Evaluation of the Blood Level of Adiponectin in Pregnant Adolescents.

OBJECTIVE: To evaluate serum levels of adiponectin in pregnant adolescents between 30 and 36 weeks of gestation. METHOD: A prospective cross-sectional study enrolled 67 normal pregnant women between 30 and 36 weeks of gestation and eutrophic (body mass index [BMI]: 18.5-25 kg/m2), of which 36 were adolescents (< 20 years old) and 31 adults (≥ 20 years old). Serum adiponectin levels were determined by enzyme-linked immunosorbent assay (ELISA). The t-student or Mann-Whitney tests were used for intergroup comparison. RESULTS: Pregnant adolescents showed significantly higher serum adiponectin concentrations compared with pregnant adults (p = 0.04). No differences were observed in adiponectin levels in younger pregnant adolescents (< 16 years old) compared with older pregnant adolescents (≥ 16 years old). Adiponectin values were divided into 3 subgroups: < 3,000 ng/mL, between 3,000 and 5,000 ng/mL, and > 5,000 ng/mL. Birthweight was significantly higher in women > 5,000 ng/mL when compared with < 3,000 ng/mL in the adolescent group. No association between pregestational adiponectin levels and BMI, gestational weight gain, and gestational age was observed; however, there was a positive relation with birthweight (p = 0.0239). CONCLUSION: Serum adiponectin values in pregnant adolescents between 30 and 36 weeks of gestation were higher compared with pregnant adults; however, no differences between younger and older pregnant adolescents were observed.

OBJETIVO: Avaliar os níveis séricos de adiponectina em gestantes adolescentes entre 30 e 36 semanas de gestação. MéTODOS: Estudo prospectivo e transversal incluindo 67 gestantes normais entre 30 a 36 semanas e eutróficas (índice de massa corporal [IMC]: 18,5­25 kg/m2), sendo 36 adolescentes (< 20 anos) e 31 adultas (≥ 20 anos). Os níveis séricos de adiponectina foram avaliados por teste imunoenzimático (ELISA, na sigla em inglês). Para a comparação entre os grupos, utilizou-se os testes t-Student ou Mann-Whitney. RESULTADOS: As gestantes adolescentes apresentaram significativamente maiores concentrações séricas de adiponectina do que as adultas (p = 0,04). Não houve diferenças nos níveis de adiponectina quando comparadas as gestantes adolescentes precoces (< 16 anos) às tardias (≥ 16 anos). Os valores de adiponectina foram subdivididos em 3 grupos: < 3.000 ng/mL, entre 3.000 e 5.000 ng/mL e > 5.000 ng/mL. O peso do recém-nascido foi significantemente maior nas mulheres com > 5.000 ng/mL, quando comparadas as com < 3.000 ng/mL no grupo das adolescentes. Não foi observada associação entre os níveis de adiponectina e o IMC pré-gestacional, ganho de peso gestacional e a idade gestacional, porém houve relação positiva com o peso do recém-nascido (p = 0,0239). CONCLUSãO: Os valores séricos de adiponectina em gestantes adolescentes entre 30 e 36 semanas de gestação foram maiores do que os das gestantes adultas; contudo, sem diferenças entre gestantes adolescentes precoces e tardias.

Evaluation of the Blood Level of Adiponectin in Pregnant Adolescents / Avaliação dos níveis séricos de adiponectina em gestantes adolescentes

Abstract Objective To evaluate serum levels of adiponectin in pregnant adolescents between 30 and 36 weeks of gestation. Method: A prospective cross-sectional study enrolled 67 normal pregnant women between 30 and 36 weeks of gestation and eutrophic (body mass index [BMI]: 18.5-25 kg/m2), of which 36 were adolescents (< 20 years old) and 31 adults (≥ 20 years old). Serum adiponectin levels were determined by enzyme-linked immunosorbent assay (ELISA). The t-student or Mann-Whitney tests were used for intergroup comparison. Results Pregnant adolescents showed significantly higher serum adiponectin concentrations comparedwith pregnant adults (p=0.04). No differences were observed in adiponectin levels in younger pregnant adolescents (< 16 years old) compared with older pregnant adolescents (≥ 16 years old). Adiponectin values were divided into 3 subgroups:<3,000 ng/mL, between 3,000 and 5,000 ng/mL, and>5,000 ng/mL. Birthweight was significantly higher in women>5,000 ng/mL when compared with<3,000 ng/mL in the adolescent group. No association between pregestational adiponectin levels and BMI, gestational weight gain, and gestational age was observed; however, there was a positive relation with birthweight (p=0.0239). Conclusion Serum adiponectin values in pregnant adolescents between 30 and 36 weeks of gestation were higher compared with pregnant adults; however, no differences between younger and older pregnant adolescents were observed.

