BACKGROUND: South Asia is witnessing a rise in obesity among reproductive-aged women, and the repercussions of this condition extend to their offspring. Our research aims to assess the impact of caesarean section and iron supplementation during pregnancy on different forms of double burden of malnutrition among mother-child dyads in South Asia. METHOD: This study utilized cross-sectional survey data from 116,547 non-pregnant women having at least one child from Bangladesh, Nepal, Pakistan, India, and the Maldives who completed a Demographic and Health Survey from 2016-2022. A descriptive, bivariate, log-binomial regression model and population attributable fraction for analysis were also employed, with a 5% significance level. RESULTS: Mothers who underwent caesarean delivery demonstrated a 53%, 42%, and 50% increased likelihood of being overweight/obese with stunted child, with wasted child, and with underweight child, respectively, in comparison to those who experienced vaginal delivery. Caesarean delivery without iron supplementation exhibited the highest individual risk across all categories: adjusted prevalence ratio (aPR) of 1.68 (95% CI: 1.48, 1.90) for stunted children of overweight mothers, aPR of 1.65 (95% CI: 1.39, 1.96) for wasted children of overweight mothers, and aPR of 1.79 (95% CI: 1.55, 2.06) for underweight children of overweight mothers. CONCLUSION: Positive population attributable fraction of the exposure highlights that the prevalence of double burden of malnutrition would be higher in the presence of caesarean delivery. Policymakers should promote awareness initiatives regarding the risk of caesarean delivery and the necessity of iron supplementation during pregnancy in South Asia.
Mahazabin et al. (Thu,) studied this question.