Deficiency In Pregnant Women Research Articles

Evidence of the functions of vitamin D in pregnant women in COVID-19: a systematic review

Introduction: In the world, about 1 million people suffer from vitamin D deficiency. Vitamin D deficiency in pregnant women increases maternal mortality and morbidity rates. In the scenario of COVID-19, it is known that the immune response, inflammation, and coagulation are modulated by vitamin D activity. Objective: It was to analyze the main considerations of the effects of vitamin D on pregnant women and fetuses in the scenario of COVID-19, presenting the mechanisms of inflammatory and immunological processes in an attempt to mitigate the worsening of comorbidities and deaths. Methods: The systematic review rules of the PRISMA Platform were followed. The research was carried out from September to October 2022 in Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 210 articles were found, 82 articles were evaluated and 32 were included in this systematic review. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 28 studies with a high risk of bias and 28 studies that did not meet GRADE. Most studies showed homogeneity in their results, with I2 =98.9% >50%. There is a relationship between vitamin D status and the severity of COVID-19 in pregnant women. Vitamin D levels are low in pregnant women with COVID-19. Furthermore, there is a significant difference regarding the level of vitamin D and the severity of COVID-19 in pregnant women. Maintaining adequate vitamin D levels may be useful as an approach to preventing an aggressive course of inflammation induced by this novel coronavirus in pregnant women.

Iodine status of pregnant women in iodine-sufficient regions: A tertiary care unit experience.

The recommended urinary iodine concentration (UIC) levels in the overall adult population is 100-199 μg/L whereas 150-249 μg/L in pregnant women. The objective is to determine the prevalence and severity of iodine deficiency in pregnant women in Amasya, which is located in the Western Black Sea region in Turkey, where sufficient iodine levels were achieved in the normal population. In this single-center study, we retrospectively searched hospital patient records and identified pregnant women who were assessed for iodine levels between January 2019 and January 2021. A total of 408 pregnant women were found eligible for the study. Thyroid-stimulating hormone (TSH), free triiodothyronine, free thyroxine, antithyroid peroxidase antibodies, and antithyroglobulin antibodies in serum samples and UIC were evaluated and compared between the trimesters. Insufficient iodine intake in pregnancy was defined as UIC <150 μg/L. Median UIC and median TSH levels were 129 (range 45-452) μg/L and 2.98 (range 0.01-71.2) μIU/ml, respectively. 81.1% of pregnant women had UIC <150 μg/L. Iodine intake was adequate in 17.4% of pregnant whereas excessive in 1.5%. Prevalence of iodine deficiency during 1st, 2nd, and 3rd trimesters were 82.1%, 82.4%, and 74.5%, respectively. There was no significant difference in UIC levels between trimesters (P = 0.399). 72.9% of pregnant womens had TSH >2.5 mIU/L in the 1st trimester. Iodine deficiency in pregnancy may exist in an iodine-sufficient population. Appropriate measures must be taken to ensure sufficient iodine levels in these individuals.

Effect of maternal haemoglobin, serum ferritin and gestational age on neonatal iron indices

Background: Iron is the most common micronutrient deficiency in pregnant women and infants throughout the world, mainly in developing countries like India. 30 to 50% of the pregnancies are affected by maternal iron deficiency and in developing countries, more than 80% of the pregnant women are estimated to be anemic. The effects of perinatal iron deficiency are anemia and most importantly neurodevelopmental impairments which are long-lasting and sometimes irreversible. The main goal of this study was to determine the influence of maternal and neonatal factors on the iron stores in neonates and to estimate the appropriate time to supplement iron for neonates in different scenarios. Methods: This is a prospective observational study. Mother-infant pairs were enrolled in the study by following specific inclusion and exclusion criteria. Maternal demographic details, complications during pregnancy, intrapartum details, and neonatal details were recorded. The maternal and cord blood samples were collected for measurement of hemoglobin, serum ferritin, serum iron, total iron-binding capacity, and transferrin saturation. If failed to collect the cord blood sample, the first 24hour sample of the baby was taken into consideration in place of it. The correlation between maternal neonatal iron indices and the influence of the gestational age and IUGR on cord serum ferritin levels was analyzed by using paired t-test and chi-square test for multiple groups. A probability of p&lt;0.05 (two-sided) was used to consider the difference as significant. Results: 125 term and 47 preterm neonates were included in the study. There was correlation between maternal and neonatal iron profiles at birth when there was severe depletion of maternal ferritin (&lt;12µg/dl) with p values less than 0.05 for hemoglobin and serum ferritn levels. Serum ferritin levels at birth were less in preterm as compared to term neonates (mean of 128.9µg/l in the preterm vs. 156.9µg/l in the term, p=0.04). There was a significant correlation between neonatal iron indices at birth with that at 28 days of life (p&lt;0.01). Conclusions: Neonatal iron stores are not affected unless there was severe depletion of maternal iron stores. Preterm neonates have low iron stores compared to term neonates. Gestational age is the major determinant for iron stores at birth as compared to other maternal and neonatal factors. As the most significant adverse effects of iron deficiency are irreversible and long-lasting neurodevelopmental impairments. The term and preterm babies should take prophylactic iron from eight weeks and four weeks of age respectively and continued up to the introduction of iron-fortified cereals as recommended by the American academy of paediatrics.

