Extremes of maternal anthropometry are associated with adverse pregnancy outcomes, and may influence response to nutritional interventions. Prior to initiating a trial of preconception maternal lipid-based micronutrient supplementation, we examined the prevalence of maternal stunting, underweight (UW), and overweight/obesity (OW/Ob) by country and by age.
At enrollment, anthropometric measures were obtained by trained assessment teams on non-pregnant women aged 15-37 yr in rural areas of Democratic Republic of Congo (1,741), Guatemala (1,695), India (1,823) and Pakistan (2,006). Associations between categorical variables were assessed using a Cochran-Mantel-Haenszel test, controlling for country.
Eighteen percent of women were stunted (height<145 cm), ranging from 3% in DRC to 45% in Guatemala. While 26% of women in DRC had height =160 cm, overall only 12% of women achieved this stature. Overall median maternal BMI was 20.7. Extremes of BMI varied by country with greater than one third of Asian women being UW (BMI<18.5) and half of Guatemalan women being OW/Ob (BMI>25), the only setting in which OW/Ob exceeded UW. BMI was associated with age (p<0.0001). For all countries, adolescents and younger women were more often UW, while older women were more often OW/Ob.
The wide variations in baseline nutritional risk among different countries observed here may have an impact on responses to nutrition supplementation interventions designed to promote fetal growth prior to and during pregnancy.