NUTRITIONAL EFFECTS OF THE SIEGE ON NEWBORN BABIES IN SARAJEVO

Objective: To investigate the influence of maternal nutrition on perin atal mortality, morbidity, malformations and low birth weight (< 2500 grams). Design: Ail mothers and their babies born in Kosevo Hospital d uring three different time periods were sampled: September 1992 to Feb ruary 1993 (pilot study), May 1993 to February 1994 (main study) and s tatistics compiled in 1991(pre-war). Setting: Data were collected at t he gynaecology and obstetric clinic, Kosevo hospital, city of Sarajevo . Subjects: A total of 920 babies were included in the pilot study, 12 25 mothers of 1237 babies participated in the main study and birth dat a from 8676 babies born in 1991 were used as baseline data. Interventi ons: Birth outcome data were compiled for all three time periods. In t he main study, a questionnaire was administered on arrival at the clin ic in which mothers were asked to estimate their weight prior to pregn ancy. Information on energy and protein intake was collected for all w omen by estimating weekly food intake during pregnancy. Mothers were w eighed and had their heights measured within 12 hours of delivery. Wom en were divided into three groups based on their body mass index (BMI) using self-reported prepregnancy weight (underweight BMI < 21.5; norm al weight BMI 21.5-25.6; overweight BMT > 25.6). Four groups were defi ned according to dietary intake during pregnancy (daily energy intake < 2755 kcal and 2755 + kcal; protein intake < 80 and 80 + grams). Resu lts: Weight gain during pregnancy was low in overweight women (3.2 kg) compared with normal weight (10.4 kg) and underweight (11.7 kg) women . Underweight women had babies with the lowest mean birthweight (3072 grams) and the highest percentage of low birth weight babies (13.0%). Perinatal mortality increased from 15.8/1000 live births in 1991 (pre- war) to 36/1000 in May 1993-February 1994. Morbidity among babies incr eased from 3.4% to 8.2% in the same time period. There was a significa nt increase in babies born with malformations from 0.4% in the pre-war period to 3.0% in May 1993 to February 1994. Conclusions: It is concl uded that the war has had a deleterious effect on birth outcomes in Sa rajevo.