Evaluation of the Blood Level of Adiponectin in Pregnant Adolescents / Avaliação dos níveis séricos de adiponectina em gestantes adolescentes

Abstract Objective To evaluate serum levels of adiponectin in pregnant adolescents between 30 and 36 weeks of gestation. Method: A prospective cross-sectional study enrolled 67 normal pregnant women between 30 and 36 weeks of gestation and eutrophic (body mass index [BMI]: 18.5-25 kg/m2), of which 36 were adolescents (< 20 years old) and 31 adults (≥ 20 years old). Serum adiponectin levels were determined by enzyme-linked immunosorbent assay (ELISA). The t-student or Mann-Whitney tests were used for intergroup comparison. Results Pregnant adolescents showed significantly higher serum adiponectin concentrations comparedwith pregnant adults (p=0.04). No differences were observed in adiponectin levels in younger pregnant adolescents (< 16 years old) compared with older pregnant adolescents (≥ 16 years old). Adiponectin values were divided into 3 subgroups:<3,000 ng/mL, between 3,000 and 5,000 ng/mL, and>5,000 ng/mL. Birthweight was significantly higher in women>5,000 ng/mL when compared with<3,000 ng/mL in the adolescent group. No association between pregestational adiponectin levels and BMI, gestational weight gain, and gestational age was observed; however, there was a positive relation with birthweight (p=0.0239). Conclusion Serum adiponectin values in pregnant adolescents between 30 and 36 weeks of gestation were higher compared with pregnant adults; however, no differences between younger and older pregnant adolescents were observed.

Resumo Objetivo Avaliar os níveis séricos de adiponectina em gestantes adolescentes entre 30 e 36 semanas de gestação. Métodos Estudo prospectivo e transversal incluindo 67 gestantes normais entre 30 a 36 semanas e eutróficas (índice de massa corporal [IMC]: 18,5-25 kg/m2), sendo 36 adolescentes (< 20 anos) e 31 adultas (≥ 20 anos). Os níveis séricos de adiponectina foram avaliados por teste imunoenzimático (ELISA, na sigla em inglês). Para a comparação entre os grupos, utilizou-se os testes t-Student ou Mann-Whitney. Resultados As gestantes adolescentes apresentaram significativamente maiores concentrações séricas de adiponectina do que as adultas (p=0,04). Não houve diferenças nos níveis de adiponectina quando comparadas as gestantes adolescentes precoces (< 16 anos) às tardias (≥ 16 anos). Os valores de adiponectina foram subdivididos em3 grupos:<3.000 ng/mL, entre 3.000 e 5.000 ng/mL e>5.000 ng/mL. O peso do recém-nascido foi significantemente maior nas mulheres com>5.000 ng/mL, quando comparadas as com<3.000 ng/mL no grupo das adolescentes. Não foi observada associação entre os níveis de adiponectina e o IMC pré-gestacional, ganho de peso gestacional e a idade gestacional, porém houve relação positiva com o peso do recém-nascido (p=0,0239). Conclusão Os valores séricos de adiponectina em gestantes adolescentes entre 30 e 36 semanas de gestação foram maiores do que os das gestantes adultas; contudo, sem diferenças entre gestantes adolescentes precoces e tardias.

Perfil de aminoácidos plasmáticos en adolescentes saludables embarazadas de Maracaibo, Venezuela / Plasma amino acids profile of healthy pregnant adolescents in Maracaibo, Venezuela

One hundred female adolescents (13-18 y) were clinical and anthropometrically studied to select only those with adequate nutrition. Most adolescents belonged to IV socio-economic stratum families (worker class). Height, weight, age, body mass index and medial arm circumference were used as anthropometric parameters. After screening, only 41 non pregnant girls (control) and 42 pregnant girls with adequate nutrition were selected to analyze plasma amino acids. Fasting peripheral venous blood was drawn, and plasma amino acids were analyzed by HPLC. Amino acid concentrations were expressed as umol/L +/- SE. SAS/STAT program was used for statistical analysis. Amino acid values of control adolescent group were found in ranges reported by other investigators, with slight variations, mostly in diminution, presumably due to nutritional, metabolic or genetic conditions of people living in tropical regions. In pregnant healthy adolescents, distributed according to gestational age: < 32 weeks (n = 30) and > 32 weeks (n = 12), a diminution of total molar plasma amino acids was found, by comparing with control values. Ten amino acids (Pro, Gly, Gln, Arg, Ser, Orn, Tau, Leu, Thr and Val) appeared significantively diminished throughout gestation, being Gly. Gln and Arg most affected since earlier weeks. During the 2nd period. Thr and Val increased their grade of affectation; whereas some amino acids values (Orn, Pro and Tau) tended to recuperate. Several of affected amino acids are gluconegoenic, thus, they could be utilized to supply the energy required by the pregnant adolescent against her double stress: the fetus development and her own development. The plasma amino acid values reported in both, healthy non pregnant and pregnant adolescents, could be taken as regional referential profile of plasma amino acids in this poblational group for further research on adolescent and fetal--maternal malnutrition.

