Nutrition and Maternal Survival in Low and Middle Income Countries

Abstract

Maternal mortality has declined globally but continues to be high in regions where maternal nutrition is poor. The specific role of nutrition in affecting maternal health and survival has received some attention, and nutrition interventions have proven to be effective against some causes of maternal mortality. Calcium supplementation during pregnancy, in populations with dietary deficiency, has been shown to reduce the risk of preeclampsia and is a context-specific recommendation by the World Health Organization (WHO). However, the recommended daily dose of 1.5-2.0 g is high, creating challenges for the implementation of large-scale distribution. Severe anemia is likely to increase the risk of cardiac shock related to postpartum hemorrhage, but its causal link to mortality remains unclear. Antenatal iron supplementation, also recommended by WHO, when done adequately, can bring about improvements in hemoglobin concentrations and reduce anemia, but programmatic success is low in many high-burden settings. Maternal night blindness due to vitamin A deficiency may be associated with an increased risk of maternal deaths, but the evidence from three vitamin A supplementation trials does not support universal antenatal use, except in high-burden vitamin A-deficient settings. Adolescent pregnancies and maternal short stature are risk factors for dysfunctional labor; prevention of premature pregnancy and nutrition support for adolescents could lead to improved attained adult height. Nutrition care through antenatal care and other platforms that are able to achieve high coverage may be an effective means for impacting maternal health and survival in undernourished populations of the world, where the burden of maternal mortality is high. © Springer International Publishing AG, part of Springer Nature 2018. Humana Press, a part of Springer Science+ Business Media, LLC.