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      Prevalence of nutritional deficiencies in Mexican adolescent women with early and late prenatal care


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          SUMMARY. The objective was to evaluate the prevalence of specific nutritional deficiencies in a group of pregnant adolescents according to the gestational age when they started to receive prenatal care. A group of 163 pregnant adolescents that attended the Instituto Nacional de Perinatología (Mexico City) for the first time to receive prenatal care was evaluated. An anthropometrical evaluation was performed and a blood sample taken to determine hemoglobin, ferritin, erythrocyte folate and plasma zinc to all cases. The mean age was 15 years (11 to 17 years). The mean gestational age when starting prenatal care was 27 ± 7 gestation weeks and most of them tended to have low weight (97± 12% expected weight for height and gestational age). Eight of every ten adolescents had anemia and iron deficiency. Late prenatal care ( > or = 25 weeks) was associated with the risk of presenting anemia OR 5.11 (CI 95% 2.4- 10.7) iron deficiency (OR 3.5; CI 95% 1.7 to 7.1) and zinc deficiency (OR 2.9; CI 95%1.1 a 7.6). In relation to folate deficiency, the opposite effect was observed (OR 0.10; CI 95% 0.02 a 0.48). Lack of opportune prenatal care was associated with the presence of iron and zinc depletion. Probably iron deficiency contributes to an erythrocyte folate accumulation.

          Translated abstract

          RESUMEN. Con el objeto de evaluar la prevalencia de deficiencias nutricias específicas en un grupo de adolescentes embarazadas de acuerdo con la edad gestacional en que inician su control prenatal, se estudió en forma transversal a un grupo de 175 embarazadas adolescentes que acudieron por primera vez a control prenatal al Instituto Nacional de Perinatología (Ciudad de México). En todos los casos se realizó una evaluación antropométrica y se tomó una muestra de sangre para determinar hemoglobina, ferritina, ácido fólico eritrocitario y zinc plasmático. El promedio de edad fue de 15 años (11 a 17 años). El promedio de edad gestacional al inicio del CP fue de 27 ± 7 semanas de gestación y en su mayoría tendieron al bajo peso (97± 12% del peso esperado para la estatura y edad gestacional). Ocho de cada diez adolescentes mostraron anemia y deficiencia de hierro. El control prenatal tardío ( > o = 25 semanas) se asoció con el riesgo de presentar anemia (RM 5.11 IC95% 2.4-11.9), depleción de hierro (RM 3.53; IC95% 1.75- 7.10) y de zinc (RM 2.94; IC 95%1.14 a 7.58). En el caso de la deficiencia de folatos paradójicamente se observó el efecto contrario (RM 0.10; IC95% 0.02 a 0.48). La falta de control prenatal oportuno se asocia con a la presencia de anemia, deficiencia de hierro y zinc. Probablemente la depleción de hierro conduce a la acumulación de folato eritrocitario.

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          Most cited references30

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          A clinical evaluation of serum ferritin as an index of iron stores.

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            Definition of chronic energy deficiency in adults. Report of a working party of the International Dietary Energy Consultative Group.

            New criteria are proposed for classifying chronic energy deficiency (CED) in adults. A progressively more precise approach to identifying affected individuals involves measuring body weight and height, then energy intake (or expenditure) and finally the basal metabolic rate (BMR). Three cut-off points for body mass index (BMI) were identified: 18.5, 17.0 and 16.0. A BMI above 18.5 is classified as normal and below 16.0 as grade III CED. A diagnosis of grades I and II CED depends on finding the combination of a BMI of 16.0-16.9 or 17.0-18.4 with a ratio of energy turnover to predicted BMR of less than 1.4. Measuring the individual BMR avoids misclassification and confirms the diagnosis. In groups of African adults 38-63 per cent of each group had a BMI below 18.5 and the majority require studies of their energy turnover before specifying their degree of CED; 3 per cent of Ethiopian women and 24 per cent of a selected male African group had grade III CED. These guidelines can be used when assessing the input of aid programmes and for clinical and other studies.
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              Clinical Hematology


                Author and article information

                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Archivos Latinoamericanos de Nutrición
                Sociedad Latinoamericana de Nutrición (Caracas )
                March 2003
                : 53
                : 1
                : 35-38



                SciELO Venezuela

                Self URI (journal page): http://www.scielo.org.ve/scielo.php?script=sci_serial&pid=0004-0622&lng=en
                NUTRITION & DIETETICS

                Nutrition & Dietetics
                Adolescents,nutrition,pregnancy,prenatal care,iron,folate,zinc,Adolescencia,nutrición,embarazo,vitamina A,hierro,folato


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