Skip to main content

Nutrition of pregnant mothers in developing countries

  • Chapter
Book cover Recent Developments in Infant Nutrition

Part of the book series: Tenth Nutricia Symposium ((NUSY,volume 9))

  • 115 Accesses

Abstract

In an attempt to attain delivery of a full-term, well-developed and healthy infant considerable attention has focused on nutritional status, weight gain and dietary intake of the pregnant mother. While achieving optimal outcomes in developed countries is within reach, less developed countries (LDC) remain slow to eradicate problems of maternal and infant morbidity and mortality. Pregnancy commits the mother to a considerable investment of resources which must be met by a combination of increased dietary intake and mobilization of body stores. Since fertility tends to be suppressed only under conditions of severe malnutrition, in many countries conception and development of the fetus commonly proceed under conditions of marginal nourishment. Undernutrition during pregnancy is certainly one of the major causes of both maternal and infant mortality in LDC. Approximately 500000 pregnant women in LDC die each year, mainly as a result of haemorrhage, sepsis, hypertensive disorders of pregnancy (HDP), obstructed labour and anaemia (1, Fig. 1). In many cases both obstructed labour and anaemia can be attributed directly to problems of undernutrition, as may HDP. Considerable evidence also suggests that maternal diet and nutritional status can significantly affect birth outcome. Twenty million low birth weight (LBW) infants are born worldwide (1) and maternal undernutrition is commonly cited as a cause for retarded fetal growth, malformations of the central nervous system such as spina bifida and hydrocephalus, and prematurity. Both premature and small-for-date babies are at considerable increased risk during their early years of life.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 169.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 219.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Abbreviations

BMI:

body mass index (weight/height2)

BMR:

basal metabolic rate

HDP:

hypertensive disorders of pregnancy

IUGR:

intrauterine growth retardation

LBW:

low birth weight

LDC:

less developed country

References

  1. WHO 1991 Maternal anthropometry for prediction of pregnancy outcomes: Memorandum from a USAID/WHO/PAHO/Mothercare meeting. Bull WHO 69:523–532

    Google Scholar 

  2. Flemming AF 1989 Tropical obstetrics and gynaecology. I. Anaemia in pregnancy in tropical Africa. Trans R Soc Trop Med Hyg 83:441–448

    Article  Google Scholar 

  3. Puolakka J, Janne O, Pakarinen A, Vihko R 1980 Serum ferritin in the diagnosis of anemia during pregnancy. Acta Obstet Gynecol Scand Suppl 95:57–63

    Article  PubMed  CAS  Google Scholar 

  4. Izak G, Levy S, Rachmilewitz M, Grossowicz N 1973 The effect of iron and folic acid on combined iron and folate deficiency anaemia: the results of a clinical trial. Scand J Haematol 11:236–240

    Article  PubMed  CAS  Google Scholar 

  5. Aung-Than-Batu, Thane-Toe, Hla-Pe, Khin-Kyi-Nyunt 1976 A prophylactic trial of iron and folic acid supplements in pregnant Burmese women. Israel J Med Sci 12:1410–1415

    Google Scholar 

  6. Sood SK, Ramachandran K, Mathur M 1975 WHO sponsored collaborative studies on nutritional anaemia in India. I. The effects of supplemental oral iron administration to pregnant women. Q J Med 44:241–258

    PubMed  CAS  Google Scholar 

  7. Chanarin I, Rothman D 1971 Further observations on the relation between iron and folate status in pregnancy. Br Med J 2:81–84

    Article  PubMed  CAS  Google Scholar 

  8. Taylor DJ, Matter C, McDougall N, Lind T 1982 Effect of iron supplementation on serum ferritin levels during and after pregnancy. Br J Obstet Gynaecol 89:1011–1017

    Article  PubMed  CAS  Google Scholar 

  9. Dawson EB, McGanity WJ 1987 Protection of maternal iron stores in pregnancy. J Reprod Med 32:478–487

    PubMed  CAS  Google Scholar 

  10. Sandstrom B, Davidsson L, Cederblad A, Lönnerdal B 1985 Oral iron, dietary ligands and zinc absorption. J Nutr 115:411–414

    PubMed  CAS  Google Scholar 

  11. Murphy JF, O’Riordan J, Newcome RG, Coles EC, Pearson JF 1986 Relation of haemoglobin levels in first and second trimesters to outcome of pregnancy. Lancet i: 992–995

