Deficient Mothers Research Articles

Single high-dose vitamin D at birth corrects vitamin D deficiency in infants in Mexico

This study examined the prevalence of vitamin D deficiency in mothers and infants in Tijuana, Mexico and determined the effect of a single oral dose of 50 000 IU vitamin D3 at birth on 25-hydroxyvitamin D (25[OH]D) levels during infancy. Healthy infants were randomized to receive vitamin D3 or placebo at birth. At birth 23% of infants were vitamin D deficient and 77% had vitamin D insufficiency (mean 25[OH]D level 18.9 ng/ml); 10% of mothers were vitamin D deficient and 61% were insufficient. Infants receiving vitamin D3 had higher 25(OH)D levels at two months (N = 29; 33.9 versus 24.2 ng/ml) and six months (N = 21; 36.5 versus 27.4 ng/ml). Exclusively breastfed infants had lower 25(OH)D levels at two months (14.9 versus 33.4 ng/ml). Vitamin D deficiency is common in infants and mothers in Tijuana, Mexico. A single dose of vitamin D3 at birth was safe and significantly increased 25(OH)D levels during infancy.

Study of serum zinc in low birth weight neonates and its relation with maternal zinc.

Assessment of serum Zinc in LBW (Low Birth Weight) and appropriate for gestational age (AGA) neonates in relation to their maternal zinc level. A prospective study was conducted in a tertiary care teaching hospital of central India between August 2011 to July 2012. Serum samples were collected from the eligible LBW (preterm & term IUGR) and term AGA healthy neonates and their mothers for zinc level estimation. Serum zinc was measured by atomic absorption spectrophotometer. Newborn of mothers having any medical illness, on any medication, with anaemia (Hb <10 gm/dl) were excluded from the study. Neonates with any perinatal insult were also excluded. Out of 100 newborn-mother pairs enrolled in the study, 46 newborns (18 preterm and 28 term IUGR) with birth weight <2.5kg comprised the case group and rest 54 term AGA newborns (birth weight >2.5kg) were categorized as control group. Mean serum zinc level was significantly low in LBW neonates (83.45±16.74 μg/dl) in comparison to term AGA newborns (93.74±19.95 μg/dl), (p-value <0.05). Similarly, zinc level was also low in mothers of LBW babies (67.02±15.99 μg/dl) in comparison to mothers of term AGA newborns (83.59±18.46 μg/dl), (p-value < 0.05). Low maternal zinc levels were significant correlated with lower serum zinc in LBW neonates (Pearson correlation value - 0.938). However, maternal zinc levels have shown no significant correlation with neonatal serum zinc levels in term AGA (0.029). LBW neonates and their mothers have significant zinc deficiency as compared to term AGA neonates and their mothers and this deficiency is correlated with zinc deficiency in mothers of these LBW neonates.

Infl uence of selenium deficiency on neural tube defects

Objective: As for the role of selenium on human fetal development, a little data is available in literature. The purpose of this manuscript was to study the influence of selenium on neural tube defects. This study will be helpful in planning strategies for prevention of neural tube defects.Methodology: After collection of the venous blood the same was immediately centrifuged and after immediate centrifugation, the clear serum was transferred to deionized plastic vials, stored and frozen at –20º C until determination of the analysis was carried out. The selenium levels as ng/ml were determined on GBC 932 spectrophotometer by fluorometery.Results: The mean maternal blood serum and cell mass concentrations in NTD group (306.4 ± 10.95 ng/ml, 192.44 ± 6.12 ng/ml, 165.8 ± 16.99 ng/g respectively) were significantly lower than those of control mothers (363.75 ± 17.1 ng/ml, 242.34 ± 15.7 ng/ml, 260.0 ± 20.57 respectively). A significant decrease in concentration of selenium in newborns with NTD (298.4 ± 12.3 ng/ml, 96.3 ± 7.15 ng/ml, 139.8 ± 27.5 ng/g respectively) as compared with healthy babies (358.1 ± 16.11 ng/ml, 122.44 ± 6.03 ng/ml, 268.6 ± 31.37 ng/g respectively).Conclusion: Selenium deficiency in mothers during pregnancy thought to be one of the factors responsible for NTDs. However, the lowered selenium concentrations in blood, serum and cell mass can be secondary cause of an abnormal pregnancy and didn’t contribute to its production. More investigations on selenium status in mothers during antenatal period, especially in prenatal development and antenatal selenium status including normal babies and NTD babies are required.DOI: http://dx.doi.org/10.3126/ajms.v6i2.11151Asian Journal of Medical Sciences Vol.6(2) 2015 62-65

