Prenatal Nutritional Assistance May Reduce the Risk of Delivery of Small Infant

Women who enroll in a federal food–assistance program early in their pregnancies lessen the likelihood of delivering an infant who is small for his or her gestational age (SGA), according to a recent study co–authored by a Yale School of Public Health researcher.

Data from the study, which included about 370,000 infants born in Florida, was analyzed by Ralitza Gueorguieva, Ph.D., research scientist in the Division of Biostatistics. She found that increasing participation in WIC by 10 percent—e.g. participating in WIC for 10 percent more time in one’s pregnancy—conveyed a small, but statistically significant measure of protection against delivering SGA babies. Participation in the program decreased the risk by 2.5 percent for full–term infants.

“This study assesses a plausible pathway between prenatal nutrition and fetal growth,” said Gueorguieva. An SGA infant has a birth weight below the tenth percentile for a given gestational age, which varied among subjects from full–term (37–42 weeks) to extremely preterm (23–28 weeks). SGA babies face an elevated risk of infant morbidity.

This study refined the approach of previous investigations that examined birth weight alone, a variable that doesn’t take preterm delivery into account. This investigation used rigorous methods to control for selection and gestational age bias that have plagued past WIC research, added Gueorguieva.

The WIC program, funded by the Food and Nutrition Service, U.S Department of Agriculture, aims to promote the health of low–income women, infants and children by providing nutritious foods and resources for sound eating, including health care referrals. The co–authors speculate that the many facets of the WIC program improve the overall health of pregnant women, thus enhancing the function of the placenta.

“We can hypothesize that the extra nutrition, better care, education and referral to medical professionals under WIC all play a role in the outcome,” said Gueorguieva. “It’s not simply that more calories consumed by the mother directly increase caloric delivery to the fetus.”

Having led initiatives to develop a screening test for low–birth–weight babies, and to assess the effects of maternal age on children’s educational disabilities, Gueorguieva calls this study “a natural continuation” of her interests. She describes potential next steps as identifying subsets of pregnant women who may benefit the most from WIC, such as anemic women or smokers.

Gueorguieva co–authored the study with Dr. Jeffrey Roth and Dr. Steven Morse, professors of neonatology at the University of Florida College of Medicine. “This was truly a collaborative effort,” she said. Details of the research were published in the online edition of Maternal and Child Health Journal.