Researchers in Ethiopia studied 449 newborn babies to understand why some are born malnourished. They found that about 1 in 5 newborns showed signs of poor nutrition at birth. The study identified several risk factors including mothers who are too young, mothers with low body weight, infections during pregnancy, anemia, depression, domestic violence, and pregnancy complications. These findings highlight the importance of better prenatal care, nutrition support, and protection for pregnant women to ensure healthier babies.

The Quick Take

  • What they studied: What causes some babies to be born malnourished and how common this problem is in hospitals in Ethiopia
  • Who participated: 449 newborn babies and their mothers at public hospitals in Jimma Zone, Ethiopia, studied between April and July 2024. About half were girls and half were boys.
  • Key finding: About 20 out of every 100 babies born in these hospitals showed signs of malnutrition. Babies were more likely to be malnourished if their mothers were very young, underweight, had infections, anemia, depression, or experienced domestic violence during pregnancy.
  • What it means for you: If you’re pregnant or planning to become pregnant, this research suggests that getting proper nutrition, treating infections early, taking iron supplements, managing mental health, and staying safe from domestic violence are all important for your baby’s health. Talk to your healthcare provider about these factors.

The Research Details

Researchers conducted a cross-sectional study, which means they looked at a group of people at one point in time rather than following them over months or years. They studied 449 newborn babies and their mothers at public hospitals in the Jimma Zone of Ethiopia from April to July 2024. They used a systematic sampling method, which means they selected every certain number of babies born during that time period to make sure their sample was representative.

The researchers collected information about the mothers through interviews using a questionnaire. They asked about age, nutrition, health conditions, and other factors. For the newborns, they used a special scoring system called the Clinical Assessment of Nutrition (CAN score) to measure whether babies showed signs of malnutrition. This system looks at physical signs that indicate how well-nourished a baby is.

The data was entered into computer programs and analyzed using statistical methods. Researchers used logistic regression, which is a way to figure out which factors are most strongly connected to malnutrition in newborns.

This research approach is important because it gives us a clear picture of the problem in a real-world setting. By studying babies right after birth in actual hospitals, researchers can identify which mothers and babies are at highest risk. This helps doctors and public health workers know where to focus their efforts to prevent malnutrition before it happens.

This study has several strengths: it included all 449 mothers and babies who were eligible (100% participation rate), it was conducted in real hospital settings, and it looked at many different risk factors. However, because it’s a cross-sectional study, it can show which factors are connected to malnutrition but cannot prove that one thing directly causes another. The study was conducted in one region of Ethiopia, so results may not apply everywhere. Additionally, the study relied on mothers’ memories and reports, which could sometimes be inaccurate.

What the Results Show

The main finding was that 91 out of 449 newborns (about 20%) showed signs of malnutrition at birth. This means roughly 1 in every 5 babies born in these hospitals had poor nutrition. The researchers identified 11 major factors strongly connected to malnutrition in newborns.

Maternal factors were very important. Mothers who were teenagers (under 19 years old) were nearly 3 times more likely to have malnourished babies. Mothers with low body weight (measured by arm circumference) were about 4 times more likely to have malnourished babies. Mothers who didn’t take iron and folic acid supplements during pregnancy were almost 3 times more likely to have malnourished babies.

Health problems during pregnancy also mattered significantly. Mothers with anemia (low iron in blood) were about 3.7 times more likely to have malnourished babies. Mothers who had infections during pregnancy were about 2.7 times more likely, and those with malaria were about 2.1 times more likely. Mothers who experienced complications during pregnancy were about 4.6 times more likely to have malnourished babies.

Emotional and safety factors were surprisingly important. Mothers with depression during pregnancy were about 7 times more likely to have malnourished babies—the strongest connection found in the study. Mothers who experienced intimate partner violence were about 5.6 times more likely to have malnourished babies. Additionally, babies with low birth weight or low placental weight were much more likely to show signs of malnutrition.

The study also found that about 67% of mothers had anemia, 66.8% didn’t take iron and folic acid supplements, 45.4% had low placental weight, and 34% experienced either depression or intimate partner violence. These high percentages show that these problems are very common among pregnant women in this region and represent major opportunities for improvement.

