Abstract
Dietary pattern is an important and modifiable lifestyle that can influence individual health and well-being. For women, it is one of the main determinants of her nutritional statut, of embryo and fetal development. It is essential that women have a quality diet in order to reduce the prevalence of maternal and neonatal morbidity and mortality, before conception and throughout pregnancy. This is important and worrying, because it’s now a consensus that maternal nutrition influences the health of the child not only in the short term but also in the long term. In developing countries, studies are increasingly focusing on the assessment of the quality of the diet and the nutritional status of women during pregnancy, but very few follow up them from preconception to delivery.The present study, which has recruited 897 women before pregnancy, of whom 234 have been followed up to delivery, had aimed to assess the quality of the diet and the changes in women's diets before and during pregnancy. This assessment was made through the study of dietary diversity and the level of coverage of nutrient requirements in Abomey-Calavi and Sô-Ava dostricts in southern Benin. Dietary diversity score and his influencing factors, the energy and nutrient intakes, and the level of satisfaction of the recommended dietary allowences were compared before and during pregnancy.At inclusion, women entered in the first phase of follow up called "primary cohort" and once they were pregnant, they were considered to second phase called "secondary cohort". Women were included after a negative pregnancy test. They were received a 24-hours recall questionnaire at baseline and one at each trimester of pregnancy. Womens’ dietary diversity scores (WDDS) were calculated using the 10 food groups defined by FAO. Food composition table compiled, recipe table elaborated and a recipe catalog (with average quantification of each ingredient) allowed to determine their nutritional intakes in Benin. In addition to energy and macronutrients (carbohydrates, proteins and lipids), a total of 8 minerals (iron, calcium, magnesium, zinc, sodium, potassium, phosphorus and copper) and 10 vitamins (C, D, E, B1, B2, B3, B5, B6, B9 and B12) were explored. Mixed-effect linear and logistic regression models were used for statistical analysis.The results showed that at preconception the mean WDDS was low (4.3±1.1 food groups) and the diet was mainly composed of cereals, oils, vegetables, and fish. This mean WDDS did not change during pregnancy and was equally low at all trimesters. Parity and household wealth index were positively associated with the WDDS before and during pregnancy. Women had lower intakes of vitamins D, B1, B3, B9 and B12 during pregnancy compare to preconceptional period (p<0.05). More than 50% of women had adequate vitamin intake only for vitamin D and B12. The lowest proportions (less than 10%) were observed for vitamin B1, B2, B3, B5 and B9. The median intake of magnesium, vitamin C, D and B12 achieved the RDA before pregnancy, because of large consumption of peanut, fermented seed of nere, of potatoes, chilli peper, pineapple, citrus fruits and mangos, of fish species rich in vitamin D such as catfish or salomon, of horse mackerel, crab and oysters. Higher than 50% of women were reached RDA for macronutrients, sodium, vitamin D and B12 before pregnancy. But during pregnancy, lower than 50% were cover recommended intake excepted for carbohydrate sodium and vitamin B12. Additional qualitative researches on determinants of women's food consumption before and during pregnancy in Benin are necessary. Actions should be carried out to provide Benin with a national food and recipes composition table. Women should be informed on the importance of nutrients and the food sources of these nutrients.