Macrosomia Research Articles

Retinal blood flow association with age and weight in infants at risk for retinopathy of prematurity

This prospective study evaluated the relationship between laser speckle contrast imaging (LSCI) ocular blood flow velocity (BFV) and five birth parameters: gestational age (GA), postmenstrual age (PMA) and chronological age (CA) at the time of measurement, birth weight (BW), and current weight (CW) in preterm neonates at risk for retinopathy of prematurity (ROP). 38 Neonates with BW < 2 kg, GA < 32 weeks, and PMA between 27 and 47 weeks underwent 91 LSCI sessions. Correlation tests and regression analysis were performed to quantify relationships between birth parameters and ocular BFV. Mean ocular BFV index in this cohort was 8.8 +/− 4.0 IU. BFV positively correlated with PMA (r = 0.3, p = 0.01), CA (r = 0.3, p = 0.005), and CW (r = 0.3, p = 0.02). BFV did not correlate with GA nor BW (r = − 0.2 and r = − 0.05, p > 0.05). Regression analysis with mixed models demonstrated that BFV increased by 1.2 for every kilogram of CW, by 0.34 for every week of CA, and by 0.36 for every week of PMA (p = 0.03, 0.004, 0.007, respectively). Our findings indicate that increased age and weight are associated with increased ocular BFV measured using LSCI in premature infants. Future studies investigating the associations between ocular BFV and ROP clinical severity must control for age and/or weight of the infant.

Morphometric Analysis of Placenta and Fetal Doppler Indices in Normal and High-Risk Pregnancies.

Background High-risk pregnancies, encompassing pregnancy-induced hypertension (PIH), gestational diabetes mellitus (GDM), preeclampsia toxemia (PET), and intrauterine growth restriction (IUGR), represent intricate medical challenges with potential repercussions for maternal and fetal health. This research undertakes a comprehensive comparative investigation into the variations of Doppler indices and placental parameters within the context of these high-risk conditions when juxtaposed against pregnancies characterized as normal. Methodology Employing a rigorous cross-sectional study design, a diverse cohort of pregnant individuals with gestational diabetes, IUGR, PIH, and preeclampsia was meticulously assembled. Additionally, a group of normal pregnant women served as the comparative reference. Doppler ultrasound assessments, viz, pulsatility index (PI), were carefully performed to estimate blood flow velocities within critical maternal and fetal vessels, while placental parameters were meticulously quantified, encompassing dimensions, vascular architecture, and morphological features. Results Except in the GDM group, all high-risk groups had reduced estimated placental weight and actual birth weight than normal pregnant women. All high-risk groups showed a highly significant elevation of the PI of the umbilical artery and PI of the middle cerebral artery (MCA) than normal but the PI of MCA was significantly reduced in the PET group than in normal individuals. The cerebro-placental ratio in the GDM and IUGR groups revealed markedly greater values, whereas PET showed lower values. IUGR and PIH groups showed a substantial reduction in the fetal birth weight. All high-risk groups (GDM, IUGR, PIH, and PET) showed a highly significant reduction in luminal area umbilical artery 1 than the normal pregnant women. In IUGR, marginal placental insertion was very high, followed by GDM and PET groups. Conclusions This study reveals that Doppler indices, placental parameters, newborn weight, and their related ratios may beutilizedto anticipate gestation difficulties and gain insight into the pathophysiology of problematic conceptions.

Low levels of Vitamin D during pregnancy associated with gestational diabetes mellitus and low birth weight: results from the MAASTHI birth cohort.

