Maternal Anthropometric Measurements Research Articles

Gestational organophosphate esters (OPEs) exposure in association with placental DNA methylation levels of peroxisome proliferator-activated receptors (PPARs) signaling pathway-related genes

BackgroundOrganophosphate esters (OPEs) exposure could affect offspring health. However, the underlying mechanisms are not well documented. ObjectivesBased on a birth cohort study, we aimed to investigate the associations among gestational OPEs exposure, placental DNA methylation levels of peroxisome proliferator-activated receptor (PPAR) signaling pathway-related genes, and fetal growth. MethodsWe measured the concentrations of eight OPE metabolites in maternal urine samples and neonatal anthropometric measurements in 733 mother-child pairs. In 327 placental samples, we assessed the DNA methylation levels of 14 genes which were involved in the PPARs signaling pathway and expressed in placenta. Multiple linear regression models were used to examine the associations of OPEs exposure with placental DNA methylation, and of OPEs and placental DNA methylation with neonatal anthropometric measurements. Causal mediation analyses were conducted to examine the potential mediating role of placental DNA methylation in the pathway between OPEs exposure and fetal growth. ResultsWe observed a general pattern of OPEs exposure being associated with hypermethylation of candidate genes, with statistically significant associations identified for several OPEs with RXRA, ACAA1, ACADL, ACADM, PLTP, and NR1H3 methylation. Further, gestational exposure to BCIPP, DPP, BBOEP, ∑NCl-OPEs, and ∑OPEs tended to be associated with lower anthropometric measurements, with more significant associations observed on arm circumference, and abdominal and back skinfold thickness. Notably, RXRA, ACAA1, ACOX1, CPT2, ACADM, and NR1H3 methylation tended to be associated with lower neonatal anthropometric measurements, especially for abdominal and back skinfold thickness. Moreover, mediation analyses showed that 19.42 % of the total effect of DPP on the back skinfold thickness was mediated by changes in RXRA methylation, and there was a significant indirect effect of RXRA methylation. ConclusionsGestational OPEs exposure could disrupt the placental DNA methylation levels of PPAR signaling pathway-related genes, which might contribute to the effect of OPEs on fetal growth.

The Effect of Maternal Overweight/Obesity on Serum and Breastmilk Leptin, and Its Associations with Body Composition, Cardiometabolic Health Indices, and Maternal Diet: The BLOOM Study.

In overweight and obese patients, elevated serum and breastmilk leptin concentrations are observed, with serum leptin also being likely affected by the diet. We analyzed serum and breastmilk leptin in normal weight (NW) and overweight/obese (OW/OB) mothers, and evaluated its associations with (1) maternal anthropometric parameters; (2) markers of cardiometabolic health; and (3) the maternal diet. The BLOOM (Breastmilk and the Link to Overweight/Obesity and Maternal diet) study was conducted among 40 women (n = 20 OW/OB; n = 20, NW) who were exclusively or predominantly breastfeeding for 15.5 ± 1.2 (OW/OB group (0.99)) weeks. We collected 24 h breastmilk and fasting blood samples for leptin analysis by ELISA. Maternal dietary habits were evaluated using a 3-day dietary record and food frequency questionnaire, which were used to calculate the Polish-adapted Mediterranean Diet score. Maternal anthropometric measurements and DEXA scans were performed, and anthropometric and cardiometabolic indices were calculated. The OW mothers had 1.4 times higher serum levels, while OB mothers had 4.5 and 6.2 higher serum and breastmilk leptin levels, respectively, in comparison to the NW mothers. The FM% was correlated with serum and breastmilk leptin levels (r = 0.878, r = 0.638). Serum leptin was associated with markers of cardiometabolic health such as AIP, CMI, and VAI in the NW mothers, and with LAP in the OW/OB mothers. Higher energy, fructose intake and adherence to the Mediterranean diet were associated with serum leptin in the NW mothers (β = 0.323, 0.039-0.608; β = 0.318, 0.065-0.572; β = 0.279, 0.031-0.528); meanwhile, higher adherence to the Mediterranean diet could protect against elevated breastmilk leptin concentrations in OW/OB mothers (β = -0.444, -0.839--0.050), even after adjustment for FM%. Our results suggest a potential association between maternal serum leptin concentrations and cardiometabolic health. In addition, we confirm the importance of healthy dietary patterns in the improvement of breastmilk composition.

