Hostname: page-component-cd9895bd7-gbm5v Total loading time: 0 Render date: 2024-12-23T16:53:17.709Z Has data issue: false hasContentIssue false
  • English
  • Français

Nutrition and maternal morbidity and mortality

Published online by Cambridge University Press:  09 March 2007

Andrew Tomkins
Andrew Tomkins*
Affiliation:
Centre for International Child Health, Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK
*
Corresponding author: Dr Andrew Tomkins, tel +44 20 7905 2123, fax +44 171 404 2062, email [email protected]
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

Nearly 600 000 women die every year from pregnancy related conditions and the maternal mortality rates (MMR = deaths per 100 000 live births) in developing countries may be as high as 1000 compared with less than ten in industrialised countries. In the light of the striking impact of deficiencies of micronutrients such as vitamin A and zinc on immune function, morbidity and mortality in children it seems reasonable to suggest that such deficiencies might play a contributing role in the high rates of morbidity and mortality in mothers. Hitherto, there has been rather little published on the contribution of malnutrition to maternal morbidity or mortality but recent results of micronutrient supplementation show a major effect of vitamin A or beta carotene supplementation on maternal mortality in Nepal and an impressive effect of a multiple micronutrient mixture on pregnancy outcome in Tanzania. There is now data showing that subclinical mastitis, a potential risk factor for mother to child transmission of HIV by increasing levels of virus in breast milk, is influenced by maternal diet in Tanzania and feeding patterns in South Africa. Considering the massive tragedy of maternal mortality the recent data provides opportunities for new, innovative nutritional interventions for the reduction of the global burden of maternal morbidity and mortality.

Keywords

InfectionPregnancyIllnessMicronutrientsHuman Immunodeficiency VirusVitamin A
Type
Research Article
Information
British Journal of Nutrition , Volume 85 , Issue S2 , May 2001 , pp. S93 - S99
Copyright
Copyright © The Nutrition Society 2001

