We stay up to date on the literature on child malnutrition first and foremost because access to food and proper nutrition are human rights. In addition, malnutrition is well-known to be the underlying cause or a factor in approximately 45 percent of child deaths. Two key concepts are worth reviewing briefly, stunting and linear growth retardation.
Stunting is the result of chronic malnutrition, repeated infections and neglect resulting in a lower height for a given age. Stunting (Height-for-age) isan indicator of linear growth retardation and cumulative growth deficits in children (Chronic malnutrition). The WHO definition of stunting is: "Children are defined as stunted if their height-for-age is more than two standard deviations below the WHO Child Growth Standards median." The WHO has developed a Conceptual Framework on stunting. Of tremendous interest to Maternova is the fact that stunting can and often does begin in utero, meaning babies whose mothers are malnourished, stressed and neglected, are of course beginning on a life course of stunting. It is estimated that 20 percent of stunting begins in utero.
"Linear growth retardation (or linear growth faltering) is defined as a failure to reach one's linear growth potential. Linear growth retardation implies that (groups of) children are too short for their age, but does not imply that they are stunted. As explained in the text, the number of children suffering from linear growth retardation is much higher than the number of children that are stunted." (Leroy and Frangillo 2019 https://doi.org/10.1093/advances/nmy101)_
Though stunting is associated with cognitive and motor deficits, risk of chronic disease and a number of other lifelong risk factors, the causal link between stunting and each of these outcomes is under debate. There is one outcome that has more solid evidence, and that is the fact that women who are stunted are more likely babies that are SGA (small for gestational age) putting those babies at risk for stunting, for neonatal mortality and for child morbidity.
Identification of anemia in pregnant women is important, since it is an important cause of multiple complications during pregnancy (preterm delivery, low birth weight and perinatal death), so it is recommended to all pregnant women, in the first prenatal visit and at 28 weeks of gestation, the measurement of serum concentrations of hemoglobin and hematocrit as a screening test for anemia.
Prenatal assessment seeks to identify, through clinical history, sociodemographic characteristics, mean blood pressure, Doppler of the uterine arteries and biochemical markers such as pregnancy-associated plasma protein A (PAPP-A) and placental growth factor (PlGF), those women who are at high risk of developing preeclampsia in order to take appropriate measures. that can help reduce that risk.