Effects of maternal nutrition on fetal growth and infant development
Klein, R.E.; Arenales, P.; Delgado, H.; Engle, P.L.; Guzmán, G.; Irwin, M.; Lasky, R.; Lechtig, A.; Martorell, R.; Mejía Pivaral, V.; Russell, P.; Yarbrough, C.
Bulletin of the Pan American Health Organization 10(4): 301-306
1976
ISSN/ISBN: 0085-4638 PMID: 67867 Document Number: 438158
The 4 villages in Guatemala had moderate malnutrition, infection, no sanitation and contaminated water. Staples were maize and beans, with animal protein 12% of total protein intake. Women in 2 villages were given supplements of atole, a maize gruel, and in the other 2 fresco, a cool drink. In 180 ml, atole supplied energy 163 kcal and protein 11 g; fresco 59 kcal and no protein; they provided equal minerals and vitamins. Children studied were 412 aged under 3 years when study began in January 1969 and 671 born between then and February 1973. Women had about the same energy intakes from home food; 68 got over and 118 got under 20 000 kcal beginning during pregnancy or lactation from fresco, 102 got over and 117 got under 20 000 kcal from atole. The higher-energy supplements gave on average 35 000 kcal/pregnancy or 125 kcal daily. From bar charts, incidence of infants under 2500 g birthweight was about 18% with less and 8% with more energy in supplement. Association between birthweight and supplement was not accounted for by variables other than energy, such as mother's size or obstetric characteristics, morbidity or socioeconomic status. Protein:energy ratio of ordinary diet was high and energy supplement alone seemed sufficient. For 581 children up to 3 years old, the incidence of measurements showing retarded growth was about 40% for infants given under 5000 kcal/3 months for at least 42 months, directly or through the mother; 25% with 5000 to 10 000 kcal and 15% with more. Atole may have been slightly better than fresco, and the difference is being studied. Tables give details of the relation between supplement and results of psychological tests. From age 15 months onward, the better-nourished infants did better in mental and motor tests; that applied to grouping as high, medium or low-supplemented infants and to the measure of total supplement ingested. Relations remained significant when only the mother's supplement during pregnancy was considered, and disappeared when only the lactating mothers' and infants' were considered, so pregnancy was the critical time for supplements. Results are discussed; they have wide implications for public health. Of 671 children born during the study 44 died in their 1st year; the relation between low birthweight and high mortality is known.