The Relationship Among Trace Elements, Pica, Social Support and Infant Birthweight

Abstract

This study examined the relationships of iron and zinc, pica, social support and infant birthweight among socioeconomically disadvantaged pregnant women in context of the Roy Adaptation Model. The sample was composed of 128 socioeconomically disadvantaged women receiving prenatal care from two rural community health agencies. Demographic and sociocultural data were collected, and two survey tools--Brown's Support Behaviors Inventory and the Pica History Interview Schedule were administered during the prenatal clinic visit. Pica substances; ice, laundry starch, cornstarch and clay were collected via home visit from women verbalizing the practice of pica during this pregnancy. The plasma samples and the pica substances were analyzed to determine extractable iron and zinc.

Descriptive statistics, chi-square tests, Pearson product-moment correlation, ANOVAs and stepwise multiple regression were used to analyze the data. Statistical analysis controlled for ethnicity.

The majority of the sample were single, African-American women, two demographic characteristics significantly related to lower infant birthweight. Predictors of increased infant birthweight were increased dietary/vitamin iron levels and decreased plasma iron and plasma zinc levels. In addition, Combined Social Support (Family/Friends and Partner) was a predictor of increased infant birthweight. Decreased plasma zinc levels was associated with pica practice. In African-American women, the practice of pica was associated with increased birthweight.

This research supports the multifaceted nature of infant mortality. Implications for future research include investigation of the specific effects of iron and zinc on fetal development at varying gestational stages, the relationship of specific social support interventions to infant birthweight, the relationship of pica to iron and zinc bioavailability and the relationship of dietary iron and zinc, and plasma iron and zinc to infant birthweight, particularly in high risk populations.