Effect Of Maternal Nutritional Status Research Articles

Modeling the effects of maternal nutritional status and socioeconomic variables on the anthropometric and psychological indicators of Kenyan infants from age 0-6 months.

This paper presents a comprehensive empirical analysis of the factors affecting growth and psychological development of over 100 infants from birth to age 6 months in the Embu region of Kenya. The analysis was divided into four parts. First, infants' birth weight, and length and head circumference as measured few days after birth, were modeled using multiple regression models. Maternal prepregnancy body mass index (BMI), gestation period, and parity were associated with infants' anthropometric measurements (P < 0.05). Second, the scores on seven clusters of the Brazelton Neonatal Behavioral Assessment Scale were explained by health and socioeconomic indicators. While the models had poor predictive power, the scores were comparable to those reported in the literature for Puerto Rican and African American infants. The third part of the analysis modeled infant growth between 1-6 months by analyzing longitudinal data on length, head circumference, and weight. Dynamic models were postulated for the effects of nutritional, socioeconomic, and environmental factors and morbidity on anthropometric variables. The results showed that infants' calcium intakes were positively associated with length (P < 0.05). Maternal BMI and hemoglobin concentration were positively associated with infant weight (P < 0. 05); infant morbidity was negatively associated with weight (P < 0. 05). Lastly, the infants' scores at 6 months on the Bayley Motor Scale and on eight items from the Bayley Infant Behavior Record were explained using anthropometric, socioeconomic, and psychological variables. The infants' arm circumference and intake of protein were significant predictors of scores on the Bayley Motor Scale. In addition, time spent by the mother talking to the infant was positively associated with the scores on the Bayley Infant Behavior Record. The empirical results have implications for identifying vulnerable children in developing countries.

Modeling the effects of maternal nutritional status and socioeconomic variables on the anthropometric and psychological indicators of Kenyan infants from age 0–6 months

This paper presents a comprehensive empirical analysis of the factors affecting growth and psychological development of over 100 infants from birth to age 6 months in the Embu region of Kenya. The analysis was divided into four parts. First, infants' birth weight, and length and head circumference as measured few days after birth, were modeled using multiple regression models. Maternal prepregnancy body mass index (BMI), gestation period, and parity were associated with infants' anthropometric measurements (P < 0.05). Second, the scores on seven clusters of the Brazelton Neonatal Behavioral Assessment Scale were explained by health and socioeconomic indicators. While the models had poor predictive power, the scores were comparable to those reported in the literature for Puerto Rican and African American infants. The third part of the analysis modeled infant growth between 1–6 months by analyzing longitudinal data on length, head circumference, and weight. Dynamic models were postulated for the effects of nutritional, socioeconomic, and environmental factors and morbidity on anthropometric variables. The results showed that infants' calcium intakes were positively associated with length (P < 0.05). Maternal BMI and hemoglobin concentration were positively associated with infant weight (P < 0.05); infant morbidity was negatively associated with weight (P < 0.05). Lastly, the infants' scores at 6 months on the Bayley Motor Scale and on eight items from the Bayley Infant Behavior Record were explained using anthropometric, socioeconomic, and psychological variables. The infants' arm circumference and intake of protein were significant predictors of scores on the Bayley Motor Scale. In addition, time spent by the mother talking to the infant was positively associated with the scores on the Bayley Infant Behavior Record. The empirical results have implications for identifying vulnerable children in developing countries. Am J Phys Anthropol 111:89–104, 2000. © 2000 Wiley-Liss, Inc.

Effects of Under- and Overnutrition on Lactation in Laboratory Rats ,

To study the effects of maternal nutritional status on lactational performance, the diets of laboratory rats were manipulated with food restriction or increases in fat concentration. Compared with rats fed control diets ad libitum, conception rate, milk production and litter growth decreased and milk fat concentration increased in both chronically food restricted and obese animals. Chronically food restricted rats mobilized body fat and reduced their energy expenditure for maintenance and activity. Differences in suckling pattern between control and food-restricted rats affected hormone concentrations important for successful lactation. Obese rats experienced greater difficulty than controls in delivering their pups and more of their pups died in the first days of life. Milk production among obese rats may be constrained by poor appetite and the high heat production that characterizes lactation in litter-bearing species. There are many parallels as well as important differences between results obtained from these models and findings in nursing women. Nevertheless, these models provide useful information about the possible mechanisms by which maternal nutritional status affects lactational performance. J. Nutr. 128: 390S’393S, 1998.

Nutritional issues for women in developing countries.

