الفهرس 
I. IntroductionOnly 14 pages are availabe for public view
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Abstract
The gestational weight is the amount of weight a pregnant woman gains between the time of conception and the onset of labor; it is one of the key markers of intrauterine nutritional environment (Mottola, 2010). Many women, particularly those who have worked hard to control their weight before pregnancy, may have difficulty to understand why the weight gain goal is so high when a newborn infant is small (Bobak et al., 2012).
Low weight gain during pregnancy is associated with small-for-gestational age, low birth weight, and preterm birth of the baby (Bobak et al., 2012). In contrast, high GWG is related to several complications in mothers, such as hypertension, diabetes, pre-eclampsia, macrosomia, and maternal weight retention postpartum (Davis et al., 2011)
Recommended gains vary according to a woman’s BMI before Pregnancy (French, 2012).Women with a BMI of 18.5 to 24.9 are considered of normal weight; women with a BMI of 25 to 29.9 are considered overweight; and, women with a BMI greater than 30 are considered obese ( Institute of medicine, 2009).
McEvvoy et al., (2011) stated that women’s recommended weight gains during pregnancy with a single fetus as follows: women who are considered of normal weight need to gain about 11.5 to 16 kg during pregnancy; women who are underweight need to gain about 12.5 to 18 kg during pregnancy; overweight women need to gain 5 to 11.5 kg during pregnancy; and, obese women need to gain 5 to 9 kg during pregnancy.Vasant et al., (2012) assumed that a larger proportion of individuals are overweight or obese among lower-educated groups, multi parity and low income than among other sociodemographic groups, and socioeconomic differences in obesity rates tend to be larger for women than for men
Nutrition is an important point in women’s life especially during pregnancy Chen et al., (2013). At this time, a woman must nourish not only her own body but also that of her baby Kao et al., (2010). Moreover, nutrition may affect the size of the fetus and determine whether it has adequate stores of some nutrients after birth. If the woman fails to consume sufficient nutrients during pregnancy, her own stores of some nutrients may be too depleted to meet the needs of the fetus, who also may be deprived of essential nutrients (McEvvoy et al., 2012).
The activities performed by the rural women are dichotomized into house hold activities and income generating activities. (Coco, 2012). In Egypt, domestic activities consume a considerable amount of women’s time and energy, especially in rural areas as electrical appliances are not yet in common use (Bellamy, 2011). Domestic work mainly involves cooking, washing utensils and clothes, and sweeping the floor.
The current study aims at assessing the relationship between sociodemographics, dietary intake and activity of daily living with gestational weight among pregnant women in a rural area.
The present study was conducted at the Maternal and Child Health Centers at Shebin El-Kom, Menoufia. Research questions and descriptive design (a subtype of the non-Experimental design) were used in carrying out the study.The target population of this study was pregnant women. The accessible population of interest was volunteer pregnant women willing to participate in this study and fulfilling the inclusion criteria. A convenient sample was recruited. The inclusion criteria were as follows: (1) Pregnant women at second and third trimesters (2) Aged 18-49 years (3) Single pregnancy (4) Normal pregnancy with no medical or obstetric complications. The target population was 324 pregnant women.
Throughout the course of the present study data were collected using the following two tools:-
Tool I: Structured interviewing questionnaire which is consisted of the following four parts (Appendix I):-
Sociodemographic Data (Part I) :
This part consisted of the following data: name, age, educational level, occupation, and income.
Data about current pregnancy and labor (Part II) :
It recorded data about the following:
a- Number of pregnancies
b- Duration of current pregnancy per weeks.
c- Presence of any complications during this pregnancy.
Data about current Dietary Intake ((Part III):-
The tool consisted of the following:
a- Number of daily meals
b- Types of daily food c- Types of in between meals
d- Methods of cooking foods
e-Three days’ 24-hour recalls according to Tumilowicz, Alison.( 2010): was obtained from the respondents, and the reported estimates were based on the average of three recalls. Women were individually interviewed on their intakes of food and beverages. All portion-sizes were described in household measures (cup, spoon, plate, glass were used for improving the accuracy of the recalls.
Data about Activities of Daily Living (part IV):-
This part was constructed by Matsuzaki1, Haruna1, Ota1, Yeo2, et al .(2010) and modified by the researcher as some items needed to be omitted as it is not applicable in our community and it consisted of the following items:
a- Indoor activities of daily living .
b- Outdoor activities of daily living
c- Work daily activities
d- Field daily activities
Tool II :- Anthropometric Measurements (Appendix II):
The tool consisted of the following:
a- Weight before Pregnancy……………………………. kg
b- Height: ………………………………. m
c- Body Mass Index (BMI) = Weight (kg)/ Height (m2)……… ( as categorized by Institute of Medicine ,2009 )After measuring the body mass index women were categorized into:
- Underweight when BMI is less than 18.5
- Normal Weight when BMI is between 18.5 and 24.5
- Over Weight when BMI is between 25 and 29.5
- Obese when BMI is higher than 30
d- Current Weight: ……………………………. Kg
A pilot study was carried out on 32 women who were excluded from the study. The aim of the pilot study was to assess the clarity, feasibility and time needed to complete the tool.
Human rights and ethical consideration were observed in conducting the study. The purpose of the study was explained to each woman in the sample. The researcher approached each woman, giving her an overview of the study. Each woman gave her oral informed consent to participate in the present study before inclusion in the study sample. She was informed that participation in the study is voluntary, and that she could withdraw from the study whenever she decides to. Total confidentiality of obtained information, as well as respect of subject’s privacy was ensured.
Eligible women were identified from the maternal and child health care centers. After obtaining the acceptance of women to participate in the study, the researcher informed each participant alone about the study in simple terms. The study was conducted over 3 days per week. The researcher interviews about 7-8 women daily. After determining the sample of the study, the researcher introduced herself to each participant and provided verbal explanation of the study in simple terms, then explained the tool content and filled the form by herself for each woman and answered all related questions.
The researcher collected data related to sociodemographic characteristics including: age, level of education, occupation and income. Then, The researcher collected data related to current pregnancy including: number of pregnancies, any complications during pregnancy. Also, data related to current Dietary Intake using Three days’ 24-hour recalls were obtained from the respondents, and the reported estimates were based on the average of three recalls.
The researcher collect data related to activities of daily living using Pregnancy physical activity questionnaire according to Matsuzaki1, Haruna1, Ota1, Yeo2, et al., (2010) after modifying it as some items needed to be omitted as it is not applicable in our rural communities. The women were categorized as house wife and working woman. Each woman was asked about her daily activities as methods of washing, ways of cooking, sweeping, climbing stairs, shopping, working activities and farming activities.
The main findings of the current study were as follows:
Regarding age, most of women with the age between 25 to 29 years (75.9%) had inadequate weight gain while about half of women with the age between 20 to 24 years had excessive weight gain ( 43.3 %) and 44.9% of women with the age of 30 to 34 had adequate weight gain.
In relation to level of education, most of the women with secondary level of education (69%) had adequate weight gain, while 67.2% of the women with basic education had excessive weight gain