A quasi-experimental study on fortified tempeh: A nutritional intervention for fetal growth in Indonesia.

Preconception Dietary Patterns in Human Pregnancies Are Associated with Preterm Delivery

The kingdom of Bhutan is a tiny country, landlocked between the two Asian giants of India and China, and has a population of about 762 864 (Bhutan at a glance 2014). Despite the very small size, the country has made remarkable progress towards modern development since initiating planned development in the 1960s. Bhutan has also experienced rapid progress in many of the key determinants of nutrition and health.

PROTOCOL: Nutrition interventions and programs for reducing mortality and morbidity in pregnant and lactating women and women of reproductive age: a systematic review

Preventing intrauterine growth restriction and improving infant growth outcomes in Bangladesh

After completing this article, readers should be able to: 1. Describe the roles of insulin-like growth factor on fetal growth and development. 2. Delineate components of “maternal constraint.” 3. Explain the role of the placenta in regulating fetal growth. 4. Describe the effects of fetal glucose, amino acid, and fat supply on fetal growth. The principal determinants of fetal growth are fetal genotype and in utero environment. Environmental factors include maternal and paternal genetics, maternal size, and the capacity of the placenta to provide nutrients to the fetus. These environmental factors interact with the intrinsic growth pattern of the fetus, yielding a particular rate and composition of fetal growth. Most of the variation in fetal growth in a population is due to variations in environmental factors, not the fetal genome, although a genetically abnormal fetus clearly might not grow as well as a normal fetus if affected genes include those that are important for growth. Many genes contribute to fetal growth and birthweight. Techniques in which specific genes can either be deleted (“knockouts”) or overexpressed have led to greater understanding of how some of these genes regulate fetal growth. Such studies have shown that both maternal and paternal influences are present during fetal development and are passed on to the developing fetus by spermatozoa or oogonia by a mechanism called imprinting. Although the maternal genetic composition exerts greater influence than fetal genotype in the overall regulation of fetal growth, both maternal and paternal genomes are important in fetal growth and development (1)(2). For example, gynogenetic zygotes (two maternal genome copies) lead to underdeveloped extraembryonic tissues but well-developed embryos. The more modest regulation offered by the paternal genotype is essential for trophoblast development. For example, zygote nuclear transfer experiments have shown that androgenetic zygotes (two paternal genome copies) develop extensive trophoblast tissues but …

Maternal Nutritional Deficiencies and Interventions

Short birth length in children indicates a lack of nutrients consumed by the mother during pregnancy, so that fetal growth is not optimal and results in short birth length. Research Objective: to determine the effect of consumption of crispy biscuits of tuna fish bone meal on height growth in children aged 12-48 months. Quasy experimental design with pre-test-post test design using paired t-test. The results of the proximate test of crispy biscuits of tuna fish bone meal moisture content 4.41%, ash content 11.19%, carbohydrate content 47.64%, protein content 6.40%, fat content 30.36%, calcium content 7038. 70 mg/kg, phosphorus 0.91 mg/kg, potassium 2700.93 mg/kg, iron 60.73 mg/kg. The average height of children in the intervention group d crispy biscuits of tuna fish bone flour pre test 78.43 cm and post test 80.17 cm with a difference of 1.74 cm, control group pre test 88.84 cm and post test 89.84 cm with a difference of 1.01 cm. The results showed that there was a significant difference in the pre-test-post test of giving crispy biscuits of tuna fish bone meal on children's height (p = 0.03 <0.05). The conclusion is that giving crispy biscuits with tuna fish bone meal can increase height in children

