Macronutrient and Sociodemographic Determinants of Gestational Weight Gain among HIV-Negative Women in Tanzania

Changamire, Freeman T.; Mwiru, Ramadhani S.; Msamanga, Gernard; Spiegelman, Donna; Urassa, Willy; Hertzmark, Ellen; Fawzi, Wafaie W.; Peterson, Karen E.

doi:10.1177/156482651403500106

Cited by 12 publications

(18 citation statements)

References 37 publications

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“…Increased gravidity was associated with increased odds of low GWG (<50th centile); similar findings have been reported in Tanzania (Changamire et al, ). It is possible that higher gravidity and parity, and frequent reproductive cycling, may result in maternal nutritional depletion in the context of high food insecurity and thus increasing the risk of SGA and LBW (Klerman, Cliver, & Goldenberg, ; Miller, ).…”

Section: Discussionsupporting

confidence: 85%

“…Similar findings were reported in the Philippines, where higher maternal height was associated with greater total weight gain (Siega‐Riz & Adair, ). In a study conducted in Tanzania, taller women (>159.5 cm) were also more likely to gain more weight than shorter women (<151.5 cm; Changamire et al, ). Maternal height reflects both genetic and environmental factors, as well as long‐term dietary intake and nutritional status (Perkins, Subramanian, Davey Smith, & Ozaltin, ), all of which have been also shown to influence GWG (IOM and NRC, ).…”

Section: Discussionmentioning

confidence: 97%

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Prevalence and determinants of gestational weight gain among pregnant women in Niger

Ouédraogo

Wessells

Young

et al. 2019

Maternal & Child Nutrition

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Low gestational weight gain (GWG) and low mid-upper arm circumference (MUAC) are associated with adverse pregnancy outcomes. We aimed to assess the prevalence and determinants of low GWG and low MUAC among pregnant women in rural Zinder, Niger. A community-based survey was conducted among 1,384 pregnant women in the catchment areas of 18 integrated health centers in the region of Zinder, Niger. Weight and MUAC were measured during an in-home visit and again 1 month later, when haemoglobin concentration and micronutrient status were also assessed. The prevalence of low GWG was defined based on the 2009 United States Institute of Medicine (U.S. IOM) guidelines (<0.35 kg/week) and less than the third centile of the International Fetal and Newborn Growth Consortium for the 21st Century (INTERGROWTH-21st) standards. Factors associated with GWG and MUAC were identified using logistic regression models adjusting for season, village, and gestational age. The median (interquartile range) age was 25.0 (20.7, 30.0) years, and 16.4% were ≤19 years. The prevalence of low GWG were 62.9% and 27.5% according to 2009 IOM and less than the third INTERGROWTH-21st centile, respectively; 24.9% had low MUAC. Higher α-1-acid glycoprotein (OR = 1.7, 95% CI [1.1, 2.8]) and C-reactive protein (OR = 1.2, 95% CI [1.02, 1.50]) increased the odds of low GWG. Adolescents (OR = 2.7, 95% CI [1.8, 4.0]), housewives (OR = 1.97, 95% CI [1.36, 2.86]), and those who reported recent food assistance (OR = 1.80, 95% CI [1.04, 3.11]) had higher odds of low MUAC. Prevalence of low GWG and low MUAC was high among pregnant women. Determinants of GWG and MUAC included socioeconomic, demographic, and biological factors, although only markers of inflammation were consistent predictors across different definitions of low GWG. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. 1 of 15 2 of 15 OUÉDRAOGO ET AL. bs_bs_banner The prevalence of low GWG was high among pregnant women in the Zinder region of Niger, and the odds of low GWG were consistently associated with higher concentrations of markers of inflammation (AGP and CRP). A considerable proportion of pregnant women also had low MUAC. Considering the importance of adequate GWG and MUAC for maternal health and pregnancy outcomes, effective and cost-effective interventions (e.g., daily iron folic acid supplementation; Baltussen, Knai, & Sharan, 2004, behaviour change communication about nutrition; Lamstein et al., 2014, and balanced protein energy dietary supplementation; Imdad & Bhutta, 2012) to ensure adequate GWG and nutritional status should be considered. ACKNOWLEDGMENTSWe would like to thank the NiMaNu study team, the participants, the local communities, staff of the Zinder and Mirriah health districts, and the national steering committee. Our sincere appreciation goes to Pro-The authors declare that they have no conflicts of interest. CONTRIBUTIONSThe ...

