Defining nutritional status of women in developing countries

Abstract

Objective: To define a de facto reference body mass index (BMI) for women in developing countries and compare its performance with the Quetelet BMI. Design: A logarithmic equation for elite wt/ht references was developed using the weight (wt) and height (ht) of 10 524 non-pregnant elite mothers. Functional outcomes were compared using both BMIs. Setting: Forty-six national surveys from 36 developing countries. Subjects: Mothers 15 -49 years old. Results: The de facto reference standard deviation showed 2.2% of elite women were undernourished and 6.3% overnourished; lower and upper limits for 'ideal' wt/ht were 73% and 137%, respectively. Compared with the age-based and medium frame standards of the First and Second National Health and Nutrition Examination Surveys (NHANES I & II), the de facto reference defined fewer women as undernourished (5.3% vs. 10.5% and 14.4%, respectively), but more as overnourished (20.4% vs. 13.7% and 15.9%, respectively). In the de facto reference, BMI ¼ wt=ht 1:6 . Using the agebased and medium-frame-based Quetelet BMI (wt/ht 2 ), 28.5% and 31.7% had a low and 13.0% and 14.7% a high BMI, respectively. For the de facto reference, 18.4% of the elite mothers had a low BMI and 19.3% a high BMI. Applying the de facto reference to all women showed that the distribution of BMI was similar irrespective of the reference used. Functional outcomes were similar for both BMIs. Conclusions: The NHANES I & II growth curves define more women as overnourished than the de facto curve, but the opposite for defining the undernourished. Functional outcomes were similar for both BMIs, suggesting there is no great advantage to using a de facto BMI based on national-level data from these 46 national surveys.

Ultrasound‐derived fetal size nomogram for a sub‐Saharan African population: a longitudinal study

“…In the context of sub‐Saharan Africa, excluding women with poor nutritional status or antenatal infections from the study population would create an ‘artificially healthy’ pregnancy cohort, and produce mean and centile values that overestimate the true source population fetal weight. The prevalence of undernutrition and malaria parasitemia observed in this Kinshasa population is similar to that of other sub‐Saharan African antenatal populations22, 23. However, the antenatal HIV prevalence in Kinshasa is among the lowest in the region24 and all enrolled women received monthly antenatal care including aggressive antimalarial treatment as part of the parent study.…”

Risk factors associated with preterm delivery and low delivery weight among HIV‐exposed neonates in China

“…Although different thresholds of BMI have been used to define underweight, the present findings are in line with most studies . They are also consistent with findings among women without HIV infection . A study in the Côte d'Ivoire of 326 HIV‐infected pregnant women (46% receiving cART in pregnancy) found that low BMI (<25) at delivery increased the risk of low delivery weight by a factor of 2.43 (95% CI, 1.20–4.91; P =0.013) .…”

“…16,24 They are also consistent with findings among women without HIV infection. 25 Women who received a single dose of NPV before delivery or no treatment before delivery. b Women who received cART before pregnancy or during the first trimester of pregnancy.…”

Anorexia nervosa: Definition, epidemiology, and cycle of risk

“…[63][64][65] Women with low prepregnancy BMI, both in developing and developed countries, are at risk for preterm birth and intrauterine growth retardation. [64][65][66][67][68] In addition, women with low prepregnancy BMI appear to be more sensitive to additional risk factors, such as smoking and psychosocial risk factors 69,70 and to benefit more from zinc supplementation during pregnancy. 69 Neggers and Goldenberg 71 have discussed the mechanism whereby low maternal prepregnancy BMI affects pregnancy outcome.…”