Cause Of Low Birth Weight Research Articles

Long-term health in individuals born preterm or with low birth weight: A cohort study.

To measure the association of prematurity and non-preterm low birth weight (LBW) with several long-term health outcomes. We selected adult participants from the Constances cohort. Associations between preterm birth (<37 weeks versus ≥37 weeks) and outcomes were measured using modified Poisson regression with adjustment for participant age and parental history. We used the same modeling methods to measure the association between LBW (i.e., <sex-specific 10th percentile) and outcomes in participants born ≥ 37 weeks. We tested for an interaction between exposures and sex. Among 30,295 participants, preterm birth (5.2%) was associated with (RR[CI95]): obesity (1.25[1.08-1.46]), hypertriglyceridemia (1.23[1.07-1.42]), high LDL-cholesterol (1.16[1.05-1.28]), high blood pressure (HBP) (1.22[1.08-1.36]), metabolic syndrome (1.35[1.06-1.71]), non-alcoholic fatty liver disease (1.26[1.08-1.47]), allergic and atopic symptoms (1.06[1.01-1.12]), and lack of tertiary education (1.11[1.02-1.20]). Women had a significantly higher risk of hypertriglyceridemia and metabolic syndrome. In non-preterm participants, LBW was associated with prediabetes/diabetes (1.30[1.12-1.52]), HBP (1.22[(1.12-1.33]) and lack of tertiary education (1.13[1.07-1.20]), whereas the risk of obesity (0.83[0.73-0.95]) and abdominal obesity (0.84[0.76-0.93]) was reduced. Preterm birth and non-preterm LBW are both risk factors for several adult outcomes. However, regarding excess fat storage, their long-term effect seems to be in the opposite direction. Preterm birth is associated with a higher long-term risk of obesity, whereas low birth weight is not. This study improves the understanding of the common idea that low birth weight is associated with a long-term risk of obesity, whereas it might depend on the cause of low birth weight. These findings provide new insights into the difficult distinction between the long-term adverse health effects of preterm birth and low birth weight.

Helminthiasis and malaria co-infection among women of reproductive age in a rural setting of Kilifi County, coastal Kenya: A mixed method study.

Soil transmitted helminthiasis (STH), Schistosoma haematobium and malaria co-infection lead to increased susceptibility to other infections and poor pregnancy outcomes among women of reproductive age (WRA). This study sought to establish risk factors, burden of co-infection with STH, S. haematobium and Plasmodium sp. among WRA in Kilifi County, Kenya.A mixed method cross-sectional study was conducted on 474 WRA in 2021. Simple random sampling was used to select WRA from four villages in two purposively sampled sub-counties. Study participants were interviewed, and stool samples collected and analysed using Kato-Katz technique for STH. Urine samples were collected for examination of S. haematobium while malaria microscopic test was done using finger prick blood samples. Further, 15 focus group discussions (FGDs) were conducted with purposively selected WRA and qualitative data analyzed thematically using Nvivo software. Quantitative and qualitative methods were triangulated to comprehensively strengthen the study findings. Prevalence of S. haematobium was 22.3% (95%CI: 13.5-36.9), any STH 5.2% (95%CI: 1.9-14.3) and malaria 8.3% (95%: 3.8-18.2). Co-infections between any STH and S. haematobium was 0.8% (95%CI: 0.2-3.2) and between S. haematobium and malaria 0.8% (95%CI: 0.2-3.1). Multivariable analysis showed increased odds of any STH infections among participants in Rabai Sub-County, (aOR = 9.74; p = 0.026), businesswomen (aOR = 5.25; p<0.001), housewives (aOR = 2.78; p = 0.003), and casual laborers (aOR = 27.03; p<0.001). Qualitative analysis showed that the three parasitic diseases were common and responsible for possible causes of low birth weight, susceptibility to other infections and complications such as infertility and cancer later in life.The study demonstrated that STH, S. haematobium and malaria are still a public health problem to WRA. Some of the associated risks of infection were geographical location, socio-economic and WASH factors. Hence the need to implement integrated control efforts of the three parasitic infection.

