Korean Journal of Community Nutrition

[English]
Risk Factors Affecting the Health of Pregnant Women and Fetus: Hyun Sook Bae; Korean J Community Nutr 2008;13(6):805-817. Published online December 31, 2008

Abstract PDF: The aim of this study was to determine the predictors of desirable pregnancy outcomes. The subjects were 795 pregnant women participating in the 2007 Mom and Baby Expo. They were grouped by gestational age: group I (3-12 wk: n = 95), group II (13-25 wks: n = 263) and group III (26-42 wks: n = 437). We collected data for general characteristics, sociocultural factors, life styles and nutrient intakes. We also collected pregnancy outcome data of 634 pregnant women including birth weight, maternal weight gain and gestational age. Dietary intakes of the subjects were estimated by Food Frequency Questionnaire. folate, iron and calcium intakes from foods of pregnant women were 88%, 79% and 58% of KDRIs, respectively. Bivariate analysis showed that birth weight was significantly associated with pre-pregnancy BMI, maternal weight gain, maternal age, gestational age and intakes of iron, potassium, vitaminB1, B6, fatty acids, MUFA. And also, bivariate analysis showed that maternal weight gain was significantly associated with pre-pregnancy BMI, maternal age, gestational age and intakes of energy, potassium. Further multivariate analyses suggest that vitaminB6 may be a significant predictor for low birth weight and energy intake and maternal age for maternal weight gain. Our findings suggest that dietary and lifestyle interventions during pregnancy can improve maternal and infant pregnancy outcomes. Prepregnancy weight control and intakes of energy and vitamin B6 need to be taken into considerations in developing strategic prenatal care programs to promote desirable pregnancy outcome.

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[English]
Serum Iron Concentration of Maternal and Umbilical Cord Blood during Pregnancy: Hey Mi Jang, Hong Seok Ahn; Korean J Community Nutr 2005;10(6):860-868. Published online December 31, 2005

Abstract PDF: Anemia diagnosed early in pregnancy is associated with increased risks of low birth weight and preterm delivery. The purposes of this study were to assess the maternal iron status during pregnancy and to evaluate the relationships between the iron indices of maternal-umbilical cord serum iron and ferritin levels and pregnancy outcomes. Dietary intakes of the pregnant women were estimated by 24 hour-recall (3 times). Serum iron and ferritin levels in maternal blood and umbilical cord were measured at 1st-, 2nd-, 3rd- trimester and delivery, respectively. The mean of maternal serum iron levels of the trimester and delivery were 124.27microgram/dl, 97.03microgram/dl, 94.32microgram/dl, and 145.53microgram/dl. Those maternal levels were significantly lower than that of umbilical cord blood (222.59microgram/dl). Serum ferritin levels of maternal trimester and delivery were 22.68microgram/l, 11.09microgram/l, 14.18microgram/l and 24.54microgram/l, which were significantly lower than those of umbilical cord blood (184.35microgram/l)(p<0.0001). This prevalence of anemia of total subjects was 30.3% by WHO criteria (Hb<11.0 g/dl, Hct<33%). Iron levels of 2nd-trimester was significantly higher in the normal group than in the anemia group. And ferritin levels of 3rd-trimester and delivery was significantly higher in the normal group than in the anemia group. Therefore, we suggest for successful pregnancy outcome and delivery differential iron supplementation programs will be carried out with individual pregnant women on the basis of pre-pregnancy nutrition.

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[English]
A Change of Serum Folate and Vitamin B12 Concentrations of Maternal and Umbilical Cord Blood during Pregnancy: Geum Ju Lee, Hey Mi Jang, Hong Seok Ahn; Korean J Community Nutr 2005;10(5):615-622. Published online October 31, 2005

Abstract PDF: Folate and Vitamin B12 are essential nutrients important during pregnancy. This study was conducted to evaluate the folate and vitamin B12 nutritional status of Korean pregnant women and to investigate the relationship between maternal-umbilical cord serum folate and vitamin B12 levels and pregnancy outcomes. Dietary intakes of the pregnant women were estimated by 24 hour-recall (3 times). Serum folate and vitamin B12 levels in maternal blood and umbilical cord of 27 pregnant women at 1'st-, 2'nd-, 3'rd- trimester and delivery were measured by RIA (radioimmuno assay), respectively. Means of folate and vitamin B12 intake were 283.53 +/- 58.01 microgram/day and 2.99 +/- 1.32 mg/day, respectively. Maternal mean serum folate levels of the trimester and delivery were 9.75 +/- 3.60 ng/ml, 10.46 +/- 4.63 ng/ml, 10.71 +/- 4.14 ng/ml and 15.05 +/- 7.04 ng/ml. Those maternal levels were significantly lower than that of umbilical cord blood (23.99 +/- 9.42 ng/ml). Serum vitamin B12 levels of maternal trimester and delivery were 479.07 +/- 137.56 pg/ml, 310.96 +/- 137.56 pg/ml, 308.22 +/- 74.65 pg/ml, and 295.67 +/- 93.36 pg/ml, which were significantly lower than those of umbilical cord blood (500.13 +/- 185.60 ng/ml). This finding indicates that the uptake of folate and vitamin B12 in the fetus may be due to an active placental transport mechanism. Maternal serum level correlated positively with those of umbilical cord blood, showing that folate and vitamin B12 concentration of umbilical cord blood might be affected by maternal status. There was no significant correlation between the serum folate levels in maternal-umbilical cord blood and the pregnancy outcomes. However, maternal vitamin B12 level at 1'st trimester was significant positive correlation between the gestational age except for birth weight and weight gain.

