Pregnancy outcome in South Asian women: Factors affecting diet and nutrition

Abstract

Infants born to women of South Asian origin in England have a lower birth weight than the UK general population (1) and the cause is yet largely unknown but as maternal nutrition can account for up to 5.0% variance in birth weight further investigation is required (2). Social and cultural norms and constraints affect food choice (3) and therefore the factors affecting food choice for pregnant South Asian women also need to be investigated. The objectives of this study were to evaluate the relationship between nutritional intakes from the diet and supplements with birth outcomes in Caucasian and South Asian women living in the UK, and to explore the social and cultural determinates of food choice during pregnancy for South Asian women.

Pregnant women attending the Bradford Royal Infirmary were recruited as part of the Born in Bradford project (4). Five hundred and eleven Caucasian and 651 South Asian women completed a baseline questionnaire to gather data regarding supplement use, sources of nutritional advice during pregnancy and compliance and adherence to the government 5 a day initiative (5). Birth weight data was subsequently collected. Dietary nutrient intakes of South Asian women recruited in Blackburn were assessed by using a 7 day diet diary. Finally 2 focus groups and 7 individual semi-structured interviews were held with South Asian women recruited at a SureStart Centre in Bradford to explore the social and cultural determinates of food choice. Term birth weight was significantly lower for South Asian (P<0.001) compared to Caucasian infants. Iron supplementation was significantly associated with increased term birth weight (P=0.047) between South Asian women who did and did not take iron supplements during pregnancy but further potential confounding variables would need to be considered before any causal link could be identified. The dietary nutrient intake analysis of non-pregnant South Asian women found that iron, vitamin D, calcium, iodine and selenium intakes were all below the dietary recommended values. Eighteen factors centred around biology, support networks and cultural and social norms were identified as affecting food choice for pregnant South Asian women. In conclusion, nutritional supplementation during pregnancy does not appear to affect term birth weight with the exception of iron in South Asian women and as iron intake appears to be inadequate in the South Asian diet further investigation in required. Food choice during pregnancy for South Asian women is not only determined by concern for the health of the mother and infant, but it is also underpinned by biological, social and cultural norms as well as the support networks surrounding the women.