Low Body Weight Gain, Low White Blood Cell Count and High Serum Ferritin as Markers of Poor Nutrition and Increased Risk for Preterm Delivery

低體重增加、低白血球計數和高血清鐵蛋白可做為較差營養狀況的標記及增加早產的風險

Wen-Yin Hsu ； Cheng-Hsuan Wu ； Charles Tsung-Che Hsieh ； Hui-Chen Lo ； Jen-Shiou Lin ； Mei-Ding Kao

《Asia Pacific Journal of Clinical Nutrition》 22卷1期 (2013/03) Pp. 90-99

https://doi.org/10.6133/apjcn.2013.22.1.05

摘要

This study determined factors of preterm delivery in Taiwan. Healthy women (n=520, age 29.1±4.2 y) at 8-12 weeks of pregnancy were recruited from prenatal clinics. Background information, anthropometrics, biochemical parameters, and dietary intake, collected by 24 h-recall were obtained from the first, second, and third trimesters to delivery. Clinical outcomes of neonates were also collected. The results show that 53.7% of women were primiparous and that the incidence of preterm delivery was 6.2%. Body weight gains in the first trimester and throughout pregnancy were significantly lower in mothers with preterm delivery (preterm group) than in mothers with term delivery (term group, p＜0.05). Maternal cholesterol intake, circulating white blood cell counts (WBC) and serum albumin were significantly lower and that serum magnesium and ferritin were significantly higher in the preterm group than in the term group. Maternal weight gain was positively correlated with caloric and nutrient intake (p＜0.05). Neonatal birth weight was positively correlated with maternal weight gain and intakes of protein and phosphate during pregnancy; with intakes of calories, vitamin B-1 and B-2 in the first trimester; and with intakes of calcium, magnesium, iron and zinc, as well as circulating WBC in the third trimester. However, neonatal birth weight was negatively correlated with serum iron in the third trimester and with serum iron and ferritin at the time of delivery. In conclusion, maternal weight gain in early pregnancy and WBC, mineral intake and iron status in late pregnancy seem to be major factors affecting delivery and neonatal outcomes.

關鍵字

營養素攝取 ； 孕期體重增加 ； 白血球數 ； 血鐵蛋白 ； 早產

並列摘要

This study determined factors of preterm delivery in Taiwan. Healthy women (n=520, age 29.1±4.2 y) at 8-12 weeks of pregnancy were recruited from prenatal clinics. Background information, anthropometrics, biochemical parameters, and dietary intake, collected by 24 h-recall were obtained from the first, second, and third trimesters to delivery. Clinical outcomes of neonates were also collected. The results show that 53.7% of women were primiparous and that the incidence of preterm delivery was 6.2%. Body weight gains in the first trimester and throughout pregnancy were significantly lower in mothers with preterm delivery (preterm group) than in mothers with term delivery (term group, p＜0.05). Maternal cholesterol intake, circulating white blood cell counts (WBC) and serum albumin were significantly lower and that serum magnesium and ferritin were significantly higher in the preterm group than in the term group. Maternal weight gain was positively correlated with caloric and nutrient intake (p＜0.05). Neonatal birth weight was positively correlated with maternal weight gain and intakes of protein and phosphate during pregnancy; with intakes of calories, vitamin B-1 and B-2 in the first trimester; and with intakes of calcium, magnesium, iron and zinc, as well as circulating WBC in the third trimester. However, neonatal birth weight was negatively correlated with serum iron in the third trimester and with serum iron and ferritin at the time of delivery. In conclusion, maternal weight gain in early pregnancy and WBC, mineral intake and iron status in late pregnancy seem to be major factors affecting delivery and neonatal outcomes.

並列關鍵字

nutrient intake ； maternal weight gain ； white blood cells ； ferritin ； preterm delivery

參考文獻

Wen SW, Smith G, Yang Q, Walker M. Epidemiology of preterm birth and neonatal outcome. Semin Fetal Neonatal Med. 2004;9:429-35.

Goldenberg RL, Culhane JF, Iams JD, Romero R. Epidemiology and causes of preterm birth. Lancet. 2008;371:75-84.

Siega-Riz AM, Adair LS, Hobel CJ. Maternal underweight status and inadequate rate of weight gain during the third trimester of pregnancy increases the risk of preterm delivery. J Nutr. 1996;126:146-53.

Spinillo A, Capuzzo E, Piazzi G, Ferrari A, Morales V, Di Mario, M. Risk for spontaneous preterm delivery by combined body mass index and gestational weight gain patterns. Acta Obstet Gynecol Scand. 1998;77:32-6.

Schieve LA, Cogswell M E, Scanlon KS, Perry G, Ferre C, Blackmore-Prince C, Yu SM, Rosenberg D. Prepregnancy body mass index and pregnancy weight gain: associations with preterm delivery. Obstet Gynecol. 2000;96:194-200.