Pregnant women who are experiencing acute starvation are at risk of severe vomiting, placenta dysfunctions and respiratory distress, all of which could lead to poor pregnancy outcomes, experts say.
Experts in a study published in online journal, ResearchGate, identified foetal growth restrictions, stillbirths, increased newborn foetal morbidity/mortality and predispositions to maternal preeclampsia and gestational diabetes as other complications of acute starvation in pregnancy.
The experts said effects of acute starvation in pregnancy is worse in the third trimester.
Speaking on the issue, Consultant Obstetrician and Gynaecologist, Dr. Lateef Akinola, said, “It is well established that an adequate and balanced diet during pregnancy is essential for the health of mother and baby, both in the womb and when born.
“For instance, obesity, diabetes, cardiovascular disease and abnormal reproductive functions in adulthood might be predicated on inadequate nutrition during pregnancy. Acute starvation in pregnancy usually precipitated by severe hyperemesis gravidarum (severe vomiting during pregnancy.”
Dr. Akinola, who is the Medical Director of Medison Specialist Women’s Hospital, Lagos, noted, “Acute starvation in pregnancy can cause severe metabolic dysfunction, notably, starvation ketoacidosis and infrequently causes severe metabolic acidosis and placental dysfunctions, which can precipitate insulin resistance, gestational diabetes and preeclampsia.
“This in turn increases susceptibility to ketosis [when the body doesn’t have enough carbohydrates to burn for energy. Instead, it burns fat and makes things called ketones, which it can use for fuel], particularly in the third trimester that can be complicated by foetal growth restrictions and stillbirths.”
According to the United Nations Children’s Fund, out of more than 2.5 million babies that are born dead globally each year, more than 400,000 such deaths happen to babies born in Nigeria annually.
UNICEF rates Nigeria one of the five countries in the world with the highest number of under-five deaths.
The reproductive endocrinologist and IVF specialist stresses that early diagnosis and management of this condition is necessary to prevent maternal and foetal complications.
“Symptoms to watch out for include severe vomiting, especially late in pregnancy.
“Respiratory distress and significant acid-base disturbances can occur. Other notable causes to watch out for aside from hyperemesis [persistent nausea and vomiting during pregnancy] include diabetic ketoacidosis and alcohol induced acidosis.
“Management should be promptly instituted. Hospital admission is necessary where daily monitoring of vital signs and diligent foetal monitoring are essential to prevent maternal and foetal morbidity and mortality.
“Sometimes, early delivery in the presence of an experienced neonatologist is essential to prevent foetal complications, including stillbirth,” he explained.
According to the National Bureau of Statistics in its Poverty and Inequality Report 2019, one in 10 or more than 82.9 million Nigerians live in poverty.
Also, the World Bank says 96 million Nigerians will be living in poverty by 2022.
Poverty, experts say, is a key hindrance to women’s wellbeing, especially during pregnancy, resulting in malnutrition, anaemia, low birth babies or foetal loss.
Also, a Consultant Gynaecologist and Obstetrician at the Lagos State University Teaching Hospital, Ikeja, Dr. Modupe Adedeji, says the foetus is actually a parasite in the mother.
“The foetal nutrition in utero keeps going on until a certain stage that could now be detrimental when starvation is prolonged for too long.
“This could result in intrauterine growth restrictions and eventually, if not attended to, intrauterine foetal death,” the gynaecologist said.
Dr. Adedeji said it was important to detect this problem during pregnancy so that appropriate care can be given.
“A growth restricted foetus may be born to need expert care to survive. They come out quite hungry,” she added.
The President, Federation of African Nutrition Societies, Prof. Ngozi Nnam, told our correspondent that a pregnant woman is supposed to feed well and have adequate diets at all times for optimal development of the foetus.
Highlighting the dangers of poor nutrition in pregnancy, Nnam, who is a professor of Community and Public Health Nutrition at the University of Nigeria, Nsukka, warns, “Poor nutrition will cause inadequate development of the baby because nutrients are required for cells of the foetus to develop properly.
“Nutrients such as iron are very important in the development of the cells. When a pregnant woman stops taking foods rich in iron, she will be deficient in iron and that deficiency will affect the foetus and the cells will not form properly and this will lead to malformation when the baby is born.”
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