Gestational Iron Deficiency Is Associated with Pica Behaviors in Adolescents

Abstract

A relation between pica (the craving and purposive consumption of nonfood items) during pregnancy and anemia is observed frequently. However, few studies related pica behaviors to biomarkers of iron status, and little is known about pica prevalence in U.S. pregnant adolescents. To address this, we undertook a longitudinal study examining iron status and pica behaviors among a group of 158 pregnant adolescents (aged ≤18 y). Approximately two-thirds of the participants were African American and 25% were Hispanic. Maternal iron status indicators [hemoglobin, soluble transferrin receptor, serum ferritin (SF), total body iron (TBI), and serum hepcidin] were assessed during pregnancy (18.5-37.3 wk) and at delivery. Pica behavior was assessed up to 3 times across gestation. Among the 158 adolescents, 46% reported engaging in pica behavior. Substances ingested included ice (37%), starches (8%), powders (4%), and soap (3%). During pregnancy, mean SF [geometric mean: 13.6 μg/L (95% CI: 11.0, 17.0 μg/L)], TBI (mean ± SD: 2.5 ± 4.2 mg/kg), and hepcidin [geometric mean: 19.1 μg/L (95% CI: 16.3, 22.2 μg/L)] concentrations were significantly lower (P < 0.05) in the pica group (n = 72) than values observed among the non-pica group [SF, geometric mean: 21.1 μg/L (95% CI: 18.0, 25.0 μg/L); TBI, mean ± SD: 4.3 ± 3.5 mg/kg; hepcidin, geometric mean: 27.1 μg/L (95%: 23.1, 32.1 μg/L); n = 86]. Although additional studies must address the etiology of these relations, this practice should be screened for, given its association with low iron status and because many of the substances ingested may be harmful. This trial was registered at clinicaltrials.gov as NCT01019902.

Vitamin D status is inversely associated with anemia and serum erythropoietin during pregnancy

“…Serum was stored at 2808C until analysis. Results on calcitropic hormones (23,24), fetal bone growth (7), bone turnover and osteoprotegerin (25), changes in maternal bone quality across gestation (26), maternal iron status, erythropoietin and hepcidin (22), pica behaviors (27), placental iron transporter expression (28)(29)(30), maternal diet and fetal adiposity (31), and placental vitamin D hydroxylase expression (24) in this cohort have been published. To estimate habitual dietary intake during pregnancy, study personnel trained by research dietitians at the University of Rochester's Clinical and Translational Science Center administered 24-h dietary recalls to study participants during their scheduled study visits.…”

Fatores nutricionais e psicológicos associados com a ocorrência de picamalácia em gestantes

“…Outros termos adotados são: pica, picacia, picacismo, malácia, geomania, pseudorexia, entre outros [1][2][3][4][5][6] . Segundo a Associação Americana de Psiquiatria (DSM-IV) 7 , a picamalácia é a ingestão persistente de substâncias não nutritivas por período de pelo menos um mês; ou a ingestão de substâncias não nutritivas impróprias para saúde; ou um comportamento alimentar que não faz parte da cultura praticada; ou um comportamento alimentar que ocorre exclusivamente durante o curso de um transtorno mental.…”

Multiple Micronutrients Versus Iron Folic Acid on Pica and Hemoglobin Levels Among Pregnant Women in Kenya

“…[2] Pica experience is experienced more among the pregnant adolescents in the USA at 46% with pagophagia (pica for ice) at 37%. [3] Pica experience for geophagia (pica for soil) in Tanzania is at 5.2% and amylophagia (pica for raw starch) at 36.3% and other pica practices at 40%. [4] Ghana pica practice prevalence is at 9.1%.…”

“…The relationship between pica and iron status biomarkers is unknown though it has been in observance since > 2000 years according to Hippocrates in 400BCE. [3] Pica practice is common in developing countries. Pica prevalence in Ghana is 9.1%, in Pemba, Tanzania for amylophagia -36.3%, geophagia and any pica-40.1%.…”