India has a high prevalence of Vitamin D insufficiency among women of childbearing age. In this study, we aimed to evaluate the potential relationship between Vitamin D deficiency and gestational diabetes mellitus (GDM) and low birth weight (LBW) of newborns in the "Maternal antecedents of adiposity and studying the transgenerational role of hyperglycaemia and insulin" (MAASTHI) birth cohort. A prospective cohort study involving 230 participants was conducted in public hospitals located in urban Bengaluru, India. Healthy pregnant women who visited these hospitals for antenatal care (ANC) and who were between 14 and 36 weeks of gestational age were recruited after obtaining their informed consent. An oral glucose tolerance test (OGTT) was administered between 24 and 36 weeks of pregnancy and blood samples were preserved at -80°C for Vitamin D analysis. Follow-up at birth included recording the child's birth weight. We found that 178 (77.4%) of the study participants were vitamin D deficient, 44 (19.1%) were diagnosed with GDM, and 64 (27.8%) gave birth to LBW babies. Women in the lowest quartile of serum Vitamin D levels had three times higher odds of developing GDM than women in the higher quartiles [OR = 3.22 (95% CI: 1.03, 10.07), p = 0.04] after adjusting for age, parity, socioeconomic status, season, and adiposity. For every one-unit increase in Vitamin D levels, Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) decreased by nearly 18%. Furthermore, causal mediation analysis showed that a decrease in one unit of Vitamin D is associated with a decrease of 0.015 units of fasting blood sugar (FBS) and 0.019 units of postprandial blood sugar (PPBS) as it flows through the mediator variable insulin resistance. Vitamin D-deficient women were twice at risk of giving birth to LBW babies (OR 2.04, 95% CI 0.99, 4.19, p = 0.05). Low levels of Vitamin D during pregnancy are associated with a greater risk of pregnant women developing GDM and giving birth to LBW babies in urban Bengaluru.

Association of Medicaid expansion with birth outcomes: evidence from a natural experiment in Texas

BackgroundEmpirical evidence on the effects of Medicaid expansion is mixed and highly state-dependent. The objective of this study is to examine the association of Medicaid expansion with preterm birth and low birth weight, which are linked to a higher risk of infant mortality and chronic health conditions throughout life, providing evidence from a non-expansion state, overall and by race/ethnicity.MethodsWe used the newborn patient records obtained from Texas Public Use Data Files from 2010 to 2019 for hospitals in Texarkana, which is located on the border of Texas and Arkansas, with all of the hospitals serving pregnancy and childbirth patients on the Texas side of the border. We employed difference-in-differences models to estimate the effect of Medicaid expansion on birth outcomes (preterm birth and low birth weight) overall and by race/ethnicity. Newborns from Arkansas (expanded Medicaid in 2014) constituted the treatment group, while those from Texas (did not adopt the expansion) were the control group. We utilized a difference-in-differences event study framework to examine the gradual impact of the Medicaid expansion on birth outcomes.ResultsMedicaid expansion was associated with a 1.38-percentage-point decrease (95% confidence interval (CI), 0.09–2.67) in preterm birth overall. Event study results suggest that preterm births decreased gradually over time. Medicaid expansion was associated with a 2.04-percentage-point decrease (95% CI, 0.24–3.85) in preterm birth and a 1.75-percentage-point decrease (95% CI, 0.42–3.08) in low birth weight for White infants. However, Medicaid expansion was not associated with significant changes in birth outcomes for other race/ethnicity groups. ConclusionsOur findings suggest that Medicaid expansion in Texas can potentially improve birth outcomes. However, bridging racial disparities in birth outcomes might require further efforts such as promoting preconception and prenatal care, especially among the Black population.

Urinary Incontinence in the Third Trimester of Pregnancy of Type 1 Diabetic Women.

Type 1 diabetes increases the prevalence of urinary incontinence and may be responsible for additional changes to those existing in a regular gestational period. This study aimed to describe the presence and symptoms of urinary incontinence in pregnant women with type 1 diabetes. In this Cross-sectional case control study, forty pregnant women in third gestational trimester were allocated in two equal groups - control group (CG) and type 1 diabetic group (1DMG). The patients answered the International Consultation on Incontinence Questionnaire Short Form and, to characterize the sample, they answered the Pregnancy Physical Activity Questionnaire, gynecological history and, after delivery, the newborn weight was registered. The groups were compared using the Student's T Test for parametric variables and the U-Mann Whitney Test for non-parametric variables, both at 5% probability. The International Consultation on Incontinence Questionnaire Short Form score (p = 0.026) is higher in 1DMG (3.95 ± 4.70) compared to CG (1.05 ± 2.23). No correlations were found between time of diagnosis, HbA1c and newborn weight in relation to ICIQ-SF and other variables in CG and 1DMG with ICIQ-SF (p < 0.05). Type 1 diabetes mellitus, in the third trimester of gestation, seem to be associated with increase in the ICIQ-SF score.