There has been increased recognition over the past decade of the importance of nutrition in women in developing countries with international organizations' initiatives encouraging work on the issue. However, discussion of women's nutrition in developing countries has focused upon maternal nutrition with regard to the effect of maternal nutritional status on birth weight and lactational performance. Little attention has been given to the well-being of the mother and the effects of nutrition on her performance in social and economic activities. The author instead discusses maternal nutrition in relation to the nutritional status of the mother rather than that of the child. She also considers other aspects of women's nutrition. Developing countries, childhood undernutrition, gender discrimination, reproductive health, teenage pregnancy, work and energy expenditure, the implications of time constraints for nutrition and health care, dietary intakes, intrahousehold food distribution, chronic energy deficiency, anemia, and older women are discussed.

Maternal vitamin A deficiency and mother-to-child transmission of HIV-1

Summary Studies show that around 10-40% HIV-positive women will give birth to children who are also infected. However, the risk factors for transmission from mother to child are not well understood and the effects of maternal nutritional status are unknown. We conducted a study of vitamin A status in pregnant women as a risk factor for mother-to-child transmission of HIV in Malawi. Serum vitamin A, height, weight, CD4 T-cell counts, and duration of breastfeeding were measured in 338 HIV-positive mothers whose infant's HIV serostatus was known. Mother-to-child transmission of HIV was 21 9% among mothers whose infants survived to 12 months of age. Mean vitamin A concentration in 74 mothers who transmitted HIV to their infants was lower than that in 264 mothers who did not transmit HIV to their infants (0·86 [0 03] vs 1·07 [0 02], p<0·0001). We divided HIV positive mothers to 4 groups, those with vitamin A concentrations of less than 0 70, between 0·70 and 1·05, between 1 05 and 1·40, and greater than or equal to 1 40 μmol/L. The mother-to-child transmission rates for each group were 32·4%, 26 2%, 16·0%, and 7·2%, respectively (p<0·0001). Maternal CD4 cell counts, CD4%, and CD4/CD8 ratio were also associated with increased mother-to-child transmission of HIV. Maternal age, body-mass index, and breastfeeding practices were not significantly associated with higher mother-to-child transmission. Our study suggests that maternal vitamin A deficiency contributes to mother-to-child transmission of HIV.

Effects of maternal nutritional status and maternal energy supplementation on length of postpartum amenorrhea among Guatemalan women

To investigate the extent to which better maternal nutrition leads to reduction in length of postpartum amenorrhea, multivariate-logistic and linear-regression analyses were applied to data on 339 mother-infant pairs from the longitudinal Guatemalan Four Village Study, 1969-1977. Maternal triceps skinfold thickness was negatively associated with length of amenorrhea when infant supplementation (a proxy for reduced suckling) was accounted for. However, its effect was small: amenorrhea was only 0.5 mo shorter among women at the 75th percentile than among those at the 25th, equivalent to less than even one additional child during the women's reproductive years. Maternal supplementation was not associated with length of amenorrhea when infant supplementation was controlled. This is in contrast to previous studies in which breast-feeding or infant supplementation was not controlled. These results suggest that infant, not maternal, supplementation influences length of postpartum amenorrhea, and that maternal nutritional status has minimal influence.

Vitamin A content of human milk affected by time after delivery and by gestational age at birth

To determine the average concentration of vitamin A in human milk according to time after delivery and to gestational age at birth, all reports of vitamin A activity in human milk during the past 40 years were reviewed. To minimize the effect of maternal nutritional status on the vitamin A content of milk, only those values from developed countries (with under 5 child mortality <20/1000 live births) were included in this study. All reports of vitamin A activity were translated into retinol equivalents (RE) to allow comparison among studies. Reported values were divided by the time after delivery during which the samples were obtained (1–6, 7–13, or 14–21 days; 1–2, 3–4, or 5–6 months). The studies were further divided by whether the birth was term or preterm (<37 weeks). There were no reports from developed countries of the vitamin A content of term milk after 6 months of lactation and no reports of the vitamin A content of preterm milk after 2 months of lactation. Because human milk changes to meet the changing needs of the growing infant, the vitamin A content changes over time. Colostrum and transitional milk are particularly rich in vitamin A activity. The weighted average vitamin A concentration (retinol plus beta-carotene) in term milk during the first week of lactation was 1654 RE/liter, approximately double the weighted average of 716 RE/liter at 1–2 months, 694 RE/liter at 3–4 months, and 780 RE/liter at 5–6 months after delivery. Preterm milk contains an even higher concentration of vitamin A activity (retinol plus beta-carotene) than term milk during the first two months of lactation. As in term milk, the weighted average concentration of vitamin A in preterm colostrum and transitional milk was much higher than in mature milk, and it remained higher for longer: 1859 RE/liter at 1–6 days, 1796 RE/liter at 7–13 days, 1420 RE/liter at 14–21 days, and 1256 RE/liter at 1–2 months. The higher concentration of vitamin A in preterm milk appears to complement the low vitamin A stores of preterm infants.

