الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
To evaluate the nutritional status and health complications for fifty one (51) of 3rd trimester pregnant women visiting Maternal &Infancy Care trimester Center ,Zawiet Abu-Musallam (Corner),Abu, EL-Numros, Giza Governorate, were included in this study. The main aim of this study was to determine the prevalence of iron deficienancy anemia among the pregnants of this rural area in relation to their nutritional status.Socio-economic status and health parameters were investigated, and anthropometric measurements obtained .The level of blood hemoglobin determined and blood pressure measured. Using sutable questionnaire the food habits and daily food intake recorded &Nutrients intake calculated by food intake analyses using Food Composation Tables for Egypt of the National Nutrition Institute (Cairo, A.R.E). Many deviation found concerning nutritional and health status considerable deficieneies in nutrients intakes and recorded anemia cases amounted to 33.3%of the total sample. The results arrived at revealed the following: 1-About 10% of the total sample was at 18 and less years of age . About 4%(2cases) were 16 and 17 years old against the low (not less than 18 ages). 2-About 90% of the total sample was over 18 years old . Four cases were 30 and more years of age .Oldest pregnant women was 36 years old. 3-Most total sample were illiterate &Read& write (82.3%) groups as they may be either suffering of pregnancy complications or gained marked health awareness from T.V. programs so , they asked help in Maternal &Infancy Care Centers. Medium& university educational level group(less than 18%) may be this group is in no need for much awareness about pregnancy. 4- The majority of pregnant women (98.04%) do not work which is influenced by many factors including the effect of rural habits, the low educational level (about 82.3%) and the fact that pregnants of present work were at the 3rd trimester of pregnancy. 5-Total month income came mostly from the husband (98.04%) and at minimum from the wife (1.96%); same recorded level reported for not working women (98.04%) and working pregnants (1.96%) .This may indicate that possibly working pregnants had sick handicapped or not employed husbands specially knowing that all of them were at the 3rd trimester of pregnancy. 6-Although the family size of participants was not big, it is expected to be bigger giving rise of larger family size ,specially when pregnants give birth and pregnants are still in the production time .Family size in rural is known to be large. 7-Most of pregnants (88.2%) live in own property, while loding of the smaller percentage (11.8%) were living in laired home. 8-Croding of pregnant families was pronounced as 80.39% of sample belong to the low crowding ratio, while 17.65% to the medium ratio (2.5-4.0) and lowest percent of prognants (1.96%) belong to the high ratio (>4). 9-Monthly income per person averaged 405.7 L.E. which seems to be very low. Monthly income 900 L.E. was found only for only 2 cases. For most of cases 61% monthly income per person was only 180-400 L.E. 10-Family month income was evidently low. Only 7.8% of total sample gained the maximum income being > 1500-1800 L.E. per monthly, while 62.8% of sample gained the lower ranges while were 700-900& >900-1100 L.E. per month. 11-Most of studied cases (86.3% of total sample) suffered of colic, followed by dizziness (82.4%), low appetite (80.4%), nausea (80.4%), while vomiting as apregnancy complication suffered by 78.4%. 12-About 6% of pregnant women (5.88%) were suffering of diabetes alone (1.96%), diabetes mellitus plus hypertension (1.96%) or hypertension alone (1.96%).According about (4%) of total sample (3.92%) were suffering of diabetes alone or diabetes with hypertension. Family members, previously inflicted with diabetes (1.96%) or hypertension (1.96%) were actually low (3.92%) of total sample. Diabetes mellitus was found to be inherited from the mother only. 14-Most of 3rd trimester pregnants (47%) were at the 7th month of pregnancy , while the other (53%) were either at the 8th (23.5%) or the 9th month (29.5%) . 15- 43.3% of pregnants did not gave birth before, while 39.2% gave birth once, 13.7% twice. About 1.9% of women gave birth for 3 time, and other 1.9% for 4 times . The last pregnant will have 5 kids after delivery. 