Altered expression of placental microRNAs in folate deficient teenage mothers

Altered expression of placental microRNAs in folate deficient teenage mothers

Asymptomatic maternal 3-methylcrotonylglycinuria detected by her unaffected baby's neonatal screening test.

3-methylcrotonyl-coenzyme A carboxylase (3MCC) deficiency is an autosomal recessive disorder in which leucine catabolism is hampered, leading to increased urinary excretion of 3-methylcrotonylglycine. In addition, 3-hydroxyisovalerylcarnitine levels increase in the blood, and the elevated levels form the basis of neonatal screening. 3MCC deficiency symptoms are variable, ranging from neonatal onset with severe neurological abnormality to a normal, asymptomatic phenotype. Although 3MCC deficiency was previously considered to be rare, it has been found to be one of the most common metabolic disorders in newborns after the neonatal screening test using tandem mass spectrometry was introduced. Additionally, asymptomatic 3MCC deficient mothers have been identified due to abnormal results of unaffected baby's neonatal screening test. Some of the 3MCC-deficient mothers show symptoms such as fatigue, myopathy, or metabolic crisis with febrile illnesses. In the current study, we identified an asymptomatic 3MCC deficient mother when she showed abnormal results during a neonatal screening test of a healthy infant.

Prevalence of iodine deficiency among pregnant and lactating women: Experience in Kolkata.

Objective:The cross-sectional study was carried out to assess the iodine status of pregnant and lactating mothers, using median urinary iodine excretion (UIE) as the measure of outcome, to document the prevalence of iodine deficiency.Materials and Methods:The present study assessed the UIE in the morning urine samples from 237 pregnant women, 73 lactating mothers and 59 healthy non-pregnant female controls.Results:Out of 237 pregnant women, 88 (37%) exhibited insufficient iodine nutrition (UIE < 150 μg/l), out of 73 lactating mothers, 24 (33%) exhibited insufficient iodine nutrition (UIE < 100 μg/l) and only 3% female control subjects exhibited insufficient iodine nutrition (UIE < 100μg/l). Additionally, a number (32.3%) of babies born of iodine deficient mothers had respiratory distress at birth.Conclusion:It appears that the present salt iodination program is adequate for the general population but insufficient for the pregnant and lactating mothers. They need to be targeted with iodine supplements throughout pregnancy and lactation. Increased incidence of respiratory distress in the new born of iodine deficient mothers merits further study.

Fisiopatología e impacto de la deficiencia de hierro y la anemia en las mujeres gestantes y en los recién nacidos/infantes

