Poor diet in pregnancy may be a proxy for some other hostile influence on fetal growth

A review of low birth weight: predictors, precursors and morbidity outcomes

This paper reviews the global evidence concerning infant low birth weight (LBW) (2.500kg and below) in relation to suggested causative factors, such as undernutrition, stress, smoking, drug abuse and deprived living environments. In addition, health promotion strategies in place to reduce LBW incidence in both developed and underdeveloped countries are reviewed. The paper also focuses on the high incidence of LBW in the UK in comparison to other European and developed countries. Predictors of LBW are then considered comparing findings of a study conducted in the UK with findings in underdeveloped countries. In addition, LBW risk is discussed in the context of vulnerability factors, such as teen pregnancy, child abuse and domestic violence. In conclusion, the author argues for a health promotion policy in the UK to reduce incidence of LBW in areas of deprivation and suggests that the improvement of maternal health is key in improving the health of today's infants and children who will one day become the adults of tomorrow.

Maternal nutrition and fetal growth: practical issues in international health

The relationship between maternal nutrition and fetal growth is more complex than might be at first assumed. Low birthweight (LBW) increases the risk of early mortality and later morbidity, and attempts to improve fetal outcome in developing countries need to address the problem of compromised fetal growth. This paper examines the links between birthweight and women's nutritional status in both biomedical and programmatic contexts.

Nutrient intakes during pregnancy: the influence of smoking status and age

STUDY OBJECTIVE

To examine the relation of antioxidant and other nutrient intakes in pregnancy to smoking and sociodemographic variables.

DESIGN

Cohort study.

SETTING

St Mary's Maternity Hospital, Portsmouth.

PARTICIPANTS

Pregnant nulliparous women, with no existing complications of pregnancy, were recruited from antenatal booking clinics. A total of 774 women completed seven day food diaries, and supplied detailed data on their use of nutrient supplements.

MAIN RESULTS

Smokers had lower intakes of most micronutrients. After adjustment for the confounding effects of maternal age, height, and education, only vitamin C and carotenoid intakes remained significantly depressed. Age was strongly and significantly associated with the intake of most nutrients, including antioxidants, and this association was independent of other maternal factors. Antioxidant intake was therefore lowest in young women who smoked: for example smokers under 24 years had a mean vitamin C intake of 57 mg (SD 35) compared with 106 mg (SD 52) for non-smokers aged 28 and over (difference 49 mg, 95% CI 39, 59). The corresponding intakes of carotenoid equivalents were 1335 micrograms (SD 982) and 2093 micrograms (SD 1283) (difference 758 micrograms, 95% CI 496, 1020).

CONCLUSIONS

The study has identified, for the first time, young pregnant women as a group at particular risk of low micronutrient intake. The health implications of poor nutrition now need to be evaluated, particularly for those women who smoke.