Proper nutrition during pregnancy, lactation, and early childhood helps to prevent micronutrient deficiencies for mothers and children. Improved maternal nutrition during pregnancy has been associated with improved birth outcomes and minimized risk of pregnancy-related complications. Poor nutrition during pregnancy is associated with increased risk of preeclampsia, anemia, hemorrhage, and death in mothers. In addition, poor nutrition status of mothers leads to stillbirth, wasting, low birth weight, and delayed developmental milestones in children. Mothers are the source of many generations. Thus, their nutrition status predominantly influences the nutrition status of the forthcoming generations. Given the sensitivity of maternal, infant, and young children nutrition services, the government of Kenya, in partnership with international agencies such as UNICEF and WHO, has developed policies and guidelines to ensure the well-being of this key population. These guidelines and policies address malnutrition, exclusive breastfeeding, complementary feeding, health education and counseling, access to healthcare, food security, and policy coordination and implementation. Although Kenya has come a long way in implementing these policies, there appear to be several gaps in the promotion and application of these policies. Kenya is still struggling with potential gaps in maternal and infant nutrition policies in Kenya including limited coverage of nutrition counseling and support to pregnant women, inadequate focus on preconception nutrition, inadequate support for exclusive breastfeeding, poor integration of nutrition into maternal and child health programs, inadequate coverage of complementary feeding programs especially to children above 24 months of age, poor monitoring and evaluation of systems to examine the effectiveness of various maternal, infant and young children practices. Further, the COVID-19 pandemic increased the uncertainties in the application of nutrition guidelines in maternal nutrition. In particular, the impact of the COVID-19 pandemic exacerbated misperceptions in antenatal nutrition practices, breastfeeding practices, and complementary feeding. These misperceptions persist three years after the onset of the pandemic, thus adding to the existing gaps in the country’s maternal, infant, and young child nutrition policies. Within this context, the proposed study will explore the present gaps in Kenya’s maternal, young, and infant child feeding policies post-COVID-19 era and suggest sound recommendations to address these gaps effectively. Key Words: COVID-19 Pandemic, Maternal, Infant, and Young Child Nutrition Guidelines, Gaps in Maternal, Infant, and Young Child Nutrition Policies, Key policy recommendations, Evaluation of maternal and child nutrition programs

Pregnancy is a state of constant physiological compensation, processes that simultaneously account for the physical needs of both mother and foetus. These changes create a complex and continuously evolving environment, one which depends on essential elements for continued optimal function. While these processes are vital to the maintenance of pregnancy, they are also pivotal to parturition, a process which relies on the actions of numerous micronutrients for essential endocrine and inflammatory pathways. As such, proper maternal nutrition is pivotal to optimal birth outcomes. Global, national and state agencies address nutrition within theoretical and conceptual frameworks; these interact with governance, clinical, and consumer factors to create complexities individuals must navigate when making nutrition-related decisions. This decision-making becomes more complicated during pregnancy due to social influences, such as advertising and peer pressure, and cultural factors such as food avoidance, traditions and beliefs. The confluence of these determinants influences each woman’s nutrition state, with the potential to result in transgenerational health consequences. Malnutrition is associated with suboptimal perinatal outcomes, a situation not restricted to low and middle-income countries. Although outcomes in these regions have improved with supplement interventions, research is yet to determine the efficacy of supplementation in high-income countries. However, despite the lack of evidence surrounding their safety and efficacy, and recommendations relating to the use of supplements during pregnancy, the pregnancy supplement market is estimated to reach a value of $673.8 million by the year 2025. This quantitative research explored data collected from three cross-sectional cohorts in order to explore the associations between micronutrient supplementation and birth outcomes in South-East Queensland women. The first of these datasets – the Environments for Healthy Living cohort - was a longitudinal birth cohort study with self-reported perinatal data collection undertaken between 2006 and 2011. The second was the Gold Coast Health and Hospital Service Maternity Information System cohort; a clinician controlled digital perinatal database with data available from 2014 to 2017. The third was the Maternal Outcomes and Nutrition Tool database, a cohort recruited explicitly for this study between 2016 and 2018, self-declaring data using a specially designed digital data collection tool. Collectively, these three cohorts examine the relationships between demographics, socio-cultural factors, micronutrition status, supplement use, dietary decision-making and their influence on the birth outcomes of 9300 women from South-East Queensland over the twelve years from 2006 to 2018. Six research aims informed three formative enquiries addressing the central research question. These aims examined evidence informing current recommendations regarding micronutrient supplements during pregnancy in Australia, determined if evidence of benefit exists regarding micronutrient supplements and birth outcomes in South-East Queensland women and explored the human factors affecting nutrition-related decision making in the study population. This research aimed to determine relationships between socio-cultural determinants of health, micronutrition, supplement use and birth outcomes in pregnant women of South-East Queensland. A literature review was conducted, highlighting current limitations and knowledge gaps relating to the influence of supplementation in nutritionally replete and high-income populations. Furthermore, current data collections were found to exhibit significant limitations inhibiting accurate determination of causal relationships. As such evidence informing current recommendations during pregnancy was determined to be neither robust nor contemporary. Driving dietary decision making were several social, health, cultural and economic factors. These include smoking, income, education, cultural and linguistic diversity, access to maternity care models, the range of maternity care models and providers, and health service resources. In particular, women from low-socioeconomic backgrounds - including women who smoke and women from cultural and linguistically diverse backgrounds - reported nutrition motives that position health factors as a low priority. While these women did not demonstrate evidence of benefit from micronutrient supplements, they did declare nutrition decision-making behaviours that would benefit from dietary counselling and support strategies. The synthesis of information afforded by this research has determined that micronutrient supplementation is not appropriate in pregnant women of South-East Queensland. Further, supplementation did not improve birth outcomes in either the general population or in women from demographic groups considered to be at risk for suboptimal outcomes. Conversely, non-therapeutic use demonstrated the capacity for detrimental effects across all three cohorts, particularly concerning the effect of micronutrient supplements on overweight women and the incidence of prolonged pregnancy. Determination of what constitutes sustainable, safe and effective nutrition interventions in women at risk of suboptimal birth outcomes requires further empirical research.