Prevalence and management of vitamin D deficiency in pregnant women in India: A physician survey

Background: Vitamin D deficiency in pregnancy has important maternal and foetal implications. Aim: This survey was conducted to understand gynaecologists’ perspectives on the prevalence of and management practices for vitamin D deficiency in pregnant women in India. Methods: This was a questionnaire-based survey conducted across India between October 2021 and December 2021. The questionnaire consisted of 30 questions related to the prevalence and management practices related to vitamin D deficiency among pregnant women. Results: In total, 39 gynaecologists participated in the study. Vitamin D was recommended to women during pre-conceptual counselling by 82.1% of the gynaecologists. One-third (33.4%) gynaecologists observed that >75% of pregnant women in their clinical practice had vitamin D deficiency, with the women aged >30 years being most likely to have this deficiency. Low back pain and vague body pain were the most common symptoms of vitamin D deficiency observed among pregnant women. Daily 2000 IU as continuous therapy was the most common regimen of vitamin D supplementation preferred by the participating gynaecologists (64.1%), followed by weekly 60,000 IU with monthly maintenance by 10 (25.6%) gynaecologists. Two-third gynaecologists 25 (64.1%) shared that

Inhibition of LAMP3 mediates the protective effect of vitamin D against hypoxia/reoxygenation in trophoblast cells.

Inadequate invasion and excessive apoptosis of trophoblast cells are associated with the development of preeclampsia. Vitamin D deficiency in pregnant women may lead to an increased risk of preeclampsia. However, the underlying mechanisms by which vitamin D is effective in preventing preeclampsia are not fully understood. The objectives of this study were to investigate the role of lysosome-associated membrane glycoprotein 3 (LAMP3) in the pathogenesis of preeclampsia and to evaluate whether vitamin D supplementation would protect against the development of preeclampsia by regulating LAMP3 expression. Firstly, the mRNA and protein levels of LAMP3 were significantly upregulated in the placentas of preeclampsia patients compared to normal placentas, especially in trophoblast cells (a key component of the human placenta). In the hypoxia/reoxygenation (H/R)-exposed HTR-8/Svneo trophoblast cells, LAMP3 expression was also upregulated. H/R exposure repressed cell viability and invasion and increased apoptosis of trophoblast cells. siRNA-mediated knockdown of LAMP3 increased cell viability and invasion and suppressed apoptosis of H/R-exposed trophoblast cells. We further found that 1,25(OH)2D3 (the hormonally active form of vitamin D) treatment reduced LAMP3 expression in H/R exposed trophoblast cells. In addition, 1,25(OH)2D3 treatment promoted cell viability and invasion and inhibited apoptosis of H/R-exposed trophoblast cells. Notably, overexpression of LAMP3 abrogated the protective effect of 1,25(OH)2D3 on H/R-exposed trophoblast cells. Collectively, we demonstrated trophoblast cytoprotection by vitamin D, a process mediated via LAMP3.

Thrombin Generation Decrease After LMWH Administration in an Antithrombin-Deficient Pregnant Woman With a Homozygous HBS II Mutation.