Resumo Objetivo Avaliar os níveis séricos de adiponectina em gestantes adolescentes entre 30 e 36 semanas de gestação. Métodos Estudo prospectivo e transversal incluindo 67 gestantes normais entre 30 a 36 semanas e eutróficas (índice de massa corporal [IMC]: 18,5-25 kg/m2), sendo 36 adolescentes (< 20 anos) e 31 adultas (≥ 20 anos). Os níveis séricos de adiponectina foram avaliados por teste imunoenzimático (ELISA, na sigla em inglês). Para a comparação entre os grupos, utilizou-se os testes t-Student ou Mann-Whitney. Resultados As gestantes adolescentes apresentaram significativamente maiores concentrações séricas de adiponectina do que as adultas (p=0,04). Não houve diferenças nos níveis de adiponectina quando comparadas as gestantes adolescentes precoces (< 16 anos) às tardias (≥ 16 anos). Os valores de adiponectina foram subdivididos em3 grupos:<3.000 ng/mL, entre 3.000 e 5.000 ng/mL e>5.000 ng/mL. O peso do recém-nascido foi significantemente maior nas mulheres com>5.000 ng/mL, quando comparadas as com<3.000 ng/mL no grupo das adolescentes. Não foi observada associação entre os níveis de adiponectina e o IMC pré-gestacional, ganho de peso gestacional e a idade gestacional, porém houve relação positiva com o peso do recém-nascido (p=0,0239). Conclusão Os valores séricos de adiponectina em gestantes adolescentes entre 30 e 36 semanas de gestação foram maiores do que os das gestantes adultas; contudo, sem diferenças entre gestantes adolescentes precoces e tardias.

Vitamin D deficiency in adolescent pregnancy and obstetric outcomes.

OBJECTIVE: The aim of this study was to evaluate the rates of vitamin D deficiency in adolescent pregnants and its influence on the obstetric outcomes. MATERIALS AND METHODS: A total of 300 singleton pregnant women aged between 14 and 20 years, were divided into three groups according to their gestational weeks (100 pregnant adolescents from each trimester). Randomly selected 300 singleton pregnant women older than 20 years of age with the similar gestational ages were designed as the control group at the same time period. We divided serum 25(OH)D levels into three categories deficiency, inadequacy and adequate levels according to the Endocrine Society guidelines. Serum 25(OH)D levels were also evaluated according to age, seasons and gestational periods. Adverse obstetric outcomes were recorded. RESULTS: Overall, 86% of the subjects were found to have deficient 25(OH)D levels (<20 ng/ml). The levels indicated an inadequate state in 72 subjects (12%) and only 12 (2%) women had adequate 25 (OH) D levels. Among adult pregnant women the rates of deficient, inadequate and adequate levels were 88.3%, 11%, and 0.7% respectively. Among adolescent pregnant women these rates were 83.7%, 13%, and 3.3% respectively. The lowest 25(OH)D levels occurred during the winter while the highest levels were detected during the summer in both groups. Calcidiol, 25(OH)D, was a significant predictor for preterm delivery (AUC = 0,909; p < 0,001) and also for SGA (AUC = 0,915; p < 0,001). Maternal age was another significant predictor for SGA (AUC = 0,787; p < 0,001) and preterm delivery (AUC = 0,785; p < 0,001). CONCLUSION: We found a high incidence of 25(OH)D deficiency in Turkish pregnant women. Adolescent age and low 25(OH)D levels are significant risk factors for PTD and SGA. Effective prophylaxis programs for vitamin D deficieny and/or fortification of foods with vitamin D are essential in pregnant women especially in the winter season.

