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Individual assessment of a patient's particular vitamin C needs is important before dosage advice is given. The biochemical and physiological effects of Vitamin C need to be carefully analyzed under controlled experimentation before its value as a pharmacologic agent in preventive medicine can be fully understood.

With a modified methylene blue immersion technique, it has been possible to demonstrate neural fibers in cleared whole mounts of human umbilical cords. The nerve fibers run in Wharton's jelly and give off branches to form a plexus in the walls of the umbilical vessels. It is suggested that vasomotor responses in the umbilical vessels are mediated via a neural mechanism.

Social background, dietary intake, and clinical course and outcome of pregnancy were evaluated in 18 pregnant teenagers in San Francisco (group I). The pregnancies of 34 other teenage girls were also evaluated from their medical records (group II). Diet records were also kept by five, healthy, never-pregnant girls of the same age group (group III) and by 14 of the previously pregnant teenagers in group I during the postpartum period.Generally, the pregnant teenagers in group I were more than 2 years postmenarche, unmarried at the time of conception, came from various racial backgrounds, and were concerned by the lack of money. The sample is unique in that all but one did not quit high school when they became pregnant. Only six lived in homes of their own; the others lived with their families, relatives, or friends so they were not completely free to choose their diets.The teenagers in this study consumed more food during their pregnancy than the never-pregnant girls studied, but there was not one nutrient tabulated that was adequately supplied to all the girls, with or without prescribed prenatal supplements to the food intake. The nutrients most poorly supplied by the diets during and after pregnancy were calcium, iron, vitamin A, and energy. Protein was the most nearly adequate with all the girls during pregnancy and postpartum meeting at least two-thirds of the suggested allowance for nonpregnant females (36 g). Most, but not all, of the pregnant girls took prescribed nutrient supplements, but not regularly.The total weight gain of the teenagers was in the range of adult pregnancies, although it was often erratic. Clinical edema or periods of rapid weight gain were detected in 25 out of 47 girls. Diuretics or low sodium diets, or both, were used to treat 20 of these girls. Additional complications, including proteinuria, inadequate weight gain, anemia, and glycosuria, were found in 15 other girls. Thus, 85% of the 47 pregnant teenagers had some problems during pregnancy.The infants of the girls in group I weighed 3,030 g; one infant was stillborn and four had problems at birth. The infants in group II weighed 3,318 g and did not have any problems at birth. The birth weight of the infant was positively associated with the weight gain of the mother during pregnancy (P< 0.01), and the smaller the girl prior to pregnancy the more she gained (P< 0.01). Neither birth weight nor maternal weight gain were influenced by maternal age, height, or recorded dietary energy and nutrient intake.

There is a crying need for a national maternity care program, if pregnant women are to be assured their rights to sufficient, nutritious food. But first, the scope and dimensions of the problem must be surveyed. Resulting information will then make it possible to provide first class nutritional service to pregnant women within the changing national health program.