The cases of antithrombin (AT)-deficient pregnant women with a homozygous HBS II mutation are relatively rare and are accompanied by an increased thrombophilic risk, which is manifested by increased thrombin generation (TG). It is very difficult to ensure their prophylactic treatment during pregnancy. We aimed to determine the utility of the thrombin generation assay (TGA) and anti-factor Xa (anti-FXa) test to monitor the effects of a prophylactic dose of low-molecular-weight heparin (LMWH) in a 28-year-old woman with homozygous AT deficiency caused by mutation c.391C > T#, (p.Leu131Phe†) in the SERPINC1 gene and to compare the findings with those from a group of pregnant and non-pregnant women also treated with LMWH. TG monitoring was chosen due to severe AT deficiency that was manifested by low levels of anti-FXa activity when monitoring the efficacy of LMWH treatment. A significant decrease in TG was detected in all monitored groups (P < .05). There were no thrombotic complications during the whole pregnancy of the woman with AT deficiency. Consistent monitoring of TG with LMWH anticoagulant therapy administration during pregnancy together with AT administration before and after delivery may improve the overall condition of pregnant women and the quality of their care.

Immuno-hormonal and dopplerometric characteristics of placental insufficiency in pregnant women with exacerbation of chronic bronchitis associated with reactivation of cytomegalovirus infection

Aim. To give immune-hormonal and dopplerometric characteristics of placental insufficiency in pregnant women with exacerbation of chronic bronchitis associated with reactivation of cytomegalovirus infection (CMVI).Ma­terials and methods. The concentration of IL-ie, IL-2 and progesterone was studied in the blood serum, and the pulsation index (PI) in the right uterine artery (RUA) was determined in 80 patients at 21-24 weeks of gestation, uncomplicated and complicated by exacerbation of chronic simple bronchitis due to reactivation of CMVI. In a retrospective analysis, 3 groups were formed. The first group - 30 women with CMV-seronegative physiological pregnancy; the second - 25 patients with chronic bronchitis in the acute stage, initiated by the acute phase of CMVI, leading to chronic compensated placental in­sufficiency (CCPI); the third - 25 women with exacerbation of chronic bronchitis CMVI etiology, causing the development of chronic subcompensated placental insufficiency (CSPI) in the third trimester of gestation.Results. In the first group, the concentration of IL-ie was 22.8±0.02 pg/mL, IL-2 - 30.6±2.34 pg/mL, progesterone - 130.8±8.19 nmol/L, and the value of PI in RUA - 0.83±0.04 rel. units. In patients of the second group, compared with the first, the level of IL-ie in­creased by 3.82 times (p&lt;0.00i), IL-2 - by 2.55 times (p&lt;0.00i) and PI in the RUA - by i.40 times (p&lt;0.00i) against the background of a decrease in the progesterone concentration by i.47 times (p&lt;0.00i). The third group compared with the first was characterized by an increase in the concentration of IL-ie by 6.87 times (p&lt;0.001), IL-2 - by 3.19 times (p&lt;0.001) and PI in RUA by i.66 times (p&lt;0.00i) with lower levels of progesterone (i.93 times, p&lt;0.00i). In the third group, in contrast to the second one, an increase in IL-ie was observed by 1.79 times (p&lt;0.001), IL-2 - by 1.24 times (p&lt;0.05) and PI in RUA - by i.i7 times (p&lt;0.05), as well as a decrease in progesterone levels by i.3i times (p&lt;0.0i). There was an in­crease in the relationship of PI in RUA with the concentration of IL-ie (r=0.69; p&lt;0.001), IL-2 (r=0.75; p&lt;0.001) and progesterone (r=-0.55; p&lt;0.01).Conclusion. A more pronounced systemic inflammatory reaction, leading to inhibition of progesterone synthesis and increased resistance to blood flow at RUA develops in exacerbation of chronic bronchitis in the second trimester of gestation against the background of reactivation of CMVI, which initiates the development of CCPI, in comparison with the exacerbation of bronchopulmonary pathology of a similar etiology, which determines the formation of subsequent CCPI.

