Symposium on national evaluation of the school nutrition programs. Guest editorial.
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Biomedical subjects
Publications and source records attributed to D Rush.
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The nineteen-item assessment of newborn neurologic maturity developed by Koenigsberger was applied to 682 infants born to women enrolled in a randomized controlled trial of nutritional supplementation in a poor, urban, black, clinic population. The total score of the neurologic scale, four clusters of items derived from principal component factor analysis followed by a varimax rotation, and the four clusters taken simultaneously (using Cohen's method of set correlation) were related to the conceptional age, weight, length, and head circumference of the infants. Taken in any of these ways, neurologic maturity was more strongly related to somatic development than to conceptional age. Although these results are consistent with a set pattern and order of neurologic development, they are incompatible with such a pattern following a rigid and universal time scale. Rather, at all stages of conceptional age, there appears to be a range of neurologic maturity, related more strongly to concurrent somatic development than to the child's conceptional age.
The joint associations of maternal cigarette smoking and social class on perinatal outcome were studied in the 1970 British birth cohort (British Births). Whereas smoking was much more frequent among women in social classes III, IV, and V, there was little difference in the birthweight decrement associated with smoking across class. Perinatal mortality, however, was increased only among smokers in the manual social classes. Thus whereas the offspring of more privileged smokers were not protected from intrauterine growth retardation, they did not suffer from increased perinatal mortality. Observations of other populations suggest a possible nutritional mediation of this protective effect.
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Protein and nucleic acid content, and RNase levels were measured in placentas collected at birth in a randomized controlled trial of prenatal nutritional supplementation in New York City. These biochemical indices were explored to understand better the effects of nutritional supplementation. (With high-protein supplements, gross measures had shown no improvement in outcome at birth and adverse effects on fetal growth, prematurity, and newborn survival; with balanced protein-calorie supplements, there was a nonsignificant rise in birth weight and longer gestation.) The biochemical indices were in general somewhat weakly related to fetal growth measures. Significant effects of nutritional treatment on the indices were minimal, and added no information that could account for gross effects observed in the fetus.
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Since 1963, unselected prenatal patients at the Royal Victoria Hospital, Montreal, have been given nutritional counselling and, if it was judged necessary, dietary supplementation by the Montreal Diet Dispensary. From uniform data collected for all obstetric patients in 1963--74, 1213 recipients of the dispensary services (89.7% of those available and eligible for matching) were paired with controls matched for date of delivery (within 12 months), religious affiliation, parity, trimester of pregnancy during which prenatal care was begun and weight at the time of conception. The proportion of infants of low birthweight (less than 2500 g) was 5.7% for the recipients and 6.8% for the controls; the difference was not significant, but the recipients' infants were heavier at birth than the controls' infants, by an average of 40 g (P less than 0.05). The difference in birthweight was greatest for the infants of women in their first pregnancy (average 61 g) and least for the infants of women with three or more past deliveries (average 9 g). Increased birthweight (by an average of 53 g, P less than 0.02) among the recipients' infants was limited to those born to women weighing less than 140 lb (63 kg) at the time of conception; among the heavier women the controls had infants who were heavier, but not significantly so. Differences between the groups in duration of gestation and maternal weight gain accounted for only a small part of these differences in birthweight. This study provides evidence that the Montreal Diet Dispensary program significantly increased birthweight. Further efforts must now be directed towards judging the long-term benefit of these changes.
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