Prevalence and associated factors of optimal dietary practices during pregnancy in Ethiopia: a systematic review and meta-analysis

OBJECTIVES: Maternal 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. DESIGN: A 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: ² statistic and conducted subgroup analysis to explore the source of heterogeneity among the included studies. Funnel plots and Egger's regression test were used to determine publication bias. RESULTS: A 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