The Relationship between Micronutrients: Fe, Zn, and Vitamin A to Maternal Dietary Intake and their New borns

Abstract

This is a descriptive, analytical, hospital based study, conducted in Omdurman Maternity hospital, designed to determine the relationship between maternal dietary intake mainly the micronutrients iron, zinc and vitamin A and pregnancy outcomes. Methodology: Participants in this study were 83 pregnant mothers (15 to 41years) in their third trimester of pregnancy and 65 newborn babies. Dietary intake was assessed by 3-days 24-hour dietary recall sheet. Pregnancy outcome was assessed based on the progress of labor, birth weight and general status of the newborn. Measurements of serum iron(SFe),serum ferritin(SF), total iron inding capacity(TIBC),transferring saturation(TS),vitamin A(VA) ,serum zinc(SZn), estimation of Hb and calculations of Hct of mothers and their newborn babies were done. Results: Most of the pregnant mothers were from middle economic class and educated. Eighty eight percent(88%) of the babies were normal whereas 12% LBW. Sixty one mothers used iron/folic acid supplement whereas 10 consumed food alone. Results of the mean intakes of 13 nutrients (68.4%) for all subjects were below RDA, The minimum intake was recorded for vitamin A which is <20% RDA. Risk of energy inadequacy was >57.9%. Mothers who used iron supplements had 100% adequate iron and folic acids, whereas those on diet alone 100% very inadequate folic acid (<50%RDA) and 80% inadequate iron. Mean serum levels of TIBC, TS, SR, and Hct were normal for all, whereas mean MSF were low. Most of the mothers and babies were zinc deficient. SFe, SF, TS, SR and haematological indicies, were higher in cord blood than maternal blood whereas TIBC and SZn higher in maternal blood compared to cord blood. Mean Hb levels in mothers and babies were close to the lower limits of normality(11.23 ± 1.84 g/dl and 14.70 ± 2.10 g/dl) respectively. Anemia was found in 33.3% of the mothers and in 33.3% of newborns. IDA was found in 15.5% while iron depletion 46.7%, low haemglobin alone 28.9% and only 8.9% were normal. BSF was significantly higher in iron group whereas BSZn was significantly lower. All mothers in diet group gave birth to anaemic babies. Maternal adequate intakes of macronutrients; vitamins A,B1,B2, B6, C, folic acid and the minerals Ca, Fe, and was associated with normal BW among more than 90% . Income and mothers education positively correlated with most of the nutrients. Age correlated very significantly with protein intake (r=0.77, P=0.00). Zinc deficiency was associated with obstructed labor. Discussion: Results of the mean intakes of nutrients 5%). Adequate intakes of fat and carbohydrates were associated with normal BW (n = 57; 87.7 %), whereas inadequacy of VA, (n = 8; 12.3%), energy, protein, and carbohydrates was related to LBW infants. Micronutrients status of the pregnant mothers was not influenced by dietary intake alone, intake of supplements improved Hb status. In contrast to this iron supplements interfere with zinc bioavailability and reduces its absorption.Nutrients intake was affected in 80% by economic status and 93.3% by family size. Conclusion: Inadequate intake of some nutrients, but not iron affected infants BW. All subjects were at high risk of anaemia, VAD and zinc deficiency. Micronutrients status of the pregnant mothers is not influenced by other factors rather than dietary intake. Fetus might make use of these nutrients regardless of his mother needs. Energy intake should be increased from carbohydrates and decreased from fats. Iron and zinc supplements, good nutrition, nutrition education and counseling are crucial for maternal and newborn health