Maternal factors such as age, education, family size and marital status have also been found to significantly influence the nutritional status of their under-five children [8, 9]. Institution-based cross-sectional study was conducted to assess the prevalence and associated factors of undernutrition among pregnant women visiting ANC follow up clinics of health facilities. Around 45% of deaths among children under 5 years of age are linked to undernutrition. Bivariable and multivariable logistic regression was used to determine the degree of association between independent and dependent variables. official website and that any information you provide is encrypted There is also evidence from animal studies of tissue re-modelling in the pancreas, liver and hypothalamus in response to fetal under-nutrition. Furthermore, there is limited data on prevalence and factors associated with maternal undernutrition in the study area particularly the southern region of Ethiopia. Chilot D, Belay DG, Merid MW, Kibret AA, Alem AZ, Asratie MH, Teshager NW, Aragaw FM. altered expression of genes in the insulin signalling pathway). INTRODUCTION. A Systematic review and meta-analysis of risk factors associated with malnutrition among pregnant, Fig 5. The current study found 21.8% (MUAC<23) prevalence rate of undernutrition. Inadequacies in intake of vitamins and minerals often referred to as micronutrients, can also be grouped together. These mostly occur in low- and middle-income countries. Meal frequency was considered to be recommended (adequate) when respondents take an additional meal (>3 meals per day) as a result of the current pregnancy [36]. As another example, indicators to predict a need for service . 2019;14(2). Recent follow-up of children born after randomised nutritional interventions in pregnancy provides weak evidence of beneficial effects on growth, vascular function, lipid concentrations, glucose tolerance and insulin resistance. According to the health facilities report, on average, 1530 pregnant women visit the ANC daily and 2066 pregnant women have been enrolled in ANC of selected health facilities. The above mechanisms would have to involve changes in gene expression, and there is great interest currently in effects of fetal nutrition on epigenetic phenomena, such as DNA methylation, that have a role in switching genes on and off. Variables with p-value of <0.25 in the Bivariable logistic regression analysis were entered into multivariate logistic regression analysis. In animal models, maternal obesity, or high-fat feeding during pregnancy, cause obesity, insulin resistance and diabetes in the offspring [15]. Both the altered methylation and the later abnormalities are prevented by supplementing the maternal diet with folic acid. It is defined as a persons weight in kilograms divided by the square of his/her height in meters (kg/m). People who are poor are more likely to be affected by different forms of malnutrition. Google Scholar. On contrary, better household economic status (POR = 0.47%; 95%CI: 0.36-0.62; I2 = 24.2%) negatively determine maternal malnutrition. Federal government websites often end in .gov or .mil. 2016;29(2):7581. Osmond C, Barker DJP, Winter PD, Fall CHD, Simmonds SJ. Therefore, this study was aimed to determine the prevalence and associated factors of undernutrition among pregnant women visiting ANC clinics in Silte Zone. There are therefore problems at both extremes of birthweight. CAS Maternal nutritional status, C1 metabolism and offspring DNA methylation: a review of current evidence in human subjects. These links will open a new browser tab or window onto the selected view. National Library of Medicine 2020. Nutritional deficiencies included: protein-energy malnutrition, iodine deficiency, vitamin A deficiency, and iron deficiency anaemia. This work is framed by the Comprehensive implementation plan on maternal, infant, and young child nutrition, adopted by Member States through a World Health Assembly resolution in 2012. Stunting holds children back from reaching their physical and cognitive potential. Lancet. Group Practice. Malnutrition should be catered in the first two years of life among children or even during the prepregnancy or pregnancy period before the symptoms begin to appear [8]. https://doi.org/10.1186/s40795-019-0281-z. Global trends As in previous years, the 2018 Global Nutrition Report finds again that the problem of malnutrition remains severe: the world is not on track to achieve the targets it has set itself. Maryland, USA: Central