Nutritional Status Of Pregnant Adolescents Research Articles

The Impact of Dietary Intake and Nutritional Status on Birth Outcomes Among Pregnant Adolescents: A Systematic Review

Birth outcomes have been linked to the overall maternal general health including nutrition as well as maternal age during pregnancy. Compared to adults, delivery outcomes during adolescence are poor. Nutrient intake and nutrition status during adolescent pregnancy may be linked to birth outcomes. This review aims to identify the association between dietary intake and nutrition status of pregnant adolescents and their maternofetal outcomes. Literature search on nutrient intake and nutritional status of pregnant adolescents (aged 11-19 years) which identified 17 English papers from 1995 to 2019 was reviewed. Papers that did not include data on birth outcomes in relation to nutrient intake or nutritional status were excluded. The review showed that most micronutrients with the exception of Riboflavin, vitamins B12 and C were below the recommended levels whilst macronutrients levels were above the recommended levels. Energy intakes were also below the recommended levels. Most studies presented normal hemoglobin levels in the first trimester of pregnancy but these levels decreased as pregnancy progressed to the third trimester leading to a high prevalence of anemia. Well-regulated provision and intake of micronutrient supplementation and nutrition education to improve healthy eating habits will significantly reduce poor birth outcomes such as low birth weights (LBW), still births, preterm deliveries, small or large for gestational age (SGA and LGA) and intrauterine growth restrictions in pregnant adolescents. This review provides to a large extent evidence to support the importance of adolescent nutrition and birth outcomes. There is the need to implement policies to improve adolescent nutrition through a multisectoral approach.

Effect of nutrition counseling on nutritional status and gestational weight gain of pregnant adolescents in West Arsi, Central Ethiopia: a cluster randomized controlled trial

When pregnancy occurs in adolescence, the growth and development of the mother and fetus may be impaired due to strong competition for nutrients between the still-growing adolescent and the fetus. Pregnant adolescents constitute an underserved population; they lack adequate nutritional knowledge. Therefore, this study investigated the effect of nutritional behavior change communication (NBCC) through alliance for development (AFD) on the nutritional status and gestational weight gain (GWG) of pregnant adolescents. A two-arm parallel cluster randomized controlled community trial was conducted in the West Arsi Zone, central Ethiopia, from August 2022 to July 2023. The nutritional status of the pregnant adolescent was assessed using mid-upper arm circumference. Weight was measured at baseline and at the end of the intervention. A total of 207 and 219 pregnant adolescents participated in the intervention and control clusters, respectively. The intervention started before 16 weeks of gestation, and the intervention group attended four NBCC sessions. The NBCC was based on the health belief model (HBM) and was given at the participants’ homes with their husbands. The NBCC intervention was delivered by AFDs and community-level health actors. Pregnant adolescents in the control group received routine nutrition education from the health care system. A linear mixed-effects model and difference in difference (DID) were used to measure the intervention effect after adjusting for potential confounders. After the implementation of the trial, the mean mid-upper arm circumference (MUAC) in the intervention arm significantly increased from baseline (p ≤ 0.001), 23.19 ± 2.1 to 25.06 ± 2.9 among intervention group and 23.49 ± 2.1 to 23.56 ± 2.0 among control group and the mean difference in the MUAC (DID) was 1.89 ± 2 cm (p ≤ 0.001); the mean GWG in the intervention arm significantly increased from baseline; 51.54 ± 4.7 to 60.98 ± 4.6 among intervention group and 52.86 ± 5.27 to 58 ± 5.3 among control group; the mean GWG in the intervention group was 9.4 kg, and that in the control group was 5.14 kg, and the difference in difference was 4.23 kg and this was statically significant p ≤ 0.001). This study demonstrated that the use of the HBM for NBCC delivered through the AFD was effective at improving the nutritional status and GWG of pregnant adolescents. These results imply the need for the design of model-based nutritional counseling guidelines.Clinical trial registration: PACTR202203696996305, Pan African Clinical Trials Registry, date of first registration: 16/03/2022.

