Review of the importance of nutrition during the first 1000 days: maternal nutritional status and its associations with fetal growth and birth, neonatal and infant outcomes among African women

Maternal nutritional status (MNS) is a strong predictor of growth and development in the first 1000 days of life and may influence susceptibility to non-communicable diseases in adulthood. However, the role of nutrition during this window of developmental plasticity in Africa is unclear. This paper reviews published data to address whether maternal nutrition during the first 1000 days is important for Africa, with a focus on MNS and its associations with fetal growth and birth, neonatal and infant outcomes. A systematic approach was used to search the following databases: Medline, EMBASE, Web of Science, Google Scholar, ScienceDirect, SciSearch and Cochrane Library. In all, 26 studies met the inclusion criteria for the specific objectives. MNS in Africa showed features typical of the epidemiological transition: higher prevalences of maternal overweight and obesity and lower underweight, poor diet quality 1 and high anaemia prevalence. Maternal body mass index and greater gestational weight gain (GWG) were positively associated with birth weight; however, maternal overweight and obesity were associated with increased risk of macrosomia and intrauterine growth restriction. Maternal anaemia was associated with lower birth weight. Macro- and micronutrient supplementation during pregnancy were associated with improvements in GWG, birth weight and mortality risk. Data suggest poor MNS in Africa and confirms the importance of the first 1000 days as a critical period for nutritional intervention to improve growth, birth outcomes and potential future health risk. However, there is a lack of data beyond birth and a need for longitudinal data through infancy to 2 years of age.

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Maternal nutritional status during pregnancy as a predictor of Ponderal index and body proportionality at birth, in term neonates

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20204524 ◽

2020 ◽

Vol 7 (11) ◽

pp. 1712

Author(s):

Brinda Prasanna Kumar ◽

Adarsh E. ◽

Sahana G.

Keyword(s):

Birth Weight ◽

Nutritional Status ◽

Demographic Data ◽

Positive Association ◽

Ponderal Index ◽

Maternal Body Mass Index ◽

Cross Sectional ◽

Maternal Nutritional Status ◽

Foetal Growth ◽

Recumbent Length

Background: It is well established that maternal body mass index (BMI) and haemoglobin (Hb) level has an impact on foetal growth. Various studies have concluded that intrauterine growth as reflected by the Ponderal index (PI) is strongly influenced by various maternal factors. Therefore, we undertake this study to address the evidence gap to establish the strength of association between maternal nutritional status as indicated by her pre-pregnancy BMI and haemoglobin levels and neonatal PI.Methods: A hospital based cross-sectional, observational study was conducted that included 236 normal newborns and their mothers. A predesigned questionnaire was used to collect relevant socio-demographic data and obstetric history. Details regarding the maternal pre-pregnancy weight were collected from antenatal records, maternal height was measured and BMI was calculated. Neonatal birth weight and recumbent length was measured. PI was calculated and co-related with the maternal BMI and haemoglobin values.Results: 11.9% of the mothers were underweight and 51.3% had normal BMI. Majority of the mothers (62.7%) had normal Hb levels and 0.4% were found to have severe anemia (Hb <7 mg/dl). We saw a significant positive correlation (p<0.05) between BMI and birth weight, BMI and PI that is, with decrease in BMI there was a significant decrease in the birth weight and PI of the newborn. There was no significant correlation between haemoglobin level and PI.Conclusions: Our study showed a positive association between maternal pre-pregnancy BMI and birth weight, BMI and PI. Therefore, interventions aimed at improving the nutritional status of the mother have a direct impact on the foetal growth outcomes.

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The Impact of Maternal Obesity on Human Milk Macronutrient Composition: A Systematic Review and Meta-Analysis

Nutrients ◽

10.3390/nu12040934 ◽

2020 ◽

Vol 12 (4) ◽

pp. 934 ◽

Cited By ~ 3

Author(s):

Gabriela E. Leghi ◽

Merryn J. Netting ◽

Philippa F. Middleton ◽

Mary E. Wlodek ◽

Donna T. Geddes ◽

...

