RESUMO

The objective of this study was to compare lactoferrin (LF) levels and unsaturated iron-binding capacity (UIBC) of colostrum from Brazilian women aged 20-38 years of low (N = 28) and high (N = 15) socioeconomic level. Both groups received a similar amount of supplemental iron (25-65 mg/day) during pregnancy. We also determined the relationship between LF levels and UIBC, and between these components and maternal iron status. Both groups (low and high socioeconomic level) showed adequate and similar mean hematocrit (35.0 +/- 1.3% and 35.9 +/- 1.3%, respectively) and serum ferritin (64 +/- 12 micrograms/l and 57 +/- 12 micrograms/l, respectively) levels. Furthermore, LF levels (5.7 +/- 0.9 mg/ml and 5.5 +/- 0.6 mg/ml) and UIBC (3.8 +/- 0.3 micrograms/ml and 3.1 +/- 0.3 micrograms/ml) were not significantly different in the two groups of women, nor were they related to maternal hematocrit or serum ferritin. UIBC was significantly (P = 0.009), although weakly positively correlated (r = 0.45) with LF levels, suggesting that other colostrum ligands may contribute substantially to the capacity of colostrum to bind exogenous iron.

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RESUMO

The effects on pregnancy outcome and maternal iron status of powdered milk (PUR) and a milk-based fortified product (V-N) were compared in a group of underweight gravidas. These take-home products were distributed during regular prenatal visits. Women in the V-N group had greater weight gain (12.29 vs 11.31 kg, p less than 0.05) and mean birth weights (3178 vs 3105 g, p less than 0.05) than those in the PUR group. Values for various indicators of maternal Fe status were also higher in the V-N group. Compared with self-selected noncompliers, similar in all control variables to compliers, children of women who consumed powdered milk or the milk-based fortified product had mean birth weights that were higher by 258 and 335 g, respectively. Data indicate a beneficial effect of the fortified product on both maternal nutritional status and fetal growth.

PIP: The effects on maternal and infant weight gain and maternal iron status of powdered milk (PUR) and a milk-based fortified product (V-N) were compared in underweight women attending prenatal clinics in Santiago, Chile. All pregnant women attending 9 prenatal clinics of the Southeast Health Area, over 18 years old, parity 0-5, nonsmoking, nonalcohol-consuming and underweight (95% of standard) joined the study. They were given either the PUR, powdered milk with 26% milkfat, or V-N, (Vita-Nova Mother-food, Melkunie Holland, Woerden) which contained micronutrients and added vegetable fat, as mandated by law. Those who failed to consume supplements were relegated to the control group. The V-N group had greater weight gain (12.29 vs 11.31 kg, p0.05), mean birth weights (3178 vs 3105 g, p0.05) than the PUR group. Iron status, shown by significantly higher mean hematocrit, hemoglobin, mean corpuscular volume, transferrin saturation and plasma ferritin levels near term, was also better in the V-N group than in the PUR. Other significant differences in favor of the V-N supplement were number of intrauterine growth retarded infants and birth weights under 3001 g. The V-N group had greater fluid retention: the import of this is unknown. The infants of non-compliers had birthweights 258 and 335 g lower than the women consuming PUR and V-N, respectively. The babies of V-N mothers gained 74 g/kg maternal weight gain, higher than many previously reported increments, perhaps due to the micronutrients in the supplement.

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RESUMO

PIP: Hematological status of pregnant women from low and middle economic classes before and after similar hematinic therapy were compared. Subjects were 88 economically indigent and 88 middle-class women. Both groups came from the same ethnic background. Before treatment mean values for hemoglobin and nutrients were significantly lower in the poor pregnant women, except for serum folate which was similar. The only parasitic infestations found were whipworm (Trichuris trichiura) in 10% of the poor group and 2% of the middle-class group. Treatment of 40 poor and 33 middle-class patients was with oral doses of 130 mg of ferrous fumarate. The other 48 poor and 55 middle-class patients also received 2.5 mg of folic acid orally daily. At term, after treatment, there was still a statistically but lesser difference between the 2 groups, with the exception of serum iron. Total iron binding capacity was similar in both groups. The frequency of preeclampsia was 4% in the middle-class and 5% in the poor patients. At term, despite the iron dosage, anemia frequency and iron deficiency remained the same in both groups. Those taking folic acid improved so that the 2 classes were equal. Low serum folate levels for those of the middle class not taking folic acid were 25%. It is concluded that all pregnant women in this population should receive both iron and folic acid supplementation throughout pregnancy. For women with an iron deficiency at the beginning of pregnancy, 120 mg/day was not enough. There was the possibility of impaired iron absorption in these patients.^ieng

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