The Nutritional Status of Filipino Pregnant Adolescents 14 to 19 Years Old in a Tertiary Hospital

Objectives. 1) To determine the nutritional status of pregnant adolescents aged 14 to 19 years seen at the Philippine General Hospital Teen Mom Clinic from February to July 2014; 2) To describe the demographic characteristics, pregnancy history, and lifestyle and health habits of adolescent mothers; 3) To describe the adequacy of the daily intake of nutrients (caloric energy, carbohydrates, protein, fats, folate, calcium, and iron) of adolescent mothers; and 4) To determine the association of specific demographic characteristics with body mass index categories.
 Methods. This was a prospective cross-sectional study. Included were the pregnant adolescents aged 14 to 19 years of age, referred to the Teen Mom Clinic, who planned to deliver at the Philippine General Hospital. Informed consent and assent forms were signed, and the principal investigator interviewed the subjects for demographic and clinical history at the time of enrolment. The adolescents were taught and instructed to fill up the food diary (2 weekdays and 1 weekend) and the food frequency (once) forms. These were submitted on their next visit and given to a licensed nutritionist for analysis. The nutritional status was assessed by gathering the weight and height of the patients in order to compute for the body mass index at the time of enrolment in the study.
 Results. The percentage distribution of nutritional status of pregnant adolescents consisted of the following: 65% normal; 28% underweight; 3.5% overweight; 3.5% obese. The 60 pregnant adolescents had a mean age of 16.9 years (SD 1.2). Their partners had a mean age of 20.3 years [SD 3.8]. On the average, they had a total of five pre-natal checkups. Majority of the respondents (85%) still depended primarily on their parents for financial support. Around 93% of the pregnancies were unplanned. Their median percent adequacy for daily calories was 72%, carbohydrates 69%, proteins 73%, and fats 86%. For the micronutrients, the median percent adequacies for folate, calcium, and iron, based on the needs of pregnant women, were 18%, 63%, and 29%, respectively. If amounts were compared to the requirements by age, the median adequacies of intake were 27%, 50%, and 41%, respectively. The nutritional status was not found dependent on the age, educational attainment, number of siblings, and the monthly family income of the respondents.
 Conclusion. Only 65% of the pregnant adolescents had normal nutritional status. There was still an elevated level of malnutrition among pregnant adolescents as shown in this study: 28% were underweight, 3.3% were overweight, and another 3.3% were obese.

Nutrition intervention of pregnant adolescents: a systematic review

Purpose This paper aims to evaluate the effectiveness of nutrition interventions conducted in pregnant adolescents and their implications for future research. Design/methodology/approach The papers in this systematic study were searched through PubMed, PMC, the Cochrane Library (Trial), ScienceDirect and Google Scholar that were published from 2000 to 2019. An experimental study using a randomized controlled trial (RCT) or non-RCT among pregnant adolescents aged 10-19 years were inclusion criteria for this study. While exclusion criteria were studies published before 2000, non-experimental study and non-English-language studies. Findings A total of 14 studies were identified in this review. Six studies provided interventions in the form of nutrition and health education and seven studies provided interventions in the form of nutritional supplementation (calcium, vitamin D, iron-folate, lipid-based nutrient supplements and multi-micronutrient powder. One study provided dietary intervention. The interventions in pregnant adolescents in the form of education and nutritional supplementation effectively increased the knowledge and nutrition of pregnant adolescents and decreased low birth weight (LBW) and premature birth. The impact on birth outcomes was still quite diverse. Some of the studies in this review were conducted without a comparison group, a small sample size and conducted in health-care facilities. Conclusion This systematic review implies a future nutrition intervention for pregnant adolescents is needed to improve nutritional status of pregnant adolescents and birth outcome. Future research using double blind RCT method with bigger sample size and various nutritional outcome are wide open to be developed. Originality/value Interventions in pregnant adolescents effectively increased the knowledge and nutrition of pregnant adolescents and decreased LBW and premature birth. The program implementation in the community needs to be improved so that the effectiveness of the program remains optimal as in healthcare facilities.