Factors Associated With Low Birth Weight Among the Tribal Population in India: A Narrative Review.

Low birth weight (LBW)is defined by the WHO as a birth weighing less than 2500 g (5.5 lb). The highest burden of any nation is LBW infants. In countries where the frequencyof neonatebabies is high, short gestation is a major cause. LBW babies have an 11-13 times greater risk of delayed developmental milestones and other medical diagnoses. Greater than the globalincidence, LBW prevalence is a severe public health problem in India. A comprehensive literature search was conducted using internet sources like PubMed, Web of Science, Cochrane Library, and Google Scholar. The words "birth weight," "abnormal birth weight," "LBWs," "neonates," "premature birth," "risks factors," "causes," "factors," "prevalence," and "frequency" weresearched.In this review, we examine the causes of LBW, implementation of pre-birth prevention strategies, and post-birth multifaceted health promotion interventions. The mother's knowledge, dietary requirements, and prenatal services need to be addressed to decrease the prevalence of LBWs among tribal districts of India.

FAKTOR-FAKTOR YANG BERHUBUNGAN DENGAN KEJADIAN BAYI BERAT LAHIR RENDAH (BBLR)

Low birth weight (LBW) infants are newborns with a birth weight less than 2500 grams. In 2017, the Simangambat Community Health Center in Bandung City reported the highest number of LBW cases, which amounted to 3,147 cases. The incidence of LBW at the Simangambat Community Health Center fluctuated from 2016 to 2018 and did not reach the set target, which was a maximum of 7%. The causes of LBW can be categorized into three factors: maternal factors, including maternal age, parity, anemia, and pregnancy complications such as antepartum bleeding, preeclampsia, and prenatal care; fetal factors, such as polyhydramnios and multiple gestations; and environmental factors, such as socioeconomic conditions. The objective of this study was to identify factors associated with the occurrence of low birth weight children at Simangambat community health center. The research employed Accidental Sampling, involving a total of 83 respondents. The findings revealed no significant correlation between maternal age and LBW, with a p-value of 0.585. A relationship was found between parity and LBW with a p-value of 0.029. Conversely, there was no link between twin pregnancies and LBW, indicated by a p-value of 0.248. On the other hand, there was a connection between preeclampsia and LBW, with a p-value of 0.038. Additionally, socioeconomic factors, particularly education and family income, were also linked to LBW. The p-value for the education factor was 0.003, and for family income, it was 0.024.

Causative Factor of Low Birth Weight (LBW) Babies in Bandung City Hospital

The LBW mortality rate reaches 15 to 20% in the world. the proportion of infant deaths originating from the age of 0-28 days (Neonatal) was 84.63% or 3.32/1000 live births and and body weight 2500 grams reached 6.3%, while the proportion of babies born weighing 2500 grams with body length 48 cm in Indonesia reached 4.0% and in West Java reached 4.2%. The purpose of this study was to determine the factors that cause babies born with low birth weight. The type of research used by researchers is a descriptive survey research method using a retrospective study design using medical record register data for newborns who have been treated. The population in this study were all low-birth-weight babies in the last year at Bandung City Hospital, using secondary data at the medical record installation section in the last year as many as 543 babies. The sample in this study is secondary data from babies born with LBW as many as 85 respondents. The sampling technique is probability sampling using a random sampling method using register data from medical records. The analysis in this study uses univariate analysis to see the frequency distribution of each sub-variable. The results of the study occurred in multipara parity, namely 46 (54.1%), gestational age at risk, namely 47 (55.3%), maternal age at risk, namely 46 (54.1%), twin births, namely 19 (22.4%) of the 85 respondents, pregnancies without placenta previa were 77 (90.6%). The results of this study indicate that the factor of gestational age is the highest that causes LBW babies to be born. It is recommended that efforts be made to reduce the number of LBW babies born by optimizing preventive efforts, health workers are required to provide health education about the causes of LBW.

