The study was inspected the dietary calcium intakes and associated factors among pregnant women. Low dietary Calcium intake was widespread among pregnant women. Findings of this cross-sectional study indicate that a high proportion of pregnant women in study area do not consume enough calcium as well as calcium-rich food products; and meeting adequate intake of this nutrient is not possible through the current dietary patterns in the majority of the studied population. Dietary calcium intake was associated with age, occupation of respondents, family size, nutritional counseling, attitude towards dietary calcium intake and knowledge on calcium importance and regular consumption of milk.
Dietary Calcium Intake
The study presented that the average calcium intake in pregnant women in our study area was low (543 mg/day) compared to WHO recommendation. This result clearly reflects the low consumption of calcium-rich products and culture of the community. The finding was correlated with survey conducted in china and Iran mean intakes were 633.2 ± 492.4 and 644 ± 255 respectively in 2015[13]. Likewise, low calcium intakes (561 mg/day) were observed in Benin 2014 [14].Researcher’s also reported similar finding on the pregnant women in the study conducted in Sidama Zone, Southern Ethiopia. As it was observed with the other micronutrients, calcium intake was also lower than the recommendation in both of the study groups. Its intake was much lower (below half of the requirement) during their pregnancy [15].
In differently, higher dietary calcium intakes 1,256.9 mg/day were observed in Thailand 2018[16].
Consequently to low average calcium intakes, the occurrence of adequate calcium intake in pregnant women in the current study is low. 33.4% of pregnant women have adequate calcium intake. This result is comparable in Nigeria the prevalence of calcium intake is 40% [10].
In contrast, higher prevalence of adequate calcium intake in America and Canada, and Europe, with their mean daily calcium intake as 1176, and 1141 mg/day respectively [6, 17].The discrepancy of the two studies may be due to the fact that the differences between the study participants, in that the present study was conducted on rural communities ( pregnant mothers) which can be lower than rural mothers in terms of educational, economic status and more access to nutrition information during pregnancy.
The different results underlined differences in dietary consumptions. In developing country especially in our study area dietary calcium intakes among pregnant women are very low for the reason that diets are mainly on cereal and legumes based [18, 8, 19]. In addition the culture of community were prohibited to consume calcium rich food products for pregnant women mainly milk and milk products because of this food groups fattening the fetus and difficulty happen during delivery time. Whereas, in developed country, calcium intake is high due to production and usual consumption of dairy products. Definitely, consumption of calcium-rich foods is low in the study population [19].
Meaningful that hypertensive conditions and its difficulties during gestation are prevalent in developing countries and the positive role of adequate calcium intake in reducing the risk of hypertensive disorders, the common inadequate calcium intake through pregnancy in developing countries requires adequate interventions [7].
Factors Associated with Dietary Calcium Intake in Pregnant Women
Women who were being civil servants (AOR 0.052 95% CI 0.01–0.269) were less likely to have calcium intakes than farmers. This result is supported by the study conducted in Kenya in which employee was associated with dietary calcium intakes (AOR = 1.08 95% CI 0.88–2.45).
Also in this study women’s dietary attitude had shown negative relationship with dietary calcium intake of mothers during pregnancy (AOR = 0.003 95% CI 0.001–0.016). This finding is also in agreement with the study conducted in America in which the most significant predictor for good dietary practice was women’s attitude towards dietary intake of calcium (AOR = 2.32, 1.56–3.43).
The present study also demonstrated that there was strong statistical association between regular consumption of milk and milk products and dietary calcium intake during pregnancy (AOR = 3.256 95% CI 1.241–8.547). This result is supported by the study conducted in Thailand in which consumption of milk products was significantly associated with dietary calcium intakes (3.9 95% CI: 2.0-5.9)[16]
The finding of this study identified that nutritional counseling have strong statistical association with dietary calcium intake of mothers during pregnancy AOR = 2.432 95% CI: 1.072–5.517).This result is supported by the study conducted in Thailand in which nutrition information was the predictor factor for dietary calcium intakes in the study area (AOR = 0.985, 95% CI: 0.775–1.250).
Pregnant women in urban areas, women with those whose household size is less than four were significantly less likely to have higher calcium intakes compared to rural women, with those whose household’s size was four or less(AOR 0.285 95% CI 0.111–0.733). This result is supported by the study conducted in Benin in which house hold size was significantly associated with dietary calcium intakes (AOR 1.330 95% CI 1.092–1.618)[19]