Assessment of dietary diversity, antenatal care, food taboos, meal frequency, and nutritional status of pregnant adolescents in rural Malawi: a cross-sectional study

High rates of pregnancy during adolescence in Malawi compromise the nutritional status of adolescent mothers and their infants. When a pregnant adolescent is malnourished, she is at risk for health complications. Research focusing on the nutritional status of pregnant adolescents in Malawi is minimal. The purpose of this study was to assess dietary diversity, antenatal care, food taboos, meal frequency, and nutritional status of pregnant adolescents in rural Malawi. The study included sixty-two pregnant adolescents between 15-19 years old. Data collection included the use of a pre-tested questionnaire, standardized dietary diversity survey and measurements of mid-upper arm circumference (MUAC), height, and hemoglobin. Statistical analysis included descriptive analysis, linear and logistic regression. Mean (SD) age was 17.7 (1.2) years. Mean MUAC was 25.9 (2.0) cm; 31% had MUAC <25 cm. The occurrence of stunting was 19% and 21% were ≤150 cm tall. The mean hemoglobin was 10.37 (1.93) g/dL and 66% were anemic. The mean dietary diversity score was 4.06 (1.18) and 69% did not achieve minimum dietary diversity (score ≥ five.) No participants consumed dairy and only 7% consumed eggs. Eating meat and poultry or dark green leafy vegetables predicted a 1.31g/dL (pvalue = 0.0306) or 1.08 g/dL (p-value =0.0331) increase in hemoglobin levels, respectively (R 2 =0.15). Food taboos during pregnancy were common (35%). Compared to the Malawi National Nutrition Guidelines, 87% were not eating daily from each of the six food groups and 74% were not meeting the recommended meal frequency during pregnancy (three meals and at least one snack/day). Less than 50% consumed foods from legumes/nuts and animal food groups. The majority (63%) did not take antenatal supplements and only 37% consumed ferrous sulfate. Only 52% received advice about nutrition during pregnancy and few (8%) received advice about infant and young child feeding. Girls who received nutrition advice were more likely to take an iron supplement [OR=4.19 (1.82-9.68), p =0.0008] compared to those who did not. As the number of antenatal visits increased, the participants were more likely to take a supplement [OR=11.88 (3.40-41.49) p =0.001]. Interventions for pregnant adolescents in rural Malawi should occur early in pregnancy and include education on dietary diversity, increasing hemoglobin levels, meal frequency, food taboos, antenatal supplements and infant and young child feeding. Keywords: Adolescent nutrition, Pregnant adolescents, Dietary diversity, Food taboos, Hemoglobin Afr. J. Food Agric. Nutr. Dev . 2019; 19(3): 14555-14570

Assessment of dietary diversity, antenatal care, food taboos, meal frequency, and nutritional status of pregnant adolescents in rural Malawi: A cross-sectional study

Assessment of dietary diversity, antenatal care, food taboos, meal frequency, and nutritional status of pregnant adolescents in rural Malawi: A cross-sectional study

Nutritional assessment of Nursing in pregnant adolescents

Introductionthe stage of adolescence is a vital process to become adults, where physiologically many changes are going to occur and eating habits will significantly influence this process. Pregnant women should maintain a balanced, varied and sufficient diet to avoid future nutritional complications related to inadequate intake, producing imperfections in fetal growth and development. Objectiveto assess the nutritional status of pregnant adolescents and identify the socio-psycho-cultural and intrafamilial factors that influence it. Materials and methodsQuantitative, descriptive and transversal. Technique: Observation and Direct Survey. Instrument: Questions questionnaire and direct observation matrix directed to pregnant teenagers. Resultspregnant adolescents between 17 to 19 years of age who were in the second trimester of pregnancy, with complications characterized by low weight, anemia, preeclampsia and gestational diabetes. Discussionthey live in precarious conditions or in an environment of violence, so that the maintenance of pregnancy or the growth of the infant will become difficult.Conclusions The pregnant adolescent is considered high risk due to the complications involved from the anato-physiological structure.

