Adolescent pregnancy. Zinc supplementation and iron effects.
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Biomedical subjects
Publications and source records attributed to F F Cherry.
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In a previous report of a zinc supplementation trial in pregnant adolescents zinc effect varied according to maternal weight (wt) status--normal (90-110% of expected wt), light or heavy, prompting this analysis of effects of wt status and gestational wt gain on fetal heaviness relative to length and gestational age (GA) and other pregnancy outcomes. One-third of adolescents shifted in or out of normal wt by delivery, creating seven outcome groups--light-light, light to normal, normal to light, normal-normal, normal to heavy, heavy to normal, and heavy-heavy. These wt class change groups varied significantly as to intrauterine growth (SGA, low AGA, high AGA, and LGA); by weekly grams gain per cm height (ht), birth wt, infant wt/length ratio, and occurrence of low birth wt (LBW). Infants with above average intrauterine growth had an advantage in: absolute size, length of hospital stay, rates of LBW, fetal demise, rates of low Apgar score, and "other" complications. This association between intrauterine growth and maternal wt class change suggests that promotion of wt gain might lower rates of LBW. Birthwt varied by quartiles of weekly wt change (gm) per cm ht in women grouped by their percent of expected wt: in the lowest quartile (Q1) only one group in seven reached average Bwt (3025 grams); with Q4 gain all groups did. Thus, the parameter wt gain/wk/cm ht deserves study as a tool for monitoring wt status and gain to identify those pregnant adolescents in greatest need for nutritional counseling and to set wt gain goals.
On a sample of some 2000 children living in two ecologically different zones (the Wooded and Guinea savanna) in Kwara state, Nigeria, body measurements were taken, to serve as indicators of the state of nutrition. There was more undernutrition in the Guinea savanna than in the Wooded. More males than females were undernourished in the Guinea savanna but not in the Wooded. It is argued that the differences between districts stem from social and cultural variables.
In a double-blind zinc trial in low-income, pregnant adolescents thought to be at risk for poor zinc nutriture, subjects were randomly assigned to receive 30 mg zinc (gluconate) or placebo. Response to zinc was related to maternal weight. Infants of normal-weight mothers given zinc had reduced rates of prematurity (p = 0.05) and assisted respiration (p = 0.006). Underweight multiparas given zinc had longer gestational lengths (p = 0.008) than did subjects given the placebo. Multiple stepwise regression analysis, used to identify predictors of infant size, revealed that 14-26% more variance was accounted for in the zinc than in the placebo group. Except for gestational age, the predictors selected were entirely different in the two groups. The zinc group had a positive toxemia screen more often, which did not appear to affect outcome. Zinc supplementation improved pregnancy outcome in normal-weight women and in underweight multiparas. The nonresponse in underweight primiparas was perhaps due to multiple limiting factors.
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A study was conducted at Charity Hospital, New Orleans, among 272 adolescent pregnant women to ascertain the relationship of pregnancy outcome to plasma zinc level measured once at the time of enrollment. Regression analyses were performed on zinc status versus parameters concerning success of pregnancy corrected for gestational stage at specimen collection. Analysis of variance was performed on groups according to presence or absence of complications, with analyses of covariance used to analyze dichotomous groups. Low, though widely variable, plasma zinc levels were found (mean = 58 +/- 12.6 micrograms/dl). Zinc values differed significantly by gestational stage at collection, the regression coefficient indicating a decline of 0.07 micrograms/dl/day. Plasma zinc level correlated significantly with Hb, red blood cells, ferritin, and folic acid. As to course of pregnancy, women experiencing hypertension/toxemia were found to have significantly lower plasma zinc level. Among infants displaying congenital defects at birth those with undescended testes and metatarsus varus were delivered by mothers whose plasma zinc was well below the mean for the group. These findings indicate the need to investigate the influence of dietary patterns and zinc intake on maternal plasma zinc level and pregnancy outcome, further delineating the role of zinc in human reproduction, particularly hypertension of pregnancy.
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A sample of New Orleans black primiparous women under 25 years of age, participants in the national collaborative perinatal study, and their singleton children were studied to determine the relationship of maternal gestational age (GeA), gynecologic age (GyA) and size for GeA (S/GeA) on the child's growth over seven years observation. Early childbearers (less than 4 years GyA) had a somewhat higher proportion of preterm births than the late group (greater than or equal to 4 yrs GyA). A repeated measures analysis of variance after correction for maternal prepregnant weight and weight gain, demonstrated the early group remained smaller throughout the seven years in weight, length and head circumference. Preterm infants showed catch up by one year in height and weight in both Early and Late Groups, though the Early Preterm infants failed to catch up with the other groups in head circumference. In this lower socio economic group, the legacy of early childbearing appears to be smaller child body dimensions which are likely permanent.