La deficiencia de hierro es el trastorno de deficiencia más prevalente; y la anemia por deficiencia de hierro es la forma de anemia más frecuente en las mujeres gestantes. Son causas menores de la anemia la deficiencia de folato y de la vitamina B12; así como las hemoglobinopatías y la anemia hemolítica. Se define a la anemia como niveles de hemoglobina &lt;110 g/L en el primer y en el tercer trimestre y &lt;105 g/L en el segundo trimestre de la gestación. El diagnóstico se basa en la medición de los valores de la hemoglobina, así como en un perfil hematológico completo y la determinación de los niveles plasmáticos de ferritina, los cuales pueden sustentarse en la saturación de la transferrina en el plasma y el receptor soluble de transferrina en el suero (sTfR, soluble transferrin receptor). En las mujeres no gestantes en edad reproductiva, un 40% tiene valores de ferritina por debajo de 30 μg/L, lo cual indica que las reservas de hierro o son pequeñas o están ausentes; y, en consecuencia, tienen un pobre nivel del hierro con respecto a un embarazo futuro. Los requerimientos para la absorción del hierro aumentan durante la gestación, de 0,8 mg/día en el primer trimestre a 7,5 mg/día en el tercer trimestre, siendo el promedio 4,4 mg/día. En cuanto a la edad reproductiva, un 40% de las mujeres en Escandinavia y posiblemente hasta un 80% de las mujeres peruanas (dependiendo de su condición social y su lugar de residencia) tienen niveles bajos de hierro con respecto a un embarazo futuro. En el Perú, la prevalencia de la anemia en las mujeres no gestantes de edad reproductiva es 22%, y en las mujeres gestantes es de 27%. La prevalencia de la anemia en el tercer trimestre puede variar desde 14 hasta 52% en las mujeres que no toman suplementos de hierro (dependiendo del país y de la condición social); y de 0 a 25% en las mujeres que toman suplementos de hierro (dependiendo de las dosis del citado elemento). La deficiencia de hierro y la anemia poseen consecuencias severas en las mujeres gestantes, estando asociadas con una menor capacidad para trabajar, fatiga, debilidad y disturbios psíquicos, condiciones que en su totalidad afectan la calidad de vida tanto a nivel físico como psíquico. En el feto/en el recién nacido la deficiencia de hierro puede tener consecuencias serias para el desarrollo de las funciones cerebrales. Incrementa la prevalencia de nacimientos prematuros y la frecuencia de peso bajo al nacer, así como la mortalidad perinatal. Los niños nacidos de madres con deficiencia de hierro tienen un menor desarrollo cognitivo, motor, socio-emocional y neurofisiológico, así como menores valores del cociente de inteligencia en comparación con los infantes y niños nacidos de madres con niveles normales de hierro. La anemia por deficiencia de hierro posee consecuencias serias en las mujeres y en los fetos/neonatos; y requiere una intervención eficiente con una profilaxis y/o tratamiento con hierro. En el futuro, los sistemas de cuidado de la salud prenatal deberán dedicar más esfuerzos para erradicar este problema tan significativo. Palabras clave: Anemia; deficiencia de hierro; embarazo.

Spatial memory deficits in maternal iron deficiency paradigms are associated with altered glucocorticoid levels

"The goal of this study was to examine the effect of maternal iron deficiency on the developing hippocampus in order to define a developmental window for this effect, and to see whether iron deficiency causes changes in glucocorticoid levels. The study was carried out using pre-natal, post-natal, and pre+post-natal iron deficiency paradigm. Iron deficient pregnant dams and their pups displayed elevated corticosterone which, in turn, differentially affected glucocorticoid receptor (GR) expression in the CA1 and the dentate gyrus. Brain Derived Neurotrophic Factor (BDNF) was reduced in the hippocampi of pups following elevated corticosterone levels. Reduced neurogenesis at P7 was seen in pups born to iron deficient mothers, and these pups had reduced numbers of hippocampal pyramidal and granule cells as adults. Hippocampal subdivision volumes also were altered. The structural and molecular defects in the pups were correlated with radial arm maze performance; reference memory function was especially affected. Pups from dams that were iron deficient throughout pregnancy and lactation displayed the complete spectrum of defects, while pups from dams that were iron deficient only during pregnancy or during lactation displayed subsets of defects. These findings show that maternal iron deficiency is associated with altered levels of corticosterone and GR expression, and with spatial memory deficits in their pups."

A Phenomenological Study on the Experiences of Parenting Burden of Working Mother with Young Children in Korea.

The purpose of this study was to describe the essential structure of the lived experience of working mothers' parenting burden in Korea. Eight working mothers with young children were interviewed. The Colaizzi analysis of phenomenological research was applied. Seven theme clusters were extracted: a life with constant conflict, sense of guilt, feeling anxious because of lack of information about education for their children, social stigma as a deficient mother, family relationship becoming distant, a life being exhausted, day to day struggle. These results provide an opportunity to have a better understanding of the experiences of working mothers related to parenting their young children. It would also serve as a medium for the formulation of appropriate nursing intervention relevant to burdens of parenthood.