The Relationship Between Trimester 3 Anemia Status and Chronic Energy Deficiency In Pregnant Women with Low Birth Weight Incidence

Background Low birth weight (LBW) is a newborn whose birth weight is &lt; 2500 grams. There are several factors that can influence the occurrence of LBW, among others, 3rd trimester anemia, chronic energy deficiency (CED), and those who experience 3rd trimester anemia and CED, and the characteristics of pregnant women.&#x0D; Objective This study aims to analyze the relationship between pregnant women with 3rd trimester anemia, CED and pregnant women with 3rd trimester anemia and KEK with the incidence of LBW.&#x0D; Methods This study uses a descriptive quantitative design. The sample of this research was taken by purposive sampling. Then in univariate analysis, bivariate analysis using Chi Square test and multivariate analysis using multiple logistic regression.&#x0D; Results In this study, it was found that there was a relationship between anemia in the 3rd trimester and the incidence of LBW with a p value of 0.000, there was a significant relationship between pregnant women who experienced CED and the incidence of LBW with a p value of 0.000. However, there is no relationship between pregnant women who experience third trimester anemia and CED simultaneously with the incidence of LBW. From the characteristics of pregnant women, there is a relationship between the age of pregnant women with the incidence of LBW with a p value of 0.043 and the gestational age with the incidence of LBW with a p value of 0.01&#x0D; Conclusion From this study, it was concluded that there are 4 factors that influence the occurrence of LBW, which are third trimester anemia, CED, maternal age and gestational age.&#x0D; &#x0D; Key words : Anemia, Chronic Energy Deficiency, low birth weight, Pregnant mother

PENERAPAN MODEL PEMBERDAYAAN KELOMPOK IBU HAMIL DALAM UPAYA PREVENTIF ANEMIA PADA KEHAMILAN DI WILAYAH PUSKESMAS MANGASA KECAMATAN RAPPOCINI KOTA MAKASSAR

ABSTRACTAnemia during pregnancy is not only a public health problem, although it is a result of physiological conditions in general view, but if it does not get adequate attention, it can cause conditions that endanger health during pregnancy. Ignorance of the public, especially pregnant women, regarding the need for food intake and the importance of consuming Fe, as well as the importance of screening for the possibility of infection, is one of the causes of anemia which until now has not been successfully reduced. The results of the analysis of the situation in the Mangasa Community Health Center with a prevalence of nutritionally deficient pregnant women reaching 13% of all registered pregnant women during 2022. Increasing public awareness requires approaches and cultivation in various disciplines, both technical health, technical production, socio-culture to be the right solution . Community service independently is the implementation of research results that have been carried out using educational methods with the target of empowering groups of pregnant women in an effort to prevent anemia during pregnancy as an effective strategy in increasing public awareness. The results of the final evaluation of the activity turned out to be able to increase knowledge on an average of 4.1±10.64 points, and change negative attitudes towards a more positive one to achieve a pattern of consuming nutritious food and an average Fe consumption pattern of 5.1±13.8 points. It is suggested the need for continuous education about nutrition during pregnancy and the pattern of Fe consumption until delivery.

GAMBARAN HEMOGLOBIN IBU HAMIL DI UPTD PUSKESMAS III DINAS KESEHATANKECAMATAN DENPASAR UTARA TAHUN 2022

Background: Hemoglobin deficiency in pregnant women is one of the health issues that can occur during the pregnancy. Anemia is more common in pregnant women because they require more oxygen, which causes an increase in erythropoietin production. The risk of anemia is connected to hemoglobin levels in pregnant women, with hemoglobin levels of less than 11 g/dl being classified low. Premature labor, miscarriage, extended labor, uterine atony, hemorrhage, and shock are all risks of anemia during pregnancy. Methods: The study used a descriptive design with a sample population of 34 pregnant women. Results: Hemoglobin levels in 22 pregnant women (64.7%) were relatively low, with the majority of them coming onto an age category of not at risk 18 people (81.8%), second trimester age 9 pregnant women (40.9%), pregnancy distance 13 pregnant women (59.1%), and parity 16 pregnant women (72.7%). Conclusion: The majority of pregnant women at UPTD PUSKESMAS III North Denpasar District Health Office have low hemoglobin levels.

Association between 25-OH Vitamin D Deficiency and COVID-19 Severity in Pregnant Women.

