Parity differences and inflammatory signatures relative to neonatal nutritional status in a community near the Atlantic Ocean coastline of Lagos, Southwest Nigeria: a cross-sectional study.

BACKGROUND

Neonatal malnutrition (NM) remains a major public health concern in sub-Saharan Africa (SSA), driven by complex maternal, placental, and fetal factors. This study determined the prevalence of neonatal malnutrition and examined the potential influence of placental Tumor Necrosis Factor-alpha (TNF-alpha) and Interferon-gamma (IFN-gamma) on maternal and neonatal characteristics in Lagos, Nigeria.

METHOD: A cross-sectional, facility-based study was conducted from March to November 2024 among 254 pregnant women in their first, second, or ≥third pregnancies. Participants were enrolled in the late third trimester and followed through delivery. Maternal sociodemographic and obstetric data were collected using semi-structured questionnaires. Placental characteristics and neonatal anthropometry were recorded postnatally. Neonatal nutritional status was classified using the Ponderal Index Percentile (PIP). Data was analyzed using NCSS 2022.

RESULTS

The mean age of participants was 29.3 ± 5.0 years, with significant variation across groups. The mean age of mother with severely malnourished neonates (26.2 ± 4.1 years) was significantly lower than that of mother of moderately malnourished babies (29.2 ± 3.8 years), healthy (29.2 ± 4.9 years), or overweight neonates (31.9 ± 6.0 years). The prevalence of severe and moderate NM was 4.7% and 5.9%, respectively, with the highest burden among primigravida women. Placental TNF-α concentrations were significantly higher among first-pregnancy mothers (29.7 ± 7.8 pg/mL) than among second-pregnancy mothers (12.1 ± 4.2 pg/mL) who delivered severely malnourished neonates.

CONCLUSION

Severe neonatal malnutrition was most common in 1st and 2nd pregnancies and elevated placental TNF-α may contribute to its pathophysiology. These findings highlight the need for targeted nutritional and medical interventions for first-time mothers and underscore the importance of multi-center research to better characterize the biological mechanisms underlying NM in SSA.