Dietary intake of pregnant adolescents cared for in primary health care units of a Brazilian urban municipality.

to evaluate the adequacy of dietary intake and the anthropometric nutritional status of pregnant adolescents in the city of Niterói, Rio de Janeiro, Brazil. METERIALS AND METHODS: forty-two adolescents (13-19 years of age), with single-fetus gestation, assisted in the public prenatal health care units between 2008-2014, participated in the study. Body mass index (BMI) was used to assess the nutritional status. Dietary intake was assessed by 24h dietary recalls on two days during a week and one during weekend. Basal metabolic rate was measured by indirect calorimetry and used to determine the energy requirements. Mixed effects models were used to assess dietary intake over the gestational weeks (random effect) and BMI. mean age (SD) of the pregnant women was 16.5 (1.5) years and the majority received allowance from a cash transfer federal program. Overall, 30.3% were overweight/obese pre-pregnancy and 16.7%, during pregnancy. Energy and protein intake adequacies decreased with increasing BMI and gestational week. There was adequate dietary intake of energy, protein, vitamin A and zinc and insufficient intakes of iron and calcium. There was excessive intake of sodium. pregnant adolescents living in underprivileged socio-economic environments assisted for prenatal care in primary health care units have adequate intakes of energy, protein, vitamin A and zinc. Pre-pregnancy overweight and high sodium intake are causes of concern due to the future implications for their health. The official Brazilian recommended criterion for anthropometric assessment in pregnancy of adolescents proved to be inadequate.

Cross Sectional Survey of Pregnant Adolescent Malnutrition in Rural Malawi

The high rates of adolescent pregnancies in Malawi challenge the health and nutritional status for both the mother and infant. If an adolescent is unable to meet her own nutritional needs and becomes malnourished, this may lead to a continued cycle of complications. Research involving the nutritional status of pregnant adolescents in Malawi is lacking. The purpose of this study was to assess diet diversity and nutritional status in pregnant adolescents in rural Malawi. The study included sixty‐two pregnant adolescents. The mean age of the subjects was 17.7 years (SD 1.2). Of the sixty‐two subjects, 84% were married, 98% were not enrolled in school, and 92% were not working outside of the home. For 89% of the subjects, this was their first pregnancy. Data were collected using a pre‐tested questionnaire and a standardized dietary diversity survey. Mid‐upper arm circumference (MUAC), height, weight, and hemoglobin (Hgb) were measured. The mean (SD) MUAC was 25.9 (2.0) cm. The mean Hgb was 10.4 (1.9) g/dL and 66% had a Hgb lower than 11 g/dL. In this season of relatively available fruits and vegetables, the mean diet diversity score was 3.8 (3.2). Dietary intake results included 98% eating starchy staples, 62% eating dark leafy green vegetables, 56% eating Vitamin A rich fruits and vegetables, 89% eating other fruits and vegetables, 39% eating meat or fish, 31% eating legumes, nuts, or seeds, 6% eating eggs, and 0% eating milk or milk products. Of the sixty‐two subjects, 63% were not taking any vitamin/mineral supplements while 37% were taking ferrous sulfate. 35% restricted some foods during pregnancy, 52% received no advice regarding foods to eat during pregnancy, and 92% received no advice regarding infant and young child feeding (IYCF) practices. Interventions for pregnant adolescents should include nutrition education on dietary diversity, healthy nutrition during pregnancy, and IYCF guidelines.Support or Funding InformationSupported by Child Legacy International (CLI) and CLI Scholarship, Humphrey's Travel Grant, and Watkins' Matthew 25:40 Scholarship.