Cohort study for prevention of atopic dermatitis using hair mineral contents

We undertook a cohort study to determine the association between hair mineral content and the onset of atopic dermatitis (AD) in infants. Eight hundred and thirty-four mother–infant pairs, who donated hair samples during one and ten-month health checkups, had their samples analyzed by proton induced X-ray emission (PIXE) for 32 mineral concentrations, and these mineral concentration data together with their AD family history were statistically examined for any relationships between them. Results indicated that of all minerals, only selenium (Se) and strontium (Sr) showed statistically significant associations for infants, while the same two elements were only marginally significant for mothers. Se deficiency in either infant or mother increased the AD risk. A Sr deficiency in infants increased AD risk, while the same deficiency in mothers decreased the risk. To predict the probability of AD development using this data, we performed logistic regression analysis, which provided a sensitivity of 65.9%, a specificity of 70.5%, a positive predictive value (PPV) of 10.3%, a negative predictive value (NPV) of 97.6% and a relative risk (RR) of 4.2, all far better than any corresponding figures explicitly mentioned in previously published papers.

1349 Treating Infants of Vitamin D Deficient Mothers - is Routine Supplementation with Abidec Alone Sufficient

Background and AimsInfants with maternal vitamin D deficiency are at increased risk of low vitamin D levels. Cholecalciferol is the usual treatment for such infants. We wanted to see whether...

763 Vitamin B12 and Folate Deficiency in Healthy Neonates and their Mothers

Background and AimWe aimed to determine the incidence of vitamin B12 and folate deficiency in healthy neonates and their mothers; to show the correlation between maternal and neonatal B12 and...

Vitamin D and Bone Health in Childhood and Adolescence

Vitamin D plays a key role in bone metabolism. The link between vitamin D deficiency and rickets is well understood. However, subclinical vitamin D deficiency may also be detrimental to bone health in childhood. Its effects on bone mineralization have the potential to result in lower peak bone mass being attained, which could in turn contribute to increased fracture risk in both childhood and older adult life. As vitamin D deficiency is common globally, any detrimental effects of vitamin D deficiency on bone health are likely to have substantial public health implications. This review describes the current literature relevant to vitamin D and bone health in childhood and adolescence, with a particular emphasis on evaluating the emerging evidence for the impact of subclinical vitamin D deficiency on bone health and the effectiveness of vitamin D supplementation. The evidence suggests that subclinical vitamin D deficiency does affect bone acquisition, potentially beginning in utero and extending into adolescence. However, the effectiveness of vitamin D supplementation for improving bone health in situations of subclinical deficiency remains unclear, particularly in early life where there are few trials with bone density outcomes. The available evidence suggests that benefits are likely to be greatest in or even restricted to children with serum 25-hydroxyvitamin D levels at least below 50 nmol/L and possibly even lower than this. Trials of sufficient duration in deficient pregnant mothers, infants, and children are urgently required to address critical evidence gaps.

Prevalence and associated risk factors for Vitamin K deficiency in mothers and their newborn babies in an East African setting

Introduction Vitamin K deficiency bleeding remains a serious but preventable problem worldwide with a high risk of mortality or permanent disability especially among exclusively breastfeeding infants. This was a cross sectional hospital based study to determine the prevalence and describe the associated risk factors for vitamin K deficiency in mothers and their newborn babies which has not been reported from Africa before. Methods Eligible Mothers delivering from April 2010 to August 2010 between 8 am and 8 pm were consecutively enrolled in the study with ethical clearance and informed consent. Specific maternal and newborn characteristics were assessed. 2 ml of maternal venous blood and neonatal cord blood were each collected at birth, processed and serum analysed for Protein Induced by Vitamin K Absence (PIVKA II). Vitamin K deficiency was defined as a detectable PIVKA II of greater than or equal to 0.2 AU/ml. The significance of association between various maternal and newborn characteristics with vitamin K deficiency was assessed using the Chi-squared (X2) test and the strength of association determined using univariate logistic regression. Results Forty seven (33.3%) out of the 141 mothers in the study were vitamin K deficient. Up to 65% of the babies in the study had a detectable PIVKA II with 22% having clinically significant PIVKA II levels (> 5.0 AU/ml). Eating beans or fried foods less than five times a week was associated with lower odds of vitamin K deficiency in mothers (ORs = 0.46 and 0.13 respectively). These relationships were statistically significant (p-values 0.0380 and 0.003). We found no correlation between maternal and newborn vitamin K status. Conclusions Vitamin K deficiency is highly prevalent among newborn babies and pregnant mothers in the population studied. The lack of correlation between maternal and newborn vitamin K status leaves routine vitamin K prophylaxis to all newborn babies at birth as the effective and preventive remedy to vitamin K deficiency bleeding in infants.