This study’s finding that about 20% of newborns are malnourished is consistent with other research showing that malnutrition in newborns is a significant problem in developing countries. The identified risk factors—teenage pregnancy, maternal underweight, anemia, infections, and depression—have been found in other studies as well. However, this research emphasizes the particularly strong connection between intimate partner violence and newborn malnutrition, which is an important finding that deserves more attention in public health efforts.

This study has several limitations to keep in mind. First, it only looked at hospitals in one region of Ethiopia, so the results may not apply to other areas or countries. Second, because it’s a cross-sectional study (a snapshot in time), it can show which factors are connected to malnutrition but cannot prove that one thing directly causes another. Third, the study relied on mothers remembering and accurately reporting information about their health and experiences, which could sometimes be inaccurate. Fourth, the study couldn’t measure all possible factors that might affect newborn nutrition. Finally, the study was conducted in public hospitals, so results may not represent private hospitals or home births.

The Bottom Line

Based on this research, healthcare providers should: (1) Ensure all pregnant women receive iron and folic acid supplements—this is strongly supported by the evidence. (2) Screen pregnant women for anemia and treat it promptly—the evidence strongly supports this. (3) Provide mental health support and screen for depression during pregnancy—the evidence strongly supports this. (4) Screen for and address intimate partner violence—the evidence strongly supports this. (5) Provide extra nutrition counseling and support to teenage mothers and underweight mothers—the evidence supports this. (6) Treat infections and malaria promptly during pregnancy—the evidence supports this. (7) Monitor for pregnancy complications and manage them carefully—the evidence supports this. Confidence level: Moderate to High for most recommendations, as they are based on a well-conducted study with a large sample size.

This research is most relevant to pregnant women and those planning pregnancy, especially in developing countries or areas with limited healthcare. Healthcare providers, midwives, and public health workers should use these findings to improve prenatal care. Policymakers should use this information to develop programs addressing teenage pregnancy, domestic violence, and maternal nutrition. Partners and family members should understand how their support affects pregnancy outcomes. However, these findings are most directly applicable to settings similar to the study location (rural Ethiopia); women in developed countries with strong healthcare systems may have different risk profiles.

The factors identified in this study affect babies during pregnancy, so the benefits of addressing them would be seen at birth and in the newborn period. Improvements in maternal nutrition, treating infections, managing anemia, and addressing mental health and safety issues during pregnancy would ideally be started before pregnancy or as early as possible during pregnancy. The effects on the baby’s nutrition status would be measurable at birth through the baby’s weight and physical signs of nutrition.

Want to Apply This Research?

  • Track weekly: (1) Iron and folic acid supplement intake (yes/no each day), (2) Any infections or fever (date and type), (3) Mood check-in using a simple 1-10 scale, (4) Safety check-in (any concerning interactions with partner), (5) Weight at prenatal visits, (6) Arm circumference measurement if available. Create a simple dashboard showing compliance with supplements and trend in mood over time.
  • Users can set daily reminders to take iron and folic acid supplements. The app could provide nutrition tips for weight gain during pregnancy, connect users to mental health resources, provide information about safe relationships, and encourage regular prenatal visits. Users could log meals to track protein and calorie intake, set goals for prenatal appointment attendance, and receive educational content about pregnancy complications to watch for.
  • Create a pregnancy health score that combines supplement adherence, mood stability, safety indicators, and prenatal visit attendance. Set monthly goals for each factor. Generate reports for healthcare providers showing which areas need more support. Use trend analysis to alert users and providers if concerning patterns emerge (e.g., declining mood, missed appointments). After birth, track newborn weight gain and development to provide feedback on whether prenatal interventions were effective.

This research was conducted in Ethiopia and describes factors associated with newborn malnutrition in that specific setting. While the findings are scientifically sound, they may not directly apply to all populations or healthcare settings. This information is educational and should not replace professional medical advice. If you are pregnant or planning to become pregnant, consult with your healthcare provider about your individual risk factors and appropriate prenatal care. If you are experiencing depression, infections, or intimate partner violence during pregnancy, seek help from your healthcare provider or local support services immediately. The findings suggest associations between various factors and newborn malnutrition but do not prove direct causation.