16-Previous abortion occurred once (9.8% of cases) or twice (3.9%), for 86.3% cases no previous abortions recorded. Over straining caused 57.1% of abortion and virus infections (14.3%), Therefore by good health care 71.4% of abortions may be avoided .Infections were responsible for conception or of uterus was responsible for 28.6% of abortions. 17-Hemorhage recorded for 3rd trimester pregnants for 11.8% of the total sample . About 9.8% of them taking supplements. 18-Mean hemoglobin for all sample was 11.13 g/dl rang in 9-12.6 g/dl. Must of participants fell in the range >11-12g/dl (50.98%). Participants with higher range ( >12 g/dl) were low (1.96% only of total sample). On the other hand pregnants with first two low ranges ( 9-10 and >10-11 g/dl) were markedly high (47.06 of total sample), indicating anemia risk for about half the total sample. 19- one third of total sample were anemic showing less than 11 g/dl of blood hemoglobin. This is a dramatic result due to side effects of anemia. Anyhow it is not satisfactory to find out that only 2/3 of total sample were not anemic. 20-symptoms of low hemoglobin level revealed that prevalence was recorded for (panting when going up stairs) general weakness, followed by sluggishness, pale yellow face, headache , pale inside the eyelid, angular cheilitis and cooling of body extremities. Symptoms were found for more than the 17 anemic pregnants , for example panting when giving up stairs appeared for 98% of total sample (anemic were only 33.33%). Therefore these symptoms many have been found for pregnants with some what low, but more than 11 g/dl of hemoglobin, otherwise threshold(11 g/dl) should be somewhat raised for pregnants. 21-the number of pregnants taking supplements (23) was more than that inflicted with anemia (17) indicating that mal absorption of iron may be involved. 22- 27.5% of total sample showed obesity (clas), over weight (49%) and normal weight (23.5%) with no under weight. 23- None of pregnants had high blood pressure (BP) indicated by ≥140/90 ; maximum measured value was 130/80 and for only 1.96% of total sample. 24-Most of pregnants (70.6%) had regular menstruation before pregnancy, nevertheless, a large proportion (29.4%) did not. 25-most of participants (66.7%) attained puberty rarely at 11, 12 or 13 years of age. Few girls, however, became mature lately, at 16(5.9%) or 17(5.9%) years of age. 26-menstruation period on average was 4.5 days before conception, ranging 3-8 days. About 90% of participants it was 3-6 days, being 7 days for 9.8% and 8 days for only 1.96% of total sample. 27- Food pattern study revealed that 3rdtrimester pregnants liked variable foods differently. Among legumes- they liked more medames; bread-baladi bread; fruits-guava and tomatoes; vegetables-parsley; meat- red meat and chickens, and they liked also the cane syrup. 28-different foods in different food groups had variable levels of Fe. Among legume group highest Fe- found in corticated lentil and kidney beans; breadbaladi bread; fruits-dates and figs; vegetables- radish; meat-chicken and rabbits; cane syrup had also pronounced Fe level. 29-in many of the cases (legumes, fruits, vegetables), the food which showed highest consumption ratio was not necessary that which had the highest Fe content. This simply indicated that food preference of trimester pregnants should be regulated and changed via nutritional awareness programs. pregnants liked vegetables more than fruits as participants who consumed vegetables daily were higher (43.14%) than that who like to consume fruits daily (7.8%). And pregnants who do not take vegetables daily (13.72%). These results may be affected by the high prices of fruits compared to vegetables. 31- About 61% of participants take 3 meals per day which is not a good result, since about 39% of 3rd trimester pregnants omit one meal. 32- It is a good practice that pregnants do not take outside home meals, since fast food is incriminated of high oxidized for and heavy salt. 33- Most of pregnants used stewing (88.24%) for cooking, which is not a good cooking method in Egypt due to use of much fat Extremely less pregnants liked Nai fi Nai method. None of them used boiling or roasting. 34- Most of pregnants do not drink coffee, and those who drink coffee take eith one or two cups per days. 35- Sugar spoons in each coffee cup ranged ½-2 spoons. 36- About half the total sample used to take tea Dailey (52.94%) while 47.06% of total sample do not drink tea. 37- About 24% of drinking tea syrup 3 cups daily. But 7.84% take 4-5 cups daily. 