ArticleBMJ open2026
Determinants of neonatal size and body composition: protocol of a prospective cohort study of mother-newborn pairs in Bloemfontein, South Africa.
Article in BMJ open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionNeonatal size and body composition, including fat mass and fat-free mass, are influenced by maternal nutritional status, lifestyle and overall health during pregnancy. Paternal health and household factors may also be contributory to neonatal body composition and subsequent growth trajectories. Neonatal anthropometry and body composition are important predictors of early morbidity, growth faltering, stunting and childhood adiposity and long-term risk of obesity and non-communicable diseases (NCDs). In South Africa, 28% of children under 5 years are stunted, alongside a growing overweight and obesity prevalence and NCD risk in children. Limited evidence exists regarding the maternal and paternal determinants of neonatal body composition in this setting. METHODS AND ANALYSIS: This prospective cohort study aims to investigate maternal and paternal nutritional, health, body composition and lifestyle factors that influence neonatal size and body composition in Bloemfontein. The study will enrol 200 mother-neonate pairs at birth from Universitas Academic Hospital and follow them to 6 weeks postpartum. Maternal assessments at enrolment include anthropometry, body composition (using bioimpedance analysis), dietary intake, medical history, mental health, household food security and socio-economic and lifestyle factors. Neonatal measurements include birth weight and length, gestational age and body composition (using air displacement plethysmography). Paternal data include anthropometry, body composition, dietary intake, chronic disease risk and lifestyle factors, including alcohol use and smoking. At 6 weeks postpartum, infant feeding practices, growth and body composition are assessed. Multiple linear and logistic regression models will be used to assess the relationships between maternal and paternal factors and neonatal outcomes. ETHICS AND DISSEMINATION: This study is approved by the Health Sciences Research Ethics Committee of the University of the Free State and the Free State Department of Health. Findings of this study will be published as scientific articles in peer-reviewed journals, presented at scientific conferences and workshops and disseminated at hospital staff forums and in local media.
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