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Comprehensive analysis of the association of seasonal variability with maternal and neonatal nutrition in lowland Nepal

Saville, NM; Cortina-Borja, M; De Stavola, BL; Pomeroy, E; Marphatia, A; Reid, A; Manandhar, DS; (2021) Comprehensive analysis of the association of seasonal variability with maternal and neonatal nutrition in lowland Nepal. Public Health Nutrition 10.1017/s1368980021003633. (In press).

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Abstract

Objective: to provide a comprehensive seasonal analysis of pregnant mothers’ eating behaviour and maternal/newborn nutritional status in an undernourished population from lowland rural Nepal, where weather patterns, agricultural labour, food availability and disease prevalence vary seasonally. Design: Secondary analysis of cluster-randomized Low Birth Weight South Asia Trial data, applying cosinor analysis to predict seasonal patterns. Outcomes: maternal mid-upper arm circumference (MUAC), body mass index (BMI), dietary diversity, meals per day, eating down and food aversion in pregnancy (≥31 weeks’ gestation), and neonatal z-scores of length- (LAZ), weight- (WAZ) and head circumference-for-age (HCAZ) and weight-for-length (WLZ). Setting: rural areas of Dhanusha and Mahottari districts in plains Nepal Participants: 2831 mothers aged 13 to 50 and 3330 neonates. Results: We found seasonal patterns in newborn anthropometry and pregnant mothers’ anthropometry, meal frequency, dietary diversity, food aversion, and eating down. Seasonality in intake varied by food group. Offspring anthropometry broadly tracked mothers’. Annual amplitudes in mothers’ MUAC and BMI were 0.27kg/m2 and 0.22cm, with peaks post-harvest and nadirs in October when food insecurity peaked. Annual LAZ, WAZ and WLZ amplitudes were 0.125, 0.159 and 0.411 z-scores. Neonates were shortest but least thin (higher WLZ) in winter (December/January). In the hot season, WLZ was lowest (May/June) while LAZ was highest (March and August). HCAZ did not vary significantly. Food aversion and eating down peaked pre-monsoon (April/May). Conclusions: Our analyses revealed complex seasonal patterns in maternal nutrition and neonatal size. Seasonality should be accounted for when designing and evaluating public heath nutrition interventions.

Type: Article
Title: Comprehensive analysis of the association of seasonal variability with maternal and neonatal nutrition in lowland Nepal
DOI: 10.1017/s1368980021003633
Publisher version: https://doi.org/10.1017/s1368980021003633
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: seasonality, cosinor models, Nepal, newborn anthropometry, nutrition in pregnancy
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Population, Policy and Practice Dept
URI: https://discovery.ucl.ac.uk/id/eprint/10133535
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