Quality of the diet of pregnant women in the scope of Primary Health Care

LEÃO, Giselle Mara Mendes Silva; CRIVELLENTI, Lívia Castro; BRITO, Maria Fernanda Santos Figueiredo; SILVEIRA, Marise Fagundes; PINHO, Lucinéia de

doi:10.1590/1678-9865202235e210256

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Sumário

ORIGINAL • Rev Nutr 35 • 2022 • https://doi.org/10.1590/1678-9865202235e210256 copy

Quality of the diet of pregnant women in the scope of Primary Health Care

Qualidade da dieta de gestantes no âmbito da Atenção Primária à Saúde

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective

To evaluate the quality of the diet of the pregnant women monitored by the Family Health Strategy teams and associated factors.

Methods

This is a population-based cross-sectional study, carried out with 1244 pregnant women between 2018 and 2019. The Diet Quality Index Adapted for Pregnant Women was used to measure the quality of the diet and associate it with risk factors (sociodemographic, obstetric, clinical, behavioral, nutritional status) during the pregnancy. A hierarchical model composed of three blocks was used. A multinomial logistic regression was applied.

Results

The general average of this Diet Quality Index was 72.75 points, the average of the 1^st tercile was 56.06 points, the average of the 2^nd tercile was 73.71 points and the average of the 3^rd was 88.51 points. The worst diet quality was related to pregnant women with lower education (OR=2.36; 95% CI=1.39-4.01), sedentary women (OR=1.37; 95% CI=1.17-2, 61), those who had a negative self-perception of food (OR=2.00; 95% CI=1.45-2.76) and who had 3 to 5 meals a day (OR=1.83; 95% CI=1.26-2.77), and less than 3 (OR=2.64; 95% CI=1.13-6.18).

Conclusion

The present study identified that pregnant women with less education, sedentary, and with inadequate nutritional characteristics presented worse diet qualities.

Keywords
Diet, healthy; Diet, food, and nutrition; Prenatal nutrition

Terciles	n	M	SD	95% CI to mean		Min.	Max.
Terciles	n	M	SD	Lower limit	Upper limit	Min.	Max.
Total	1244	72.75	14.71	71.93	73.57	21.69	100.00
1^st Third	415	56.06	08.90	55.20	56.92	21.69	067.05
2^nd Third	415	73.71	03.68	73.36	74.07	67.06	080.05
3^rd Third	414	88.51	05.38	87.99	89.03	80.07	100.00

Variables		Quality Index of the Diet Adapted to Pregnant Women						^ Chi-square test. n: sample size. p-value
		1^st Third		2^nd Third		3^rd Third
		^* * The variation in totals is due to loss of information; n	%	^* * The variation in totals is due to loss of information; n	%	^* * The variation in totals is due to loss of information; n	%
Distal Level
Sociodemographic Characteristics
Age Range								0.691
	Older than 30	115	28.9	117	29.4	102	26.3
	20 to 30 years	213	53.5	218	54.8	226	58.2
	Younger than 20 years	70	17.6	63	15.8	60	15.5
Marital Status								0.129
	With a partner	305	73.5	328	79.2	320	77.7
	Without a partner	110	26.5	86	20.8	92	22.3
Education								0.020
	Higher education	80	19.3	71	17.1	94	22.8
	High school	259	62.6	279	67.2	274	66.3
	Elementary school	75	18.1	65	15.7	45	10.9
Family Income (minimum wages - MW)								0.007
	Higherthan 2 MW	70	17.7	83	20.6	106	26.7
	Up to 2 MW	325	82.3	320	79.4	291	73.3
Intermediate Level
Obstetric Characteristics
Gestational Trimester								0.298
	1^st quarter	124	29.9	107	25.8	97	23.4
	2^nd quarter	124	29.9	107	25.8	97	23.4
	3^rd quarter	162	39.0	171	41.3	170	41.1
	3^rd trimester	129	31.1	136	32.9	147	355.0
Number of Prenatal Appointments								0.849
	Six or more	120	28.9	115	27.7	122	29.5
	Less than six	295	71.1	300	72.3	292	70.5