Role of dietary food intake patterns, anthropometric measures, and multiple biochemical markers in the development of pregnancy-specific urinary incontinence in gestational diabetes mellitus

ObjectivesThe aim of this study was to assess maternal dietary food intake patterns, anthropometric measures, and multiple biochemical markers in women with gestational diabetes mellitus and pregnancy-specific urinary incontinence and to explore whether antedating gestational diabetes mellitus environment affects the pregnancy-specific urinary incontinence development in a cohort of pregnant women with gestational diabetes mellitus and pregnancy-specific urinary incontinence. MethodsMaternal dietary information and anthropometric measurements were collected. At 24 wk of gestation, with a fasting venipuncture sample, current blood samples for biochemical markers of hormones, vitamins, and minerals were analyzed. The groups were compared in terms of numerical variables using analysis of variance for independent samples followed by multiple comparisons. ResultsOf the 900 pregnant women with complete data, pregnant women in the gestational diabetes mellitus pregnancy-specific urinary incontinence group had higher body mass index during pregnancy, arm circumference, and triceps skinfold than the non–gestational diabetes mellitus continent and non–gestational diabetes mellitus pregnancy-specific urinary incontinence groups, characterizing an obesogenic maternal environment. Regarding dietary food intake, significant increases in aromatic amino acids, branched-chain amino acids, dietary fiber, magnesium, zinc, and water were observed in pregnancy-specific urinary incontinence group compared with the non–gestational diabetes mellitus continent group. Serum vitamin C was reduced in the gestational diabetes mellitus pregnancy-specific urinary incontinence group compared with the non–gestational diabetes mellitus pregnancy-specific urinary incontinence group. ConclusionsThis study emphasizes the necessity for a comprehensive strategy for gestational diabetes mellitus women with pregnancy-specific urinary incontinence in terms of deviation in maternal adaptation trending toward obesity and maternal micronutrients deficiencies.

Neonatal anthropometric measurements and its relation to maternal anthropometry and demographics

AbtsractBackgroundHealthy pregnancy and maternal health status influence fetal growth. Studies linking maternal and neonatal anthropometry showed confounding results.ObjectivesTo study the relationship between maternal and neonatal anthropometry.MethodsThis cross-sectional study included 491 full-term healthy newborns born to healthy mothers with uncomplicated pregnancy. Neonatal and maternal anthropometric measurements as well as detailed perinatal history were recorded.ResultsThird trimester weight, body mass index (BMI), and mid upper arm circumference (MUAC) were positively related to neonatal birth weight (BW), length and head circumference (HC) (p < 0.001 for all of them except for MUAC with length, p = 0.021). Maternal education was inversely related to BW (p = 0.031) and positively related to HC (p = 0.001). Consanguinity had a positive relation to HC (p < 0.001).ConclusionsMaternal 3rd trimester weight, MUAC, BMI, education, and consanguinity can be related to different neonatal anthropometric measurements.

Associations between serum taurine concentrations in mothers and neonates and the children’s anthropometrics and early neurodevelopment: Results from the Seychelles Child Development Study, Nutrition Cohort 2

BackgroundHigh concentrations of taurine are present in the developing human brain and maternal breast milk. Taurine is thought to influence fetal growth and brain development based on experimental rodent studies. As fish is an important dietary source of taurine, we investigated associations between taurine concentrations and child outcomes in a high fish consuming population. ObjectiveTo examine associations between maternal and cord serum taurine concentrations and birth anthropometric measures and cognitive development in children at 20 months of age. MethodsPregnant women were recruited between 2008 and 2011 as part of Nutrition Cohort 2 (NC2) of the Seychelles Child Development Study (SCDS). Maternal taurine serum concentrations were measured at 28 week’s gestation and in cord serum. Child weight, length and head circumference were measured at birth and neurodevelopment was assessed using Bayley Scales of Infant Development II (BSID-II) at 20 months of age. Associations between taurine status, birth measures and neurodevelopmental outcomes were examined (n = 300) using regression models and adjusted for relevant covariates. ResultsMean (SD) maternal and cord taurine concentrations were 124.9 (39.2) µmol/L (range 28.2–253.9 µmol/L) and 187.6 (60.0) µmol/L (range 55.0–417.4 µmol/L) respectively. We found no associations between maternal taurine concentrations and child anthropometric and neurodevelopmental measures (weight β = −0.001, SE=0.001; length β = −0.006, SE=0.006; head circumference β = −0.002, SE=0.002; MDI β = −0.005, SE=0.015; PDI β = −0.004, SE=0.016; all P > 0.05), or between cord taurine concentrations and outcomes (weight β = −0.001, SE<0.000; length β = −0.001, SE=0.004; head circumference β < 0.000, SE=0.002; MDI β = 0.004, SE=0.010; PDI β = −0.015, SE=0.012; all P > 0.05). ConclusionThe Seychellois population have high maternal and cord taurine concentrations owing to their high fish intake and may be considered taurine replete compared to individuals who consume a Westernised diet. This high taurine status may explain why there were no significant associations between maternal and cord taurine concentrations and outcomes after adjusting for covariates.

