Hostname: page-component-76fb5796d-5g6vh Total loading time: 0 Render date: 2024-04-25T10:48:42.500Z Has data issue: false hasContentIssue false
  • English
  • Français

Review of the importance of nutrition during the first 1000 days: maternal nutritional status and its associations with fetal growth and birth, neonatal and infant outcomes among African women

Part of: Advancing the DOHaD Agenda in Africa 9th World Congress: Cape Town

Published online by Cambridge University Press:  17 August 2015

S. V. Wrottesley ,
C. Lamper  and
P. T. Pisa
S. V. Wrottesley*
Affiliation:
MRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
C. Lamper
Affiliation:
MRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa Radboud University` Medical Center, Nijmegen, The Netherlands
P. T. Pisa
Affiliation:
MRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
*
*Address for correspondence: S. V. Wrottesley, MRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa 1864. (Email stephanie.wrottesley@gmail.com)
Get access Rights & Permissions [Opens in a new window]

Abstract

Maternal nutritional status (MNS) is a strong predictor of growth and development in the first 1000 days of life and may influence susceptibility to non-communicable diseases in adulthood. However, the role of nutrition during this window of developmental plasticity in Africa is unclear. This paper reviews published data to address whether maternal nutrition during the first 1000 days is important for Africa, with a focus on MNS and its associations with fetal growth and birth, neonatal and infant outcomes. A systematic approach was used to search the following databases: Medline, EMBASE, Web of Science, Google Scholar, ScienceDirect, SciSearch and Cochrane Library. In all, 26 studies met the inclusion criteria for the specific objectives. MNS in Africa showed features typical of the epidemiological transition: higher prevalences of maternal overweight and obesity and lower underweight, poor diet quality 1 and high anaemia prevalence. Maternal body mass index and greater gestational weight gain (GWG) were positively associated with birth weight; however, maternal overweight and obesity were associated with increased risk of macrosomia and intrauterine growth restriction. Maternal anaemia was associated with lower birth weight. Macro- and micronutrient supplementation during pregnancy were associated with improvements in GWG, birth weight and mortality risk. Data suggest poor MNS in Africa and confirms the importance of the first 1000 days as a critical period for nutritional intervention to improve growth, birth outcomes and potential future health risk. However, there is a lack of data beyond birth and a need for longitudinal data through infancy to 2 years of age.

Keywords

Africabirth outcomesfetal growthfirst 1000 daysmaternal nutrition
Type
Review
Information
Journal of Developmental Origins of Health and Disease , Volume 7 , Issue 2: Themed Issue: Developmental Origins of Health and Disease: Importance of research for Africa , April 2016 , pp. 144 - 162
Check for updates
Copyright
© Cambridge University Press and the International Society for Developmental Origins of Health and Disease 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Dennedy, MC, Dunne, F. The maternal and fetal impacts of obesity and gestational diabetes on pregnancy outcome. Best Pract Res Clin Endocrinol Metab. 2010; 24, 573–589.Google Scholar
2. Kerrigan, AM, Kingdon, C. Maternal obesity and pregnancy: a retrospective study. Midwifery. 2010; 26, 138–146.CrossRefGoogle ScholarPubMed
3. Leddy, MA, Power, ML, Schulkin, J. The impact of maternal obesity on maternal and fetal health. Rev Obstet Gynecol. 2008; 1, 170–178.Google Scholar
