Ada M. Graff

Serum phosphatase relations in mother and fetus.

Abstract Profound alterations in the bodys economy of calcium and phosphate occur during pregnancy and lactation, to provide for the fetal needs for these substances and for their excretion by the mammary glands. Studies in placental permeability employing tracer doses of radioactive phosphorus have shown, for example, that the guinea pig fetus near term retains in each hour as much phosphorus as the total quantity of this element in the circulating plasma of its mother. 27 Changes in inorganic phosphate as well as calcium in the serum of the pregnant woman are so slight, however, that they are practically completely lacking in significance for the interpretation of metabolic phenomena. Maternal stores are obviously essential to the growth of the fetus. These stores of phosphorus exist in the form of organic esters, the phosphate ions being liberated as needed through the mediation of enzymes, notably alkaline phosphatase. This enzyme, widely distributed in the body, occurs in particularly high concentration in bone and cartilage, where it presumably plays an essential part in the process of ossification by producing an excess concentration of phosphate ions which leads in turn to the precipitation of calcium phosphate. The enzyme is present also in the blood serum, where it can be measured by a variety of techniques. Its activity is expressed in arbitrary units, dependent upon the type of substrate employed in the determination. When glycerophosphate is used (Bodansky method) the range of normal for adults is 1.5 to 4.0 units per 100 c.c. of serum. In children the phosphatase activity is increased, ranging between 5 to 12 units per 100 c.c. The enzyme concentration is also elevated in some diseases of the liver, especially those with obstructive jaundice, and in many types of bone disease including rickets, osteomalacia, osteitis fibrosa cystica, and osteitis deformans. 24 The behavior of alkaline phosphatase in relation to the various phases of reproduction is interesting because of the need for mobilization of phosphorus which the reproductive cycle imposes. This study is divided into four parts: pregnancy, puerperium, lactation, and fetal-maternal relations.

Nutrition and premature labor.

Abstract 1. 1. The literature dealing with the relation of maternal nutrition to premature labor has been reviewed. Despite the prevailing view that nutritional inadequacy is a common cause of premature labor, the evidence for this is not convincing. 2. 2. Dietary histories of a group of patients who had premature labors revealed no significant differences from those of a control group with full-term pregnancies in calculated intake of the various food essentials. 3. 3. Hematological and blood biochemical determinations in the early puerperium also failed to reveal any significant differences between the premature parturients and their full-term controls. Determinations included serum proteins, serum amino acid nitrogen, red cell volume, hemoglobin, serum alkaline phosphatase, serum vitamin A, serum carotene, serum ascorbic acid, and whole blood ascorbic acid. 4. 4. This study offers no support to the theory that nutritional deficiency is a common cause of premature labor.