Home Nutrition Counselling Boosts Pregnancy Weight Gain in Dhaka Slums

Inadequate weight gain during pregnancy is a recognised public health concern in low- and middle-income countries, where it is associated with adverse birth outcomes. A quasi-experimental study conducted in an urban slum in Dhaka, Bangladesh, tested whether home-based nutritional counselling combined with micronutrient supplementation could improve gestational weight gain among women living in resource-poor settings. The results, published in BMC Pregnancy and Childbirth, show a measurable improvement in total and weekly weight gain, although the intervention did not significantly increase the likelihood that participants achieved weight gain considered optimal for their pre-pregnancy body mass index.

The study enrolled 362 pregnant women at 16 weeks of gestation or earlier. Participants were allocated to an intervention group of 216 women, who received home-based nutritional counselling from trained peer-counsellors alongside micronutrient supplementation, or to a comparison group of 146 women receiving standard care. Maternal weight was measured longitudinally from early pregnancy through to delivery, allowing the researchers to track weight gain trajectories across the whole of pregnancy rather than relying on a single measurement.

The participants had a median age of 23.1 years, with an interquartile range of 19.9 to 28.3 years, and 16.9 percent were underweight at the start. Overall, the mean total gestational weight gain was 8.6 kilograms, with a standard deviation of 3.9 kilograms, and the mean weekly gain was 0.40 kilograms. Only 22.6 percent of participants achieved optimal gestational weight gain according to Institute of Medicine guidelines based on their pre-pregnancy BMI, underscoring how far most women in this setting fell short of recommended targets.

The intervention group gained more weight than the comparison group. Mean total gestational weight gain was 9.0 kilograms in the intervention arm compared with 7.9 kilograms in the comparison arm, a difference that was statistically significant with a p-value of 0.007. Across BMI categories, the rate of weight gain during the second and third trimesters among intervention participants was more consistent with the ranges recommended by the Institute of Medicine than the rates observed in the comparison group.

Mixed-effects modelling of the longitudinal weight data indicated a steeper rate of weekly gain among intervention participants, with a beta coefficient of 0.04 and a 95 percent confidence interval of 0.01 to 0.08. Because the confidence interval did not include zero, this difference was statistically significant at the threshold of p less than 0.05 used in the study. The modelling approach allowed the researchers to estimate weight gain trajectories while accounting for repeated measurements within individuals over the course of pregnancy.

The analysis also identified factors associated with gestational weight gain independent of the intervention. Maternal education, the husband’s age, and being overweight or obese before pregnancy were each positively associated with weight gain, all with p-values below 0.001. Being underweight was inversely related to gestational weight gain, also with a p-value below 0.001.

Statistical methods were matched to the study design. Multiple linear regression and mixed-effects models were used to assess gestational weight gain trajectories, while propensity score matching was applied to evaluate the intervention’s effects on achieving optimal gestational weight gain and on birth outcomes. Despite the gains in total and weekly weight, the propensity score analysis found that the intervention did not significantly increase the likelihood of achieving optimal gestational weight gain as defined by the Institute of Medicine guidelines.

The authors conclude that home-based nutrition counselling with micronutrient supplementation improved total and weekly gestational weight gain in this population, even though it did not translate into a significantly higher rate of optimal weight gain. They suggest that peer-led, community-based interventions of this kind may help improve maternal nutrition in similar resource-constrained settings. Because the study was quasi-experimental rather than randomised, and was conducted in a single urban slum population in Dhaka, the findings should be interpreted with attention to those design and scope limitations.

The trial was registered at ClinicalTrials.gov under identifier NCT05311436, with registration dated 27 March 2022. The article, authored by Mustafa Mahfuz, Md Fuad Al Fidah, S. M. Tafsir Hasan, Ar-Rafi Khan, Fahmida Dil Farzana, Gulshan Ara and Tahmeed Ahmed, among others, was published on 28 October 2026 as open access research.

Subject of Research: Home-based nutritional counselling and micronutrient supplementation and gestational weight gain among pregnant women in urban slums in Dhaka, Bangladesh

Article Title: Improving gestational weight gain among urban Bangladeshi women living in resource-poor settings: effects of home-based nutritional counselling and micronutrient supplementation

Article References: Mahfuz, M., Al Fidah, M. F., Hasan, S. M. T., Khan, A.-R., Farzana, F. D., Ara, G., & Ahmed, T. (2026). Improving gestational weight gain among urban Bangladeshi women living in resource-poor settings: effects of home-based nutritional counselling and micronutrient supplementation. BMC Pregnancy and Childbirth. https://doi.org/10.1186/s12884-026-10158-5

Image Credits: AI Generated

DOI: 10.1186/s12884-026-10158-5

Keywords: gestational weight gain, pregnancy nutrition, Bangladesh, urban slums, micronutrient supplementation, peer counselling, maternal health, quasi-experimental study, Institute of Medicine guidelines, Dhaka, low- and middle-income countries, birth outcomes