Pica Practices and Nutritional Implications in Pregnant Women

Pica is the persistent craving and intentional consumption of non-food substances such as earth (geophagy), ice (pagophagy) and raw starch (amylophagy). Although observed across cultures and age groups, pregnant women are among the most affected, often citing cultural beliefs, relief of gastrointestinal discomfort and perceived nutritional benefits as motives. While certain clays may supply trace minerals such as iron or calcium, habitual ingestion can introduce toxic elements (lead, arsenic, chromium), compromise absorption of essential micronutrients, exacerbate iron-deficiency anaemia and expose both mother and foetus to pathogenic microorganisms. Regional variation in the mineral composition, pH and organic content of consumed materials underlies divergent health outcomes. A nuanced understanding of the balance between perceived benefits and potential hazards is essential for developing antenatal nutritional guidance, culturally sensitive education programmes and risk-based screening protocols that safeguard maternal and neonatal health.

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Pica Practices and Nutritional Implications in Pregnant Women publication trend

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Technical terms

Pica: A compulsive eating disorder characterised by the consumption of non-nutritive substances.

Geophagy: The deliberate ingestion of earth, clay or soil, often driven by cultural practices or physiological needs.

Bioaccessibility: The fraction of a substance in a material that becomes soluble in the gastrointestinal tract and is available for absorption.

Hazard quotient (HQ): A risk assessment metric comparing estimated exposure to a substance against a reference dose below which adverse effects are unlikely.

References

1. Current status of research and gaps in knowledge of geophagic practices in Africa. Frontiers in Nutrition (2023).
2. Geochemical composition and potential health risks of geophagic materials: an example from a rural area in the Limpopo Province of South Africa. Environmental Geochemistry and Health (2023).
3. Toward a Comprehensive Approach to the Collection and Analysis of Pica Substances, with Emphasis on Geophagic Materials. PLOS ONE (2008).
4. Potential health risk assessment of toxic metals contamination in clay eaten as pica (geophagia) among pregnant women of Ho in the Volta Region of Ghana. BMC Pregnancy and Childbirth (2020).