Pregnant Teens Should Be Screened for Pica, Study Suggests

August 27, 2014

Pregnant teens are more likely to engage in pica, a behavior characterized by compulsive cravings for nonfood items. Anemia may have something to do with it.

Pregnant teenagers should be screened for pica, researchers suggested after finding an increased risk of this behavior among this young population. Pica is characterized by persistent and compulsive cravings for nonfood items, such as ice, clay, sand, soil, or chalk.

Pertinent Points

- Pregnant teens should be screened for pica, researchers said after their study findings showed an increased risk of the condition among this young population.

- The authors also noted a strong association between anemia and pica, suggesting that iron deficiency may be a biomarker for pica behavior.

Scientists from Cornell University, Ithaca, NY, and the University of Rochester, Rochester, NY, found nearly half of the 158 pregnant adolescents included in their study, engaged in pica. Most of these young women craved and consumed ice; however, some also ate starches, powders, and soap, the authors reported online in The Journal of Nutrition. All of the teens in this study were 18 years old or younger, and nearly two thirds were black and 25% were Hispanic.

The young women exhibiting pica behavior also had significantly lower iron levels than those teens who did not engage in the behavior. That finding prompted the researchers to believe there is a strong association between anemia and pica. The relationship between the two findings requires further research, however.

"As anemia increased, so did these [pica] behaviors, but we don't know what happens first," said Kimberly O'Brien, PhD, professor of nutritional sciences and the study's senior author. Still, since ice is not known to impact iron levels, she hypothesizes that iron deficiency may have an effect on brain chemistry that leads to these cravings.

The study found 46% of the teens engaged in pica behavior, with 37% ingesting inordinate amounts of ice, 8% consuming starches (eg, cornstarch), 4% eating powders (eg, baby powder), and 3% consuming soap.

Among the maternal iron status indicators tested during the study were hemoglobin, soluble transferrin receptor, serum ferritin, total body iron, and serum hepcidin. The levels were assessed during pregnancy and at delivery. In each case, the concentrations were significantly lower during pregnancy in the teens exhibiting pica than in the non-pica patients, the authors reported.

"The public health importance of pica really needs to be acknowledged," said Sera Young, PhD, a coauthor of the study. "My hope is that these studies put pica on the radar as a legitimate public health issue."