Seroprevalence of HIV, HTLV, CMV, HBV and rubella virus infections in pregnant adolescents who received care in the city of Belém, Pará, Northern Brazil.

BACKGROUND: Prenatal tests are important for prevention of vertical transmission of various infectious agents. The objective of this study was to describe the prevalence of human immunodeficiency virus (HIV), human T-lymphotropic virus (HTLV), hepatitis B virus (HBV), cytomegalovirus (CMV), rubella virus and vaccination coverage against HBV in pregnant adolescents who received care in the city of Belém, Pará, Brazil. METHODS: A cross-sectional study was performed with 324 pregnant adolescents from 2009 to 2010. After the interview and blood collection, the patients were screened for antibodies and/or antigens against HIV-1/2, HTLV-1/2, CMV, rubella virus and HBV. The epidemiological variables were demonstrated using descriptive statistics with the G, χ2 and Fisher exact tests. RESULTS: The mean age of the participants was 15.8 years, and the majority (65.4%) had less than 6 years of education. The mean age at first intercourse was 14.4 years, and 60.8% reported having a partner aged between 12 and 14 years. The prevalence of HIV infection was 0.3%, and of HTLV infection was 0.6%. Regarding HBV, 0.6% of the participants had acute infection, 9.9% had a previous infection, 16.7% had vaccine immunity and 72.8% were susceptible to infection. The presence of anti-HBs was greater in adolescent between 12 and 14 years old (28.8%) while the anti-HBc was greater in adolescent between 15 and 18 years old (10.3%). Most of the adolescents presented the IgG antibody to CMV (96.3%) and rubella (92.3%). None of the participants had acute rubella infection, and 2.2% had anti-CMV IgM. CONCLUSIONS: This study is the first report of the seroepidemiology of infectious agents in a population of pregnant adolescents in the Northern region of Brazil. Most of the adolescents had low levels of education, were susceptible to HBV infection and had IgG antibodies to CMV and rubella virus. The prevalence of HBV, HIV and HTLV was similar to that reported in other regions of Brazil. However, the presence of these agents in this younger population reinforces the need for good prenatal follow-up and more comprehensive vaccination campaigns against HBV due to the large number of women susceptible to the virus.

Serum Concentration of Leptin in Pregnant Adolescents Correlated with Gestational Weight Gain, Postpartum Weight Retention and Newborn Weight/Length.

Introduction: Gestational weight gain is an important modifiable factor known to influence fetal outcomes including birth weight and adiposity. Leptin is normally correlated with adiposity and is also known to increase throughout pregnancy, as the placenta becomes a source of leptin synthesis. Several studies have reported positive correlations between cord blood leptin level and either birthweight or size for gestational age, as well as body mass index (BMI). Objective: To determine the correlation of prenatal leptin concentration in pregnant adolescents with their gestational weight gain, postpartum weight retention, and weight/length of their newborn. Methods: A cohort study was conducted on pregnant Mexican adolescents from Gestational Week 26-28 to three months postpartum (n = 168 mother-child dyads). An anthropometric assessment was made of each pregnant adolescent, and the serum level of leptin and the intake of energy were determined. The newborn was evaluated each month during postpartum. Clinical records were reviewed to obtain sociodemographic data. Bivariate correlations, tests for repeating measurements and logistic regression models were performed. Results: Leptin concentration gradually increased during the third trimester of pregnancy. At Gestation Week 36, leptin level correlated with gestational weight gain. When comparing adolescents that had the lowest and highest concentration of leptin, the former presented a mean of 6 kg less in gestational weight gain (inter-subject leptin concentration, p = 0.001; inter-subject energy intake, p = 0.497). Leptin concentration and gestational weight gain exerted an effect on the weight of the newborn (inter-subject leptin concentration for Week 32, p = 0.024; inter-subject gestational weight gain, p = 0.011). Newborn length was associated with leptin concentration at Week 28 (leptin effect, p = 0.003; effect of gestational weight gain, p = 0.722). Conclusions: Pregnant adolescents with leptin concentration over 20 ng/mL showed a greater gestational weight gain. Leptin concentration correlated with length and weight of the newborn.