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Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 97%

Prevalence and determinants of gestational weight gain among pregnant women in Niger

Ouédraogo

Wessells

Young

et al. 2019

Maternal & Child Nutrition

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“…The importance of nutrition during the first 1000 days 145 MNS of pregnant African women (Table 1) In all, 19 studies met the inclusion criteria. [18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36] The publication year ranged from 2002 to 2014. The number of pregnant women examined in the studies ranged from 30 to 191,834 and the gestational age at MNS assessment varied between 18 and 39 weeks.…”

Section: Resultsmentioning

confidence: 99%

“…The number of pregnant women examined in the studies ranged from 30 to 191,834 and the gestational age at MNS assessment varied between 18 and 39 weeks. Six studies used anthropometric measurements to describe MNS in pregnant women, 19,[23][24][25]31,33 one used a biomarker of anaemia (haemoglobin (Hb)), 36 two used reported dietary intakes 20,26 and the remaining 10 used a combination of anthropometry, biomarkers and reported dietary intakes 18,21,22,[27][28][29][30]32,34,35 (Table 1). Of the studies including anthropometric measures of MNS, five provided data for the mean/median body mass index (BMI).…”

Section: Resultsmentioning

confidence: 99%

“…21 All studies described mean Hb values above the threshold for diagnosis of anaemia in pregnant women (<11 g/dl), with the exception of one study in Tanzania. 21 Based on this cut-off point 66.7 of rural and 26.7% of urban women were classified as anaemic in one study in Ghana and 32% were classified as anaemic in another study in the same setting. 34,36 Kenyan pregnant women had a 32% anaemia prevalence in one study, 28 whereas 42.2 and 21.8% of women from pastoral and farming communities, respectively, were diagnosed with anaemia in another study.…”

Section: Resultsmentioning

confidence: 99%

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Review of the importance of nutrition during the first 1000 days: maternal nutritional status and its associations with fetal growth and birth, neonatal and infant outcomes among African women

Wrottesley

Lamper

Pisa

2015

J Dev Orig Health Dis

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Maternal nutritional status (MNS) is a strong predictor of growth and development in the first 1000 days of life and may influence susceptibility to non-communicable diseases in adulthood. However, the role of nutrition during this window of developmental plasticity in Africa is unclear. This paper reviews published data to address whether maternal nutrition during the first 1000 days is important for Africa, with a focus on MNS and its associations with fetal growth and birth, neonatal and infant outcomes. A systematic approach was used to search the following databases: Medline, EMBASE, Web of Science, Google Scholar, ScienceDirect, SciSearch and Cochrane Library. In all, 26 studies met the inclusion criteria for the specific objectives. MNS in Africa showed features typical of the epidemiological transition: higher prevalences of maternal overweight and obesity and lower underweight, poor diet quality 1 and high anaemia prevalence. Maternal body mass index and greater gestational weight gain (GWG) were positively associated with birth weight; however, maternal overweight and obesity were associated with increased risk of macrosomia and intrauterine growth restriction. Maternal anaemia was associated with lower birth weight. Macro- and micronutrient supplementation during pregnancy were associated with improvements in GWG, birth weight and mortality risk. Data suggest poor MNS in Africa and confirms the importance of the first 1000 days as a critical period for nutritional intervention to improve growth, birth outcomes and potential future health risk. However, there is a lack of data beyond birth and a need for longitudinal data through infancy to 2 years of age.

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Effects of nutritional interventions during pregnancy on birth, child health and development outcomes: A systematic review of evidence from low‐ and middle‐income countries

Lassi

Padhani

Rabbani

et al. 2021

Campbell Systematic Reviews

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Background: Optimal nutrition plays a crucial role in pregnancy. Poor maternal nutrition and maternal obesity has risk factors for serious fetal complications and neonatal outcomes, including intrauterine growth restriction, congenital abnormalities, stillbirth, low birth weight (LBW), preterm birth, fetal macrosomia, increased risk of neonatal infections, neonatal hypothermia, and neonatal death. The prevalence of maternal malnutrition is higher in low-and middle-income countries (LMICs) (10-19%) when compared with highincome countries, with variation by region and by country. Several behavioral interventions, including dietary control and exercise, have been found to reduce the risk of these adverse outcomes. However, none has reviewed dietary interventions to prevent maternal obesity in pregnant women.Objectives: The review aims to assess the effectiveness of balanced energy protein (BEP) supplementation, food distribution programs (FDPs), and dietary interventions to prevent maternal obesity during pregnancy on birth, child health, and developmental outcomes.Search Methods: We searched Cochrane Controlled Trials Register (CENTRAL), MEDLINE, Embase, CINAHL, and 12 other databases, and trials registers for ongoing studies up until April 2019. We also searched for gray literature from different sources and for citations on Google Scholar and Web of Sciences. We also checked the reference lists of included studies and relevant reviews and contacted the authors of studies for any ongoing and unpublished studies. The search was followed by title/abstract screening, full-text screening and data extraction. Selection Criteria: We included randomized control trials, and quasi experimental trials to evaluate the impact of nutritional interventions (BEP, FDP, and dietary interventions to prevent maternal obesity) compared to control or standard of care, among healthy pregnant women of any age living in LMICs.

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Macronutrient and Sociodemographic Determinants of Gestational Weight Gain among HIV-Negative Women in Tanzania

Abstract: Background.

Cited by 12 publications

References 37 publications

Prevalence and determinants of gestational weight gain among pregnant women in Niger

Prevalence and determinants of gestational weight gain among pregnant women in Niger

Review of the importance of nutrition during the first 1000 days: maternal nutritional status and its associations with fetal growth and birth, neonatal and infant outcomes among African women

Effects of nutritional interventions during pregnancy on birth, child health and development outcomes: A systematic review of evidence from low‐ and middle‐income countries

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