Nutritional status and serum levels of some micronutrients and their relationship with some maternal, fetal and neonatal outcomes in adolescent pregnant women: A prospective study

Abstract

Abstract Introduction: Pregnancy in adolescence (10-19 years) is a global challenge. Complications of pregnancy and childbirth are the most important cause of death in girls aged 15 to 19 in the world. Studies show that malnutrition and deficiency of some micronutrients during pregnancy also increase the likelihood of adverse maternal-fetal consequences. The aim of this study was to determine the nutritional status and serum levels of some micronutrients in adolescent pregnant women and the relationship between micronutrient deficiency and some maternal, fetal and neonatal outcomes. Methods: This prospective study was performed on 200 healthy pregnant adolescents (aged 11-19 years) with gestational age of 32 to 26 weeks. Participants were covered by 93 health centers in the city of Tabriz, the capital of East Azerbaijan Province located in northwestern Iran. Eligible women completed the Maternal Demographic Questionnaire and the Food frequency Questionnaire after signing informed consent forms. A venous blood sample was then taken to determine the serum level of micronutrients. All participants were followed up for one month after delivery. Results: The mean (standard deviation) age of women was 17.6 (1.3) years. Weight gain during pregnancy was excessive for one-third (34%) of women and less than normal for 10%. Intake (diet and supplements) of zinc and folate in all, magnesium in 96%, calcium in 72.5%, and vitamin D in 94% of the women were less than the recommended amount. Serum levels of vitamin D were lower than normal in 92%, folate in 39.5% and zinc in 37.5% of the women. Serum levels of ferritin, iron, magnesium, copper and calcium were in the normal range in most of the women. In women with serum vitamin D deficiency, the frequency of cesarean section and the frequency of preterm birth were significantly higher. All four cases of stillbirths occurred in women with vitamin D deficiency. Serum levels of vitamin D and ferritin were significantly lower in mothers with low birth weight infants. There was a statistically significant relationship between serum ferritin level and neonatal height and head circumference, also between serum copper level and neonatal weight (P < 0.05). Serum zinc and hemoglobin levels had no statistically significant relationship with any of the maternal and neonatal outcomes. Conclusion: The findings of this study show that deficiency of zinc, folate, magnesium, calcium and vitamin D received through diet and supplements as well as low serum levels of vitamin D, folate and zinc are very common in adolescent pregnant women. Deficiencies of serum levels of vitamin D, ferritin and folate of adolescent women during pregnancy are associated with some adverse maternal and neonatal outcomes. To prevent nutritional deficiencies of this group of women and their adverse maternal and neonatal consequences, health system policymakers should adopt appropriate health policies and health workers should place greater emphasis on proper nutrition during pregnancy to adolescent pregnant women and their families.