B Vitamins in Breast Milk: Relative Importance of Maternal Status and Intake, and Effects on Infant Status and function

Infants should be exclusively breastfed for the first 6 mo of life. However, maternal deficiency of some micronutrients, conveniently classified as Group I micronutrients during lactation, can result in low concentrations in breast milk and subsequent infant deficiency preventable by improving maternal status. This article uses thiamin, riboflavin, vitamin B-6, vitamin B-12, and choline as examples and reviews the evidence for risk of inadequate intakes by infants in the first 6 mo of life. Folate, a Group II micronutrient, is included for comparison. Information is presented on forms and concentrations in human milk, analytical methods, the basis of current recommended intakes for infants and lactating women, and effects of maternal supplementation. From reports of maternal and/or infant deficiency, concentrations in milk were noted as well as any consequences for infant function. These milk values were used to estimate the percent of recommended daily intake that infants fed by a deficient mother could obtain from her milk. Estimates were 60% for thiamin, 53% for riboflavin, 80% for vitamin B-6, 16% for vitamin B-12, and 56% for choline. Lack of data limits the accuracy and generalizability of these conclusions, but the overall picture that emerges is consistent across nutrients and points to an urgent need to improve the information available on breast milk quality.

Prevention of vitamin D deficiency in mothers and infants worldwide — a paradigm shift

Vitamin D deficiency in mothers and infants is a global health disorder despite recognition that it is preventable. Recent data support the theory that vitamin D deficiency in adults and children may increase the risk of infections and auto-immune diseases. In most cases, vitamin D deficiency is caused by sunlight deprivation and inadequate corrective vitamin D intake. There is a strong mother/infant vitamin D relationship that affects vitamin D status both in utero and in infancy. Recognition that vitamin D deficiency is a worldwide mother/infant health problem is a basis on which to modify public health strategies to reduce the burden of disease and improve maternal and child vitamin D nutrition. This review provides an update on vitamin D function and the global scope and implications of vitamin D deficiency as it relates to pregnancy and infancy. It also addresses a combined strategy to prevent vitamin D deficiency during pregnancy, lactation and infancy.

Vitamin B12 and folate statuses are associated with diet in pregnant women, but not with anthropometric measurements in term newborns

Objective: To investigate the frequencies of vitamin B12 and folate deficiencies in pregnant women in low socioeconomic group, the relation between the animal-source foods consumption and maternal vitamin B12-folate statuses, and their impacts on anthropometric measurements of the infants. Methods: A total of 208 pregnant women in the last trimester were included in the study. A questionnaire about socio-demographic status, consumption of meat, egg, milk-dairy products, multivitamin supplementation was used. Vitamin B12 and folate concentrations were studied by chemiluminescence method. The babies of Vitamin B12 deficient mothers were evaluated after birth. Results: The rate of vitamin B12 deficiency was 47.6% and folate deficiency was 17.3% of pregnant women. Animal food consumption was inadequate about half of pregnant women and vitamin B12 levels in these women were significantly low. There were no statistically significant relationships between the birth weight, birth length and head circumference measurements, and maternal vitamin B12 and folate concentrations. Conclusion: The rate of vitamin B12 deficiency in pregnant women in low socioeconomic population is high. Although there were no significant effects of the vitamin B12 and folate deficiencies on birth size, additional studies are required to elucidate the subsequent effects.