Assessment of dietary consumption in a group of pregnant women at their second and third trimesters in Amman

Background: For a child's healthy growth and development, nutrition is indispensable before and during pregnancy. Meeting nutritional needs during pregnancy has always been a significant public health issue. Objective: The study aimed to assess and evaluate energy, macronutrients, and micronutrient consumption from food among pregnant women in Amman Governorate during the second or third trimesters, then compare the consumption to the Recommended Dietary Allowance (RDA). In addition, it aimed to assess micronutrient consumption from foods and supplements; finally, it investigated macronutrient consumption among under-weight, normal-weight, overweight, and obese pregnant women. Methods: A cross-sectional study was carried out in 2018 at the Ministry of Health's (MoH) Maternal and Children Health Centers (MCHC) in Amman to assess the dietary intake in a convenient sample of 300 seemingly healthy pregnant women between 17 and 40 years old and at ≥ 13 weeks of gestation. Maternal demographic characteristics, medical history, anthropometric measurements, and dietary data (three-day recall) were collected. Results: The daily mean intake of carbohydrates exceeded the recommended intake in 45.3% of pregnant women. Fiber intake was less than 28g/day in 90% of them. Total fats intake (45.6g/day) was lower than the RDA in 42.3% of pregnant women. Two-thirds of the pregnant women consumed a moderate amount of saturated fats (14.6g/day). The mean daily intake of proteins was 50.5±20.2g—more than two-thirds consumed protein less than the RDA. Subsequently, intakes of all essential amino acids were below RDAs.The intake of fat-soluble vitamins was lower than RDA for vitamins D, E, and K.While, whereas vitamin A was higher than RDA. Copper and salt intakes were more significant than the RDA for minerals (calcium, fluoride, iodine, iron, zinc, and selenium). Conclusion: The results showed inadequate and imbalanced dietary intake compared to RDA. Maternal nutrition and diets of pregnant women in this study show alarming indicators that may negatively affect the well-being of both pregnant women and fetal growth.

Dietary Intakes, Anthropometric Measurements and Pregnancy Outcomes

The relationships of maternal prenatal dietary intakes and anthropometric measurements to pregnancy outcomes were investigated in a prospective observational study of urban African American women. The 322 subjects, a subset of the 744 women recruited for the study using purposive sampling, were all nulliparous, free of diabetes mellitus and abnormal hemoglobins, and delivered term, singleton infants. Sociodemographic data and monthly quantitative 24-hour food recalls were collected by trained interviewers. Maternal anthropometric measurements were obtained from the subjects' hospital records. Pregnancy outcome data were obtained by physical examinations of the newborn infants by the project pediatrician. With the exception of vitamin C, average maternal dietary intakes were within the ranges of intakes obtained in previous studies. Mean intakes of protein, vitamins A and C, thiamin, riboflavin, and niacin exceeded the 1989 RDA, while those of food energy, vitamin B-6, folate, calcium, iron, magnesium, and zinc were below the RDA. Underweight prior to pregnancy and low pregnancy weight gains were found among 12.9% and 44.4% of the subjects respectively. Dietary intakes were not significantly correlated with pregnancy outcomes. Maternal anthropometric measurements significantly correlated with pregnancy outcomes included delivery weight, pregnancy weight gain, weekly weight gain, prepregnancy weight, net weight gain, height, prepregnancy body mass index, and % ideal prepregnancy body weight (P < 0.05). Using the stepwise selection procedure in multiple regression analysis, delivery weight, % ideal prepregnancy body weight, and prepregnancy body mass index were selected as being predictive of infant birth weight. It was concluded that anthropometric measurements were better nutritional predictors of pregnancy outcome than dietary intake.

Selected Lifestyle Practices in Urban African American Women—Relationships to Pregnancy Outcome, Dietary Intakes and Anthropometric Measurements

The relationships of selected lifestyle factors (cigarette smoking, consumption of alcoholic beverages, recreational drug use, and exercise during pregnancy), all self-reported, to pregnancy outcomes, dietary intake during pregnancy, and maternal anthropometric measurements, were investigated in a group of urban African American pregnant women. The 234 subjects were aged 16-35 years and were free of diabetes and abnormal hemoglobins. The lifestyle data were collected by trained interviewers during the subjects' prenatal clinic visits, and the dietary data by monthly, quantitative 24-hour food recalls conducted during these same visits. Maternal anthropometric measurements were obtained from the subjects' hospital records, and pregnancy outcome data during physical examinations of the newborn infants. Both cigarette smoking and drug use were associated with significantly lower mean birth weight, length, and head circumference, while exercise was associated with a significantly higher mean birth weight, and head circumference (P < 0.05). Drug use during pregnancy was associated with a significantly higher intake of vitamin C, and a significantly lower intake of iron; while women reporting drug use before pregnancy had significantly higher mean intakes of food energy, protein, total and saturated fat, and zinc. Prepregnancy weight, percent ideal prepregnancy body weight, prepregnancy body mass index, and delivery weight were significantly lower among those reporting drug use before pregnancy. Multiple regression analyses indicated that smoking explained a relatively small proportion of the variance in infant birth weight compared with delivery weight and percent of ideal prepregnancy body weight.

