Maternal Anthropometric Measurements Research Articles

Pre-eclampsia renamed and reframed: Intra-abdominal hypertension in pregnancy

This hypothesis proposes pre-eclampsia is caused by intra-abdominal hypertension in pregnancy. Sustained or increasing intra-abdominal pressure ⩾12mmHg causes impaired venous return to the heart, systemic vascular resistance, ischemia reperfusion injury, intestinal permeability, translocation of lipopolysaccharide endotoxin to the liver, cytotoxic immune response, systemic inflammatory response, pressure transmission to thoracic and intra-cranial compartments, and multi-organ dysfunction. This hypothesis is predicated on Pascal’s law, evidence founded in the intra-abdominal hypertension literature, and the adapted equation ΔIAP-P=ΔIAVF/Cab, where ΔIAP-P=change in intra-abdominal pressure in pregnancy, ΔIAVF=change in intra-abdominal vector force (volume and force direction) and Cab=abdominal compliance. Factors causing increased intra-abdominal pressure in pregnancy include: progressive uterine expansion, obstetrical factors that increase intra-uterine volume excessively or acutely, maternal anthropometric measurements that affect intra-abdominal pressure thresholds, maternal postures that increase abdominal force direction, abdominal compliance that is decreased, diminished with advancing gestation, or has reached maximum expansion, habitation at high altitude, and rapid drops in barometric pressure. We postulate that the threshold for lipopolysaccharide translocation depends on the magnitude of intra-abdominal pressure, the intestinal microbiome complex, and the degree of intestinal permeability. We advance that delivery cures pre-eclampsia through the mechanism of abdominal decompression.

How do pregnancy-related weight changes and breastfeeding relate to maternal weight and BMI-adjusted waist circumference 7 y after delivery? Results from a path analysis

ABSTRACT Background: Reproduction has been related to long-term maternal weight gain, and changes in fat mass, with gestational weight gain, have been identified as an important contributor. However, the influence of weight changes during the whole reproductive cycle and the modifying effect of breastfeeding are unknown. Objective: The objective was to examine how prepregnancy weight, gestational weight gain, postpartum weight changes, and breastfeeding influence maternal weight and body mass index–adjusted waist circumference (WCBMI) 7 y after delivery. Design: This was a prospective cohort study of 23,701 women participating in the Danish National Birth Cohort with singleton births and no births during follow-up. Path analysis was used to assess the total, direct, and indirect effects; the latter was mediated through weight changes on the pathways. Results: Postpartum weight retention at 6 mo and weight gain from 6 to 18 mo postpartum were highly positively associated with both outcomes. A 1-kg increase in weight retention at 6 mo postpartum corresponded to an average increase of 0.5 kg at 7 y. Gestational weight gain was not associated with WCBMI but was positively associated with weight at 7 y; 87% of this effect was mediated through later weight changes. For both outcomes, a small inverse association was observed for breastfeeding duration. This was strongest for WCBMI, for which 97% of the effect was direct, ie, not mediated through postpartum weight. Conclusions: These findings show that postpartum weight retention at 6 mo and weight gain from 6 to 18 mo postpartum contribute equally to adverse maternal anthropometric measures 7 y after delivery. Breastfeeding duration may have a beneficial effect.

Maternal anthropometric characteristics as determinants of birth weight in North-West Nigeria: A prospective study