Suboptimal nutrition during pregnancy is recognised as a significant modifiable determinant in the development of chronic disease in offspring in later life. The current study aimed: (i) to assess the dietary intakes of pregnant Indigenous Australian women against national recommendations and (ii) to investigate the associations between maternal nutrition during pregnancy and the growth of the offspring, including kidney development in late gestation in the Gomeroi gaaynggal cohort (n = 103). Maternal dietary intake in the third trimester was assessed using the Australian Eating Survey Food Frequency Questionnaire. Estimated fetal weight (EFW) and kidney size were obtained by ultrasound. Birth weight was retrieved from hospital birth records. Of the five key nutrients for optimal reproductive health (folate, iron, calcium, zinc and fibre), the nutrients with the highest percentage of pregnant women achieving the nutrient reference values (NRVs) were zinc (75.7%) and folate (57.3%), whereas iron was the lowest. Only four people achieved all NRVs (folate, iron, calcium, zinc and fibre) important in pregnancy. Sodium and saturated fat intake exceeded recommended levels and diet quality was low, with a median score of 28 out of 73 points. After adjusting for smoking and pre-pregnancy body mass index, only maternal intake of retinol equivalents and the proportion of energy from nutrient-dense or energy-dense, nutrient-poor (EDNP) foods were associated with fetal growth. EFW decreased by 0.13 g and birth weight decreased by 0.24 g for every µg increase in maternal dietary retinol intake. Interestingly, EFW, but not actual birth weight, was positively associated with percentage energy from nutrient dense foods and negatively associated with percentage energy from EDNP foods. Dietary supplement usage was associated with increased birthweight, most significantly iron and folate supplementation. Current dietary intakes of pregnant Australian women from this cohort do not align with national guidelines. Furthermore, current findings show that maternal retinol intake and diet composition during pregnancy can influence fetal growth, but not fetal kidney growth in late gestation. Strategies that aim to support and optimise nutrient intakes of Indigenous pregnant women are urgently needed. Future studies with long-term follow-up of the children in the current cohort to assess renal damage and blood pressure are imperative.