    Article  Google Scholar 

  12. Klein L 1962 Premature birth and maternal prenatal anaemia. Am J Obstet Gynecol 83:588–590

    PubMed  CAS  Google Scholar 

  13. MacGregor MW 1963 Maternal anaemia as a factor in prematurity and perinatal mortality. Scott Med J 8:134–140

    Google Scholar 

  14. Leiberman E, Ryan KJ, Monson RR, Schoenbaum SC 1987 Risk factors accounting for racial differences in the rate of premature birth. New Engl J Med 317:743–748

    Article  Google Scholar 

  15. Murray M J, Murray AB, Murray NJ, Murray MB 1978 The effect of iron status of Nigerian mothers on that of their infants at birth and 6 months and on the concentration of Fe in breast milk. Br J Nutr 39:627–630

    Article  PubMed  CAS  Google Scholar 

  16. Agrawal RMD, Tripathi AM, Agrawal KN 1983 Cord blood haemoglobin, iron and ferritin status in maternal anaemia. Acta Paediatr Scand 72:545–548

    Article  PubMed  CAS  Google Scholar 

  17. Harrison KA 1985 Child-bearing, health and social priorities: a survey of 22774 consecutive hospital births in Zaria, Northern Nigeria. Br J Obstet Gynaecol 92:1–119

    PubMed  Google Scholar 

  18. Lo CW, Jarjue LM, Poppitt SD, Cole TJ, Neer R, Prentice A 1990 Delayed development of bone mass in West African adolescents. In: Christiansen C, Overgaard K (eds) Osteoporosis 90 (Third international symposium on osteoporosis). Copenhagen, Denmark

    Google Scholar 

  19. Prentice AM, Cole TJ, Foord FA, Lamb WH, Whitehead RG 1987 Increased birthweight after prenatal dietary supplementation of rural African women. Am J Clin Nutr 46:912–925

    PubMed  CAS  Google Scholar 

  20. Chesley LC 1976 Blood pressure, edema and proteinurea in pregnancy. I. Historical developments. Prog Clin Bio Res 7:19–66

    CAS  Google Scholar 

  21. Tompkins WT, Wiehl DG, Mitchell RM 1955 The underweight patient as an increased obstetric hazard. Am J Obstet Gynecol 69:114–123

    PubMed  CAS  Google Scholar 

  22. Thomson AM, Billewicz WZ 1957 Clinical significance of weight trends during pregnancy. Br Med J 1:243–247

    Article  PubMed  Google Scholar 

  23. Naeye RL 1982 Maternal nutrition and pregnancy outcome. In: Dobbing J (ed) Maternal nutrition in pregnancy: Eating for two? Academic Press, London, pp 89–111

    Google Scholar 

  24. Shepard MJ, Hellenbrand KG, Bracken MB 1986 Proportional weight gain and complications of pregnancy, labor and delivery in healthy women of normal prepregnant stature. Am J Obstet Gynecol 155:947–954

    PubMed  CAS  Google Scholar 

  25. Hambidge KM, Casey CE, Krebs NF 1986 Zinc. In: Mertz W (ed) Trace elements in human and animal nutrition. Academic Press, Orlando, FL, pp 1–137

    Google Scholar 

  26. Hunt IF, Murphy NJ, Shroads J, Smith JC 1979 Dietary zinc intake of low-income pregnant women of Mexican descent. Am J Clin Nutr 32:1511–1518

    PubMed  CAS  Google Scholar 

  27. Hunt IF, Murphy NJ, Cleaver AE 1983 Zinc supplementation during pregnancy: zinc concentration of serum and hair from low-income women of Mexican descent. Am J Clin Nutr 37: 573–582

    Google Scholar 

  28. Hunt IF, Murphy NJ, Martner-Hewes PM, Faraji B, Swenstid ME, Reynolds RD 1987 Zinc, vitamin B6, and other nutrients in pregnant women attending prenatal clinics in Mexico. Am J Clin Nutr 46:563–569

    PubMed  CAS  Google Scholar 

  29. Abraham R 1982 Trace element intake by Asians during pregnancy. Proc Nutr Soc 41:261–265

    Article  PubMed  CAS  Google Scholar 

  30. Turnlund JR, King JC, Wahbeh CJ 1983 Zinc status and pregnancy outcome of pregnant Lebanese women. Nutr Res 3:309–315

    Article  Google Scholar 

  31. Hambidge KM, Neider KH, Walravens PA 1975 Zinc, acrodermatitis enteropathica, and congenital malformations. Lancet i: 577–578

