CHAPTER ONE
INTRODUCTION
1.1 Background to the study
Nutrition is a major intrauterine environmental factor that alters expression of the foetal genome and may have life long consequences (Guoyao, Fuller, Timothy, Cynthia & Thomas, 2005). Alterations in foetal nutritional status may result in developmental adaptations that permanently change the structure, physiology and metabolism of the offspring, thereby predisposing individuals to metabolic, endocrine, and cardiovascular diseases in adult life (Guoyao et al., 2005). Maternal nutrition comprises of anthropocentric factors such as per-pregnancy weight for height (body mass index (BMI) and gestational weight gain which partly reflects the balance between energy intake and energy expenditure, but also includes increases in body water, as well as intake of protein and micro nutrients (Tannys, Pat, Francesca & Leah, 2006). Of the pregnancy outcomes that might be affected by maternal nutrition, the one encountered most often in research literature is low birth weight. Other outcomes are deformities, morbidity and mortality rate (Kramer, 1998).
Low birth weight is defined as a body weight at birth of less than 2500g . There are two main causes of low birth weight: prematurity and intrauterine growth retardation (IUGR). Infants born with low birth weight suffer from extremely high rates of morbidity and mortality from infectious disease, and are underweight, stunted and wasted beginning in the neonatal period through childhood (ACC/SCN, 2000). The causes and effects of low birth weight are complex and best considered within’s the lifecycle conceptual framework. Poor nutrition often begins in the intrauterine environment and extends throughout the lifecycle. Low birth weight is an inter generational problem where low birth weight infants grow up to be undernourished and stunted children and adolescents and, ultimately undernourished women of child bearing age, and undernourished pregnant women who deliver low birth weight infants. This amplifies risk to the individual’s and perpetuates the cycle of poverty, under nutrition and disease. This is especially so when adolescents become pregnant before their own growth is completed, leaving little to fulfil their own or their infant’s nutritional requirement (ACC/SCN, 2000).
