Nutritional Problems of Pregnant Women

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International Journal of Management (IJM)
Volume 11, Issue 11, November 2020, pp. 3745-3753, Article ID: IJM_11_11_368
Available online at https://iaeme.com/Home/issue/IJM?Volume=11&Issue=11
ISSN Print: 0976-6502 and ISSN Online: 0976-6510
DOI: https://doi.org/10.34218/IJM.11.11.2020.368
© IAEME Publication Scopus Indexed
NUTRITIONAL PROBLEMS OF PREGNANT
WOMEN IN THANJAVUR DISTRICT
Dr. A. Sivagami
Head and Assistant Professor, Department of Social Work,
Government Arts and Science College for Women, (Affiliated to Bharathidasan University,
Tiruchirappalli), Orathanadu, Tamil Nadu, India
Smt. V. Reka
Research Scholar, Department of Social Work,
Government Arts and Science College for Women, (Affiliated to Bharathidasan University,
Tiruchirappalli), Orathanadu, Tamil Nadu, India
ABSTRACT
Motherhood is a special and sacred fulfilment in a women’s life. Pregnancy is a
period of rapid growth and cell differentiation, both for the mother and the fetus. But
this period is associated with certain complications and many women die in the process
of childbirth, especially in developing countries. This study concentrates on the
reproductive and nutritional status of the rural women with reference to selected
villages in Thanjavur District. The study has a wide scope in the community as it deals
with the impact of maternal nutrition education on behaviour of pregnant and lactating
women, directly benefiting the families and indirectly benefiting the community. The
study will help to know the main reproductive health problems of rural women in the
present time. This study will contribute to the society and government to know the
expectations of rural women regarding health care services. About 50 respondents were
selected through simple random sampling in Orathanadu Block, Thanjavur. Both
primary and secondary data used for this study. The primary data were collected by
using a pretested questionnaire. It was identified that 58% of the respondents were
taking Nutritious food.
Key words: Pregnancy, Nutrition, Primigravida
Cite this Article: A. Sivagami and V. Reka, Nutritional Problems of Pregnant Women
in Thanjavur District, International Journal of Management (IJM), 11(11), 2020,
pp. 3745-3753.
https://iaeme.com/Home/issue/IJM?Volume=11&Issue=11
1. INTRODUCTION
Motherhood is a special and sacred fulfilment in a women’s life. But this period is ssociated
with certain complications and many women die in the process of childbirth, especially in

Nutritional Problems of Pregnant Women in Thanjavur District
developing countries. The health problems of mothers may have an effect on child’s health
because the health of children lies much more in the nutrition and health of women. Nutrition
is responsible for the nutritional status of an individual person. Good nutrition and malnutrition
are directly linked to the nutritional status of a person. Nutritional status must take into account
the state of the body before and after experiments, as well as the chemical composition of the
whole diet and of all material excreted and eliminated from the body. Nutritional status can be
measured in four ways: Anthropometric measurement, dietary intake, biochemical and
chemical examination.
Integrated Child Development Scheme (ICDS) aims to improve the health and nutritional
status of the children and women of poor sections. Children up to the age of six years, pregnant
women and lactating mothers are the main beneficiaries of the project through Anganwadi
centres. Under this scheme, the facilities such as supplementary nutrition diet, health check-
ups, primary healthcare/consultation services, vaccination, nutrition and health education, and
pre-school informal education are provided.
Pregnancy could be a high-flying event during a woman’s life, ready to convert her life
forever. Pregnancy could be a physiological condition, which produces several normal and
expected changes all told the maternal organ systems. Pregnancy can happen by gender or
assisted reproductive technology. Child birth naturally occurs around forty weeks from the Last
Menstrual Period (LMP). Pregnancy is simply over nine months, where every month averages
29½ days. When calculated from conception it's about period of thirty-eight weeks. An embryo
is that the just beginning offspring during the primary eight weeks following conception, after
which, the term foetus is employed until birth. Pregnancy is of course partitioned into three
trimesters. The principal trimester is from week one through week twelve and incorporates
origination. Origination is that the point at which the sperm prepares the egg. The prepared egg
at that time moves down the salpinx and joins to inside the uterus, where it starts to shape the
developing life and placenta. The most trimesters conveys the foremost astounding danger of
unsuccessful labour (characteristic demise of developing life or baby). The trimester is from
week thirteen to twenty-eight. Round the centre of the trimester, development of the embryo
may well be felt. At twenty-eight weeks, over 90 percent of youngsters can survive outside to
the uterus if gave top notch medicinal care. The trimester is from twenty-nine weeks to forty
weeks. For a pregnant woman, feeling a replacement life developing inside her body is a
tremendous experience, while she might not always feel her best at some points along the way.
