Stillbirth rates and folic acid and zinc status in low-socioeconomic pregnant women of Brazilian Amazon.

Twenty-five women in their first trimester and 25 women in their third trimester of pregnancy were randomly chosen from the slum areas of eight towns in the Brazilian Amazon (Manaus, Sao Luis, Boa Vista, Porto Velho, Sao Gabriel, Santarem, Tefe, and Benjamin Constant). Blood samples were removed from the subjects for folic acid and zinc analyses, and the women were asked questions about whether they had suffered from complications during previous pregnancies. It was found that the stillbirth rates reported ranged from 0 to 20/1000 pregnancies. The town that had the highest stillbirth rate (Santarem) also had the highest percentage of women with deficient erythrocyte (red blood cell, RBC) folate status. All of the women in Santarem also had deficient serum folate levels in both trimesters of pregnancy, as well as the lowest average RBC folate value in the third trimester of pregnancy. The same town was also one of two in which the pregnant women had the lowest mean serum zinc levels in the third trimester.

Breast milk folic acid and zinc concentrations of lactating, low socioeconomic, Amazonian women and the effect of age and parity on the same two nutrients.

The levels of folic acid and zinc in breast milk of about 25 women in their first trimester of lactation from each of eight towns in the Brazilian Amazon basin were determined. In order to compare the effects of age and parity on the breast milk folate and zinc levels, the results were analysed together. Thirty-one (60 per cent) of the women in their first month of lactation and 35 (51.5 per cent) in their second month had milk total folate levels below the calculated lower limit of adequacy; only 21 (47 per cent) of the women in their third month of lactation had milk total folate concentrations below the same limit. The breast milk zinc levels, however, were worse, with 35 (95 per cent) and 61 (97 per cent) of the women in their first and second months of lactation and all the women in their third month of lactation having values below the calculated lower limit of adequacy. Both in the case of total folate and zinc, the calculated lower limits of adequacy were obtained from the respective Recommended Dietary Allowances (RDAs) of a 0-6 month old infant and the average milk production of lactating women. While the mean breast milk folate levels (both total and free) showed no significant changes during the months of lactation, the average milk zinc levels showed a significant decrease between the first and second and first and third months of lactation. The age of the women did not significantly influence either the breast milk folate or zinc levels.(ABSTRACT TRUNCATED AT 250 WORDS)

Iron, folic acid and zinc intakes and status of low socio-economic pregnant and lactating Amazonian women.

Dietary intakes were obtained by 24-h recall from 25 women in the first and third trimesters of pregnancy and 25 women in the first 3 months of lactation from eight towns in the Amazon valley. No consistent differences were found between the towns, so the results have been analysed together. Intakes of iron, free and total folate and zinc were nearly all very low compared with current recommendations. Despite their low intakes, the majority of the women had acceptable values of haemoglobin, haematocrit and MCHC. Serum folate concentrations were almost all extremely low (less than 2.5 ng/ml). The levels of RBC folate were also low, but in general not as severely so as those for serum folate. Serum zinc concentrations ranged from 0.2 to 0.7 microgram/ml, whereas the lower limit of acceptability has been put by various authors as 0.59-0.69 microgram/ml according to the stage of pregnancy. In breast milk, total folate in the majority of women ranged from 25 to 50 ng/ml, the greater part of it being in the free form. Zinc levels in breast milk were within the range 0-2 microgram/ml.

PIP: Dietary intakes were obtained by 24-hour recall from 25 women in the 1st and 3rd trimesters of pregnancy and from 25 women during their 1st 3 months of lactation from 8 towns in the Amazon valley. No consistent differences were found between the towns and therefore the results have been analyzed together. Intakes of iron, free and total folate, and zinc were nearly all very low intakes, the majority of the women had acceptable values of hemoglobin, hematocrit, and MCHC. Serum folate concentrations were almost all extremely low ( 2.5 ng/ml). The levels of RBC folate were also low, but in general not as severely as those for serum folate. Serum zinc concentrations ranged from 0.2-0.7 mcg/ml, whereas the lower limit of acceptability has been put by various authors as 0.59-0.69 mcg/ml according to the stage of pregnancy. In breastmilk, total folate in the majority of women ranged from 25-50 ng/ml, the greater portion of it being in its free form. Zinc levels in breastmilk were within the 0-2 mcg/ml range.