Maternal dietary intake during pregnancy and its association to birth size in rural Malawi: A cross-sectional study

Katrine G. Hjertholm, Per Ole Iversen, Gerd Holmboe-Ottesen, Ibrahimu Mdala, Alister Munthali, Kenneth Maleta, Zumin Shi, Elaine Ferguson, Penjani Kamudoni

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18 Citations (Scopus)


In low-resource settings, such as rural Malawi, pregnant women are prone to energy and micronutrient deficiencies with the consequence of delivering low-birth weight infants with higher risks of morbidity and mortality. This study aimed to examine the association between maternal dietary intakes during pregnancy and infant birth size. Dietary intakes of 203 pregnant women were assessed between 28 and 35 weeks of gestation and their infants' (n = 132) birth size measured. Intakes of energy, macronutrients, and 11 micronutrients were estimated using a 3-day interactive 24-hr diet recall. Semiquantitative data on food intakes for four additional days were also collected to assess food patterns. Using multilevel linear regression modeling, maternal intakes of carbohydrate were negatively associated with neonate length (β: -0.1; 95% CI: -0.2, 0.0 cm/E%) and abdominal circumference (β: -0.1, 95% CI: -0.2, 0.0 cm/E%), whereas intakes of fat were positively associated with neonate length (β: 0.1; 95% CI: 0.0, 0.2 cm/E%) and abdominal circumference (β: 0.1; 95% CI: 0.0, 0.2 cm/E%). Vitamin C intakes were positively associated with birth weight (β: 1.4; 95% CI: 0.5, 2.3 g/mg). The frequency of milk intake was positively associated with birth weight (β: 75.3; 95% CI: 13.6, 137.0 g/day). These findings offer practical suggestions for food-based interventions in the study area to promote inclusion of fat, vitamin C-rich foods, and milk in pregnancy.

Original languageEnglish
Article numbere12433
JournalMaternal and Child Nutrition
Issue number1
Publication statusAccepted/In press - 2017


  • Food group intake
  • Malawi
  • Milk intake
  • Neonatal anthropometry
  • Nutrient intake
  • Pregnancy

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Nutrition and Dietetics
  • Obstetrics and Gynaecology
  • Public Health, Environmental and Occupational Health

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