Internet of things-based digital scale to detect stunting symptoms in babies under two years of age

Given the ongoing global challenge of stunting, characterized primarily by chronic underweight in infants under two years of age, a new approach leveraging digital scale and the internet of things (IoT) has been developed. This innovative system was designed to facilitate the early detection and continual monitoring of stunting symptoms caused by malnourishment. Key features include an IoT-enabled digital scale for precise weight measurement, a robust cloud platform for reliable data storage and comprehensive analysis, and an easy-to-use mobile app for user engagement. This system demonstrates its potential to simplify tracking fluctuations in baby weight and development progress related to stunting over time. Early trials demonstrated an impressive accuracy rate of 99.4% in body weight measurements and provided excellent conclusions in determining the body weight status of the infants. Overall, this IoT-based solution catalyzes the improvement of stunting detection methodologies and early intervention strategies, thus promising a better solution and a significant positive impact on global child health.

Little evidence of inbreeding depression for birth mass, survival and growth in Antarctic fur seal pups

Inbreeding depression, the loss of offspring fitness due to consanguineous mating, is generally detrimental for individual performance and population viability. We investigated inbreeding effects in a declining population of Antarctic fur seals (Arctocephalus gazella) at Bird Island, South Georgia. Here, localised warming has reduced the availability of the seal’s staple diet, Antarctic krill, leading to a temporal increase in the strength of selection against inbred offspring, which are increasingly failing to recruit into the adult breeding population. However, it remains unclear whether selection operates before or after nutritional independence at weaning. We therefore used microsatellite data from 885 pups and their mothers, and SNP array data from 98 mother–offspring pairs, to quantify the effects of individual and maternal inbreeding on three important neonatal fitness traits: birth mass, survival and growth. We did not find any clear or consistent effects of offspring or maternal inbreeding on any of these traits. This suggests that selection filters inbred individuals out of the population as juveniles during the time window between weaning and recruitment. Our study brings into focus a poorly understood life-history stage and emphasises the importance of understanding the ecology and threats facing juvenile pinnipeds.

Unraveling DREAM-PL: A Case Report on Challenges and Management

An uncommon autosomal recessive condition called DREAM-PL syndrome is typified by dysmorphic facial features, renal agenesis, male ambiguous genitalia, microcephaly, polydactyly, and lissencephaly. The CTU2 gene, which is in charge of tRNA post-transcriptional modification, is mutated in the syndrome. This alteration is necessary for the correct translation of genes, and its disruption can result in several aberrant embryonic processes. The severity of DREAM-PL syndrome can vary from moderate to severe, and the clinical characteristics can be diverse. While some patients may exhibit only some of the distinguishing features, others may have all of them. The most common characteristics include ambiguous genitalia, dysmorphic facies, and microcephaly. Diagnosis of DREAM-PL syndrome is typically based on clinical signs and confirmed through genetic testing, which can identify mutations in the CTU2 gene. Material and methodology: In the case being referred to as a study, a 37-week-old male neonate was delivered by lower segment cesarean section. The baby's birth weight was 2.760 Kg, and a heterozygous CMP mutation of the CTU2 gene was confirmed through whole-exome sequencing (WES). Unfortunately, there is currently no known cure for DREAM-PL syndrome. Result: Treatment focuses on managing the symptoms and providing supportive care. In some cases, surgical correction of birth defects may be beneficial.

Non-Targeted Metabolomics Analysis of Mother and Infant in Gestational Diabetes Mellitus and Neonatal Clinical Characterization.