Keyword(s):

Human Milk ◽

Maternal Obesity ◽

Overweight And Obesity ◽

Cochrane Library ◽

Maternal Body Mass Index ◽

Qualitative Synthesis ◽

Lactating Women ◽

Maternal Overweight ◽

The Impact

Maternal obesity has been associated with changes in the macronutrient concentration of human milk (HM), which have the potential to promote weight gain and increase the long-term risk of obesity in the infant. This article aimed to provide a synthesis of studies evaluating the effects of maternal overweight and obesity on the concentrations of macronutrients in HM. EMBASE, MEDLINE/PubMed, Cochrane Library, Scopus, Web of Science, and ProQuest databases were searched for relevant articles. Two authors conducted screening, data extraction, and quality assessment independently. A total of 31 studies (5078 lactating women) were included in the qualitative synthesis and nine studies (872 lactating women) in the quantitative synthesis. Overall, maternal body mass index (BMI) and adiposity measurements were associated with higher HM fat and lactose concentrations at different stages of lactation, whereas protein concentration in HM did not appear to differ between overweight and/or obese and normal weight women. However, given the considerable variability in the results between studies and low quality of many of the included studies, further research is needed to establish the impact of maternal overweight and obesity on HM composition. This is particularly relevant considering potential implications of higher HM fat concentration on both growth and fat deposition during the first few months of infancy and long-term risk of obesity.

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Nutritional Status Measurement Instruments for Diabetes: A Systematic Psychometric Review

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17165719 ◽

2020 ◽

Vol 17 (16) ◽

pp. 5719

Author(s):

Pedro Montagut-Martínez ◽

David Pérez-Cruzado ◽

José Joaquín García-Arenas

Keyword(s):

Nutritional Status ◽

Dietary Intake ◽

Psychometric Properties ◽

Premature Death ◽

Diabetes Mellitus Type 1 ◽

Measurement Properties ◽

Cochrane Library ◽

Individual Treatment ◽

Measurement Instruments ◽

Increased Risk

Background: Diabetes is a serious chronic disease associated with a large number of complications and an increased risk of premature death. A dietary evaluation is of utmost importance for health promotion, disease prevention and individual treatment plans in patients with diabetes. Methods: An exhaustive search was carried out in various databases—Medline, Web of Science, Open Gray Cochrane Library and Consensus-based Standards for the selection of health status Measurement Instruments (COSMIN)—for systematic review of the measurement properties of instruments that evaluate the dietary intake of people with diabetes mellitus type 1 and/or 2 according to COSMIN standards. Results: Seven instruments were identified. There was no instrument measuring nutritional status for which all the psychometric properties were evaluated. The methodological quality for each of the psychometric properties evaluated was ‘inadequate’ or ‘doubtful’ for all instruments. The Food Frequency Questionnaire (FFQ) evaluated the most psychometric characteristics and with a better score in terms of quality of the evidence. Conclusions: Several instruments have been developed for the evaluation of dietary intake in people with diabetes. Evaluation of this construct is very useful, both in clinical practice and in research, requiring new knowledge in this area. The FFQ is the best instrument available to assess dietary intake in people with diabetes.

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Maternal nutritional status (as measured by height, weight and BMI) in Bangladesh: trends and socio-economic association over the period 1996 to 2007

Public Health Nutrition ◽

10.1017/s1368980015002839 ◽

2015 ◽

Vol 19 (8) ◽

pp. 1438-1445 ◽

Cited By ~ 8

Author(s):

Masuda Mohsena ◽

Rie Goto ◽

CG Nicholas Mascie-Taylor

Keyword(s):

Nutritional Status ◽

Considerable Increase ◽

Substantial Reduction ◽

Overweight And Obesity ◽

Demographic And Health Surveys ◽

Economic Variables ◽

Maternal Nutritional Status ◽

Economic Association ◽

Education Of Women ◽

Socio Economic Variables

AbstractObjectiveTo analyse trends in maternal nutritional status in Bangladesh over a 12-year period and to examine the associations between nutritional status and socio-economic variables.DesignMaternal nutritional status indicators were height, weight and BMI. Socio-economic variables used were region, residency, education and occupation of the mothers and their husbands, house type, and possession score in the household.SettingBangladesh Demographic and Health Surveys (1996, 2000, 2004 and 2007) were the source of data.SubjectsA total of 16 278 mothers were included.ResultsAll of the socio-economic variables showed significant associations with maternal nutritional status indicators. Regional variation was found to be present; all three indicators were found to be lowest in the Sylhet division. Upward trends in maternal height, weight and BMI were evident from no possessions to four possessions in households, and for no education to higher education of women and their husbands. Bangladeshi mothers measured in 2007 were found to be on average 0·34 cm taller and 3·36 kg heavier than mothers measured in 1996. Between 1996 and 2007 maternal underweight fell from nearly 50 % to just over 30 % while overweight and obesity increased from about 3 % to over 9 % (WHO cut-offs) or from 7 % to nearly 18 % (Asian cut-offs).ConclusionsThe study reveals that over the 12-year period in Bangladesh there has been a substantial reduction in maternal underweight accompanied by a considerable increase in obesity. It is also evident that malnutrition in Bangladesh is a multidimensional problem that warrants a proper policy mix and programme intervention.

