Balanced plate for mothers to improve birthweight: a cluster randomised controlled trial in rural Bangladesh

"Background Low birthweight (LBW) significantly contributes to neonatal mortality and morbidity. A large proportion of infants (36%) in Bangladesh are born with LBW. Intrauterine growth restriction is one of the major causes of LBW. The nutritional status of mothers during pregnancy is critical for optimal growth and development of the foetus. Nutrition education has been found to improve maternal nutrition status. Our study aims to determine whether antenatal nutrition education with a practical demonstration is an effective intervention for improving birthweight of the infants compared to standard nutrition education only. Methods We are conducting a community based cluster randomised controlled trial in one rural district of Bangladesh. Treatment is allocated evenly between the study 36 clusters. Participants in the intervention group receives ‘balanced plate nutrition education' with practical demonstration by community health workers four to seven times throughout their entire pregnancy starting from the first trimester. The control group receives standard nutrition education delivered by government and other healthcare providers as per ongoing antenatal care schedule. Our sample size is 900 pregnant women to determine 100g difference in mean birthweight, considering 5% type 1 error, 80% power and 0.03 intra-cluster correlation coefficient. The primary outcome is birthweight and the secondary outcomes include daily caloric intake and dietary diversity score among the pregnant women. Outcomes will be measured at baseline (enrolment), 3rd to 9th month of gestation (monthly) and at delivery. Discussion This trial will generate evidence about the effectiveness of a new nutrition education technique to improve birthweight of infants in rural Bangladesh. Key words: Low birthweight, nutrition education, and mother Key messages 1. Balanced diet in pregnancy is crucial to ensure adequate nutrition in terms of energy density and essential nutrients. 2. Realistic education technique is more efficient compared to conventional ones for better compliance and sustainability. 3. Nutrition education is essential to narrow-down enduring gaps in overall knowledge in balanced diet resulting in widespread malnutrition (under-nutrition and obesity) irrespective of economic status. "

Morseda Chowdhury

The University of Sydney

I am a development worker from Bangladesh. My area of interest is maternal, neonatal and child health and nutrition. Over the last ten years I have been directly contributed to many community based health and nutrition intervention project of BRAC Health Nutrition and Population Programme. Currently I am a PhD candidate in the University of Sydney and my research topic is nutrition literacy among pregnant mothers and perinatal outcome.