4. Rowlands, I, Graves, N, de Jersey, S, McIntyre, HD, Callaway, L. Obesity in pregnancy: outcomes and economics. Semin Fetal Neonatal Med. 2010; 15, 94–99.Google Scholar
5. Wang, Z, Wang, P, Liu, H, et al. Maternal adiposity as an independent risk factor for pre-eclampsia: a meta-analysis of prospective cohort studies. Obes Rev Off J Int Assoc Study Obes. 2013; 14, 508–521.Google Scholar
6. Abu-Saad, K, Fraser, D. Maternal nutrition and birth outcomes. Epidemiol Rev. 2010; 32, 5–25.Google Scholar
7. Jeric, M, Roje, D, Medic, N, et al. Maternal pre-pregnancy underweight and fetal growth in relation to Institute of Medicine recommendations for gestational weight gain. Early Hum Dev. 2013; 89, 277–281.CrossRefGoogle ScholarPubMed
8. Cnattingius, S, Villamor, E, Johansson, S, et al. Maternal obesity and risk of preterm delivery. JAMA. 2013; 309, 2362–2370.CrossRefGoogle ScholarPubMed
9. Han, Z, Mulla, S, Beyene, J, Liao, G, McDonald, SD. Maternal underweight and the risk of preterm birth and low birth weight: a systematic review and meta-analyses. Int J Epidemiol. 2011; 40, 65–101.Google Scholar
10. Ruager-Martin, R, Hyde, MJ, Modi, N. Maternal obesity and infant outcomes. Early Hum Dev. 2010; 86, 715–722.CrossRefGoogle ScholarPubMed
11. Kim, D, Saada, A. The social determinants of infant mortality and birth outcomes in western developed nations: a cross-country systematic review. Int J Environ Res Public Health. 2013; 10, 2296–2335.Google Scholar
12. Boney, CM, Verma, A, Tucker, R, Vohr, BR. Metabolic syndrome in childhood: association with birth weight, maternal obesity, and gestational diabetes mellitus. Pediatrics. 2005; 115, e290–e296.Google Scholar
13. Eriksson, JG, Forsén, T, Tuomilehto, J, Osmond, C, Barker, DJP. Early growth and coronary heart disease in later life: longitudinal study. BMJ. 2001; 322, 949–953.Google Scholar
14. Forsén, T, Eriksson, J, Tuomilehto, J, et al. The fetal and childhood growth of persons who develop type 2 diabetes. Ann Intern Med. 2000; 133, 176–182.CrossRefGoogle ScholarPubMed
15. O’Reilly, JR, Reynolds, RM. The risk of maternal obesity to the long-term health of the offspring. Clin Endocrinol (Oxf). 2013; 78, 9–16.Google Scholar
16. Gluckman, PD, Hanson, MA, Pinal, C. The developmental origins of adult disease. Matern Child Nutr. 2005; 1, 130–141.Google Scholar
17. Pisa, PT, Pedro, TM, Kahn, K, et al. Nutrient patterns and their association with socio-demographic, lifestyle factors and obesity risk in rural South African adolescents. Nutrients. 2015; 7, 3464–3482.CrossRefGoogle ScholarPubMed
18. Abebe, Y, Bogale, A, Hambidge, KM, et al. Inadequate intakes of dietary zinc among pregnant women from subsistence households in Sidama, Southern Ethiopia. Public Health Nutr. 2008; 11, 379–386.CrossRefGoogle ScholarPubMed
19. Assefa, N, Berhane, Y, Worku, A. Wealth status, mid upper arm circumference (MUAC) and antenatal care (ANC) are determinants for low birth weight in Kersa, Ethiopia. PLoS ONE. 2012; 7, e39957.Google Scholar
20. Belgnaoui, S, Belahsen, R. Nutrient intake and food consumption among pregnant women from an agricultural region of Morocco. Int J Food Sci Nutr. 2006; 57, 19–27.Google Scholar
21. Changamire, FT, Mwiru, RS, Msamanga, GI, et al. Macronutrient and sociodemographic determinants of gestational weight gain among HIV-negative women in Tanzania. Food Nutr Bull. 2014; 35, 43–50.Google Scholar
22. Darwish, AM, Mohamad, SN, Gamal Al-Din, HR, Elsayed, YA, Ahmad, SI. Prevalence and predictors of deficient dietary calcium intake during the third trimester of pregnancy: the experience of a developing country. J Obstet Gynaecol Res. 2009; 35, 106–112.Google Scholar
