Neonatal cord serum alpha 2-macroglobulin and fetal size at birth.

Serum concentrations of alpha-2-macroglobulin (alpha 2M) were measured in cord blood from neonates born in Alabama, USA and in Guatemala. Results indicate an inverse relationship between cord serum alpha 2M concentrations and birth weight of newborns in both locations. Infants with lower birth weight had higher cord serum alpha 2M concentrations as compared to those with higher birth weight. The results of the present study using cord serum are similar to those in our previous reports indicating an inverse relationship between maternal serum alpha 2M concentrations and birth weight. This distinctive and reproducible association between alpha 2M concentrations and fetal size in maternal as well as cord blood samples warrants further investigations to determine the mechanism of this relationship.

Maternal alpha-2-macroglobulin levels and fetal growth in Guatemala.

Maternal serum alpha-2-macroglobulin (alpha 2M) levels were measured at the time of delivery in 244 women in the central highlands of Guatemala. Significantly higher alpha 2M levels were found in thin women and in poor women. In multiple regression analysis controlling for gestational age, race, sex, maternal triceps skinfold thickness and socioeconomic status, high alpha 2M levels were significantly associated with decreased birthweight. These findings agree with those in a predominantly black population in the United States and extend the relationship between alpha 2M and decreased birthweight to a developing country.

[Risk factors of fetal malnutrition in a group of Guatemalan mothers and neonates]. / Factores de riesgo de malnutrición fetal en un grupo de madres y neonatos guatemaltecos.

In order to determine the relationship between nutritional, sociodemographic, and obstetrical variables and fetal malnutrition, a study was done on a group of mothers of nonpremature neonates born in a hospital in the central mountainous region of Guatemala. Of the 306 neonates, 105 (34%) presented fetal malnutrition (intrauterine growth retardation, IUGR), which in 77% of the cases was chronic (fetal atrophy, or IUGR type I) and in 23% of the cases was acute (fetal emaciation, or IUGR type II). The maternal factors related to fetal atrophy were puerperal nutritional indicators (weight, height, skinfold thickness, and arm circumference) and sociodemographic indicators (schooling, literacy, and socioeconomic level). Fetal emaciation was found to be related to obstetrical characteristics such as number of previous deliveries and birth interval. The results suggest that poverty, malnutrition, and precarious living conditions over prolonged periods of time are related to chronic fetal malnutrition (fetal atrophy), which is very frequent in this population.

Maternal risk factors for low birth weight and intrauterine growth retardation in a Guatemalan population.

Hospital data on 306 mother-infant pairs in Cobán, Guatemala, were studied to assess factors responsible for low infant birth weights involving the two general kinds of intrauterine growth retardation (IUGR), these being Type I (symmetric stunting) and Type II (asymmetric stunting or wasting). The results indicate that the Type I IUGR observed arose primarily from long-term poverty, malnutrition, and chronic poor living conditions, while much of the Type II IUGR seemed attributable to maternal disorders affected by short interbirth intervals.

PIP: In 1988, researchers studies data from 306 mother-infant pairs at the Helen Losi de Laugerud regional hospital in Coban, Guatemala to determine the relationship between intrauterine growth etiology and the mothers nutritional, demographic, socioeconomic, and obstetric characteristics. Maternal education and socioeconomic status had a significant positive effect on birth weight. The relationship between maternal education and socioeconomic status, however. Maternal height, maternal triceps skinfold thickness, and maternal weight measurements revealed an association between maternal childhood nutrition status and infant birth weight (p,.0001) and an association between current maternal nutrition status and infant birth weight (p.0001). Indian mothers were more likely to have low birth weight infants than Ladino mothers (p.0001). Infants of mothers of low socioeconomic status had a lower mean birth weight than those of higher socioeconomic status, even when controlled for race (p=.034). 26.5% of all infants exhibited Type I intrauterine growth retardation (IUGR). In fact, 77% of all IUGR infants were Type I. The most significant determinants of these chronically malnourished infants were prolonged poverty, maternal malnutrition, and poor living conditions (p.05). Maternal disorders which were a result of short birth intervals significantly contributed to Type II IUGR--the acutely malnourished infants. In fact, more short intervals (42.9% vs. 21.9%). Since Type I IUGR was so prevalent in this group and chronic malnutrition and poor socioeconomic conditions render mothers susceptible to chronic infections which, in turn, impede growth of the rapidly growing fetus as they do in infants, further research on the etiology of Type I IUGR is warranted.

Chronic fetal malnutrition and vitamin A in cord serum.

The relationship between type I IUGR (chronic fetal malnutrition) and cord serum levels of vitamin A was studied in 269 infants from Guatemala. Of the newborns in the sample, 28 per cent were type I IUGR, 8 per cent were type III UGR (acute fetal malnutrition), and 64 per cent were of normal weight for gestational age. A trend of increasing birthweight with increasing vitamin A levels was found. Also, vitamin A levels in the cord blood of the smallest type I IUGR babies were significantly lower than levels in the smallest type II IUGR babies. Vitamin A levels and birthweight were positively associated only among type I IUGR neonates. Significantly more type I IUGR babies had vitamin A levels in the lowest quartile than did babies of normal birthweight.