The goal was to analyze serums of GDM patients and healthy pregnant women using HPLC-MS and preliminarily screen differential metabolites by metabolomics. Sixty pregnant women who underwent elective cesarean section at term in Dongguan Dalang Hospital from January 2023 to April 2023 were selected and divided into the GDM group and healthy pregnancy group. Pre-pregnancy and pregnancy examination information, such as age, BMI, OGTT results, triglyceride, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and other clinical data were col-lected for statistical analysis. Non-targeted metabolomics of serum from 30 GDM patients and 30 healthy pregnant women were studied by HPLC-MS, and different ions were searched. The structures of differential metabolites were identified by HMDB database. The metabolic pathways of differential metabolites were analyzed by KEGG database. The OGTT result, pCO2, pO2, HCO3, BE, Apgar score, and bilirubin levels in the GDM group were higher than those in the healthy pregnancy group (p < 0.05). However, there were no significant differences in age, triglyceride, total cholesterol, newborn birth weight, newborn birth blood glucose, and blood gas pH between the two groups (all p > 0.05). Using p < 0.05 as the screening standard, 55 differential metabolites were identified in serum, mainly including fatty acyl, carboxylic acids and their derivatives, steroids and their derivatives, ketoacids and their derivatives, and pyrimidine nucleosides, etc., all of which were up-regulated or down-regulated to varying degrees. The 55 metabolites were mainly involved in the metabolism of pyrimidine, pyruvate, alanine, aspartic acid, glutamic acid, and arachidonic acid, glycolysis, and biosynthesis of unsaturated fatty acids. The discovery of these metabolites provides a theoretical basis for an indepth understanding of GDM pathogenesis. Non-targeted metabonomics analysis of blood metabonomics research technology has shown great potential value in the early diagnosis of obstetric diseases and the study of disease mechanisms.

Effects of infant care posture and weight on static postural balance.

Studies investigating postural balance during various infant care postures have not been reported yet. The aim of this study was to measure static postural balance when holding an infant dummy in-arms and carrying an infant dummy on back according to different infant dummy weights. Sixteen healthy young subjects participated in a balance test. Infant dummies with weights of 4.6 kg (1-month) and 9.8 kg (12-month) were used in this study. All subjects were asked to naturally stand on a force platform in two infant care postures (holding an infant in-arms and carrying an infant on one's back). Center of pressure (COP) was measured from the force platform. Quantitative variables were derived from the COP. Two-way repeated measure analysis of variance (ANOVA) was performed to determine main effects of infant care postures, infant weight, and their interactions on COP variables. Back carrying a 12-month infant dummy had the greatest amplitude in all COP variables. Back carrying posture showed significantly greater mean distance and peak power, faster mean velocity, and wider COP area compared to holding posture (P< 0.05). There were significant weight effects of most COP variables mainly in AP direction (P< 0.01). Our results could contribute to the prevention of musculoskeletal diseases or prevention of fall due to various infant care activities by developing an assisting device to improve postural balance.

Kisspeptin signalling and its correlation with placental ultrastructure and clinical outcomes in pregnant South African women with obesity and gestational diabetes

IntroductionGestational diabetes mellitus (GDM) is a major pregnancy metabolic disorder and is strongly linked with obesity. Kisspeptin is a hormone that increases several thousand-fold in the maternal circulation during human pregnancy, with placenta as its main source. Studies have suggested that kisspeptin regulates trophoblast invasion and promotes pancreatic insulin secretion and peripheral insulin sensitivity. MethodsIn a well-characterized cohort of pregnant South African women and molecular and histological techniques, this study explored the impact and interaction of maternal obesity and GDM on kisspeptin (KISS1) signalling in relation to placental morphology and maternal and neonatal parameters. ResultsWe found that GDM had no effect on placental KISS1 and KISS1R (KISS1 receptor) mRNA and/or protein expression. However, obesity reduced placental KISS1R mRNA expression even though overall KISS1 protein abundance or localization was not different from the non-obese group. Maternal and cord circulating KISS1 concentrations did not vary with obesity or GDM, but maternal circulating KISS1 was positively correlated with placenta weight in non-GDM obese women, and negatively correlated with placental intervillous space volume in non-GDM non-obese women. Cord serum KISS1 was positively correlated with infant weight in GDM obese women, but negatively correlated with maternal BMI in the non-obese GDM group. Placental syncytiotrophoblast extracellular vesicles exhibited detectable KISS1 and its abundance was ∼50 % lower in those from obese GDM compared to non-GDM women. DiscussionThis study shows maternal obesity and GDM can modulate placental kisspeptin signalling and placental morphological development with potential pathophysiological implications for clinically-relevant pregnancy and perinatal outcomes.

