Pradeilles, Rebecca; Allen, Elizabeth; Gazdar, Haris; Bux Mallah, Hussain; Budhani, Azmat; Mehmood, Rashid; Mazhar, Sidra; Mysorewala, Ayesha; Aslam, Saba; Dangour, Alan D; +1 more... Ferguson, Elaine; (2019) Maternal BMI mediates the impact of crop-related agricultural work during pregnancy on infant length in rural Pakistan: a mediation analysis of cross-sectional data. BMC pregnancy and childbirth, 19 (1). 504-. ISSN 1471-2393 DOI: https://doi.org/10.1186/s12884-019-2638-3
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Abstract
BACKGROUND: Stunted growth in early infancy is a public health problem in low-and-middle income countries. Evidence suggests heavy agricultural work during pregnancy is inversely associated with maternal body mass index (BMI) and infant birth weight in low- and middle-income countries; but pathways linking agricultural work to length-for-age Z-scores (LAZ) in early infancy have not been examined. This study aimed to investigate the relationship between agricultural work during pregnancy, post-natal maternal BMI and LAZ among young infants in rural Pakistan; and explored whether maternal BMI mediated the relationship between agricultural work and infant LAZ. METHODS: A cross-sectional survey was conducted from December 2015 to January 2016 in rural Sindh, Pakistan. Mother-infant dyads were recruited via systematic random cluster sampling at 2-12 weeks' post-partum (n = 1161). Anthropometric measurements (maternal and infant height/length and weight) and questionnaire data were collected. Multivariable linear regression and structural-equation based mediation analyses were used to examine associations of agricultural work during pregnancy with maternal BMI and infant LAZ. RESULTS: During pregnancy, women reported engaging in livestock-related work (57.0%), crop-related work (42.7%), and cotton harvesting (28.4%). All three forms of agricultural work were negatively associated with maternal BMI (β = - 0.67 [- 1.06; - 0.28], β = - 0.97 [- 1.51; - 0.48]; and β = - 0.87 [- 1.33; - 0.45], respectively). Maternal engagement in cotton harvesting alone was negatively associated with infant LAZ after controlling for confounding factors. The total negative effect of cotton harvesting on infant LAZ was - 0.35 [- 0.53; - 0.16]. The indirect effect of maternal BMI on infant LAZ was - 0.06 [- 0.08; - 0.03], revealing that 16% (- 0.06/- 0.35) of the relationship between cotton harvesting and infant LAZ, after adjustment, was mediated via maternal BMI. CONCLUSION: These results underscore a need to reduce labour-intensive agricultural workload demands during pregnancy, especially in cotton harvesting, to reduce risks of negative maternal energy balance and poor growth outcomes in early infancy.
Item Type | Article |
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Faculty and Department |
Faculty of Epidemiology and Population Health > Dept of Medical Statistics Faculty of Epidemiology and Population Health > Dept of Population Health (2012- ) |
Research Centre | Centre for Maternal, Reproductive and Child Health (MARCH) |
PubMed ID | 31847831 |
Elements ID | 142258 |
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Licence: Creative Commons: Attribution 3.0
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