnancy. The American journal of clinical nutrition. 2000; 71 (5): 1334s-1343s.
Mohamed AA, Ali AA, Ali NI, Abusalama EH, Elbashir MI, Adam I. Zinc, parity, infection, and severe anemia among pregnant women in Kassla, eastern Sudan. Biological trace element research. 2011; 140 (3): 284-290.
Chandyo RK, Strand TA, Mathisen M, Ulak M, Adhikari RK, Bolann BJ, Sommerfelt H. Zinc deficiency is common among healthy women of reproductive age in Bhaktapur, Nepal. The Journal of nutrition. 2009; 139 (3): 594-597.
Aldrian PS, Keen CL, Lönnerdal B, Dewey KG. Effects of coffee consumption on iron, zinc and copper status in nonpregnant and pregnant Sprague-Dawley rats. International journal of food sciences and nutrition. 1997; 48 (3): 177-189.
Dash S, Brewer GJ, Oelshlegel FJ. Effect of zinc on haemoglobin binding by red blood cell membranes. Nature. 1974; 250 (5463): 251-252.