Evidence from studies in the general population suggests an association between vitamin D insufficiency/deficiency and COVID-19 susceptibility and disease severity. The present study was performed on 165 third-trimester pregnant women at the time of delivery. Seventy-nine women tested negative for SARS-CoV-2. From 86 women testing positive, 32 were asymptomatic, 44 presented a mild form of the disease, and 10 experienced severe symptoms. Serum 25-OH vitamin D levels were measured on blood samples collected on admission. Low vitamin D levels were detected in symptomatic but not asymptomatic COVID-19 patients compared to healthy women (p = 0.0227). In addition, 20 (45.4%) pregnant women in the mild COVID-19 group and 6 (60%) in the severe group were vitamin D deficient (p = 0.030). On the other hand, lasso regression analysis showed that 25-OH vitamin D deficiency is an independent predictor of severe COVID-19 with an odds ratio (OR) of 5.81 (95% CI: 1.108-30.541; p = 0.037). These results show the relationship between vitamin D deficiency in pregnant women and the severity of COVID-19 infection and support the recommendation to supplement with vitamin D to avoid worse COVID-19 outcomes during pregnancy.

The Influence Of Preconceptional Nutrition Counseling On Knowledge And Attitude Of Women Of Reproductive Age

Background : Health problems in the preconception period include anemia, obesity and chronic lack of energy. In Indonesia, cases of Chronic Energy Deficiency are caused by lack of nutritional intake such as energy and protein, so that the nutrients needed by the body are not fulfilled. To prevent the risk of Chronic Energy Deficiency in pregnant women before pregnancy, women of childbearing age must have good nutrition. Maternal nutritional status before pregnancy has a significant influence on the incidence of LBW. Knowledge of nutrition plays an important role in fulfilling one's nutritional adequacy. The level of knowledge will encourage a person to have optimal abilities in the form of knowledge and attitudes. Objective : Knowing the effect of preconception nutrition counseling on the knowledge and attitudes of women of childbearing age. Methods : Quasi experimental with one group pretest-posttest design. The sample in this study was some women of childbearing age who were married in the preconception period from July to September 2022 in Sanggar Buana Village, Seputih Banyak District, Central Lampung as many as 81 people, the sampling technique was purposive sampling. Results : Most of them have knowledge of WUS before being given counseling that is enough 64.2% and after 85.2% have good knowledge. Attitudes before being given counseling were mostly negative 55.6% and afterward were positive 97.5%. There is an effect of preconception nutrition counseling on the knowledge and attitudes of women of childbearing age (p value 0.000). Conclusions and Suggestions: There is an effect of preconception nutrition counseling on the knowledge and attitudes of women of childbearing age. Health services are expected to provide education and counseling, especially regarding preconception nutrition

Systematic Review: The Benefit of Vitamin D Supplementation During Pregnancy

World Health Organization (WHO) states vitamin D deficiency in pregnant women is still high and recognized as a global problem. Vitamin D supplementation can support increasing vitamin D status for pregnant women and babies. This study aims to know the importance of vitamin D during pregnancy and its benefits for pregnant women and their babies. A systematic review of Randomized Controlled Trials (RCT) used PubMed, Science Direct, and Springer Link databases. The determination flow article used the PRISMA diagram. The total number of articles reviewed is four articles. The result has obtained that vitamin D has several benefits if its needs are sufficient during pregnancy, such as reducing the risk of recurrent asthma/wheezing in newborns from mothers with or without asthma, and beneficial in pregnancy with diabetes mellitus. However, the benefits of vitamin D are not proven to change blood pressure at the beginning and middle of pregnancy. Researchers still find inconsistency about the effect of vitamin D on pregnant women if it has compared the results of this article review with another similar research.

PREGNANCY-RELATED IRON DEFICIENCY ANEMIA AND ITS ASSOCIATION WITH HBA1C

BACKGROUND: Iron deficiency anemia is most common nutritional deficiency in pregnant women due to increased iron turnover and additional requirement by fetus. Glycemic index is popularly measured by assessing glycated proteins. HbA1c is affected by several factors including pregnancy.OBJECTIVE: The aim of this study is to assess the relationship between iron deficiency anemia in pregnant women and glycated protein (HbA1c).PATIENTS AND METHODS: It is a prospective study conducted at a tertiary care hospital between the duration of April 2019 to June 2019. Total of 40 normal females were taken as control group, while 42 pregnant non – diabetic iron deficient patients.RESULTS: Both groups included females of reproductive age. All parameters including hemoglobin, serum iron, serum total iron – binding capacity (TIBC), serum transferrin saturation and serum ferritin showed statistically significant between two groups (p &lt;0.001). HbA1c also showed statically significant difference (p = 0.021).CONSLUSION: Study showed strong correlation between iron deficiency anemia and glycated proteins as it is increased as iron deficiency develops. So it may give false increase in levels in evaluation of glycemic index.