Assessment by ABPM verified the presence of hypertension in patients with self-reported hypertension, pregnant women, as well as differences between ethnicities in women aged 38-39years in the Ribeirão Preto cohort.

Introduction: Arterial hypertension is a global health problem and one of the main risk factors for cardiovascular diseases (CVD), and therefore for morbidity and mortality among adult men and women. Factors related to obstetric history, family history, sociodemographic characteristics, and lifestyle habits are known determinants of arterial hypertension. Methods: Case-control study of women belonging to the 1978/79 birth cohort conducted in the city of Ribeirão Preto/SP. Sociodemographic data, presence of comorbidities, maternal comorbidities, paternal comorbidities, comorbidities during pregnancy, and biometric and biophysical markers associated with blood pressure measured by 24-h ambulatory blood pressure monitoring (ABPM) were assessed in women aged 38-39 years. We want to study which variables of the previous sentence are related to the presence of hypertension measured by ABPM. Results: Data from 281 women were analyzed. Our results showed that ethnicity, a history of hypertension, and gestational hypertension reported by the women were significantly associated with the presence of hypertension measured by ABPM. Other factors such as marital status, educational level, comorbidities of the woman, paternal or maternal comorbidities, anthropometric measurements or serum levels of cardiovascular markers were not associated with the presence of hypertension measured by ABPM. Conclusion: We conclude that ethnicity, self-reported hypertension, and gestational hypertension are associated with arterial hypertension measured by ABPM.

Breastmilk PUFA strongly associated with maternal dietary intake but not anthropometric parameters and breastmilk carotenoids

BackgroundLong chain polyunsaturated fatty acids (PUFA) and the optimal n-6/n-3 fatty acids ratio are essential for proper neurodevelopment in infancy. This study aimed to evaluate the association between breastmilk fatty acid intake and maternal dietary intake, anthropometrics and breastmilk carotenoid levels. MethodsThis observational, prospective study included 44 women in the first, third, and sixth month of lactation. At each study visit, maternal anthropometric measures were assessed and breastmilk samples were collected and assessed for fatty acids and carotenoids. At the third and sixth month, maternal diet was evaluated by three-day foods record. ResultsMean breastmilk docosahexaenoic (DHA) was 0.58%, 0.47%, and 0.49%, respectively at the 1, 3, and 6 month (p ≤ 0.05). Mean DHA intake were higher in month 3 compared to 6: 357 vs. 169 mg/day. Pre-pregnancy BMI was associated with SFA, PUFA, and n-6 PUFA at 1 month, whereas current BMI to SFA at months 1 and 3. DHA was correlated with lycopene, total carotenoids at 1 month and total carotenoids at month 3, whereas n-3 PUFA to lycopene at 1 month. DHA, n-3 PUFA, n-6 PUFA and saturated (SFA) levels were associated with its dietary intake both at months 3 and 6, AA/DHA and LA/ALA ratios only at month 3. ConclusionsMaternal intake of PUFA and n-6/n-3 ratios were a good predictor of its breastmilk composition, whereas pre-pregnancy and current BMI, as well as breastmilk carotenoids had a limited influence.

Association of maternal characteristics with child feeding indicators and nutritional status of children under-two years in Rural Ghana

BackgroundOptimal nutrition during the first two years of a child’s life is critical for the reduction of morbidity and mortality. In Ghana, majority of children miss out on optimal nutrition and only few (13%) of children receive a Minimum Acceptable Diet (MAD). Several studies have investigated the influence of community-level factors on infants and young children feeding (IYCF) practices. However, little is known about the influence of maternal factors on IYCF practices in rural settings. Therefore, this study assessed the influence of maternal factors on the feeding indicators and nutritional status of children aged 6–23 months in two administrative districts in Ghana.MethodsData were collected among 935 mothers who had children aged 6–23 months and accessed 21 Child Welfare Clinics within the study area. The study involved a face- to-face interview using structured questionnaires to capture maternal characteristics, dietary intake and anthropometric measurements of children. Multivariate logistic regression was used to study the association between maternal factors and child nutrition outcomes (MAD, dietary diversity score (DDS) and anthropometric indicators) using Stata 16.0 software.ResultsBeing employed (AOR = 3.07, 95% CI: 1.71—5.49, p < 0.001) and attaining secondary or higher education (AOR = 2.86, 95% CI: 1.42—5.78, p = 0.003) were significant predictors of children receiving MAD. Similarly, having an average decision-making autonomy increased the child’s odds of receiving MAD (AOR = 1.68, 95% CI: 1.02—2.76, p = 0.040). Children of mothers who attained secondary or a higher level of education (AOR = 0.59, 95% CI: 0.36 -0.97, p = 0.040) and those whose mothers were employed (AOR = 0.71, 95% CI: 0.47—1.07, p = 0.043) were associated with a reduced risk of underweight and stunting respectively. Children of mothers with average financial independence status were more likely to receive diversified meals (AOR = 1.55, 95% CI: 1.01–2.38, p = 0.045).ConclusionsHigh educational level and being employed have positive influence on MAD, stunting and underweight of children. High decision-making power and average financial independence of mothers are good predictors of children receiving MAD. Family planning, women empowerment in decision-making, providing employment opportunities for mothers and promoting girl-child education are recommended.