Nutrition education is that the foundation for any programme meant for biological process
improvement (Devadas et al, 1970). Its going to be outlined as a method of translating
biological process needs into food and adjusting the food decisions to satisfy biological process,
cultural, psychological and economic desires. Anemia is the most common nutritional
deficiency disorder globally. Among all nutritional deficiency anemias, the predominant one is
iron deficiency anemia, which causes major health problem to pregnant women living in
developing countries. It has most hazardous effects on pregnant women.
Nutrition plays an important role in maternal and fetal healthcare. Its supplementation
during pregnancy may decide the course of the pregnancy, fetal development and the child's
health in its early and also adult life. Over-nutrition, under-nutrition or unbalanced nutrition
during pregnancy is gaining increasing importance as a major cause of ill-health worldwide.
Actions are taken at the national level through various programs like the United Nation’s
Millennium Development Goals (MDGs), with one of its core objective being “improving
maternal health for better pregnancy outcome”.
The requirement for almost all nutrients is increased during pregnancy to encounter the
growing demands of both the mother and the fetus. The mother herself goes through a growth
period to carry the fetus and prepare for lactation. Nutrition during pregnancy is considered

A. Sivagami and V. Reka
important for both postnatal health and for infant’s long-term health. Malnutrition or
deficiencies during this stage is identified as detrimental to the infant and can predispose
chronic diseases later in life. Required dietary intake during pregnancy for important
macronutrients and fats are described.
2. REVIEW OF LITERATURE
The researcher reviewed various books, journals, news papers, research reports and several
websites to avail the information the nutrition’s of pregnancy women. Balanced nutrition is one
of the human beings required for proper functioning of the human body system. Good nutrition
is essential for human health, physical growth, mental development, performance and
productivity throughout all life span. (Paknahad et al., 2019). The nutrition requirement varies
according to age, gender and during physiological changes such as pregnancy, because it is a
critical period in a woman’s life where there are many physiological and biological changes
occurred to meet the mother’s usual requirements as well as the needs of the growing fetus and
enabling mother to maintain her own stores of nutrients required for fetal and infant health as
well as for future breastfeeding practices. (Desta et al., 2019).
Balanced nutrition during pregnancy helps to maintain normal growth and development of
the fetus. It also helps to improve delivery outcomes and prevent childhood diseases later in
life, such as heart diseases and obesity (Tahir et al., 2019). During pregnancy, unhealthy
nutrition of the mother or an inability to meet the nutritional requirements leads to some health
problems for the mother and the infant such as anaemia, osteomalacia and pregnancy toxaemia
can be seen in pregnancy. Other risk factors may be increased such as stillbirth, premature birth,
congenital anomalies and mental retardation. Risks increase in infants due to insufficient and
unbalanced nutrition (Koletzko et al., 2019).
Sucharita Sen et, al., (2016) observed that the India’s evolving economy and rapid
urbanization are affecting nutrition statuses of Indian women. This study aimed to assess the
nutritional status of urban women and find out the factors affecting it. A cross sectional study
of randomly selected 550 women of age group of 18-60 years was conducted in Mumbai and
Pune. Nutritional status was measured using BMI and cut off points given by WHO. Pre-
validated questionnaire was used to acquire information about eating habit and background
characteristics.
Rartham et al., (2012), conducted a study to investigate nutritional deficiencies and
infections in anaemic pregnant Nepali women (n=479) of Patan Hospital, Kathmandu, in a 12-
month period. Anaemia in pregnancy is a major health problem in many developing countries
where nutritional deficiency, malaria, and other parasitic infections are common. It contributes
to increased maternal and perinatal mortality and morbidity. Sreelakshmi et, al., (2012)
investigated the nutritional problems especially protein energy malnutrition and concluded that
protein energy malnutrition are quite rampant among the tribal group and more so among the
tribal group more so among the tribal women and children. This study aims to estimate the
prevalence of anemia and underweight among tribal women in the reproductive age group (15-
45years), in Palakkad district of Kerala. Allen et al., (2011), in their study mentioned that apart
from nutritional deficiency of iron and folic acid, there are other causes of anaemia. Malaria,
sickle cell disease, bacterial infection, blood loss from obstetric causes (following delivery,
abortion or ectopic pregnancy) or from intestinal parasites such as hook worms, are some of the
important causes.
