Malnutrition during pregnancy

Running head: MALNUTRITION DURING PREGNANCY

Malnutrition in Pregnant Women

Malnutrition during pregnancy

Malnutrition in pregnant women

This literature review is being carried out to study the effect of malnourishment in pregnant
women. Nutrition is one factor that plays a critical role in the ability of a woman to sustain a
pregnancy. Poor nutritional status in women has been proven to impair the outcome of
pregnancy, increase chances of infant mortality and impair early childhood development. A
pregnant woman needs extra 300-400 kcal of energy daily along with vitamins and mineral such
as iron, folate and calcium. Maternal protein restriction which may or may not be coupled with
energy restriction results in decreased growth in many species including humans (kramer, 1987).
This decreased growth includes physical and mental deficits and a general failure to thrive.
Malnutrition in pregnant women is a phenomenon occurring in all parts of the world but the
reasons vary from place to place. For instance, in USA, gestational weight gain is a source of
anxiety to expecting mothers and a study showed that 24% to 79% women entering prenatal
classes were on dieting during the last trimester because they were anxious about the weight that
they might need to lose after the birth of their child (shearer, 2007). According to NFHS-3,
56.2% women are anemic while only 22.3% take folate and iron supplements for 90 days or less
during pregnancy in India (survey, 2009) but most of this is due to the inability to buy food.
Poverty remains the major reason behind malnutrition all over the world with the developing
world being the biggest victim.
Not only does malnutrition of expecting mothers result in infertility, miscarriages and abortions,
they have long-term effects as well. A survey showed that about 600000 women were suffering
from uterine prolapse in Nepal, most of these attributed to malnourishment and repeated
pregnancies (kunwar, 2008). One of those effects of epidemiological importance is the high rate
of maternal mortality that prevails in all those regions that are deprived of food, qualitatively or

Malnutrition during pregnancy

quantitatively. 60% of maternal deaths in Nigeria are attributed to poor nutritional status of the
mother (ogunyemi, 2010) and in Afghanistan the maternal mortality ratio as high as
1600/100000 live births (world food program, 2010). Thus all epidemiological surveillance
undertaken on this issue proves poor nutritional status of pregnant women to be a high priority
issue.
Over the years, studies have been undertaken to find out interventions that can improve this
situation. One retrospective study showed that the population boom in Northern England during
1750s is related to qualitative improvement in diet of women and men that led to drastic fall in
infant mortality rates and increased birth rates (scott, 1999) showing the positive effect that good
nourishment alone can have on a society that is still predominantly agricultural. Another study
suggests that simple supplementation of vitamin a or beta-carotene during pregnancy can reduce
maternal mortality by 40%. (gillespie, 2001).In a study conducted in Tezonteopan, a small
village in Mexico, the effect of nutritional intervention on pregnant women was assessed. The
population of the village suffered from generalized malnutrition but the women seemed worst hit
due to their reproductive ability. The post partum amenorrhea in these women lasted for 27
months, the mean age for menopause was 40.5 years and every woman gave birth to 9 children
on average out of which only 5 survived till early adulthood. A group of 41 mother-infant dyads
was selected on the report of recent amenorrhea and were given a drink made up of milk and
fruits along with dietary supplements. The results demonstrated how far good nutrition could
affect the health of a woman as well as the fetus. The women given food supplements should
post partum amenorrhea to be less than 12 months and their babies had a better nutritional status
at birth than the babies of their counterparts who had not been supplemented (chavez, 1973).

Malnutrition during pregnancy

Several countries have taken measures to eradicate health issue of maternal malnutrition. The
United Nations Population Fund (UNFPA) has given outlines for such measures. These include
interventions to reduce deficiency anemia and promotion of maternal nutrition through
information, education and maternal counseling as well as nutritional care of women of childbearing age under the banner of maternal health and safe motherhood programs. India is one of
those countries that bear the burden of poor nutritional status of women during pregnancy.
Several plans have been launched in this regard which include the National Nutrition Policy and
the National Plan of Action. These have been limited to paper-work and their actual
implementation remains to be seen. The Integrated Child Development Services was another
such program which was started in collaboration with the World Bank and was directed towards
providing nutrition as well as related knowledge to pregnant women and children under 3 years
of age but according to a paper released by World Bank has also failed to give benefit due to
allocation of funds and lack of co-ordination and monitoring. (malnourishment: world bank raps
india, 2009) . In order to tackle this situation effectively, such programs must be tailored to the
particular problems, cultural conditions and resource constraints of the local context (Scroeder,
2001). A suitable example is the collaboration of Bhartiya Agro Industries Foundation (BAIF)
and the Council for Advancement of Peoples Action and Rural Technology (CAPART) that
works across the tribal belt of Maharashtra which was afflicted by high maternal and infant
mortality rates due to poor nutrition for decades. The program launched by the two NGOs works
by providing a mixture of millet, jiggery and milk to mothers and infants at Aganwadi centres
that have been setup across the area. These grains are locally grown and are not taxing on the
predominantly poor population of this area. This program has led to a drastic fall in maternal
mortality rates as well as infant mortality rates, the latter one decreasing from 60/1000 births to

Malnutrition during pregnancy

53/1000 births in just one year (raman, 2008) . The results are dramatic confirming the method
and the importance of eradication of malnutrition during pregnancy. Such community based
strategies serve as suitable templates for other countries plagued by a similar situation regarding
malnutrition in pregnant women

Malnutrition during pregnancy

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