The effect of maternal nutritional variables on birthweight outcomes of infants born to Sherpa women at low and high altitudes in Nepal

Abstract

A prospective, longitudinal study was conducted in Nepal to investigate the effects of maternal nutrition on the pregnancy outcome of Sherpa women living at low and high altitudes. It was hypothesized that variation in nutrition and energy expenditure of pregnant women would correlate with variation in infant birthweight. Anthropometric dimensions, energy consumption and expenditure, and demographic and migration information were collected on a large sample of women living in two regions of Nepal: the Khumbu region (3480–3930 m) and Kathmandu (1330 m). This paper reports findings for a subset of the sample; 17 women at low altitude and 21 women at high altitude who became pregnant and were followed during pregnancy. The results showed no significant differences for mean birthweights between the low (X = 3069 ± 341 grams) and high (X = 3099 ± 483 grams) altitude samples. Furthermore, larger birthweights were associated with larger weight gains during pregnancy for the high altitude sample. A stepwise regression analysis found a negative association between high energy expenditures during the second trimester and infant birthweight, but positive associations were found between third trimester calcium and second trimester protein intakes and birthweight. Prepregnancy BMI and stature were associated positively with infant birthweight, suggesting that good nutritional status prior to pregnancy may play an important role in pregnancy outcome for this population. Am. J. Hum. Biol. 9:751–763, 1997. © 1997 Wiley-Liss, Inc.