Association between adverse perinatal outcomes and amino acid levels measured with nutrient questionnaire in adolescent pregnancies.

BACKGROUND: To evaluate the maternal serum amino acid levels in first trimester adolescent pregnancies by using a new developed dietary questionnaire. METHODS: A group of 169 pregnant women in the first trimester of their pregnancy were asked to complete the dietary questionnaire. Among all the women, 39 were adolescent pregnancies. The results of the questionnaire were evaluated by a nutrient database program (BeBiS software program) designed to evaluate Turkish traditional foods and commercial processed foods. RESULTS: There was no statistically significant difference between the groups in terms of body mass index and educational and socio-economic status. The mean age and gravidity was statistically significantly lower in adolescent pregnancies. The mean isoleucine, leucine, lysine, methionine, phenylalanine, tyrosine, threonine, valine, arginine, and proline levels were statistically significantly lower in adolescent pregnancies. Receiver operating characteristic (ROC) curve analysis showed the cut-off values of these amino acids. Of these amino acids; lower values of histidine, serine, and alanine were associated with lower birth weight, and lower values of histidine and alanine were associated with preterm delivery. CONCLUSION: To the best of our knowledge, this is the first study evaluating the amino acid levels in adolescent pregnancies. According to this study, some amino acid levels were lower in adolescent pregnancies and associated with adverse perinatal outcomes. Further studies with maternal and perinatal outcomes are needed to demonstrate the effects of these amino acids in such pregnancies.

Prevalence of anemia and associations between neonatal iron status, hepcidin, and maternal iron status among neonates born to pregnant adolescents.

BACKGROUND: Little is known about anemia and iron status in US newborns because screening for anemia is typically not undertaken until 1 y of age. This study was undertaken to characterize and identify determinants of iron status in newborns born to pregnant adolescents. METHODS: Pregnant adolescents (≤ 18 y, n = 193) were followed from ≥ 12 wk gestation until delivery. Hemoglobin, ferritin, soluble transferrin receptor, serum iron, hepcidin, erythropoietin (EPO), IL-6, and C-reactive protein were assessed in maternal and cord blood. RESULTS: At birth, 21% of the neonates were anemic (Hb < 13.0 g/dl) and 25% had low iron stores (ferritin < 76 µg/l). Cord serum ferritin concentrations were not significantly associated with gestational age (GA) at birth across the range of 37-42 wk. Neonates born to mothers with ferritin < 12 µg/l had significantly lower ferritin (P = 0.003) compared to their counterparts. Hepcidin and IL-6 were significantly (P < 0.05) higher in neonates born to mothers with longer durations of active labor. CONCLUSION: Given the importance of the iron stores at birth on maintenance of iron homeostasis over early infancy, additional screening of iron status at birth is warranted among those born to this high risk obstetric population.

Hormonal State Comparison (Progesterone, Estradiol, and Leptin) of Body Fat and Body Mass Indices in Mexican Women as a Risk Factor for Neonatal Physiologic Condition.

STUDY OBJECTIVE: Describe the impact of teen pregnancy on later ovarian activity and metabolic hormones considering the concentration of current levels of ovarian steroids and leptin in a sample of Mexican females. DESIGN: Cross-sectional study in the maternity of the General Hospital of Atlacomulco and campus of the Autonomous University of the State of Mexico. PARTICIPANTS: 71 women between the ages of 18 and 24, and 160 neonates seen between March 2010 and June 2012. MAIN OUTCOME MEASURES: The measurements obtained included anthropometric body composition (bioelectrical impedance), serum hormone quantification of ovarian steroids and leptin (immunoassays), and the Apgar scores, height, and weight in neonates. Statistical analysis included ANOVA, Student, and chi-square for P < .05. RESULTS: Adolescent mothers showed significantly lower concentrations of estradiol (P = .001) and progesterone (P = .001). However, higher levels of leptin in adolescent mothers were not statistically different compared with older mothers (P = .84). Also, leptin was correlated with all measures of adiposity. The mean birth weights (P = .001) and Apgar scores (P = .001) were lower in neonates of adolescent mothers than in neonates of adult mothers. There was no association between maternal age with the anthropometric variables studied. CONCLUSIONS: Early reproduction represents a metabolic stress condition that modifies the long term ovarian activity and metabolic hormones, and impacts the morbidity-mortality of the mother and offspring in a later vital life cycle stage.

