Maternal Diet and Morbidity Factors Associated with Low Birth Weight in Haiti: A Case-Control Study.

Abdirahim Rashid,Kenneth Macneal,Lora Iannotti,Will Ross,Thomas Park

doi:10.1089/heq.2017.0063

Abstract

Objective: A matched, case–control study was conducted to examine the association between development of low birth weight (LBW) and maternal factors, including dietary intake, comorbidities, and socioeconomic factors, among women in Cap Haitien, Haiti.Design: Mothers who delivered LBW babies; defined as ≤2.5 kg, were identified by review of the medical record and matched to mothers of similar age, parity, with normal birth weight (NBW) babies. A survey was administered consisting of Women's Dietary Diversity Score (WDDS), maternal reporting of comorbidities, income, and educational level.Subjects: Women were eligible if they delivered and had newborns weighed within the last 2 years. Total study participants consisted of 32 cases and 34 controls matched for age, parity, and month of delivery.Results: Mothers who consume eggs were 78% less likely to have given birth to a LBW infant (OR 0.22 (95% CI: 0.05–0.87). Mothers with NBW babies had a nonsignificant trend towards higher WDDS. The prevalence of hypertension in mothers who were seen in the clinic at least once over the past 2 years was found to be 27%, and 78% of mothers were not aware of their diagnosis.Conclusion: Enhancing maternal nutrition during pregnancy has broad implications for reducing LBW, improving fetal health and reducing fetal predilection for chronic diseases in adulthood. Longitudinal prospective studies are needed to evaluate the selective benefit of eggs and other high-quality foods in protecting fetal growth. Efforts to improve knowledge and awareness of hypertension in Haiti should be undertaken.

Highlights

According to the Developmental Origins of Health and Disease Hypothesis, maternal micronutrient insufficiency leads to fetal undernutrition, causing maladaptive changes and increased risk of chronic diseases in adulthood.[1–3] Low birth weight (LBW) is associated with increased risk of coronary artery disease and hypertension in old age.[3–8] Characterizing the impact of being born LBW on noncommunicable diseases in developing countries is challenging due to paucity of maternal health data and birth weight records
We examined the association between maternal dietary diversity, anemia, blood pressure, and reporting of comorbidities such as diabetes, hypertension, and socioeconomic status on the development of LBW infants in a matched, case–control study conducted in CapHaıtien, Haiti
Participants This study was conducted according to the guidelines laid down in the Declaration of Helsinki and all procedures involving human subjects/patients were approved by the Institutional Review Board (IRB) at Washington University in St

Summary

Introduction

According to the Developmental Origins of Health and Disease Hypothesis, maternal micronutrient insufficiency leads to fetal undernutrition, causing maladaptive changes and increased risk of chronic diseases in adulthood.[1–3] Low birth weight (LBW) is associated with increased risk of coronary artery disease and hypertension in old age.[3–8] Characterizing the impact of being born LBW on noncommunicable diseases in developing countries is challenging due to paucity of maternal health data and birth weight records. According to the Developmental Origins of Health and Disease Hypothesis, maternal micronutrient insufficiency leads to fetal undernutrition, causing maladaptive changes and increased risk of chronic diseases in adulthood.[1–3]. Low birth weight (LBW) is associated with increased risk of coronary artery disease and hypertension in old age.[3–8]. Characterizing the impact of being born LBW on noncommunicable diseases in developing countries is challenging due to paucity of maternal health data and birth weight records. 21% of children are born LBW, defined as weighing at or below 2.5 kg.[9]. Among the factors contributing to LBW, lack of dietary diversity with few fruits, vegetables, and animal sources of food has been noted in low and middle-income countries.[10]. Maternal hypertension was noted to be a significant risk factor for LBW infants in recent Haitian immigrants to the United States.[11]

Methods

Results

Conclusion