Nutrient intakes and nutritional biomarkers in pregnant adolescents: a systematic review of studies in developed countries.

BackgroundBabies born to adolescent mothers have been shown to have poorer outcomes compared to those born to adults. Nutritional status may have an important role to play in improving the health of pregnant adolescents; however there is a lack of evidence regarding the adequacy of adolescent diets during pregnancy. This systematic review aims to examine what is known about the nutritional status of adolescent pregnant women.MethodsA systematic search of the literature identified 21 studies which met the inclusion criteria for the review. Primary research papers using any methods were included where they were published in English between January 1995 and May 2015 and included measurements of nutrient intakes or biological markers of nutritional status in pregnant women aged 11–19 years. Individual study data was first summarised narratively before study means were pooled to give an estimate of nutritional status in the population.ResultsThe results show that individual studies reported intakes of energy, fibre and a number of key micronutrients which were below recommended levels. Biological markers of iron and selenium status also showed cause for concern. Pooled analysis of individual means as a percentage of UK Dietary Reference Intakes showed intakes of vitamin D (34.8 % CI 0–83.1) to be significantly below recommendations (p = 0.05). Serum selenium levels were also found to be low (61.8 μg/L, CI 39–84).ConclusionsThis review has identified a number of areas where the nutritional status of pregnant adolescents is sub-optimal, which may have implications for the health of adolescent mothers and their babies. It was not however possible to examine the impact of supplement use or socio-demographic characteristics which limits the interpretation these results. Further work is needed to establish the characteristics of those most at risk within this population, how this differs from adult pregnant women and the role of supplementation in achieving adequate nutrition.Electronic supplementary materialThe online version of this article (doi:10.1186/s12884-016-1059-9) contains supplementary material, which is available to authorized users.

Perfil alimentario-nutricional de la gestante adolescente

OBJETIVO: Determinar el estado nutricional de la gestante adolescente. PACIENTES: Se estudi6 177 adolescentes gestantes, de 15 a 19 años de edad, atendidos en los Hospitales Santa Rosa y Dos de Mayo. MÉTODOS: El peso y la talla fueron tomadas a toda la población. A 56 gestantes se les midió los indicadores del brazo (perímetro del brazo, y pliegue tricipital). Con los dos primeros se calculó el índice de Quetelety con los dos primeros el área muscular y grasa. La referencia de Must y col. fue utilizada para el análisis del IQ; los indicadores del brazo fueron analizados con la referencia de Frisancho. En 56 gestantes se dosó Hb (11gr/dL). A 54 gestantes se evaluó su consumo cuantitativo de energía y nutrientes. RESULTADOS. El 62,5% de gestantes es anémica. De ellas el 77% no recibe algún tipo de suplementación. El 10% de las gestantes del primer trimestre presentan peso bajo. Alrededor del 6 y 8% presentan una ligera disminución de sus indicadores de depósito graso y magro, respectivamente. CONCLUSI0NES: El 70% de gestantes recibe una ingesta adecuada de energia, proteínas, retinol y vitamina C. Las ingestas de hierro y calcio son muy bajas.

