Bill & Melinda Gates Foundation

Maternal Obesity Linked to Newborn Death in Sub-Saharan Africa

August 24, 2012

For the first time researchers have discovered a link between overweight and obese mothers in sub-Saharan Africa and infant mortality. In a study published in The Lancet this month, researchers from the London School of Hygiene and Tropical medicine show a definitive correlation between maternal obesity and the prevalence of neonatal deaths (infants who die in the first 28 days of life) especially before two days of age; the results come from analyzing Demographic and Health Survey data of 81,126 women from 27 sub-Saharan countries.

Despite perpetual images and stereotypes that all of Africa is underweight or malnourished, some estimate that 17.5 percent of sub-Saharan adults will be overweight by 2030 especially in urban centers. In fact, a World Health Organization data map shows that Cameroon, Equatorial Guinea, Gabon, Namibia and Botswana all had between 10-19 percent of obese adults in 2008.

In fact, South Africa ranked alongside the United States with more than 30 percent of adults being obese in 2008. Last year saw the opening of the first U.S. fast food restaurant in Kenya--KFC--in Nairobi, according to Business Week. There is a growing middle class in sub-Saharan Africa that has enough disposable household income to afford new "luxuries" such as fast food.

Now that there is growing maternal obesity in sub-Saharan Africa – albeit slow - this poses a stark contrast to the traditional indicators of neonatal deaths such as underweight mothers and lack of access to health services and trained health workers for pregnancy and delivery in developing countries. And while those factors cannot be discounted, we now have evidence that a new, emerging story may be developing about maternal obesity and the risk it poses to babies’ lives.

The findings? Of roughly 81,000 women, 15,518 were overweight and 4,226 were obese. The women who were overweight saw an increased risk of delivering premature babies with infections or of experiencing various childbirth complications. In fact, notes the London School of Hygiene & Tropical Medicine, "The estimates suggest that babies of obese mothers had about 50% greater odds of their baby dying in the first 4 weeks of life than women who were of optimum weight, even after adjusting for certain factors known to affect the risk of neonatal death including maternal age, educational level, and birth order.

Through the dataset the researchers found that the higher a woman’s Body Mass Index (BMI) the greater her chance of delivering an infant that would die within its first few days of life. Women who were of optimum weight or who were underweight had significantly decreased odds of infant mortality.  

According to the researchers, “The primary strengths of this study were the availability of a large, nationally representative dataset providing sufficient power to investigate neonatal deaths in infants born to obese mothers in greater detail than had been attempted previously in low-income settings.”

Due to the findings of the study the researchers suggest that expectant sub-Saharan women should be screened for potential obesity complications and diabetes during antenatal visits and should also be encouraged to lose weight and to give birth in a health facility.  

The study, then, not only shines a foreboding light on one of sub-Saharan Africa’s impending health problems: the increasing prevalence of overweight and obese adults due to high calorie, high fat foods. It connects the issue of obesity with infant mortality in this region, in a way that must be looked at more deeply if we are to continue figuring out how best to save the lives of babies in the poorest parts of the world.


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