Variables			Quality Index of the Diet Adapted to Pregnant Women						^ Chi-square test. n: sample size. p-value
			1^st Third		2^nd Third		3^rd Third
			^* * The variation in totals is due to loss of information; n	%	^* * The variation in totals is due to loss of information; n	%	^* * The variation in totals is due to loss of information; n	%
Intermediate Level
Clinical Characteristics
	Presence of gastrointestinal symptoms								0.852
		No	31	7.5	27.0	6.5	30.0	7.2
		Yes	384	92.5	388	93.5	384.0	92.8
	Diabetes Mellitus								0.038
		No	401	97.1	411	99.0	409.0	99.0
		Yes	12	2.9	4	1.0	4.0	1.0
	Anemia								0.574
		No	321	77.9	322	77.6	331.0	80.3
		Yes	91	22.1	93	22.4	81.0	19.7
	Hypertension								0.754
		No	395	95.6	400	96.6	396.0	95.9
		Yes	18	4.4	14	3.4	17.0	4.1
Behavioral Characteristics
	Physical Activity Practice								0.031
		Mild/intense	106	29.0	123	34.1	140.0	39.0
		Light	159	43.4	155	42.9	149.0	41.5
		Sedentary	101	27.6	83	23	70.0	19.5
	Alcoholism								0.176
		No	356	86	371	89.6	369.0	89.6
		Yes	58	14	43	10.4	43.0	10.4
Proximal Level
Nutritional Status
	Pre-Gestational Overweight								0.829
		No	189	55.9	185	53.8	187	55.7
		Yes	149	44.1	159	46.2	149	44.3
	Prenatal Food Guidance								0.566
		No	283	68.4	291	70.3	297	71.7
		Yes	131	31.6	123	29.7	117	28.3
	Nutritional Monitoring in Prenatal Care								0.263
		Yes	30	7.2	20	4.8	21	5.1
		No	385	92.8	394	95.2	392	94.9
	Diet during Pregnancy								0.153
		Yes	51	12.3	36	8.7	37	8.9
		No	364	87.7	379	91.3	377	91.1
	Number of daily meals during Pregnancy								0.003
		More than 5	68	16.4	88	21.2	111	26.8
		3 to 5	326	78.6	315	75.9	291	70.3
		Less than 3	21	5.1	12	2.9	12	2.9
	Self-Perception of Food								<0.001
		Very good/good	246	59.3	278	67.0	306	73.9
		Very bad/bad	169	40.7	137	33.0	108	26.1

Variables			IQDAG – 1^st Tercile^* * The IQDAG reference category is 3rd Tercile.		IQDAG – 2^nd Tercile^* * The IQDAG reference category is 3rd Tercile.
Variables			OR (95% CI)	p-value	OR (95% CI)	^ Multinomial analysis. Model adjustment adequacy test: the Deviance statistic indicated that the multiple model presented an adequate fit to the data: Deviance = 93.98; df=86; p-value=0.26. CI: Confidence Interval; IQDAG Quality Index of the Diet Adapted to Pregnant Women; OR: Odds Ratio. p-value
Distal Level
	Education
		Higher education	1.00		1.00
		High school	1.16 (0.79-1.68)	0.455	1.48 (1.02-2.17)	0.042
		Elementary scholl	2.36 (1.39-4.01)	0.002	2.41 (1.20-4.15)	0.001
Intermediate Level
	Physical Activity Practice
		Mild/intense	1.00		1.00
		Light	1.34 (0.95-1.88)	0,093	1.14 (0.82-1.59)	0.435
		Sedentary	1.37 (1.17-2.61)	0.006	1.23 (0.82-1.84)	0.320
Proximal Level
	Self-Perception of Food
		Very good/good	1.00		1.00
		Very bad/bad	2.00 (1.45-2.76)	<0.001	1.42 (1.02-1.97)	0.037
Number of Meals
		More than 5	1.00		1.00
		3 to 5	1.83 (1.26-2.67)	0.002	1.61 (1.12-2.31)	0.010
		Less than 3	2.64 (1.13-6.18)	0.025	1.31 (0.51-3.36)	0.511

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[1] Correspondence to: L PINHO. E-mail: lucineiapinho@hotmail.com.