Background/Aim: Foetal weight cannot be measured directly in utero, but it can be estimated or predicted from foetal and maternal anatomical characteristics. This study was undertaken to examine the relationship between birth weights and certain maternal anthropometric measurements (weight, height and BMI). Context/Setting: This study was done in Aminu Kano Teaching Hospital (AKTH), North-West, Nigeria. Aminu Kano Teaching Hospital is a 500-bed tertiary hospital located in Kano, the most populous state in Nigeria. Materials and Methods: This was a prospective study. Interviewer-administered questionnaires were used to retrieve sociodemographic and obstetrics information. Two-hundred (88.9%) pregnant women responded completely. The weight, height and BMI of the women were measured. Unclothed newborns were weighed immediately after delivery. The data obtained was analysed using SPSS version 16.0 statistical software. The accuracy of maternal weight, height and body mass index in predicting birth weight was compared using Student's t-test, Chi-square test and Pearson's Coefficient of Correlation and P < 0.05 was considered statistically significant. Results: The mean maternal age was 28.2 ± 5.7 years. The mean parity was 3 ± 2. The mean gestational age at delivery was 38.5 ± 2 years. The mean actual birth weight was 3.27 ± 0.53 kg. The mean maternal weight was 72.03 ± 11 kg. Maternal weight showed a strong positive correlation with birth weight ( r = 0.48) and this was statistically significant ( P < 0.001). The mean maternal height was 1.64 ± 0.55 m. The mean maternal BMI was 27.9 ± 4.33. Maternal BMI showed a weak positive correlation with birth weight ( r = 0.28) and this was statistically significant ( P < 0.001). Maternal weight and BMI are better predictors of birth weight than maternal height. Conclusion: Maternal weight and BMI are good predictors of birth weight and can be recommended for use as screening test in poor resource setting.

Cord blood C‐peptide levels relate to the metabolic profile of women with and without gestational diabetes

Plasma C-peptide reflects the insulin-secretory activity of pancreatic β-cells which modulates fetal growth. Cord blood C-peptide levels were measured in women with gestational diabetes mellitus (GDM) and in women with normal glucose tolerance (NGT). Forty-one women underwent a 75-g oral glucose tolerance test (18 GDM, 23 NGT). Cord blood C-peptide (p = 0.09) and glucose levels (p = 0.08) from newborns of GDM women tended to be higher than those from NGT women. In the entire group, cord blood C-peptide correlated with maternal insulin, fasting C-peptide, insulin sensitivity, interleukin-6, weight and body mass index measured at screening (ρ from 0.34 to 0.48, all p < 0.05) and tended to correlate with offspring weight (ρ = 0.28, p = 0.08). Newborns of GDM women tended to have elevated cord blood C-peptide which correlated with maternal insulin, insulin sensitivity and anthropometric measures at diagnosis and with offspring characteristics. This suggests that insulin-secretory activity of the newborn is related to maternal metabolic parameters.

Effect of Maternal Body Mass Index on the Retinal Microvasculature in Pregnancy

To estimate the effects of maternal body mass index (BMI) and pregnancy weight gain on the retinal microvasculature among pregnant women. We studied 814 pregnant women aged 18-46 years who were recruited as part of the Growing Up in Singapore Toward Health Outcomes study, an ongoing birth cohort study from two government hospitals in Singapore since 2009. Recalled prepregnancy weight was recorded, and maternal anthropometric measurements of weight and height were performed at 26 weeks of gestation together with retinal photography. In multiple linear regression models, each standard deviation increase of 26-week pregnancy BMI (4.57) was associated with narrower retinal arteriolar caliber (by 1.58 micrometers, P<.001), wider venular caliber (by 1.28 micrometers, P=.02), and increased retinal venular tortuosity (P=.01). Compared with mothers with normal weight, obese mothers (prepregnancy BMI greater than 30.0) had narrower retinal arteriolar caliber (118.81 compared with 123.38 micrometers, P<.001), wider retinal venular caliber (175.81 compared with 173.01 micrometers; P<.01), and increased retinal venular tortuosity (129.92 compared with 121.49 × 10(-6); P<.01). Pregnant women whose BMI-specific weight gain from prepregnancy to 26 weeks of gestation was above Institute of Medicine recommendations had narrower retinal arteriolar caliber (120.68 micrometers) than women with ideal (121.91 micrometers) and less than ideal weight gain (123.17), respectively (P trend=.05). These data indicate that greater prepregnancy BMI and pregnancy BMI are associated with adverse retinal microvascular measures, suggesting that maternal obesity has an effect on her microcirculation.

