Thesis (Mnutr)--University of Stellenbosch, 2003. / ENGLISH ABSTRACT: Pregnancy and growth have been found to have a detrimental effect on the
micronutrient status of adolescent girls. Dietary studies in adolescents have shown
serious shortfalls in their dietary iron and folate intake. The competition for
nutrients between the fetus and a pregnant adolescent may carry the risk of
complications such as intrauterine growth retardation, pre-eclampsia, both
maternal and fetal intrapartum mortality, the increased risk of birth injuries and
low birth weight.
The aim of the study was to assess the nutritional status of rural black, pregnant
teenagers attending the antenatal clinic at Siloam Hospital in the Limpopo
Province, with special emphasis on iron and folic acid intake, and evaluation of
the newborn babies in terms of weight status and neural tube defects. The
nutritional status was determined in 40 pregnant and 40 non-pregnant adolescent
girls. The pregnant girls were selected during their first visit to the antenatal
clinic, and the non-pregnant girls were selected from nearby schools.
The demographic and dietary history questionnaires were used to collect
information from the subjects. The dietary intake of the subjects was collected by
the completion of a pre-tested quantified food frequency questionnaire. The
anthropometric questionnaire was used to get information from the pregnant
adolescents and the control group. The infant anthropometric measurements
questionnaire provided information on the infant and the outcome of birth. Blood
was collected from the pregnant adolescent girls and the control subjects.
Anaemia was observed in 57.5% of the pregnant and 27.5% of the non-pregnant
adolescents (haemoglobin <Il g/dl and <12 g/dl, respectively). The prevalence of
low serum ferritin « 12 ug/L) and low transferrin saturation « 16%) was high in
both the pregnant (30% and 60% respectively) and the non-pregnant adolescents
(17% and 72.5% respectively). Iron deficiency was observed in 45% of the pregnant girls and 35% of the control subjects. The prevalence of iron deficiency
anaemia in the pregnant girls (30%) and the control subjects (22.5%) was high.
Low red blood cell folate in pregnant and non-pregnant girls was uncommon.
Low serum vitamin BI2 was common in most of the pregnant girls.
Analysis of the quantitative food frequency questionnaire (QFFQ) that was
completed for 80 of the pregnant and non-pregnant girls showed that 55% had
low dietary iron intakes «67% of the RDA) (p = 0.7307). Forty-five percent of
the pregnant girls reported taking iron supplements. The QFFQ showed 20% of
pregnant girls with low intake of folate (p = 0.0577). Forty-five percent of
pregnant girls also reported taking folate supplements. Anthropometric
measurements of pregnant girls and their dietary intake could not be correlated to
the birth outcome. The social profile of the subjects did not seem to influence
their iron and folate status and the outcome of pregnancy.
The findings in this study showed that pregnant adolescents appeared to be similar
to the non-pregnant adolescent girls socio-economically, anthropometric and
nutritionally. We recommend that educational programmes targeted at adolescents
and teenagers in the Siloam area should reach girls that could potentially fall
pregnant. An educational programme must include: reproductive needs
(avoidance of sex or safe sex); nutritional needs, especially targeted at improving
nutritional status to meet future reproductive needs; early booking at the antenatal
clinic and effective supplementation during pregnancy. The need to improve the
dietary and nutrient intake of the adolescent girls should be addressed within the
current framework of the Integrated Nutrition Programme (!NP). A food
fortification programme with essential micronutrients such as iron, folic acid, zinc
and Vitamin A to improve the micronutrient status should be promoted among the
adolescent girls. / AFRIKAANSE OPSOMMING: Daar is bevind dat swangerskap en groei 'n nadelige effek het op die
mikronutriëntstatus van vroulike adolessente. Dieetstudies in adolessente het
ernstige tekortkominge in dieetyster- en folaatinnames getoon. Die kompetisie vir
nutriente tussen die fetus en die swanger adolessent kan verantwoordelik wees vir
komplikasies soos intra-uterine groeivertraging, preeklampsie, verhoogde
mortaliteit van beide moeder en baba tydens kraam, 'n verhoogde risiko vir
geboortebeserings en lae geboortegewig.
Die doel van die studie was om die effek van voedingstatus by swart, swanger
tieners by die voorgeboortekliniek in Siloam Hospital in die Limpopo-provinsie te
bepaal, met spesifieke verwysing na die yster- en foliensuurinname, asook die
evaluering van die pasgebore babas in terme van gewig en neurale buis defekte.
