The nutritional status of women in the first trimester of pregnancy attending an inner-city antenatal department in the UK

Abstract

We have previously found high rates of poor iron and folate status in women who had delivered a low birthweight baby (LBW) in an ethnically diverse inner-city area of the UK. However, little was known of the nutritional status in the local general obstetric population. We therefore investigated biochemical measures of nutritional status in the first trimester of the first pregnancy. Routine blood samples collected at the antenatal booking clinic were analysed for haemoglobin (Hb), serum ferritin, red cell folate (RCF) (n = 100) and erythrocyte transketolase activation coefficient (ETKAC) for thiamin status (n = 90). We found 9% of women in our sample had a low Hb level, 10% had a low serum ferritin and only one had a low RCF. This is a substantially lower number of women with biochemical deficiencies than we found previously in women three months after delivering a LBW baby. However, 34% had low thiamin status. Thiamin status was negatively correlated with gestational age at birth (r = -0.407, p < 0.001). Differences in nutritional status were observed between ethnic and socio-economic groups. Hb levels differed between ethnic (p = 0.001) and socio-economic groups (p = 0.02), with Africans and women in manual occupations/unwaged having the lowest Hb levels. RCF levels also differed between groups (p < 0.001) with Caucasians and those in non-manual occupations having highest levels. ETKAC also differed between ethnic groups (p = 0.008) with Africans having the highest level indicating a poorer status. The study highlights the need to improve nutrition particularly in ethnic minorities and low income groups who are most at risk of adverse birth outcomes such as LBW.

Social and ethnic differences in folic acid use preconception and during early pregnancy in the UK: effect on maternal folate status

“…The present study also substantiated previous research (Rees et al. , 2005) showing maternal SC I & II had the highest mean folate levels and unwaged and students the lowest.…”

“…The present study also substantiated previous research (Rees et al, 2005) showing maternal SC I & II had the highest mean folate levels and unwaged and students the lowest. This gradient was also apparent with level of education: women with degree or professional qualifications had a higher mean folate concentration than women with no qualifications.…”

Social and ethnic differences in folic acid use preconception and during early pregnancy in the UK: effect on maternal folate status

“…The present study also substantiated previous research (Rees et al. , 2005) showing maternal SC I & II had the highest mean folate levels and unwaged and students the lowest.…”

“…The present study also substantiated previous research (Rees et al, 2005) showing maternal SC I & II had the highest mean folate levels and unwaged and students the lowest. This gradient was also apparent with level of education: women with degree or professional qualifications had a higher mean folate concentration than women with no qualifications.…”

Effect of multiple-micronutrient supplementation on maternal nutrient status, infant birth weight and gestational age at birth in a low-income, multi-ethnic population

“…The prevalence of low Fe status at recruitment in the present study was similar to a previous Hackney study (9 % anaemic and 10 % low Fe stores) ( 4 ) . Hb and PCV concentrations are known to decrease from the first to the third trimester and increase slightly at term ( 14 ) ; this trend was clearly seen in the present study, however, the decrease was greatest for women receiving the placebo.…”

Thiamine deficiency in pregnancy and lactation: implications and present perspectives

“…Rees and colleagues assessed the nutritional status of women ( n = 83) in the first trimester of pregnancy in the United Kingdom. They reported that 34% ( n = 31) had low thiamine status and of these 24 had marginal thiamine status (ETKAC 1.15–1.25) and seven were thiamine deficient (ETKAC > 1.25) ( 139 ). In a double-blind randomized clinical trial conducted by Whitfield et al ( 140 ), 90 pregnant women were recruited in the Prey Veng province, Cambodia to determine the maternal thiamine levels at baseline and in breastmilk and among infants at end-line after the consumption of thiamine-fortified fish sauce.…”

Social and ethnic differences in folic acid use preconception and during early pregnancy in the UK: effect on maternal folate status

“…The present study also substantiated previous research (Rees et al. , 2005) showing maternal SC I & II had the highest mean folate levels and unwaged and students the lowest.…”

“…The present study also substantiated previous research (Rees et al, 2005) showing maternal SC I & II had the highest mean folate levels and unwaged and students the lowest. This gradient was also apparent with level of education: women with degree or professional qualifications had a higher mean folate concentration than women with no qualifications.…”

Effect of multiple-micronutrient supplementation on maternal nutrient status, infant birth weight and gestational age at birth in a low-income, multi-ethnic population

“…The prevalence of low Fe status at recruitment in the present study was similar to a previous Hackney study (9 % anaemic and 10 % low Fe stores) ( 4 ) . Hb and PCV concentrations are known to decrease from the first to the third trimester and increase slightly at term ( 14 ) ; this trend was clearly seen in the present study, however, the decrease was greatest for women receiving the placebo.…”

Thiamine deficiency in pregnancy and lactation: implications and present perspectives

“…Rees and colleagues assessed the nutritional status of women ( n = 83) in the first trimester of pregnancy in the United Kingdom. They reported that 34% ( n = 31) had low thiamine status and of these 24 had marginal thiamine status (ETKAC 1.15–1.25) and seven were thiamine deficient (ETKAC > 1.25) ( 139 ). In a double-blind randomized clinical trial conducted by Whitfield et al ( 140 ), 90 pregnant women were recruited in the Prey Veng province, Cambodia to determine the maternal thiamine levels at baseline and in breastmilk and among infants at end-line after the consumption of thiamine-fortified fish sauce.…”

Social and ethnic differences in folic acid use preconception and during early pregnancy in the UK: effect on maternal folate status

“…The present study also substantiated previous research (Rees et al. , 2005) showing maternal SC I & II had the highest mean folate levels and unwaged and students the lowest.…”

“…The present study also substantiated previous research (Rees et al, 2005) showing maternal SC I & II had the highest mean folate levels and unwaged and students the lowest. This gradient was also apparent with level of education: women with degree or professional qualifications had a higher mean folate concentration than women with no qualifications.…”

Effect of multiple-micronutrient supplementation on maternal nutrient status, infant birth weight and gestational age at birth in a low-income, multi-ethnic population

“…The prevalence of low Fe status at recruitment in the present study was similar to a previous Hackney study (9 % anaemic and 10 % low Fe stores) ( 4 ) . Hb and PCV concentrations are known to decrease from the first to the third trimester and increase slightly at term ( 14 ) ; this trend was clearly seen in the present study, however, the decrease was greatest for women receiving the placebo.…”

Thiamine deficiency in pregnancy and lactation: implications and present perspectives

“…Rees and colleagues assessed the nutritional status of women ( n = 83) in the first trimester of pregnancy in the United Kingdom. They reported that 34% ( n = 31) had low thiamine status and of these 24 had marginal thiamine status (ETKAC 1.15–1.25) and seven were thiamine deficient (ETKAC > 1.25) ( 139 ). In a double-blind randomized clinical trial conducted by Whitfield et al ( 140 ), 90 pregnant women were recruited in the Prey Veng province, Cambodia to determine the maternal thiamine levels at baseline and in breastmilk and among infants at end-line after the consumption of thiamine-fortified fish sauce.…”