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Iron consumption in obese pregnant women and birth outcome

Published online by Cambridge University Press:  19 October 2012

J. C. Abayomi ,
M. Charnley ,
L. D. Richardson  and
A. Weeks
J. C. Abayomi
Affiliation:
Faculty of Education, Community and Leisure, Liverpool John Moores University, IM Marsh Campus, Barkhill Road, Liverpool L17 6BD
M. Charnley
Affiliation:
Faculty of Education, Community and Leisure, Liverpool John Moores University, IM Marsh Campus, Barkhill Road, Liverpool L17 6BD
L. D. Richardson
Affiliation:
Faculty of Education, Community and Leisure, Liverpool John Moores University, IM Marsh Campus, Barkhill Road, Liverpool L17 6BD
A. Weeks
Affiliation:
Liverpool Women's Hospital, Crown Street, Liverpool L8 7SS, UK
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Abstract

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Information
Proceedings of the Nutrition Society , Volume 71 , Issue OCE2: Summer Meeting hosted by the Irish Section, 16–19 July 2012, Translational nutrition: integrating research, practice and policy , 2012 , E108
Copyright
Copyright © The Authors 2012

Low BMI and iron deficiency anaemia in pregnancy are associated with increased risk of pre-term delivery (PTD) and low birth weight (LBW)( Reference Scholl and Hediger 1 , Reference Johnson and Yancy 2 ). The National Diet and Nutrition Survey (2010) found that iron intakes fell below the lower reference nutrient intake (LRNI) in 20% of adult women( 3 ). Other studies show that 80% of pregnant women achieve intakes less than the reference nutrient intake (RNI) for iron( 3 ). The aim of this study was to explore the dietary intake of obese pregnant women in relation to LBW and PTD. Women were recruited from antenatal clinic and asked to complete three-day food diaries during each trimester of pregnancy. Data regarding food portion size was verified using a food atlas( Reference Alwan, Greenwood, Simpson, McArdle, Godfrey and Cade 4 ) and the diaries were then analysed using Microdiet™. Following delivery comparisons were made between dietary data and birth outcome data routinely recorded at delivery by the hospital. Data were collected for 139 pregnant women with a BMI ≥35kg/m2. Mean booking-in weight was 110 kg (sd 15.5).

Table 1. Mean iron intake over 3 trimesters and % of women achieving each dietary reference value( Reference Nelson, Atkinson and Meyer 5 ).

AVisit 1 16–20 weeks gestation (n=93).

BVisit 2 28 weeks gestation (n=99).

CVisit 3 36 weeks gestation (n=73).

Mean energy intakes at each trimester were similar to the estimated average requirement (EAR) of 1940–2140 kcal/d( Reference Nelson, Atkinson and Meyer 5 ) (1849 kcal/d; 1984 kcal/d; 2066 kcal/d respectively). Overall iron intakes were low with 63.6% achieving<EAR and 22.5% achieving<LRNI (table 1). Spearman's correlation test failed to show a significant relationship between iron intake and birth outcome (all p>0.05) but all 6 women with a LBW baby (<2.5 kg) and 7 out of 8 women with pre-term delivery (<37 weeks) failed to achieve RNI for iron. The results suggest that despite a high BMI and an adequate energy intake, quality of diet may be lacking in obese pregnant women. This provides further evidence of the association between iron deficiency and LBW and PTD.

References

1. Scholl, TO & Hediger, ML (1994) Anemia and iron-deficiency anemia: compilation of data on pregnancy outcome. Am J Clin Nutr 59, 492S–500S.CrossRefGoogle ScholarPubMed
2. Johnson, JWC & Yancy, MK. (1996) A Critique of the New Recommendations for Weight Gain in Pregnancy. American Journal of Obstetrics and Gynecology 174(1): 254–258.Google Scholar
3. National Diet and Nutrition Survey (2010) Available at: http://www.food.gov.uk/multimedia/pdfs/publication/ndnsreport0809.pdf. (Accessed 28/04/12)Google Scholar
4. Alwan, N, Greenwood, DC, Simpson, NAB, McArdle, HJ, Godfrey, KM and Cade, JE. (2011) Dietary iron intake during early pregnancy & birth outcomes in a cohort of British women. Hum Reprod 26(4): 911–919.Google Scholar
5. Nelson, M, Atkinson, M and Meyer, J (2002) A photographic atlas of food portion sizes FSA.Google Scholar
6. COMA (1991) Dietary Reference Values for Food, Energy & Nutrients for the UK. HMSO: London.Google Scholar
Figure 0

Table 1. Mean iron intake over 3 trimesters and % of women achieving each dietary reference value(5).