Correct Use of a Conventional Lap-and-Shoulder Seatbelt Is Safest for Pregnant Rear-Seat Passengers: Proposal for Additional Safety Measures

The objectives of this study were to assess the safety of various methods of seatbelt use and propose safety improvements to the lap-and-shoulder seatbelt for pregnant rear-seat passengers. The Maternal Anthropometric Measurement Apparatus dummy, version 2B, was used. Sled tests were performed to simulate frontal impact at a speed of 48 km/h in the right rear seat. Kinematics of the dummy were examined using high-speed video imaging, and time courses of the seatbelt loads and displacement and acceleration of the chest and pelvis were measured during impact. The kinematic parameters were compared under the following conditions: conventional lap-and-shoulder seatbelt used correctly, lap belt crossed over left and right femurs, and lap belt attached to both thighs using an extra restraint device. Then, by applying pretensioner and/or force limiter systems, the safest condition was investigated. Correct conventional seatbelt use was the most effective restraint method. When both pretensioner and force limiter were applied, the kinematic parameters were smallest, and the best restraint was achieved. The safety of rear-seat travel can be improved by using both pretensioner and force limiter systems, which would reduce the risk of chest and abdominal injuries to pregnant passengers and prevent negative fetal outcomes.

Iron Status in Pregnant Women in Latvia: An Epidemiological, Cross-Sectional, Multicenter Study According to WHO and UK Criteria.

Background and Objectives: During pregnancy, iron deficiency anaemia is a common problem associated with health risks for both the mother and her foetus/infant. This study aimed to investigate the prevalence of iron deficiency, iron deficiency anaemia, and related dietary patterns in pregnant women in Latvia. Materials and Methods: This cross-sectional, multicentre study included pregnancy data from 974 women. The sample selection was based on the stratification principle (population of women of childbearing age in regions of Latvia). Maternal demographic details, anthropometric measurements, iron status, dietary patterns, and supplementation information were obtained from maternal files and during interviews held in eight outpatient departments of medical institutions and maternity departments. The prevalence was assessed. Chi-square tests and logistic regression were used to identify associations between iron deficiency and sociodemographic characteristics, dietary patterns, and iron supplement intake during pregnancy. The criterion used for the diagnosis of iron deficiency anaemia is a Hb level < 110 g/L in the 1st and 3rd trimesters and <105 g/L during the 2nd trimester as recommended by the WHO. However, the UK guideline was used for borderline iron deficiency, which is an SF level < 30 μg/L in all trimesters. Results: The observed prevalence of anaemia was 2.8% in the first trimester, 7.9% in the second trimester, and 27.0% in the third trimester. The prevalence of iron deficiency was 46.7% in the first trimester, 78.1% in the second trimester, and 91.7% in the third trimester. No associations with dietary patterns were found. Single women had 1.85 times the odds (95% CI 1.07 to 3.18) of being anaemic than married women. Conclusions: Iron deficiency affects a large proportion of pregnant women in Latvia in all trimesters, with iron deficiency anaemia affecting pregnant women in the third trimester. Monitoring and intervention should be performed in a timely and more targeted manner.

Associations of maternal anthropometrics with newborn anogenital distance and the 2:4 digit ratio.

