Dietary protein energy supplementation of pregnant Asian mothers at Sorrento, Birmingham. II: Selective during third trimester only.

Viegas, O. A. C.; Scott, Peter; Cole, T J; Eaton, Phyllis M.; Needham, Peter; Wharton, B A

doi:10.1136/bmj.285.6342.592

Cited by 83 publications

(51 citation statements)

References 6 publications

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“…Lighter women gained relatively more weight during their pregnancy than heavier women, a result in keeping with other studies in East Java, Indonesia (19) , Pakistan (20) and Taipei, Republic of China (21) . The present study showed that supplementation had an insignificant effect on birth weight and LBW, in keeping with some studies (22)(23)(24)(25)(26)(27) , while other studies have reported a significant impact of supplementation on birth weight (12,(28)(29)(30)(31)(32) . The most recent food supplementation trial on undernourished women from the Gambia (12) reported considerably larger effects on birth weight.…”

Section: Discussionsupporting

confidence: 91%

Impact of targeted food supplementation on pregnancy weight gain and birth weight in rural Bangladesh: an assessment of the Bangladesh Integrated Nutrition Program (BINP)

Nahar

Mascie-Taylor

Begum

2009

Public Health Nutr.

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Objectives: To assess whether the Bangladesh Integrated Nutrition Programme (BINP) correctly identified which pregnant women should be enrolled in the food supplementation programme, whether supplementation commenced on time and was taken on a regular basis. A second objective was to determine whether food supplementation led to enhanced pregnancy weight gain and reduction in the prevalence of low birth weight. Design: A one-year community-based longitudinal study. Setting: A rural union of Bhaluka Upazila, Mymensingh, located 110 km northwest of Dhaka City, the capital of Bangladesh. Participants: A total of 1104 normotensive, non-smoking pregnant women who attended Community Nutrition Centres were studied from first presentation at the centre until child delivery. Results: Pregnant women who had a BMI of ,18?5 kg/m 2 on first presentation should have been selected for supplementary feeding (2512 kJ (600 kcal)/d for six days per week) starting at month 4 (16 weeks) of pregnancy. However, of the 526 women who had BMI , 18?5 kg/m 2 , only 335 received supplementation; so the failure rate was 36?3 %. In addition, of those receiving supplementation, only 193 women (36?7 % of 526 women) commenced supplementation at the correct time, of whom thirty-two (9?6 % of 335 women) received supplementation for the correct number of days (100 % days). There were no significant differences in mean weight gain between BMI , 18?5 kg/m 2 supplemented or non-supplemented groups or between the equivalent groups with BMI $ 18?5 kg/m 2 . Weight gain was inversely related to initial weight, so lighter women gained relatively more weight during their pregnancy than heavier women. The mean birth weight in the supplemented and non-supplemented groups was 2?63 kg and 2?72 kg, respectively. Mothers with BMI , 18?5 kg/m 2 who were or were not supplemented had almost equal percentages of low-birth-weight babies (21 % and 22 %, respectively). Conclusion: The study raises doubt about the efficiency of the BINP to correctly target food supplementation to pregnant women. It also shows that food supplementation does not lead to enhanced pregnancy weight gain nor does it provide any evidence of a reduction in prevalence of low birth weight. Keywords Pregnancy weight gainFood supplementation Low birth weight Intra-uterine growth and development is one of the most vulnerable periods in the human life cycle. The weight of an infant at birth is an important indicator of maternal health and nutrition prior to, and during, pregnancy, and a powerful predictor of infant growth and survival (1) . Approximately 25 million babies are born each year weighing less than 2500 g, the WHO cut-off for low birth weight (LBW), of which 90 % are born in developing countries (2) . Bangladesh is one such country, where 50 % of childbearing women are suffering from malnutrition defined by BMI , 18?5 kg/m 2 and more than 20 % are severely stunted (3) . Bangladesh has the highest worldwide prevalence of LBW with rates estimated at between 20 % and 60 % (4,5) . The h...

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Section: Discussionsupporting

confidence: 91%

Impact of targeted food supplementation on pregnancy weight gain and birth weight in rural Bangladesh: an assessment of the Bangladesh Integrated Nutrition Program (BINP)

Nahar

Mascie-Taylor

Begum

2009

Public Health Nutr.