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[English]
Maternal Plasma Homocysteine Levels and Pregnancy Outcomes: Hong Seok Ahn; Korean J Community Nutr 2004;9(4):483-490. Published online August 31, 2004

Abstract PDF: Elevated maternal plasma homocysteine concentrations have been associated with adverse pregnancy outcomes, including birth defects, low birth weight, preeclampsia, spontaneous abortion, placental abruption, and other maternal or fetal complications. The purpose of this study was to assess the maternal plasma homocysteine level during pregnancy and to investigate the relationship between the plasma homocysteine concentrations and pregnancy outcomes. Venous blood samples were drawn from 82 pregnant women who were grouped with gestational age, 1st trimester (n = 26), 2nd trimester (n = 27) and 3rd trimester (n = 29). The concentration of plasma homocysteine was analyzed by HPLC, and pregnancy outcomes including gestational length, maternal weight gain, infant birth weight, and Apgar score were collected with the medical records of the pregnant women. The levels of plasma homocysteine of the pregnant women at the 1st, 2nd, and 3rd trimester were 5.7 +/- 3.7 micronmol/L, 5.6 +/- 4.1 micronmol/L and 7.0 +/- 4.5 micronmol/L, respectively, which had not showed any significant difference. The result of this study showed that in case of the pregnant women at the 1st trimester, the maternal plasma homocysteine level of the pregnant women whose gestational length was less than 38 weeks was significantly high (p < 0.01) compared to that of the pregnants whose gestational length was more than 38 weeks. And also, the level of homocysteine of the pregnant women at the 2nd trimester was significantly low when the maternal weight gain was high (p < 0.05). These findings suggest that maternal plasma homocysteine level at early stage of gestation will be a predicter of gestational length and maternal weight gain.

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[English]
The Relationship between Zinc Concentration of Maternal, Umbilical Cord, and Placenta and Birth Weight: Hyun Sook Bai, Hong Seok Ahn; Korean J Community Nutr 2003;8(6):814-821. Published online December 31, 2003

Abstract PDF: The purpose of this study was to assess the maternal zinc status during pregnancy and to evaluate the relationship between the zinc concentration of maternal, umblical cord blood and placental tissue and pregnancy outcomes. Venous blood samples were drawn from 53 pregnant women just before delivery and the cord blood of their newborn babies was collected immediately after birth. In addition, placental tissues were extracted. We investigated the difference in the concentration of zinc in maternal, umbilical cord blood and placental tissue in two gestational age groups (preterm delivery group [PT] and normal term delivery group [NT]) at 34.7 wk and 39.0 wk of mean gestational age, respectively). We also assessed correlations of the zinc concentration of maternal, umbilical cord blood and placental tissue. Lastly, we studied the correlations between the birth weights and the zinc concentration in the maternal, umbilical cord blood and placental tissue. The concentrations of maternal serum zinc and of umbilical cord serum zinc were significantly higher in the PT group (76.9 +/- 37.4 microgram/dl, 101.3 +/- 41.4 microgram/dl) than in those of the NT group (57.8 +/- 22.4 microgram/dl, 80.7 +/- 27.5 microgram/dl), respectively (p < 0.05). The zinc concentration of the umbilical cord blood was significantly higher than that of the maternal blood in both groups (p < 0.05). There was no significant correlation between the gestational age and the serum zinc concentration in the cord or the maternal serum. Our results showed that there was a negative relationship between the birth weight (r = -0.286) and the maternal serum zinc concentration. Despite there not being a significant difference, there was tendency for the highest concentrations of maternal serum zinc to be associated with the lowest birth weights. These findings support a possible relationship between the maternal zinc status and the pregnancy outcome, and suggest that zinc may play a role in the many biological processes involved in the successful outcome of a pregnancy.

