Abstract:
450 serial cases of pregnancy of 20 weeks duration or less reporting for antenatal check up in a military hospital were registered with the project out of which 215 completed their pregnancy during the one year period under review. The socio-economic physical, dietary, weight gain, haematological and biochemical parameters of the mothers were related to each other and to the birth weight of the baby in an attempt to evaluate the nutritional problems of pregnant women in Pakistan.
2. The studies have clearly brought out the importance of maternal height in the reproductive performance. Tall mothers have been shown to have a more spontaneous labour and higher birth weight of babies. The pregnancy weight of the mother however, did not show any correlation with reproductive performance. The average height in the series (mainly punjabi women) comes to 62" with a S.D of 2.1". This is only 1.5" less than the Harvard Standard of heights of adult women. The average weight was 107 lbs with a S.D of 11.9 lbs as against the Harvard Standard of average height of 121 lbs. Compared to height, there is a greater deficiency in weight showing caloric deficit in the diet. The birth weight of children is 7.1 lbs which is closely similar to the Harvard standard of 7.4 lbs. This speaks of the great efficiency of human reproductive performance. The fertility, the birth weight and the growth rate during the first few months of life in the poor developing countries are closely similar to those seen in advanced countries. However, the growth and mortality rate get woefully adverse within a few months after the child has left the womb.
3. The average dietary intake was found to have calories 72%, proteins 120%, calcium 33%, iron 41%, vitamins Bl, 114%, B2 41%, Niacin 100% and C 64% of the recommended intake. The diet therefore is adequate only in proteins, vitamins b and Niacin content only and is grossly inadequate in all other ingredients. The crucial deficiencies are in calories, ca & Fe. The caloric deficiency is due to low caloric density of traditional Pakistani diet due to low fat intake. The extensive shortages that has been brought out in dietary intake tends to indicate that the current recommendations are too high and need to scaled down. However, more data are needed to come to a firm conclusion on this point. There was a positive correlation of +0.3 between the caloric intake and birth weight of baby and of +0.5 between the protein intake and birth weight Both the correlations were significant.
4. This average weight gain pregnancy was found to be 12 lbs with range of 0-24 lbs. Thus the weight gain is just 50% of the reported weight gain in western world. No correlation could be seen between the weight gain and the birth weight of the baby except in the cases which the women actually lost weight. The average serum calcium of Pakistani women during pregnancy is 10±1.5 mg/dl which is well within the normal limits. However, as many as 25% of cases have serum Ca less than 8 mg/dl. However, the biochemical evidence of occult osteomalacia, based on values of serum Ca x P less than 40 and serum Alkaline Phosphatase more than 20 K A Units was seen in 6% to 9% cases only. These figures pertain to the families of troops only.
Conclusions:
6. The data collected so far brings out the importance of adequate prepubertal nutrition of females to permit the full realization of the growth potential of our women. There is also an unequivocal evidence of the need for fortification of atta with calcium and iron in order to overcome the shortage of these two important minerals.