Assessment of the Patterns of Exercise and Diet Intake among the Pregnant and Pre-pregnant Women Reported at Gynae OPD Civil Hospital Khairpur, Sindh, Pakistan

Department of Obstetrics & Gynae, Khairpur Medical College (KMC), Khairpur Mirs, Sindh, Pakistan. Department of Biochemistry, People’s University of Medical and Health Sciences for Women (PUMHSW), Nawabshah, Sindh, Pakistan. 3 Department of Anatomy, People’s University of Medical and Health Sciences for Women (PUMHSW), Nawabshah, Sindh, Pakistan. 4 Department of Physiology, People’s University of Medical and Health Sciences for Women (PUMHSW), Nawabshah, Sindh, Pakistan. Institute of Pharmaceutical Sciences, People’s University of Medical and Health Sciences for Women (PUMHSW), Nawabshah, Sindh, Pakistan.


INTRODUCTION
For satisfactory birth outcomes adequate diet and exercise is very important before and during pregnancy. In developing countries, inadequate diet and exercise before and during pregnancy is the major cause of low birth weight. Increased mortality is significantly associated with low birth weight as well as post natal growth is also associated due to which the cognitive and physical health of the baby might be affected [1][2][3][4].
In Pakistan, the government policies address the diet intake for children under 5 year age and pregnant women. There is prevalence of underweight women is approximately 23% in Pakistan. In Pakistan, micronutrient and anemia among pregnant women are high approximately 50% which results in poor outcomes of the pregnancy. In Pakistan, there is very inadequate intake of diet and improper exercise among pregnant women [5].
According to the WHO, during any disease the health not only absent, but the physical and mental performance of an individual is also affected. Malnutrition is worsened due to imbalanced nutrients which can lead to improper mental and physical health as well performance. In developing countries, the deficiencies of nutrition began in first 1000 days of life which are irreversible mostly [6].
Proper diet and exercise has a great impact on the health of mother and has vital role fatal development. According to the Institute of Medicine, it was recommended that three meals or two to three snacks should be taken per day and minimum thrice a week exercise should be performed [7].
This study aims to assess the patterns of exercise and diet intake among the pregnant and pre pregnant women visiting the Gynae OPD Civil Hospital Khairpur, Sindh, Pakistan.

METHODOLOGY
This is a descriptive cross sectional study conducted at the Gynae OPD Civil Hospital Khairpur, Sindh, Pakistan, from November 2020 to January 2021. A well-structured questionnaire was introduced (consist of the questions related to study) to all pregnant women visiting Gynae OPD to collect the study data by purposive sampling technique and consent was taken. Sample size was calculated by Slovin's Formula [8] which was 400 with 95% confidence level and 5% margin of error. Results were analyzed by using statistical package for social sciences (SPSS) software version 23.

RESULTS
Results reported that, out of 400 women, during pregnancy 304 were not having gestational diabetes, before pregnancy 348 women did not exercise, before pregnancy 284 were not walking, during pregnancy 354 did not exercise, before pregnancy 266 preferred the climbing stairs, during pregnancy 266 preferred climbing stairs, before pregnancy 312 did household work, during pregnancy 370 did household work, during pregnancy 284 took meats thrice a day, during pregnancy 110 took snacks twice a day, before pregnancy 232 were taking three chapattis//wheat flour, during pregnancy 228 were taking three chapatis/wheat flour, before pregnancy 230 were not taking milk, during pregnancy 152 were taking one glass of milk, before pregnancy 164 were not taking dairy substances, during pregnancy 170 were taking one dairy substance, during pregnancy 180 were taking 1 fruit and before pregnancy 356 did not take supplements. It was also found that out of 322 having normal range of BMI during pregnancy 36 of participants performed exercise, before pregnancy 40 performed the exercise, during pregnancy 256 did the household work, during pregnancy 42 followed the special diet [ Table 1-23].

DISCCUSSION
Exercise and malnutrition resembles as a phenomena of iceberg. Most individuals in the developing and developed countries are evolved in adequate exercise and malnutrition.     Concerning timings of food admission in between dinners just scarcely any investigation members (7.3%) took food before breakfast. Most took snacks "after lunch" (60%), trailed by after supper (59%), and after breakfast (56.4%) individually. These outcomes are far superior to the investigation of Ogun State. In this high recurrence was accounted for "after breakfast" 30%. Recurrence announced for "After lunch" is 18% and for "after supper 6% [11].
In a post hoc sub-bunch examination among PPW to explore whether there are contrasts in supplement admissions of overweight+obese ladies (BMI>25 kg/m2) and ladies with ordinary BMI (18·5-25 kg/m2), we discovered factual meanings (P<0·05, as per t test or Mann-Whitney test dependent on typical/non-typical conveyance) in four among 28 potential correlations (seven supplements, three financial quintiles+total gathering), all of which demonstrated lower consumption in the overweight+obese sub-bunch contrasted and the typical BMI sub-gathering. We are, notwithstanding, hesitant to presume that there might be a propensity among overweight+obese ladies to really burn-through less of the particular supplements including energy, yet would prefer to credit this finding to an inclination for underrevealing, particularly by overweight and stout subjects as detailed from different investigations [12][13].
In our study, out of 400 women, during pregnancy 304 were not having gestational diabetes, before pregnancy 348 women did not exercise. It was also found that out of 322 having normal range of BMI during pregnancy 36 of participants performed exercise, before pregnancy 40 performed the exercise, during pregnancy 256 did the household work, during pregnancy 42 followed the special diet.

CONCLUSION
It was concluded that women who visited the OPD do not exercise properly and do not take proper diet before and during pregnancy because of inadequate awareness of role of exercise and diet for pregnancy. Before, during and after pregnancy the nutritional and health status of women can be improved by awareness regarding the exercise and diet maintenance.

CONSENT
As per international standard or university standard, patients' written consent has been collected and preserved by the author(s).

ETHICAL APPROVAL
Ethical Review Committee ERC of Civil Hospital Khairpur Mirs gave the ethical approval to conduct the study.