Statistical Agency and ORC Macro; 2016. Studies have shown that the high rate of teenage pregnancy contributes significantly to the high prevalence of malnutrition among under-five children [6, 7]. Funnel plot presented the visual inspection of publication bias for systematic review and, Fig 3. Furthermore, principal investigators carefully cleaned and entered collected data into a computer. Facility-based cross-sectional study was conducted from July to January 2019. Addis Ababa, Ethiopia, and Calverton. use of cutoffs for mid-upper arm circumference (MUAC) as an Indicator or predictor of nutritional and health related outcomes in adolescents and adults: a systematic review. Maternal and child nutrition is one of its targets that need updated data on the nutritional profile of pregnant women which is essential to develop effective intervention strategies to prevent maternal and child undernutrition. It could also explain the recent rise in cardio-metabolic disease in low-income countries undergoing rapid economic transition. Therefore, maternal undernutrition has to be understood in a specific context to develop effective and tailored interventions. An official website of the United States government. An interviewer-administered questionnaire was used to collect the data. 2019;2020. . An error occurred while trying to display the data. Nigatu M, Gebrehiwot TT, Gemeda DH. J Nutr. Earlier to thedata collection, data collectors and supervisors were trained. https://doi.org/10.4172/2155-9600.1000454. Brazzaville:World Health Organization;. However, the DOHaD hypothesis is beginning to be tested by studying children of undernourished women who took part in nutrition supplementation trials in pregnancy (Table 1). eCollection 2020. By using this website, you agree to our BMC Nutr. Healthy children learn better. The current study found one in every five women was undernutrition. In India, pregnant mothers and children under 6 years of age in intervention villages received food-based energy and protein supplements. The DOHaD concept has stimulated enormous scientific interest, but has had little impact on how the common women thinks about nutrition in pregnancy, or on national policies on maternal nutrition. Malnutrition in pregnancy remains unacceptably high across all regions of Africa though promising progresses have been made globally. It is hypothesised that the resulting metabolic changes persist and increase the risk of developing diabetes and cardiovascular disease, especially if additional stressors are acquired in later life (such as obesity and physical inactivity). Pregnant women who had birth interval greater than 2years had a lesser risk of undernutrition compared to those who had a birth interval of fewer 2 years. eCollection 2023 May. The odds of undernutrition among pregnant women with poor nutritional knowledge were higher than their counterparts. An official website of the United States government. Independent Oversight and Advisory Committee, Prevalence of stunting (height for age <-2 standard deviation from the median of the World Health Organization (WHO) Child Growth Standards) among children under 5 years of age, Prevalence of malnutrition (weight for height >+2 or <-2 standard deviation from the median of the WHO Child Growth Standards) among children under 5 years of age, by type (Overweight), Prevalence of malnutrition (weight for height >+2 or <-2 standard deviation from the median of the WHO Child Growth Standards) among children under 5 years of age, by type (Wasting), Prevalence of anaemia in women aged 15 to 49 years, by pregnancy status (percentage). Your US state privacy rights, 2013;3(4). 2016;1(1). strengthening and promoting nutrition governance and accountability, everywhere. Children with low weight-for-age are known as underweight. The instrument was pretested in 5% of the sample size. Bethesda, MD 20894, Web Policies Socio-demographic factors (such as Age, Marital status, Residence, Occupation, maternal educational status, religion, and husband educational status), Obstetric history of respondents, nutrition knowledge, dietary practice, and anthropometric data were collected. A child who is underweight may be stunted, wasted, or both. This site needs JavaScript to work properly. The mean of triplicate measurement was taken. Select the option that best describes you. These statistics are not mere numbers; each of . The prevalence of maternal undernutrition in Africa including Ethiopia found between 11 and 36% [20,21,22,23,24,25,26,27]. 