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Br Med J (Clin Res Ed). Aug 28, 1982; 285(6342): 592–595.
PMCID: PMC1499470

Dietary protein energy supplementation of pregnant Asian mothers at Sorrento, Birmingham. II: Selective during third trimester only.


Unselective dietary protein energy supplementation of Asian mothers at Sorrento Maternity Hospital did not enhance intrauterine growth. The effect of selective supplementation was therefore studied. Forty-five mothers who at 28 weeks were known to be nutritionally at risk (triceps increment less than or equal to 20 microns/week between 18 and 28 weeks) received one of three supplements during the third trimester: (a) vitamins only--a multivitamin sachet daily containing vitamins A, B, C, and D; (b) energy--42-125 MJ (10 000-30 000 kcal), all from carbohydrate, plus vitamins; (c) protein energy--energy and vitamins as before, but with 5-10% of energy from milk protein. Eighty-three mothers regarded as adequately nourished at 28 weeks also received one of the three supplements. In the nutritionally at-risk mothers the protein energy supplement was associated with a heavier crude birth weight and heavier weight for gestational age. Supplementation did not lead to improved intrauterine growth in those mothers who were adequately nourished. The differential effect of supplementation depending on the mothers' nutritional state during the second trimester may explain apparently conflicting results of other studies where some have shown a substantial effect of supplementation and others only a small effect. This effect of intervention is further evidence that "poor nutrition" contributes to poor intrauterine growth in selected mothers, even in developed countries.

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Selected References

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  • Viegas OA, Scott PH, Cole TJ, Mansfield HN, Wharton P, Wharton BA. Dietary protein energy supplementation of pregnant Asian mothers at Sorrento, Birmingham. I: Unselective during second and third trimesters. Br Med J (Clin Res Ed) 285(6342):589–592. [PMC free article] [PubMed]
  • Bissenden JG, Scott PH, King J, Hallum J, Mansfield HN, Wharton BA. Anthropometric and biochemical changes during pregnancy in Asian and European mothers having light for gestational age babies. Br J Obstet Gynaecol. 1981 Oct;88(10):999–1008. [PubMed]
  • Thomson AM, Billewicz WZ, Hytten FE. The assessment of fetal growth. J Obstet Gynaecol Br Commonw. 1968 Sep;75(9):903–916. [PubMed]
  • Gore SM. Assessing clinical trials--trial discipline. Br Med J (Clin Res Ed) 1981 Jul 18;283(6285):211–213. [PMC free article] [PubMed]
  • Lechtig A, Habicht JP, Delgado H, Klein RE, Yarbrough C, Martorell R. Effect of food supplementation during pregnancy on birthweight. Pediatrics. 1975 Oct;56(4):508–520. [PubMed]
  • Mora JO, de Paredes B, Wagner M, de Navarro L, Suescun J, Christiansen N, Herrera MG. Nutritional supplementation and the outcome of pregnancy. I. Birth weight. Am J Clin Nutr. 1979 Feb;32(2):455–462. [PubMed]

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