3. STATEMENT OF THE PROBLEM
This study concentrates on the reproductive and nutritional status of the rural women with
reference to selected villages in Thanjavur District, Tamil Nadu state, India. The reproductive

health status depends on nutritional status. Hence there is a need to analyze the nutritional status
of rural women. The nutritional components include cereals, pulses, vegetables, oil seeds, milk,
milk product, fish and flesh food stuffs and other supplementary nutrients. Lack of appropriate
care during pregnancy and child health, inadequate services for detecting and managing the
complications are the main causes for maternal deaths. Women in rural area were much less
likely to receive medical care than in women in urban area. Hence this research study aims to
explore the nutritional and reproductive health status of rural women from their food habits,
food consumption, reproductive health care and health problems faced during the reproductive
period.
Human resource development is the most important approach to raise the levels of desire
and productivity and to break the vicious cycle of poverty at the most vulnerable points. By
releasing this “creative spirit” without which no wealth can be created it can rightly be
considered as the critical input for realizing the pent up forces of progress. Nutrition has major
effects on health. Nutrition refers to the availability of energy and nutrients to the body’s cells
in relation to body’s requirements. Nutrition is essential for the healthy growth of children
which is maintaining healthy cell, tissues, glands and organs. Nutrition and Health are
increasingly being recognized as two sides of the same coin.
3.1. Scope
After careful consideration and in the light of prevailing knowledge pertaining to nutritional
package among pregnant woman, present study was planned and directed to understand and
assess the impact of nutritional package on the behavioral changes among pregnant and
lactation woman. The study has a wide scope in the community as it deals with the impact of
maternal nutrition education on behaviour of pregnant and lactating women, directly benefiting
the families and indirectly benefiting the community. The study, by its very nature, could be
very vast and exhaustive.
3.2. Significance
The study will help to know the main reproductive health problems of rural women in the
present time. This study will contribute to the society and government to know the expectations
of rural women regarding health care services. There was ambiguity regarding 'cause' and
'effect' of nutritional status in any individual, e.g. In any under nourished individual, his
nutritional deficiencies are the 'cause' of his under nourished status. On the other hand the
clinical features evident on his body are the 'effects' of his under nourished status. Hence, in
order to determine the nutritional status of any individual 'cause' that is dietary assessment
rather than the 'effects' that is clinical features were considered to be necessary in the study.
Food contamination, increased intake of medicinal drugs and ever increasing use of cosmetics
have introduced a great number of newer chemicals in human body. Many of those chemicals
have side effects on structures like hair, nails and skin. These side effects, at times, considerably
resemble clinical features that have so far been classically and traditionally associated &
correlated with dietary deficiencies of various nutrients. Nutrition is a determinant of health. A
well balanced diet increases the body’s resistance to infection, thus warding off a host of
infections as well as helping the body fight existing infection. Nutrition signifies a dynamic
process in which the food that is consumed is utilized for nourishing the body. Nutrients are
organic and inorganic complexes contained in food. There are about 50 different nutrients
which are normally supplied through the food we eat. Each nutrient has specific functions in
the body. Women are regarded as the nerve centre of the family and society

4. OBJECTIVES OF THE STUDY
• To find out the relationship between socio-demographic profile of the respondents and
selected dimensions of nutritional problems associated with primigravida.
• To assess the nutritional status and dietary pattern of the selected pregnant women.
• To identify the level of nutritional problems of the respondents with regard to
primigravida.
5. RESEARCH METHODOLOGY
The researcher adopted descriptive research design as the research aimed at describing
nutritional problems in primigravida and the researcher collected data from the pregnancy
women of Thanjavur district. About 50 respondents were selected through simple random
sampling in Orathanadu Block, Thanjavur. Both primary and secondary data used for this study.
The primary data were collected by using a pretested questionnaire .
