Aim: Assessment of Nutritional Status and Sleep Quality and its association with Stress and Anxiety in pregnant women. Methodology: A cross-sectional study was conducted on 100 pregnant women attending antenatal clinics at selected hospitals in Mumbai. Data was collected using standardized tools: 24-hour dietary recall, a semi-quantitative food frequency questionnaire, Pittsburgh Sleep Quality Index (PSQI) for sleep assessment, Perceived Stress Scale (PSS), and the Pregnancy-Specific Anxiety Tool. Anthropometric and biochemical measurements (hemoglobin) were also recorded. Statistical analysis included One way ANOVA, Pearsons Correlation, and chi-square tests, where p < 0.05 is considered to be statistically significant. Results: The majority of participants (61%) were in their third trimester. The mean hemoglobin level was 10.69 ± 1.43 g/dl, indicating prevalence of anemia among study participants. Dietary recall revealed suboptimal intakes for most nutrients: energy (1346 ± 317.5 kcal), protein (53.13 ± 11.7 g), iron (15.3 ± 3.4 mg), calcium (737.5 ± 169.1 mg), and zinc (7.24 ± 1.58 mg). Folate intake (580.2 ± 178.2 µg) was adequate. The diet pattern was primarily vegetarian, featuring homecooked foods such as roti, rice, dal, sabzi, fruits, khakhra, and tea, with minimal intake of animal protein or fortified products. Supplement usage among participants with consumption of various micronutrients like iron (38.4%), multivitamins (26%), and folate (20.5%) were the most common. Statistically significant associations were observed between trimester and folate (p = 0.03) and multivitamin supplementation (p = 0.005). Based on PSQI scores, 67% of participants had poor sleep quality. Sleep indicators such as subjective sleep quality (p = 0.029), sleep duration (p = 0.005), and sleep efficiency (p = 0.01) were significantly associated with trimester of participants. Moderate to high levels of stress and anxiety were observed in the majority of participants, with anxiety increasing in the third trimester. vi Significant positive correlations were observed between perceived stress and protein (p = 0.03), iron (p = 0.007), and zinc intake (p = 0.01). A negative correlation was observed between stress and sleep efficiency (p = 0.005). Higher animal protein intake was significantly associated with poorer sleep quality (p = 0.002). Conclusion: The findings highlight a complex interplay between inadequate nutrient intake, elevated psychological stress, and poor sleep quality among pregnant women. These issues were most pronounced in the third trimester, likely due to cumulative physical discomfort, hormonal changes, and heightened anxiety regarding childbirth. Despite consumption of traditional home-cooked meals, key nutrient deficiencies were observed, reflecting a lack of dietary diversity. Poor sleep and high stress were closely linked, suggesting a bidirectional influence. These results emphasize the urgent need for integrated antenatal care that addresses nutritional adequacy, emotional wellbeing, and sleep health to promote optimal maternal and fetal outcomes. Key words: Pregnancy, Nutritional status, Sleep quality, Perceived stress, Anxiety, Pittsburgh Sleep Quality Index, Perceived Stress Scale, Pregnancy-Specific Anxiety Tool, 24-hour dietary recall, Micronutrient intake.
Shah et al. (Sat,) studied this question.