Effects of maternal nutritional status on fetal and placental growth and on fetal urea synthesis in sheep.

Fetal and placental growth, and fetal and maternal urea synthesis in late gestation, were studied in 2-year-old Corriedale ewes on a maintenance ration (M) except when subjected to moderate dietary restriction from day 50 to day 100 (RM), day 100 to day 135 (MR) or day 50 to day 135 (RR). In comparison with fetuses of ewes maintained throughout the experiment (MM), RR fetuses were smaller and RM fetuses were larger whereas MR fetuses were unaffected; all restrictions were associated with increased placental size. Fetal urea synthesis at day 133 in the well-nourished ewes (MM) was 21.5 mg N h-1 kg-1 increasing to, respectively, 25.7, 27.3 and 38.8 mg N h-1 kg-1 in groups MR, RM and RR; these values were 1.6, 3.9, 2.2 and 3.8 times the maternal rates of synthesis. On the basis of the observed urea synthesis rates, amino acid oxidation could have accounted for up to, respectively, 32, 38, 40 and 57% of fetal oxygen consumption in groups MM, MR, RM and RR. Amino acids, in addition to their role in tissue accretion, may be key energy substrates for the fetus.

Effect of maternal nutritional status on immunological substances in human colostrum and milk

Substances in colostrum and breast milk confer significant disease resistance to the breast-fed infant. The influence of maternal nutritional status on both immunological and nonimmunological milk factors was studied in a group of 23 Colombian women during the first 2 months of lactation. Maternal malnutrition was characterized by significantly lower weight/height ratio, creatinine/height index, total serum proteins, serum albumin, and serum IgG and IgA. The colostrum of malnourished mothers contained only one-third the normal concentration of immunoglobulin G and less than half the normal level of albumin. Significant reductions in colostrum levels of IgA and the fourth component of complement (C4) were also observed in the malnourished group. No differences were observed in colostral concentrations of lysozyme, C3 complement, or IgM. Titers of antibody in milk directed against respiratory syncytial virus were not influenced by maternal nutritional status. The differences noted above tended to disappear in mature milk, concomitant with improvement in the nutritional status of malnourished mothers during the first several weeks postpartum. We conclude that the protective qualities of colostrum and milk may be significantly influenced by maternal nutritional status.

Maternal and child nutritional status: Its association with the risk of pregnancy

Breastfeeding reduces the interval between births by its effect on prolonging the period of postpartum anovulation and in some cases, reducing the likelihood of conception once ovulation has occurred. Extended durations of postpartum amenorrhea (18 months and longer) are observed among many women in developing countries, while shorter durations (6 months or less) are common among women in developed countries. This differential effect has been suggested to be related to maternal nutritional status, but numerous other factors also differ. This paper reviews the literature in this area, and suggests that most studies indicate a small and demographically insignificant effect of maternal nutritional status on the period of postpartum amenorrhea. Factors associated with suckling patterns appear to be more important in determining the length of postpartum infertility. Suckling frequency and intensity which affects the hormonal stimulus preventing ovulation appear to be affected by the type of and how supplemental feeding is given to the child (use of bottles), whether suckling is on demand or scheduled, the frequency of night-time feedings (influenced by whether or not the mother sleeps with the child), whether or not pacifiers are used, and the child's nutritional and health status.

Nutrition, lactation, and birth interval components in rural Guatemala

The effects of maternal nutritional status and food supplementation ingested by the infant on the duration of postpartum amenorrhea and on the duration of the menstruating interval was examined. A significant negative association was found between the nutritional status of the mother during the 3rd trimester of pregnancy and infant supplementation, on the one hand, and the length of postpartum amenorrhea on the other hand. These associations remained significant after controlling for each other and for other potentially confounding factors for which data wee collected. These results support the hypothesis that maternal nutritional status, by determining the amount of breast milk available, hence the frequency, duration, and intensity of suckling, is indirectly, negatively associated to the length of postpartum amenorrhea. Furthermore, no association between maternal nutritional status and the length of the menstruating interval was found.

Effect of maternal nutritional status and infant supplementation during lactation on postpartum amenorrhea

This paper explores the effects of maternal nutritional status and food supplementation ingested by the infant on the duration of postpartum amenorrhea. A significant negative association was found between the nutritional status of the mother during the third trimester of pregnancy and the length of postpartum amenorrhea. A negative association was also found between infant supplementation and duration of postpartum amenorrhea. Each of these associations remained significant after controlling for the other, suggesting that both factors independently affect the length of postpartum amenorrhea.