Vitamin D Status Affects Serum Metabolomic Profiles in Pregnant Adolescents.

Vitamin D is linked to a number of adverse pregnancy outcomes through largely unknown mechanisms. This study was conducted to examine the role of vitamin D status in metabolomic profiles in a group of 30 pregnant, African American adolescents (17.1 ± 1.1 years) at midgestation (26.8 ± 2.8 weeks), in 15 adolescents with 25-hydroxy vitamin D (25(OH)D) ≥20 ng/mL, and in 15 teens with 25(OH)D <20 ng/mL. Serum metabolomic profiles were examined using gas chromatography-mass spectrometry and liquid chromatography-tandem mass spectrometry. A novel hierarchical mixture model was used to evaluate differences in metabolite profiles between low and high groups. A total of 326 compounds were identified and included in subsequent statistical analyses. Eleven metabolites had significantly different means between the 2 vitamin D groups, after correcting for multiple hypothesis testing: pyridoxate, bilirubin, xylose, and cholate were higher, and leukotrienes, 1,2-propanediol, azelate, undecanedioate, sebacate, inflammation associated complement component 3 peptide (HWESASXX), and piperine were lower in serum from adolescents with 25(OH)D ≥20 ng/mL. Lower maternal vitamin D status at midgestation impacted serum metabolic profiles in pregnant adolescents.

Adaptation of in vivo amino acid kinetics facilitates increased amino acid availability for fetal growth in adolescent and adult pregnancies alike.

During pregnancy, adult women with a normal BMI synthesise extra amino acids after an overnight fast by increasing body protein breakdown and decreasing amino acid oxidation. It is not known whether adolescent girls can make these adaptations during pregnancy. The present study aimed to measure and compare the protein, glutamine and alanine kinetics of adult women and adolescent girls at early-, mid- and late-pregnancy. Kinetics were measured in the overnight fasted state using intravenous infusions of 13C-leucine, 15N-glutamine and 15N-alanine in ten adults and twenty adolescents aged 14-17 years in the first and second trimesters (phase 1 study) and infusions of 13C-leucine and 15N2-urea in ten adults and eleven adolescents aged 16-17 years in the first and third trimesters (phase 2 study). In phase 1 study, there were no significant differences between the groups with regard to any of the kinetic parameters measured. In both groups, leucine flux increased (P< 0.05), the percentage of leucine flux oxidised decreased (P< 0.05) and non-oxidative leucine disposal to protein synthesis increased (P< 0.05) from the first to the second trimester. In phase2 study, leucine flux was significantly slower (P< 0.05) in the adult group than in the adolescent group during both trimesters, and whole-body leucine flux and non-oxidative leucine disposal increased significantly in the adolescent group (P< 0.05, respectively) and were higher in the adult group from the first to the third trimester. These results suggest that similar to their adult counterparts after an overnight fast, adolescent girls with a normal BMI provide extra amino acids required for net protein deposition during pregnancy by increasing protein breakdown and decreasing amino acid oxidation.

Ambulatory assessments of psychological and peripheral stress-markers predict birth outcomes in teen pregnancy.

OBJECTIVE: Pregnant adolescents have high rates of poor birth outcomes, but the causes are unclear. We present a prospective, longitudinal study of pregnant adolescents assessing associations between maternal psychobiological stress indices and offspring gestational age at birth and birthweight. METHOD: Healthy nulliparous pregnant adolescents were recruited (n=205) and followed during pregnancy. Ambulatory assessments over 24h of perceived psychological stress (collected every 30 min) and salivary cortisol (6 samples) and a summary questionnaire, the Perceived Stress Scale, were collected at three time points (13-16, 24-27, and 34-37 gestational weeks). Corticotropin-releasing hormone, C-reactive protein, and interleukin 6 were assayed from blood taken at the latter 2 sessions. A final sample of 119 participants was selected for analyses. RESULTS: The ambulatory assessment of perceived psychological stress was positively correlated with the Perceived Stress Scale (r=.20, p=.03) but neither was associated with any of the biological assays (all ps>.20). Based on backward selection regression models that included all stress variables and relevant covariates, the ambulatory assessments of perceived psychological stress and cortisol - though not the Perceived Stress Scale - were negatively associated with gestational age at birth (F(4, 107)=3.38, p=.01) while cortisol was negatively related to birthweight (F(5, 107)=14.83, p<.0001). CONCLUSIONS: Targeted interventions to reduce psychological and biological indicators of heightened stress during pregnancy may have positive public health benefits for the offspring given the associations of shortened gestation and lower birthweight with risk for poor mental and physical health outcomes.