    Article  Google Scholar 

  32. Prema K 1980 Predictive value of serum copper and and zinc in normal and abnormal pregnancy. Indian J Med Res 71:554–560

    PubMed  CAS  Google Scholar 

  33. Meadows NJ, Ruse W, Smith MF 1981 Zinc and small babies. Lancet ii: 1135–1137

    Article  Google Scholar 

  34. Meadows NJ, Grainger SL, Ruse W 1983 Oral iron and the bioavailability of zinc. Br Med J 287:1013–1014

    Article  CAS  Google Scholar 

  35. Simmer K, Thomson RPH 1985 Zinc in the fetus and newborn. Acta Paediatr Scand 74 (Suppl 319):158–163

    Article  Google Scholar 

  36. Jameson S 1976 Effects of zinc deficiency in human reproduction. Acta Med Scand Suppl 593: 1–89

    PubMed  CAS  Google Scholar 

  37. Hunt IF, Murphy NJ, Cleaver AE 1983 Zinc supplementation during pregnancy: zinc concentration of serum and hair from low-income women of Mexican descent. Am J Clin Nutr 37: 572–582

    PubMed  CAS  Google Scholar 

  38. Hunt IF, Murphy NJ, Cleaver AE 1984 Zinc supplementation during pregnancy: effect on selected blood constituents and on progress and outcome of pregnancy in low-income women of Mexican descent. Am J Clin Nutr 40:508–521

    PubMed  CAS  Google Scholar 

  39. Breskin MW, Worthington-Roberts BS, Knopp RH 1983 First trimester serum zinc concentration in human pregnancy. Am J Clin Nutr 39:943–953

    Google Scholar 

  40. Jameson S 1982 Zinc status and pregnancy outcome in humans. In: Prasad AS, Dreosti EI, Hetzel BS (eds) Clinical Applications of Recent Advances in Zinc Metabolism. Alan R Liss, New York, pp39–52

    Google Scholar 

  41. Hambidge KM, Krebs NF, Jacobs MA, Favier A, Guyette L, Ikle DN 1983 Zinc nutritional status during pregnancy: a longitudinal study. Am J Clin Nutr 37:429–442

    PubMed  CAS  Google Scholar 

  42. Spatling L, Spatling G 1988 Magnesium supplementation in pregnancy. A double blind study. Br J Obstet Gynaecol 95:120–125

    Article  PubMed  CAS  Google Scholar 

  43. Lopez-Jaramillo P, Narvaez M, Yepez R 1987 Effect of calcium supplementation on the vascular sensitivity to angiotensin II in pregnant women. Am J Obstet Gynecol 156:261–262

    PubMed  CAS  Google Scholar 

  44. Belizan JM, Villar J, Repke J 1988 The relationship between calcium intake and pregnancy-induced hypertension: up-to-date evidence. Am J Obstet Gynecol 158:898–902

    PubMed  CAS  Google Scholar 

  45. Neer RM 1979 Calcium and inorganic phosphate homeostasis. In: DeGroot LU, Cahill GF, Odell WD (eds) Endocrinology. Grune & Stratton, New York, pp 669–692

    Google Scholar 

  46. Glorieux FH, Delvin EE, Salle BL 1988 Calcium and vitamin D status during pregnancy. In: Berger H (ed) Vitamins and Minerals in Pregnancy and Lactation (Nestle Nutrition Workshop Series, vol 16). Raven Press, New York

    Google Scholar 

  47. Paunier L, Lacourt G, Pilloud P, Schlaeppi P, Sizonenko PC 1978 25-Hydroxyvitamin D and calcium levels in maternal, cord and infant serum in relation to maternal vitamin D intake. Helv Paediatr Acta 33:95–103

    PubMed  Google Scholar 

  48. Cockburn F, Beiton NR, Purvis RJ, Giles MM, Brown JK, Turner TL, Wilkinson EM, Forfar JO, Barrie WJM, McKay GS, Pocock SJ 1980 Maternal vitamin D intake and mineral metabolism in mothers and their newborn infants. Br Med J 281:11–14

    Article  PubMed  CAS  Google Scholar 

  49. Brooke OG, Brown IRF, Bone CDM, Carter ND, Cleeve HJW, Maxwell JD, Robinson VP, Winder SM 1980 Vitamin D supplements in pregnant Asian women: effects of calcium status and fetal growth. Br Med J 280:751–754