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[English]
Common Functional Problems during Pregnancy and Association with Nutritional Status and Weight of Newborns: Bong Soon Choi, In Sook Lee, Joung Ja Shin, Myeung Hee Park, Hyo Jee Joung; Korean J Community Nutr 2003;8(2):138-148. Published online April 30, 2003

Abstract PDF: Morning sickness during pregnancy is a very common functional problem with different kinds of symptom, but little data are available concerning the nutrition intervention program for pregnant women in local area. A total of 152 pregnant women who had experienced morning sickness were surveyed to investigate the relationships between morning sickness, nutrient intakes and pregnancy outcome. The results showed that prevalent symptoms were nausea (68.4%), heartburn (59.2%), morning sickness (48.7%), vomiting (42.1%), and constipation (44.7%). The onset of the symptom occurred during the first 3 months (9.3 +/- 2.3 weeks); 21.1% of the subjects was experienced two symptom at the same time. This significantly correlated with vomiting (p < 0.01), nausea (p < 0.001), morning sickness (p < 0.001), and heartburn (p < 0.01) with pregnancy weight. There were also correlations between the four symptoms and nutrient intakes. Mean birth weight of 21 newborns was 3.06 +/- 0.42 kg, and the one and five minutes of Apgar scores were 7.74 +/- 0.99 and 8.84 +/- 0.69, respectively. There were negative correlations between vomiting and pregnancy outcomes (p < 0.05). Our data support that morning sickness, especially vomiting during pregnancy is associated with Apgar score and body weight of newborn.

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[English]
Iron Status Indices of Maternal, Umbilical Cord, Placenta and Birth Weight: Hyun Sook Bai, Geum Ju Lee, Min Sook Lee, Ju Ye Lee, Yong Mi Shin, Hong Seok Ahn; Korean J Community Nutr 2002;7(5):686-695. Published online October 31, 2002

Abstract PDF: The purpose of this study is to assess the maternal iron status during pregnancy and to evaluate the relationships between the iron indices of maternal, umbilical cord serum, placenta and pregnancy outcomes. Venous bloods samples were drawn from 54 pregnant women just before delivery and cord bloods of their newborn babies were collected immediately after birth. And also, placental tissues were extracted. We investigated the difference of the iron status indices of maternal, umbilical cord serum and placental tissue between two gestational age group (PT group, NT group : preterm delivery and normal term delivery at 34.9wk and 39.0wk of mean gestational length, respectively) and also assessed correlations of iron status indices of maternal, umbilical cord serum and placenta tissue. And lastly, we related between birth weight and iron status indices of maternal, umbilical cord serum and placental tissue. The concentrations of maternal serum ferritin and of placental iron were significantly higher in PT group (32.1 +/- 21.1 ng/ml, 68.5 +/- 16.7microgram / g), than those of NT group (20.8 +/- 11.6 ng / ml, 53.2 +/- 17.4 microgram / g) respectively (p < 0.001). However the serum ferritin of umbilical cord were significantly higher in NT group (PT : 109.4 +/- 65.7 ng/ml, NT : 147.0 +/- 56.8 ng / ml) than those of PT group (p < 0.05). Our results showed that a negative association between birth weight (r=-0.361) and maternal serum ferritin and that a positive association between birth weight and umbilical cord serum ferritin (r=0.261). Despite not a significant difference, there was tendency that highest concentration of maternal serum ferritin was associated with the lowest birth weight. These findings indicate that birth weight of newborn is dependent of multiple factors such as maternal iron status during pre-pregnancy, body size, general nutritional status. Although for women who enter pregnancy with low iron stores, enough intakes of iron during pregnancy could produce undesirable pregnancy outcome. Therefore we suggest for successful pregnancy outcome and delivery differential iron supplementation program will be carried out individual pregnant women on the basis of pre-pregnancy nutritional status.

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[English]
Effects of Maternal Anemia on the Iron Status of the Cord Blood and Pregnancy Outcomes: Hyeon Sook Lim, Hee Ah Kim; Korean J Community Nutr 1998;3(4):565-573. Published online October 31, 1998

Abstract PDF: Iron deficiency anemia in pregnant women has been of great concern because of its negative effects on the outcomes of pregnancy. Much of evidence has shown that there are associations between pregnancy outcomes and maternal iron status. Maternal iron status might affect pregnancy outcomes through the iron status of the cord blood. In this study, we divided 91 subjects into two groups : the anemic and the normal groups. The groups were classified according to their hemoglobin(Hb) and hematocrit(Hct) values of the maternal blood in the third trimester of the pregnancies. We determined the parameters for the iron status of the cord blood and then analyzed the correlations between these parameters and the pregnancy outcomes. Mothers in the anemic group had a significantly higher parity number and a lower dietary score as well as a shorter duration of iron supplements consumed compared to those in the normal group. Maternal Hb values in the third trimester had positive correlations with the infant's head and chest circumferences, and the Hct values related positively to the infant's chest circumferences. On the other hand, Hb concentrations of the cord blood had positive correlations with the infant's height and head and chest circumferences. The Hct values of the cord blood had positive correlations with gestational periods and the cord lengths. These results suggest that the maternal iron status might influence fetal development through the iron status of the cord blood.

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