Nutrition-risk pregnancies and its association with birth outcomes: findings from a community-based intervention in India
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20221277Keywords:
Nutrition risk, Low-birth weight, Pre-term birth, Pregnancy, Gestational weight gainAbstract
Background: The intervention is a part of a maternal and child nutrition project, operational in three districts of West Bengal, India. The current paper focuses on the identification of “nutrition risk pregnancies” at the community level and to determine the associations of the risk factors with birth outcomes like low-birth weight and pre-term birth.
Methods: A cohort of 468 pregnant women attending antenatal clinics in their 1st trimester were identified from 74 sub-health centers from 3 diversified blocks of West Bengal, India. Five key intervention strategies were followed in order to achieve desired pregnancy weight gain birth outcomes, like low-birth weight, pre-term birth was analyzed in relation to “nutrition risk pregnancies”.
Results: About 22.2% of the pregnant women in severe thin body mass index (BMI) categories gave birth to low-birth weight children and about 33.3% had pre-term deliveries compared to pregnant women with normal BMI with 16.8% and 18.8% low-birth and pre-term deliveries respectively. Among the nutrition risk factors, 1st weight at the time of pregnancy registration (95% CI, p=0.04), gestational weight gain (95% CI, p=0.002), were significantly associated with low-birth weight children. Gestational weight gain was also significantly associated with pre-term births (95% CI, p=0.009).
Conclusions: Gestational weight gain beyond or less than recommended range may pre-dispose to low-birth weight and pre-term births. Since this factor could be managed through the existing, public health service delivery systems and family-based inputs, efforts should be geared towards identifying the risk factors and working towards appropriate weight gain.
References
Sharma D, Shastri S, Sharma P. Intrauterine Growth Restriction: Antenatal and Postnatal Aspects. Clin Med Insights: Pediatrics. 2016;10.
National Family Health Survey 2015-16. Available at: http://rchiips.org/nfhs/NFHS-4Reports/India.pdf. Accessed on 12 December 2021.
Sethi V, Kumar P, Wagt AD. Development of a maternal service package for mothers of children with severe acute malnutrition admitted to nutrition rehabilitation centres in India. Field Exchange. 2019;59:24.
Bodeau-Livinec F, Briand V, Berger J, Xiong X, Massougbodji A, Day KP, Cot M. Maternal anemia in Benin: Prevalence, risk factors, and association with low birth weight. Am J Trop Med Hygiene. 2011;85(3):414-20.
Yi SW, HanYJ, Ohrr H. Anemia before pregnancy and risk of preterm birth, low birth weight and small-for-gestational-age birth in Korean women. Eur J Clin Nutr. 2013;67(4):337-42.
Headen I, Mujahid MS, Cohen AK, Rehkopf DH, Abrams B. Racial/ethnic disparities in inadequate gestational weight gain differ by pre-pregnancy weight. Matern Child Health J. 2015;19:1672-86.
Uzogara SG. Underweight the less discussed type of unhealthy weight and its implications: A review. Am J Food Sci Nutr Res. 2016;3:126-42.
Akgun N, Keskin HL, Ustuner I, Pekcan G, Avsar AF. Factors affecting pregnancy weight gain and relationships with maternal/fetal outcomes in Turkey. Saudi Med J. 2017;38(5):503-8.
Tabatabaei M. Gestational weight gain, prepregnancy body mass index related to pregnancy outcomes in Kazerun, Fars, Iran. J Prenatal Med. 2011;5(2):35-40.
Bhavadharini B, Anjana RM, Deepa M, Jayashree G, Nrutya S, Shobana M, et al. Gestational weight gain and pregnancy outcomes in relation to body mass index in Asian Indian women. Indian J Endocrinol Metab. 2017;21(4):588-9.
Huang A, Ji Z, Zhao W, Hu H, Yang Q, Chen D. Rate of gestational weight gain and preterm birth in relation to pre- pregnancy body mass indices and trimester: A follow-up study in China. Reprod Health. 2016;13(1).
