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The effect of nutritional intake on outcome of pregnancy in smokers and non-smokers

Published online by Cambridge University Press:  09 March 2007

F. M. Haste
Affiliation:
Departments of Public Health Sciences, Departments of Child Health, St George's Hospital Medical School, Cranmer Terrace, London SW17 ORE
O. G. Brooke
Affiliation:
Departments of Child Health, St George's Hospital Medical School, Cranmer Terrace, London SW17 ORE
H. R. Anderson
Affiliation:
Departments of Public Health Sciences, Departments of Child Health, St George's Hospital Medical School, Cranmer Terrace, London SW17 ORE
J. M. Bland
Affiliation:
Departments of Public Health Sciences, Departments of Child Health, St George's Hospital Medical School, Cranmer Terrace, London SW17 ORE
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Abstract

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The relationship between nutrient intake and pregnancy outcome (adjusted birth weight and gestational age) was investigated in randomly selected non-smokers (n 97) and in heavy smokers (15 + cigarettes/d) (n 72) booking for ante-natal care at a hospital in South London. Weighed dietary intakes (7 d) were obtained at 28 and 36 weeks gestation. Birth weight was adjusted for gestational age, maternal height, parity and sex of infant.

Compared with non-smokers, intakes of micronutrients and fibre were lower in smokers at both 28 and 36 weeks, and smokers reduced their intakes more in late pregnancy. The babies of smokers had a lower adjusted birth weight but there was no difference in length of gestation between smokers and non-smokers. After controlling for smoking, social class and alcohol consumption, nutrient intakes at 28 weeks were found to have no effect on adjusted birth weight. However, intakes of protein, zinc, riboflavin and thiamin at 36 weeks, and the change in intakes of these nutrients (plus iron) between 28 and 36 weeks, had independent positive effects on birth weight. Some of the effect of smoking on birth weight appeared to be mediated through differences in nutrient intakes. Smoking explained 14.3% of the variance in birth weight in this population and a further 2.4–7.2 % was explained by change in nutrient intakes between 28 and 36 weeks. It is recommended that women in pregnancy do not reduce their dietary intakes in late pregnancy.

