Energy supplementation in the last trimester of pregnancy in East Java: I. Effect on birthweight

Kardjati, S; Kusin, J. A.

doi:10.1111/j.1471-0528.1988.tb06553.x

Cited by 53 publications

(50 citation statements)

References 18 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: 74%

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: 74%

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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“…40 kg 6,21,22 , and a PPW cut-off of 40 kg is the most commonly cited figure in developing countries used to assess risk of various pregnancy outcomes. Ideally, PPW should be taken before the woman is diagnosed as pregnant.…”

Section: Discussionmentioning

confidence: 99%

Maternal anthropometry as a predictor of birth weight

Nahar

Mascie‐Taylor

Begum

2007

Public Health Nutr.

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Objective: To determine whether maternal anthropometry predicted birth weight, and if so, to identify which cut-offs provided the best prediction of low birth weight (LBW) in a field situation. Design: Community-based longitudinal study. Setting: A rural union of Bhaluka Upazila, Mymensingh, located 110 km north-west of Dhaka, 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 delivery of their child. Results: Most of the pregnant mothers were between 20 and 34 years of age. Over one-third of the women were nulliparous, while 12.8% were multiparous (parity $ 4). Most (93%) mothers registered between the 3rd and 5th month of pregnancy. The frequency of LBW (, 2500 g) was 17%. Polynomial regression analyses showed that the best predictors of birth weight (based on adjusted R 2 values) were in general weight at registration and weight at month 9, with adjusted R 2 ranging from 2.5% to nearly 20%. Sequential regression analyses with height and weight showed that there was a significant effect of height after removing the weight variables, and adjusted R 2 increased in all analyses. Weight and height at registration month continued to be the best predictors of LBW. Sensitivity and specificity curves were drawn for each registration month, body mass index and different weight gain groups, and using different weight and height combinations. The results showed that, for registration month 3-5, a combination of weight (# 45 kg) and height (#150 cm) gave the highest sensitivity, which was 50%. However, maternal weight # 43 kg in pregnancy month 3 -5 alone gave the highest sensitivity of 80%. Conclusion: The best predictor of birth weight as a continuous variable was maternal weight at registration, each 1 kg increase in weight at registration being associated with an increase in birth weight of about 260 g. Maternal weight #43 kg in pregnancy month 3-5 alone gave the highest sensitivity of 80%. A combination of initial weight and height of the mother was not as good a predictor of LBW as weight alone.

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“…105,114 Moreover, other studies showed no impact on maternal weight gain. 116,117 In the few studies that examined effects on the stillbirth 104,105 and perinatal mortality 104,105,118 rates, reductions were seen. The largest of these studies 104 was undertaken in The Gambia, where, in an RCT, chronically undernourished pregnant women were provided a higher-energy supplement (3780 kJ), largely toward the last trimester, with little micronutrient content.…”

Section: Tontisirin Et Al 110mentioning

confidence: 99%

“…Kardjati et al 116 East Java, Indonesia; rural setting; double-blind, randomized, controlled trial (DBRCT)…”

Section: Balanced Protein-energy Supplementationmentioning

confidence: 99%

Community-Based Interventions for Improving Perinatal and Neonatal Health Outcomes in Developing Countries: A Review of the Evidence

et al. 2005

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ABSTRACT. Background. Infant and under-5 childhood mortality rates in developing countries have declined significantly in the past 2 to 3 decades. However, 2 critical indicators, maternal and newborn mortality, have hardly changed. World leaders at the United Nations Millennium Summit in September 2000 agreed on a critical goal to reduce deaths of children <5 years by two thirds, but this may be unattainable without halving newborn deaths, which now comprise 40% of all under-5 deaths. Greater emphasis on wide-scale implementation of proven, cost-effective measures is required to save women's and newborns' lives. Approximately 99% of neonatal deaths take place in developing countries, mostly in homes and communities. A comprehensive review of the evidence base for impact of interventions on neonatal health and survival in developingcountry communities has not been reported.Objective. This review of community-based antenatal, intrapartum, and postnatal intervention trials in developing countries aimed to identify (1) key behaviors and interventions for which the weight of evidence is sufficient to recommend their inclusion in communitybased neonatal care programs and (2) key gaps in knowledge and priority areas for future research and program learning.Methods. Available published and unpublished data on the impact of community-based strategies and interventions on perinatal and neonatal health status outcomes were reviewed. Evidence was summarized systematically and categorized into 4 levels of evidence based on study size, location, design, and reported impact, particularly on perinatal or neonatal mortality. The evidence was placed in the context of biological plausibility of the intervention; evidence from relevant developed-country studies; health care program experience in implementation; and recommendations from the World Health Organization and other leading agencies.Results. A paucity of community-based data was found from developing-country studies on health status impact for many interventions currently being considered for inclusion in neonatal health programs. However, review of the evidence and consideration of the broader context of knowledge, experience, and recommendations regarding these interventions enabled us to categorize them according to the strength of the evidence base and confidence regarding their inclusion now in programs. This article identifies a package of priority interventions to include in programs and formulates research priorities for advancing the state of the art in neonatal health care.Conclusions. This review emphasizes some new findings while recommending an integrated approach to safe motherhood and newborn health. The results of this study provide a foundation for policies and programs related to maternal and newborn health and emphasizes the importance of health systems research and evaluation of interventions. The review offers compelling support for using research to identify the most effective measures to save newborn lives. It also may facilitate dialogue with policy...

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Energy supplementation in the last trimester of pregnancy in East Java: I. Effect on birthweight

Cited by 53 publications

References 18 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)

Maternal anthropometry as a predictor of birth weight

Community-Based Interventions for Improving Perinatal and Neonatal Health Outcomes in Developing Countries: A Review of the Evidence

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