Locks Lindsey M, Patel Archana, Katz Elizabeth, Simmons Elizabeth, Hibberd Patricia
Department of Health Sciences, College of Health and Rehabilitation Sciences: Sargent College, Boston University, Boston, Massachusetts, USA.
Department of Global Health, School of Public Health, Boston University, Boston, Massachusetts, USA.
Matern Child Nutr. 2021 Apr;17(2):e13087. doi: 10.1111/mcn.13087. Epub 2020 Oct 1.
Few studies have assessed whether women and infants in rural and peri-urban communities in South Asia experience seasonal fluctuations in nutritional status; however, a handful of studies have documented seasonal variability in risk factors for undernutrition including food availability, physical activity and infections. We used data from the Maternal and Newborn Health (MNH) registry, a population-based pregnancy and birth registry in Eastern Maharashtra, India, to analyse seasonal trends in birthweight and maternal nutritional status-body mass index (BMI) and haemoglobin-in the first trimester of pregnancy. We plotted monthly and seasonal trends in birthweight, and maternal BMI and haemoglobin, and used multivariable regression models to identify seasonal and maternal characteristics that predicted each outcome. Between October 2014 and January 2018, MNH included 29,253 livebirths with recorded birthweight. BMI was assessed in 15,252 women less than 12 weeks of gestation and haemoglobin in 18,278 women less than 13 weeks of gestation. Maternal characteristics (age, education, parity and height) were significantly associated with nutritional status; however, there were minimal seasonal fluctuations in birthweight or maternal nutrition. There were significant secular trends in maternal haemoglobin; between 2014 and 2018, the prevalence of maternal anaemia decreased from 91% to 79% and moderate or severe anaemia from 53% to 37%. The prevalence of maternal underweight (45.3%) and overweight (9.8%) and low birthweight (19.1%) remained relatively constant over the study period. Our findings highlight that in some rural and peri-urban areas in South Asia, tackling systemic drivers of malnutrition may be more effective than targeted interventions based on season.
很少有研究评估南亚农村和城市周边社区的妇女和婴儿营养状况是否存在季节性波动；然而，有少数研究记录了包括食物供应、身体活动和感染在内的营养不良风险因素的季节性变化。我们使用了印度马哈拉施特拉邦东部基于人群的孕产妇和新生儿健康（MNH）登记处的数据，该登记处记录了怀孕和分娩情况，来分析妊娠早期出生体重以及孕产妇营养状况——体重指数（BMI）和血红蛋白——的季节性趋势。我们绘制了出生体重、孕产妇BMI和血红蛋白的月度和季节性趋势图，并使用多变量回归模型来确定预测每个结果的季节性和孕产妇特征。在2014年10月至2018年1月期间，MNH登记了29253例有记录出生体重的活产。对15252名妊娠少于12周的妇女进行了BMI评估，对18278名妊娠少于13周的妇女进行了血红蛋白评估。孕产妇特征（年龄、教育程度、胎次和身高）与营养状况显著相关；然而，出生体重或孕产妇营养状况的季节性波动很小。孕产妇血红蛋白水平存在显著的长期趋势；在2014年至2018年期间，孕产妇贫血患病率从91%降至79%，中度或重度贫血患病率从53%降至37%。在研究期间，孕产妇体重过轻（45.3%）、超重（9.8%）和低出生体重（19.1%）的患病率保持相对稳定。我们的研究结果表明，在南亚的一些农村和城市周边地区，解决营养不良的系统性驱动因素可能比基于季节的针对性干预措施更有效。
