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Thinness and Time to Pregnancy among Rural Bangladeshi Adolescents
Author(s) -
Hur Jinhee,
West Keith P.,
Shamim Abu Ahmed,
Rashid Mahbubur,
Labrique Alain B.,
Wu Lee SF.,
Mehra Sucheta,
Klemm Rolf D. W.,
Christian Parul
Publication year - 2016
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.30.1_supplement.1149.4
Subject(s) - medicine , pregnancy , demography , obstetrics , incidence (geometry) , gestation , anthropometry , proportional hazards model , gynecology , pediatrics , genetics , physics , sociology , optics , biology
Few studies have examined the relationship between maternal nutritional status and fecundability. We assessed the temporal association between preconceptional mid‐upper arm circumference (MUAC), measured in adolescence (12–19 years) with low MUAC reflecting thinness, and time to pregnancy (TTP) among rural, newlywed, largely non‐ contracepting (< 10.5%) women ( n 5 374) in northwestern Bangladesh. Women were recruited into a pregnancy surveillance system from 2001–2002 to participate in an antenatal vitamin A or beta‐carotene supplementation trial (West et al . JAMA 2011) and visited at home every 5 wks to ascertain a 1‐month history of menstruation. Amenorrheic women received a urine test to confirm pregnancy. Surveillance continued until pregnancy or for up to 312 weeks. Mean ± SD age and MUAC at surveillance enrollment were 15.3 ± 1.9 y and 22.5 ± 1.9 cm. Age at pregnancy ascertainment was 16.8 ± 1.9 y. Compared to those with a MUAC > 21.5 cm, adolescents with a smaller MUAC (≤ 21.5 cm) had a longer TTP (10 wks in median survival time, overall P < 0.001) and 5% lower cumulative incidence of first pregnancy ( P < 0.001), evident at each age, but especially so among youngest newlyweds (12 to 13 y). In a Cox proportional hazards model, thinner women (MUAC < 21.5 cm) were 12% less likely to become pregnant than those better nourished, adjusting for age, year and season of enrollment, and family planning practice (HR 0.88, 95% CI 0.82–0.93, P < 0.001). Undernourished adolescent girls may experience a longer time to pregnancy than those of better nutritional status. Support or Funding Information Supported by the Bill and Melinda Gates Foundation (GH614) and USAID, Washington DC.