Born Malnourished? Parity Differences and Inflammatory Signatures of Neonatal Nutritional Status in a Community Near the Atlantic Ocean Coastline Area of Lagos, Southwest Nigeria. A Cross-Sectional Study

Background Neonatal malnutrition (NM) remains a critical public health issue in sub-Saharan Africa (SSA) with multifactorial causes including maternal, placental, and genetic factors. This study aimed to determine the prevalence of newborn malnutrition and to evaluate the potential influence of Tumor Necrosis Factor-alpha (TNF-α) and Interferon-gamma (IFN-γ) on maternal and neonatal indices. This cross-sectional, facility-based study was conducted between March and November 2024 in Lagos, Nigeria. Method A total of 254 pregnant women in their 1st, 2nd, and ≥3rd pregnancies were recruited and study participation began in the latter stages of their third trimester and continued through delivery. Maternal sociodemographic and pregnancy-related information were collected using semi-structured questionnaires. Post-natal data included placental characteristics and neonatal anthropometric measurements. The Ponderal Index Percentile (PIP) was used to classify neonatal nutritional status. 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 rates observed among first-time mothers. Placental TNF-α concentration was significantly higher in 1st pregnancy mothers (29.7 ± 7.8 pg/ml) compared to 2nd pregnancy mothers (12.1 ± 4.2 ng/ml) of severely malnourished neonates. Discussion Malnutrition on the first day of life is an indicator of intrauterine challenges the fetus was exposed to, especially among primigravid women. The nutritional status of pregnant women and that of the fetus should be accurately evaluated during antenatal care, to minimize or avoid early mortality or future health implications of malnutrition during adulthood. Conclusion Severe neonatal malnutrition was highest among first pregnancies and TNF-α may play a significant role in the pathophysiology of this health status, highlighting the need for targeted nutritional and medical interventions for first-time mothers. This study underscores the urgent necessity for multi-centered and multidisciplinary research on NM in SSA to better understand its causes and develop effective preventive strategies.