Impaired fetal thymic growth precedes clinical preeclampsia: a case–control study

In preeclampsia the maternal adaptive immune system undergoes specific changes, which are different from the physiological processes associated with healthy pregnancy. Whether preeclampsia also affects the fetal immune system is difficult to investigate, due to limited access to the fetus. We hypothesized that if preeclampsia affects the fetal adaptive immune system this might be associated with early changes in thymic growth. In this case–control study, 53 preeclamptic and 120 healthy control pregnancies were matched for maternal age, gestational age and smoking. Fetal thymus diameter was measured as the greatest width perpendicular to a line connecting sternum and spine based on ultrasound images taken at 17–21 weeks gestation. Independent of fetal and maternal anthropometric measures, thymuses were found to be smaller in preeclamptic pregnancies than healthy controls (16.2mm versus 18.3mm, respectively, mean difference=2.1mm, 95% CI: 0.8–3.3, p<0.001), and the odds of developing preeclampsia was estimated to be 0.72 (95% CI: 0.60–0.86, p<0.001) lower for each 1mm increase in thymus diameter. There was no correlation between the onset of preeclampsia and fetal thymus size. This is the first study to suggest that fetal thymus growth is reduced before the clinical onset of preeclampsia and precedes any described fetal anomalies or maternal immunological changes associated with preeclampsia. We propose that the fetal adaptive immune system is either passively affected by maternal processes preceding clinical preeclampsia or is actively involved in initiating preeclampsia in later pregnancy.

Impact of perinatal different intrauterine environments on child growth and development in the first six months of life - IVAPSA birth cohort: rationale, design, and methods

BackgroundIn the last twenty years, retrospective studies have shown that perinatal events may impact the individual health in the medium and long term. However, only a few prospective studies were designed to address this phenomenon. This study aims to describe the design and methods of the Impact of Perinatal Environmental Variations in the First Six Months of Life - the IVAPSA Birth Cohort.Method/DesignThis is a clinical study and involves the recruitment of a birth cohort from hospitals in Porto Alegre, Rio Grande do Sul, Brazil. Mothers from different clinical backgrounds (hypertensive, diabetics, smokers, having an intrauterine growth restricted child for idiopathic reasons, and controls) will be invited to join the study twenty-four hours after the birth of their child. Data on economic, social, and maternal health care, feeding practices, anthropometric measures, physical activity, and neuropsychological evaluation will be obtained in interviews at postpartum, 7 and 15 days, 1, 3 and 6 months of life.DiscussionTo our knowledge, this is the first thematic cohort focused on the effects of intrauterine growth restriction to prospectively enroll mothers from different clinical backgrounds. The IVAPSA Birth Cohort is a promising research platform that can contribute to the knowledge on the relationship between perinatal events and their consequences on the children's early life.

Maternal anthropometric measurements and other factors: relation with birth weight of neonates

The objective of this study was to examine the influence of anthropometric measurements of pregnant women, gestational weight gain, fundal height, and maternal factors, namely age, education, family income, parity along with maternal hemoglobin, on birth weight of neonates. A cross sectional study was performed in Khoy City in north west of Iran. Four hundred and fifty healthy pregnant women in the age between 16-40 years were selected for this study from seven health urban centers and one referral hospital. Findings showed that the mean age, height, fundal height, maternal weight, and gestational weight gain during pregnancy were 26.1 years, 159.1 cm, 32.9 cm, 72.0 kg, 11.8 kg respectively. The mean birth weight of neonates was 3.2 kg and 11% of neonates showed low birth weight. Age, family income, maternal height, weight, gestational weight gain and fundal height were significantly associated with birth weight of neonates. Using binary logistic regression analysis, fundal height, maternal hemoglobin, family income and gestational weight gain of pregnant women could be considered as predictive factors of birth weight of neonates.

