Levels and correlates of maternal nutritional status in urban Bangladesh

Abstract

Objective: To determine the levels and correlates of maternal nutritional status.

Design: Cross-sectional maternal weight, height, and mid-upper arm circumference (MUAC) data were correlated with sociodemographic data.

Setting: Slums of Dhaka, Bangladesh.

Subjects: Weight, height and MUAC were collected from a representative sample of 2417 nonpregnant mothers. Socioeconomic data such as age, education, religion and household economic status was collected from 2048 mothers; data on reproductive experiences such as number of pregnancies and number of children born alive now dead was available from 1314 mothers; and both sets of data from 1185 mothers.

Methods: Using weight, height, MUAC and body mass index (BMI) data, the levels of maternal nutritional status were estimated. Bivariate and multivariate relationships of maternal nutritional status with socioeconomic and reproductive experiences variables were examined.

Results: Mothers' mean weight, height, MUAC and BMI were 41.8 kg, 148.8 cm, 232.5 mm, and 18.8 respectively. In multivariate regression analyses, mothers' weight, BMI and MUAC were significantly positively correlated with mothers' years of schooling (P < 0.05) and household economic status (P < 0.01). Mothers' height was significantly positively correlated with years of schooling (P < 0.05), but not with household economic status. Maternal height and weight were significantly negatively correlated with number of child deaths (P < 0.05).

Conclusions: The findings suggest a possible inter-generational effect; thus, improvement of the nutritional status of girls of this generation would improve child survival in the next generation. This, however, will require complex and long-term planning. As an interim measure, shorter mothers should be targeted for appropriate antenatal and obstetric services.

PIP: Researchers analyzed anthropometric data from 2417 nonpregnant mothers, socioeconomic data from 2048 mothers, reproductive history data from 1314 mothers, and socioeconomic and reproductive history data from 1185 mothers to determine the levels and correlates of maternal nutritional status of nonpregnant mothers in the slums of Dhaka, Bangladesh. Mean weight, height, middle-upper-arm-circumference (MUAC), and body mass index (BMI) of the 2417 mothers stood at 41.8 kg, 148.8 cm, 232.5 mm, and 18.8, respectively. Multivariate regression analyses revealed that mothers' schooling and household economic status had a significant positive effect on weight, MUAC, and BMI (p .05 and .01, respectively). Schooling had a significant positive association with mothers' height (p .05), but household economic status did not. Maternal height and weight had a significant negative association with child death (p .001 and .05, respectively). Mothers equal to or less than 155 cm had an increased risk of child death (odds ratio [OR] = 1.4-2.64), with those less than 140 cm in height having the greatest risk of child death (OR = 2.64). Short stature linked to child loss indicates a possible intergenerational influence of poor childhood nutrition, suggesting that improvement of nutritional status for girls would improve child health in the next generation. Sophisticated and long-term planning is needed, however, to achieve improved nutritional status of girls due to various obstacles (e.g., son preference, poverty, food scarcity, and high prevalence of infectious diseases). In the meantime, maternal and child health workers should target shorter mothers (i.e., 145 cm) for appropriate prenatal and obstetric care, since they face the greatest risk of child death.