Maternal nutrition, pregnancy outcome and public health policy.
Year: 1998
Type: article
Abstract: How important is maternal nutrition in determining the outcome of pregnancy? “Very important,” most lay persons, prenatal care providers and public health policy-makers would reply. But a careful examination of the available evidence does not strongly support such an answer, at least not in industrialized countries such as Canada. Before I review the evidence, it is essential to specify what is meant by both “maternal nutrition” and “pregnancy outcome.” Maternal nutrition comprises anthropometric factors such as pre-pregnancy weight-for-height (i.e., body mass index [BMI]) and gestational weight gain (which partly reflects the balance between energy intake and energy expenditure, but also includes increases in body water), as well as intake of protein and micronutrients (vitamins and minerals). Of the pregnancy outcomes that might be affected by maternal nutrition, the one encountered most often in the research literature is low birth weight, that is, a birth weight less than 2500 g. Low birth weight is a concept developed and promulgated by epidemiologists and public health practitioners. As far as I can tell, its popularity can be attributed to 2 facts: infant mortality (particularly neonatal mortality) increases exponentially at birth weights below 2500 g, 1 and birth weight (and hence low birth weight) can be measured with excellent validity and precision. Thus, countries or regions where all newborn infants are weighed can be compared, regardless of the availability or validity of gestational age estimates and regardless of whether infant deaths are completely ascertained. From a clinical, etiologic or prognostic perspective, however, low birth weight is not a very useful outcome. Birth weight is a function of 2 factors: duration of gestation and rate of fetal growth. Thus, the weight of newborns can be low either because they are born early (preterm birth) or because they are small for their gestational age or both. 2
Source: Europe PMC (PubMed Central)
Author: M S Kramer
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W2141050761