Comparison of cord blood and 6-month-old vitamin D levels of healthy term infants supplemented with 400 IU/day dose of vitamin D.

To determine the prevalence and risk factors of vitamin D deficiency in pregnant women and their infants at birth (cord blood) and at six months of age in Turkey, as well as to assess the compliance rates of families with vitamin D supplementation. Serum 25-hydroxyvitamin D [25(OH)D] level was measured of the mothers before delivery and of the infants both at birth (cord blood) and at six months of age. Infants who received and did not take regular vitamin D supplements were compared in terms of 25(OH) levels. Independent risk factors were determined by multiple logistic regression analysis. The study included a total of 140 pregnant women and their infants. Vitamin D deficiency was found in 95.7% of the mothers. The prevalence of vitamin D deficiency was 87.1% in infants at birth but decreased to 5.8% at sixth month. 65.7% of infants received vitamin D supplements regularly. Despite regular vitamin D use, it was determined that 2.2% of the infants in the supplementation compliant group had vitamin D deficiency. Maternal age, maternal education level, and the number of siblings were determined to be determining factors on infants' 25(OH)D levels at six months (p < 0.05). In Turkey, vitamin D deficiency still exists in both pregnant women and infants. Healthcare professionals and the public need to be more educated about the importance of regular supplementation. Serum 25(OH)D levels of infants should be tested periodically and personalized vitamin D supplementation planning is required based on test results.

Preclinical study of the effects of vitamin-mineral complex use during normal pregnancy in white rats

Vitamin-mineral deficiency is quite common in the world, which negatively affects the growth and development of children, provokes the development of chronic pathologies, allergic conditions. Children and pregnant women are particularly sensitive to this condition. Considering the vitamin and elemental composition of each of the drugs, it becomes necessary to examine the effect of various complexes on the body. The purpose of the study is to examine the morphological state of organs from the use of a vitamin-mineral complex during normal pregnancy in white rats and their offspring and examine the elemental analysis of target organs and whole blood. The experiment was conducted on pregnant female white laboratory rats and their offspring to achieve this goal. Histological, ultramicroscopic, morphometric, atomic-absorptic, functional methods, and statistical analysis are used for the study. A positive effect of the vitamin-mineral complex of the selected composition on both pre- and postnatal development of offspring is identified. The average offspring rate increased by 9.79% (p = 0.0443), while the stillbirth rate decreased by 81.82% (p = 0.0324). The absence of negative side effects of the complex on the development of basic reflex and behavioural reactions, motor activity, and cognitive activity of offspring is proved. A positive effect on the morphological characteristics of the liver, brain, heart, and kidneys is evident: the number of full hepatocytes in mature animals increased by 8.17% (p = 0.0482), and in young animals – by 5.03% (p = 0.0137), in the brain tissue of 7-day-old animals, the number of neurons increased by 7.70% (p = 0.0438), and the number of functionally defective neurons decreased. Microelement analysis of organs identified a tendency to increase the amount of a number of trace elements, which was reflected in the improvement of the antioxidant systems pf the body. A positive effect of the complex on the processes of hematopoiesis is noted. The results obtained can become morphological evidence for the choice of correction of macro-, microelement, and vitamin balance, prevention of its deficiency in pregnant women, and prevention of the development of deficient conditions in infants

The effect of long and short-term use of folate supplementation on shunt revision and spina bifida in demographically matched pregnant women: A cross-sectional clinical study