Fetal sex and risk of pregnancy-associated malaria in Plasmodium falciparum-endemic regions: a meta-analysis

In areas of moderate to intense Plasmodium falciparum transmission, malaria in pregnancy remains a significant cause of low birth weight, stillbirth, and severe anaemia. Previously, fetal sex has been identified to modify the risks of maternal asthma, pre-eclampsia, and gestational diabetes. One study demonstrated increased risk of placental malaria in women carrying a female fetus. We investigated the association between fetal sex and malaria in pregnancy in 11 pregnancy studies conducted in sub-Saharan African countries and Papua New Guinea through meta-analysis using log binomial regression fitted to a random-effects model. Malaria infection during pregnancy and delivery was assessed using light microscopy, polymerase chain reaction, and histology. Five studies were observational studies and six were randomised controlled trials. Studies varied in terms of gravidity, gestational age at antenatal enrolment and bed net use. Presence of a female fetus was associated with malaria infection at enrolment by light microscopy (risk ratio 1.14 [95% confidence interval 1.04, 1.24]; P = 0.003; n = 11,729). Fetal sex did not associate with malaria infection when other time points or diagnostic methods were used. There is limited evidence that fetal sex influences the risk of malaria infection in pregnancy.

Successfully managed extremely low birth weight baby in a resource limited setting

Birthweight significantly influences the health and nutrition of a newborn. Low birth weight (LBW) is a global problem in both high and low income countries and it carries significant morbidity and mortality. In Nigeria, Prematurity, has been found to be a major cause of LBW. The burden of managing these patients especially those who are extremely low birth weight(&lt;1000g) is high, due to lack of specialized and equipped newborn units, thus survival rate is still low in the country. This is a case report of an extreme low birth weight (ELBW) preterm female baby, who is a second twin, delivered at a gestational age of 23 weeks +5days, with a birth weight of 600g, and was successfully managed and discharged home after 59 days on admission. This highlights that survival rate of ELBW neonates delivered before the age of viability, can be improved even in low income countries( LICs) or Low middle income countries( LMICs) with adequate newborn care and good nursing care.

Clinical Patterns and Outcome of Low Birth Weight Babies Admitted in NICU Tertiary Hospital of Western Nepal

Introduction: Low birth weight (LBW) is one of the major determinants of neonatal morbidity and mortality. The survival and outcomes of LBW infants varied from hospital to hospital within a country. The objective of the study is to identify the clinical patterns and hospital outcome of LBW babies in a Tertiary care centre, Pokhara. Methods: A descriptive cross-sectional study conducted in a tertiary hospital after taking ethical approval from the institutional review board. Data on all the LBW babies admitted in Neonatal Intensive Care Unit from 15th May 2019 to 16th October 2020 were retrospectively reviewed. Data entered in excel and descriptive analysis were done in SPSS version 25. Results: Of 198 LBW babies, 120 (60.6%) were males and 78 (39.4%) females. Mean birth weight was 1.67 kg (± 0.42 SD), median 1.7 kg, ranging from 0.6 kg to 2.4 kg. Mean gestational age was 32.86 weeks (± 2.72 SD) and median was 33 weeks. 187 (94.4%) were preterm and 11 (5.6%) term. By birth weight, 17 (8.6%) were found to be ELBW, 53 (26.8%) VLBW and 128 (64.6%) LBW. 143 (72.2%) were AGA, 54(27.2%) SGA and one was LGA. Hyperbilirubinemia, neonatal sepsis and hypoglycemia were common problems encountered in NICU. Inadequate ANC, premature rupture of membrane, and low hemoglobin were the common maternal factors for LBW babies. Conclusions: Prematurity was the major cause of LBW and majority were male babies. LBW babies had relatively more problems in NICU.