Impact of a Mother’s Weight History on Her Offspring

ObjectiveTo explore the relationship between maternal lifelong body weight history and anthropometric measurements in the offspring. MethodsWe studied a prospective sample of 48 pregnant women with either gestational diabetes mellitus (GDM, n = 21) or normal glucose tolerance (NGT, n = 27). Reported maternal weight at birth, 20 years of age and 30 years of age, and pre-pregnancy and maximal weight outside pregnancy were obtained by questionnaire. BMI was calculated using data from the questionnaire. Maternal anthropometric parameters were measured during pregnancy. Offspring anthropometrics were obtained at birth and eight weeks later. ResultsMaternal weight at birth, weight or BMI at 20 years of age and at 30 years of age, and maximal weight or BMI did not differ between groups. In all women, maternal birth weight, BMI at 20 years of age, and maximal BMI correlated with newborn birth weight (ρ = 0.39, 0.37, and 0.27, respectively, P ≤ 0.05), with newborn length (ρ = 0.46, 0.32, and 0.30 respectively, P < 0.05), and with infant weight eight weeks later (ρ = 0.43, 0.30, and 0.31, respectively, P < 0.05). Reported maternal BMI at 30 years of age correlated with infant weight (ρ = 0.31) and cranial circumference (ρ = 0.33) at eight weeks of life (P < 0.05). Besides gestational age, maternal weight at screening was the most significant predictor of infant birth weight. ConclusionSeveral parameters of maternal weight history were related to offspring anthropometric measurements in early life in a sample of women with and without GDM.

Impact of perinatal somatic and common mental disorder symptoms on functioning in Ethiopian women: the P-MaMiE population-based cohort study.

BackgroundLittle is known of the relationship between perinatal somatic and common mental disorder (CMD) symptoms and impaired functioning in women from settings where the burden of undernutrition and infectious disease morbidity is high.MethodsA population-based sample of 1065 women from Butajira, Ethiopia, was recruited in pregnancy (86.4% of those eligible) and reassessed two months postnatal (954 with singleton, live infants). At both time-points, women were administered a modified version of the Patient Health Questionnaire-15 and the Self-Reporting Questionnaire (locally-validated) to assess somatic and CMD symptoms, respectively. Negative binomial regression was used to investigate associations of CMD and somatic symptoms with functional impairment (World Health Organisation Disability Assessment Scale, version-II), after adjusting for maternal anthropometric measures, physical ill-health and sociodemographic factors.ResultsIn pregnancy, somatic and CMD symptoms were independently associated with worse maternal functional impairment after adjustment for confounders (WHODAS-II score multiplied by 1.09 (95%CI 1.06, 1.13) and 1.11 (95%CI 1.08, 1.14) respectively for each additional symptom). In the postnatal period, the size of association between somatic symptoms and functional impairment was diminished, but the association with CMD symptoms was virtually unchanged (multiplier value 1.04 (95%CI 1.00, 1.09) and 1.11 (95%CI 1.07, 1.16) respectively).LimitationsUse of largely self-report measures.ConclusionsSomatic and CMD symptoms were independently associated with functional impairment in both pregnancy and the postnatal period, with CMD symptoms showing a stronger and more consistent association. This emphasises the public health relevance of both CMD and somatic symptoms in the perinatal period.

Pregestational overweight and obesity: prevalence and outcome associated with pregnancy

To describe the obstetric outcome of women with overweight/obesity treated at the prenatal care clinic of a public maternity hospital in Rio de Janeiro. A descriptive cross-sectional study which investigated 433 women (≥20 years-old, without any chronic diseases) and their newborns treated at public hospitals in Rio de Janeiro. Information was collected from medical records and through interviews. The characteristics of mothers and newborns evaluated were divided into maternal (social habits, anthropometric measurements and clinical, obstetric, and prenatal care) and newborn groups (birth conditions). Data regarding the categories of nutritional status were analyzed using the odds ratio (OR) and 95% confidence interval (CI). The prevalence of overweight/obesity in this sample was 24.5% (n=106). There was an association between inadequate weight gain and the prevalence of overweight/obesity (OR 2.7, 95%CI 1.5-4.9, p<0.05). Overweight/obese women had an increased risk for preeclampsia (OR 3.3, 95%CI 1.1--9.9, p=0.03). Regarding birth conditions, mean birth weight was 3291.3 g (±455.2), with rates of low birth weight of 4.7% (n=5) and rates of macrosomia of 2.8% (n=3). There was an alarming prevalence of inadequate nutritional status before and during pregnancy, which may be associated with increased risk of perinatal morbidity and mortality. This suggests the need for nutritional monitoring of these pregnant women.