Factors Causing Stunting In Toddlers In West Sumatra And Its Relationship With Sanitation And Environmental Hygiene : Literatur Review

One of the health problems that occurs in the world is stunting. Stunting or what is commonly known as short toddlers is a condition where toddlers are less tall compared to their age. West Sumatra Province is ranked 17th out of 34 provinces that experience stunting with a prevalence of stunting in toddlers (aged 24-59 months) of 36.2%, which is higher than the national prevalence, namely 30.8%. Stunting can also occur due to direct factors of stunting such as maternal nutrition during pregnancy, toddler nutrition and disease infections. Apart from direct factors, there are also indirect factors that can occur from various aspects, one of which is water, sanitation and hygiene (WASH). This research uses a literature study method using PICO. The research results obtained were that there was a relationship between the LBW factor (lower baby weight) and the incidence of stunting in toddlers, three articles were obtained. Two articles were found regarding the relationship between exclusive breastfeeding and MP-ASI. On the relationship between parenting styles, four articles were found. Three articles were found regarding the relationship between sanitation and the environment. Three articles were found regarding the relationship between height and height. One article was found regarding the relationship between zinc levels. On the relationship between mother's work, one article was found. Regarding the history of infectious diseases, one article was found. One article was found regarding the relationship between the age of pregnant women and the incidence of stunting in toddlers. From the conclusion above regarding the relationship between environmental sanitation and hygiene on stunting among toddlers in West Sumatra, the most common one is parenting patterns in children.Keyword : abstract; nutrition; words; research

Incidence, Risk Factors and Development of Retinopathy of Prematurity in Mid-Preterm and Late-Preterm Infants.

To evaluate the incidence, risk factors, and development of retinopathy of prematurity (ROP) in midpreterm and late-preterm infants born at 32 to 36 6/7 weeks of gestational age. The ophthalmic examination findings and risk factors of 5,477 preterm infants who underwent ophthalmological examination were evaluated retrospectively. The rates of any stage and severe ROP (requiring treatment) development and treatment options were recorded. The risk factors were analyzed by using logistic regression analysis. A total of 5,477 infants were included in the study, of whom 2,715 (49.57%) were mid-preterm and 2,762 (50.43%) were late-preterm. The rates of any stage and severe ROP were 8.2% (n = 223) and 0.6% (n = 15) in mid-preterm infants, respectively. In late-preterm infants, the rate of any stage ROP was 2.1% (n = 59), and no severe ROP was detected. There was no significant difference in mean birth weight in mid-preterm infants between infants with any stage ROP and severe ROP (P = .104). Of the 15 infants (0.3%) who required treatment, 14 (0.2%) infants had laser photocoagulation, 1 (0.01%) had intravitreal bevacizumab, and 2 (0.03%) had additional therapy (laser photocoagulation and intravitreal bevacizumab). In logistic regression analysis, a significant association was found between treatment requirement and transport from an external center (P < .001, ß = 0.04). Although ROP development rates decrease as birth weight and gestational age increase, late-preterm infants should be examined for ROP at least once, especially those born in low-income countries because ROP development can still be observed. [J Pediatr Ophthalmol Strabismus. 20XX;X(X):XX-XX.].

Risk Factors and Outcomes Associated with Maternal Obesity and Overweight: A Cross Sectional Study among Moroccan Women in Marrakech.

Obesity is becoming a real challenge for public health among pregnant women. This study aimed to identify sociodemographic and lifestyle risk factors and outcomes linked to maternal obesity and overweight. A cross-sectional study was carried out from Nov 2021 to Dec 2022 in the maternity health facility of Mohammed VI Hospital, as well as in one of the main health centers with a delivery unit in Marrakech, Morocco. Parturients were divided into four categories according to their pre pregnancy BMI: underweight, normal weight, overweight and obese. We used the chi-square test (χ2) to analyze the sociodemographic and lifestyle factors associated with maternal obesity and overweight. The same tool was utilized to explore maternal and neonatal complications. Overall, 400 parturient women with singleton pregnancies were included in the study. The prevalence of overweight and obesity was 29.8% and 31.5% respectively. Maternal age, type of housing, practicing sports, feelings about pregnancy were correlated with an increased risk of maternal obesity and being overweight. The risks of gestational diabetes, hypertension, anemia, cesarean delivery, and fetal macrosomia were higher among overweight and obese women compared to normal weight ones. The differences were significant (P<0.05). Maternal overweight and obesity are strongly linked with socio-economic, lifestyle, and psychological factors which can lead to serious complications for both mother and baby. Further research is needed to develop appropriate preventive measures and interventions for maternal obesity and overweight.

Maternal diet quality trajectories from pregnancy to 3.5 years postpartum and associated maternal factors.

