A prospective study of micronutrient status in adolescent pregnancy

Abstract

Background: Adolescents are more likely than adults to consume energy-dense, micronutrient-poor diets and to experience adverse pregnancy outcomes. Objectives: The objectives were to assess micronutrient intake and blood biomarkers prospectively in pregnant adolescents recruited to the About Teenage Eating (ATE) Study and to determine associations with pregnancy outcome. Design: Pregnant adolescents (n ¼ 500) were recruited from 2 UK inner city populations. Dietary intake was assessed with three 24-h dietary recalls, and micronutrient status was assessed by measurement of third trimester blood biomarkers. Pregnancy outcomes included small-for-gestational age (SGA) birth and preterm delivery. Results: Median iron and folate intakes were lower than UK and US recommended amounts. Folate and vitamin B-12 status were lower in smokers, despite no differences in dietary intake. Serum folate was ,7.0 nmol/L in 12% of subjects, and serum total homocysteine (tHcy) was elevated (.10 lmol/L) in 20% of subjects. Fifty-two percent of the subjects had iron deficiency anemia, and 30% had serum 25-hydroxyvitamin D concentrations ,25 nmol/L. The incidence of SGA birth was higher in subjects with poorer folate status (red blood cell folate, P ¼ 0.003; serum folate, P ¼ 0.02; tHcy, P ¼ 0.01; simple regression) and those with low folate intakes, regardless of the inclusion (P ¼ 0.021) or exclusion (P ¼ 0.049) of intake from supplements (simple regression). Adjustment for confounding variables confirmed the independence of these associations. The risk of SGA birth was also higher in subjects with low food iron intake (P ¼ 0.049), but not when intake included iron from supplements (P ¼ 0.21). The risk of SGA birth was lower in subjects with iron deficiency anemia (P ¼ 0.002). Conclusion: Poor micronutrient intake and status increase the risk of SGA births in pregnant adolescents.

Serum Level of Some Minerals during Three Trimesters of Pregnancy in Iranian Women and Their Newborns: A Longitudinal Study

“…The prevalence of iron deficiency in pregnant women in the studies conducted in UK [32]; in China [33]; and in India [16] was 34, 42.6 and 73.4 % respectively. The high prevalent of iron deficiency amongst pregnant women found in the present study was possibly due to the inadequate iron consumption or the bread eaten by Iranian is made from flour of high extraction and without added leaven.…”

Is 5-methyltetrahydrofolate an alternative to folic acid for the prevention of neural tube defects?

“…Mean folate intake in European populations ranges from 180 to 280 μg/day [5,29,139], which is not sufficient to prevent folate-responsive NTD cases. In addition, factors like smoking, very young age, and lack of knowledge about the importance of folate supplementation before pregnancy can adversely affect the folate status and increase the risk of having a child with a NTD.…”

Vulnerability of the fetal primate brain to moderate reduction in maternal global nutrient availability

“…Recently, one study has shown that most women do not improve their dietary and lifestyle patterns in pregnancy (3). Decreased nutrient delivery to the fetus also occurs in teenage pregnancy (4) and during pregnancy in women over 35 y of age (5). Severe global reduction in nutrition during pregnancy has long been known to result in fetal growth restriction and to cause permanent brain dysfunction, especially cognitive and behavior deficits (6)(7)(8)(9)(10).…”