Maternal nutritional status in pregnancy and blood pressure in childhood

OBJECTIVE: To examine the relation between indices of maternal nutrition during pregnancy, including haemoglobin concentration, skinfold thickness and body weight, and the child's blood pressure at 10 to 12 years of age. DESIGN: Follow up study of children whose mothers had haemoglobin estimations, weights and skinflod thickness recorded during pregnancy. SETTING: Kingston, Jamaica. SUBJECTS: Seventy-seven children whose mothers took part in a prospective study of nutrition during pregnancy in relation to fetal growth. MAIN OUTCOME MEASURE: Blood pressure at 10 to 12 years of age. RESULTS: The child's mean systolic pressure adjusted for current weight rose by 2.6 mmHg (95 percent CI 0.5-4.6, P = 0.01) for each 1 g/dl fall in the mothers's lowest haemoglobin suring pergnancy. Mothers with a lower haemoglobin had thinner skinfold thickness, especially over the triceps (P=0.005). In multiple regression analyses, taking account of the child's sex and current weight, there was a strong association between thin maternal triceps skinfold thickness at 15 weeks of gestation and raised blood pressure in the offspring. Taking account of the mother's tricep skinfold thickness abolished the relation between lower haemoglobin and raised blood pressure in the child. Lower weight gain between 15 and 35 weeks of gestation was independently associated with raised children's blood pressure. Systolic pressure rose by 10.7 mmHg (95 percent CI 5.7 to 15.6, P= 0.0001) for each log mm decrease in the mother's triceps skinfold thickness, and by 0.6 mmHg (95 percent CI 0.1 to 1.0, P = 0.02) for each 1 kg decrease in the mother's weight gain during pregnancy. CONCLUSION: These results parallel animal experiments suggesting that impaired maternal nutrition may underlie the programming of adult hypertension during fetal life (AU)

Nutritional status of preschoolers in a new settlement in Haiti - abstract

The three-year-old housing scheme at Petit Place Cazeau (PPC) was part of an urbanization programme set up by the government of Haiti. Satisfactory sanitary and housing conditions were provided for the 328 resident low-income working class families. The anthropometry of all the 6 to 36-month-olds were taken. Their medical history, socio-economic background and the prevalence of helminthiasis were investigated. According to the Gomez classification, 41.5 per cent of the children were normal, 38.1 per cent had grade 1 malnutrition, 15.5 per cent had grade 2 and 3.4 per cent had grade 3. The factors significantly associated with poor nutritional status were the following: previous hospital admission (p < 0.01), being female (p < 0.01), crowding (p < 0.05) and low family income (p < 0.05). The children's risk of having low weight for age and low weight for height (wasting), increased with age. Children whose fathers worked in the military tended to thrive well. A very low helminths prevalence was revealed. The prevalence of malnutrition among these preschoolers, although high, was lower than that observed in Haitian urban slums and on the national level. This survey identified children needing immediate treatment. It also provided the nearby clinics with baseline data and information about those at risk of malnutrition for the formulation of relevant and targeted intervention (AU)

Psychosocial functioning of mothers of malnourished children

The relationship between infant malnutrition and maternal psychosocial behavior was explored by comparing mothers of malnourished children with mothers whose children were matched for age and family income but were not malnourished. The mothers were interviewed and asked to describe their relationships with their children, their children's fathers, extended families, friends, and employers. The mothers of malnourished children described more chronically disrupted lives. Their housing conditions and employment records reflected disorganization. They had fewer social contacts except with extended families who supervised excessively. The fathers of their babies were either not present or unsupportive. Relationships were more stereotyped, transient, and focused on material aspects. The mothers' narcissistic concerns took precedence over the needs of their children. Nearly all the mothers, including the controls, had suffered severe deprivation in childhood. Some mothers of malnourished children were apathetic and dependent, whereas others were manipulative and evasive. These findings were consistent with "failure-to-thrive" in affluent countries.(AU)