Open Collections

Kinshella, Mai-Lei Margaret

University of British Columbia

Pre-eclampsia and other hypertensive disorders of pregnancy are the second leading cause of maternal mortality in sub-Saharan Africa, where they account for 22% of maternal deaths. Nutritious and diverse foods during pregnancy have vital roles to play in maternal and child health. The objectives of the work presented in this Dissertation are to: 1) systematically evaluate the current evidence for the influence of maternal diets on pregnancy hypertension in resource-constrained settings, 2) understand maternal diets and influencing factors from community perspectives in sub-Saharan Africa, and 3) investigate associations between nutritious and diverse maternal diets and pregnancy hypertension among women living in three geographical settings in sub-Saharan Africa. This study used quantitative data from the PRECISE Network, a prospective cohort that enrolled women in Kenya, Mozambique and The Gambia between June 2019 and December 2022. Based on foods consumed in the previous 24-hours, Minimum Dietary Diversity for Women (MDD-W) was assessed among women participating in PRECISE. Quantitative research was accompanied by qualitative community-based research in PRECISE study communities to understand local perspectives. The systematic review was the first to focus on dietary patterns and pregnancy hypertension in low- and middle-income countries and found substantially lower odds of pre-eclampsia associated with fruits or vegetables consumption at least once per week. Through qualitative interviews, community members shared that diverse meals were valued to support pregnancy health, but maternal diets did not substantially differ from typical household meals, especially due to affordability constraints. This was confirmed in the quantitative data that found pregnant women had slightly higher rates of meeting MDD-W, but the MDD-W was only met by less than half the population (48.4% pregnant vs 45.6% non-pregnant women). Among women with lower frequency of unhealthy food group consumption, meeting MDD-W was associated with reduced rates of gestational (aOR 0.84, 95% CI: 0.72-0.97) or any pregnancy hypertension (aOR 0.86, 95% CI: 0.75-0.99). The effect was not significant among women with higher unhealthy food consumption patterns. Findings support efforts to strengthen nutrition guidance to improve maternal health in sub-Saharan Africa.

Text

2024-08-02

Attribution-NonCommercial-NoDerivatives 4.0 International

http://hdl.handle.net/2429/88866

Women+ and Children’s Health Sciences

University of British Columbia

UBCV

http://creativecommons.org/licenses/by-nc-nd/4.0/