Assessment of Nutritional Status of Pregnant Adolescents in Baghdad City

Objectives: The study aims to assess the nutritional status, identify nutrition-related health problems andfind out the relationships between nutritional status and demographic characteristics of the pregnantadolescents in Baghdad City.Methodology: A descriptive study was carried out from April/20/2009 to June/30/2009 through a "Nonprobability"purposive sample of (196) pregnant adolescents their age between (13–19) years who attend (14)primary health care centers in Baghdad City seeking for antenatal care. The data were collected by theinvestigator who interviewed the pregnant adolescents and filled out the constructed questionnaire formatswhich designed for the purpose of the study. Internal consistency of reliability determined through thecomputation of alpha-Chronbach correlation coefficient for quality of life items. Test-retest of reliability wasdetermined through the computation of Spearman's correlation coefficient for the same items. The contentvalidity of the constructed questionnaire was determined through a panel of experts. Data were analyzedthrough the application of descriptive statistical approach (frequencies and percentages) and inferentialstatistical approach (Chi-Square).Results: The findings revealed that imparity in weight per (kg) according to the pregnancy trimester recordedthe following mean values (after excluding the extreme values). 1st trimester (0.00 – 0.66kg), 2nd trimester(2.83 – 3.51kg) and 3rd trimester (4.90 – 6.96kg). Regarding nutritional related problems; anemia,hypoglycemia, hyperglycemia, protein urea (trace), teeth decay and urinary tract infection, nausea, vomiting,and heartburn. Common dietary patterns: skipping meals, snacks eating, food dislike, and not drinking enoughamounts of water or beverages daily(6–8) glasses, The dietary intake through the (24) hours diet recall andfood frequency questionnaire which in comparison with food pyramid do not meet daily requirements of theirservings.Recommendations: The study recommends health promotion and nutrition-oriented education programscan be designed, structured and presented to female adolescents to prepare them for a healthy marriage andpregnancy.

Nutritional status in pregnant adolescents: a systematic review of biochemical markers.

Adolescent pregnancy is a major public health challenge for many industrialized countries and is associated with significant medical, nutritional, social and economic risk for mothers and their infants. Despite this, relatively little is known about the nutritional status of this population. The aim of this paper was to conduct a systematic review of the current evidence relating to the biochemical markers of nutritional status of pregnant adolescents living in industrialized countries. Six papers were identified that fulfilled the inclusion criteria, the majority of which were conducted in the United States. The studies were of variable quality and most failed to control for potential confounders which may have strongly influenced the findings. Due to limited research, conclusions cannot be drawn about the zinc and calcium status of pregnant adolescents, and data on folate and vitamin B(12) status appeared conflicting. There was some consensus among studies, however, to suggest that indicators of anaemia and iron status were compromised in pregnant adolescents, particularly during the third trimester of pregnancy. Chronological age did not appear to influence nutritional status, although there was some evidence to suggest that increasing gynaecologic age may positively influence plasma ferritin levels. Current research is limited by sampling and measurement bias, and research is urgently required to address these limitations. Further consideration should also be made of the influence of the role of socio-economic support on pregnant adolescents' nutritional status. The achievement of improved nutrition in pregnancy among adolescents requires multidisciplinary collaborations of adolescent healthcare providers, academics, professional organizations, policymakers, industry and service users. Only once this is achieved can adolescent nutrition, and adolescent nutrition in pregnancy, be significantly and sustainably optimized.

Impacto do estado nutricional no peso ao nascer de recém-nascidos de gestantes adolescentes

PURPOSE: to evaluate the impact of the nutritional status of pregnant adolescents on the birth weight. METHODS: a cohort study including 97 adolescents and their respective newborns, evaluated from May to June, 2004. Pregnant women from 10 to 19 years old in labor were included in the study, and those with multiple pregnancies, complications, less than 37 weeks gestation, and incomplete data records were excluded. Maternal nutritional status evaluation included height, body mass index (BMI) before pregnancy, gestational weight gain (GWG) and caloric-proteic intake, obtained by habitual food intake recordatory by the end of the third gestational trimester. The association between maternal variables (height, pre-gestational BMI, GWG and intake) and the newborn weight was analyzed by Spearman's correlation test. Statistical significance was assumed when p<0.05. RESULTS: the mean age was 17.8±1.12 years old. Most adolescents (66%) started pregnancy with adequate weight, 29% had low weight and 5% overweight. Most adolescents showed inadequate GWG, caloric and proteic intake. Low birth weight was recorded in 7% of the newborns and insufficient weight was recorded in 37% of them. Maternal height and GWG showed positive and significant BW relation. Pre-gestational BMI and protein intake showed statistically significant inverse correlation with birth weight. No correlation between caloric intake and BW was demonstrated. CONCLUSION: maternal height and GWG influence the newborn nutritional status.

