African American women with prenatal psychiatric disorder: Protein intake protects fetus from compromised birth weight and shortened gestation

APHA Scientific Session and Event Listing

4047.0: Tuesday, November 06, 2007 - 8:45 AM

Abstract #152637

Louise H. Flick, DrPH, School of Nursing, Southern Illinois University Edwardsville, Box 1066, Edwardsville, IL 62026-1066, 314-692-2383, lflick@siue.edu, Cynthia A. Loveland Cook, PhD, School of Social Service, St. Louis University, 3550 Lindell Blvd., St. Louis, MO 63103-1024, Sharon M. Homan, PhD, School of Public Health, St. Louis University, 3545 Lafayette Ave, St. Louis, MO 63104, Mildred Mattfeldt-Beman, PhD, Nutrition and Dietetics, College of Health Sciences, 3437 Caroline Mall, St. Louis, MO 63104, Kristan Pierce, MPH, Dietetics and Nutrition, Doisy College of Health Sciences, 1527 Natalie Ln. #108, 3437 Caroline Mall, Ann Arbor, MI 48105, Claudia Campbell, PhD, School of Public Health and Tropical Medicine, Tulane University, 1440 Canal Street, Suite 1900, New Orleans, LA 70112-2824, Maryellen McSweeney, PhD, School of Nursing, Professor Emeritus, St. Louis University, 3525 Caroline Mall, St. Louis, MO 63104, Lisa Parnell, MSW, Social Services, St. Luke's Hospital, 337 Winchester Drive, , MO, Winchester, MO 63021, Mary Elizabeth Gallagher, PhD, Mission and Ministry, St. Louis University, 3711 West Pine Mall, St. Louis, MO 63108, Nujjaree Chaimongkol, PhD, MCH Nursing Department, Burapha University, Faculty of Nursing, 169 Longhad Bangsaen St., Chonburi, 20131, Thailand, and Leigh Tenkku, MPH, School of Medicne, St. Louis University, 1320 South Grand Blvd., St. Louis, MO 63104-1087.

Neuroendocrine stress hormones have been associated with both psychiatric disorders and poor birth outcomes. Recently, rat studies indicated protein intake below pregnancy recommendations interferes with an enzyme that blocks cross-placental transfer of maternal cortisol. This study tests the hypothesis that prenatal psychiatric disorder is more strongly associated with lower birth weight and shorter gestational length when protein intake is below the pregnancy RDA. In a prospective cohort of WIC-enrolled pregnant women, we analyzed data from 500 women. More than a quarter of women reported protein intake below 85% of the pregnancy RDA and 16% of births were preterm (<37 weeks). The Diagnostic Interview Schedule (DIS-IV), a structured diagnostic interview, assessed 22 current and lifetime diagnoses. Psychiatric disorders were operationalized as 'any current disorder' and 'lifetime symptoms above the 75th percentile' (chronicity and severity). Protein intake at WIC entry, as percent of RDA, was determined using the Harvard Food Frequency Questionnaire. Analyses using multiple linear regression, adjusted for mother's age, income, parity, and pre-pregnancy body mass, indicate significant interactions between RDA and both high lifetime symptoms and 'any disorder' for birth weight (p=.001 and p=.003) and length of gestation (p=.004 and p=.009) among African American but not Caucasian women. Effects show birth weight and gestational age to be compromised when a woman with a psychiatric disorder consumes less than 85% of the RDA. This study suggests pregnancy recommended protein intake may protect offspring of African American women with prenatal psychiatric disorders from associated effects of lower birth weight and shorter gestation.

Learning Objectives:

To examine prior evidence suggesting an interaction between nutrition and prenatal effects of psychiatric disorder on birthweight and gestational age.
To evaluate one study's evidence indicating such an interaction for African American women but not Caucasian women.
To explore the public health implications of the findings.

Keywords: Psychiatric Epidemiology, Pregnancy Outcomes

Presenting author's disclosure statement:

Any relevant financial relationships? No
Any institutionally-contracted trials related to this submission?

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Infant Mortality Risk Reduction Among Diverse Populations: From Research to Action

The 135th APHA Annual Meeting & Exposition (November 3-7, 2007) of APHA