Are maternal anthropometrics associated with anogenital distance (AGD) and 2:4 digit ratio (2:4D) in newborns? Select maternal anthropometrics indicative of obesity or increased adiposity are associated with elongated AGD in daughters. Excessive maternal weight or adiposity before or in early pregnancy may impact child reproductive, and other hormonally mediated, development. AGD and 2:4D are proposed markers of in utero reproductive development. This study includes 450 mother/newborn dyads participating in the Illinois Kids Development Study (I-KIDS), a prospective pregnancy cohort from Champaign-Urbana, IL, USA. Participants included in the current study enrolled between 2013 and 2018. Most mothers in this study were college-educated (82%) and non-Hispanic White (80%), and 55% were under- or normal weight before pregnancy. Pregnant women aged 18-40 years reported pre-pregnancy weight and height to calculate pre-pregnancy BMI. At 8-15 weeks gestation, we measured waist and hip circumference, and evaluated weight, % body fat, visceral fat level, % muscle and BMI using bioelectrical impedance analysis. Within 24 h of birth, we measured newborn 2nd and 4th left/right digits to calculate the 2:4D. In daughters, we measured AGDAF (anus to fourchette) and AGDAC (anus to clitoris). In sons, we measured AGDAS (anus to scrotum) and AGDAP (anus to base of the penis). Select maternal anthropometrics were positively associated with AGD in newborn daughters, but not sons. For example, AGDAC was 0.73 mm (95% CI: 0.15, 1.32) longer for every interquartile range (IQR) increase in pre-pregnancy BMI and 0.88 mm (95% CI: 0.18, 1.58) longer for every IQR increase in hip circumference, whereas AGDAF was 0.51 mm (95% CI: 0.03, 1.00) and 0.56 mm (95% CI: 0.03, 1.09) longer for every IQR increase in hip and waist circumference, respectively. Quartile analyses generally supported linear associations, but additional strong associations emerged in Q4 (versus Q1) of maternal % body fat and visceral fat levels with AGDAC. In quartile analyses, we observed only a few modest associations of maternal anthropometrics with 2:4D, which differed by hand (left versus right) and newborn sex. Although there is always the possibility of spurious findings, the associations for both measures of female AGD were consistent across multiple maternal anthropometric measures, which strengthens our conclusions. Our study sample was racially and ethnically homogenous, educated and relatively healthy, so our study may not be generalizable to other populations. Additionally, we may not have been powered to identify some sex-specific associations, especially for 2:4D. Increased maternal weight and adiposity before and in early pregnancy may lengthen the female AGD, which warrants further investigation. This publication was made possible by the National Institute for Environmental Health Sciences (NIH/NIEHS) grants ES024795 and ES022848, the National Institute of Child Health and Human Development grant R03HD100775, the U.S. Environmental Protection Agency grant RD83543401 and National Institute of Health Office of the Director grant OD023272. Its contents are solely the responsibility of the grantee and do not necessarily represent the official views of the US EPA or NIH. Furthermore, the US EPA does not endorse the purchase of any commercial products or services mentioned in the publication. This project was also supported by the USDA National Institute of Food and Agriculture and Michigan AgBioResearch. The authors declare no competing interests. N/A.

Effect of Maternal Body Composition and Hemoglobin Percentage at Term Gestation on Labour and Neonatal Outcome

Background: The Pre-pregnancy body weight and the haemoglobin percentage are two important parameters whichdetermine and influence the maternal and fetal outcome. The fetal weight gain during pregnancy is about 9-12 kgs inIndian conditions. The maternal body composition is dependent on many factors like genetic, constitutional, racial,socioeconomic and nutritional factorsObjectives: To study the effects of maternal body composition and haemoglobin percentage at term gestation on labourand neonatal outcomeMethods: A total of 150 patients were taken into study. Gestational age was calculated from LMP and by early Ultra-soundExamination. Patient’s haemoglobin was measured by spectrophotometric method. The following set of measurementswere taken by single examiner. Maternal nutritional anthropometric measurements were taken, two to three days beforeEDD or after completion of 38 weeks by USG.Results: Around 49% of the mothers belonged to the group 3 and a significant(35.32%) no. of mothers had HB% levels of&lt;9. This indicates the nutritional status of the pregnant women in our population. All the parameters were significantlycorrelated with HB% when comparison is made between severely anaemic and non- anaemic group.Conclusion: The young, illiterate women belonging to lower socioeconomic status have poor dietary intake as evidencedby lower fat free mass, fat mass, ANW, BMI and HB%. They showed adverse pregnancy out comes as evidenced byhigh prevalence of low birth weight babies, lower mean birth weight, lower Ponderal index and lower APGAR scorescompared to non-anaemic women.

Association of maternal socio-demographic factors, maternal anthropometric measurements, and foetal sex with LGA newborns in Sri Lanka

