Estado nutricional das gestantes de uma região tropical - Fortaleza, Ceará, Brasil - e suas repercussões materno-fetais

Abstract

Pregnancy imposes increased consumption of nutrients on the maternal organism, in the order to provide the requeriments of the mother and the fetus. The nutritional status during pregnancy needs to be evaluated, as its benefits to the newborn are obvious. In order to study the association between the maternal and fetal nutritional status, 449 pregnant women attended to in the Maternity School of Assis Chateubriand, during the period of June’95 to June’96, were evaluated. Of these, 337 were studied during the pre-natal period, with regard to the frequency of anemia, iron defíciency, hypoproteinemia and hypoglobulinemia , as well as the associations among maternal anemia and the variables:age, gestational age and parity. 112 pregnant women were tested during labour (which resulted in an equal number of newborn), for associations among maternal anemia and the variables-under weight, prematurity and Apgar of the newborn, as well as between maternal hypoproteinemia and the variables mentioned previosly. The correlations between hematological values (hemoglobin, hematocrit and iron) and biochemical parameters (total protein, albumin and globulins) of the mothers and the children. The newborn were also studied for the frequency of anenia, iron defíciency, hypoproteinemia, hypoalbuminemia and hypoglobulinemia. The results obtained were as follows. The frequency of anemia in pregnant women and the newborn were 26 and 31%, respectively The frequencies of iron deficiency, hypoproteinemia, hypoalbuminemia and hypoglobulinemia in the pregnant women were 12,5%, 8%, 12,5% and 6,8%; and the values for the newborn were 34%, 15%, 19% and 2% respectively. All the mothers and newborn had average values of hemoglobin, hematocrit, iron, total proteins, albumin and globulin, with in the normal ranges used as standards. Statistically significant correlations were not observed between maternal anemia and the variabes (age, age of pregnancy and parity). However, significant associations were observed between all the hematological and biochemical variables of the mothers and the children: hemoglobin (r=0,25, p<0,05), hematocrit (r=0,25, p<0,05), iron (r=0,27, p<0,05), total proteins (r=0,24, p<0,05), albumin (r=0,18, p<0,05) and globulins (r=0.27, p<0,05). There was a greater tendency towards underweight at birth, when the pregnant women were anemic (rn-0,50, p<0,05), or had low protein (rn=0,50, p<0,05). Prematurity had association with maternal anemia (rn=0,36, p<0,05), but not with hypoproteinemia. Apgar was signifícantly associated with maternal hypoproteinemia (rn=0,80, p<0,05), but not with maternal anemia.