Dietary intake, nutritional status and healthcare characteristics of mothers and newborn infants in a prospective cohort study (CHAMP) from a malnutrition-endemic region of Pakistan

Background: Dietary intake, nutritional status, healthcare access, and early-life exposures play a critical role in shaping infant growth and development. Recent evidence suggests that the impact is largely mediated by gut microbiome. The Child Health, Nutrition and Microbiome in Pakistan (the CHAMP study) is a longitudinal cohort study aiming to assess the bidirectional relationship between gut microbiome and infant growth and development in a cohort of children residing in malnutrition endemic areas of Pakistan. Objectives: The current study report the baseline sociodemographic, dietary, healthcare, and nutritional characteristics of mother-infant dyads participating in the CHAMP study. Methods: Baseline data were collected from 70 mothers and 72 newborn infants recruited from rural communities in District Swat, Pakistan. Information on household socioeconomic status, maternal dietary intake, antenatal, delivery and postnatal care, infant feeding practices, morbidity, and anthropometric measurements was obtained using validated tools. Descriptive and sex-stratified analyses were conducted. Results: Households were socioeconomically disadvantaged, with low parental education, large family size, and mean household income substantially below the national minimum wage. Maternal utilization and quality of antenatal and postnatal care were suboptimal, including limited completion of recommended antenatal visits. Dietary quality was also poor, and none of the mothers met the recommended minimum dietary diversity for women. Among infants, morbidity was common, with nearly half experiencing diarrheal illness or respiratory infections. Exclusive breastfeeding reported only in 43.1% of infants. Anthropometric assessment revealed evidence of early growth faltering, with 35.4% of infants were low-length-for-age with higher prevalence among females. Conclusion: These baseline findings highlight substantial socioeconomic vulnerability, poor maternal diet quality, gaps in maternal and infant healthcare, and early-life undernutrition in this rural Pakistani cohort. The study finding provides foundation for longitudinal analyses examining how these factors interact with gut microbiome development and child growth, informing and cost effective and culturally relevant intervention strategies.