NUTRITIONAL STATUS OF PREGNANT WOMEN IN LOWER-MIDDLE-INCOME COUNTRIES: A REVIEW OF PREVALENCE, DETERMINANTS, AND MATERNAL–NEONATAL OUTCOMES

Abstract

Background: Maternal malnutrition in lower-middle-income countries (LMICs) serves as a primary underlying catalyst for global maternal mortality, with malnourished women facing a mortality risk twice as high as their well-nourished counterparts This review synthesizes current evidence on the prevalence, multi-level determinants, and clinical consequences of nutritional depletion to inform integrated public health strategies in resource-constrained settings. Methods: We searched electronic databases including PubMed, Cochrane Library, CINAHL, EMBASE, and Scopus for studies published between 2013 and 2026. The inclusion criteria targeted maternal anthropometric indicators BMI, micronutrient status (anemia, iron, folate), and their associations with gestational success and offspring health in LMICs. Results: Three primary dimensions were identified. First, epidemiological data indicates that nearly 462 million pregnant women are malnourished globally, with subnational prevalence reaching 75.7% in conflict-affected regions like Mogadishu, Somalia. Second, nutritional status is dictated by a "syndemic" of factors, where household poverty (AOR=1.49) and illiteracy (AOR=3.6) intersect with cultural practices, such as humoral "hot-and-cold" food taboos and the practice of "eating down" to avoid obstructed labor Third, maternal depletion is the primary driver of the "small vulnerable newborn" phenotype and is responsible for 14.4% of childhood stunting globally. Conclusions: Addressing this crisis requires a transition from standard iron-folic acid to Multiple Micronutrient Supplementation (MMS), the integration of routine low-dose calcium, and culturally tailored counseling to bridge the "adherence gap". Long-term solutions must incorporate nutrition-sensitive programming that addresses structural inequality through female education and financial empowerment.