Changes in nutritional status among women and infants aged 6-23 months before and after the COVID-19 pandemic in low-income areas of two cities in Peru

Rousham Emily, Pareja Rossina, Pradeilles Rebecca, Creed-Kanashiro Hilary

Loughborough University, Loughborough, United Kingdom of Great Britain and Northern Ireland; Instituto de Investigación Nutricional, Lima, Peru; UMR MoISA, Montpellier, France

Abstract: Background: Peru has made significant progress in the reduction of stunting and undernutrition in children. However, malnutrition persists with high rates of anaemia, overweight and obesity and stunting. We aimed to assess whether the changing conditions over the course of the COVID-19 pandemic (lockdowns, unemployment, access to healthcare) led to changes in maternal and infant and young child (IYC) nutritional status over this period.

Methods: A nutritional and anthropometric survey on mothers and IYC aged 6-23 months (n=244) was conducted prior to the COVID-19 pandemic (January-March 2020) in low-income peri-urban areas of Huánuco city and Manchay in Lima. A second cross-sectional survey of mother-infant dyads (n=253) was carried out 2 years later (February-April 2022). Height, weight and haemoglobin (Hb) were assessed. Hb values from Huánuco were adjusted for altitude (~1900 m). Anaemia cut points were <105 g/L for 6–23-month-olds and <120 g/L for non-pregnant women (WHO, 2024).

Results: In mothers, univariate analyses showed no change in BMI, but mean Hb was lower (122 g/L vs. 126 g/L, p<0.001) and anaemia prevalence higher (38.5% vs. 26.1%, p<0.003) pre- compared to post- pandemic. Overweight and obesity prevalence was similar in both surveys, but obesity prevalence was higher post-pandemic (20.4% vs. 28.1%, p<0.05). Among IYC, mean Hb was lower (104 g/L vs. 107 g/L, p<0.001) and anaemia prevalence higher (51.6% vs. 40.3%, p=0.011) pre- compared to post-COVID-19. All other indicators remained similar (height-for-age and weight-for-length z-scores; prevalence of stunting, underweight and risk of overweight).

Conclusions: Despitenegative impacts of the pandemic in Peru, maternal and child nutritional status pre- and post-COVID-19 was relatively stable, with higher mean haemoglobin and lower anaemia prevalence in both mothers and infants post-COVID-19. The increase in maternal obesity prevalence, however, may indicate a negative trend in nutritional outcomes.