The Indian Journal of Nutrition and Dietetics

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Maternal Nutrition and Birth Weight in Dual Nutrition Burden Era


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1 Division of Public Health Nutrition, Nutrition Foundation of India, New Delhi, Delhi - 110 016, India
     

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In the 1970s low dietary intake, pre-pregnancy under-nutrition and low weight gain during pregnancy were thought to be the major factors responsible for over 1/3rd of infants being born with low birth weight in India. Over decades there has been improvement in nutritional status of women; currently both maternal under-nutrition and over-nutrition are major public health problems. Despite improvement in maternal nutritional status, there has been no improvement in birth weight. A study was taken up in women from urban low-middle-income families, to assess maternal nutritional status, weight gain during pregnancy and birth weight; in a sub-group of women the magnitude of residual post-pregnancy weight retention was investigated. Urban women from low-middle-income families (1235) attending antenatal clinics in primary health care institution or receiving antenatal care in community settings, were enrolled for this longitudinal observational study. Gestational age and weight were recorded in 1235 women during 4467 antenatal visits. Mean weight gain in 2nd and 3rd trimester was 7.5 kg. Data on birth-weight was available in 853 women; mean birth-weight was 2.7 kg. In 145 women in whom pre- and post-pregnancy weight was available; the post-pregnancy weight retention was 1.9 kg. Women were heavier before and during pregnancy and there has been improvement in pregnancy weight gain as compared to two decades ago but there was no change in mean birth-weight. Screening, identifying under- or over-nourished pregnant women and providing them with appropriate nutrition and health care can enable improvement in maternal nutrition and birth weight.

Keywords

Pre Pregnancy Weight, Pregnancy Weight Gain, Post Pregnancy Weight Retention, Women from Low Middle Income Groups, Birth Weight
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  • Joint FAO/WHO Ad Hoc Expert Committee on Energy and Protein Requirements, ( 1973) . Energy and protein requirements. WHO Tech Rep Ser No.552. Available from: https://apps.who.int/iris/handle/10665/41042 accessed on 20.6.2020.

  • National Nutrition Monitoring Bureau (NNMB) All the Technical Reports of the NNMB. Available from: http//nnmbindia.org/downloads accessed on 20.6.2020.

  • Ramachandran, P. (1989). Nutrition in pregnancy in women and nutrition in India. Editors. C. Gopalan, Surinder Kaur, Special Publication no. 5. Nutrition Foundation of India.

  • Ramachandran, P. Maternal nutrition- effect on fetal growth and outcome of pregnancy. Nutr. Rev., 2002, 60, 26-34.

  • Ramachandran, P. and Kalaivani, K. Nutrition transition in India: Challenges in achieving global targets. Proc. Ind. Natn. Sci. Aca., 2018, 84.

  • IIPS. National Family Health Survey-3. Available from: http://rchiips.org/nfhs/pub_nfhs-3.shtml accessed on 20.6.2020.

  • IIPS. National Family Health Survey-4. Available from: http://rchiips.org/nfhs/pub_nfhs-4.shtml accessed on 20.6.2020.

  • Goel, A., Devi, A.T., Kalaivani, K. and Ramachandran, P. Dual nutrition burden in urban women from low middle income families. The Ind. J. Nutr. Diet., 2020, 57, 10-24.

  • Sharma, A., Patnaik, R., Garg, S. and Ramachandran, P. Detection and management of anaemia in pregnancy in an urban primary health care institution. Ind. J. Med. Res., 2008, 128.

  • Darby, W.J., McGanity, W.J., Martin, M.P., Bridgforth, E., Densen, P.M., Kaser, M.M. and Cannon, R. O. The vanderbilt cooperative study of maternal and infant nutrition: IV. Dietary, laboratory and physical findings in 2,129 delivered pregnancies: Five figures. The J. Nutr., 1953, 51, 565-597.

  • Thomson, A.M. and Billewicz, W.Z. Clinical significance of weight trends during pregnancy. Br. Med. J., 1957, 1, 243.

  • Thomson, A.M. and Hytten, F.E. Calorie requirements in human pregnancy. Proc. Nutr. Soc., 1961, 20, 76-83.

  • Venkatachalam, P. S. Maternal nutritional status and its effect on the newborn. Bull. World Heal. Organiz., 1962, 26, 193.

  • Bagchi, K. and Bose, A.K. Effect of low nutrient intake during pregnancy on obstetrical performance and offspring. Am. J. Clin. Nutr., 1962, 11, 586-592.