References

Alnwick, DJ (1998) Combating micronutrient deficiencies: problems and perspectives. Proceedings of the Nutrition Society 57, 137–147.CrossRefGoogle ScholarPubMed
Ayhan, A, Bilgin, F, Tuncer, ZS, Tuncer, R, Yanik, A & Kisnisci, HA (1994) Trends in maternal mortality at a university hospital in Turkey. International Journal of Gynecology & Obstetrics 44, 223–228.CrossRefGoogle Scholar
Beck, MA (2000) Nutritionally induced oxidative stress: effect on viral disease. American Journal of Clinical Nutrition 71, 1676S-1681S.CrossRefGoogle ScholarPubMed
Beck, MA & Levander, OA (2000) Host nutritional status and its effect on a viral pathogen. Journal of Infectious Diseases 182, S93-S96.CrossRefGoogle ScholarPubMed
Beesley, R, Filteau, S, Tomkins, A, Doherty, T, Ayles, H, Reid, A, Ellman, T & Parton, S (2000) Impact of acute malaria on plasma concentrations of transferrin receptors. Transactions of the Royal Society of Tropical Medicine and Hygiene 94, 295–298.CrossRefGoogle ScholarPubMed
Brabin, L, Verhoeff, FH, Kazembe, P, Brabin, BJ, Chimsuku, L & Broadhead, R (1998) Improving antenatal care for pregnant adolescents in southern Malawi. Acta Obstetricia et Gynecologica Scandinavica 77, 402–409.CrossRefGoogle ScholarPubMed
Ceesay, SM, Prentice, AM, Cole, TJ, Foord, F, Weaver, LT, Poskitt, EM & Whitehead, RG (1997) Effects on birth weight and perinatal mortality of maternal dietary supplements in rural Gambia: 5 year randomised controlled trial. British Medical Journal 315, 786–790.Google Scholar
Chi, IC, Agoestina, T & Harbin, J (1981) Maternal mortality at twelve teaching hospitals in Indonesia—an epidemiologic analysis. International Journal of Gynecology & Obstetrics 19, 259–266.CrossRefGoogle ScholarPubMed
Christian, P, Schulze, K, Stoltzfus, RJ & West, KP (1998) Hyporetinolemia, illness symptoms, and acute phase protein response in pregnant women with and without night blindness. American Journal of Clinical Nutrition 67, 237–1243.Google Scholar
Christian, P, West, KP, Khatry, SK, Katz, J, LeClerq, SC, Kimbrough-Pradhan, E, Dali, SM & Shrestha, SR (2000 a) Vitamin A or beta-carotene supplementation reduces symptoms of illness in pregnant and lactating Nepali women. Journal of Nutrition 130, 2675–2682.CrossRefGoogle ScholarPubMed
Christian, P, West, KP, Khatry, SK, Kimbrough-Pradhan, E, LeClerq, SC, Katz, J, Shrestha, SR, Dali, SM & Sommer, A (2000 b) Night blindness during pregnancy and subsequent mortality among women in Nepal: effects of vitamin A and beta-carotene supplementation. American Journal of Epidemiology 152, 542–547.CrossRefGoogle ScholarPubMed
Cooreman, BF, Cronje, HS & Grobler, CJ (1989) Maternal deaths at Pelonomi Hospital Bloemfontein, 1980–1985. A survey of 81 consecutive cases. South African Medical Journal 76, 24–26.Google ScholarPubMed
Darling, JC, Filteau, SM, Kitundu, JA, Kingamkono, RR, Msengi, AE & Tomkins, AM (1999) Acute phase proteins as markers of systemic illness in acute diarrhoea. Acta Paediatrica 88, 259–264.CrossRefGoogle ScholarPubMed
de Silva, NR, Kodituwakku, KK, Edirisinghe, SS & de Silva, HJ (1996) Routine use of mebendazole in pregnancy. Ceylon Medical Journal 41, 99–101.Google ScholarPubMed
de Silva, NR, Sirisena, JL, Gunasekera, DP, Ismail, MM & de Silva, HJ (1999) Effect of mebendazole therapy during pregnancy on birth outcome. Lancet 353, 1145–1149.CrossRefGoogle ScholarPubMed
Delange, F (2000) The role of iodine in brain development. Proceedings of the Nutrition Society 59, 75–79.CrossRefGoogle ScholarPubMed
Faisel, H & Pittrof, R (2000) Vitamin A and causes of maternal mortality: association and biological plausibility. Public Health Nutrition 3, 321–327.Google Scholar
Fawzi, WW, Msamanga, GI, Spiegelman, D, Urassa, EJ, McGrath, N, Mwakagile, D, Antelman, G, Mbise, R, Herrera, G, Kapiga, S, Willett, W & Hunter, DJ (1998) Randomised trial of effects of vitamin supplements on pregnancy outcomes and T cell counts in HIV-1-infected women in Tanzania. Lancet 351, 1477–1482.CrossRefGoogle Scholar
