Caffeine consumption, khat chewing, and associated factors among pregnant mothers in Illu Aba Bor Zone, South West Ethiopia

Background: Substance use during pregnancy remained to be public health concern. Excess caffeine consumption and khat chewing during pregnancy have multiple preventable effects on the fetus and mothers. So, understanding the prevalence of using these substances and their predictors during pregnancy is the first step to take measurements. However, there is information scarcity regarding the estimated magnitude of these substances use during pregnancy and their associated factors at a national level, especially in our study area. Objective: To identify the magnitude of caffeine intake above the recommended level, chewing khat and their predictors during the prenatal period in the Ilu Aba Bor zone in 2021. Methods: To recruit 830 participants, a community-based cross-sectional study design with multistage sampling was used. Data were entered into Epi-data version 3.1 and transferred to SPSS version 23 for analysis. A multivariable logistic regression was run, and variables with a p-value of <0.05 at a CI of 95% were declared significant variables. Result: This study revealed that 16.3% [95% CI(13.9,18.9)] of respondents consumed caffeine excessively and about 27.4%(95% CI:24.5,30.4%) of them chewed khat in the present pregnancy. Lack of counseling service during antenatal care to limit caffeine consumption (AOR = 2.27;95 %CI:1.18,4.38), lack of awareness of the risk of excess caffeine consumption (AOR = 4.93; 95 %CI:2.10,11.09), and being in the second trimester (AOR = 2.16;95 %CI:1.10,4.25) were significantly shown association with excessive caffeine intake.Being urban resident (AOR = 2.10;95CI:1.26,3.48), lack of formal education (AOR = 4.22;95CI:2.28,7.82), unwanted Pregnancy (AOR = 4.87;95 %CI:2.86,8.29), Multigravida (AOR = 1.91;95CI:1.12,3.20), and lack of awareness about risk of using khat on the fetus (AOR = 8.66;95 %CI:5.00,14.99) were the main factors significantly associated with khat chewing during pregnancy. Conclusion: Significant number of pregnant mothers were exercising caffeine consumption above the recommended level and chewing khat during pregnancy. Thus, we suggest counseling for excess caffeine consumption and khat chewing as an integral part of antenatal care. Plain language summary: The first step in intervening is to understand the magnitude of caffeine consumption, khat chewing, and their associated factors during pregnancy. This study determined that 16.3% of respondents consumed caffeine excessively and 27.4% chewed khat during the current pregnancy. Excess caffeine consumption and chewing khat during prenatal period have numerous preventable impacts on the fetus and mothers. Being urban resident, lack of formal education, and gestational age of second trimester were shown association with excessive caffeine intake. Lack of awareness of the risk of excess caffeine consumption and khat chewing during pregnancy is the first step to taking intervention