Professor Ricarco Uauy presents a wealth of information on global trends of low birth weight (LBW) and the consequences of maternal and foetal malnutrition. The prevalence of LBW is falling in most regions of the world, although some areas of sub-Saharan Africa have rates that are static or rising. An increasingly important driver of LBW rates is food price. A frequent reaction to rising food price rises is to decrease the quality of the diet; an immediate consequence of this is increased foetal vulnerability.
The health of the mother is a major determinant of foetal and child health. Abundant evidence links small stature/underage mothers with LBW and high rates of infant mortality. Professor Uauy stresses the importance of “investing in human capital” from pre-conception, during gestation and during the first 1000 days of life. An adequate food supply including amino acids, vitamins and micronutrients is essential.
Maternal, placental and foetal conditions for healthy children can sometimes be modified with relatively simple measures. Goitre – a key factor in stunting – can be treated with iodised salts. A single corticosteroid injection given to women in preterm labour (<34th week) can reduce perinatal mortality by 40%, likely by facilitating lung development.
Professor Uauy highlights the release of new Intergrowth 21st international standards for measurement of foetal growth. He concludes by reminding us that improved monitoring of the health of the mother and child and investments before birth will pay off in later life.