title: Pica in pregnancy: does it affect pregnancy outcomes?
abstract: OBJECTIVE
  To discover the prevalence of pica, the documentation of pica on medical records, and any relationship of pica to pregnancy outcomes in rural socioeconomically disadvantaged pregnant women.
  
  
  METHODS
  Prospective, descriptive, correlational investigation with 128 women who sought prenatal care from two rural community health agencies. Demographic and sociocultural variables, pica practices, pica substances ingested, and pregnancy outcomes were collected.
  
  
  RESULTS
  Thirty-eight percent of these pregnant women practiced pica. African-American women reported practicing pica more often than other ethnicities. Substances ingested included ice (>1 cup/day), freezer frost, laundry starch, cornstarch, clay dirt, and baked clay dirt. Polypica (ingestion of more than one substance) was practiced by 11 women. Women practicing pica were more likely to have been underweight prior to pregnancy, and smoked fewer cigarettes. Women reporting daily pica practice were significantly more likely to have lower prenatal hematocrits than women who did not practice pica, or who practiced pica less frequently than daily. No specific pregnancy complication was associated with the practice of pica.
  
  
  CONCLUSIONS
  Pica exists, and might be more common than healthcare providers assume. Although this study did not show specific pregnancy complications associated with pica, other studies have shown anemia and lead poisoning among women who practice pica. It is not clear that patients volunteer information about pica, so it would be helpful if nurses queried patients at each prenatal visit regarding pica practice. Discussion of pica practices should be based on a nonjudgmental model, for pica may have strong cultural implications, and may be practiced for cultural reasons unknown to the nurse.
authors.affiliation: School of Nursing, East Carolina University, Rivers Building, Greenville, NC 27858, USA. corbettr@mail.ecu.edu
authors.forename: Robin Webb
authors.initials: RW
authors.lastname: Corbett
authors.forename: Cass
authors.initials: C
authors.lastname: Ryan
authors.forename: Sally P
authors.initials: SP
authors.lastname: Weinrich
mesh_terms: D000328:Adult; D001741:Black or African American; D000740:Anemia / Q000209:etiology; D018864:Cultural Diversity; D005260:Female; D006801:Humans; D007855:Lead Poisoning / Q000209:etiology; D009730:Nursing Assessment; D010842:Pica / Q000150:complications* / Q000453:epidemiology / Q000517:prevention & control; D011204:Poverty Areas; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology / Q000517:prevention & control; D011256:Pregnancy Outcome / Q000453:epidemiology; D011295:Prenatal Care; D015995:Prevalence; D011446:Prospective Studies; D012423:Rural Health; D015144:Southeastern United States / Q000453:epidemiology; D011795:Surveys and Questionnaires