Annex: Maternal anthropometry as a risk predictor of pregnancy outcome: the Nutrition CRSP in Kenya.

A longitudinal study on food intake and human function in three countries, within the Nutrition Collaborative Research and Support Program (CRSP), enabled us to follow 247 Embu households in rural Kenya. Food intake, nutritional status, morbidity and a number of household and environmental characteristics were studied longitudinally for one to two years during the period, January 1984 to March 1986. From the available data it was possible to determine whether or not maternal anthropometric indicators had predictive values for identifying the risk of poor maternal pregnancy and infant outcomes. If this was so, then village health workers and traditional midwives would be able to detect women at risk for poor pregnancy outcomes and promote early intervention and referral to more expert treatment. The 60-sq.km study area was on the south-east slope of Mount Kenya and subject to periodic drought and food shortages. As a result of seasonal food shortages and the need to sell food crops for cash, energy intake was found to be less than twothirds of the recommended level. Animal protein intake was very low, resulting in vitamin B12, zinc and iron deficiencies. The latter two were worsened by high phytate, fibre, and tea intake. Calcium and vitamin A intakes were also less than two-thirds of the recommended dietary allowance (RDA). Folic acid intake was low in 23% of the pregnant women although requirements were probably greater because of the pregnancy and malaria. Iodine deficiency was also present, with 24% of pregnant women noted to have a goitre. Biochemical evidence of low thyroid hormones was also found. Anaemia due to nutritional deficiencies was prevalent, with endemic malaria and hookworm con-