1. Maggie Mphande (Mphil) maggie.mphande@studmed.uio.no
Effectiveness of diet counselling during pregnancy on birth outcomes
Maggie Mphande (Mphil)

2. Methodology Data collected from 195 mother-baby pairs (end point)
2 study sites – 1 primary health facility and 1 health center
Anthropometric measurements were taken using WHO standard procedures;
birth weight
length
abdominal and
head circumference
Training was given to all data collectors

3. Birth weight procedure
Two birth weight measurements were taken
The first measurement was taken immediately (within 1 hour) after birth
The second measurement was taken after 24 hours
‘Seca 376 infant weighing scale’ was used with baby undressed

4. Birth length
Measured using a stadiometer with a fixed vertical backboard and an adjustable head piece
Two people involved
Measured twice just like birth weight (1 hour after birth and 24 hours after birth)

5. Head circumference Measured using paper tape measure
Placed the head circumference tape around the child’s head so that the tape lies: across the frontal bones of the skull; slightly above the eyebrows; perpendicular to the long axis of the face; above the ears; and over the occipital prominence at the back of the head.

6. Abdominal circumference
Measured using paper tape measure
Upper hip bone was located and the top of the right iliac crest
Measuring tape was placed in a horizontal plane around the abdomen at the level of the iliac crest
Then ensure that the tape is snug, but does not compress the skin, and is parallel to the floor.

7. Mean neonatal size at birth (preliminary results)
Birth outcomes
Intervention
N = 96
Control
N = 88
Unadj.
P-value
Birth weight (g)
± 459.8
± 483.0
0.43
Birth length (cm)
47.6 ± 3.0
47.4 ± 3.0
0.60
Head circumference (cm)
34.0 ± 1.8
0.93
Abdominal circumference
30.5 ± 2.6
29.1 ± 3.2
0.002
Low birth weight: n (%)
12 (12.5)
14 (15.9)
0.53
AC of neonates in the intervention arm were significantly larger than in the control
There was a trend towards a bigger size of neonates (bwt, L & HC ) in the intervention arm, even though not statistically significant
12.5% of the neonates in the Intervention weighed < 2500 g compared
to 15.9% in the control arm

8. Prevalence of low birth weight
Weight at birth of less than 2,500 grams (5.5 pounds)
Very LBW is less than 1,500 g
Of the 25 neonates with LBW, 13 were in the Control arm
1 baby had very LBW (Control)

9. Effect of intervention on neonatal size at birth
There were no variations in BW, length, HC and AC between the clusters (villages) [ICC < 0.01%]
Being in the intervention arm showed trends towards increasing birth size, length and head circumference (even though this was not significant)
Birth outcomes
β (95 % CI)
P-value
Ref: Control arm
Birth weight
55.7 (-81.7, 193.1)
0.43
Birth length
0.10 (-1.16, 1.36)
0.88
Head circumference
0.02 (-0.48, 0.52)
0.93
Abdominal circumference
1.60 (0.53, 2.67)
0.003

10. Factors associated with BW
On average, babies born to over weight women weighed g more than babies born to women with normal birth weight [147.8 (7.7, 303.4)] (P = 0.05)
For each year increase in age, BW increased by 15.6 g [15.6 (5.0, 26.2)] (P = 0.04)
Female babies weighed g lesser than male babies [ (-280.9, -8.6)] (P = 0.04)

11. Abdominal circumference
Birth length
Head circumference
Abdominal circumference
β (95 % CI)
P-value
SES
0.11 (0.002, 0.23)
0.05
BMI (over-w)
1.38 (0.48, 2.28)
0.003
0.70 (0.13, 1.26)
0.02
Maternal age
15.6 (5.11, 26.11)
0.004
HH size
0.82 (0.34, 1.31)
0.001
SBP
-0.04 (-0.07, )
0.03

12. Conclusions
Preliminary findings showed that diet counselling was associated with AC
However there was a trend towards larger birth lengths, HC and BW in the intervention arm
The prevalence of LBW was lower among women who were counselled
We found stronger associations between SES, BMI, maternal age with BW
Significant associations were also found between BMI, HH size with HC