Magnitude of undernutrition and Associated Factors among Pregnant Women Attending Antenatal Care in Public Health Centers of Guna District, Arsi Zone, Oromia, Ethiopia

Abstract

Abstract Background: Undernutrition during pregnancy remains a leading contributor to poor maternal and neonatal outcomes, especially in resource-limited settings. Undernourished mothers face a higher risk of low-birth-weight infants, increasing susceptibility to infectious diseases and perpetuating intergenerational malnutrition. In Guna District, where local data are scarce, the extent and drivers of undernutrition among pregnant women attending public health centers remain poorly documented. Objective: To assess the magnitude of undernutrition and associated factors among pregnant women attending antenatal care in public health centers in Guna district. Methods: A cross-sectional study was conducted in Guna district from February 27 to April 12, 2025 among 438 pregnant women who attended antenatal care. Data were collected through face-to-face interviews using a structured questionnaire, translated into Afan Oromo and pre tested on 22 pregnant women. Data collection was conducted using Kobo Toolbox version 2.4, and data cleaning and statistical analysis were performed with Statistical Package for the Social Science version 25. Variables with a p-value less than 0.25 in bivariable logistic regression were included in the multivariable model. In the final analysis, variables with p-values below 0.05 were considered statistically significant. The results were summarized by tables and graphs. Results: Out of 438 pregnant women, 430 voluntarily participated, yielding a response rate of 98%. The magnitude of undernutrition was [20%; 95% CI (16%, 23%)]. In multivariable logistic regression, consuming additional meals [(AOR=0.21, 95% CI: (0.05-0.99)] , P=0.049), family size greater than five [(AOR=2.96, 95% CI: (1.37-6.38)], P=0.006), household monthly income less than 2000 Ethiopian birr[(AOR=5.64, 95% CI: (2.98-10.68)], P<0.001), skipping meals [(AOR=6.31, 95% CI: (3.23-12.29)], P<0.001), and food avoidance [(AOR=9.73, 95% CI: (4.66 20.32)], P<0.001) were identified as significant factors associated with undernutrition. Conclusion: The magnitude of undernutrition was found to be 20%, indicating that one in five pregnant women is affected, which signifies a high public health problem. This study found that consuming additional meals was protective against undernutrition, while household monthly income, family size, skipping meals, and avoiding food were risk factors. Health workers are encouraged to counsel pregnant women to eat regularly, with more than three additional meals per day, and avoiding unnecessary food restrictions. Keywords: Maternal, undernutrition, pregnant women, Arsi, Ethiopia