Maternal infection, malnutrition, and low birth weight

MP Roy 
 Department of Pediatrics, Safdarjung Hospital, New Delhi, India

Correspondence Address:
M P Roy
Department of Pediatrics, Safdarjung Hospital, New Delhi
India

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The article by Borah on low birth weight (LBW) reemphasized the need of strengthening antenatal care for better delivery outcomes.[1] This is important as India alone is responsible for 40% of the LBW born in developing world.[2] Although the study took care of maternal anemia and weight gain as indicator for maternal nutrition, further discussion may be added on this important determinant of LBW, particularly in Indian context.

Apart from prematurity, intrauterine growth retardation (IUGR) may also result in LBW. This growth retardation has two strong predictors - maternal infection and low nutrient consumption. Infection not only reduces appetite and dietary intake but affects maternal absorption of nutrient as well. There may be metabolic stress, resulting in higher requirement of nutrients. On the other hand, maternal energy and protein intake, when compromised, can precipitate in IUGR.[3] An underweight mother has 30% higher risk of delivering a LBW baby than her well-nourished counterpart.[4] Fact, most of the fetal weight gain occurs during the last trimester. However, the influences of nutrients are not limited to the second or third trimester. Animal studies highlighted that inadequate diet around peri-implantation stage affect fetal growth to a crucial extent.[5] Thus, infection and malnutrition complement each other to sustain a vicious cycle in pregnancy, leading to poor obstetric outcomes including LBW. Therefore, all we need is a continuum of care during periconceptional period, pregnancy, and lactation periods to ensure the best outcome and newborn health.

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Conflicts of interest

There are no conflicts of interest.

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