The prevalence and risk factors of hypokalemia among pregnant women in rural Eastern Cape South Africa

Abstract

Background. Hypokalaemia is a rare disorder among healthy pregnant women. Life-threatening muscle and cardiac malfunction may develop if it remains untreated.

Objectives. This study was carried out to estimate the prevalence and risk factors of hypokalaemia among pregnant women in rural Eastern Cape (EC) Province, South Africa (SA), and to establish whether geophagia, a common practice, increases the risk.

Methods. This cross-sectional analytical study included 188 participants with geophagia and 233 participants without geophagia enrolled at Mthatha Gateway Clinic, EC, SA. Data included sociodemographic characteristics, magnitude of geophagia, dietary patterns and serum potassium levels. The χ2 test for categorical variables, analysis of variance to compare means, multivariate logistic regression for independent risk factors and principal component analysis for latent variable patterns that were associated with hypokalaemia were carried out. P<0.05 was considered statistically significant.

Results. Hypokalaemia among pregnant women in rural EC was five times higher than expected. Geophagia accounted for only 15% of the observed cases. The risk of hypokalaemia was higher among primigravidas aged <25 years with low meat, fruit and vegetable consumption who practised geophagia, with concurrent excessive cola or caffeinated soft-drink consumption.

Conclusion. Hypokalaemia is disproportionally prevalent among pregnant women in the rural EC. Young age, primigravida, geophagia, diet deficiency in meat, vegetables and fruits and excessive consumption of soft drinks increased the risk of hypokalaemia. The association of geophagia with low meat, vegetable and fruit consumption may indicate an underlying iron deficiency, necessitating further investigation.