Indmedica Home | About Indmedica | Medical Jobs | Advertise On Indmedica
Search Indmedica Web
Indmedica - India's premier medical portal

Indian Journal of Community Medicine

Effect of maternal nutritional status on the birth weight among women of tea tribe in Dibrugarh district

Author(s): Gogoi Gourangie, Ahmed FU

Vol. 32, No. 2 (2007-04 - 2007-06)

ORIGINAL ARTICLE

Year : 2007 | Volume : 32 | Issue : 2 | Page : 120-122

Effect of maternal nutritional status on the birth weight among women of tea tribe in Dibrugarh district

Gogoi Gourangie, Ahmed FU
Department of Community Medicine, Assam Medical College and Hospital, Dibrugarh, Assam, India
Date of Submission 05-Sep-2004

Correspondence Address:
Gogoi Gourangie
Department of Community Medicine, Assam Medical College and Hospital, Dibrugarh - 786002
India

Source of Support: None, Conflict of Interest: None
Keywords: Anthropometry, birth weight, nutritional status, pregnancy
How to cite this article:
Gogoi G, Ahmed FU. Effect of maternal nutritional status on the birth weight among women of tea tribe in Dibrugarh district. Indian J Community Med 2007;32:120-2
How to cite this URL:
Gogoi G, Ahmed FU. Effect of maternal nutritional status on the birth weight among women of tea tribe in Dibrugarh district. Indian J Community Med [serial online] 2007 [cited 2007 Nov 30];32:120-2. Available from: http://www.ijcm.org.in/text.asp?2007/32/2/120/35649

Abstract

Research Question: What is the influence of maternal nutritional status during pregnancy on the birth weight? Objective: To assess the effect of maternal nutritional status during pregnancy on the birth weight of the baby among tea tribe women in Dibrugarh district. Study Design: Field-based cohort study. Setting: Five tea estates in Dibrugarh District, Assam. Period of Study: One year (April 1998 to April 1999). Participants: A cohort of non-pregnant currently married tea garden women of reproductive age group (15-44 years) from similar socio-economic background. Materials and Methods: Oral questionnaire for age, family structure, obstetric history, annual income, and period of gestation. Anthropometric measurements of weight and height were recorded using bathroom scales and the anthropometric rod. Measurements of weight were repeated during the first, second, and third trimesters of pregnancy. Birth weight of the baby was recorded at delivery, irrespective of the period of gestation and mode of delivery. Statistical Analysis: Correlation co-efficient, standard deviation, and regression analysis. Results and Conclusions: Of all, 88% mothers had pre-pregnant weight of <45 kg, and 61% babies had birth weight <2500 gm. Subjects with better pre-pregnant weight had corresponding favorable total weight gain, resulting in better birth weight of the babies. Pre-pregnant weight had direct positive linear relationship with the birth weight. There is a need to improve the nutritional status of the adolescent girl in order to build up her pre-pregnant weight for a favorable birth weight.

In any community, the mother and the child have always been considered as one unit-be it biologically, socially, or culturally. The biological support that the mother gives to the child during its growth and development through pregnancy and lactation, in turn, depends on her own nutritional status. In India, women in the reproductive age group of 15-44 years comprise 20%-22% of the total population.[1] The health status of this group invariably determines the health status of the generations to come, which in turn determines the health of the entire community.

One common outcome of poor maternal nutrition is low birth weight.[2] It is also observed that infants with low birth weight are at increased susceptibility to morbidity and mortality.[3] Maternal weight gain during pregnancy, which is necessary to ensure favorable birth weight, among women of low pre-pregnant weight may be unrealistic for a developing country like India. With this backdrop, a study was conducted among the tea tribe population of Dibrugarh district to find out the relationship between maternal nutritional status and birth weight.

Materials and Methods

This study was conducted in five tea estates of Dibrugarh district in Assam involving 450 non-pregnant currently married women belonging to the reproductive age group. Of the 450 subjects, 120 subjects conceived in the course of the study and were followed-up as the study cohort. A pre-tested oral questionnaire was used to determine the family structure, socio-economic class, and the status of the fertility cycle of the study subjects.

Anthropometric rod and bathroom scale were used to record the weight and height of the individuals. Both these instruments were calibrated periodically by the Department of Weights and Measurements, Government of Assam. The body mass index (BMI) was calculated by using the weight and the height measurements. The weight measurements were repeated during the first, second, and third trimesters of pregnancy. The total weight gain for individual study subjects was calculated toward the end of the third trimester.