6. DISCUSSION OF KEY FINDINGS
Table 1 Socio-Demographic Profile of the Respondents
S.NO Particulars Frequency (n = 250) Percentage
I Age
18 to 21 years
22 to 24 Years
25 to 27 Years
28 to 35 Years
60
52
90
48
24.0
20.8
36.0
19.2
II Religion
Hindu
Muslim
Christian
96
83
116
85.6
1.6
12.8
III Education
Upto Higher Secondary
Education
Under Graduation
Post Graduation
ITI and Diploma
49
84
96
21
19.6
33.6
38.4
8.4
IV Domicile
Rural
Urban
204
46
18.4
81.6
V Type of Family
Nuclear
Joint
84
166
33.6
66.4
This table no.1 infers that little more than one third of the respondents (36 percent) were in
the age group between 25 to 27 years, one fourth of the respondents (24 percent) were in the
age group between 18 to 21 years, a small portion of the respondents (20.8 percent) were in the
age group between 22 to 24 years, a sizable portion of the respondents (19.2 percent) were in
the age group between 28 to 35 years. As far as religion was concerned a high majority of the
respondents (85.6 percent) belong to Hindu community, a small portion of the respondents (12.8
percent) were from Christian community, a negligible portion of the respondents (1.6 percent)
were from Muslim community. This infers that little more than one third of the respondents i.e
38.4 percent had completed post graduation and one third of the respondents (33.6 percent) had
completed under graduation. That a high majority of the respondents (81.6 percent) were living
in rural area, and remaining sizable proportion of the respondents (18.4 percent) were living in

urban area. The family type of the respondents. The table clearly explains that more than two
third of the respondents (66.4 percent) were living in joint families and remaining one third of
the respondents (33.6 percent) were living in nuclear families. This concludes that the joint
families are still alive in rural areas.
Table 2 Distribution of Respondents by their Nutrition’s food Intake
S. No Taking nutritious food Frequency Percentage
1. Intaking Nutritious food 29 58
2. Lack of Nutritious food 21 42
50 100
From Table No.2, it is identified that 58% of were taking Nutritious food and 42% of were
not conscious in taking nutritious food which probably shows that they are unaware of nutrients
required for their baby.
Figure 1 Distribution of Respondents by their Fruits Intake
the Diagram No.1 that 40% were taking fruit juices and 36% ensured that they had taken
fruits of one or the other and 24% had not taken any fruit which may be due to their lack of
awareness about the benefit of taking fruits during pregnancy or their economic condition which
blocks them to avail the same.
6. MATERNAL DIETARY CONSUMPTION AND MATERNAL
HEALTH
Iron: Increased iron is necessary for fetal growth, expansion of maternal tissues including the
red cell mass, iron content of placenta and the blood losses during parturition. Additional iron
is also required to build stores of iron in fetal liver to last for about 4-6 months after birth, since
the baby's first food-milk is deficit in iron. However, there is a saving of menstrual loss during
pregnancy. Thus, the iron needs during pregnancy will include basal requirements of the woman
and additional requirements of pregnancy. According to ICMR (1990), for a woman whose
body weight is 50kg, basal iron requirement is 14μg/kg body weight/day. In addition to this
normal basal requirement, 46 μg /kg body weight/day is also required for meeting the extra
needs of pregnancy. Thus, the total daily iron requirement during this period is 60 μg /kg body
weight/day, i.e., nearly 3mg of iron/day. Mean dietary iron absorption during pregnancy on a
mixed cereal diet is 8%. Therefore, ICMR has suggested an amount of 38mg dietary iron/day.
36%
40%
24%
0
5
10
15
20
25
30
35
40
45
Fruits Fruit Juices No intake of
fruits
Fruits
Fruit Juices

In a study of effect of different levels of iron supplementation on maternal iron status and
pregnancy outcome, Mehta et al. (2004) observed that there was a linear correlation between
maternal hemoglobin, serum ferritin and infant’s birth weight and birth length. The highest
level of iron supplementation had the heaviest and tallest infant.
