Abstract
BackgroundDuring pregnancy, a mother’s nutritional needs increase to meet the added nutrient demands for fetal growth and development. An enhanced understanding of adequate nutrition and sufficient weight gain during pregnancy can guide development of policies and strategies for maternal nutrition care, actions that will ultimately promote better pregnancy outcomes. In a sample of pregnant women in Vietnam, this study characterized maternal nutrition status and gestational weight gain at a mid-pregnancy baseline, then examined the association of these variables with specific birth outcomes.MethodsThe study used baseline data from a randomized, controlled trial that compared pregnant Vietnamese women who received a nutritional intervention group with those who received only standard dietary counseling (control group). At baseline (26–29 weeks gestation), mothers’ dietary reports were collected, and intake of 10 macro- and micronutrients was estimated; data for baseline gestational weight gain was collected for all pregnant women enrolled into the study (n = 228). This analysis also used weights, lengths, and head circumferences at birth for infants of mothers in the control group.ResultsAt baseline, 95% of the pregnant women had concurrent inadequacies for more than five nutrients, and nearly half had concurrent inadequacies for more than ten nutrients. Almost two-thirds of the pregnant women did not meet recommendations for gestational weight gain. We found a significant, inverse association between the number of nutrient inadequacies and gestational weight gain (overall p ≤ 0.045). After adjusting for potential confounders, gestational weight gain was positively associated with birth weight, length at birth, birth weight-for-age z-score and length-for-age z-score (all p ≤ 0.006).ConclusionsOur findings raise concern over the high proportion of pregnant women in Vietnam who have multiple concurrent nutrient inadequacies and who fall short of meeting recommended gestational weight gain standards. To ensure better birth outcomes in this population, policies and strategies to improve the status of maternal nutrition are greatly needed.Trial registrationThe trial was retrospectively registered at clinicaltrials.gov on December 20, 2013, registration identifier: NCT02016586.
Highlights
During pregnancy, a mother’s nutritional needs increase to meet the added nutrient demands for fetal growth and development
Almost two-thirds of the women did not meet the gestational weight gain recommended by the Institute of Medicine (IOM) at the mid-pregnancy interval of 26 to 29 weeks gestation
The fifteen nutrients that were included in this analysis were protein, calcium, iron, zinc, vitamins A, D, E, C, B1, B2, B3, B5, B6, B9, and B12 (Table 1)
Summary
A mother’s nutritional needs increase to meet the added nutrient demands for fetal growth and development. In a sample of pregnant women in Vietnam, this study characterized maternal nutrition status and gestational weight gain at a mid-pregnancy baseline, examined the association of these variables with specific birth outcomes. A suboptimal maternal diet and inadequate gestational weight gain during pregnancy increase risk for adverse health outcomes for both mother and child [1,2,3,4,5]. Inadequate nutrient intakes during this time may lead to reprogramming within fetal tissues, which is associated with increased risk for noncommunicable chronic diseases in adulthood [5, 17,18,19,20]. For pregnant women who have difficulty achieving recommended nutrient intake through usual diet alone, it is strategic to intervene with supplements containing protein, energy, and other nutrients
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