Researchers examine prenatal nutrition among low-income Latinas

A study of prenatal nutrition among low-income Latinas in Hartford shows that food insecurity, and maternal weight gain during pregnancy that is lower than recommended by the national Institute of Medicine, are both independently linked with low birth weight.

“Food insecurity – the inability to access nutritional food in sufficient quantities – and insufficient weight gain during pregnancy predict a low birth weight baby,” says Rafael Pérez-Escamilla, professor of nutritional sciences and director of UConn’s Center for Eliminating Health Disparities among Latinos (CEHDL), which conducted the study.

Low birth weight is, in turn, a predictor of a child’s long-term health.

The study also found that there are major differences in quality of diet between Latinas who have recently arrived in this country and those who have been here longer.

Longitudinal study
Working in collaboration with the Hispanic Health Council, Hartford and St. Francis hospitals, and other community agencies, the researchers recruited pregnant Latina women mostly during their second trimester.

On two occasions during the pregnancy and once after the infant’s birth, bilingual/bicultural interviewers collected data including the participants’ dietary intake, food security status before and during pregnancy, meal-skipping patterns, pre-pregnancy body mass index, gestational weight gain, and infant birth weight.

Only 25 percent of the study participants gained the recommended amount of weight during pregnancy.

Approximately 30 percent gained less than the recommended amount, while 45 percent gained more than is recommended.

Women were at increased risk of gaining excessive weight during pregnancy if they experienced household food insecurity.

The highest rates of excessive gestational weight gain were seen among those women who were overweight or obese before pregnancy.

Forty-three percent of the women in the study were overweight or obese before pregnancy, with more than 80 percent of overweight women and 50 percent of obese women gaining more weight than recommended during pregnancy.

“Being overweight is an extremely serious problem during pregnancy,” says Pérez-Escamilla, who is currently serving on an Institute of Medicine committee to revise the national guidelines on weight gain during pregnancy.

“It can lead to gestational diabetes and to either low birth weight or macrosomic – very large – babies. Individuals born with either low or high birth weight are more likely to develop diabetes and other diseases later in life.”

A mother’s excessive gestational weight gain can also adversely affect an infant’s weight at birth and subsequent growth.

Even though these associations were not examined in this study, Pérez-Escamilla says other studies have shown that gaining an excessive amount of weight during pregnancy causes hypertension (high blood pressure), which limits the blood supply to the fetus.

With inadequate nutrition, the fetus becomes ‘programmed’ to live in an environment where there is not enough food. Yet a baby born in the U.S. is born into an environment where an enormous amount of calories are available.

“If a child has a low weight at birth and gains weight rapidly during the first couple of years, that’s a pretty lethal combination for the future,” he says.

“These populations are at high risk of developing various chronic diseases as a result of this early programming.”

But steps to reduce weight need to be taken before, not after, a woman becomes pregnant, he notes.