To understand the neurological repercussions on newborns of pregnant women with inadequate prenatal care, it is crucial to explore how the quality of prenatal care can influence children's neurological development. Inadequate prenatal care can result in deficiencies in medical monitoring, such as lack of nutritional supplementation, insufficient monitoring of fetal growth and inadequate treatment of maternal conditions that directly affect the neurological development of the fetus. Objective: Analyze and synthesize the available evidence on the implications neurological disorders in newborns whose mothers received inadequate prenatal care. Methodology: followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) checklist, using databases such as PubMed, Scielo and Web of Science. The descriptors used were "prenatal care", "neurological outcomes", "neonates", "inadequate care" and "neurodevelopment". The inclusion criteria were studies published in the last 10 years, focused on inadequate prenatal interventions and their neurological consequences in newborns, available in English, Spanish or Portuguese. Exclusion criteria included studies unrelated to the topic, non-systematic reviews and studies with small samples. Results: revealed that pregnant women with inadequate prenatal care have a higher incidence of neurological complications in newborns, such as delays in motor and cognitive development, in addition to greater vulnerability neurological diseases such as cerebral palsy. Conclusion: improvements in the quality of prenatal care are essential to mitigate these repercussions and promote better neurological health outcomes in newborns. This review highlights the importance of public health policies that guarantee adequate prenatal care for all pregnant women.

Femur-sparing pattern of abnormal fetal growth in pregnant women from New York City after maternal Zika virus infection

Heifer nutrition during early- and mid-pregnancy alters fetal growth trajectory and birth weight

Developmental potential is the ability to think, learn, remember, relate, and articulate ideas appropriate to age and level of maturity, and an estimated 39 percent of the world’s children under age five years do not attain this potential (Grantham-McGregor and others 2007).The main reason for giving prominent attention to mental development from conception through the first 24 months of life is that early unfavorable conditions can impair the normal development of the brain. The impairment is often incremental and unnoticed until schooling begins. The most striking example of impairment is the gradual deletion of unused brain synapses. The lack of use may be due to the absence of stimulation in the family environment or lack of available energy for brain activity. Regenerating those lost synapses may occur at an older age but with additional costs. For example, children who do not acquire a good vocabulary in the early years will have difficulty learning how to read; children who do not acquire simple problem-solving strategies in the first 24 months will have difficulty understanding math concepts; children who do not develop secure emotional attachments to adults will have difficulty coping with stresses and challenges throughout life. The plasticity of the brain diminishes with age, but greater plasticity in the very early years suggests that brain development has a greater chance of being modified by protective interventions than by interventions later in life (Werker and Hensch 2015).A second reason for attending to early mental development is that individuals, communities, and societies are healthier and more productive if they have mature mental skills. More educated adults are healthier and wealthier than less educated adults. Educated mothers have healthier children and are more likely to recognize symptoms of illness, follow medical advice, feed their children nutritious foods, and keep their homes clean (Boyle and others 2006; Cleland and van Ginneken 1988). Educated husbands are less likely to condone or use violence to resolve domestic conflicts (Abraham and others 2006). Follow-up data of adults who participated in early psychosocial stimulation programs demonstrate some of these long-term benefits (Gertler and others 2014).This chapter discusses mental development from birth to age 24 months in low- and middle-income countries (LMICs). We include recent literature published since the 2011 child development series in The Lancet. Although we focus on cognitive and language domains, we touch on socioemotional, fine motor, and gross motor development. First, a description of how these domains are measured provides an operational definition of the term mental development. Second, conditions that derail early child development are examined. These conditions arise during the prenatal period and continue throughout the next 24 months; they include psychosocial stimulation, prenatal and postnatal nutrition, the physical environment, and maternal mental health. Finally, the results of several systematic reviews and meta-analyses are presented to show the effects of stimulation and nutrition, along with disease-related interventions to promote mental development. Maternal interventions related to nutrition and mental health are also reviewed. A framework of critical components to include in programs is outlined.

Paraoxonase 2 gene polymorphisms and prenatal phthalates' exposure in Chinese newborns