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The Maternal Phenylketonuria International Study: 1984-2002.

AbstractOBJECTIVE:
The purpose of this report is to review the obstetric medical, psychological, and nutritional aspects and outcome of the women and offspring enrolled in the Maternal Phenylketonuria Study, which was established to assess the efficacy of a phenylalanine (Phe)-restricted diet in preventing the morbidity associated with this disorder.
METHODS:
A total of 382 women with hyperphenylalaninemia (HPA) were enrolled in the study and completed 572 pregnancies. Outcome measures were analyzed with chi2, Fisher exact text, analysis of variance, t test, Wilcoxon nonparametric test, and multiple logistic regression. Outcome measures were stratified according to maternal HPA classification and the time when dietary control was achieved.
RESULTS:
Optimal birth outcomes occurred when maternal blood Phe levels between 120 and 360 micromol/L were achieved by 8 to 10 weeks of gestation and maintained throughout pregnancy (trimester averages of 600 micromol/L). Mothers with mild HPA achieved similar birth outcomes as mothers who were in control preconceptually and those in control by 8 to 10 weeks of pregnancy.
CONCLUSIONS:
Before conception, counseling and early entrance into a prenatal care program is essential in achieving optimal fetal outcome in women with HPA. The achievement of pre- and periconceptional dietary control with a Phe-restricted diet significantly decreased morbidity in the offspring of women with HPA.
AuthorsRichard Koch, William Hanley, Harvey Levy, Kim Matalon, Reuben Matalon, Bobbye Rouse, Frederick Trefz, Flemming Güttler, Colleen Azen, Larry Platt, Susan Waisbren, Keith Widaman, Jiaping Ning, Eva G Friedman, Felix de la Cruz
JournalPediatrics (Pediatrics) Vol. 112 Issue 6 Pt 2 Pg. 1523-9 (Dec 2003) ISSN: 1098-4275 [Electronic] United States
PMID14654658 (Publication Type: Clinical Trial, Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, P.H.S.)
Chemical References
  • Phenylalanine
Topics
  • Analysis of Variance
  • Birth Weight
  • Child
  • Child, Preschool
  • Embryonic and Fetal Development
  • Female
  • Humans
  • Infant, Newborn
  • Intelligence
  • Logistic Models
  • Phenylalanine (blood)
  • Phenylketonuria, Maternal (blood, diet therapy)
  • Phenylketonurias (diet therapy)
  • Pregnancy
  • Pregnancy Outcome
  • Prenatal Care
  • Statistics, Nonparametric

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