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BIRTH WEIGHT AND OVERWEIGHT IN ADOLESCENTS: THE ERICA PROJECT IN THE CITY OF RECIFE, PERNAMBUCO

Revista Paulista de Pediatria ◽

10.1590/1984-0462/2021/39/2019380 ◽

2021 ◽

Vol 39 ◽

Author(s):

Kamilla Brianni de Araújo Gomes ◽

Vanessa Sá Leal ◽

Juliana Souza Oliveira ◽

Crislaine Gonçalves da Silva Pereira ◽

Fabiana Cristina Lima da Silva Pastich Gonçalves ◽

...

Keyword(s):

Physical Activity ◽

Birth Weight ◽

Nutritional Status ◽

Abdominal Obesity ◽

Poisson Regression ◽

High Birth Weight ◽

Cardiovascular Risks ◽

Anthropometric Parameters ◽

Biological Variables ◽

Maternal Overweight

ABSTRACT Objective: To verify the association of anthropometric parameters at birth, socioeconomic and biological variables, physical activity, and parental nutritional status with overweight and abdominal obesity in adolescents. Methods: A cross-sectional study was carried out on 39 public and private schools in Recife (state of Pernambuco, Brazil). The sample consisted of 1,081 teenagers aged from 12 to 17 years. Data were collected from the Study of Cardiovascular Risks in Adolescents (ERICA). Body mass index according to age (BMI-for-age), waist circumference (WC), and waist-to-height ratio (WtHR) were considered as outcome variables, whereas the explanatory variables were birth weight, Röhrer’s Ponderal Index (RPI), biological and socioeconomic variables, physical activity, and parental nutritional status. The crude and adjusted prevalence ratios (PR) for the studied association were estimated by Poisson Regression. Results: The multivariate Poisson regression showed that the variable that remained significantly associated with overweight in adolescence was maternal overweight, PR=1.86 (95% confidence interval [95%CI] 1.09-3.17). High birth weight also remained significantly associated with abdominal obesity assessed by WC, PR=3.25 (95%CI 1.0-9.74). Conclusions: High birth weight may be a marker for abdominal obesity in adolescence; and high maternal BMI, for overweight.

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Optimization of antenatal monitoring approaches of women with chronic inflammatory bowel diseases

Reproductive Endocrinology ◽

10.18370/2309-4117.2021.57.84-92 ◽

2021 ◽

pp. 84-92

Author(s):

O.V. Bulavenko Bulavenko ◽

D.G. Konkov ◽

N.V. Kuzminova ◽

T.V. Lobastova ◽

I.V. Oleksienko

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Inflammatory Bowel Diseases ◽

Clinical Guidelines ◽

Cochrane Library ◽

Chronic Inflammatory Bowel Diseases ◽

Increased Risk ◽

Bowel Diseases ◽

Inflammatory Bowel ◽

Chronic Inflammatory Bowel

Chronic inflammatory bowel diseases (CIBD) affect patients at their peak of reproductive age. Clinical presentation of CIBD in pregnancy is associated with an increased risk of adverse effects in mother and fetus, including prematurity, low birth weight, increased indications for caesarean section. Thus optimizing of the CIBD diagnosis and treatment before and during pregnancy is essential to improve maternal and fetal outcomes.Research aim: to analyze the effectiveness of the CIBD clinical management at the stage of preconception and during pregnancy.Materials and methods. It was searched the Cochrane Library, WHO platform, clinical guidelines, and research reference database Medline. All potential studies have evaluated the clinical practice guidelines in women with CIBD for conception, pregnancy and breastfeeding. Recommendations related to the necessary laboratory and instrumental examination methods, therapeutic strategy, the safety of drugs for mother and fetus, the features of multidisciplinary antenatal observation, the timing and method of delivery of pregnant women with CIBD. Results. Treatment in the planning phase and pregnancy should be multidisciplinary, involving a gastroenterologist, obstetrician-gynecologist, primary care physician, pediatrician and a colorectal surgeon if necessary, as well as stakeholders from the association of patients with CIBD. Communication between these professionals is critical to avoid ambivalent or even conflicting counseling, which is an additional source of anxiety for patients, and also potentially dangerous for suboptimal prevention of clinical CIBD manifestation. Obtained results of the analysis will prevent laboratory and therapeutic polypharmacy and significantly improve the pregnancy outcome.Conclusions. Most women with CIBD had a physiological pregnancy and healthy children. However, some studies have linked CIBD to an increased risk of preterm birth and low birth weight infants. The development of national clinical guidelines will optimize and improve the quality of perinatal care to women with CIBD in the Ukraine, and will lead to a decrease in obstetric, fetal and neonatal complications.