IntroductionNewborn defects are one of the leading causes of admission to the pediatric service. The incidence of neural tube defects (NTD) increases with folate deficiency in pregnant women. This study focuses on folate supplementation and its postpartum effects. Materials and methodsThis cross-sectional study was designed to assess neural tube defect-related risks in data-matched pregnancies in terms of Folate supplementation. ResultsFolate supplementation at ≥3 months pregnancy had a 10 times higher protectivity against Tethered Cord Syndrome (TCS) than pregnancies without folate supplementation (p = 0,028; Odds ratios [OR] = 10.2). However, folate supplementation provided between 0 and 2 months of pregnancy did not differ from pregnant women who did not receive folate supplementation (p = 0,887). Compared to pregnant women without folate supplementation, pregnant women with folate supplementation at ≥3 months did not have higher protectivity against Spina Bifida, yet pregnant women with folate supplementation between 0 and 2 months did provide 19 times more protection against Spina Bifida (p = 0,023; OR = 19,444). Although there was no difference between not using folate supplementation during pregnancy or using it for less than 3 months (p = 0,491) in the protection against shunt revisions, the risk of shunt revisions increased 4 times if it was used for greater than 3 months during pregnancy (p = 0,018; OR = 4,03). ConclusionThe probability of shunt revision increased 4 times if folate was used for more than 3 months during pregnancy. Folate supplementation for only short periods of time protects against Spina bifida while long-term folate supplementation provides highly effective protection for TCS.

FAKTOR YANG BERHUBUNGAN DENGAN KEJADIAN KEKURANGAN ENERGI KRONIK (KEK) PADA IBU HAMIL

Pregnant women are prone to malnutrition because they have increased nutritional needs for the mother and fetus. Therefore, pregnant women often experience Chronic Energy Deficiency (KEK). Based on the results of a preliminary study conducted at the Independent Practice of Midwife Ritta Nurhayati in 2021, 34 out of 50 pregnant women experienced chronic energy deficiency obtained from the results of the LILA measurement.&#x0D; The results showed that there was a relationship between education, occupation, income, nutritional intake, ANC examination with the incidence of chronic energy deficiency in pregnant women.

Under-Two Children Hunger Levels in Indonesia

Objective: To analyze the hunger level of toddlers under 2 years old using the Under-two Children Hunger Index (CHI). Methods: This study used secondary data from the Indonesian Basic Health Survey 2018. This study focused on the development of measurement for under-two children hunger index (CHI) using six indicators of the prevalence of chronic energy deficiency in pregnant women; the prevalence of risk height of pregnant women; the prevalence of under-two children who never being breastfeed; the prevalence of malnutrition for under-two children; the prevalence of wasting for under-two children; and the prevalence of stunting for under-two children. These six indicators were weighted differently and were calculated using the Principal Component Analysis (PCA) method.Results: The calculation of CHI using loading factors as weighted indicators has a higher precision with the percentage of 94.12 percent. With a 2018 CHI score of 46.40, Indonesia is at a serious CHI level. From the 34 provinces in Indonesia, 47.06% of provinces are at an extremely alarming level, 8.82% are at an alarming level, 17.65% are at a serious level, 17.65% are at a moderate level, and 8.82% are at a low level. Efforts can be performed by the government to increase the CHI based on the 6 indicators mentioned above.Conclusion: Based on this analysis, 25 provinces need attention in terms of the CHI level with six, three, and sixteen provinces suffered from a serious, alarming, and extremely alarming levels of CHI, respectively. Nevertheless, CHI is dynamic and should be updated annually to assess the province’s achievement in eradicating hunger. This time-series data is very important to evaluate government programs and programs to accelerate the eradication of under-two children's hunger should focus on the six indicators in this study.

THE INCIDENCE OF ANEMIA IN TERMS OF GESTATIONAL AGE AND HISTORY OF CHRONIC ENERGY DEFICIENCY IN PREGNANT WOMEN

Background:Anemia is a condition with hemoglobin levels below 11 gr/dl in pregnant women I and III or levels &lt;10.5 gr/dl in the II trimester. The purpose of this study was to analyze the relationship between the incidence of anemia in terms of gestational age and Chronic Energy Deficiency in pregnant women at the Central Sulawesi.Method:The research design used in this study is correlational analytic with a cross sectional time approach.The sampling method in this study uses accidental sampling techniques.Results:The analysis test using Chi Square shows that the significance level is 0.000 &lt; = 0.05. Thus, there is a relationship between gestational age and Chronic Energy Deficiency in pregnant women with the incidence of anemia at the Siniu Public Health Center.Conclution: It was concluded that gestational age and Chronic Energy Deficiency can cause anemia in pregnant women at the Siniu Health Center, Motong Regency, Central Sulawesi.Keywords:Anemia, Gestational Age, Chronic Energy Deficiency