Pica Practice and Associated Factors among Pregnant Women Receiving Antenatal Care in Obio Cottage Hospital, Port Harcourt, Rivers State

Background: PICA is a psychological disorder characterized by an appetite for substances that are largely non-nutritive, such as ice, paper, soil etc. Pica practice in pregnancy has persisted through the years over time and in some societies considered normal, pica prevalence in Nigeria has been recorded to be 78%, 53%, 13% and 50% respectively, conducted in the East, North, and Western parts of Nigeria. Pica practices play major roles in maternal and fetal nutrition as whatever is ingested will undoubtedly have impacts, positive or negative on health. The aim of this study was to determine the prevalence of pica practice among pregnant women receiving antenatal care in Obio Cottage Hospital, Rumuobiakani, Port Harcourt, Nigeria.

Methodology: The study employed a descriptive, cross-sectional design on a sample of 420 pregnant who were in their second and third trimester that were selected using a convenience sampling method. The study used both quantitative and qualitative data. Qualitative data was extracted using an interview guide and quantitative data was collected using an interviewer-administered questionnaire. The statistical package for Social Sciences (SPSS) version 20 was used for data analysis.

Results: The findings of the study revealed a relatively high prevalence (62.86%) of pica practice among pregnant women. On the pattern of pica practice, clay was the commonest (50%) followed by nail biting (7.58%), sour food (6.06%) and plant roots/seeds/leaves (4.11%) among others. About 80.31% of those that practiced pica consumed the preferred items almost every day with over 94% taking the item 2 or more times each day. The main reasons for consumption are pleasant taste/smell (40.95%), craving (35.71%), control of nausea/hyperemesis gravidarum (14.52%) and sex (male or female) of fetus (12.62%) among several.

On the perceived effect, 30.71% of respondents think it has positive effect on pregnancy which are mainly cleansing the baby’s body (69.77%), nourishes the baby (13.18%) and calms the baby (10.08%). Additionally, 40.95% felt pica has positive effects on the health of the woman which are majorly control of nausea (47.09%), cleansing of the system (14.53%) energy (11.63%). The main perceived negative effect on health is anaemia (28.0%).

On the factors associated with pica practice, having secondary education or less (OR= 1.7; 95% CI: 1.11-2.62; p = 0.02), perceived positive effect on health (OR = 134.36; 95% CI: 16.45-5812.12; p =0.000), perceived positive effect on pregnancy (OR = 128; 95% CI: 0.82-10093.90; p = 0.006) and being anaemic (OR = 4.19; 95% CI: 2.70-6.53; p =0.000).

Conclusion: From the findings, it is evident that majority of pregnant women practice pica. The patterns practiced were clay consumption, followed by finger nail biting, consumption of sour foods and fruits, plant roots, seeds and leaves. To discourage the practice, there is the need to improve female education, correct misconceptions on the positive effects of the practice and creation of awareness on the negative effects of the practice particularly anemia.