@2024 Afarand., IRAN

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ISSN: 2383-2150    Journal of Education and Community Health 2017;4(3):4-11

Background
Preeclampsia (PE) is the most common complication of pregnancy and one of the top three causes of maternal death.
Previous Studies
[1-9]. ... Several studies have focused on the role of diet in pregnancy and the incidence of PE [10-12]. [13-15]. ... Richardson's study also found that preeclampsia was lower in women who consumed two glasses of milk a day than other women [16]. … [17]. On the other hand, low levels of literacy are associated with less involvement in preventive behaviors, late diagnosis of diseases and disability in healthy lifestyle [18, 19].
Aim(s)
This study was conducted to determine the effect of nutrition training program for the prevention of PE on the nutritional behaviors of pregnant women.
Research type
This research was a quasi-experimental study.
Research society, place and time
This study was carried out on 120 pregnant women in their third trimester of pregnancy referred to the healthcare centers of Pol-e dokhtar, Iran, in 2017.
Sampling method and number
The subjects were selected through cluster sampling method. For this purpose, 2 centers were selected randomly among 8 health centers in Pol-e dokhtar city. Then, randomly, 1 center was considered as the experimental group and the other center as control group. The sample size with a 95% confidence level and 80% power in each group was estimated 50 subjects; however regarding the 20% possibility of reduction, it increased to 60 in each group. The inclusion criteria included reading and writing literacy, active health records, third trimester of pregnancy regardless of the number of pregnancy and the willingness to attend the study.
Used devices&materials
The data collection tool was a researcher-made questionnaire designed based on reference books and available resources [20-23]. It consisted of four sections of demographic information, questions of knowledge, attitudes and nutritional behaviors. The knowledge questions included ten questions with 3 scales (yes, no, and I do not know). Yes scored 2 and no scored zero score. Higher scores in this section indicate mothers' higher awareness of food and nutritional behaviors preventing PE. Attitudes toward preventive nutrition behaviors included 5 items scored on a 5-point Likert scale ranged very opposed (1) to so agree (5). Higher scores indicated positive attitude of mothers towards preventative nutritional behaviors of PE. PE preventive behaviors were also measured by 4 questions with 2-option scale, including yes (1) and no (zero). In addition, the content validity of the questionnaire was confirmed by experts and by 10 gynecologists and health educators. The reliability of the questionnaire was evaluated in a preliminary study on 30 pregnant women using Cronbach's alpha coefficient. The knowledge, attitude and behavior variables were 0.804, 0.701, and 0.855, respectively. The intervention program was designed using reference books and available resources [20-23] and also the opinion of the professors of midwifery and nutrition in three 2-hour training sessions and was held for the participants of the experimental group. In these sessions, PE and its symptoms and complications in mothers and fetus were presented followed by introducing the role of nutrition in prevention of PE. Then, using questions and answers, embarrassed and shy women were participated in the discussion, so that they could express their attitudes and, according to the topics provided by the teacher and the information obtained by other pregnant women, they identified their wrong attitudes and behaviors and made changes to solve them. Educational equipment, such as pamphlets and educational brochures were distributed among the participants in the experimental group. During this period, the control group received only routine education through health centers. Both experimental and control groups completed the questionnaires three months after the intervention. It should be noted that during this 3 month interval, no reminder messages were provided to the experimental group. Data was analyzed by SPSS 16 using Chi-square, Fisher's exact, independent t-test and paired T-test.
Findings by Text
The mean age of the participants in the experimental and control groups was 31.17±4.98 and 31.08±5.14 years, respectively. Also, 35% of them had a below diploma degree, 40% diploma and 25% had university degree. In addition, 67.7% had medium household economic status followed by 16.7% good and 6.7% poor. Other demographic characteristics of the participants in the experimental and control group are presented in Table 1. According to the findings, there was no significant statistical difference between two groups in most demographic variables before the educational intervention (P>0.05); however, there were significant differences between two groups in the history of preterm delivery, abortion and history of high blood pressure plus seizure (P<0.05). The mean scores of knowledge, attitude and function of participants in both control and experimental groups before and after educational intervention are presented in Table 2. Based on the findings, the mean scores of knowledge, attitude and function of the two groups did not show a significant difference before and after the intervention (P> 0.05); however, 3 months after the intervention, the mean of these scores in two groups was statistically significant (P<0.001). Intra-group comparison of scores also showed that the mean scores of knowledge, attitude and function of the intervention group before and 3 months after the intervention were statistically significant (P<0.001); however, the mean of these scores before and 3 months after the intervention in the control group did not show a significant difference (P>0.05).
Main comparison to the similar studies
… [24-26]. The results of studies by Anderson et al. in Scotland [27] and Boyd et al., in the USA [28] indicate the effect of an educational program on increasing and improving the nutritional awareness of pregnant women. Other research results in India also found that nutrition education and counseling led to an increase in the consumption of fruits, vegetables, milk and dairy products in pregnant women [29]. In the Widga & Lewis research, after training, there was a significant improvement in the consumption of fruits and vegetables, folate, energy, calcium and vitamins in pregnant women [30]. However, the findings of some studies indicate that education has no effect on the improvement of nutritional behaviors in pregnant women [31, 32]; as in Anderson et al. study no improvement in nutritional behaviors despite the increased awareness of pregnant women was observed [27]. … [33-38].
Suggestions
The use of educational reminder messages is recommended to avoid forgetting trainings and making a lasting change in people's behavior and performance.
Limitations
Only the individual factors associated with preventative nutritional behaviors of PE have been investigated, which can be considered as one of the limitations of this research.
Conclusions
Educational intervention was effective in the prevention of PE in pregnant women through changing their nutritional behaviors. Therefore, it is suggested to educate pregnant women; moreover, further studies are recommended to confirm the results.
Acknowledgments
All participated pregnant women are appreciated.
Conflict of interest
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Ethical Permissions
The present research is approved by the ethics committee of Tarbiat Modarres University (ethics code: IR.TMU.REC.1395.473).
Funding Sources
The present research is supported by the Tarbiat Modarres University as well as Lorestan University of Medical Sciences and Pol-e dokhtar Healthcare Network.

TABLES and CHARTS

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