Type
Nutrient Intake and Status
Copyright
Copyright © The Nutrition Society 1991

References

REFERENCES

Adams, S. O., Barr, C. D. & Huenemann, R. L. (1978). Effect of nutritional supplementation in pregnancy. 1. Outcome of pregnancy. Journal of the American Dietetic Association 72, 144147.CrossRefGoogle Scholar
Bergner, L. & Susser, M. W. (1970). Low birthweight and prenatal nutrition: an interpretative review. Pediatrics 46, 946965.CrossRefGoogle ScholarPubMed
Bland, J. M., Peacock, J. L., Anderson, H. R. & Brooke, O. G. (1990). The adjustment of birthweight for very early gestational ages: two related problems in statistical analysis. Applied Statistics 39, 229239.CrossRefGoogle Scholar
Brooke, O. G., Anderson, H. R., Bland, J. M., Peacock, J. L. & Stewart, C. M. (1989). The effects on birthweight of smoking, alcohol, caffeine, socio-economic factors and psychosocial stress. British Medical Journal 298, 795801.CrossRefGoogle ScholarPubMed
Calder, J. H., Curtis, R. C. & Fore, H. (1963). Comparison of vitamin C in plasma and leucocytes of smokers and non-smokers. Lancet i, 556.CrossRefGoogle Scholar
Campbell Brown, M. (1983). Protein–energy supplements in primigravid women at risk of low birthweight. In Nutrition in Pregnancy, pp. 85100 [Campbell, D. M. and Gillmer, M. D. G., editors]. London: Royal College of Obstetricians and Gynaecologists.Google Scholar
Crosby, W. M., Metcoff, J., Costiloe, J. P., Mameesh, M., Stanstead, H. H., Jacob, R. A., McClain, P. E., Jacobson, S., Reid, W. & Burns, G. (1977). Fetal malnutrition: an appraisal of correlated factors. American Journal of Obstetrics and Gynaecology 128, 2231.CrossRefGoogle ScholarPubMed
Davies, D. P., Gray, O. P., Ellwood, P. C. & Abernethy, M. (1976). Cigarette smoking in pregnancy – associations with maternal weight gain and foetal growth. Lancet i, 385387.CrossRefGoogle Scholar
Ebbs, J. H., Tisdall, F. F. & Scott, W. A. (1941). Influence of prenatal diet on mother and child. Journal of Nutrition 22, 515526.CrossRefGoogle Scholar
Elwood, P. C., Haley, T. J. L., Hughes, S. J., Sweetnem, P. M., Gray, O. P. & Davies, D. P. (1981). Child growth and the effect of entitlement to a milk supplement. Archives of Diseases of Childhood 56, 831835.CrossRefGoogle ScholarPubMed
Garn, S. M. (1979). Is there nutritional mediation of the smoking effect on the fetus? American Journal of Clinical Nutrition 32, 11811184.CrossRefGoogle ScholarPubMed
Haste, F. M., Brooke, O. G., Anderson, H. R., Bland, J. M., Shaw, A., Griffin, J. & Peacock, J. L. (1990). Nutrient intakes during pregnancy: observations on the influence of smoking and social class. American Journal of Clinical Nutrition 51, 2936.CrossRefGoogle ScholarPubMed
Haworth, J. C., Ellestad-Sayed, J. J. M., King, J. & Dilling, C. A. (1980). Fetal growth retardation in cigarette-smoking mothers is not due to decreased maternal food intake. American Journal of Obstetrics and Gynecology 137, 719723.CrossRefGoogle Scholar
Lechtig, A., Delgado, H., Lasky, R. E., Klein, R. E., Engle, P. L., Yarborough, C. & Habicht, J. P. (1975 a). Maternal nutrition and foetal growth in developing societies. American Journal of Diseases of the Child 129, 434437.CrossRefGoogle Scholar
Lechtig, A., Habicht, J. P. & Delgado, H. (1975 b). The effect of food supplementation during pregnancy on birthweight. Paediatrics 56, 508519.CrossRefGoogle ScholarPubMed
Meadows, N. J., Smith, M. F., Keeling, P. W. N., Ruse, W., Day, J. & Scopes, J. W. (1981). Zinc and small babies. Lancet ii, 11351137.CrossRefGoogle Scholar
Meyer, M. B. (1977). Effects of maternal smoking and altitude on birthweight and gestation. In Epidemiology of Prematurity, pp. 81103 [Reed, D. and Stanley, F., editors]. Baltimore, MD: Urban & Schwarzenberg.Google Scholar
Meyer, M. B., Jonas, B. S. & Tonascia, J. A. (1976). Perinatal events associated with maternal smoking during pregnancy. American Journal of Epidemiology 103, 464476.CrossRefGoogle ScholarPubMed
Mora, J. D., Paredes, B., Wagner, M., Navarro, L., Suescun, J., Christiansen, N. & Herrera, M. G. (1979). Nutritional supplementation and the outcome of pregnancy. American Journal of Clinical Nutrition, 32, 455462.CrossRefGoogle ScholarPubMed