Filteau, SM, Lietz, G, Mulokozi, G, Bilotta, S, Henry, CJ & Tomkins, AM (1999) Milk cytokines and subclinical breast inflammation in Tanzanian women: effects of dietary red palm oil or sunflower oil supplementation. Immunology 97, 595–600.Google Scholar
Friis, H, Ndhlovu, P, Kaondera, K, Sandstrom, B, Michaelsen, KF, Vennervald, BJ & Christensen, NO (1996) Serum concentration of micronutrients in relation to schistosomiasis and indicators of infection: a cross-sectional study among rural Zimbabwean schoolchildren. European Journal of Clinical Nutrition 50, 386–391.Google ScholarPubMed
Garner, P, Kramer, MS & Chalmers, I (1992) Might efforts to increase birthweight in undernourished women do more harm than good? Lancet 340, 1021–1023.CrossRefGoogle ScholarPubMed
Goldenberg, RL, Tamura, T, DuBard, M, Johnston, KE, Copper, RL & Neggers, Y (1996) Plasma ferritin and pregnancy outcome. American Journal of Obstetrics & Gynecology 175, 1356–1359.CrossRefGoogle ScholarPubMed
Goodburn, EA, Gazi, R & Chowdhury, M (1995) Beliefs and practices regarding delivery and postpartum maternal morbidity in rural Bangladesh. Studies in Family Planning 26, 22–32.CrossRefGoogle ScholarPubMed
Hakimi, M, Dibley, MJ, Suryono, A, Nurdiati, D, Th, Ninuk SH, Dawiesah, Ismadi S (1999) Impact of vitamin A and zinc supplements on maternal postpartum infections in rural central Java. IVACG Abstracts, Durban.Google Scholar
Hetzel, BS (1989) The Story of Iodine Deficiency an International Challenge to Nutrition. New York: Oxford University Press.Google Scholar
Hickey, MU & Kasonde, JM (1977) Maternal mortality at University Teaching Hospital, Lusaka. Medical Journal of Zambia 11, 74–78.Google Scholar
Hoestermann, CF, Ogbaselassie, G, Wacker, J & Bastert, G (1996) Maternal mortality in the main referral hospital in The Gambia, West Africa. Tropical Medicine and International Health 1, 710–717.CrossRefGoogle ScholarPubMed
Huffman, SL, Baker, J, Shumann, J, ZehnerER, ER, (1998) The case for promoting multiple vitamin/mineral supplements for women of reproductive age in developing countries. pp. 1–40, Linkages, AED, USAID.Google Scholar
Jacobson, RJ (1972) Puerperal folate deficiency resembling tropical sprue. South African Medical Journal 46, 1103.Google ScholarPubMed
Kulier, R, de Onis, M, Gulmezoglu, AM & Villar, J (1998) Nutritional interventions for the prevention of maternal morbidity. International Journal of Gynecology & Obstetrics 63, 231–246.Google Scholar
Lamb, WH, Foord, FA, Lamb, CM & Whitehead, RG (1984) Changes in maternal and child mortality rates in three isolated Gambian villages over ten years. Lancet 2, 912–914.CrossRefGoogle ScholarPubMed
Lankoande, J, Ouedraogo, CM, Ouedraogo, A, Tieba, B, Akotionga, M, Sanou, J & Kone, B (1999) Maternal mortality in adolescents at the university hospital of Ouagadougu. Review Medicales Brussels 1999, 87–89.Google Scholar
Liskin, LS (1992) Maternal morbidity in developing countries: a review and comments. International Journal of Gynecology & Obstetrics 37, 77–87.CrossRefGoogle Scholar
Loudon, I (1987) Puerperal fever, the streptococcus, and the sulphonamides, 1911–1945. British Medical Journal (Clinical Research Edition) 295, 485–490.Google Scholar
Loudon, I (1992) The transformation of maternal mortality. British Medical Journal 305, 1557–1560.CrossRefGoogle ScholarPubMed
Loudon, I (2000) Maternal mortality in the past and its relevance to developing countries today. American Journal of Clinical Nutrition 72 (1 Suppl), 241S-246S.Google Scholar
Maine, D (2000) Role of nutrition in the prevention of toxemia. American Journal of Clinical Nutrition 72 (1 Suppl), 298S-300S.CrossRefGoogle ScholarPubMed
McDermott, JM, Slutsker, L, Steketee, RW, Wirima, JJ, Breman, JG & Heymann, DL (1996) Prospective assessment of mortality among a cohort of pregnant women in rural Malawi. American Journal of Tropical Medicine and Hygiene 55 (1 Suppl), 66–70.CrossRefGoogle ScholarPubMed