Vitamin D3 deficiency enhances allergen‐induced lymphocyte responses in a mouse model of allergic airway disease

There is debate as to whether vitamin D deficiency contributes towards the extent of the asthma epidemic. In this study, using a mouse model, we determined whether vitamin D deficiency in utero and during early life modulated the severity of asthma. Using dietary restriction, vitamin D(3) -replete and vitamin D(3) -deficient colonies of BALB/c mice were established. Utilizing the allergic airway disease model of asthma with the experimental allergen ovalbumin (OVA), we examined asthma-like responses 24 h after airway challenge with OVA in adult offspring born to vitamin D(3) -replete and vitamin D(3) -deficient mothers. The ability of airway-draining lymph node cells to proliferate and secrete cytokines in response to OVA ex vivo was significantly enhanced by vitamin D(3) deficiency. However, other aspects of allergic disease, including the numbers and proportions of inflammatory cells and cytokines in the lungs and the quantity of OVA-specific IgE in serum, were not modified. These results suggest that vitamin D(3) deficiency modulates the capacity of lymphocytes to respond to allergens.

Preeclampsia Rates are Elevated during Winter Month when Sunlight Dependent Vitamin D Production is reduced

Aim: To assess maternal vitamin D deficiency in early pregnancy and risk of preeclampsia. Settings and Design: Nested case control study. Two maternal blood samples, one at <20 wks and other at term along with cord blood at delivery were taken. Patients were classified into preeclampsia (n=57) and control group (n=178) after abstracting past medical records at delivery. Methods and material: Vitamin D was estimated by 25-Hydroxyvitamin D 125 I RIA Kit and categorized according to ACOG criteria. Statistical analysis used: Pearson χ2, ANOVA and logistic regression were used. Linear correlation and regression coefficient was used between maternal 25(OH) D at <20 wks and term and cord serum 25(OH) D levels. Results: Serum 25(OH)D concentrations in early pregnancy were 56% significantly lower in women who subsequently developed preeclampsia compared with controls [mean, 9.79 ± 4.09 ng/ml , 95% CI, 8.71–10.88 ng/ml, vs 22.26 ± 15.28 ng/ml, 95%CI, 20.0 -24.52 ng/ml, P <0.001] independent of age, BMI, calcium intake, socioeconomic status, periconceptional multivitamin use, residence. There was 17 times increased risk of preeclampsia in vitamin D deficient mothers compared to controls at early pregnancy and at term. (P<0.001; rr = 17.93). Newborns of preeclampsia mothers were more than three times as likely as newborns of controls to have hypovitaminosis D (relative risk 3.55) Conclusions: Maternal vitamin D deficiency is highly prevalent in early pregnancy and is an independent risk factor for preeclampsia

The biological reaction of arterial pressure and pathogenesis of programmed arterial hypertension

Phylogenetically, the following scheme is relevant in vivo: cell → cell community → structural unit of an organ → organ → organ system. A paracrine-regulated cell community is a structural and functional unit of an internal organ; the nephron composed of renal capillary, afferent (efferent) muscular arteriole, and paratubular loose connective tissue is the basic unit of the kidney. In primates the nephron is induced from three germ layers within the first 16 weeks of embryogenesis, which is followed by nephron development during prenatal period; neonephrogenesis does not occur in the postnatal period. Impaired biological function of exotrophy, protein deficiency in mother's diet, and glucocorticoid therapy reduce the number of nephrons, which is reflected by low body weight of the newborn. If a newborn weights less than 2,5 kg, the number of nephrons is so small that they cannot provide the biological function of endoecology in adults without compensatory hypertrophy, which leads to the hydrodynamic pressure elevation in the arterial bed over glomerular filter and increased glomerular filtration. However, hypertrophy is not optimal for compensation of the nephron function. Low body weight at birth and small number of nephrons are risk factors of programmed arterial hypertension in an adult organism.