This study examined maternal diet quality trajectories from pregnancy to 3.5 years postpartum and associated maternal factors. Data of 473 Australian women from the Healthy Beginnings Trial were used. A food frequency questionnaire collected dietary intake in pregnancy and 1, 2 and 3.5 years postpartum. Diet quality scores were calculated using the 2013 Dietary Guideline Index (DGI-2013) and RESIDential Environments Guideline Index (RDGI). Group-based trajectory modelling identified diet quality trajectories from pregnancy to 3.5 years postpartum. Multivariable logistic regression investigated factors associated with maternal diet quality trajectories. Two stable trajectories of low or high diet quality were identified for the DGI-2013 and RDGI. Women who smoked had higher odds of following the low versus the high DGI-2013 (OR 1.77; 95%CI 1.15, 2.75) and RDGI (OR 1.80; 95%CI 1.17, 2.78) trajectories, respectively. Women who attended university had lower odds of following the low versus the high DGI-2013 (OR 0.41; 95%CI 0.22, 0.76) and RDGI (OR 0.38; 95%CI 0.21, 0.70) trajectories, respectively. Women who were married had lower odds of following the low versus the high DGI-2013 trajectory (OR 0.39; 95%CI 0.17, 0.89), and women who were unemployed had higher odds of following the low versus the high RDGI trajectory (OR 1.78; 95%CI 1.13, 2.78). Maternal age, country of birth, household composition and pre-pregnancy body mass index were not associated with diet quality trajectories. Maternal diet quality trajectories remained stable from pregnancy to 3.5 years postpartum. Women who smoked, completed high school or less, were not married or were unemployed tended to follow low, stable diet quality trajectories.

Neonatal outcomes in women with diabetes mellitus — analysis of DAPSY data

BACKGROUND: Hyperglycemia in pregnancy is associated with short- and long-term implications for children. Nevertheless, the effects of different types of diabetes mellitus and treatment methods on the neonatal outcomes are to be investigated. AIM: The aim of this study was to evaluate the contribution of different types of maternal diabetes mellitus to the risk of adverse neonatal outcomes. MATERIALS AND METHODS: This retrospective cohort study included women (n = 3261) who delivered at the Research Institute of Obstetrics, Gynecology and Reproductology named after D.O. Ott, Saint Petersburg, Russia in 2008–2017. The following comparison groups were used: type 1 diabetes mellitus (n = 506; 1a, continuous subcutaneous insulin injections; 1b, multiple daily insulin injections), type 2 diabetes mellitus (n = 229; 2a, diet; 2b, insulin therapy), gestational diabetes mellitus (n = 2387; 3a, diet; 3b, insulin therapy), and control (n = 139). The main birth outcomes assessed included weight and length of newborns, Apgar score at birth and at 5 minutes after birth, and pathological conditions such as fetal macrosomia, syndrome of infant of mother with gestational diabetes mellitus or diabetic mother (P70.0–P70.1), light (P05.0) or small for gestational age (P05.1), intrauterine growth restriction, prematurity (P07), neonatal hypoglycemia (P70.4), and neonatal respiratory distress syndrome (P22). The secondary birth outcomes assessed included birth trauma (P10–P15), stillbirth (P95), disturbances of cerebral status of newborn (P91), and congenital malformations, deformations and chromosomal abnormalities (Q00–Q99). RESULTS: Pregestational diabetes mellitus is strongly associated with adverse neonatal outcomes. Type 1 diabetes mellitus women had the highest risks for fetal macrosomia and diabetic fetopathy, neonatal hypoglycemia, prematurity, and congenital malformations (odds ratio 3.54, 20.2, 5.59, 4.24 and 3.92 respectively). In type 2 diabetes mellitus patients, the risks of low birth weight, intrauterine growth restriction and birth trauma (odds 9.14, 5.42 and 6.3 respectively) were higher. For women with gestational diabetes mellitus, these risks were lower. CONCLUSIONS: This study provides a comprehensive analysis of the major neonatal pathology in patients with different types of diabetes mellitus, taking into account the treatment method. Preconception care and optimal glycemic control are necessary to reduce the risk of obstetric and perinatal complications in women with pregestational types of diabetes mellitus. Further research into the health status of this cohort of children at a later age is required.