Older pregnant women and adolescents: Nutrition data after enrollment in WIC

Although there has been an increase in pregnancy in women over 35 years of age, the literature contains no information on dietary intakes of older pregnant women. Several studies have reported the nutritional status of pregnant adolescents who are considered to be at nutritional risk. This study investigated the energy, nutrient, and food intake patterns of 63 low-income pregnant women over 35 compared with 526 pregnant adolescents. Nutrient intake was assessed using a standardized 24-hour dietary recall protocol. Energy values for both groups were below recommended levels, and neither group gained the recommended amount of weight. Obesity may have been the reason for the lack of weight gain by the older pregnant women, since more than 50% of the older pregnant women were calculated to be obese prior to pregnancy. The younger women reported consuming less milk but more snack foods with lower nutrient densities, which significantly increased their energy values over those of the older group. In comparison with diets reported in other studies, the diets of the older pregnant women were more nutrient dense for most nutrients. Although all participants were enrolled in WIC, an equal number of women from both groups stated that they did not have the supplemental foods in their households at the time of interview.

Comparison of the nutritional status of pregnant adolescents with adult pregnant women. III. Maternal protein and calorie intake and weight gain in relation to size of infant at birth

Factors influencing the outcome of pregnancy were studied in 98 women, ages 12 to 32, divied into four age groups. A significantly higher weight gain was recorded for the youngest age group and the lowest gain for the oldest age group. The amount of weight gained was a function of length of gestation, but was not influenced by calorie intake of the mother. Neither was there significant correlation between protein and calorie intake of the mother and the infant's birth weight. Mean calorie intakes averaged below and mean protein intakes above the 1974 RDA. About 10% of the infants weighed less than 2,500 g and no single factor could be identified as the cause of low birth weight.

Comparison of the nutritional status of pregnant adolescents with adult pregnant women. II. Anthropometric and dietary findings

Weight, triceps and subscapular skinfold measurements, and mean intakes of 11 nutrients and calories were evaluated for 102 pregnant women in four age groups. The increase in weight during the antepartum period was the only significant finding for anthropometric measurements. Comparison of antepartum group means showed the two younger groups, 12-17 and 18-19 years, had higher intakes of calories, protein, fat, carbohydrate, calcium, phosphorus, and iron than the two older groups, 20-24 and 25-32. The two older groups had higher mean intakes of vitamin A, thiamin, niacin, and ascorbic acid, most of them significantly so. In the postpartum period, there were no significant differences among age groups for mean intakes of calories, protein, fat, carbohydrate, or phosphorus. The two older groups had the higher mean intakes of the remaining nutrients. There were no significant differences among age groups for any of the nutrients with respect to level of education. Regardless of age, the subjects attending the low-cost clinic had a mean intake of iron significantly higher than those having private physicians, while the latter had a mean ascorbic acid intake significantly higher than that of the clinic group.

Comparison of the nutritional status of pregnant adolescents with adult pregnant women. I. Biochemical findings

Biochemical findings on blood samples from 102 pregnant women in four age groups, 12-17, 18-19, 20-24, and 25-32, are reported. Samples represent 8 antepartum periods of 4 weeks each and 3 postpartum periods over 6 weeks. Blood analyses were carried out for hemoglobin, plasma iron, plasma total protein, glucose, plasma alkaline phosphatase, plasma ascorbic acid, plasma vitamin A and carotene, erythrocyte transketolase as a measure of thiamine status, plasma cholesterol, plasma lipid phosphorus, plasma total fatty acids, and triglyceride fatty acids. For the most part, means of these nutrients were in acceptable ranges for all age groups. Although adolescents had better levels than anticipated, the two younger groups on several occasions had means significantly lower than those of the two older groups, indicating that they needed greater nutritional support during pregnancy than older women.