  • Ministry of Women and Child Development, Integrated Child Development Services (ICDS).Available from: wcd.nic.in accessed on 20.6.2020.

  • ICMR –NIN Report of an Expert Group: Nutrient requirements for Indians, (2020). National Institute of Nutrition - Hyderabad

  • Pramanik, A., Kalaivani, K. and Ramachandran, P. Food security and dietary intake in pregnant women from urban low-income group. The Ind. J. Nutr. Diet., 2021, 58, 161 -173

  • Kramer, M. S. Determinants of low birth weight: Methodological assessment and meta-analysis. Bull. World Health Organization, 1987, 65, 663.

  • Ghosh, S., Bhargava, S.K., Madhavan, S., Taskar, A.D., Bhargava, V. and Nigam, S.K. Intra-uterine growth of North Indian babies. Pediat., 1971, 47, 826-830.

  • Ramachandran, P. Nutrition and child survival in India. The Ind. J. Pediat., 2010, 77, 301-5.

  • Gopalan, S. Low birth weight-causes, consequences and interventions to achieve reduction. In Proc. Ind. Natl. Sci. Acad., 2018, 84, 843-851.

  • Ramalingaswami, V., Jonsson, U. and Rhode, J. Malnutrition: A south Asian enigma. Malnutrition in south Asia: A regional profile. UNICEF Regional Office for South Asia, 1997, 11-22.

  • Ramachandran, P. and Kalaivani, K. Millennium development goals (MDG): India’s progress and way forward to sustainable development goals. Proc. Ind. Natl. Sci. Acad., 2016, 82, 1351-1365.

  • Ministry of Statistics and Programme Implementation. Millennium Development Goals India Country Report. (2015) Available from: http://mospi.nic.in/sites/default/files/publication_reports/mdg_2july15_1.pdf accessed on 20.6.2020.

  • Institute of Medicine (US). Subcommittee on Nutritional Status and Weight Gain during Pregnancy. Nutrition during Pregnancy: Part I, Weight Gain: Part II, Nutrient Supplements. National Academy Press, 1990.

  • Rasmussen, K.M., Yaktine, A. L. and Institute of Medicine (US) and National Research Council (US) Committee to Re-examine IOM Pregnancy Weight Guidelines (Eds.). Weight Gain During Pregnancy: Re-examining the Guidelines. National Academies Press (US), 2009.

  • Goel, A., Devi, A.T. Kalaivani, K. and Ramachandran, P. Effect of lactation on nutritional status in urban women from low middle-income families. The Ind. J. Nutr. Diet., 2020, 57, 222-239.


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  • Maternal Nutrition and Birth Weight in Dual Nutrition Burden Era

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Authors

Amrita Pramanik
Division of Public Health Nutrition, Nutrition Foundation of India, New Delhi, Delhi - 110 016, India
Prema Ramachandran
Division of Public Health Nutrition, Nutrition Foundation of India, New Delhi, Delhi - 110 016, India
K. Kalaivani
Division of Public Health Nutrition, Nutrition Foundation of India, New Delhi, Delhi - 110 016, India

Abstract


In the 1970s low dietary intake, pre-pregnancy under-nutrition and low weight gain during pregnancy were thought to be the major factors responsible for over 1/3rd of infants being born with low birth weight in India. Over decades there has been improvement in nutritional status of women; currently both maternal under-nutrition and over-nutrition are major public health problems. Despite improvement in maternal nutritional status, there has been no improvement in birth weight. A study was taken up in women from urban low-middle-income families, to assess maternal nutritional status, weight gain during pregnancy and birth weight; in a sub-group of women the magnitude of residual post-pregnancy weight retention was investigated. Urban women from low-middle-income families (1235) attending antenatal clinics in primary health care institution or receiving antenatal care in community settings, were enrolled for this longitudinal observational study. Gestational age and weight were recorded in 1235 women during 4467 antenatal visits. Mean weight gain in 2nd and 3rd trimester was 7.5 kg. Data on birth-weight was available in 853 women; mean birth-weight was 2.7 kg. In 145 women in whom pre- and post-pregnancy weight was available; the post-pregnancy weight retention was 1.9 kg. Women were heavier before and during pregnancy and there has been improvement in pregnancy weight gain as compared to two decades ago but there was no change in mean birth-weight. Screening, identifying under- or over-nourished pregnant women and providing them with appropriate nutrition and health care can enable improvement in maternal nutrition and birth weight.

Keywords


Pre Pregnancy Weight, Pregnancy Weight Gain, Post Pregnancy Weight Retention, Women from Low Middle Income Groups, Birth Weight

References