    Article  PubMed  CAS  Google Scholar 

  50. Kuoppala T, Tuimala R, Parviainen M, Koskinen T, Ala-Houhala M 1986 Serum levels of vitamin D metabolites, calcium, phosphorus, magnesium and alkaline phosphatase in Finnish women throughout pregnancy and in cord serum at delivery. Hum Nutr: Clin Nutr 40C:287–293

    CAS  Google Scholar 

  51. Nehama H, Weintroub S, Eisenberg Z, Birger A, Milbauer B, Weisman Y 1987 Seasonal variations in paired maternal-newborn serum 25-hydroxyvitamin D and 24,25-dihydroxyvitamin D concentrations in Israel. Israel J Med Sci 23:274–277

    PubMed  CAS  Google Scholar 

  52. Verity CM, Burman D, Beadle PC, Holton JB, Morris A 1981 Seasonal changes in perinatal vitamin D metabolism: maternal and cord blood biochemistry in normal pregnancies. Arch Dis Child 56:943–948

    Article  PubMed  CAS  Google Scholar 

  53. Hytten F, Chamberlain G 1980 Clinical Physiology in Obstetrics. Blackwell Scientific Publications, Oxford

    Google Scholar 

  54. Martin RD 1980 Adaptation and body size in primates. Z Morphol Anthrop 71:115–124

    CAS  Google Scholar 

  55. Goldberg GR, Prentice AM, Coward WA, Davies HL, Murgatroyd PR, Wensing C, Black AE, Harding M, Sawyer M 1993 Longitudinal assessment of energy expenditure in pregnancy by the doubly-labelled water method. Am J Clin Nutr 57:494–505

    PubMed  CAS  Google Scholar 

  56. Durnin JVGA, McKillop FM, Grant S, Fitzgerald G 1987 Energy requirements of pregnancy in Scotland. Lancet ii: 897–900

    Article  Google Scholar 

  57. van Raaij JMA, Vermaat-Miedema SH, Schonk CM, Peek MEM, Hautvast JGAJ 1987 Energy requirements of pregnancy in The Netherlands. Lancet ii:953–955

    Article  Google Scholar 

  58. Spaaij CJK 1993 The efficiency of energy metabolism during pregnancy and lactation in well-nourished Dutch women. University of Wageningen, The Netherlands: PhD Thesis

    Google Scholar 

  59. Forsum E, Sadurskis A, Wager J 1988 Resting metabolic rate and body composition of healthy Swedish women during pregnancy. Am J Clin Nutr 47:942–947

    PubMed  CAS  Google Scholar 

  60. Lawrence M, Lawrence F, Coward WA, Cole TJ, Whitehead RG 1987 Energy requirements of pregnancy in the Gambia. Lancet ii: 1072–1076

    Article  Google Scholar 

  61. Poppitt SD, Prentice AM, Jequier E, Schutz Y, Whitehead RG 1993 Evidence of energy-sparing in Gambian women during pregnancy: a longitudinal study using whole-body calorimetry. Am J Clin Nutr 57:353–364

    PubMed  CAS  Google Scholar 

  62. Tuazon MAG, van Raaij JMA, Hautvast JGAJ, Barba CVC 1987 Energy requirements of pregnancy in The Philippines. Lancet ii: 1129–1131

    Article  Google Scholar 

  63. Thongprasert K, Tanphaichitre V, Valyasevi A, Kittigool J, Durnin JVGA 1987 Energy requirements of pregnancy in rural Thailand. Lancet ii: 1010–1012

    Article  Google Scholar 

  64. Poppitt SD, Prentice AM, Goldberg GR, Whitehead RG 194 Energy-sparing strategies to protect human fetal growth. Am J Obstet Gynecol 171:118–125

    Google Scholar 

  65. Hytten FE 1991 Weight gain in pregnancy. In: Hytten FE, Chamberlain G (eds) Clinical Physiology in Obstetrics. Blackwell Scientific Publications, Oxford

    Google Scholar 

  66. FAO/WHO/UNU. Report of a Joint Expert Consultation: Energy and Protein Requirements. WHO. 1985. WHO Tech Rep Series No 724. WHO, Geneva

    Google Scholar 

  67. Chase HC 1972 A comparison of Neonatal Mortality from Two Cohort Studies. US Health Services and Mental Health Administration, Washington DC

    Google Scholar 

  68. Lubchenko LO, Searls DT, Brazie JV 1972 Neonatal mortality rate: relationship to birth weight and gestational age. Fetal Neonatal Med 81:814–822

