title: A comparison of pregnancy outcomes in Ghanaian women with varying dietary diversity: a prospective cohort study protocol.
abstract: BACKGROUND
  Poor dietary intake during pregnancy can have negative repercussions on the mother and fetus. This study therefore aims to explore the dietary diversity (DD) of pregnant women and its associations with pregnancy outcomes among women in Northern Ghana. The main outcome variables to be measured are gestational weight gain and birth weight.
  
  
  METHODS
  A prospective cohort study design will be used and 600 pregnant women in their first trimester will be systematically recruited at health facilities and followed until delivery. In three follow-up visits after recruitment, information on sociodemographic and general characteristics, physical activity (International Physical Activity Questionnaire (IPAQ) short form, dietary intake (24-hour food recall), anthropometry and pregnancy outcomes will be collected. DD will be measured three times using the minimum DD-women (MDD-W) indicator and the mean of the three values overall will be used to determine low (<5 food groups) and high (≥5 food groups) DD. Data will be analysed using SPSS. Comparisons between groups (categorical data) will be made using the χ2test for proportions, and t-tests and ANOVA will be performed on continuous variables. Regression analysis will be used to identify independent outcome predictors while controlling for possible confounding factors. The results may help to identify differences in DD between healthy and unhealthy pregnancy outcomes.
  
  
  BACKGROUND
  The study protocol has been approved by the ethics committee of Tehran University of Medical Sciences and the ethical review committee of the Tamale Teaching Hospital. Written informed consent will be obtained from all subjects. The results will be published in due course.
authors.affiliation: Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences-International Campus, Tehran, Iran.
authors.forename: Shaibu Mohammed
authors.identifier: http://orcid.org/0000-0002-8635-5667
authors.initials: SM
authors.lastname: Osman
authors.affiliation: Department of Community Nutrition, School of Allied Health Sciences, University for Development Studies, Tamale, Ghana.
authors.forename: Mahama
authors.initials: M
authors.lastname: Saaka
authors.affiliation: Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences-International Campus, Tehran, Iran.
authors.forename: Fereydoun
authors.initials: F
authors.lastname: Siassi
authors.affiliation: Department of Community Medicine, School of Public Health, Alborz University of Medical Sciences, Karaj, Iran.
authors.forename: Mostafa
authors.initials: M
authors.lastname: Qorbani
authors.affiliation: Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences-International Campus, Tehran, Iran.
authors.forename: Parvaneh
authors.initials: P
authors.lastname: Yavari
authors.affiliation: Department Molecular Epidemiology, German Institute of Human Nutrition, Potsdam-Rehbruecke, Nuthetal, Germany.
authors.forename: Ina
authors.initials: I
authors.lastname: Danquah
authors.affiliation: Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences-International Campus, Tehran, Iran.
authors.forename: Gity
authors.initials: G
authors.lastname: Sotoudeh
keywords: 24-hour food recall; IPAQ-short form; Northern Ghana; minimum dietary diversity-women; pregnancy outcome