Low birth weight and its associated factors in East Gojjam Zone, Amhara, Ethiopia

IntroductionLow birth weight is a global public health problem, with 15–20% of all births globally, described by weight at birth of less than 2500 g ensuing fetal and neonatal mortality and morbidity, poor cognitive growth, and an increased risk of chronic diseases later in life. The prevalence is critical in East Africa where about 11% have low birth weight out of 54% of neonates whose weight was measured at birth. There are many causes of low birth weight, including early induction of labor or cesarean birth, multiple pregnancies, infections, diabetes, and high blood pressure. Moreover, socioeconomic factors and unhealthy dietary habits could contribute to low birth weight in areas with poor intake of a diversified diet. This study has indicated the association between poor dietary diversity and low birth weight in the study area for the first time.MethodsAn institutional-based cross-sectional study was conducted on eligible 423 pregnant women recruited from Gestational Age of less than 17 weeks until delivery where the birth outcomes were recorded in health institutions in randomly selected five Woredas in East Gojjam Zone, Amhara, Ethiopia from June 2019 to December 2020. Questionnaires were used to collect data on socio-economic-demographic, dietary diversity scores, and food consumption scores.ResultsThe study found a prevalence of low birth weight of 9.6%, low dietary diversity score of 53.2%, low food consumption score of 19.7%, and preterm delivery of 9.1%. Ever attended school and a higher level of education (diploma and above) decreased the risk of low birth weight with an Adjusted Odds Ratio (AOR) of 0.149 (0.024, 0.973) P ≤ 0.042; 0.059 (0.007, 0.513) P ≤ 0.007; whereas low dietary diversity score group and low food consumption group increased the risk of low birth weight with AOR 2.425 (1.342, 6.192) P ≤ 0.011and 2.983 (1.956, 9.084) P ≤ 0.044 respectively.Conclusion and recommendationParticipants with no formal education, no diploma, and above (no college or university training/degree), low diversity score group, and low food consumption group had an increased risk of low birth weight. Therefore the use of a diversified diet, educating women to a higher educational level, and health education on the intake of a diversified food rich in multiple micronutrients are recommended as strategies that will ameliorate the occurrence of low birth weight.

Prenatal methamphetamine exposure causes dysfunction in glucose metabolism and low birthweight.

Methamphetamine (METH) is a psychostimulant drug that induces addiction. Previous epidemiological studies have demonstrated that maternal METH abuse during pregnancy causes low birthweight (LBW) in the offspring. As a source of essential nutrients, in particular glucose, the placenta plays a key role in fetal development. LBW leads to health problems such as obesity, diabetes, and neurodevelopmental disorders (NDDs). However, the detailed mechanism underlying offspring's LBW and health hazards caused by METH are not fully understood. Therefore, we investigated the effects of prenatal METH exposure on LBW and fetal-placental relationship by focusing on metabolism. We found dysfunction of insulin production in the pancreas of fetuses exposed to METH. We also found a reduction of the glycogen cells (GCs) storing glycogens in the junctional zone of placenta, all of which suggest abnormal glucose metabolism affects the fetal development. These results suggest that dysfunction in fetal glucose metabolism may cause LBW and future health hazards. Our findings provide novel insights into the cause of LBW via the fetal-placental crosstalk.

Determinants of Low Birth Weight Newborns in Indonesia: Literature Review

LBW is a health problem that requires special attention in various countries, especially in developing countries with low socio-economic conditions. LBW has a greater risk of experiencing morbidity and mortality than babies born with normal weight. Factors that affect low birth weight (LBW) are teenage pregnancy, preeclampsia, anemia, and ANC visits. LBW is also one of the factors that can cause babies to die before reaching the age of 1 year. The purpose of this systematic literature review is to analyze the relationship between maternal age, preeclampsia, anemia, and ANC visits to determine the cause of LBW so that it can suppress IMR. Using the Critical Appraisal Skills Program (CASP) method with data sources obtained from PubMed, Google Scholar, and Research Gate, there are 145 articles reviewed. Inclusion criteria were (1) Teenage pregnancy, infant; (2) the incidence of LBW; (3) Factors influencing the incidence of LBW; (4) Full text; (5) Articles published from 2017 to 2021; and (6) national journals. There are 5 articles that meet the inclusion criteria. The results of this literature review are the factors that affect low birth weight (LBW), namely Teen Pregnancy, Preeclampsia, Anemia, and ANC visits.

