SynthesisBMJ open2026
Prevalence and associated factors of optimal dietary practices during pregnancy in Ethiopia: a systematic review and meta-analysis.
Synthesis in BMJ open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectivesMaternal dietary practices are vital for improving maternal and neonatal outcomes. However, comprehensive information about optimal dietary practices among pregnant women is limited in Ethiopia. Therefore, this systematic review and meta-analysis aimed to determine the pooled prevalence of optimal dietary practices and its associated factors among pregnant women in Ethiopia.
designA systematic review and meta-analysis of observational studies was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. DATA SOURCES: PubMed, EMBASE, Web of Science, Scopus, African Journals Online and Cochrane Library were searched for studies published in English before 25 March 2024. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Observational studies reporting the prevalence of optimal dietary practices and/or associated factors among pregnant women in Ethiopia were included. DATA EXTRACTION AND SYNTHESIS: Data were independently extracted by two reviewers, and the quality of the included studies was evaluated using the Newcastle-Ottawa Scale adapted for cross-sectional research. Review Manager V.5.4.1 and STATA V.14 software were used for data synthesis and statistical analysis. A random-effects and/or fixed-effects model was employed to calculate pooled ORs and 95% CIs to determine the correlation between dependent and independent factors. We checked heterogeneity using the
resultsA total of 22 studies with 10 915 participants were included in the review. The pooled prevalence of optimal dietary practice was 35.83% (95% CI 28.35 to 43.32). The overall study's quality was high, and we detected significant publication bias (Egger's test, p value=0.001). Monthly income ≥5000 ETB/90 US$) (pooled OR (OR=2.56, 95% CI 1.12 to 5.88), formal education (OR=2.74; 95% CI 1.22 to 6.16), good dietary knowledge (OR=4.1; 95% CI 3.19 to 5.25), ownership of radio/television (OR: 5.64, 95% CI 2.05 to 15.52), favourable attitude (OR=3.90, 95% CI 3.05 to 4.99) and food security (OR: 4.48; 95% CI 3.03 to 6.61), urban residency (OR=6.25, 95% CI 4.06 to 9.63), family size <5 (OR=3.48; 95% CI 1.78 to 6.80) and absence of illness (OR: 1.80, 95% CI 1.36 to 2.37) were significantly associated with optimal dietary practice during pregnancy in Ethiopia.
conclusionsOnly one in three pregnant women in Ethiopia practises optimal dietary behaviours. Several modifiable individual and sociodemographic factors influence dietary practices. Interventions focusing on improving nutrition knowledge, enhancing attitudes, expanding access to media-based nutrition information and strengthening antenatal nutrition education, particularly for rural and less educated women, may improve dietary practices and pregnancy outcomes. PROSPERO REGISTRATION NUMBER: CRD42024542652.
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