Introduction: There is an increased trend of delivering large for gestational age (LGA) newborns globally, which has already caused significant impact on health, nutrition, economics, and social aspects. LGA newborns are more vulnerable for complications developed from intrauterine life to adulthood and it is becoming additional burden to the health care and economic state of the country. However, we lack published data on incidence, trend and factors affecting LGA newborns in Sri Lanka. Determination of risk factors associated with LGA newborns would help to formulate and implement effective preventive measures. Method: A case control study was carried out at obstetrics and gynaecology unit, Teaching Hospital Kandy from 01.01.2016 to 31.12.2016. Systematic sample technique was used, and study sample was consisted of 44 cases and 132 controls. Pretested interviewer administered questionnaire was used for data collection. Significance of associations between dependent and independent variables was estimated using probit regression model. Probit coefficient was estimated to assess the significance and respective marginal effects were estimated to assess the magnitude of significance. STATA software was used for analysis. Ethical clearance was obtained from ethical review committee, Teaching Hospital Kandy. Results: According to probit regression estimates of socio-demographic factors, maternal parity of two (Coefficient 1.89: 95% CI 0.75-3.03: P &lt;0.05) or more (Coefficient 2.37: 95% CI 0.92-3.82: P &lt;0.05), Monthly family income of more than 30,000/= rupees (Coefficient 2.28: 95% CI 0.92-3.63: P&lt;0.05) and Tamil ethnicity (Coefficient 2.10: 95% CI 0.69-3.52: P&lt;0.05) were statistically significant risk factor. In the analysis, maternal age (Coefficient 0.09: 95% CI -0.05-0.23: P&gt;0.05), mother’s occupation (Coefficient 0.08: 95% CI -1.01-1.17: P&gt;0.05) and maternal educational level (Coefficient 1.68: 95% CI -0.30-3.66: P&gt;0.05) were not significant risk factors at 5% significance level. Considering the maternal anthropometric measurements, maternal weight gain during pregnancy (Coefficient 0.77: 95% CI 0.50-1.03: P&lt;0.05) was a significant risk factor. Maternal BMI at booking visit (Coefficient 1.76: 95% CI -0.34-3.85: P&gt;0.05), maternal weight at booking visit (Coefficient -0.63: 95% CI -1.5-0.26: P&gt;0.05) and maternal height (Coefficient 0.56: 95% CI -0.08-1.2: P&gt;0.05) were not significant risk factors in the analysis at 5% significance level. Foetal sex (Coefficient -0.69: 95% CI -1.5-0.13: P&gt;0.05) was not a significant causative factor at 5% significance level. Conclusions: Among maternal socio-demographic factors, high monthly family income, parity of 2 or more and Tamil ethnicity were determined as statistically significant risk factors for LGA newborns. Among maternal anthropometric measurements, increased weight gain during pregnancy was determined as significant modifiable risk factor for LGA newborns. Maternal weight gain during pregnancy should be monitored throughout the antenatal period from the booking visit to identify mothers at risk. Effective interventions should be designed to minimize the negative impact on mothers at risk.

Birth weight, head circumference, and length of newborns are unaffected by maternal levels of vitamin B12 and folate

Vitamin B12, folate, and other micronutrients are essential for healthy growth. We hypothesized that there is a high prevalence of vitamin B12 deficiency in mothers and their newborns, and that blood serum vitamin B12 and folate levels may affect anthropometric measurements at birth. A total of 204 newborn babies and their 196 mothers were included. Blood samples of newborns and mothers were obtained for vitamin B12 (<200 pg/mL) and folate (<3 ng/mL) deficiencies. Additionally, iron and ferritin levels were measured. The mean gestational age and birth weight were 37.2 ± 2.6 (22.3-41) weeks and 3045 ± 770 (505-4525) g, respectively. All micronutrient levels in cord blood were higher than maternal levels (P = .001). A total of 96.3% of mothers and 64.5% of babies had vitamin B12 deficiency; 4% of mothers and none of the infants had folate deficiency. In total, 38.2% of mothers and 10.6% of infants had ferritin deficiency and 38.7% of mothers and 41.4% of newborns had iron deficiency. There was a negative correlation between cord vitamin B12 level and birth weight and head circumference (r = -0.21, P = .004 and r = -0.16, P = .036, respectively), whereas no correlation was found between maternal micronutrient status and anthropometric measurements of newborns. In conclusion, anthropometric measurements were unaffected by maternal levels, but vitamin B12 deficiency is very common in pregnant women and newborn babies. Mothers and their infants may benefit from early diagnosis and treatment. Awareness of vitamin B12 deficiency in pregnant women and newborns should be increased in Turkey.

Episiotomy at Public Health Institutions in Hosaena Town, Southern Ethiopia: An Institution-Based Cross-Sectional Study