HUBUNGAN ANEMIA PADA IBU HAMIL TERHADAP KEJADIAN BERAT BADAN LAHIR RENDAH DI 2 RUMAH SAKIT SWASTA KOTA LHOKSEUMAWE TAHUN 2020

Low birth weight (LBW) is a infant whose weight is less than 2500 grams. Internationally, LBW is still seen as a health problem that is quite prominent because it has a high enough risk to experience death in the neonatal period, which is 40 times greater than babies born with normal weight. Data from the WHO in 2018, the prevalence of babies with LBW in the world is 15.5% or about 20 million babies born every year, of which about 96.5% of them occur in developing countries. Based on the results of Riskesdas in 2018, one of the most common causes of infant mortality in Indonesia is LBW, which is 34%. The birth rate of babies with LBW in Indonesia reaches 350,000 every year where the prevalence of LBW in Indonesia is 6.2%. One of the causes of LBW is the poor nutritional status of the mother, one of which is anemia. The purpose of this study was to determine the relationship between anemia in pregnant women and the incidence of low birth weight (LBW) in 2 private hospitals in Lhokseumawe. This research is an analytic observational study with a cross sectional study approach. The sampling technique used is total sampling with a total of 154 respondents. The data used is secondary data derived from medical records. Data analysis was performed using Chi-square’s test. The results showed is no relationship between maternal anemia and the incidence of LBW.

Impact of Maternal Education and Age on Weight of Child at Birth: Use of Multinomial Logistic Model

The World Health Organization (WHO) prescribed 2.5 kilograms to 4.2 kilograms as the standard for normal birth weight (NBW) and every child whose birth weight is below the lowest bound is regarded as low birth weight (LBW) while above the highest bound is regarded as macrosomia. The odds for a LBW child to die as reported is about 40 times high when compared to a NBW child and these overwhelming death records are higher in developing countries. Therefore, urgent research about the causes of LBW especially in developing countries is very necessary and this motivated this research in Nigeria. In this paper, the Multinomial Logistic Regression (MLR) model was applied to secondary data from the 2018 Nigerian Demographic and Health Survey (NDHS) report to predict the probability of giving birth to NBW and macrosomia babies referenced to LBW babies. The maternal education level and age were considered as the predictor variables. The data was naturally stratified by maternal education level, that is (1 = Higher Education, 2 = Secondary Education, 3 = Primary Education, and 4 = No Education). The equal sample allocation technique which assigns equal stratum sample sizes (ni = 200 for the ith maternal education level) was adopted. The 800 sample size was reduced to 735 after screening for outliers in the maternal age variable. Considering the 54 LBW babies, 57% (0.5741) were from mothers with no education. The results showed that maternal education level and age have causal effects on child birth weight in Nigeria. Younger mothers (less than 28years) are 96.5% likely to have LBW babies while mothers who attained a minimum of primary, secondary, and higher education are 88.00%, 82.00%, and 57.90% likely to have NBW babies respectively when compared to those with no formal education. The research recommends that mothers should acquire at least primary school education and early child marriage (less than 28years) of the girl child should be discouraged.

