Pregnancy is associated with physiologic changes that result in increased plasma volume and red blood cells and decreased concentrations of circulating nutrient-binding proteins and micronutrients. In many developing countries, these physiologic changes can be aggravated by undernutrition, leading to micronutrient deficiency states, such as anemia, that can have disastrous consequences for both mothers and newborn infants. Multiple micronutrients are often taken by pregnant women in developed countries, but their benefits are limited, except for prophylactic folic acid taken during the periconceptional period. Women in developing countries may benefit from multiple-micronutrient prophylaxis in pregnancy, but the underlying basis and rationale for changing from supplementation with iron and folate to supplementation with multiple micronutrients has not been debated in the context of existing program objectives. There is an urgent need for this discussion so that both program effectiveness and program efficacy can be improved. Am J Clin Nutr 2000;72(suppl):280S-90S. KEY WORDSNutrition, vitamins, trace elements, minerals, pregnancy, requirements INTRODUCTIONThe demand for both energy and nutrients is increased during pregnancy (1). For well-nourished women, only a small amount of additional energy is required because the body adapts to the increased energy requirements and becomes more energy efficient through reduced physical activity and a lowered metabolic rate. Although the average-sized, well-nourished woman requires Ϸ10 460 kJ/d (2000 kcal/d) during the last trimester of pregnancy (2), many women in developing countries restrict their food intake during pregnancy to have smaller infants, on the premise that smaller infants will carry a lower risk of delivery complications (3). Recent evidence suggests, however, that infants who are small or disproportionate at birth have increased health risks later in life (4-6). The hypothesis is that such infants have had to adapt to a limited supply of nutrients and that in so doing their physiology and metabolism are permanently changed, although the rationale for this hypothesis has been challenged (7).Requirements for many, but not all, micronutrients increase during pregnancy. Deficiencies can exist because of losses or malabsorption associated with disease or inadequate intakes, lack of knowledge about adequate prenatal nutrition, or dietary taboos associated with pregnancy (8), with potential adverse consequences for both mothers and newborn infants. Rush (9) notes that anemia in pregnancy and pregnancy-induced hypertension are common and thought to contribute significantly to maternal mortality and morbidity in developing countries. Maine (10), however, shows there is little evidence that nutrition plays a role in pregnancy-induced hypertension.This paper discusses minerals and trace elements as well as fat-and water-soluble vitamins in pregnancy-their concentrations, the requirements for them, the consequences of their deficiency, and the functional eff...

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Background: Interest in the reproductive health of adolescents continues to grow throughout the world. Few studies had explored the reproductive health knowledge, sexual behavior and experience of sexual coercion among secondary school students in North Eastern states of Nigeria. The objectives of this descriptive survey were to collect data to plan appropriate interventions that meet the reproductive health knowledge, service and skills needs of students in Bauchi, Borno and Gombe states.

Tuberculosis (TB) constitutes a significant and major public health emergency globally. Nigeria is one of the 22 high burden Tuberculosis countries. A high level of community awareness and positive perception towards TB and its management is crucial for the success of any control strategy. A national baseline survey was conducted in 2008 and a follow-up study in 2012 to measure knowledge of TB among the general population. This study therefore evaluated the knowledge of the target population about Tuberculosis in the follow-up study. A cross-sectional study design was employed with a total of 3,021 respondents interviewed from six states selected randomly from each of the six geopolitical zones in the country. Quantitative and qualitative research methodologies were adopted. From the findings, about 60% of the respondents were aged between 21 and 40 years and more than half had secondary school education. Over 80% had ever heard about TB. Although there has been a significant improvement in correct knowledge of the cause of TB from baseline (19%) in 2008 to 26.5% in 2012 (p < 0.001), findings showed that prioritized interventions are needed to improve communication and information dissemination on Tuberculosis to the general public, to aid TB control and all prevention efforts.

Maternal mortality and morbidity have remained very high in the developing countries. A common cause is ruptured uterus. In this report of 227 cases of ruptured uterus, the incidence was found to be rising. About 71.4% of the cases lacked prenatal care while 48.4% had a previously scarred uterus with many of them laboring for more than 12 h. The most common etiological factor was prolonged labor. Maternal mortality was 7.5% while perinatal mortality was 62.0%. Labor in high risk patients outside hospital because of declining economy and the rising influence of religion were some of the predisposing factors implicated. Methods to reduce this obstetric catastrophe are discussed.