Maternal nutritional status dictates neonatal outcome

Abstract

Maternal undernutrition, whether it occurs before conception or throughout gestation, may lead to physiological adaptations in the fetus that can contribute to adult cardiovascular and/or metabolic diseases. Anthropometric measurements are better nutritional predictors of pregnancy outcome than is dietary intake and the goal of anthropometric assessment in pregnancy is to provide an estimate of the prevalence and severity of malnutrition. Maternal nutritional status and fetal growth status can be assessed using a combination of anthropometric parameters, namely maternal weight, height, body mass index (BMI) calculated from the height and weight of the mother, feto-placental ratio (F/P ratio), skinfold thickness, mid-arm circumference, abdominal circumference, and fundal height. Measurement of maternal weight gain during pregnancy and maternal pre-pregnancy BMI gives an indication of the short-term and long-term nutritional status of the mothers. Improving pre-pregnancy weight and weight gain during pregnancy are effective strategies to help reduce and prevent the incidence of low birth weight. Anthropometric reference charts are useful for both clinical and epidemiological studies and estimation of reference growth curves has traditionally relied on construction of several quantile curves based on information from samples of the reference populations. Recently, more flexible methods based on nonparametric quantile regression have provided a new approach to estimating reference growth curves and these methods compare favorably with traditional methods. We believe that gestational weight gain appropriate for BMI is one of the most important predictors of neonatal outcome as well for predicting postpartum obesity and related metabolic complications and must therefore be closely monitored as pregnancy advances. Anthropometric nutritional assessment has several public health implications and increased effort should be made by public health agencies to educate health-care providers as well as the general public about the importance of these simple measurements in facilitating a favorable neonatal outcome, particularly in high-risk women who have a moderately high or low pre-pregnancy BMI.