Maternal Nutritional Status, Food Intake and Pregnancy Weight Gain in Nepal

Abstract

Poor maternal nutrition during pregnancy may predispose to intrauterine growth restriction (IUGR), immunological and metabolic adaptations which manifest as low birth weight (LBW) and increase the risk of adult non-communicable disease. This study examined the relationships between maternal nutritional status, food intake and pregnancy weight gain (PWG) which may account for risk of LBW in Nepal. A prospective cross-sectional study was undertaken in rural and urban Nepalese population using simple random sampling to select eligible subjects. Retrospective data was extracted from records and dietary intake was assessed using a Food Frequency Questionnaire and 24 Hour Dietary Recall. A total of 376 women were recruited. A high prevalence of LBW (27.9 per cent) and preterm (14 per cent) delivery were observed. LBW was higher in rural than urban subjects ( p < 0.05). Birth weight was related to period of gestation ( r = 0.609, p < 0.05) ( r = 0.49, p < 0.001), energy intake ( r = 0.061, p < 0.001) and maternal protein intake ( r = 0.501, p < 0.001). Low PWG (8.11 kg) was also observed and was associated with protein ( r = 0.499, p < 0.01) and energy intake ( r = 0.396, p < 0.01) and were lower among mothers in rural areas ( p < 0.05). Calcium intake was related to crown heel length (CHL) ( r = 0.399, p < 0.001). Lipid, zinc and folate intake were significantly different in rural and urban subjects although the latter were adequate in both. Findings demonstrate the impact of maternal nutrition on birth outcomes in relation to specific nutrients and components of the diet. Targeted interventions are supported by the findings of this study in both rural and urban areas of Nepal.