Nutrition and maternal morbidity and mortality

Nearly 600 000 women die every year from pregnancy related conditions and t he maternal mortality rates (MMR = deaths per 100 000 live births) in devel oping countries may be as high as 1000 compared with less than ten in indus trialised countries. In the light of the striking impact of deficiencies of micronutrients such as vitamin A and zinc on immune function, morbidity an d mortality in children it seems reasonable to suggest that such deficienci es might play a contributing role in the high rates of morbidity and mortal ity in mothers. Hitherto, there has been rather little published on the con tribution of malnutrition to maternal morbidity or mortality but recent res ults of micronutrient supplementation show a major effect of vitamin A or b eta carotene supplementation on maternal mortality in Nepal and an impressi ve effect of a multiple micronutrient mixture on pregnancy outcome in Tanza nia. There is now data showing that subclinical mastitis, a potential risk factor for mother to child transmission of HIV by increasing levels of viru s in breast milk, is influenced by maternal diet in Tanzania and feeding pa tterns in South Africa. Considering the massive tragedy of maternal mortali ty the recent data provides opportunities for new, innovative nutritional i nterventions for the reduction of the global burden of maternal morbidity a nd mortality.