Nutrition and Maternal Survival in Developing Countries

Postpartum hemorrhage is related to the hemoglobin levels at labor: Observational study

“…4 It has long been considered that anemia increases the risk of postpartum hemorrhage (PPH) 5 and the two conditions together contribute to 40-43% of maternal deaths in Africa and Asia. 6 Few studies exist that have linked the risk of PPH by level of anemia and indicate a weak association. 7 Recently small studies demonstrated causal -relationship between severe anemia and uterine atony which is the main cause of PPH accounting for about 90% in most studies.…”

Nutrition and maternal, neonatal, and child health

“…12 Although some catch-up in linear growth can occur later in life when accompanied by a change in the environment that gave rise to the stunting in childhood, as shown in adoption studies, frequently this is also accompanied by early onset of menarche in girls and a shortened duration of growth into adulthood such that attained adult height continues to be low. 13 In many LMIC settings, early age of marriage and first pregnancy can further exacerbate poor maternal nutritional status. Prospective studies done in Mexico and Bangladesh show that linear growth ceases among adolescents who become pregnant compared with those who are not pregnant and continue to grow.…”

“…Still, by ICD-10 MM 24 anemia is a contributory cause and not a direct cause of death. Observational data using hemoglobin assessed among women at booking and subsequent risk of death show a strong linear relationship between low Hb and maternal death 13,25 ; the combined odds ratio for mortality with each 10 g/L increase in Hb is estimated at 0.71, 26 although confounding in these observational studies may be an issue. Anemia and iron deficiency may also increase the risk of postpartum hemorrhage as shown in a study in Tanzania that assessed blood loss at delivery, 27 and in an RCT in rural Nepal, in which ironÀfolic acid supplementation significantly reduced self-reported intrapartum hemorrhage.…”

Fetal Growth Restriction and Preterm as Determinants of Child Growth in the First Two Years and Potential Interventions

“…Daily iron folic acid and prenatal multiple micronutrient supplementation (without food) also shows a significant reduction in LBW with RR of 0.80 (95% CI: 0.71-0.90) [21], and in SGA with RR 0.83 (95% CI: 0.73-0.95), respectively [22]. Although routine iron-folic acid supplement use, despite widespread policy in many countries continues to be low [23], combining food and micronutrient intervention approaches in settings with maternal undernutrition and micronutrient deficiencies would help address the high burden of fetal growth restriction, and in addition yield better nutritional status in the offspring. Although evidence is limited [24], cash transfer or food vouchers for women during pregnancy in food-insecure settings may be beneficial and should be tested for their impact on birthweight and fetal growth.…”