2019;19(1):517. Dominguez-Salas P, Cox SE, Prentice AM, Hennig BJ, Moore SE. The sample size required for the study was computed using a single population proportion formula. Risnes KR, Vatten LJ, Baker JL, Jameson JL, Jameson K, Sovio U, Kajantie E, Osler M, Morley R, Jokela M, Painter RC, et al. Interventions targeting maternal nutrition education, and child spacing with giving special emphasis to adolescent pregnant women are recommended. There were no effects on blood pressure, other lipids, glucose or insulin. Is low birth weight an antecedent of CKD in later life? There is consistent evidence that breast cancer and leukaemia are more common among people of higher birthweight, and cancer mortality is higher in men of higher birth weight [10]. Malnutrition occurs in people who are either undernourished or overnourished. Contextual risk factors for maternal malnutrition in a food-insecure zone in southern Ethiopia. PubMed Anaemia is a serious global public health problem that particularly affects young children, menstruating adolescent girls and women, and pregnant and postpartum women. Pregnant and lactating women (PLW), along with children, are among the most vulnerable groups of population during emergencies and droughts. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Masresha L, Maleda T, Mohammed G. Factors associated with malnutrition among pregnant women and lactating mothers in Miesso health center, Ethiopia. https://doi.org/10.16966/2471-8211.102. Watkins AJ, Wilkins A, Cunningham C, Perry VH, Seet MJ, Osmond C, Eckert JJ, Torrrens C, Campangang FR, Cleal J, Gray WP, et al. Maternal nutrition in rural Kenya: health and socio-demographic determinants and its association with child nutrition. All started in pregnancy, usually in the second or third trimester, and the offspring outcomes most frequently studied were growth and cardio-metabolic risk factors. . This has raised the question of whether paediatricians should try and limit post-natal weight-gain in lower birthweight infants. 2013;382(9890):45277. J Nutr Disorders Ther. The childhood environment and adult disease. Two hundred sixty four (63.3%) of women changed diet as a result of the current pregnancy. Two-year old children whose mothers received multiple micronutrient supplements during pregnancy were heavier and had larger head, chest and mid-arm circumferences and larger skinfold thickness, but lower systolic blood pressure, than children of control women, who received only iron and folic acid [19]. doi: 10.1371/journal.pone.0285621. Burden and determinants of malnutrition among pregnant women in Africa: A systematic review and meta-analysis. https://doi.org/10.1371/journal.pone.0221712. This review has been registered in Prospero with a protocol number CRD42018114949. Household food insecurity, low dietary diversity, and early marriage were predictors for Undernutrition among pregnant women residing in Gambella, Ethiopia. Longer follow-up of these trials is needed, and data are required from studies in other populations and of other interventions, including pre-conceptional trials, before conclusions can be reached. Hofman P, Regan F, Cutfield WS. The .gov means its official. Burdge GC, Lillycrop KA. Eur J Midwifery. Learn how UpToDate can help you. The authors speculated that these findings reflected permanent effects of nutritional deprivation on fetal hypothalamic centres, causing lifelong changes in food intake and growth. Bookshelf PLoS One. 2020 Mar 18;15(3):e0229698. Epidemiology of antenatal depression in Africa: a systematic review and meta-analysis. Systematic random sampling technique was used to select 422 study participants from 11 randomly selected health facilities. Yimer M. The prevalence of under nutrition and associated factors among adolescent pregnant women: a narrative review. 2020 Apr 28;15(4):e0231940. Sensitivity analysis for studies included, Fig 3. Persson L-A, Arifeen S, Khan AI, Kabir I, Lindstrom E, Ekstrom E-C. Determining a global mid-upper arm circumference cutoff to assess malnutrition in pregnant women. The majority 285(68.3%) of them had recommended meal frequency. The CINAHL(EBSCO), MEDLINE (via Ovid), Emcare, PubMed databases and Google scholar were searched. Our result is consistent with those of the other three studies carried out in other parts of Ethiopia 19.8, 19.5 and 24% [23, 24, 30]. Washington, DC: USAID; 2013. Micronutrients enable the body to produce enzymes, hormones, and other substances that are essential for proper growth and development. https://doi.org/10.1186/s12884-020-03404-x, DOI: https://doi.org/10.1186/s12884-020-03404-x. Gao H, Stiller CK, Scherbaum V, Biesalski HK, Wang Q, Hormann E, et al. Body mass index (BMI) is an index of weight-for-height commonly used to classify overweight and obesity. This would tend to reduce any differences between children from intervention and control groups. Oken E. Maternal and child obesity: the causal link. Triple burden of malnutrition among mother-child pairs in low-income and middle-income countries: a cross-sectional study. Ethiopia Demographic and Health Survey. The administrative center of the zone is Werabe town. Washington, DC: Food and Nutrition Board:National Academy Press; 1990. The study was funded by the Werabe University and the funder only involved on funding, not take a part in design of the study, data collection, analysis, and interpretation. A consistent feature of the human studies is that that the highest risk of cardio-metabolic disease and its risk factors is in children or adults who had a low birthweight but became relatively heavy (Figure 2). For each question, a correct answer was coded as 1 and an incorrect answer as 0. When autocomplete results are available use up and down arrows to review and enter to select. Birthweight and risk of type 2 diabetes: a quantitative systematic review of published evidence. doi: 10.1371/journal.pone.0231940. The prevalence of undernutrition among pregnant women was 21.8%. Multiple Micronutrient Supplementation:An approach to improving womens nutrition during pregnancy and preventing low birthweight, UNICEFs Core Commitments for Humanitarian Action (2020), Protecting Maternal Diets and Nutrition Services and Practices in the Context of COVID-19, Nutrition Commodities for Women:Technical Bulletin #26, Interim Country-Level Decision-Making Guidance for Introducing Multiple Micronutrient Supplementation for Pregnant Women, UNICEF-WHO Low Birthweight Estimates: Levels and trends, 20002015. Your privacy choices/Manage cookies we use in the preference centre. Serbesa ML, Iffa M, Geleto M. Factors associated with malnutrition among pregnant women and lactating mothers in Miesso health center, Ethiopia. Background Adolescent pregnancy is a major public health problem with significant medical, nutritional, social and economic risk for mothers and their infants. A systematic review and meta-analysis, Fig 5. Current estimate is lower than previously reported in the study area but higher than reported in developed country. Therefore, alleviating malnutrition only during pregnancy will not completely reduce low birth weight. In most populations, the predominant association of birthweight with later diabetes risk is linear and inverse, except in very large studies such as the US Nurses Study, in which gestational diabetes produces a small upturn in risk at high birthweights [6]. McMullen S, Langley-Evans SC, Gambling L, Lang C, Swali A, McArdle HJ. Willy KJK, Peter C. Dietary diversity, nutrient intake and nutritional status among pregnant women in Laikipia County, Kenya. BMC Nutr. PLoS One. Unauthorized use of these marks is strictly prohibited. Improve access to affordable nutritious foods including fruits, vegetables, eggs, fish, meat and fortified foods for all adolescent girls and women. CAS The current study showed that the prevalence of undernutrition among pregnant in the country is decreasing as compared to earlier studies. Ravaoarisoa L, Randriamanantsaina L, Rakotonirina J, Rakotomanga J, Donnen P, Dramaix M. Socioeconomic determinants of malnutrition among mothers in the Amoroni mania region of Madagascar: a cross-sectional study. Research in animals had already shown that transient environmental conditions, including nutrition, in early life could permanently alter or programme the bodys structure and function [12]. Anyone you share the following link with will be able to read this content: Sorry, a shareable link is not currently available for this article. It might also be due to less experience of maternity and related complications among adolescent women. Apart from the serious consequences of a persons health, the economy is also affected by undernutrition [17]. Unicef. The simplest mechanism is inadequate growth and/or re-modelling of tissues, due to inadequate substrates at critical periods of development. Phillips DIW. Bouret SG. At the same time, in these same countries, rates of childhood overweight and obesity are rising. We also help provide nutritionalcounselling and support during pregnancy, in line with global recommendations. However, there is some evidence that pre-term birth is also a risk factor for cardio-metabolic outcomes like hypertension, insulin resistance and the metabolic syndrome [11]. 