23. Elshibly, EM, Schmalisch, G. Relationship between maternal and newborn anthropometric measurements in Sudan. Pediatr Int Off J Jpn Pediatr Soc. 2009; 51, 326–331.Google Scholar
24. Elshibly, EM, Schmalisch, G. The effect of maternal anthropometric characteristics and social factors on gestational age and birth weight in Sudanese newborn infants. BMC Public Health. 2008; 8, 244.Google Scholar
25. Hartikainen, H, Maleta, K, Kulmala, T, Ashorn, P. Seasonality of gestational weight gain and foetal growth in rural Malawi. East Afr Med J. 2005; 82, 294–299.Google Scholar
26. Huybregts, LF, Roberfroid, DA, Kolsteren, PW, Van Camp, JH. Dietary behaviour, food and nutrient intake of pregnant women in a rural community in Burkina Faso. Matern Child Nutr. 2009; 5, 211–222.CrossRefGoogle Scholar
27. Jackson, RT, Jackson, FLC, Yu, S. The relationship between third trimester maternal weight gain, hematologic status and infant birthweight in Liberian mothers. Ecol Food Nutr. 1993; 30, 309–319.Google Scholar
28. Kamau-Mbuthia, E, Elmadfa, I. Diet quality of pregnant women attending an antenatal clinic in Nakuru, Kenya. Ann Nutr Metab. 2007; 51, 324–330.Google Scholar
29. Kesa, H, Oldewage-Theron, W. Anthropometric indications and nutritional intake of women in the Vaal Triangle, South Africa. Public Health. 2005; 119, 294–300.Google Scholar
30. Keverenge-Ettyang, GA, van Marken Lichtenbelt, W, Esamai, F, Saris, W. Maternal nutritional status in pastoral versus farming communities of West Pokot, Kenya: differences in iron and vitamin A status and body composition. Food Nutr Bull. 2006; 27, 228–235.Google Scholar
31. Liu, KC, Joseph, JA, Nkole, TB, et al. Predictors and pregnancy outcomes associated with a newborn birth weight of 4000 g or more in Lusaka, Zambia. Int J Gynaecol Obstet Off Organ Int Fed Gynaecol Obstet. 2013; 122, 150–155.Google Scholar
32. Mostert, D, Steyn, NP, Temple, NJ, Olwagen, R. Dietary intake of pregnant women and their infants in a poor black South African community. Curationis. 2005; 28, 12–19.Google Scholar
33. Nieuwoudt, M, van der Merwe, JL, Harvey, J, Hall, DR. Pregnancy outcomes in super-obese women – an even bigger problem? A prospective cohort study. S Afr J Obstet Gynaecol. 2014; 20, 54–59.Google Scholar
34. Nti, CA, Larweh, PM, Gyemfua-Yeboah, Y. Food consumption patterns, dietary quality and health status of expectant mothers: case studies in suburban and rural communities in Ghana. Int J Consum Stud. 2002; 26, 7–14.Google Scholar
35. Oguntona, CRB, Akinyele, IO. Food and nutrient intakes by pregnant Nigerian adolescents during the third trimester. Nutrition. 2002; 18, 673–679.Google Scholar
36. Stephens, JK, Ofori, MF, Quakyi, IA, Wilson, ML, Akanmori, BD. Prevalence of peripheral blood parasitaemia, anaemia and low birthweight among pregnant women in a suburban area in coastal Ghana. Pan Afr Med J. 2014; 17(Suppl. 1), 3.Google Scholar
37. Mohanty, C, Prasad, R, Srikanth Reddy, A, et al. Maternal anthropometry as predictors of low birth weight. J Trop Pediatr. 2006; 52, 24–29.Google Scholar
38. Ceesay, SM, Prentice, AM, Cole, TJ, et al. Effects on birth weight and perinatal mortality of maternal dietary supplements in rural Gambia: 5 year randomised controlled trial. BMJ. 1997; 315, 786–790.Google Scholar
39. Hawkesworth, S, Walker, CG, Sawo, Y, et al. Nutritional supplementation during pregnancy and offspring cardiovascular disease risk in the Gambia. Am J Clin Nutr. 2011; 94(Suppl.), 1853S–1860S.CrossRefGoogle ScholarPubMed
40. Hawkesworth, S, Sawo, Y, Fulford, AJC, et al. Effect of maternal calcium supplementation on offspring blood pressure in 5- to 10-y-old rural Gambian children. Am J Clin Nutr. 2010; 92, 741–747.Google Scholar
