Investigating the association between stress. Anxiety and geophagy among pregnant women in mwanza, Tanzania

Abstract Geophagy, the craving and intentional consumption of soil, is common especially among pregnant women in some low- and middle-income settings. Soils may contain a variety of non-nutritive components such as heavy metals and microbes or substances that interfere with gastrointestinal absorptive processes, posing health risks to pregnant women. Several hypotheses regarding the practice have been proposed but very few have examined the role of maternal stress. The practice of geophagy may help to alleviate stress or anxiety during gestation from perceived dietary or other pregnancy-related concerns. In this study, we evaluated several measures of maternal stress (general anxiety, Pregnancy-Related Anxiety Scores (10-item revised) and Perceived Stress Scores) and other covariates in relation to geophagic behaviour in early pregnancy in 227 women (12–19 weeks gestation) recruited from two hospitals in the Nyamagana district of Mwanza City, Tanzania. Geophagy was reported by 24.7% of the pregnant women. LASSO regression identified the self-reported treatment of nausea or vomiting during pregnancy (adjusted OR = 3.12, 95%CI: 1.43 to 6.83), paternal education level (adjusted OR = 2.79, 95%CI: 1.32 to 5.87 for primary or lower education level), antenatal hospital site (adjusted OR = 3.71, 95%CI: 1.78 to 7.75), prescription drug use prior to pregnancy (adjusted OR = 1.76, 95%CI: 0.87 to 3.56) and general anxiety (feeling worried, tense or anxious in the past four weeks) (adjusted OR = 1.81, 95%CI: 0.88 to 3.72) as predictors of geophagic behaviour. Given that relatively little has been done to examine geophagy in relation to the public health risk it may pose to pregnant women, these findings suggest the need for further investigations regarding maternal stress.