Publication:

Nutrition-risk pregnancies and its association with birth outcomes: findings from a community-based intervention in India

Background The intervention is a part of a maternal and child nutrition project, operational in three districts of West Bengal, India. The current paper focuses on the identification of “nutrition risk pregnancies” at the community level and to determine the associations of the risk factors with birth outcomes like low-birth weight and pre-term birth.

Methods A cohort of 468 pregnant women attending antenatal clinics in their 1st trimester were identified from 74 sub-health centers from 3 diversified blocks of West Bengal, India. Five key intervention strategies were followed in order to achieve desired pregnancy weight gain birth outcomes, like low-birth weight, pre-term birth was analyzed in relation to “nutrition risk pregnancies”.

Results About 22.2% of the pregnant women in severe thin body mass index (BMI) categories gave birth to low-birth weight children and about 33.3% had pre-term deliveries compared to pregnant women with normal BMI with 16.8% and 18.8% low-birth and pre-term deliveries respectively. Among the nutrition risk factors, 1st weight at the time of pregnancy registration (95% CI, p=0.04), gestational weight gain (95% CI, p=0.002), were significantly associated with low-birth weight children. Gestational weight gain was also significantly associated with pre-term births (95% CI, p=0.009).

Conclusions Gestational weight gain beyond or less than recommended range may pre-dispose to low-birth weight and pre-term births. Since this factor could be managed through the existing, public health service delivery systems and family-based inputs, efforts should be geared towards identifying the risk factors and working towards appropriate weight gain.