Es Krim Ekstrak Daun Ubi Jalar Ungu sebagai Alternatif Layanan Kebidanan terhadap Kecukupan Asi pada Ibu Post Partum

This research aims to show that purple sweet potato leaves can be extracted and made into ice cream to increase the adequacy of breast milk given to postpartum mothers. The research method used was True Experiment and Pretest-Posttest Design with Control. The study results showed a significant difference in the two intervention and control groups in the breast milk adequacy variable, namely baby weight p-value 0.000 and baby BAK (p=0.000). In conclusion, the ice cream intervention with purple sweet potato leaf extract for 14 days was effective in increasing breast milk adequacy compared to the control group. Purple sweet potato leaf extract had a lactogogum effect on postpartum mothers in stimulating breast milk production. Keywords: Breast Milk, Purple Sweet Potato Leaf Extract, Ice Cream, Postpartum

Contribution of ferritin and zinc to adverse infant outcomes among pregnancies with prenatal alcohol exposure in South Africa

Nutritional status during pregnancy can impact fetal development, yet less is known about how alcohol may interact with nutritional status to influence infant outcomes. Pregnant women (n=196) completed 2, 24-hour dietary recalls and provided a venous blood sample to be analyzed for liver enzymes (GGT –gamma-glutamyl transferase; ALT –alanine transaminase; and AST –aspartate transferase), iron, ferritin, and zinc concentrations. Infants were assessed at 6 weeks of age. Women who consumed alcohol had significantly higher ferritin levels compared to non-drinkers (51.8 vs. 34.2). While 44% of women had ferritin <30 ug/L (an indicator of iron deficiency), and 24% of women were low in serum iron, and 72% were low in serum zinc. All six drinking measures for 1st trimester and previous week were significantly correlated with GGT and AST levels while 4 out of 6 alcohol measures were associated with levels of ALT and ferritin. At six weeks of age, nearly all physical measures differentiated infants with alcohol exposure from infants without exposure. Controlling for six covariates, maternal ferritin was significantly and inversely associated with infant head circumference (OFC) centile among infants with alcohol exposure. GGT was inversely associated with infant height and weight centile among unexposed infants. Seventy-four percent (74%) of mothers who consumed alcohol were found to be low in serum zinc, yet higher maternal zinc was associated with more dysmorphology. This may indicate that higher zinc status is not protecting the fetus from the teratogenic effects of alcohol. Prenatal alcohol exposure, ferritin, and zinc status influence infant growth and neurodevelopment.

COMPLICAÇÕES NEONATAIS CONCERNENTE A MORBIDADE MATERNA: DIABETES GESTACIONAL

The monitoring of this morbidity brings with it the need at public health level to emphasize regular monitoring through prenatal care, aiming at early diagnosis and treatment for Obstetric Diabetes (OD) or gestational diabetes mellitus (GDM), thus being able to reduce complications for the mother and fetus binomial. The aim of this study is to analyze these results among fetal or neonatal complications in women with GDM, bringing in the outcomes of premature birth, birth weight, neonatal morbidity and mortality, and the synergistic effect of concomitant risk factors and poor obstetric outcomes. A literature review was carried out using the following databases: Online Medical Literature Search and Analysis System (MEDLINE/PUBMED), Nursing Database - Brazilian Bibliography (BDENF), Web of Science and Cochrane Library (SCOPUS), CAPES Journals and Latin American and Caribbean Health Sciences Literature (LILACS). The search was carried out using descriptors combined with the Boolean operator “and”. From the searches, it was possible to see that the authors corroborate each other in relation to the main neonatal outcomes: Complications include fetal macrosomia, birth injuries, increased caesarean section rates, neonatal hospitalizations, neonatal hypoglycemia, neonatal respiratory distress syndrome (RDS), prematurity and fetal death. It can be concluded that for the mother the impacts, such as the risk of urinary system infections, are high, as well as bleeding in the postpartum period and tearing of the vaginal canal. For the child, hypoglycemia, prematurity and fetal macrosomia are some of the complications resulting from diabetes.

Cohort profile of an early life observational cohort in China: Bone and MicroBiOme onset (BAMBOO) study

PurposeThe Bone And MicroBiOme Onset (BAMBOO) study is an ongoing prospective observational cohort study conducted in Tianjin, China, aiming to determine age-appropriate trajectories for microbiome maturation and bone development and...