38- About 14% of drinking tea group adds 2 spoons sugar in the tea cup. But about 4% of this group used to take heavy sugar tea adding 4 spoons of sugar in each tea cup. 39- Most of tea drinking tea(39.21%) like to prepare tea by boiling, while only 13.73% use the steeping method. 40- Nutrient intakes were calculated and found to be markedly different among 3rd trimester pregnants. Also wide variations recorded for calculated necessary total calorie, intakes in relation to age, weight and height of participants. 41- All participants had less than DRI(2002/2005) recommendations ranging 24.5- 94% of DRI. To complete the total calories needs, ample carbohydrates may be given, which will spare the protein needed for growth. About 67% of pregnants did not meet their protein requirements(less than 100 of (DRI), indicating risk of pregnancy health. Also 16 of 51 participants (31.4%) had more than DRI recommendations (sometimes about 140% of DRI) which increase the load on internal organs function, specially the kidneys. 43- pregnants of present work intake of fat was widely different ranging from38.6% to 130.3% of allowance. The lower level than allowance may decrease the intake of fat soluble vitamins, while the higher level may encourage the obstruction of blood vellels and heart diseases. 44- Carbohydrate intake varied widely among pregnants being 53.9 to 265.5% of allowance. The balance of CHO and fat is better to be considered to insure meeting needs of energy and fat soluble vitamins. 45- At least 47 cases (92% of cases) had less Ca intake than the allowance which ranged 10.5 to 96.4% of DRI. The extremely low Ca intake results in the pregnant will give birth of an infant with bones disorders. 46- Phosphor intakes were 22.6-202.4% of DRI; about 28% of pregnants (18 cases) did not take the needed recommendations, being at risk of giving birth with infants having abnormal bones and teeth. 47- pregnants need iron to strengthen the increase in the amount of blood supply to the placenta and fetus. At birth the child’s stroke pile of iron should be sufficient for a period ranging between 3 to 6 months (Madani, 2005). Insufficient dietary intake and absorption of iron as well as losses cause iron- deficiency anemic (Rebecca, 2001). Vandevi Jvere (2013) reported that iron-deficiency anemia is associated with adverse neonatal health outcomes. Fe intake by pregnants was at 5.6 to 140% of DRI. Excess intake was by only one pregnant (1.96%), but when this amount is stored it is converted to hemosidrin which cause liver cirrhosis. The low Fe intake was by 98.03% of the total sample which is a disaster, especially for woman taking only 5.6% of DRI, subjecting her and other to Fe deficiency anemia and its complications It was found that 11.8% of total sample do not take heme-iron which is absorbed at 23% , and take only non heme-iron absorbed at 10-15% only. 49- Zinc intake was at 32.2-177% of DRI. Not only the zinc deficiency halves health problems, but also the excess causes zinc toxicity reaching the renal failure. 50- Na intake was higher than DRI for 49% of total sample, and less than DRI for 51% of total sample. Both lower and higher intakes halve undesirable health effects. 51- K intake by pregnanats was 16.5-77.6% of DRI; being less than DRI for all pregnants (100% of total sample). Deficiency of K in body has its health side effects. 52- Mg was covered at 15.1-72.9% of DRI by trimester pregnants, indicating that 100% of them did not meet their requirements. 53-3rd trimester pregnants of present study met the fiber requirements at 2.5-58.9% of DRI. This indicated that 100% of total sample were taking less than DRI requirements. 54-the diets of 3rd trimester pregnants were imbalanced considering the distribution of total calories among energy sources; protein, fat and carbohydrate. A total number of cases with not ideal level of the three energy sources together were 17 forming 33.3% of the total sample. 55- 3rd trimester pregnants diet had 0-12.58 mg of non heme Fe. A total number of 47 pregnants(92.2%) did not satisfy their needs in heme Fe inconstant to only 4 pregnants,(7.8% of total sample). Non heme iron was at satisfied level for only 2 pregnants(3.9%) of total sample, in contrast to 49 case(96.1% of total sample) who had enough non heme Fe. The call for modifying of 3rd trimester pregnants diets to show balanced Fe forms.