The outcome measurement of birth weight was recorded just after delivery, irrespective of the period of gestation. For the infants, the weight was measured to the nearest 100 gm by using an infant weighing machine.

A general linear regression model was fitted for birth weight as dependent variable and BMI, age, height, hemoglobin (Hb%), pre-pregnant weight, and third trimester weight as predictor variables

Results

Of all, 12.5% of the primipara belonged to the age group of <18 years and none were above 30 years. Of all, 72% of the pregnancy occurred in the age group of 20-30 years [Table - 1].

The study subjects were from the tea garden laborer population; majority (57%) of them belonged to the upper-lower socioeconomic class.

About 20% of the subjects had their pre-pregnant weight below 40 kg. The tea garden population of Assam is mostly short statured, with 35% having a height of <145 cm.

The total maternal weight gain varied from as low as 6.5 kg to as high as 11 kg among various subjects. Majority of women, irrespective of parity status, gained considerable weight during pregnancy. However, it was observed that better pre-pregnant weight lead to a better total weight gain [Table - 4].

The outcome variable, birth weight of the newborn infant, ranged from as low as 2000 gm to 3200 gm. However, majority (60.87%) were <2500 gm [Table - 2].

Analysis showed that in both primipara and multipara samples [Table - 3] better pre-pregnant weight led to a better total maternal weight gain, finally resulting in a favorable birth weight as the outcome [Figure - 1]a and b.

Regression analysis

From the regression results, it was observed that the BMI had the highest contribution towards birth weight, followed by age, and lastly, the third trimester weight. Other variables had negligible contribution toward birth weight. As the BMI includes pre-pregnant weight and height, these two variables did not show independent contributions in the regression model. However, the combination of these two variables had the highest significant contribution toward birth weight.

The regression model for this purpose can be best expressed as follows:

Birth weight = bo . BMI + b1. Age + b2 . Third trimester weight

Thus, applying the above model, birth weight can be predicted using the variables BMI, age, and third trimester weight; using these three variables, approximately 76% of the total variation in birth weight can be best explained.

Discussions

The unfortunate nutritional situation prevalent in many developing countries reflect the effects of maternal under-nutritional level on the outcome of pregnancy.[4] One measurable indicator of nutritional status is anthropometry, and that of pregnancy outcome, is birth weight.[5] This study showed positive linear relationship between both the study and the outcome variables.

Association between maternal BMI and birth weight showed that as the BMI increased the outcome variable birth weight also increased (p significant, γ 0.89).

The maternal weight gain is a variable that has been associated with birth weight in both epidemiologic and intervention studies in populations in developing countries.[6] In the present study, direct positive linear relationship was obtained between total gestational weight gain and birth weight.

The present study clearly reflects the association between maternal nutritional status and the pregnancy outcome. Thus, there is a need to improve the health of adolescent girls in order to confirm that they do not enter pregnancy in a nutritionally disadvantaged state. Only then, the pregnancy outcome (i.e., birth weight) will be favorable, which in turn will decrease the overall infant morbidity and mortality.

References

1. Park K. Text book of preventive and social medicine. 15 th ed. M/s Banarsidas Bhanot Publishers: Jabalpur, India; 2001.
2. Krasovec K, Anderson MA. Maternal anthropometry for prediction of pregnancy outcome. Memorandum from USAID/WHO/PAHO/ Mother Care Meeting; 1991.
3. Winikoff B, Debrovner CH. Anthropometric determinants of birth weight. J Obstet Gynaecol 1981;58:678-84.
4. Jellife DB. Assessment of the nutritional status of the community. WHO Monograph: 1966. p. 53.
5. Kramer MS. Determinants of low birth weight, methodological assessment and meta analysis. WHO Bull 1987;65:663-737.
6. Gopalan C. Effect of nutrition on pregnancy and lactation. WHO Bull 1962;26:203-11.

Figures

(Please click on image for larger view)

Figure 1a: Birth weight vs. total weight gain (Primipara) 1b: Birth weight vs. total weight gain (Multipara)

Figures 1a and 1b

Tables

Table 1: Profile of study subjects

Table 1: Profile of study subjects

Table 2: Birth weight

Table 2: Birth weight

Table 3: Association between study and outcome variables

Table 4: Maternal weight gain and birth weight

Table 4: Maternal weight gain and birth weight

Table 4: Maternal weight gain and birth weight

Access free medical resources from Wiley-Blackwell now!

About Indmedica - Conditions of Usage - Advertise On Indmedica - Contact Us

Copyright © 2005 Indmedica