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Association of high birth weight with overweight and obesity in Chinese students aged 6–18 years: a national, cross-sectional study in China

BMJ Open ◽

10.1136/bmjopen-2018-024532 ◽

2019 ◽

Vol 9 (5) ◽

pp. e024532 ◽

Cited By ~ 2

Author(s):

Zhiyong Zou ◽

Zhongping Yang ◽

Zhaogeng Yang ◽

Xijie Wang ◽

Di Gao ◽

...

Keyword(s):

Birth Weight ◽

Age Groups ◽

Chinese Students ◽

Cross Sectional Study ◽

Overweight And Obesity ◽

High Birth Weight ◽

Cross Sectional Survey ◽

Anthropometric Parameters ◽

Cross Sectional ◽

Increased Risk

BackgroundThe prevalence of childhood overweight and obesity in China has drastically increased 57 times over the past 30 years, and to control birth weight is an effective way to reduce the risk of overweight and obesity across the life course.ObjectiveThis paper aimed to evaluate the association of high birth weight (HBW) with overweight and obesity in Chinese students aged 6–18 years.MethodsAll students with HBW (n=4981) aged 6–18 years were selected from a cross-sectional survey from seven provinces of China, and 4981 other students with normal birth weight (NBW) were randomly sampled with matched gender, age and province. Anthropometric parameters were measured and characteristics were collected by questionnaires. Multiple logistic regression was used to estimate the OR of overweight and obesity with HBW, unadjusted and adjusted for confounding factors.ResultsParticipants with HBW revealed higher body mass index in childhood. The prevalence of overweight and obesity was significantly higher in the HBW group than in the NBW group (overweight 15.3% vs 13.1%, p<0.05; obesity 16.9% vs 10.6%, p<0.05), and the results were similar for overweight in all age groups except age 6–7, age 14–15 and age 16–18. Additionally, HBW was positively associated with overweight (OR=1.230; 95% CI 1.056 to 1.432) and obesity (OR=1.611; 95% CI 1.368 to 1.897) after adjustment for covariates.ConclusionsHBW leads to an increased risk of overweight and obesity in childhood; thus, measures to control birth weight, such as controlling gestational weight gain, should be taken from the earliest beginning of life.Trial registration numberNCT02343588; Post-results.

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Is maternal weight gain between pregnancies associated with risk of large-for-gestational age birth? Analysis of a UK population-based cohort

BMJ Open ◽

10.1136/bmjopen-2018-026220 ◽

2019 ◽

Vol 9 (7) ◽

pp. e026220 ◽

Cited By ~ 7

Author(s):

Nida Ziauddeen ◽

Sam Wilding ◽

Paul J Roderick ◽

Nicholas S Macklon ◽

Nisreen A Alwan

Keyword(s):

Weight Gain ◽

Gestational Age ◽

Population Based ◽

Overweight And Obesity ◽

Large For Gestational Age ◽

Adjusted Relative Risk ◽

Maternal Weight ◽

Overweight Women ◽

Increased Risk ◽

Maternal Overweight

ObjectiveMaternal overweight and obesity during pregnancy increases the risk of large-for-gestational age (LGA) birth and childhood obesity. We aimed to investigate the association between maternal weight change between subsequent pregnancies and risk of having a LGA birth.DesignPopulation-based cohort.SettingRoutinely collected antenatal healthcare data between January 2003 and September 2017 at University Hospital Southampton, England.ParticipantsHealth records of women with their first two consecutive singleton live-birth pregnancies were analysed (n=15 940).Primary outcome measureRisk of LGA, recurrent LGA and new LGA births in the second pregnancy.ResultsOf the 15 940 women, 16.0% lost and 47.7% gained weight (≥1 kg/m2) between pregnancies. A lower proportion of babies born to women who lost ≥1 kg/m2(12.4%) and remained weight stable between −1 and 1 kg/m2(11.9%) between pregnancies were LGA compared with 13.5% and 15.9% in women who gained 1–3 and ≥3 kg/m2, respectively. The highest proportion was in obese women who gained ≥3 kg/m2(21.2%). Overweight women had a reduced risk of recurrent LGA in the second pregnancy if they lost ≥1 kg/m2(adjusted relative risk (aRR) 0.69, 95% CI 0.48 to 0.97) whereas overweight women who gained ≥3 kg/m2were at increased risk of new LGA after having a non-LGA birth in their first pregnancy (aRR 1.35, 95% CI 1.05 to 1.75). Normal-weight women who gained weight were also at increased risk of new LGA in the second pregnancy (aRR 1.26, 95% CI 1.06 to 1.50 with gain of 1–3 kg/m2and aRR 1.34, 95% CI 1.09 to 1.65 with gain of ≥3 kg/m2).ConclusionsLosing weight after an LGA birth was associated with a reduced LGA risk in the next pregnancy in overweight women, while interpregnancy weight gain was associated with an increased new LGA risk. Preventing weight gain between pregnancies is an important measure to achieve better maternal and offspring outcomes.