Nakazawa, Y., Chiba, K., Nobuhiko, I., Kotoii, T., Sakamato, T. & Ishizaki, T. (1983). Serum folic acid levels and antipyrine clearance rates in smokers and non-smokers. Drug and Alcohol Dependence 8, 201207.CrossRefGoogle Scholar
Papoz, L. (1982). Maternal smoking and birthweight in relation to dietary habits. American Journal of Obstetrics and Gynecology 142, 870876.CrossRefGoogle ScholarPubMed
Patrick, J., Dervish, G. & Gillieson, M. (1982). Zinc and small babies. Lancet i, 169170.CrossRefGoogle Scholar
Paul, A. A. & Southgate, D. A. T. (1978). McCance and Widdowson's The Composition of Foods, 4th ed. London: H.M. Stationery Office.Google Scholar
Peacock, J. L., Bland, J. M. & Anderson, H. R. (1991). Effects on birthweight of alcohol and caffeine consumption in smoking women. Journal of Epidemiology and Community Health (In the Press).CrossRefGoogle ScholarPubMed
Pelletier, O. (1970). Vitamin C status of cigarette smokers and non-smokers. American Journal of Clinical Nutrition 23, 520524.CrossRefGoogle Scholar
Pelletier, O. (1975). Vitamin C and cigarette smokers. Annals of the New York Academy of Sciences 258, 156158.Google ScholarPubMed
Picone, T., Allan, L. H., Schramm, M. H. & Olsen, D. (1982). Pregnancy outcome in North American women. 1. Effects of diet, cigarette smoking and psychological stress on maternal weight gain. American Journal of Clinical Nutrition 36, 12051213.CrossRefGoogle Scholar
Prentice, A. M., Whitehead, R. G., Watkinson, M., Lamb, W. H. & Cole, T. J. (1983). Prenatal dietary supplementation of African women and birthweight. Lancet i, 489492.CrossRefGoogle Scholar
Rantakallio, P. (1978). The effect of maternal smoking on birthweight and subsequent health of the child. Early Human Development 2, 371382.CrossRefGoogle ScholarPubMed
Rush, D. (1974). Examination of the relationship between birthweight, cigarette smoking during pregnancy and maternal weight gain. Journal of Obstetrics and Gynaecology of the British Commonwealth 81, 746752.CrossRefGoogle ScholarPubMed
Rush, D. & Cassano, P. (1983). Relationship of cigarette-smoking and social class to birthweight and perinatal mortality among all births in Britain, 511 April 1970. Journal of Epidemiology and Community Health 37, 249255.Google ScholarPubMed
Rush, D., Stein, Z. & Susser, M. (1980). A randomised controlled trial of prenatal nutritional supplementation in New York City. Pediatrics 65, 683697.CrossRefGoogle ScholarPubMed
Schorah, C. J., Zemrock, P. J., Sheppard, S. & Smithells, R. W. (1978). Leucocyte ascorbic acid and pregnancy. British Medical Journal 39, 139149.Google ScholarPubMed
Simmer, K. & Thompson, R. P. H. (1984). Maternal zinc and intrauterine growth retardation. Clinical Science 68, 395399.CrossRefGoogle Scholar
Smithells, R. W., Ankers, C., Carver, M., Lennon, D., Schorah, C. J. & Sheppard, S. (1977). Maternal nutrition in early pregnancy. British Journal of Nutrition 38, 497506.CrossRefGoogle ScholarPubMed
SPSS-X (1983). Statistical Package for the Social Sciences: User's Guide. Chicago: SPSS Inc.Google Scholar
Stein, Z., Susser, M. & Rush, D. (1978). Prenatal nutrition and birthweight; experiments and quasi-experiments in the past decade. Journal of Reproductive Medicine 21, 287297.Google ScholarPubMed
Wells, J. L., James, D. K., Luxton, R. & Pennock, C. A. (1987). Maternal leucocyte zinc deficiency at the start of the third trimester as a predictor of foetal growth retardation. British Medical Journal 294, 10541056.CrossRefGoogle Scholar
Whitehead, R. G., Prentice, A. M., Lamb, W. & Paul, A. A. (1983). Maternal dietary supplementation during lactation and pregnancy in a rural African village in The Gambia. In Nutrition in Pregnancy, pp. 133141 [Campbell, D. M. and Gillmer, M. D. G., editors]. London: Royal College of Obstetricians and Gynaecologists.Google Scholar
Witter, F. R., Blake, D. A., Baumgardner, R., Mellitts, E. P. & Neibyl, J. R. (1982). Folate, carotene and smoking. American Journal of Obstetrics and Gynecology 144, 857.CrossRefGoogle ScholarPubMed