Women's nutritional status, iron consumption and weight gain during pregnancy in relation to neonatal weight and length in West Java, Indonesia

Pregnant and non-pregnant women in Indramayu, West Java were examined for nutritional status, using anthropometric indicators. For the pregnant women, longitudinal data on nutritional status, iron consumption and weight gain were examined in relation to neonatal weight and length. Comparing the non-pregnant women's average nutritional status with reference tables for height, weight and MUAC, they placed at the 25th percentile or less on all indicators. Using original formulae to estimate pre-pregnancy weight and pregnancy weight gain, the study showed that 18% of pregnant women had a pre-pregnancy weight of under 40 kg and the average pregnancy weight gain was under 9 kg. Comparing estimated pregnancy weight gain with the amount of weight gain needed to compensate for generally low pre-pregnancy weight, only about 9% of women gained adequately. In multiple regression models that controlled for other maternal and neonatal factors, iron consumption during pregnancy was a significant predictor of full-term (37 weeks or more) neonatal weight (P = 0.01) and length (P = 0.01). Consumption of one or more tablets (200 mg ferrous sulfate and 0.25 mg folic acid) per week by women during pregnancy was associated with increased neonatal weight (by 172 g on average) and length (by 1 cm on average). Adequate weight gain during pregnancy and maternal height also contributed to the specification of the neonatal weight model (P = 0.07 for both). In the neonatal length model, maternal height was also nearly significant (P = 0.03). The same models did not explain the variability in neonatal weight and length in the pre-term group (<37 weeks gestation).