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“…Birth weight data was not directly measured by our project staff, but by trained hospital personnel. However, variability associated with birth weight in our study was low compared with most, [25][26][27]44 although not all 29 similar reports of hospital deliveries of well-controlled nutritional supplementation trials with birth weight as the critical study outcome. This serves as an indication of the adequacy of our birth weight data.…”

Section: Discussionsupporting

confidence: 39%

“…20 The impact on birth weight of most supplementation trials to pregnant women at high nutritional risk have had similar or smaller effects. [25][26][27][28][29][30] Only when food supplements were consumed in most stressful conditions [31][32] or during current and previous reproductive cycles, 33 is a larger effect on birth weight observed.…”

Section: Discussionmentioning

confidence: 95%

Decrease in Birth Weight in Relation to Maternal Bone-Lead Burden

et al. 1997

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Our results indicate that bone-lead burden is inversely related to birth weight. Taken together with other research indicating that lead can mobilize from bone into plasma without detectable changes in whole blood lead, these findings suggest that bone lead might be a better biomarker than blood lead. Because lead remains in bone for years to decades, mobilization of bone lead during pregnancy may pose a significant fetal exposure with health consequences, long after maternal external lead exposure has declined.

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“…In a well-nourished population there is little evidence that thinner mothers have babies of lower birthweight (Ounsted and Scott 1981), but simple indices of maternal nutrition in developing countries appear to contribute significantly to the prediction of birthweight (Naeye and Tafari 1985). Nutritional intervention in women with poor nutrition is probably associated with a modest increase in birthweight (Blackwell, Chow, Chinn, Blackwell and Hsu 1973, Habicht and Yarbrough 1974, Lechtig et al 1975, Moram De Poredos, Wagner, De Navarro, Suesain, Christiansen and Hevrea, 1979Viegas, Scott, Cole, Eaton, Needham and Wharton 1982;Prentice, Whitehead, Watkinson, Lamb and Cole 1983) although some of the studies done are open to criticism (Susser 1981). We had no access to prepregnancy weights in our study, but used BMI based on early postpartum weight as a crude means of comparison between groups.…”

Section: Maternal Nutrition and Fetal Growthmentioning

confidence: 96%

Ethnic and environmental factors affecting fetal growth in Papua New Guinea

Primhak

Macgregor

1991

Annals of Human Biology

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We studied 738 live singleton births in Papua New Guinea to examine the contribution of ethnic origin and environmental factors to birth weight and gestation. Maternal history, examination and post-partum anthropometry, infant anthropometry and clinical gestational assessment were performed, and placental blood slides and histology were examined. Mothers from Highlands provinces who delivered on the coast had larger babies (mean birthweight 3.34 SD 0.48 kg) than either indigenous coastal mothers (mean 3.10 SD 0.51 kg) or those migrating to Port Moresby from other coastal regions (mean 3.14 SD 0.51 kg). This was due to a combination of longer gestation and better intrauterine growth (assessed by birthweight standard deviation scores). Gestation was slightly longer in Highlands mothers delivering on the coast compared with those delivering in the Highlands, but birthweight standard deviation scores were unchanged. Malarial infection of the placenta was almost never found. Stepwise regression analysis showed that parity, maternal height, Highlands origin and maternal body mass index (weight/height2) were all significant predictors of birthweight standard deviation score, while maternal body mass index and Highlands origin were predictors of gestational length. We conclude that Highland mothers have a tendency to deliver heavier babies, and do not demonstrate the fetal growth-retarding effects of altitude seen in other races. Although the incidence of low birthweight was only 7.1% in our study, we found that indices of maternal nutrition were predictors of birth weight.

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Dietary protein energy supplementation of pregnant Asian mothers at Sorrento, Birmingham. II: Selective during third trimester only.

Cited by 83 publications

References 6 publications

Impact of targeted food supplementation on pregnancy weight gain and birth weight in rural Bangladesh: an assessment of the Bangladesh Integrated Nutrition Program (BINP)

Impact of targeted food supplementation on pregnancy weight gain and birth weight in rural Bangladesh: an assessment of the Bangladesh Integrated Nutrition Program (BINP)

Decrease in Birth Weight in Relation to Maternal Bone-Lead Burden

Ethnic and environmental factors affecting fetal growth in Papua New Guinea

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