OBSTETRIC NUTRITION: STUDIES ON MEETING NUTRITIONAL NEEDS OF PREGNANT WOMEN (NITROGEN BALANCE, PROTEIN, SURVEILLANCE, EDUCATION, W.I.C. PROGRAM)

Studies were conducted at Booth Residence in Omaha to determine protein needs during adolescent pregnancy. Subjects ate self-selected diets, made fecal and urine collections and had blood drawn in one to three, five-day periods. Albumin and BUN (blood urea nitrogen) levels decreased while globulin and total-iron-binding-capacity values increased as pregnancy progressed. Fecal, urinary and total nitrogen excretions decreased. Nitrogen balances tended to increase from the first to the third trimester. Caloric and protein intakes compared favorably with recommendations while iron intakes were low. Birthweight was correlated with weight gain and caloric intake. Younger adolescents were likely to: gain more weight, have a better diet and higher nitrogen intake and need, but, deliver a smaller infant (288g less) than older adolescents or young adults. Pregnancy Nutrition Surveillance was conducted in 14 clinic sites throughout Nebraska, 1981-1983. Data were obtained on race, age, due date, prepregnant weight, parity, dietary intake, height, weight, hematocrit, cigarette smoking, food stamp and vitamin/mineral supplement usage. Of 4,530 births, 60 infants died before six weeks. Mortality was associated with increased age, poor weight gain and low birthweight. Birthweight was positively correlated with gestational age, prepregnant weight, weight gain and days on WTC. Caloric, protein and intake of all nutrients (except vitamin A and iron) increased with WIC participation while breastfeeding incidence declined. Data suggested obstetric outcome could be significantly influenced by maternal characteristics. A nutrition education strategy was developed for pregnant WIC recipients in Omaha for the purpose of increasing breakfast cereal usage and knowledge of cereal as an iron source. Subjects were assigned to one of three groups: control group--no counselling or nutrition message, group A--nutrition message only, and group B--nutrition message, counselling and samples of food items. No difference was found among the groups in use of cereal as a breakfast food. But, the two experimental groups who received nutrition education demonstrated a significant increase in the use of cereal as a snack. Nutrition knowledge tended to increase in all groups