2008;371:24360. Matern Heal Neonatol Perinatol. 2004;134(9):216972. The direct cost of low birth weight. Nutrition is a critical part of health and development. Epigenetic patterns can be inherited, which could explain how transient alterations in fetal nutrition can alter body composition and metabolic parameters across more than one generation [29]. It was conducted from July to January 2019 in Silte Zone. BMJ Open. Another important disease to mention in relation to higher birthweight (and thus possibly to a fetal over-nutrition effect) is cancer. Influence of maternal nutrition on birth weight. Ethiopia is a multicultural country. Malnutrition refers to deficiencies, excesses, or imbalances in a persons intake of energy and/or nutrients. The only study with adult follow-up (Guatemala) had a very small sample size, and the age at follow-up in the other trials (either in young children or adolescents) was not ideal for examining programming effects. Adv Public HealHindawi. Shaheen S. The beginnings of chronic airflow obstruction. Khan KS, Chien PFW, Khan NB. Far too many women especially adolescents and those who are nutritionally at-risk are not receiving the nutrition services they need to be healthy and give their babies the best chance to survive, grow and develop. 2019;14(9). Careers. BMC Pregnancy Childbirth. As a library, NLM provides access to scientific literature. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. Victora CG, Adair L, Fall C, Hallal PC, Martorell R, Richter L, Sachdev HPS, the Maternal and Child Undernutrition Study Group Maternal and child undernutrition: consequences for adult health and human capital. In the study area, antenatal care service is provided in all health care facilities. Oh HK, Kang S, Cho SH, Ju Y, Faye D. Factors influencing nutritional practices among mothers in Dakar, Senegal. Expand access to social transfer programmes for adolescent girls and women, including in fragile settings and humanitarian crises. This is the oldest trial and the only one with adult follow-up data. de Onis M, Blssner M, Villar J. Diddana TZ. Black RE, Allen LH, Bhutta ZA, Caulfield LE, de Onis M, Ezzati M. Maternal and child undernutrition: Global and regional exposures and health consequences. The average pooled prevalence of malnutrition among pregnant women in Ethiopia was 29.07% (95% CI: 24.84, 33.30). Data was collected by using a structured-interviewer administered questionnaire. Vickers MH, Krechowec SO, Breier BH. Institute of Medicine. A systematic review of observational studies. Young men whose mothers lived in famine-affected areas of the Netherlands during early pregnancy had an increased risk of obesity . PubMed Nutritional status during pregnancy is directly linked to intrauterine growth retardation (IUGR) and birth weight [6,7,8]. A community-based cross-sectional study was conducted among . The analyses rest on two outcomes of the nutritional status of pregnant women: whether they are undernourished (MUAC<23cm) or not (MUAC23cm). The .gov means its official. Sociodemographic items were adapted from the Ethiopian demographic and health survey (EDHS 2016) [31]. Thus, efforts should be renewed to ensure a proper and widespread implementation of programs that would address issues identified in the current review to reduce the burden of malnutrition. Fetal undernutrition and long-term outcomes. 2020 Apr 28;20(1):251. doi: 10.1186/s12884-020-02929-5. Endocrine systems (especially for hormones that regulate fetal growth and maturation) are re-set, and tissues are supported or sacrificed differentially. In Ethiopia, household food security varies with season. Childhood obesity and metabolic imprinting: the ongoing effects of maternal hyperglycemia. Women have distinct nutritional requirements throughout their life especially before and during pregnancyand while breastfeeding, when nutritional vulnerability is greatest. This study found 91 (21.8%) of study subjects were undernourished. The effect of prenatal diet and glucocorticoids on growth and systolic blood pressure in the rat. At the time of data collection, written consent was obtained from the participants whose age is greater than 18 and emancipated minors. In the Gambian trial, women received a daily high energy biscuit, from 20 weeks of pregnancy (intervention group) or during lactation only (controls). Despite