Maternal factors in the etiology of fetal malnutrition in Nigeria.

Background: The main objective of the study was to determine the role of maternal factors in the etiology of fetal malnutrition (FM) in Nigeria. Neonatal and Maternity Units of the Wesley Guild Hospital Ilesa, Nigeria, a unit of the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife was the setting for the study.

Methods: This was a prospective study of consecutive, singleton, term live babies delivered between January and August 2001. Fetal malnutrition was diagnosed using Clinical Assessment of Fetal Nutritional Status (CANS) and the score (CANSCORE) adapted by Metcoff. The maternal prenatal record was checked and additional history was obtained from the mother. This included history of maternal illness and drugs taken during pregnancy. The socioeconomic class of the parents was also documented. Nutritional status of the mother was determined using mid arm circumference (MAC) and the body mass index (BMI). Babies were stratified into babies with FM and babies without FM. The two groups of babies were compared.

Results: Of the 473 studied, 89 [18.8%] had FM. Maternal factors found associated with FM were: lack of antenatal care, young mother (<18 years), primiparity, maternal undernutrition (BMI < 18.5 kg/m(2) and MAC < 23.5 cm), low socioeconomic status, pregnancy-induced hypertension, antepatum hemorrhage, and maternal infections especially malaria, urinary tract infections and HIV (P < 0.05).

Conclusion: Improvement in the socioeconomic status of women and good antenatal care will reduce most of the maternal factors associated with FM in Nigeria. Therefore, antenatal should be made cheap and accessible to all pregnant mothers.