Rondó, Patricia Helen de Carvalho; (1994) The influence of maternal nutritional factors on intrauterine growth retardation. Doctoral thesis (Ph.D), UCL (University College London).

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Abstract

A case-control study of 712 mother-baby pairs was performed to assess maternal nutritional risk factors for intrauterine growth retardation (IUGR) in urban Brazil. Levels of vitamin A, folate and iron were determined in maternal blood and cord blood samples from mother-baby pairs who had IUGR and adequate birth weight (ABW). The following groups of risk factors for IUGR were also explored: genetic and constitutional, demographic, socioeconomic, obstetric / antenatal care, toxic exposures, psychological, maternal morbidity and episodic illness. The relationship between micronutrient status and IUGR was investigated using stratification and logistic regression to control for the effect of confounding factors. IUGR in this population was significantly related to: coffee intake, cigarette smoking, beer intake, per capita income, cord levels of vitamin A, cord levels of haemoglobin, maternal ferritin, maternal body weight, maternal weight gain, and prior history of LBW. Causes of low cord levels of vitamin A in IUGR babies are discussed; they seem to be more a consequence than a cause of IUGR. Our study suggests that supplementation of IUGR infants with vitamin A may be important in reducing infant morbidity and mortality rates. The low levels of haemoglobin (Hb ≤ 11.0 g/d1) exhibited by 47% of the mothers may mostly be explained by folate deficiency. Iron deficiency, assessed by plasma ferritin, seems not to be a public health problem for this population, although some of the high ferritin results are probably secondary to maternal infection. Specific interventions likely to have the largest short term impact in this population are efforts to reduce coffee consumption. Pregnant and non pregnant women should be a target group for smoking and alcohol cessation programmes. Over the long term, improvement in socioeconomic conditions would be expected to produce important benefits.

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