Anthropometric measurements as predictors of cephalopelvic disproportion

We assessed the efficacy of maternal anthropometric measurements and clinical estimates of fetal weight in isolation and in combination as predictors of cephalopelvic disproportion (CPD). Prospective cohort study. Tertiary care teaching hospital, two affiliated hospitals with facilities for conducting cesarean delivery and seven affiliated primary care facilities with no operation theaters. Primigravidae over 37 weeks' gestation attending these facilities during a 20-month period with a singleton pregnancy in vertex presentation. Several anthropometric measurements were taken in 249 primigravidae. Fetal weight was estimated. Differences in these measurements between the vaginal delivery and CPD groups were analyzed. The validity of these measurements in predicting CPD was analyzed by plotting receiver operating characteristic curves and by logistic regression analysis. Mode of delivery. Maternal height, foot size, inter-trochanteric diameter and bis-acromial diameter showed the highest positive predictive values for CPD. Combining some maternal measurements with estimates of fetal weight increased predictive values modestly, which are likely to be greater if the estimates of fetal weight are close to the actual birth weight. Based on multivariate analysis the risk factors for CPD in our population were foot length ≤23cm, inter-trochanteric diameter ≤30cm and estimated fetal weight ≥3 000g. Maternal anthropometric measurements can predict CPD to some extent. Combining maternal measurements with clinical estimates of fetal weight only enhances the predictive value to a relatively modest degree (positive predictive value 24%).

Measurement of Breast Milk Intake Using Deuterium Oxide and Fourier Transformed Infrared Spectrophotometer - A Pilot Study

The measurement of breast milk intake of infants is essential to the estimation of nutrient re-quirements during infancy and lactation. The conventional method, test-weighing procedure for measuring breast milk is time consuming, most often inaccurate and may interfere with the mother�s normal activities. A more practical and accurate method is isotope dilution using stable isotope-labelled water. The accuracy and ready availability of deuterium oxide (D2O) have led to its extensive use in measuring body composition and breast milk intake of infants. The D2O turnover method was field-tested in 13 lactating Ghanaian mother-baby pairs. Maternal and baby anthropometric measurements were made. Baby milk intake and maternal body composi-tion were measured with the dose-to-mother method. Pre-dose samples of saliva were taken from each mother-baby pair. A measured D2O dose (30g) was administered orally to the mother. Post-dose saliva samples were collected from mother and baby on days 1, 2, 3, 4, 13, and 14. Samples were analysed using Fourier Transformed Infrared Spectrophotometer (FTIR). The mean � SD maternal age was 24 � 5 years. Babies were aged 3.5 months on the average and weighed 6.7 � 0.7 kg. Mean milk intake of babies was 828 � 132 ml/day with a range of 610 to 1040 ml/day. Maternal fat free mass and % body fat were 44.8 � 5.3 kg, 23.1 � 5.1 respectively. This non-invasive and convenient method has been used successfully to measure breast milk intake of Ghanaian infants.

Birth weight, length, head circumference and Maternal 25 Hydroxyvitamin D (25OHD) concentration in mother‐infant pairs living in Vancouver, British Columbia, Canada

Results of studies examining associations between maternal 25OHD and birth anthropometric measures have been equivocal. Here we examine the association between maternal 25OHD (20–35 wks) and each of birth weight, birth length, and head circumference in 306 mother‐infant pairs living in Vancouver (49°N). Mean (SD) maternal 25OHD was 66 (23) nmol/L. 25% and 65% had 25OHD levels &lt;50 and &lt;75 nmol/L, respectively, two commonly‐used cutoffs for vitamin D insufficiency. In multivariate analyses controlling for potential confounders (i.e. maternal height, season, and ethnicity) there was no association [β (95 % CI); P] between maternal 25OHD and each of birth weight [0.2 kg (−2.5, 3.0); P=0.83], birth length [0.08 cm (−0.007, 0.023); P=0.98], or head circumference [0.00 cm (−0.009, 0.008); P=0.98]. Likewise, having a maternal 25OHD &lt; 50 or &lt;75 nmol/L was not associated with birth weight, birth length, or head circumference in logistic regressions. Despite a high prevalence of vitamin D insufficiency, maternal 25OHD was not associated with birth anthropometric measures in this sample. (Supported by the Canadian Vitamin Class Action settlement)

