The relationship between maternal age, obesity and child mortality: a cross-sectional study using 2013-2014 Demographic and Health Survey in Democratic Republic of the Congo at national, and sub-national levels.

Objective: To investigate the relationship between maternal age and nutritional status, and test associations between maternal nutritional status and child mortality with a focus on maternal obesity.

Design: Secondary analysis of data from nationally representative cross-sectional sample of women of reproductive ages (15-49 years) and their children under 5 years. The outcome variable for maternal nutritional status was BMI, classified into underweight (BMI < 18·50 kg/m), normal weight (18·50-24·99 kg/m), overweight (25·0-29·9 kg/m) and obesity (>=30·0 kg/m). Child mortality was captured with five binary variables measuring the risk of dying in specific age intervals (neonatal, post-neonatal, infant, childhood and under-five mortality).

Setting: The most recent Demographic and Health Surveys from Democratic Republic of Congo (DRC).

Participants: The final samples consisted of 7892 women of reproductive ages (15-49 years) and 19 003 children aged 0-59 months.

Results: The prevalence of obesity was estimated at 3·4 %; it increased with maternal age. Furthermore, obesity unevenly affected provinces in the Democratic Republic of the Congo: Kinshasa, South Kivu, North Kivu and Maniema were most affected. Finally, maternal obesity showed mixed effects on child mortality.

Conclusion: The prevalence of obesity is still low; however, provinces are unevenly affected. Therefore, interventions and programmes to improve nutrition should incorporate geographical disparities to tackle adverse child outcomes associated with maternal obesity, to limit negative consequences of maternal obesity, including non-communicable diseases which might be a strong impediment to reach Sustainable Development Goals (SDG) 2 and 3.