Institutional members access full text with Ovid®

Share this article on:

Geophagy During Pregnancy in Africa: A Literature Review

Njiru, Haron BSc, MPH*; Elchalal, Uriel MD, PhD; Paltiel, Ora MDCM, MSc, FRCPR, PhD

Obstetrical & Gynecological Survey: July 2011 - Volume 66 - Issue 7 - p 452-459
doi: 10.1097/OGX.0b013e318232a034
CME Program: CME Review Article 21

Introduction. Geophagy is a form of pica characterized by craving and eating of soil. The main materials ingested include anthill soils and soft stone. In this review, our objectives were to study the prevalence of geophagy in pregnancy (GiP), establish the risk factors for GiP, assess the effects of GiP on pregnancy outcomes, and recommend possible interventions for reducing GiP.

Prevalence. Geophagy among pregnant women is common in many cultures. In some African countries, GiP prevalence of up to 84% has been observed. In Nigeria, the most populous country in Africa, the prevalence of GiP is estimated at 50%. The practice has been associated with religious practice, culture, and famine.

Risks. It is postulated that GiP is due to micronutrient deficiencies, cultural influences, and gastrointestinal upsets. Despite their potential to supply micronutrients, soils interfere with bioavailability of micronutrients leading to micronutrient deficiency and can also act as a pathway for ingestion of geohelminths and heavy metals, putting woman and fetus at risk.

Gaps. Despite its association with anemia, pregnancy, and micronutrients, many antenatal care guidelines or National guidelines on micronutrient deficiency control are silent on GiP. The guidelines generally recommend iron supplementation and deworming of pregnant women as anemia control measures. However, not all women seek antenatal services; hence, there is need for more innovative ways of addressing micronutrient deficiencies in pregnancy.

Recommendations. It is imperative to enquire whether pregnant women are geophagous and discourage geophagy, strengthen and expand the existing supplementation programs, and mandate flour fortification to enhance population-wide iron supply and safer pregnancies.

Target Audience: Obstetricians & Gynecologists and Family Physicians.

Learning Objectives. After completing this CME activity, physicians should be better able to analyze the prevalence of GiP, identify the risk factors for GiP, and assess the effects of GiP on pregnancy outcomes. In addition to propose remedial interventions for reducing GiP.

*International Masters in Public Health Program, Hebrew University Braun School of Public Health, Jerusalem, Israel; †Professor, Department of Obstetrics and Gynecology, Hadassah University Hospital, Jerusalem, Israel; and ‡Professor, Department of Hematology, Hebrew University Hadassah School of Public Health, Hadassah University Hospital, Jerusalem, Israel

Chief Editor's Note: This article is part of a series of continuing education activities in this Journal through which a total of 36 AMA/PRA category 1 credits™ can be earned in 2011. Instructions for how CME credits can be earned appear on the last page of the Table of Contents.

The authors, faculty and staff in a position to control the content of this CME activity and their spouses/life partners (if any) have disclosed that they have no financial relationships with, or financial interest in, any commercial organizations pertaining to this educational activity.

Correspondence requests to: Haron Njiru, BSc, MPH, POB 22150-00100, Nairobi, Kenya. E-mail: haron.njiru@hujimail.ac.il.

© 2011 Lippincott Williams & Wilkins, Inc.