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Maternal Nutrition and Mental Health
Reframing Maternal Care to Combat Low Birth Weight and Mental Health
Context: Despite remarkable strides in economic development and medical innovation, India continues to grapple with a high incidence of low birth weight (LBW) among newborns — a serious public health concern that demands urgent attention.
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- Globally, about 15.5% of babies are born with LBW, with the majority — around 95% — occurring in low- and middle-income countries.
- In India, the NFHS-5 (2019–21) reported that 17.29% of births were LBW, with nearly 6% being very low birth weight (<1500 g), revealing a stagnation in progress since NFHS-4 (2014–15).
Risks of Low Birth Weight: A Lifelong Burden
- LBW significantly increases the risk of neonatal complications like hypothermia, hypoglycemia, and long-term developmental issues.
- Studies have consistently shown that LBW babies are more prone to neurological impairments, language delays, and a higher risk of mortality in the first year.
- As they grow, these children face an increased risk of chronic diseases such as cardiovascular ailments, type 2 diabetes, and dyslipidemia, often with early onset.
Why Are So Many Babies Born with Low Birth Weight in India?
Several interlinked factors contribute to India’s persistent LBW problem:
- Social and economic disadvantage: Women from lower socioeconomic backgrounds, with limited education or teenage pregnancies, are more likely to have LBW babies.
- Inadequate antenatal care (ANC): Although 88.6% of women now opt for institutional deliveries and 70% receive ANC in the first trimester (NFHS-5), rural-urban disparities remain stark.
- Nutritional deficiencies: A lack of essential nutrients during pregnancy directly impairs fetal development.
- Multiple pregnancies, maternal infections, pre-eclampsia, and chronic conditions like hypertension or diabetes can increase LBW risk.
- Substance use, including alcohol, tobacco, or drugs, can lead to preterm births, LBW, and developmental delays.
Maternal Nutrition: The Cornerstone of Fetal Development
- Nutrition: A fetus relies entirely on the mother for its nutritional needs.
- Adequate intake of macronutrients (carbohydrates, proteins, fats) and micronutrients (iron, folate, calcium, vitamin D, B12, and others) is essential for normal growth, organ formation, and physiological development.
- Macronutrients provide the energy needed for growth.
- Micronutrients are crucial for preventing congenital malformations and promoting immunity, bone development, and neurological health.
- Implications: Deficiencies in any of these nutrients can result in restricted fetal growth, developmental delays, and increased disease risk later in life.
- Poor maternal nutrition during pregnancy has also been linked to long-term cognitive impairments and a higher risk of obesity and metabolic disorders in offspring.
Overlooked Factor: Maternal Mental Health During Pregnancy
- While postnatal depression is now receiving more recognition, maternal mental health during pregnancy remains grossly neglected — despite its profound influence on fetal and early childhood development.
- Elevated levels of stress, anxiety, or depression in pregnant women lead to increased cortisol levels, which cross the placenta and adversely affect fetal brain development.
- Chronic prenatal stress has been associated with long-term emotional, cognitive, and behavioral issues in children.
- Infants of depressed mothers are also more likely to have insecure attachment, poor emotional regulation, and delayed social skills.
Government Interventions and Gaps
The Indian government has launched multiple programs to combat adverse birth outcomes and reduce LBW:
- Janani Shishu Suraksha Karyakram (JSSK): Free maternal healthcare to reduce out-of-pocket expenditure.
- RMNCAH+N: Comprehensive maternal and child health strategy.
- Integrated Child Development Services (ICDS) and POSHAN Abhiyaan: Focused on supplementary nutrition and maternal weight monitoring.
- However, mental health support remains a missing component in most reproductive health policies.
Way Forward
Improving birth outcomes requires a comprehensive approach that goes beyond hospital-based interventions. Key strategies include:
- Enhancing nutrition support for pregnant women, particularly in underserved areas.
- Routine screening and treatment of maternal mental health issues.
- Community-based stress management programs and social support systems.
- Increased awareness around the impact of maternal stress and nutrition on fetal development.
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The Source’s Authority and Ownership of the Article is Claimed By THE STUDY IAS BY MANIKANT SINGH