    Google Scholar 

  69. Mata LJ 1978 The children of Santa Maria Cauque. A Prospective Field Study of Health and Growth. MIT Press, Cambridge, MA

    Google Scholar 

  70. Ashworth A, Feacham RG 1985 Interventions for the control of diarrhoea diseases among young children: prevention of low birth weight. Bull WHO 63:165–184

    PubMed  CAS  Google Scholar 

  71. Taffel S 1980 Factors associated with low birth weight. In: Vital and Health Statistics. Government Printing Office, Washington DC

    Google Scholar 

  72. McCormick MC 1985 The contribution of low birth weight to infant mortality and childhood morbidity. New Engl J Med 312:82–90

    Article  PubMed  CAS  Google Scholar 

  73. Babson SG 1970 Growth of low-birth-infants. J Paediatr 77:11–18

    Article  CAS  Google Scholar 

  74. Ounsted M, Taylor ME 1971 The postnatal growth of children who were small-for-dates or large-for-dates at birth. Dev Med Child Neurol 13:421–434

    Article  PubMed  CAS  Google Scholar 

  75. Garn SM 1985 Relationship between birth weight and subsequent weight gain. Am J Clin Nutr 42:57–60

    PubMed  CAS  Google Scholar 

  76. Naeye RL 1979 Weight gain and the outcome of pregnancy. Am J Obstet Gynecol 135:3–9

    PubMed  CAS  Google Scholar 

  77. Prentice AM 1991 Can maternal dietary supplements help in preventing infant malnutrition? Acta Paediatr Scand 80 (Suppl 374): 1–11

    Google Scholar 

  78. Ceesay SM, Saidykhan S, Prentice AM, Cole TJ, Day KC, Rowland MGM, Whitehead RG 1993 Effect of birth weight on a community based supplementation programme for pregnant Gambian women: first year results. Proc Nutr Soc 52:77A

    Article  Google Scholar 

  79. Lechtig A, Habicht JP, Delgado H, Klein RE, Yarborough C, Martorell R 1975 Effect of food supplementation during pregnancy on birth weight. Paediatrics 56:508–520

    CAS  Google Scholar 

  80. Mardonnes-Santander F, Rosso P, Salivas J, Ahumada E, Vial I, Steckel A 1986 Effect of two supplements on birth weight. In: Taylor TG, Jenkins NK (eds) Proc 13th Int Congr Nutr, Brighton, UK. John Libbey, London

    Google Scholar 

  81. Chavez A 1978 Effects of malnutrition on body morphology. In: Sterky G, Mellander I (eds) Birth weight Distribution — an Indicator of Social Development. SAREC, Uppsala, pp 18–20

    Google Scholar 

  82. Herrera MG, Mora JO, Paredes BD, Wagner M 1980 Maternal weight/height and the effect of food supplementation during pregnancy and lactation. In: Aebi H, Whitehead RG (eds) Maternal Nutrition During Pregnancy and Lactation. Hans Huber, Bern, pp 252–263

    Google Scholar 

  83. Adair LS, Pollitt E 1985 Outcome of maternal nutritional supplementation: a comprehensive view of the Bacon Chow study. Am J Clin Nutr 41:948–978

    PubMed  CAS  Google Scholar 

  84. Kardjati SR, Kusin JA, de With C 1988 Energy supplementation in the last trimester of pregnancy in East Java, Indonesia. I. Effect on birthweight. Br J Obstet Gynaecol 95:783–794

    Article  PubMed  CAS  Google Scholar 

  85. Ashwood A, Feacham RG 1985 Interventions for the control of diarrhoeal diseases among young children: prevention of low birth weight. Bull WHO 63:165–184

    Google Scholar 

Download references

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 1996 Kluwer Academic Publishers

About this chapter

Cite this chapter

Poppitt, S.D. (1996). Nutrition of pregnant mothers in developing countries. In: Bindels, J.G., Goedhart, A.C., Visser, H.K.A. (eds) Recent Developments in Infant Nutrition. Tenth Nutricia Symposium, vol 9. Springer, Dordrecht. https://doi.org/10.1007/978-94-009-1790-3_2

Download citation

  • DOI: https://doi.org/10.1007/978-94-009-1790-3_2

  • Publisher Name: Springer, Dordrecht

  • Print ISBN: 978-94-010-7298-4

  • Online ISBN: 978-94-009-1790-3

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics