Maternal dietary diversity and micronutrient adequacy during pregnancy and related factors in East Gojjam Zone, Northwest Ethiopia, 2016

Background: Monotonous and less diversified diets are associated with micronutrient deficiency. Evidence on maternal dietary intakes during pregnancy is essential to achieve the 2025 global nutrition target and reduce maternal and child mortalities. This study assessed pregnant women's dietary diversity and identified factors associated with inadequate dietary diversity in East Gojjam Zone. Methods: We conducted a community-based cross-sectional study between April and June 2016. Eight hundred thirty-four pregnant women were randomly sampled. The Women Dietary Diversity Score tool developed by the Food and Agricultural Organization (FAO) and Food and Nutrition Technical Assistance (FANTA) was used. Data were entered into EpiData with double entry verification, and analysis was done using IBM SPSS version 20. Level of significance was set to P < 0.05 with 95% confidence interval (CI) to identify the independent factors associated with inadequate dietary diversity. Results: The mean (±SD) dietary diversity score was 3.68 (±2.10). Inadequate dietary diversity was prevalent in 55% [95% CI (52.3-59.3%)] of pregnant women, or indirectly micronutrient was inadequate in more than half of the pregnant women. Commonly consumed dietary groups were legumes, nuts, and seeds (85.5%) followed by starchy staples (64.7%). Inadequate dietary diversity was higher among non-educated [Adjusted Odds Ratio (AOR) = 7.30, 95% CI (2.35-22.68)] compared to college and above completed women. Wealth index had significant association with dietary diversity, in which women in the poorest [AOR = 8.83, 95% CI, (1.60-48.61)], poorer [AOR = 6.34, 95% CI (1.16-34.65)], poor [AOR = 8.46, 95% CI (1.56-45.70)], and richer [AOR = 6.57, 95% CI (2.16-20.01)] had higher odds of inadequate dietary diversity. Those who had not received dietary counseling had three folds [AOR = 3.31, 95% CI (1.49-7.35)] of inadequate dietary diversity compared to their counterparts. Less likelihood of inadequate dietary diversity was among women with an increased meal frequency [AOR = 0.53, 95% CI (0.38-0.74)]. Conclusion: Consumption of less diversified food during pregnancy is common in the study area. Adequacy of micronutrients is insufficient for more than half of the studied pregnant women. We conclude that being non-educated affects pregnant women to depend on less diversified diet. Providing dietary counseling during pregnancy can improve nutritional practice for pregnant women.