Relationships of Umbilical and Maternal Adiponectin, Resistin and Osteoprotegerin to Maternaland Newborn Anthropometric Characteristics

Introduction. Adiponectin, resistin and osteoprotegerin (OPG) are cytokines expressed in the adipose tissue. Pregnancy is associated with gradually increased maternal levels of these molecules, also detected in significant amounts in umbilical cord blood serum samples. Aim, patients and methods. To establish the relationships of maternal and umbilical adiponectin, resistin and OPG levels to both maternal and fetal anthropometric measurements and insulin sensitivity, 28 mother-newborn pairs were enrolled in the study. Blood samples were collected in a fasting state, after delivery, and serum insulin, C-peptide, sex hormone-binding globulin, adipocytokines, OPG and bone specific alkaline phosphatase (BAP) were measured. Results. Compared to maternal values, umbilical serum adiponectin levels were about 3-fold higher; additionally, significantly higher resistin and lower OPG levels were observed. Stratification of umbilical and maternal adiponectin levels according to tertiles of birth body weight demonstrated significantly lower maternal adiponectin levels by tertiles of neonatal body weight. No relationships were noticed between infant birth weight and maternal or umbilical serum resistin and OPG, respectively. Umbilical resistin was significantly associated to both maternal resistin and umbilical adiponectin. Multiple regression analysis showed that maternal BMI, umbilical insulin, C-peptide and resistin explained 71.83% of umbilical serum adiponectin variability. Umbilical resistin was independently predicted by umbilical adiponectin, umbilical C-peptide and maternal BMI, and the model explained 81.49% of umbilical resistin levels. Conclusions. In human, umbilical serum adiponectin and resistin levels are significantly higher compared to adults. These adipokines may mediate the effects of maternal body mass on fetal development. The biology of the OPG/RANKL cytokine system in fetuses and newborns needs further research.

Impact of dietary counselling and probiotic intervention on maternal anthropometric measurements during and after pregnancy: A randomized placebo-controlled trial

To establish whether probiotic supplemented dietary counselling influences maternal anthropometric measurements during and after pregnancy. At the first trimester of pregnancy 256 women were randomly assigned to receive nutrition counselling to modify dietary intake according to current recommendations or as controls; dietary intervention groups were further randomized to receive probiotics Lactobacillus rhamnosus GG (ATCC 53103) and Bifidobacterium lactis (diet/probiotics) or placebo (diet/placebo) capsules in a double-blind manner, whilst the controls received placebo (control/placebo). The intervention lasted until the end of exclusive breastfeeding for up to six months. The risk of central adiposity defined as waist circumference 80cm or more was lowered in women in the diet/probiotics group compared with the control/placebo group (OR 0.30, 95%CI 0.11-0.85, p=0.023 adjusted for baseline BMI), whilst the diet/placebo group did not differ from the controls (OR 1.00, 95% CI 0.38-2.68, p=0.994) at 6 months postpartum. The number needed to treat (NNT) with diet/probiotics to prevent one woman from developing a waist circumference of 80cm or more was 4. Healthy eating pattern at 12 months postpartum (p=0.001) and BMI prior to pregnancy (p<0.001) were strong determinants of BMI at 12 months postpartum when adjusted for dietary intervention and exercise. The impact of probiotics-supplemented dietary counselling on central adiposity, may offer a novel means for the prevention and management of obesity. This trial was registered at clinicaltrials.gov as NCT 00167700, section 3.