Vitamin A: Vitamin A requirement during pregnancy has been computed on the basis of
vitamin A content of livers of the newborn. Additional intake of vitamin A required for this
purpose works out to be about 25 μg /day throughout pregnancy. Since this constitutes a very
small fraction of the recommended allowance for normal women, no additional dietary
allowance during pregnancy has been suggested by ICMR (1990). The role of oxidative
stress in the pathophysiology of pre-eclampsia and eclampsia have triggered the interest in
the direct role of 3-carotene during pregnancy. Free radicals are proposed as the toxic
elements that negatively affect maternal vascular function. Reactive radicals start
peroxidation of lipids on cell membranes changing the structure of the cell wall and
secondarily the normal function of the cell. Markers of lipid peroxidation are increased in
plasma of women with pre-eclampsia, and the low concentrations of water-soluble and lipid-
soluble antioxidants in plasma and placenta further suggest a state of antioxidant stress.
In these studies lower levels of vitamin E, C and 3 carotene were also found to be associated
with a higher risk of pre-eclampsia. Vitamin A and 3 carotene levels in the third trimester or
at birth have also been found to be predictive of low birth weight and prematurity.
6.1. Carbohydrates
Carbohydrates are an essential component of a healthy diet. However, increased caloric intake
associated with increased fat and carbohydrate consumption with adequate protein has been
associated with neonatal adiposity, which is obviously unfavourable. Additionally, a
preconception diet rich in saturated fat, carbohydrates and take-away food has been associated
with poor asthma control during pregnancy, thus affecting child well-being. Moreover,
changing the maternal eating pattern by decreasing carbohydrate load and increasing physical
activity could impact the inflammation status associated with obesity in pregnant women.
Similarly, modifying the protein/carbohydrate ratio can decrease the expected GWG.
Calcium is a major component of the skeleton, cytoskeleton and teeth Calcium-activated
enzymes and calcium-binding proteins include pancreatic α-amylase, pancreatic
phospholipases A2 and C, protein kinase C, phosphorylase kinase, calmodulin, troponin C, NO
synthase, calcium-ATPase, and blood clotting proteins. Thus, calcium is required for digestion
of dietary starch, blood clotting, intracellular proteolysis, cell-to-cell adhesion, and NO
synthesis in nearly all cell types, including endothelial cells and uterus. Furthermore, calcium
is a second messenger and in this role regulates uterine contraction. By maintaining the uterus
in a quiescent state through an NO-dependent mechanism, calcium supplementation may
modulate the risk of preterm labour.
Zinc plays a key role in nutrient metabolism as well as the structures of DNA and protein.
Although zinc is not directly involved in oxidation–reduction reactions, it tightly binds to
proteins in cells. There are probably 100 zinc enzymes associated with the mammalian genome.
Zinc-dependent enzymes and zinc-binding proteins include carbonic anhydrase,
carboxypeptidases A and B, protein kinase C, phospholipase C, insulin, superoxide dismutase
(cytosol), thymulin, and poly(ADP-ribose) polymerase. Thus, zinc plays an important role in
regulating food intake, nutrient metabolism, DNA and protein synthesis, antioxidative
reactions, neurological function, immunity, growth and development.

6.2. Protein
Both the quantity and the composition of protein are important in the context of diet quality. In
a rat model, protein deficiency in pregnancy results in decreased birth weight, decreased heart
weight, increased heart rate and increased systolic blood pressure. In general, animal protein is
of higher quality than vegetable protein, suggesting that meat should be the main source of
protein in pregnancy, but mixing different types of vegetables increases the quality of plant
protein substantially.
7. SUGGESTIONS
• Health education through mass media should focus on the management of nutritional
problems during pregnancy, and correction of unsound food habits and beliefs
commonly wide spread in the community.
• Introduce information on nutrition aspects for women in general and pregnant and
lactating women in particular in school and college students.
• Expand pre-marital counseling to include nutrition assessment and the counseling
should be based on situation analysis.
• To promote programs that attempt to improve nutrition in pregnant and lactating
women. These programs should complement, rather than replace, existing nutritional,
prenatal, and postnatal care programs.
8. CONCLUSION
Pregnancy is a period of rapid growth and cell differentiation, both for the mother and the fetus.
Consequently, it is a period when both are very susceptible to alterations in dietary supply,
especially of nutrients which are marginal under normal circumstances. The period of
intrauterine nourishment, growth and development is one of the most vulnerable periods which
affect nutrition status of fetus. Nutrition in pregnancy requires a careful balance of both quality
and quantity of intake in order to optimize foetal growth and development in addition to
reducing maternal morbidity.
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