Estado de la nutrición de folato, vitamina B12 y hierro en adolescentes embarazadas / Nutritional status of folate, vitamin B12 and iron in pregnant adolescents

Pregnancy in adolescence increases nutritional risk, due to higher demand of nutrients for maternal and fetal growth. This study was aimed to evaluate folate, vitamin B12 and iron status of pregnant adolescents at first trimester of pregnancy. A cross sectional, descriptive study was performed in 122 pregnant adolescents from Valencia, Carabobo state, 1997. Serum and erythrocyte folate and serum vitamin B12 was determined by radioassay; serum ferritin by enzimoimmunoassay; hemoglobin were performed by semi-automated method. Statistical analysis included standard deviation and frequencies. For serum folate 1.7 per cent was found in negative balance and 19.0 per cent at marginal status. For erythrocyte folate, 5.8 per cent was deficient and 1.7 per cent marginal. For serum vitamin B12, 8.3 per cent was deficient and 13.2 per cent marginal. Iron deficiency was found in 19.0 per cent of the adolescents. Prevalence of anemia was of 13.1 per cent, being iron deficiency the main cause. There was high nutritional risk regarding iron status, although iron intakes exceeded the recommendations, but only a small proportion was bioavailable. Prevalence of anemia was lower than reported by other studies and iron deficiency was higher than folic acid and vitamin B12 deficiencies. Pregnant adolescents are at a high biological and nutritional risk.

Prevalence of nutritional deficiencies in Mexican adolescent women with early and late prenatal care

The objective was to evaluate the prevalence of specific nutritional deficiencies in a group of pregnant adolescents according to the gestational age when they started to receive prenatal care. A group of 163 pregnant adolescents that attended the Instituto Nacional de Perinatología (Mexico City) for the first time to receive prenatal care was evaluated. An anthropometrical evaluation was performed and a blood sample taken to determine hemoglobin, ferritin, erythrocyte folate and plasma zinc to all cases. The mean age was 15 years (11 to 17 years). The mean gestational age when starting prenatal care was 27 +/- 7 gestation weeks and most of them tended to have low weight (97 +/- 12 per cent expected weight for height and gestational age). Eight of every ten adolescents had anemia and iron deficiency. Late prenatal care (> or = 25 weeks) was associated with the risk of presenting anemia OR 5.11 (CI 95 per cent 2.4-10.7) iron deficiency (OR 3.5; CI 95 per cent 1.7 to 7.1) and zinc deficiency (OR 2.9; CI 95 per cent 1.1 a 7.6). In relation to folate deficiency, the opposite effect was observed (OR 0.10; CI 95 per cent 0.02 a 0.48). Lack of opportune prenatal care was associated with the presence of iron and zinc depletion. Probably iron deficiency contributes to an erythrocyte folate accumulation.

Estado nutricional del hierro de gestantes adolescentes, Säo Paulo, Brasil / Iron nutritional status in pregnant adolescents, Säo Paulo, Brazil

La frecuencia de anemia, deficiencia de hierro y reserva orgánica de hierro fueron evaluadas en 155 adolescentes de condiciones socioeconómicas precarias, atendidas en su prenatal en una maternidad de beneficiencia de la ciudad de São Paulo, Brasil. Según criterio OMS (Hb < 11 g/dL), 14,2 por ciento de las ellas fueron anémicas. Por porcentaje de saturación de transferrina y la concentración de zinc protoporfirina, fueron hierro deficientes 45,8 por ciento y 42,6 por ciento respectivamente. La reserva orgánica de hierro foi insuficiente (ferritina sérica < 12 mug/L) para el 48,4 por ciento de las adolescentes. Los resultados revelaran que el estado nutricional de hierro de las adolescentes son característicos de un grupo sin reserva de hierro pregestacional. No obstante esta baja frecuencia de anémicas, la elevada proporción de hierrodeficientes y hierrodepletadas sugiere la prática del control de deficiencia de hierro, así como la suplementación medicamentosa como rutina de pre natal gestantes adolescentes.

Detección de marcadores parasitarios y virales en embarazadas adolescentes y sus recién nacidos de riesgo / Detection of parasitary and viral markers in pregnant adolescent women and their newborns in risk

Las embarazadas adolescentes constituirían por su condición etárea una población de alto riesgo de infección por agentes relevantes en el binomio madre-hijo. Se investigó en 139 embarazadas adolescentes, la prevalencia de anticuerpos anti Toxoplasma gondii, Trypanosoma cruzi, Virus hepatitis B (VHB), citomegalovirus (CMV), Virus rubéola (VR) y Virus de la Inmunodeficiencia humana (VIH), así como la presencia de marcadores de infección en sus recién nacidos (RN) de riesgo. Se utilizaron las técnicas de Sabin y Feldman, fijación del complemento, ELISA, hemoaglutinación indirecta y xenodiagnóstico. Se detectó 30.9 por ciento de seropositivas para T. gondii, siendo estas madres y sus RN IgM negativos. Se detectaron dos madres con Acs anti T. cruzi (1.4 por ciento) y uno de los RN presentaba parásitos circulantes. En relación al estudio virológico, se detectó un 93,5 por ciento de madres seropositivas para CMV siendo sus RN IgM negativos, un 90,6 por ciento de las adolescentes eran antirrubéola positivas y se detectó un caso de adolescentes positiva para VIH. Las prevalencias establecidas en este grupo de embarazadas, no son significativamente diferentes a las encontradas en la población general de embarazadas