41. Jarjou, LM, Prentice, A, Sawo, Y, et al. Randomized, placebo-controlled, calcium supplementation study in pregnant Gambian women: effects on breast-milk calcium concentrations and infant birth weight, growth, and bone mineral accretion in the first year of life. Am J Clin Nutr. 2006; 83, 657–666.Google Scholar
42. Kaestel, P, Michaelsen, KF, Aaby, P, Friis, H. Effects of prenatal multimicronutrient supplements on birth weight and perinatal mortality: a randomised, controlled trial in Guinea-Bissau. Eur J Clin Nutr. 2005; 59, 1081–1089.Google Scholar
43. Preziosi, P, Prual, A, Galan, P, Daouda, H, Boureima, H, Hercberg, S. Effect of iron supplementation on the iron status of pregnant women: consequences for newborns. Am J Clin Nutr. 1997; 66, 1178–1182.Google Scholar
44. Institute of Medicine and National Research Council. Weight Gain During Pregnancy: Reexamining the Guidelines, 2009. The National Academies Press: Washington, DC, p. 2. Retrieved 3 June 2015, from http://www.nap.edu/download.php?record_id=12584.Google Scholar
45. Black, RE, Victora, CG, Walker, SP, et al. Maternal and child undernutrition and overweight in low-income and middle-income countries. The Lancet. 2013; 382, 427–451.Google Scholar
46. Kaiser, L, Allen, LH, American Dietetic Association. Position of the American Dietetic Association: nutrition and lifestyle for a healthy pregnancy outcome. J Am Diet Assoc. 2008; 108, 553–561.Google ScholarPubMed
47. Institute of Medicine National Research Council. Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids (Macronutrients), 2005. The National Academies Press: Washington, DC. Retrieved 3 June 2015, from http://www.nap.edu/download.php?record_id=10490.Google Scholar
48. Institute of Medicine National Research Council. Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc, 2001. The National Academies Press: Washington, DC. Retrieved 3 June 2015, from http://www.nap.edu/download.php?record_id=10026.Google Scholar
49. Bailey, LB. New standard for dietary folate intake in pregnant women. Am J Clin Nutr. 2000; 71(Suppl.), 1304S–1307S.CrossRefGoogle ScholarPubMed
50. Frederick, IO, Williams, MA, Sales, AE, Martin, DP, Killien, M. Pre-pregnancy body mass index, gestational weight gain, and other maternal characteristics in relation to infant birth weight. Matern Child Health J. 2007; 12, 557–567.Google Scholar
51. Halfon, N, Lu, MC. Gestational weight gain and birthweight. The Lancet. 2010; 376, 937–938.Google Scholar
52. Siega-Riz, AM, Viswanathan, M, Moos, M-K, et al. A systematic review of outcomes of maternal weight gain according to the Institute of Medicine recommendations: birthweight, fetal growth, and postpartum weight retention. Am J Obstet Gynecol. 2009; 201, 339.e1–339.e14.CrossRefGoogle Scholar
53. Radulescu, L, Munteanu, O, Popa, F, Cirstoiu, M. The implications and consequences of maternal obesity on fetal intrauterine growth restriction. J Med Life. 2013; 6, 292–298.Google ScholarPubMed
54. Rajasingam, D, Seed, PT, Briley, AL, Shennan, AH, Poston, L. A prospective study of pregnancy outcome and biomarkers of oxidative stress in nulliparous obese women. Am J Obstet Gynecol. 2009; 200, 395.e1–395.e9.Google Scholar
55. Finkelstein, J, Duggan, C, Thomas, T, et al. Maternal anemia, iron deficiency, and pregnancy outcomes in India. FASEB J. 2014; 28(Suppl.), 804.10.CrossRefGoogle Scholar
56. Samimi, M, Asemi, Z, Taghizadeh, M, et al. Concentrations of serum zinc, hemoglobin and ferritin among pregnant women and their effects on birth outcomes in Kashan, Iran. Oman Med J. 2012; 27, 40–45.CrossRefGoogle ScholarPubMed
57. Abeysena, C, Jayawardana, P, Seneviratne, RDA. Maternal haemoglobin level at booking visit and its effect on adverse pregnancy outcome. Aust N Z J Obstet Gynaecol. 2010; 50, 423–427.Google Scholar