Iron deficiency anemia and iron stores in adult and adolescent women in pregnancy.

OBJECTIVE: To determine whether primiparous adolescent pregnancy is associated with increased risk of iron deficiency anemia and iron deficiency when compared with older primiparas. DESIGN: Prospective cohort. SETTING: Caratinga city, Minas Gerais State, Brazil. SAMPLE: A total of 183 women, being 61 adolescents and 122 adults. METHODS: Five peripheral vein blood samples were collected from each participant, at 9-16 and 29-36 weeks, upon admission for delivery, within the first hour after delivery and 30-60 days post-partum. We measured hemoglobin (Hb), transferrin saturation index and ferritin. MAIN OUTCOME MEASURES: Adolescent and adult women using chi-squared test, Student's t-test and hotelling test. RESULTS: There were significant differences in Hb concentration during the various sampling periods, for the whole cohort. The prevalence of anemia (Hb < 11 g/dl) did not differ significantly between adults and adolescents. The decrease in the mean transferrin levels was more intense in adolescents than in adults, especially during the second half of pregnancy. Low ferritin levels (<12 microg/l) were more frequent in adolescents than in adults during pregnancy and throughout the study period. CONCLUSIONS: Although there were no significant differences in the prevalence of iron deficiency anemia (Hb < 11 g/dl) in adolescents compared to adult women, low body iron stores and ferritin (< 12 microg/l) were significantly more frequent in adolescents.

[Prevalence of iron deficiency and iron deficiency anemia in pregnant adolescents from northwest Mexico, 2007-2008]. / Prevalencia de deficiencia de hierro y de anemia por deficiencia de hierro en adolescentes embarazadas del noroeste de México, 2007-2008.

Iron deficiency anemia (IDA) remains a word public health problem, particularly in children and child-bearing-age women. Iron demands need to be covered by adolescent women due to the increased physical growing, menstruation, pregnancy and fetal growing tissues at this life stage. This study was proposed to investigate the prevalence of iron deficiency and IDA in pregnant adolescent women from Northwestern Mexico. Participated 186 women under 19 years old during the first or second trimester of pregnancy who attended the local health institutions in Hermosillo Sonora. Questionnaires and 24 hr recalls were administered to collect socioeconomic and dietary information respectively. Hemoglobin (Hb), hematocrit, ferritin and eritrocytic protoporphyrin were measured. Hb and ferritin values were used to categorize the recruited women into normal (37.4%), iron deficient (55.5%) and IDA (7.1%) groups. Six and seven women showed moderated and light anemia status in the IDA group. Fe and fiber intake and weeks of pregnancy were associated with the biochemical indicators of iron at least in two women groups. The high percentage of iron deficient women in this study is demanding the identification and attention of maternal factors and food habits that are risk of iron deficiency in pregnant women.

Experiential and hormonal correlates of maternal behavior in teen and adult mothers.

This study explores the role of cortisol and early life experiences in the regulation of maternal behavior and mood in teen and adult mothers. Primiparous mothers (n=119) (teen mothers < 19 years, n=42), young mothers (19-25 years, n= 4), and mature mothers, (>25 years, n=43) were assessed for their maternal behavior, mood, and hormonal profile at approximately 6 weeks postpartum. Outcome measures were analyzed as a function of age and early life experience. Results showed an interaction between age and type of maternal behavior, where teen mothers engaged in more instrumental (e.g. changing diapers, adjusting clothes) less affectionate (e.g., stroking, kissing, patting) behavior, and mature mothers engaged in more affectionate and less instrumental behavior. When groups were reassessed based on early life experience (consistency of care during the first 12 years of life: consistent care; having at least one consistent caregiver, inconsistent care; having multiple and changing caregivers), an interaction was also found between consistency of care and type of behavior shown, where mothers who received inconsistent care engaged in more instrumental and less affectionate behavior. Compared to mature mothers, teen mothers who were breast feeding also had higher salivary cortisol levels, and high cortisol in teen mothers related to decreased fatigue and increased energy. These results suggest that early life experiences are linked to mothering behavior and are consistent with the emerging human and animal literature on intergenerational effects of mothering style.