Serum Levels of Some Nutritional, Hepatic and Renal Markers in Third Trimester Pregnant Women

Purpose: Nutritional status, before and during pregnancy, is a strong determinant of health outcomes in the mother and newborn, and can affect the foetal structure, physiology and metabolism. Maternal health, hepato-renal function, as well as calcium and magnesium levels during pregnancy are closely related, and have a great effect on the infant health outcome. The study was aimed at assessing serum levels of some nutritional parameters (total protein, albumin, calcium and magnesium), hepatic (alanine aminotransferase, aspartate aminotransferase, bilirubin, alkaline phosphatase) and renal (urea, creatinine) biomarkers and relate them with neonatal birth weight.&#x0D; Methods/Participants: Forty pregnant women in the third trimester (29 weeks to term) attending antenatal clinics for the first time, at two maternity centres within Osogbo metropolis were recruited as test participants. Forty age-matched, non-pregnant women served as control. Serum obtained from 5 mL of blood was used for the analyses. Inductive Computerized Plasma Emission Spectrometry was used for elemental study. Standard photometric methods were used to assay hepatic and renal parameters. Some pregnancy outcomes were also determined. Data were analyzed using Student’s t test and Pearson’s correlation coefficient. P≤ 0.05 was considered significant.&#x0D; Results: It was revealed that at third trimester some nutritional parameters (total protein, albumin, iron, calcium) were significantly decreased while renal biomarkers and alkaline phosphatase showed significant increase compared with control. Low birth weight but no still birth was observed.&#x0D; Conclusion: The significant decrease in levels of albumin and some nutritional parameters suggests inadequate nutrient intake of protein and minerals or confirms increased demand commonly linked with pregnancy; and may be a possible cause of low birth weight.

The Effect of Pumpkin Seed Biscuits on Nutritional and Zinc Status: A Randomized Controlled Trial in Pregnant Women

BACKGROUND: In several studies in Indonesia, low birth weight (LBW) is shown as the most dominant risk factor for stunting. Some of the causes of LBW are chronic energy deficiency during pregnancy, anemia during pregnancy, lack of nutrient supply during pregnancy, pregnancy complications, maternal parity, and birth spacing. In this case, women commonly suffer from micronutrient deficiencies including iodine, iron, Vitamin A, zinc, and folate. Related to this, about 80% of pregnant women in the world fulfill normative pregnancy needs due to inadequate zinc intake. One source of micronutrients rich in zinc is pumpkin seeds. The nutritional potential of pumpkin seeds is realized in the form of food products for pregnant women, including amino acids. One example of pumpkin seed fortification has been assessed in biscuit products by trained panelists and consumers, obtaining results that 20% additional pumpkin seed flour to biscuits becomes the best treatment. Meanwhile, in the case of this study, we expect that the pumpkin seed biscuits provided can increase the energy intake in pregnant women because when pumpkin seeds are added, the nutrition contained in the biscuits is also increased, in this case, the nutrition includes the zinc and Fe. AIM: The purpose this research is to figure out how pumpkin seed biscuits affect pregnant women concerning their nutrition status and serum zinc levels. METHODS: The method employed was a double-blind and randomized experimental research involving pre- and post-test control groups. The inclusion criteria of the participants involved were pregnant women aged 20–35 years old who were at their first and second trimesters of pregnancy and parity one to three and singleton pregnancy. Meanwhile, the exclusion criteria of the participants were pregnant women suffering from severe complications. There were 89 pregnant women further gathered in this study, but only 66 of them met the criteria and idled into two groups. In this case, one group received the pumpkin seed biscuit intervention, while the other received placebo biscuits. The intervention was conducted for 90 days where the pregnant women were provided with four biscuits for daily consumption. RESULTS: The nutritional status parameter of pregnant women involved in the current research was assessed, including body weight, mid-upper arm circumference (MUAC), and serum zinc levels. In this case, the average serum zinc level obtained was 48.75 g/dL from 60 pregnant women. Furthermore, a significant increase occurred in nutritional status for each group, marked by body weight gain, and increased MUAC. However, no significant difference emerged between the pumpkin seed biscuit group and the placebo biscuit group with p = 0.914 and p = 0.916, respectively. A significant increase in zinc levels was observed in both groups. In this case, changes in zinc levels between the two groups were significantly different (13.72 ± 1.84 vs. 9.81 ± 11.81, p = 0.007). CONCLUSION: Giving pumpkin seed biscuits contribute to weight gain and increase the MUAC the pregnant women which, in turn, improves their nutritional status and serum zinc.

