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A prospective study of micronutrient status in adolescent pregnancy.
Am J Clin Nutr 2009; 89(4):1114-24AJ

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 = 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 micromol/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 = 0.003; serum folate, P = 0.02; tHcy, P = 0.01; simple regression) and those with low folate intakes, regardless of the inclusion (P = 0.021) or exclusion (P = 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 = 0.049), but not when intake included iron from supplements (P = 0.21). The risk of SGA birth was lower in subjects with iron deficiency anemia (P = 0.002).

CONCLUSION

Poor micronutrient intake and status increase the risk of SGA births in pregnant adolescents.

Authors+Show Affiliations

Maternal and Fetal Health Research Group, School of Laboratory and Clinical Sciences, University of Manchester, St Mary's Hospital, Manchester, UK.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19244368

Citation

Baker, Philip N., et al. "A Prospective Study of Micronutrient Status in Adolescent Pregnancy." The American Journal of Clinical Nutrition, vol. 89, no. 4, 2009, pp. 1114-24.
Baker PN, Wheeler SJ, Sanders TA, et al. A prospective study of micronutrient status in adolescent pregnancy. Am J Clin Nutr. 2009;89(4):1114-24.
Baker, P. N., Wheeler, S. J., Sanders, T. A., Thomas, J. E., Hutchinson, C. J., Clarke, K., ... Poston, L. (2009). A prospective study of micronutrient status in adolescent pregnancy. The American Journal of Clinical Nutrition, 89(4), pp. 1114-24. doi:10.3945/ajcn.2008.27097.
Baker PN, et al. A Prospective Study of Micronutrient Status in Adolescent Pregnancy. Am J Clin Nutr. 2009;89(4):1114-24. PubMed PMID: 19244368.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A prospective study of micronutrient status in adolescent pregnancy. AU - Baker,Philip N, AU - Wheeler,Simon J, AU - Sanders,Tom A, AU - Thomas,Jane E, AU - Hutchinson,Cindy J, AU - Clarke,Karen, AU - Berry,Jacqueline L, AU - Jones,Rebecca L, AU - Seed,Paul T, AU - Poston,Lucilla, Y1 - 2009/02/25/ PY - 2009/2/27/entrez PY - 2009/2/27/pubmed PY - 2009/4/7/medline SP - 1114 EP - 24 JF - The American journal of clinical nutrition JO - Am. J. Clin. Nutr. VL - 89 IS - 4 N2 - 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 = 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 micromol/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 = 0.003; serum folate, P = 0.02; tHcy, P = 0.01; simple regression) and those with low folate intakes, regardless of the inclusion (P = 0.021) or exclusion (P = 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 = 0.049), but not when intake included iron from supplements (P = 0.21). The risk of SGA birth was lower in subjects with iron deficiency anemia (P = 0.002). CONCLUSION: Poor micronutrient intake and status increase the risk of SGA births in pregnant adolescents. SN - 1938-3207 UR - https://www.unboundmedicine.com/medline/citation/19244368/A_prospective_study_of_micronutrient_status_in_adolescent_pregnancy_ L2 - https://academic.oup.com/ajcn/article-lookup/doi/10.3945/ajcn.2008.27097 DB - PRIME DP - Unbound Medicine ER -