Die voedingstatus van 40 swanger en 40 nie-swanger adolessente meisies IS
bepaal. Die swanger meisies is ewekansig geselekteer gedurende die eerste
besoek aan die voorgeboortekliniek , en die nie-swanger meisies is geselekteer by
nabygeleë skole.
Die demografiese en dieetgeskiedenisvraelyste is gebruik om inligting van die
proefpersone in te samel. Voorafgetoetste gekwantifiseerde voedselfrekwensie
vraelyste is gebruik om die voedselinname van proefpersone te bepaal.
Antropometriese vraelyste is gebruik om antropometriese inligting van die
swanger adolessente en die kontrole groep. Die antropometriese vraelys vir babas
is gebruik om inligting ten opsigte van die baba aan te teken asook die verloop
van die swangerskap. Bloedmonsters is van die swanger tieners en die kontrole
groep ingesamel.
Anemie is waargeneem by 57.5% van die swanger en 27.5% van die nie-swanger
adolessente (hemoglobien <Il g/dl en <12 g/dl onderskeidelik). Die voorkoms
van lae serum ferritien « 12 ugIL) en lae transferrienversadiging « 16%) was hoog by beide die swanger (30% en 60%) en die nie-swanger adolessente (17.5%
en 72.5% onderskeidelik). Ystergebrek is in 45% van die swanger meisies en in
35% van die kontrole groep waargeneem. Die voorkoms van ystergebrekanemie
in die swanger meisies (30%) en die kontrole groep (22.5%) was hoog. Lae
rooibloedselfolaat by swanger en nie-swanger meisies is nie algemeen
waargeneem nie. Lae serum vitamien B12 was algemeen by die meeste swanger
meisies.
Ontleding van die gekwantifiseerde voedselfrekwensievraelys (KVFV) wat vir 80
van die swanger en nie-swanger meisies voltooi is, het getoon dat 55% 'n lae
dieetysterinname gehad het «67% van die ADT) (p=0.7307). Vyf-en- veertig
persent van die swanger meisies het bevestig dat hulle ystersupplemente gebruik
het. Die gekwantifiseerde voedselfrekwensievraelys (KVFV) het getoon dat 20%
van die swanger meisies 'n lae folaatinname het (0.0577). Vyf-en-veertig persent
van die swanger meisies het ook genoem dat hulle folaatsupplemente gebruik het.
Die antropometriese metings van swanger meisies en dieetinname kon nie
gekorreleer word met die verloop van die geboorte nie. Dit blyk dat die sosiale
profiel van die meisies nie 'n effek op die yster- en folaatstatus en op die verloop
van swangerskap gehad het nie.
Die bevindinge van hierdie studie toon dat swanger en nie-swanger adolessente
meisies sosio-ekonomies, antropometries en nutrisioneel dieselfde voorkom. Dit
word aanbeveel dat voorligtingsprogramme vir adolessente en tieners in die
Siloam-area meisies moet bereik wat moontlik swanger sal word. 'n
Voorligtingprogram moet die volgende insluit: reproduktiewe behoeftes
(vermyding van seks of veilige seks); voedingbehoeftes, veral geteiken om
voedingstatus te verbeter om ten einde toekomstige voorplantingsbehoeftes te
vervul; vroeë besoeke aan die voorgeboortekliniek en effektiewe supplementering
gedurende swangerskap. Die behoefte om die dieet en nutriëntinname van
adolessente meisies te verbeter moet binne die huidige raamwerk van die
Geintegreerde Voedingsprogram aangespreek word. 'n Voedselfortfiseringsprogram met essensiële mikronutriënte soos yster, foliensuur,
sink en vitamien A om die mikronutriëntstatus van adolessente meisies te
verbeter, moet bevorder word.
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:sun/oai:scholar.sun.ac.za:10019.1/53529 |
| Date | 12 1900 |
| Creators | Tshitaudzi, Gilbert Tshimangadzo |
| Contributors | Labadarios, D., Herselman, M. G., Theron, G. H., Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Interdisciplinary Health Sciences. |
| Publisher | Stellenbosch : Stellenbosch University |
| Source Sets | South African National ETD Portal |
| Language | en_ZA |
| Detected Language | Unknown |
| Type | Thesis |
| Format | 187 p. : ill. |
| Rights | Stellenbosch University |
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