Effect of morbidity during pregnancy on birth weight in a rural guatemalan population

Abstract

The high prevalence of low birth weight (≤ 2.5 Kg) babies is a major public health problem in many poor communities. Studies in humans suggest that malnutrition during pregnancy is an important factor in accounting for this problem, but almost no information is available about the effect of common maternal diseases during pregnancy. This paper reports the effects of maternal morbidity during pregnancy on birth weight in four rural villages of Guatemala. Maternal morbidity, assessed through fortnightly interviews during pregnancy, showed a consistent inverse association with birth weight (r = —0.149, n = 344, p<0.01). In each village, the proportion of low birth weight babies born to mothers who were ill more than 10 percent of their pregnancy was consistently higher than the proportion of babies born to mothers who were sick 10 percent (or less) of their pregnancy (p<0.01). The relationship between the proportion of time ill and birth weight was basically unchanged (r = —0.182, n = 334, p<0.01) after controlling for maternal height, head circumference, parity, gestational age, socioeconomic status, home energy intake, energy supplementation during pregnancy and number of days surveyed during pregnancy. Moreover, a similar association was found in consecutive pregnancies of the same mother (r = —0.197, n = 50, p = 0.16). It was concluded that maternal morbidity during pregnancy caused a decrease in birth weight.

In addition, an inverse association was observed between the proportion of time ill during pregnancy and home energy intake (r = —0.254, n = 334, p<0.01). However, the amount of birth weight variance explained by morbidity during pregnancy did not decrease significantly after statistically controlling for home energy intake. Therefore, either the diet measurement is imprecise or the decrease in energy intake observed during illness was not an important mechanism.