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. 2021 Dec;155(3):380-397.
doi: 10.1002/ijgo.13940.

Population estimates and determinants of severe maternal thinness in India

Tashi Choedon  1 , Vani Sethi  2 , Ranadip Chowdhury  3 , Neena Bhatia  4 , Konsam Dinachandra  5 , Zivai Murira  6 , Arti Bhanot  5 , Dinesh Baswal  7 , Arjan de Wagt  2 , Madhavi Bhargava  8 , Indrapal Ishwarji Meshram  9 , Giridhara R Babu  10 , Bharati Kulkarni  9 , Hema Divakar  11 , Chandni Maria Jacob  12   13 , Sarah Louise Killeen  14 , Fionnuala McAuliffe  14 , Ruby Alambusha  1 , William Joe  1 , Mark Hanson  12   13
Affiliations

Population estimates and determinants of severe maternal thinness in India

Tashi Choedon et al. Int J Gynaecol Obstet. 2021 Dec.

Abstract

Objective: To examine prevalence, risk factors, and consequences of maternal severe thinness in India.

Methods: This mixed methods study analyzed data from the Indian National Family Health Survey (NFHS)-4 (2015-2016) to estimate the prevalence of and risk factors for severe thinness, followed by a desk review of literature from India.

Results: Prevalence of severe thinness (defined by World Health Organization as body mass index [BMI] <16 in adult and BMI for age Z score < -2 SD in adolescents) was higher among pregnant adolescents (4.3%) compared with pregnant adult women (1.9%) and among postpartum adolescent women (6.3%) than postpartum adult women (2.4%) 2-6 months after delivery. Identified research studies showed prevalence of 4%-12% in pregnant women. Only 13/640 districts had at least three cases of severely thin pregnant women; others had lower numbers. Three or more postpartum women aged ≥20 years were severely thin in 32 districts. Among pregnant adolescents, earlier parity increased odds (OR 1.96; 95% CI, 1.18-3.27) of severe thinness. Access to household toilet facility reduced odds (OR 0.72; 95% CI, 0.52-0.99]. Among mothers aged ≥20 years, increasing education level was associated with decreasing odds of severe thinness (secondary: OR 0.74; 95% CI, 0.57-0.96 and Higher: OR 0.54; 95% CI, 0.32-0.91, compared with no education); household wealth and caste were also associated with severe thinness.

Conclusion: This paper reveals the geographic pockets that need priority focus for managing severe thinness among pregnant women and mothers in India to limit the immediate and intergenerational adverse consequences emanating from these deprivations.

Keywords: India; consequences of severe thinness; postpartum; pregnancy; prevalence; risk factors for severe thinness; severe thinness.

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Conflict of interest statement

The authors have no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Sampling flow chart for pregnant women (<20 weeks of gestation) and mothers in the postpartum period (2–6 months), National Family Health Survey‐4 (2015–2016)
FIGURE 2
FIGURE 2
Distribution by district of 103 severely thin (body mass index for age Z score < –2 SD) pregnant adolescents, India, National Family Health Survey‐4
FIGURE 3
FIGURE 3
Distribution by district of 296 severely thin (body mass index <16) pregnant women, India, National Family Health Survey‐4
FIGURE 4
FIGURE 4
Distribution by district of 101 severely thin (body mass index for age Z score < –2 SD) adolescent mothers, India, National Family Health Survey‐4. Body mass index for age Z score –2 SD instead of –3 SD was used as the cut‐off for severe thinness among pregnant adolescents, as described in the methods
FIGURE 5
FIGURE 5
Distribution by district of 2486 severely thin (body mass index <16) mothers aged ≥20 years, India, National Family Health Survey‐4
See this image and copyright information in PMC

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