Prenatal Maternal Zinc Supplements Reduce Infant Diarrhea

Research Article| October 01 2010 Prenatal Maternal Zinc Supplements Reduce Infant Diarrhea AAP Grand Rounds (2010) 24 (4): 43. https://doi.org/10.1542/gr.24-4-43 Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Facebook Twitter LinkedIn MailTo Tools Icon Tools Get Permissions Cite Icon Cite Search Site Citation Prenatal Maternal Zinc Supplements Reduce Infant Diarrhea. AAP Grand Rounds October 2010; 24 (4): 43. https://doi.org/10.1542/gr.24-4-43 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search toolbar search search input Search input auto suggest filter your search All PublicationsAll JournalsAAP Grand RoundsPediatricsHospital PediatricsPediatrics In ReviewNeoReviewsAAP NewsAll AAP Sites Search Advanced Search Topics: infantile diarrhea, prenatal care, zinc supplement, diarrhea Source: Iannotti L, Zavaleta N, Leon Z, et al. Maternal zinc supplementation reduces infectious disease morbidity in Peruvian infants. J Pediatr. 2010; 156(6): 960– 964; doi: https://doi.org/10.1016/j. jpeds.2009.12.023Google Scholar Investigators from the US and Peru performed this double-blind randomized controlled trial in a peri-urban slum of Lima, Peru between 1995 and 1997 to assess the effect of zinc supplementation during pregnancy on subsequent infectious diseases through infancy. Researchers enrolled 1,295 women between 10 and 24 weeks gestation who were carrying a low-risk singleton pregnancy. These women were stratified by gestational age (less than or more than 17 weeks) and parity (nulliparous or multiparous) and then randomized to take a daily supplement of 60 mg of iron and 250 μg of folic acid either with or without 15 mg of zinc. The two tablets were otherwise indistinguishable, and were taken from 10 to 24 weeks gestation until one month postpartum. Socioeconomic and household characteristics and maternal anthropometric measurements were recorded. Infant weights were recorded at birth and then monthly for 12 months. Morbidity surveillance was done by field workers through weekly home visits. Of the 421 infants who completed the 12-month study, 214 received zinc supplementation. There were no differences between the zinc-supplemented and control groups with regard to socioeconomic or household characteristics, gestational age at birth, or birth weight. Adjusting for the age of the infant, breastfeeding, season, and sanitation and hygiene covariates, prenatal zinc supplementation reduced the risk of a diarrheal episodes lasting more than seven days by 34% (OR 0.66; 95% CI, 0.43–0.99; P=.04) and decreased the presence of mucus in the stool (OR 0.65; 95% CI, 0.46–0.92; P=.01) as compared to controls. The mean observed days with diarrhea among infants prenatally treated with zinc (5.8%) was less than infants in the control group (7.7%; P=.01). There was a trend toward fewer diarrheal episodes (≥3 liquid or loose stools in 24-hour period) in the prenatal zinc-supplemented group. No effect was detected for respiratory illnesses, fever, scabies, or impetigo. The authors conclude that prenatal zinc supplementation decreased diarrhea-associated morbidity in offspring during the first 12 months of life. In 2009, the World Health Organization recommended that zinc be added to oral rehydration therapy in the treatment of acute diarrhea. 1 The authors of this article propose an immunological basis to explain the beneficial effect from prenatal zinc supplementation. Zinc deficiency in humans decreases the activity of serum thymulin (a thymic hormone), which is required for maturation of T-helper cells and plays an important role in cell-mediated immune function and also functions as an anti-inflammatory and antioxidant agent.2 Infectious diarrheal diseases are the second leading cause of morbidity and mortality worldwide.3 Zinc deficiency places children at increased risk of illness and death from diarrhea.4 Zinc deficiency is prevalent in low-income countries, as this micronutrient is mainly found in expensive red meat. Pooled analysis of studies that have assessed the effect of... You do not currently have access to this content.

