| Popis: |
The prevalence and severity of chronic energy deficiency (CED) among women of reproductive age as well as its consequences on the newborn and the mother were assessed in a longitudinal study. More than 40% of the mothers had a Body Mass Index (BMI) less than 18.5 before pregnancy, a level below which CED is considered to exist. Weight gain during pregnancy was low, on average 6.6 kg. Taking the difference between 4 week postpartum weight and pre-pregnant weight as net weight gain during pregnancy, mothers with a BMI less than 18.5 before pregnancy gained weight while those with a higher BMI lost weight. This observation suggests that the partitioning of energy to the fetus and the mother depends on the energy reserves of the mother before pregnancy. The functional significance of BMI as an indicator of CED is illustrated by its relation with birth weight. Similarly, 4 week postpartum, weight and BMI were predictive for the weight changes in the mother in the first 12 months after delivery. The groups with the lowest values gained weight, while the heaviest mothers lost weight. In view of the negative effects of CED among women of reproductive age on the infant and the mother, maternal undernutrition should receive the same attention as malnutrition among preschool children.Between late 1982 and late 1985 and early 1987 and late 1989, health workers collected anthropometric and caloric intake data on 1032 women living in a rural village on the island of Madura, East Java, Indonesia, to determine the prevalence and severity of chronic energy deficiency and the effect reproduction had on their nutritional status. These women had 2013 single births. 41.3% of all women suffered from chronic energy deficiency, defined as a body mass index (BMI) less than 18.5. Further, 2.6% of all women had severe chronic energy deficiency. This indicated that these women had suffered malnutrition during childhood. 31.6% of the women weighed less than 41 kg before pregnancy. 80% of these women had chronic energy deficiency. Caloric intake during pregnancy averaged 1550 kcal/day. Pregnancy women ate a mean of 42 g of protein/day. Their physical activity level was low. Mean total weight gained during pregnancy was a low 6.6 kg. Pregnant women used fat reserves during pregnancy, as indicated by lower upper aim circumferences and skinfold thicknesses (in 75% of cases) at the end of pregnancy compared to the first trimester. Women who weighted the least before pregnancy (35-45 kg) gained weight (0.9-2.8 kg) during pregnancy, while those weighing at least 45 kg before pregnancy lost weight (0.3-0.6 kg). There was a very significant positive trend in mean birth weight with prepregnant weight and BMI. For example, the mean birth weight for infants of mothers whose BMI was less than 16 was 2740 g, and 3044 g for =or 18.5 BMI. Thus, the tiniest women built up fat reserves during pregnancy at the expense of fetal growth. Postpartum women consumed just 200 kcal more during lactation than they did during pregnancy. Women who weighed less than 35 kg and had a low BMI at 4 weeks postpartum gained weight over the 12 months postpartum while those who weighed the most lost weight. These findings stress the need to put as much emphasis on maternal undernutrition as there is on malnutrition among preschoolers. |