the limited studies performed in different parts of Ethiopia, the information about the prevalence of undernutrition of pregnant women in the current study area is not documented. Furthermore, the variation may be due to geographical variation. Desyibelew HD, Bayih MT, Baraki AG, Dadi AF. Lancet. MY had a major role in methodology part and data interpretation. BMC Pregnancy Childbirth 20, 707 (2020). In 2016, an estimated 155 million children under the age of 5 years were suffering from stunting, while 41 million were overweight or obese. UNICEF estimates that low birthweight affects more than 20 million newborns every year. Those not willing to participate were given the right to do so. Methods Pretest was conducted on individuals with similar characteristics of the study population who were not a part of the actual study. Southern Nations, nationalities, and peoples Region. https://doi.org/10.1371/journal.pone.0215305. Healthy children learn better. Iodine, vitamin A, and iron are the most important in global public health terms; their deficiency represents a major threat to the health and development of populations worldwide, particularly children and pregnant women in low-income countries. Farah AM, Endris BS, Gebreyesus SH. Iannotti LL, Zavaleta N, Leon Z, Shankar AH, Caulfield LE. 2014;34(4):25065. Acta Obstet Gynecol Scand. HHS Vulnerability Disclosure, Help and transmitted securely. doi: 10.7759/cureus.38548. Sensitivity analysis for studies included in a systematic review and meta-analysis of malnutrition, Fig 4. Muze, M., Yesse, M., Kedir, S. et al. J Nutr Food Sci. We also help provide nutritionalcounselling and support for breastfeeding mothers during postnatal care visits. Data were entered into a computer using Epi data version 3.1, cleaned, and analyzed using SPSS version 20. The State of Food Security and Nutrition in the World 2018. Role of early hormonal and nutritional experiences in shaping feeding behaviour and hypothalamic development. Human evidence for fetal programming is still largely based on observational data and on birth measurements, which are only crude indicators of fetal nutrition. MRC Lifecourse Epidemiology Unit, University of Southampton, UK. Google Scholar. Globally, people are consuming foods and drinks that are more energy-dense (high in sugars and fats), and engaging in less physical activity. Mariyam AF, Dibaba B. Lesser degrees of maternal glucose intolerance may also be associated with increased adiposity in the children. Regassa N, Stoecker BJ. Based on the pretested results, the instrument was modified and changed. See this image and copyright information in PMC. 2018;4(18). Pregnant and lactating women (PLW), along with children, are among the most vulnerable groups of population during emergencies and droughts. The estimated value of workforce lost to child mortality was then estimated. MM conceived the idea and had major roles in the proposal development. The prevalence of undernutrition among pregnant women was 21.8%. This public health epidemic targets everyone, but the most vulnerable groups are poverty-stricken people, young children, adolescents, older people, those who are with illness and have a compromised immune system, as well as lactating and pregnant women. To increase the generalizability of the results, health facilities were stratified based on the type of the health facility, 1 hospital from the four hospitals and 10 health centers from the 33 health centers were selected randomly. Two of the multiple micronutrient (MMN) trials (both in Nepal) showed a small increase in birth weight in the MMN groups [19,20]. Using a random effect model, the overall pooled prevalence of malnutrition among pregnant women in Africa was 23.5% (95%CI: 17.72-29.32; I2 = 98.5%). Eur J Clin Nutr. Uthman O, Aremu O. Malnutrition among women in sub-Saharan Africa: rural-urban disparity. Malnutrition in pregnancy remains unacceptably high across all regions of Africa though promising progresses have been made globally. 2018;4(1):11. J Med Care Res Rev. The associations with risk factors for disease have been shown in children as well as adults. Subsequent work in animal models has shown that fetal under-nutrition, achieved either by under-nourishing the mother during pregnancy, or by impairing the fetal supply line (uterine artery ligation, placental reduction or gene knock-out models that impair placental growth), produces permanent effects on a wide range of tissues and systems [1315].
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