Dietary salt intake, dietary practices and hypertensive status among pregnant women in Thulamela municipality

Abstract

Salt intake in South Africa is beyond the 4 to 6g/day as recommended by the World Health Organization (WHO); no doubt, this is due to a high-salt diet. It is well known that high-salt diets are related to hypertension, which is the most prevalent maternal complication worldwide, and is associated with significant morbidity and mortality of the mother and foetus. Pre-eclampsia and eclampsia are the two hypertensive disorders of pregnancy; these are considered as the main causes of maternal and perinatal morbidity and mortality. High maternal deaths have been recorded in South Africa where eclampsia was the direct cause. The aim of this study was to describe dietary salt intake, dietary practices and hypertensive status among pregnant women in Thulamela Municipality (Limpopo Province). The study adopted a quantitative cross-sectional survey design where three local areas were purposively selected. Two clinics from each local area were randomly selected to give a total of three Community Health Centres (CHC) and six clinics. Pregnant women were selected by means of convenience sampling. The sample size was calculated using Slovin’s formula which resulted in a total number of 379 pregnant women. Data obtained were captured using Microsoft Excel 2016 and exported to the IBM Statistical Package for Social Sciences (SPSS) version 26 for analysis. The dietary intake was analysed using Medical Research Council of South Africa (SAMRC) Food Finder 3 (version 1.1.3) computer software. Logistic regression was used to identify factors associated with high Blood Pressure risk. Most of the participants (62.0%) were single and had passed Grade 12; majority of participants (88.1%) were unemployed and depended on parents/parents-in-law and social grant. At the time of the study, 38.3% of participants’ gestational age was 31 to 38 weeks. Analyses of the macronutrient intake by the pregnant women indicated that the mean energy intake was 5304.4±2217.5KJ per day and the mean protein intake was 35.1±16.8g per day. Majority of participants (81.0%) had received nutrition education and they usually ate three meals or more per day. Most participants (71%) indicated that they bought salt from supermarkets and added salt when cooking. Almost all the pregnant women (99.7%) were below the EAR reference values for iron while 15.0% of pregnant women were within the Estimated Average Requirement (EAR) reference value for folate intake. The study revealed that the mean diastolic pressure was 73.56±9.5mmHg and systolic pressure was 113±11.2mmHg. The majority of these pregnant women were at low risk of developing high BP. High BP risk was not associated with marital Page v of 141 status, however, there was a significant association with the educational level. Gestational age was significantly associated (p<0.05) with having a HBP risk, with those 38+ weeks having the highest risk. The study concluded that pregnant women were not meeting their daily nutrient intake, hence, there is a need to advocate for improved nutrient intake. There is also a need for other research projects to be conducted on dietary salt intake and dietary practices of pregnant women in the Thulamela Municipality.