Magnitude and determinants of malnutrition among pregnant women in eastern Ethiopia: evidence from rural, community-based setting

Maternal malnutrition is a worldwide public health problem affecting a high proportion of pregnant women. This study aimed to determine the magnitude and determinants of malnutrition among pregnant women in eastern Ethiopia. A cross-sectional study was conducted on 1731 pregnant women selected by a cluster random sampling method. Data on maternal anthropometry and other factors were gathered by trained data collectors. Mid-upper arm circumference < 22 cm defined malnutrition. Mixed-effect, multilevel logistic regression was used to control clustering effect. On average, 19.06% of subjects were malnourished, while 23.3% study participants were underweight (body mass index < 19.8 kg m(-2)). In the final adjusted analysis, the risk of malnutrition was more than twofold higher in pregnant women with low (adjusted odds ratio = 2.47, 95% confidence interval = 1.41-4.34) and medium (adjusted odds ratio = 2.74, 95% confidence interval = 1.40-5.35) autonomy of household decision-making than those who had high level of autonomy in household decision-making. Husband illiteracy and not owning livestock were associated with increased risk of malnutrition. Women in the second and third trimester had a 66% and nearly twofold increased risk of malnutrition compared with their counterparts in the first trimester, respectively. Women who improved their eating habits had a 53% lower risk of malnutrition than those who did not. The risk of malnutrition was 39% lower in respondents who received prenatal dietary advice than in those who did not. Malnutrition affects at least one of every five pregnant women studied, calling for priority attention. Interventions that improve maternal involvement in household decision-making autonomy and provision of prenatal dietary advice are recommended.