标题：Prevalence and Socio-Demographic/Economic Risk Factors of Low and High Body Mass Index of Urban versus Rural Pregnant Women at Booking for Antenatal Care in Governmental Health Centers of Jimma Zone, Southwest Ethiopia
摘要：Background: Low Body Mass Index (BMI) continues to be a major health burden in addition to the emergence of new competing public health priority (high BMI) in developing countries. Abnormal BMI threatens both the health and survival of mothers and their infants, because it increases their susceptibility to life-threatening problems during pregnancy, and during and following childbirth. Although a number of studies done on nutrition, none was done in pregnancy in our country including Jimma Zone. Objective: The aim of this study was to assess prevalence and identify the risk factors associated with BMI status of pregnant women of urban versus rural residents of Jimma Zone, Southwest Ethiopia. Methods: A cross-sectional study was conducted from March 03 to October 21, 2011 in randomly selected governmental health centers of Jimma Zone. A total of 1546 pregnant mothers (770 urban and 776 rural residents) who fulfilled the inclusion criteria were included in the study. Structured interviewer administered questionnaires were used for data collection: first exploratory/descriptive data analysis, then, multinomial logistic regression analysis employed using SPSS version 16.0 and significance level of 0.05. Results: Majority of, 60.8% urban and 60.2% rural resident, pregnant mothers had normal BMI at the time of their first booking for Antenatal Care (ANC) on static/outreach basis in the selected governmental health centers or Woredas (districts) of the Zone. Prevalence of low BMI (BMI ≤ 20 kg/m2) was higher in rural (27.3%) than urban (22.3%) pregnant mothers, whereas high BMI (BMI > 24 kg/m2) was higher in the urban (16.9%) than rural (12.6%) pregnant mothers (p < 0.05). The Woredas decreasing order by proportion of low BMI mothers was Kersa (37.6%), Omonada (33.3%) and Mana (28.5%) Gera (19.2%), Shebe Sombo (17.4%) and Seka Chekorsa (12.5%); whereas, the order by proportion of high BMI mothers was Gera (23.5%), Omonada (22.1%), Shebe Sombo (14.7%), Seka Chekorsa (10.2%), Mana (9.4%) and Kersa (8.5%) (P < 0.001). After employing multivariate multinomial logistic regression analysis: the important factors found independently associated with high BMI of the urban pregnant mothers were primary and above education level (AOR = 2.13, 95% CI, 1.21 - 3.74) and 3rd trimester gestation period (AOR = 3.21, 95% CI, 2.02 - 5.9). While, higher monthly household expenditure (351 - 500 Eth.birr, AOR = 1.89, 95% CI, 1.21 - 2.95; 501 - 700 Eth.birr, AOR = 2.80, 95% CI, 1.67 - 4.72; 701 - 1000 Eth.birr, AOR = 2.07, 95% CI, 1.07 - 4.02) and 3rd trimester gestation period (AOR = 0.44, 95% CI, 0.29 - 0.69) were for low BMI of the rural pregnant mothers at the time of their booking for ANC. Conclusion: A considerable proportion of both urban and rural pregnant mothers had low BMI as well as high BMI (higher in urban than rural). Therefore, strengthening antenatal care on nutrition, introducing/enhancing the culture of nutritional (BMI) status determination and monitoring starting1st trimester of pregnancy, preferably in pre-pregnancy period of reproductive age women, and undertaking further studies on the issue in different settings of the country are advisable.