Low birth weight and associated factors among newborn delivered in health facilities in Dhaka, Bangladesh

Introduction: Birth weight is the most important predictor of newborn health and survival. It is also a significant determinant of post neonatal, infant and childhood mortality as well as morbidity. LBW Child (birth weight&lt;2500gm) who survive, have a higher incidence of diseases, retardation in cognitive development and under nourishment. The causes of LBW are multifactorial including complication during pregnancy, genetic, environmental, social-cultural, demographic, and nutritional variables. In Bangladesh, low birth weight (LBW) rate is quite high even in urban areas. However, there is a lack of data on maternal characteristics that influence birth weight among the high-income urban population in Bangladesh. Therefore, the purpose of this study is to identify the status of low birth weight and associated factors among newborn delivered in different health facilities in Bangladesh. Method: A cross-sectional and descriptive type of study was carried out through a Systematic sampling method in 354 mothers of neonates who had delivered their babies and the mothers aged above 18 years in a few selected health facilities in Dhaka, Bangladesh. The samples were selected in a specific pre-determined interval. The data were collected from the respondents using a pre-tested and semi-structured questionnaire by face-to-face interview, after taking verbal consent from the participants. Data entry and analysis were done by using Statistical Package for Social Sciences (SPSS) statistical software version 20. The anonymity and confidentiality of the respondents were maintained strictly and study participants were informed that they can be able to leave the study at any stage of data collection. Results: The finding revealed that a total of 20.9% children were LBW whereas 79.1% had normal birth weight. Among all the LBW children, 76% children had mild low birth weight, 20% had very low birth weight and 4% children had extremely low birth weight. A significant association of birth weight was found with maternal age, occupation and weight gain during pregnancy. Conclusion: This study concluded that still one-fifth of children born with LBW among all live birth in urban areas although the majority of LBW children were mild low birth weight. Effective awareness programme needs to be taken among urban mothers to improve the overall nutritional status of neonates. Also, similar type of study should be conducted with a larger sample size to generalize the findings.

104. Maternal Mid-Upper Arm Circumference as a Predictor of Low Birth Weight Outcome Among Newborn Deliveries of Adolescents in a Tertiary Level Hospital

Maternal malnutrition is a major cause of low birth weight (LBW) newborn outcome especially among adolescent mothers. It is one of the key drivers of child stunting and initiates the vicious cycle of intergenerational malnutrition. The body mass index prior to pregnancy or at the initial trimester is currently being used to establish the desired weight gain all throughout gestation. However, Filipino adolescents often delay their first antenatal visit at a later stage of pregnancy. Without a baseline weight, the establishment of appropriate weight gain and nutritional status is often challenging.

Pregnancy in underweight women: implications, management and outcomes

Key Content Despite attention on obesity in pregnancy, within the UK and globally, many women enter pregnancy underweight. There remains a paucity of evidence‐based guidance on the optimal care of these women. Maternal underweight is associated with low birthweight and preterm birth, both spontaneous and iatrogenic, but appropriate gestational weight gain may mitigate low body mass index (BMI). Although being underweight may be protective against several antenatal and intrapartum complications, low BMI can be related to underlying organic disease and/or eating disorders, or there may be modifiable lifestyle factors that should be addressed in pregnancy. BMI at booking should assist as a screening tool. Body image, genetic, socioeconomic and cultural factors may affect BMI, making underweight women a heterogeneous group requiring individualised assessment. Learning Objectives To understand the associations of low BMI in pregnancy and its impact on maternal and fetal outcomes. To understand the antenatal care of underweight women, including nutritional advice and when additional fetal surveillance is required. To understand the heterogeneity of underlying causes of low BMI in pregnancy and the importance of gestational weight gain. Ethical Issues Beware making assumptions about different ethnicities that will interfere with offering the most appropriate care. Low BMI that is not managed as a risk issue during pregnancy is an avoidable cause of low birthweight and preterm birth. Women presenting with low BMI may have features in their history, such as certain mental health disorders, that mean they should be referred for safeguarding as a vulnerable adult. The unborn child and other children may also need assessment.

