VITAMIN-A, FOLATE, AND IRON CONCENTRATIONS IN CORD AND MATERNAL BLOODOF INTRAUTERINE GROWTH-RETARDED AND APPROPRIATE BIRTH-WEIGHT BABIES

Objectives: (i) To evaluate the relationship between the levels of vit amin A, folate and iron in maternal blood and cord blood from mother-b aby pairs who had intrauterine growth retardation (IUGR) and appropria te birth weight (ABW) for gestational age, (ii) To assess low or margi nal levels of vitamin A, folate and iron as risk factors for IUGR. Des ign: Retrospective unmatched case-control study. Setting: Maternidade de Campinas, Universidade Estadual de Campinas, Pontificia Universidad e Catolica de Campinas, Hospital Albert Sabin. Subjects: 356 mother-ba by pairs who had IUGR and 356 mother-baby pairs who had ABW for gestat ional age. Interventions: Newborns were classified as being IUGR accor ding to the Lubchenco classification. Gestational age of the newborns was evaluated by the Capurro method. Vitamin A, folate, ferritin, and haemoglobin were measured respectively by high performance liquid chro matography (HPLC), radioimmunoassay, immunoenzymetric assay and by the cyanmethaemoglobin method. Results: The percentages of IUGR babies wi th abnormal levels of nutritional indices compared with ABW babies wer e 33.1 vs 14.6 for vitamin A, 25.7 vs 19.9 for red blood cell (RBC) fo late, 37.0 vs 21.4 for haemoglobin, but similar for ferritin. The perc entages of IUGR mothers with abnormal levels of nutritional indices co mpared to ABW mothers were similar (1.1 vs 1.4) for vitamin A, and 36. 8 vs 32.1 for RBC folate. IUGR mothers were less often anaemic (43.2 v s 50.8), but tended to have higher levels of ferritin (37.6 vs 23.9) c ompared to ABW mothers. Conclusions: These results indicate marked dif ferences in cord blood between IUGR and ABW with small differences in maternal levels. They suggest that micronutrient deficiency is the res ult of being born small rather than vice versa. The high levels of fer ritin in IUGR mothers may reflect subclinical maternal infection contr ibuting to IUGR. Maternal micronutrient deficiency is unlikely to be a causative factor for IUGR in this population. Sponsorship: ODA (Overs eas Development Agency), United Kingdom; CNPq (Conselho Nacional de De senvolvimento Cientifico e Tecnologico), Brazil.