The Jamaican Fetus – Overview of Various Studies

Abstract

To describe a series of studies conducted which investigated maternal nutrition and its effect on birth outcome. Seven hundred and twelve women attending their first antenatal clinic visit at the University Hospital of the West Indies were invited to join a prospective study. The women were followed throughout their pregnancies and seen at 14, 17, 20, 25, 30 and 35 weeks gestation. At these visits, the mother's weight, height and triceps skinfold thickness were measured. Abdominal ultrasound was performed to determine placental and fetal growth. Birth and placental weight, head, chest, mid-upper arm and abdominal circumference, crown-rump and crown-heel length were measured. After delivery, mothers and their children were recruited into a longitudinal study of postnatal growth in which blood pressure was measured annually initially and then half yearly from age one year. The interrelationship of first trimester maternal weight, subsequent weight gain in pregnancy, placental weight in early pregnancy and fetal growth were reported. Placental volume was shown to be an earlier predictor of infant size, and placental volume and intrauterine life on birthweight and blood pressure in childhood showed a relationship to blood pressure at two to three years old. The ultrasound derived fetal growth curves for a Jamaican population was created. Maternal nutritional status has an important effect on fetal size and birthweight and fetal size has an effect on blood pressure in childhood, suggesting that the initiating events in programming of blood pressure occur early in pregnancy.