Effects of maternal nutrition on the human fetus
Naeye, R.L.; Blanc, W.; Paul, C.
Pediatrics 52(4): 494-503
1973
ISSN/ISBN: 0031-4005 PMID: 4742243 Document Number: 66332
From 1044 consecutive autopsies on infants between 1960 and 1968 a selection was made of 467 as without disease or abnormality of any kind, and for which information was available on maternal height and weight at the desired times. Foetal age as calculated from the last menstrual period varied between 18 and 44 weeks. Mothers were classified according as they were: overweight in the beginning and gained more than the Hytten and Leitch normal gain for the stage of gestation recorded; underweight in the beginning with an above average weight gain; overweight with a weight gain below average; underweight with a low weight gain. There was a further analysis in which maternal food intake and weight gain were matched against the combined weights of foetus, placenta and amniotic fluid. Of the total of 467 women 344 were taking diets designed to restrict weight gain to between 15 and 20 lb, and the remaining 123 were on reducing diets: 48 restricted to 1200 kcal and 75 to 1500 kcal daily for periods varying from 1 to 2 months to over 6 months before delivery. The prescribed diets had adequate protein, Ca and vitamins by USA standards. Other information recorded was: on race or birthplace; as poor or nonpoor; as employed on sedentary or active work; as the pregnancy was wanted or unwanted; and finally abnormal haemorrhage during the last month was recorded. Body measurements and organ weights of infants were expressed as percentages of standard values, and a special method was used to assess number of cells, cytoplasmic mass and nuclear mass of cells in liver and adrenals. Maternal and foetal results were then related by computer. Foetal measurements, body and tissue, decreased from maternal groups in the order shown above. Many measurements of infants from mothers on severely restricted diets were less than those of infants from mothers advised to restrict their diet. The organs most affected were adrenals and liver, and the placenta. Brain and skeleton were not much affected; brains in infants of overweight mothers who gained more than normal during pregnancy were significantly above normal standards for brain at birth. Maternal prepregnancy weight and weight gain had little effect on the foetus born before 33 weeks of gestation, mean age 27 weeks; the smaller size of liver and adrenals was due to the small number of cells; near term, mean age 38 weeks, those organs had fewer than normal cells and less cytoplasmic mass. In the first group body and organ weights rose with parity; in the group with underwieght mothers who made low weight gain there was a considerable fall. When comparisons were made within diet groups there was no effect of maternal stature on weight of foetal body or organs; nor did any of the other maternal differences recorded affect foetal weight except poverty, and there the difference was complicated by an excess in the poor group of severely restricted diets.