58. Masukume, G, Khashan, AS, Kenny, LC, Baker, PN, Nelson, G. Risk factors and birth outcomes of anaemia in early pregnancy in a nulliparous cohort. PLoS ONE. 2015; 10. Retrieved 2 June 2015, from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4398319/.CrossRefGoogle Scholar
59. Pisa, PT, Landais, E, Margetts, B, et al. Inventory on the dietary assessment tools available and needed in Africa: a prerequisite for setting up a common methodological research infrastructure for nutritional surveillance, research and prevention of diet-related non-communicable diseases. Crit Rev Food Sci Nutr. 2014; 17–19 [Epub ahead of print].Google Scholar
60. Johnson, RK, Soultanakis, RP, Matthews, DE. Literacy and body fatness are associated with underreporting of energy intake in US low-income women using the multiple-pass 24-hour recall: a doubly labeled water study. J Am Diet Assoc. 1998; 98, 1136–1140.Google Scholar
61. Thompson, FE, Subar, AF, Loria, CM, Reedy, JL, Baranowski, T. Need for technological innovation in dietary assessment. J Am Diet Assoc. 2010; 110, 48–51.CrossRefGoogle ScholarPubMed
62. Wrieden, W, Peace, H, Armstrong, J, Barton, K. A short review of dietary assessment methods used in National and Scottish Research Studies, 2003. Retrieved from 1 June 2015 http://www.food.gov.uk/sites/default/files/multimedia/pdfs/scotdietassessmethods.pdf.Google Scholar
63. Imdad, A, Bhutta, ZA. Maternal nutrition and birth outcomes: effect of balanced protein-energy supplementation. Paediatr Perinat Epidemiol. 2012; 26(Suppl. 1), 178–190.Google Scholar
64. Ramakrishnan, U, Grant, FK, Goldenberg, T, et al. Effect of multiple micronutrient supplementation on pregnancy and infant outcomes: a systematic review. Paediatr Perinat Epidemiol. 2012; 26(Suppl. 1), 153–167.Google Scholar
65. Imdad, A, Bhutta, ZA. Routine iron/folate supplementation during pregnancy: effect on maternal anaemia and birth outcomes. Paediatr Perinat Epidemiol. 2012; 26, 168–177.Google Scholar
66. Dupont, C. Protein requirements during the first year of life. Am J Clin Nutr. 2003; 77, 1544S–1549S.CrossRefGoogle ScholarPubMed
67. Greenberg, JA, Bell, SJ, Ausdal, WV. Omega-3 fatty acid supplementation during pregnancy. Rev Obstet Gynecol. 2008; 1, 162–169.Google Scholar
68. Scholl, TO. Iron status during pregnancy: setting the stage for mother and infant. Am J Clin Nutr. 2005; 81, 1218S–1222S.Google Scholar
69. Scholl, TO, Johnson, WG. Folic acid: influence on the outcome of pregnancy. Am J Clin Nutr. 2000; 71(Suppl.), 1295S–1303S.CrossRefGoogle ScholarPubMed
70. Saigal, S, Doyle, LW. An overview of mortality and sequelae of preterm birth from infancy to adulthood. The Lancet. 2008; 371, 261–269.CrossRefGoogle ScholarPubMed
71. Ergaz, Z, Avgil, M, Ornoy, A. Intrauterine growth restriction – etiology and consequences: what do we know about the human situation and experimental animal models? Reprod Toxicol. 2005; 20, 301–322.CrossRefGoogle ScholarPubMed
72. Vorster, HH, Kruger, A, Margetts, BM. The nutrition transition in Africa: can it be steered into a more positive direction? Nutrients. 2011; 3, 429–441.Google Scholar
73. Mokhtar, N, Elati, J, Chabir, R, et al. Diet culture and obesity in Northern Africa. J Nutr. 2001; 131, 887S–892S.Google Scholar
74. Gillman, MW, Ludwig, DS. How early should obesity prevention start? N Engl J Med. 2013; 369, 2173–2175.Google Scholar
75. Bhutta, ZA, Das, JK, Rizvi, A, et al. Evidence-based interventions for improvement of maternal and child nutrition: what can be done and at what cost? The Lancet. 2013; 382, 452–477.CrossRefGoogle ScholarPubMed
76. Ruel, MT, Alderman, H. Nutrition-sensitive interventions and programmes: how can they help to accelerate progress in improving maternal and child nutrition? The Lancet. 2013; 382, 536–551.Google Scholar