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Nutrition and maternal mortality in the developing world.

¹School of Nutrition Science and Policy, Tufts University, Boston, MA 02111, USA. rush@hnrc.tufts.edu

The American Journal of Clinical Nutrition

|June 29, 2000

Summary

Maternal mortality is high in developing nations. Nutritional interventions for severe anemia and obstructed labor require urgent reassessment to improve maternal health outcomes.

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Area of Science:

Obstetrics and Gynecology
Public Health
Nutritional Science

Background:

Maternal mortality rates are significantly higher in developing countries compared to industrialized nations.
Key causes of maternal death include induced abortion, puerperal infection, pregnancy-induced hypertension, hemorrhage (anemia), and obstructed labor.

Observation:

Severe anemia (Hb <70-80 g/L) significantly increases maternal mortality risk, while mild/moderate anemia shows little risk.
Nutritional strategies for increasing adult stature are largely ineffective after age 3 and may have adverse effects like earlier menarche.
Short stature (<1.5 m) in women is linked to a higher incidence of obstructed labor.

Findings:

Current universal iron supplementation programs may not effectively reduce severe anemia.
Supplemental feeding programs aimed at accelerating fetal growth could increase the risk of obstructed labor, particularly for short women.
There is insufficient data to model the risks and benefits of increased fetal size.

Implications:

Revising anemia control strategies for pregnant women is crucial.
Short women (<1.5 m) should be excluded from supplementary feeding programs targeting fetal growth acceleration, especially where obstetric services are limited.
Further research is needed to understand the complex relationship between nutrition, fetal growth, and obstructed labor to inform effective maternal health interventions.

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