title: Pica practices of pregnant women are associated with lower maternal hemoglobin level at delivery.
abstract: OBJECTIVE
  To determine the prevalence of pica during pregnancy, maternal hemoglobin levels at delivery, and the association of pica with 2 adverse pregnancy outcomes: low birth weight and preterm birth.
  
  
  METHODS
  A retrospective cohort study was conducted using eligible subjects (n=281) from a cross-sectional survey (n=366).
  
  
  METHODS
  Mothers aged 16 to 30 years with infants younger than 1 year of age who participated in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) were interviewed at 4 WIC clinics in Houston and Prairie View, Tex. Medical records from 31 hospitals were abstracted.
  
  
  METHODS
  Maternal hemoglobin levels at delivery, mean birth weight, and mean gestational age were compared for women who reported pica and women who did not.
  
  
  METHODS
  Chi(2) tests, orthogonal t tests, analysis of variance, and regression analysis were used to test the relationships among study variables.
  
  
  RESULTS
  Pica prevalence categorized by substance was as follows: ice, 53.7%; ice and freezer frost, 14.6%; other substances such as baking soda, baking powder, cornstarch, laundry starch, baby powder, clay, or dirt, 8.2%; and no pica, 23.5%. Women in all 3 pica groups had lower hemoglobin levels (mean+/-standard deviation, 114+/-12 g/L, 110+/-13 g/L, and 113+/-12 g/L, respectively) at delivery than women who did not report pica (118+/-11 g/L) (P<.01 for all pica groups vs no pica). There were no differences in mean birth weight or mean gestational age of infants born to women from the 3 pica groups and the No Pica group.
  
  
  CONCLUSIONS
  The findings suggest that pica practices are associated with significantly lower maternal hemoglobin levels at delivery but are not associated with pregnancy outcomes. Dietitians should ask pregnant women with anemia about pica and should counsel women who report pica regarding the health risks associated with it.
authors.affiliation: University of Texas School of Public Health, Human Nutrition Center, Houston, USA.
authors.forename: A J
authors.initials: AJ
authors.lastname: Rainville
mesh_terms: D000293:Adolescent; D000328:Adult; D000740:Anemia / Q000150:complications / Q000453:epidemiology; D016009:Chi-Square Distribution; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D006400:Hematocrit; D006454:Hemoglobins / Q000032:analysis*; D006801:Humans; D010842:Pica / Q000097:blood* / Q000150:complications / Q000453:epidemiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood* / Q000453:epidemiology; D011250:Pregnancy Complications, Hematologic / Q000453:epidemiology; D011256:Pregnancy Outcome; D015995:Prevalence; D012189:Retrospective Studies; D012907:Smoking / Q000009:adverse effects
chemical_list: D006454:Hemoglobins