Moodley, D, Payne, AJ & Moodley, J (1996) Maternal mortality in Kwazulu/Natal: need for an information database system and confidential enquiry into maternal deaths in developing countries. Tropical Doctors 26, 1–5.Google ScholarPubMed
Moshal, MG, Hift, W, Kallichurum, S & Pillay, K (1973) Malabsorption and its causes in Natal. South African Medical Journal 47, 1093–1103.Google ScholarPubMed
Ransjo-Arvidson, AB, Chintu, K, Ng'andu, N, Eriksson, B, Susu, B, Christensson, K & Diwan, VK (1998) Maternal and infant health problems after normal childbirth: a randomised controlled study in Zambia. Journal of Epidemiology and Community Health 52, 385–391.Google Scholar
Ronsmans, C, Vanneste, AM, Chakraborty, J & Van, Ginneken J (1998) A comparison of three verbal autopsy methods to ascertain levels and causes of maternal deaths in Matlab, Bangladesh. International Journal of Epidemiology 27, 660–666.CrossRefGoogle ScholarPubMed
Ronsmans, C, Vanneste, AM, Chakraborty, J & Van, Ginneken J (1997) Decline in maternal mortality in Matlab, Bangladesh: a cautionary tale. Lancet 350, 1810–1814.CrossRefGoogle ScholarPubMed
Roy, SK, Haider, R, Tomkins, AM & Behrens, R (1989) Effect of systemic infection on intestinal permeability in Bangladeshi children with persistent diarrhea In Malnutrition in Chronic Diet-Associated Infantile Diarrhoea, 385–389. New York: Academic Press.Google Scholar
Roy, SK, Tomkins, AM, Akramuzzaman, SM, Behrens, RH, Haider, R, Mahalanabis, D & Fuchs, G (1997) Randomised controlled trial of zinc supplementation in malnourished Bangladeshi children with acute diarrhoea. Archives of Diseases of Childhood 77, 196–200.CrossRefGoogle ScholarPubMed
Rush, D (2000) Nutrition and maternal mortality in the developing world. American Journal of Clinical Nutrition 72 (1 Suppl), 212S-240S.CrossRefGoogle ScholarPubMed
Semba, RD (1999) Vitamin A as ‘anti-infective’ therapy 1920–1940. Journal of Nutrition 129, 783–791.CrossRefGoogle ScholarPubMed
Stein, Z, Susser, M & Rush, D (1978) Prenatal nutrition and birth weight: experiments and quasi-experiments in the past decade. Journal of Reproductive Medicine 21, 287–299.Google ScholarPubMed
Tomkins, A & Watson, F (1989) Malnutrition and Infection: A Review (United Nations Administrative Committee on Coordination/Subcommittee on Nutrition, WHO, Geneva.Google Scholar
van Coeverden, de Groot HA (1979) Trends in maternal mortality in Cape Town. South African Medical Journal 1953–1977 56, 547–552.Google Scholar
Wang, Y & Walsh, SW (1996) Antioxidant activities and mRNA expression of superoxide dismutase, catalase, and glutathione peroxidase in normal and preeclamptic placentas. Journal of the Society for Gynecological Investigations 3, 179–184.CrossRefGoogle ScholarPubMed
Waterlow, JC, Tomkins, AM & Grantham-Mcgregor, SM (1992) Protein Energy Malnutrition. London: Edward Arnold.Google Scholar
West, KP, Katz, J, Khatry, SK, LeClerq, SC, Pradhan, EK, Shrestha, SR, Connor, PB, Dali, SM, Christian, P, Pokhrel, RP & Sommer, A (1999) Double blind, cluster randomised trial of low dose supplementation with vitamin A or beta carotene on mortality related to pregnancy in Nepal. The NNIPS-2 Study Group. British Medical Journal 318, 570–575.Google Scholar
Whitfield, CR (1967) Sprue complicating pregnancy in Singapore. Journal of Obstetrics & Gynecology of British Commonwealth 74, 537–543.Google Scholar
Wilkinson, RJ, Llewelyn, M, Toossi, Z, Patel, P, Pasvol, G, Lalvani, A, Wright, D, Latif, M & Davidson, RN (2000) Influence of vitamin D deficiency and vitamin D receptor polymorphisms on tuberculosis among Gujarati Asians in west London: a case-control study. Lancet 355, 618–621.Google Scholar
Willumsen, JF, Filteau, SM, Coutsoudis, A, Underwood, BA, Newell, ML & Tomkins, AM (2000) Subclinical mastitis as a risk factor for mother-infant, HIV transmission. In Advances in Experimental Medicine and Biology 478, 211–213.Google Scholar
Yanik, FF, Amanvermez, R, Yanik, A, Celik, C & Kokcu, A (1999) Pre-eclampsia associated with increased lipid peroxidation and decreased serum vitamin E levels. International Journal of Gynecology & Obstetrics 64, 27–33.Google Scholar