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Maternal Body Mass Index (BMI) and Mid-Upper Arm Circumference (MUAC) in Early Pregnancy as Predictors of Low Birth Weight Infants

Advanced Science Letters ◽

10.1166/asl.2018.12679 ◽

2018 ◽

Vol 24 (8) ◽

pp. 6203-6205

Author(s):

Yoga Dwi Oktavianda ◽

Syahru Ramadhan ◽

Thalia Mufida ◽

Ummul Mukminin ◽

Rima Irwinda

Keyword(s):

Body Mass Index ◽

Birth Weight ◽

Low Birth Weight ◽

Nutritional Status ◽

Pregnant Women ◽

Early Pregnancy ◽

Upper Arm ◽

Maternal Nutritional Status ◽

Arm Circumference ◽

Mid Upper Arm Circumference

Low birth weight is one of the determinants of infant mortality, morbidity, and disability, which can even have an impact on the future. Several studies have suggested that the condition of low birth weight (LBW) infants is influenced by the lack of maternal nutritional status in early pregnancy. Moreover, the prevalence of malnutrition in Indonesia is still high. Therefore, this study attempted to analyze the relationship of maternal nutritional status in early pregnancy as a predictor of LBW infants. Using a cross-sectional study design, this study involved 62 pregnant patients aged 20–35 years who had antenatal visits and a term delivery at Puskesmas Kecamatan Cakung. The measurements of body mass index (BMI) and mid-upper arm circumference (MUAC) in early pregnancy are used to determine the maternal nutritional status. Pregnant women with BMI <18.5 or MUAC <23.5 cm are considered to have less nutritional status. Meanwhile, LBW infants are defined as babies with birth weight <2500 grams. This study proves that the risk of birth of LBW infants is increased in pregnant women with BMI <18.5 (underweight) (OR 5.37) and less MUAC (OR 20.4).

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Nutrient partitioning during adolescent pregnancy

Reproduction ◽

10.1530/rep.0.1220347 ◽

2001 ◽

pp. 347-357 ◽

Cited By ~ 78

Author(s):

J Wallace ◽

D Bourke ◽

P Da Silva ◽

R Aitken

Keyword(s):

Birth Weight ◽

Pregnancy Outcome ◽

Adolescent Mothers ◽

Fetal Growth ◽

Adverse Pregnancy Outcome ◽

Late Gestation ◽

Gravid Uterus ◽

Maternal Body ◽

Increased Risk ◽

Nutrient Partitioning

Human adolescent mothers have an increased risk of delivering low birth weight and premature infants with high mortality rates within the first year of life. Studies using a highly controlled adolescent sheep paradigm demonstrate that, in young growing females, the hierarchy of nutrient partitioning during pregnancy is altered to promote growth of the maternal body at the expense of the gradually evolving nutrient requirements of the gravid uterus and mammary gland. Thus, overnourishing adolescent dams throughout pregnancy results in a major restriction in placental mass, and leads to a significant decrease in birth weight relative to adolescent dams receiving a moderate nutrient intake. High maternal intakes are also associated with increased rates of spontaneous abortion in late gestation and, for ewes delivering live young, with a reduction in the duration of gestation and in the quality and quantity of colostrum accumulated prenatally. As the adolescent dams are of equivalent age at the time of conception, these studies indicate that nutritional status during pregnancy rather than biological immaturity predisposes the rapidly growing adolescents to adverse pregnancy outcome. Nutrient partitioning between the maternal body and gravid uterus is putatively orchestrated by a number of endocrine hormones and, in this review, the roles of both maternal and placental hormones in the regulation of placental and fetal growth in this intriguing adolescent paradigm are discussed. Impaired placental growth, particularly of the fetal component of the placenta, is the primary constraint to fetal growth during late gestation in the overnourished dams and nutritional switch-over studies indicate that high nutrient intakes during the second two-thirds of pregnancy are most detrimental to pregnancy outcome. In addition, it may be possible to alter the nutrient transport function of the growth-restricted placenta in that the imposition of a catabolic phase during the final third of pregnancy in previously rapidly growing dams results in a modest increase in lamb birth weight.

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