[Nutritional status of folate, vitamin B12 and iron in pregnant adolescents]. / Estado de la nutrición de folato, vitamina B12 y hierro en adolescentes embarazadas.

Pregnancy in adolescence increases nutritional risk, due to higher demand of nutrients for maternal and fetal growth. This study was aimed to evaluate folate, vitamin B12 and iron status of pregnant adolescents at first trimester of pregnancy. A cross sectional, descriptive study was performed in 122 pregnant adolescents from Valencia, Carabobo state, 1997. Serum and erythrocyte folate and serum vitamin B12 was determined by radioassay; serum ferritin by enzimoimmunoassay; hemoglobin were performed by semi-automated method. Statistical analysis included standard deviation and frequencies. For serum folate 1.7% was found in negative balance and 19.0% at marginal status. For erythrocyte folate, 5.8% was deficient and 1.7% marginal. For serum vitamin B12, 8.3% was deficient and 13.2% marginal. Iron deficiency was found in 19.0% of the adolescents. Prevalence of anemia was of 13.1%, being iron deficiency the main cause. There was high nutritional risk regarding iron status, although iron intakes exceeded the recommendations, but only a small proportion was bioavailable. Prevalence of anemia was lower than reported by other studies and iron deficiency was higher than folic acid and vitamin B12 deficiencies. Pregnant adolescents are at a high biological and nutritional risk.

[Plasma amino acids profile of healthy pregnant adolescents in Maracaibo, Venezuela]. / Perfil de aminoácidos plasmáticos en adolescentes saludables embarazadas de Maracaibo, Venezuela.

One hundred female adolescents (13-18 y) were clinical and anthropometrically studied to select only those with adequate nutrition. Most adolescents belonged to IV socio-economic stratum families (worker class). Height, weight, age, body mass index and medial arm circumference were used as anthropometric parameters. After screening, only 41 non pregnant girls (control) and 42 pregnant girls with adequate nutrition were selected to analyze plasma amino acids. Fasting peripheral venous blood was drawn, and plasma amino acids were analyzed by HPLC. Amino acid concentrations were expressed as umol/L +/- SE. SAS/STAT program was used for statistical analysis. Amino acid values of control adolescent group were found in ranges reported by other investigators, with slight variations, mostly in diminution, presumably due to nutritional, metabolic or genetic conditions of people living in tropical regions. In pregnant healthy adolescents, distributed according to gestational age: < 32 weeks (n = 30) and > 32 weeks (n = 12), a diminution of total molar plasma amino acids was found, by comparing with control values. Ten amino acids (Pro, Gly, Gln, Arg, Ser, Orn, Tau, Leu, Thr and Val) appeared significantively diminished throughout gestation, being Gly. Gln and Arg most affected since earlier weeks. During the 2nd period. Thr and Val increased their grade of affectation; whereas some amino acids values (Orn, Pro and Tau) tended to recuperate. Several of affected amino acids are gluconegoenic, thus, they could be utilized to supply the energy required by the pregnant adolescent against her double stress: the fetus development and her own development. The plasma amino acid values reported in both, healthy non pregnant and pregnant adolescents, could be taken as regional referential profile of plasma amino acids in this poblational group for further research on adolescent and fetal--maternal malnutrition.

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

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.

Perfil de aminoácidos plasmáticos en adolescentes saludables embarazadas de Maracaibo, Venezuela / Plasma amino acids profile of healthy pregnant adolescents in Maracaibo, Venezuela

One hundred female adolescents (13-18 y) were clinical and anthropometrically studied to select only those with adequate nutrition. Most adolescents belonged to IV socio-economic stratum families (worker class). Height, weight, age, body mass index and medial arm circumference were used as anthropometric parameters. After screening, only 41 non pregnant girls (control) and 42 pregnant girls with adequate nutrition were selected to analyze plasma amino acids. Fasting peripheral venous blood was drawn, and plasma amino acids were analyzed by HPLC. Amino acid concentrations were expressed as umol/L +/- SE. SAS/STAT program was used for statistical analysis. Amino acid values of control adolescent group were found in ranges reported by other investigators, with slight variations, mostly in diminution, presumably due to nutritional, metabolic or genetic conditions of people living in tropical regions. In pregnant healthy adolescents, distributed according to gestational age: < 32 weeks (n = 30) and > 32 weeks (n = 12), a diminution of total molar plasma amino acids was found, by comparing with control values. Ten amino acids (Pro, Gly, Gln, Arg, Ser, Orn, Tau, Leu, Thr and Val) appeared significantively diminished throughout gestation, being Gly. Gln and Arg most affected since earlier weeks. During the 2nd period. Thr and Val increased their grade of affectation; whereas some amino acids values (Orn, Pro and Tau) tended to recuperate. Several of affected amino acids are gluconegoenic, thus, they could be utilized to supply the energy required by the pregnant adolescent against her double stress: the fetus development and her own development. The plasma amino acid values reported in both, healthy non pregnant and pregnant adolescents, could be taken as regional referential profile of plasma amino acids in this poblational group for further research on adolescent and fetal--maternal malnutrition.

Estado de la nutrición de folato, vitamina B12 y hierro en adolescentes embarazadas / Nutritional status of folate, vitamin B12 and iron in pregnant adolescents

Pregnancy in adolescence increases nutritional risk, due to higher demand of nutrients for maternal and fetal growth. This study was aimed to evaluate folate, vitamin B12 and iron status of pregnant adolescents at first trimester of pregnancy. A cross sectional, descriptive study was performed in 122 pregnant adolescents from Valencia, Carabobo state, 1997. Serum and erythrocyte folate and serum vitamin B12 was determined by radioassay; serum ferritin by enzimoimmunoassay; hemoglobin were performed by semi-automated method. Statistical analysis included standard deviation and frequencies. For serum folate 1.7 per cent was found in negative balance and 19.0 per cent at marginal status. For erythrocyte folate, 5.8 per cent was deficient and 1.7 per cent marginal. For serum vitamin B12, 8.3 per cent was deficient and 13.2 per cent marginal. Iron deficiency was found in 19.0 per cent of the adolescents. Prevalence of anemia was of 13.1 per cent, being iron deficiency the main cause. There was high nutritional risk regarding iron status, although iron intakes exceeded the recommendations, but only a small proportion was bioavailable. Prevalence of anemia was lower than reported by other studies and iron deficiency was higher than folic acid and vitamin B12 deficiencies. Pregnant adolescents are at a high biological and nutritional risk.

[Changes in plasma zinc and folic acid concentrations in pregnant adolescents submitted to different supplementation regimens]. / Mudanças na concentração plasmática de zinco e ácido fólico em adolescentes grávidas submetidas a diferentes esquemas de suplementação.

Zinc and folic acid nutritional status was evaluated in 74 low-income pregnant adolescents ranging from 13 to 18 years of age who received prenatal care at the Evangelina Rosa Maternity Hospital in Teresina, Piau State, Brazil. In order to evaluate the effects of different supplementation regimens on nutritional status, the adolescents were distributed into five groups. Groups I and II received equal amounts of folic acid (250 micro;g) and different doses of iron (ferrous sulfate), 120 and 80 mg, respectively. Groups III and IV received equal amounts of folic acid (250 micro;g) associated with zinc sulfate and iron at doses of 120 and 80 mg, respectively, while group V received only 120 mg of iron (routine dosage). There was a reduction in the zinc plasma concentration, and this decline was significant only in those groups which did not receive zinc supplementation. In relation to combination iron/folic acid and iron/folic acid/zinc, an excellent response was observed for folic acid, and this effect was larger in the groups that received folic acid combined with zinc, suggesting a possible role for zinc in folic acid metabolism.