Maternal anthropometric characteristics in pregnancy and blood pressure among adolescents: 1993 live birth cohort, Pelotas, southern Brazil

BackgroundWe investigated the association between maternal anthropometric measurements in prepregnancy and at the end of pregnancy and their children's systolic (SBP) and diastolic (DBP) blood pressure at 11 years of age, in a prospective cohort study.MethodsAll hospital births which took place in 1993 in the city of Pelotas - Brazil, were identified (5,249 live births). In 2004, the overall proportion of follow-up was 85% and we obtained arterial blood pressure measurements of 4,452 adolescents.ResultsIndependent variables analyzed included maternal prepregnancy weight and body mass index (BMI) and maternal weight, and height at the end of pregnancy. Multiple linear regression analysis controlling for the following confounders were carried out: adolescent's skin color, family income at birth, smoking, alcohol intake during pregnancy, and gestational arterial hypertension. Mean SBP and DBP were 101.9 mmHg (SD 12.3) and 63.4 mmHg (SD 9.9), respectively. Maternal prepregnancy weight and BMI, and weight at the end of pregnancy were positively associated with both SBP and DBP in adolescent subjects of both sexes; maternal height was positively associated with SBP only among males.ConclusionsAdequate evaluation of maternal anthropometric characteristics during pregnancy may prevent high levels of blood pressure among adolescent children.

Comparison of Various Maternal Anthropometric Indices of Obesity for Identifying Metabolic Syndrome in Offspring

Several maternal anthropometric markers have been associated with the metabolic syndrome (MS) in offspring. The objectives of this study were (1) to determine the association between children's MS and maternal anthropometric markers such as body mass index (BMI), waist circumference (WC), WC/height, weight/sitting height squared, and WC/sitting height and (2) to compare the abilities of these five indices to identify children with MS. Data were collected cross-sectionally from five elementary schools between April 2007 and March 2008. BMI, WC, WC/height, weight/sitting height squared, and WC/sitting height were acquired in mothers and their children. Tanner stage, blood pressure, glucose, lipids, and insulin were measured in children. Criteria analogous to Adult Treatment Panel III for MS were used for children. Of 624 children (307 boys) 8.96 +/- 1.86 years old, with their mothers being 36.25 +/- 7.14 years old, examined, 107 (17.1%) of children were obese (BMI >95th percentile per Centers for Disease Control and Prevention norms), and 95 (15.2%) were overweight (OW) (85th percentile < or =BMI < 95th percentile). Of the mothers, 109 (30.4%) were obese (BMI > 30 kg/m(2)), and 206 (33.0%) were OW (25 kg/m(2) < BMI < 30 kg/m(2)). Approximately 68% of the children were prepubertal. The prevalence of MS was 3.5% overall: 6.7% in OW and 13.9% in obese children. To determine which marker was a better predictor for MS, a receiver operating characteristics (ROC) curve was generated for the five maternal anthropometric measures, with children's MS as the dichotomous variable. The areas under the ROC curves were 0.697 +/- 0.07 for BMI, 0.698 +/- 0.07 for WC, 0.717 +/- 0.07 for WC/height, 0.725 +/- 0.07 for WC/sitting height, and 0.704 +/- 0.07 for weight/sitting height squared. There was no significant difference between the areas of the five maternal anthropometric markers as predictors of children's MS. Measurement of maternal sitting height had no advantages over total height in the prediction of children's MS. All maternal anthropometric measures identified the MS in their children consistent with known familial associations of obesity and type 2 diabetes.

Association of Maternal Nutritional Status, Body Composition and Socio-economic Variables with Low Birth Weight in India

The present cross-sectional study examines the association of maternal nutritional status, body composition and socio-economic status with newborn low birth weight (LBW). It was conducted on 503 mothers and their singleton newborns in an urban hospital in Siliguri, West Bengal, India. The maternal anthropometric measurements (weight, height, mid-upper arm circumference and triceps skinfold), socio-economic variables (education, household income, occupation and birth order) and newborn birth weight were recorded. The average birth weight was 2.746 (+/-0.40) kg and 17.30% of the newborns had LBW. The multinomial regression analysis showed maternal age, height, weight nutritional status, birth order and household income to have significant associations with newborn LBW. The receiver operating characteristic curve-area under curve analysis showed maternal weight and mid-upper arm circumference to be the best surrogate measures of LBW.