BACKGROUNDEpisiotomy was first suggested about two centuries back to prevent perineal tear as well as a fetal head injury. However, there have been controversies about its benefits over its side effects. The magnitude of episiotomy varies across the world. No study was conducted in the study area. This study was aimed at assessing the magnitude and factors associated with episiotomy at public health institutions.SUBJECTS AND METHODSInstitutional-based cross-sectional study design was employed in four public health institutions in Hosaena Town. Data were collected through interviews administered structured questionnaires and supplemented with maternal chart review and anthropometric measurement from May 1st to June 30th, 2019. Study participants were selected using a systematic random sampling technique. EpiData 3.02 and SPSS version 21 software were used for data entry, and analysis, respectively. Descriptive statistics, bivariate and multivariable logistic regression analysis were done. Variables at p-value &lt; 0.2 were transferred to multivariable logistic regression analysis. Then variables at p-value &lt;0.05with 95% CI were considered as statistically significant and AOR was used to interpret factors associated with episiotomy. Tables and graphs have been used to present the results.RESULTSA total of 410 delivered mothers were included in the study and the magnitude of episiotomy was 57.6%with a mean of 95% CI = 0.53–0.63.Being primiparous (AOR = 16.96, 95% CI: 9.26, 31.05), meconium-stained amniotic fluid (AOR = 3.82, 95% CI: 1.84, 7.96), Second stage of labor lasting more than 2 hours (AOR = 2.43, 95% CI: 1.11, 5.32), births attended by non-midwife professionals (AOR = 2.26, 95% CI: 1.24, 4.14) and newborns head circumference &gt;35 cm (AOR = 5.73, 95% CI: 3.29, 10.00) were factors significantly associated with episiotomy.CONCLUSIONSEpisiotomy was performed in more than half of the mothers included in the study. All the responsible bodies from the administrative to clinical practitioners should be in action to lower the magnitude of episiotomy by assuring that it is practiced restrictively with scientific indications.

Maternal Dietary Pattern with an Emphasis on Child Growth Pattern and Exclusive Breastfeeding Duration

&#x0D; Background: maternal nutrition and breast milk nutrient concentration are associated with infant's growth. Enhanced knowledge encourages mothers to breast feed for the sake of optimizing growth and development.&#x0D; Methods: the current study was performed longitudinally in some rural areas, south of Iran, from birth to six months. Out of 319 candidates with serial anthropometric measurements of an infant, including weight, height, and head circumference at four times (birth, two, four, and six months ), 195 were included in the multivariate regression model (total measurements, n=776) to construct the pattern of growth. Then, information regarding demographic background, lactation status and infant supplementation intake status, feeding practices, maternal anthropometric measurements, and food frequency questionnaire were collected from mothers and their children during six months in two rural health centers.&#x0D; Results: The most important association between dietary factors and infant anthropometrics (weight, height, and head circumference) involved Factor2 vegetables, including leafy vegetables, tomato, onion and garlic, (weight β=0.35 95%CI 0.27 - 0.44, length β=3.82 95%CI 3.42 - 4.22, head circumference β=2.55 95%CI 2.32 - 2.79) and Factor1 fruit, including orange, kiwi, cherries, watermelon, date, and grapes) (weight β=0.117 95%CI 0.04-0.189, length β=0.59 95%CI 0.257-0.929, head circumference β=0.307 95% CI 0.108-0.507), respectively. Generalized Estimation Equation model revealed that Factor2 dairy (including low fat milk, yogurt and dough) significantly contributed to weight growth velocity (β=-0.009 95% CI -0.016 - 0.001).&#x0D; Conclusion: a dietary habit of fruit and vegetables, which are rich in bioactive components by breast feed mother showed better growth for infants. As growth is multifactorial, maternal nutrition and breastfeeding duration is a simple modifiable factor which can affect the subsequent growth and development of the child during the first six months.&#x0D; Key words: exclusive breastfeeding, growth, anthropometric measures, maternal nutrition, and multivariate multiple regression.&#x0D;

Maternal Anthropometric Status as A Correlate of Neonatal Outcomes Among Pregnant Women in Selected Secondary Health Facilities in Ibadan Metropolis, Oyo State

Maternal anthropometric measurements provide a simple, cheap and available means of predicting neonatal outcomes. Pregnant women anthropometric indices reveal their nutritional statuses and determine to great extent the health of the neonate after they have been born. Hence, this study investigated maternal anthropometric status as a correlates of neonatal outcomes among pregnant women in selected secondary health facilities in Ibadan Metropolis, Oyo State, Nigeria. This retrospective study adopted descriptive research design. Purposive sampling technique was used to select those who met the inclusion criteria. Total enumeration was used for the study. A self-structured checklist was used to extract data about pregnant women who booked from January 1, 2019 to December 31, 2019 within 18 weeks of their gestation with singleton pregnancy. Data collected were analyzed using descriptive and inferential statistics. The results revealed a significant association between maternal BMI and Baby’s birth weight with Chi-square X2 (91.66, df =1, p&lt;0.05).The finding revealed that underweight mothers had higher chance of having small for gestational age babies (SGA) and LBW as compared to average weight mothers. The study concluded that there is a significant association between maternal BMI and birth weight. Based on the finding, the study recommended among others that the healthcare practitioners are to identify pregnant women who at risk of adverse birth outcomes and educate them appropriately. Pregnant mothers whose babies would need special care at birth should be referred to the health facility that can handle such cases before delivery to enhance the neonatal survival rate.