Structural and functional changes in the kidney caused by adverse fetal and neonatal environments

Health and disease risk in the adulthood are known to be affected by the early developmental environment. Kidney diseases are one of these diseases, and kidneys are altered both structurally and functionally by adverse pre- and perinatal events. The most known structural change is low nephron number seen in subjects born low birth weight and/or preterm. In various animal models of intrauterine growth restriction (IUGR), one of the causes of low birth weight, the mechanism of low nephron number was investigated. While apoptosis of metanephric mesenchyme has been suggested to be the cause, I showed that suppression of ureteric branching, global DNA methylation, and caspase-3 activity also contributes to the mechanism. Other structural changes caused by adverse fetal and neonatal environments include peritubular and glomerular capillary rarefaction and low podocyte endowment. These are aggravated by postnatal development of focal glomerulosclerosis and tubulointerstitial fibrosis that result from low nephron number. Functional changes can be seen in tubules, endothelium, renin-angiotensin system, sympathetic nervous system, oxidative stress, and others. As an example, I reported that aggravated nitrosative stress in a rat IUGR model resulted in more severe tubular necrosis and tubulointerstitial fibrosis after unilateral ureteral obstruction. The mechanism of various functional changes needs to be clarified but may be explained by epigenetic modifications.

Malaria and curable sexually transmitted and reproductive tract coinfection among pregnant women in rural Burkina Faso

BackgroundMalaria and sexually transmitted/reproductive tract infections (STI/RTI) are leading and preventable causes of low birthweight in sub-Saharan Africa. Reducing their impact on pregnancy outcomes requires efficient interventions that can be easily integrated into the antenatal care package. The paucity of data on malaria and STI/RTI coinfection, however, limits efforts to control these infections. This study aimed to determine the prevalence and associated factors of malaria and STI/RTI coinfection among pregnant women in rural Burkina Faso.MethodsA cross-sectional survey was conducted among 402 pregnant women attending antenatal clinics at the Yako health district. Sociodemographic and behavioral data were collected, and pregnant women were tested for peripheral malaria by microscopy. Hemoglobin levels were also measured by spectrophotometry and curable bacterial STI/RTI were tested on cervico-vaginal swabs using rapid diagnostic test for chlamydia and syphilis, and Gram staining for bacterial vaginosis. A multivariate logistic regression model was used to assess the association of malaria and STI/RTI coinfection with the characteristics of included pregnant women.ResultsThe prevalence of malaria and at least one STI/RTI coinfection was 12.9% (95% confidence interval, CI: [9.8–16.7]), malaria and bacterial vaginosis coinfection was 12.2% (95% CI: [9.3–15.9]), malaria and chlamydial coinfection was 1.6% (95% CI: [0.6–3.8]). No coinfection was reported for malaria and syphilis. The individual prevalence was 17.2%, 7.2%, 0.6%, 67.7% and 73.3%, respectively, for malaria infection, chlamydia, syphilis, bacterial vaginosis and STI/RTI combination. Only 10% of coinfections were symptomatic, and thus, 90% of women with coinfection would have been missed by the symptoms-based diagnostic approach. In the multivariate analysis, the first pregnancy (aOR = 2.4 [95% CI: 1.2–4.7]) was the only factor significantly associated with malaria and STI/RTI coinfection. Clinical symptoms were not associated with malaria and STI/RTI coinfection.ConclusionThe prevalence of malaria and curable STI/RTI coinfection was high among pregnant women. The poor performance of the clinical symptoms to predict coinfection suggests that alternative interventions are needed.