Abstract
BackgroundOverweight and obesity are increasing in low- and middle-income countries, while underweight remains a significant health problems. However, the association between double burden of nutrition and risk of adverse birth and health outcomes is still unclear in Bangladesh. The aim of this study was to determine the effect of maternal undernutrition and excessive body weight on a range of maternal and child health outcomes.MethodsIn this study, we used Bangladesh Demographic and Health Survey (BDHS) 2011 and 2014 data sets to cover the maternal, child and non-communicable diseases related health outcomes. The study considered a range of outcome variables including pregnancy complication, cesarean delivery, diabetes, hypertension, stunting, and wasting, low birth weight, genital discharge, genital sore/ulcer, stillbirth, early neonatal mortality, perinatal mortality, preterm birth and prolonged labor. The key exposure variable was maternal body mass index. Multilevel regression analysis was performed to examine the association between outcomes and exposure variables.ResultsMaternal overweight and obesity has increased from 10% in 2004 to 24% in 2014, a 240% increase in 10 years. Between 2004 and 2014, maternal undernutrition declined from 33% to 18%, a reduction rate of only 54% in 10 years. Compared to normal-weight women, overweight and obese women were more likely to have experienced pregnancy complication, cesarean delivery, diabetes, and hypertension. Underweight women were 1.3 times more likely to have children with stunting and 1.6 times more likely to experience wasting compared to normal weight women. Maternal BMI was not significantly associated with increased risk of genital sore or ulcer, genital discharge, menstrual irregularities, or low birth weight though in certain cases risk was higher.ConclusionsHigh maternal overweight and obesity were observed to have significant adverse effects on health outcomes, while underweight was a risk factor for newborn health. The findings show that weight management is necessary to prevent adverse birth and health outcomes in Bangladesh.Trial registrationData related to health was collected by following the guidelines of ICF international and Bangladesh Medical Research Council. The registration number of data collection is 132989.0.000 and the data-request was registered on March 11, 2015.
Highlights
Overweight and obesity are increasing in low- and middle-income countries, while underweight remains a significant health problems
Sources of data This study is based on a cross-sectional data from Bangladesh Demographic and Health survey (BDHS) – 2014
Age Weight Height Body mass index Systolic blood pressure Diastolic blood pressure Percentage Underweight Normal weight Overweight Obesity Diabetes Hypertension Pregnancy complication Genital sore Genital discharge Pregnancy termination Menstrual irregularities Low birth weight Cesarean delivery Stunting Wasting Preterm birth Prolonged labor Stillbirths Early neonatal mortality Perinatal mortality SE, Standard error; 95% CI, 95% confidence interval overweight and obese increased by 14 percentage points Crude prevalence
Summary
Overweight and obesity are increasing in low- and middle-income countries, while underweight remains a significant health problems. The association between double burden of nutrition and risk of adverse birth and health outcomes is still unclear in Bangladesh. Overweight and obesity increasing rapidly especially in low- and lower middle- income countries. By 2030 there will be 2.16 billion overweight and 1.12 billion obese [2]. Overweight and obesity has become a major health problem both in developed and in developing countries. High-income countries reported more than double prevalence of obesity than low- and lower middle- income countries [3]. Men in developed countries were more overweight and obese, whereas in developing countries, overweight and obesity were more prevalent in women [3]
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