Maternal and child undernutrition: global and regional exposures and health consequences

The Lancet published a series of papers in 2008 to discuss maternal an child undernutrition because “nutrition is a desperately neglected aspect of maternal, newborn, and child health. The reasons for this neglect are understandable but not justifiable.” The first paper in this series is “Maternal and child undernutrition: global and regional exposures and health consequences.”

Maternal and child undernutrition is highly prevalent in low-income and middle-income countries, resulting in substantial increases in mortality and overall disease burden. In this paper, we present new analyses to estimate the effects of the risks related to measures of undernutrition, as well as to suboptimum breastfeeding practices on mortality and disease. We estimated that stunting, severe wasting, and intrauterine growth restriction together were responsible for 2·2 million deaths and 21% of disability-adjusted life-years (DALYs) for children younger than 5 years. Deficiencies of vitamin A and zinc were estimated to be responsible for 0·6 million and 0·4 million deaths, respectively, and a combined 9% of global childhood DALYs. Iron and iodine deficiencies resulted in few child deaths, and combined were responsible for about 0·2% of global childhood DALYs. Iron deficiency as a risk factor for maternal mortality added 115 000 deaths and 0·4% of global total DALYs. Suboptimum breastfeeding was estimated to be responsible for 1·4 million child deaths and 44 million DALYs (10% of DALYs in children younger than 5 years). In an analysis that accounted for co-exposure of these nutrition-related factors, they were together responsible for about 35% of child deaths and 11% of the total global disease burden. The high mortality and disease burden resulting from these nutrition-related factors make a compelling case for the urgent implementation of interventions to reduce their occurrence or ameliorate their consequences.

The Lancet, Volume 371, Issue 9608, Pages 243 – 260, 19 January 2008

Prof Robert E Black MD, Prof Lindsay H Allen PhD, Prof Zulfiqar A Bhutta MD, Prof Laura E Caulfield PhD, Mercedes de Onis MD, Majid Ezzati PhD, Colin Mathers PhD, Prof Juan Rivera PhD, for the Maternal and Child Undernutrition Study Group