Maternal Anthropometric Research Articles

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<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 <0.05) or more (Coefficient 2.37: 95% CI 0.92-3.82: P <0.05), Monthly family income of more than 30,000/= rupees (Coefficient 2.28: 95% CI 0.92-3.63: P<0.05) and Tamil ethnicity (Coefficient 2.10: 95% CI 0.69-3.52: P<0.05) were statistically significant risk factor. In the analysis, maternal age (Coefficient 0.09: 95% CI -0.05-0.23: P>0.05), mother’s occupation (Coefficient 0.08: 95% CI -1.01-1.17: P>0.05) and maternal educational level (Coefficient 1.68: 95% CI -0.30-3.66: P>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<0.05) was a significant risk factor. Maternal BMI at booking visit (Coefficient 1.76: 95% CI -0.34-3.85: P>0.05), maternal weight at booking visit (Coefficient -0.63: 95% CI -1.5-0.26: P>0.05) and maternal height (Coefficient 0.56: 95% CI -0.08-1.2: P>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>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.

Nutrient-Dense Moringa oleifera Leaf Supplementation Increases Human Milk Output in Western Kenyan Mothers

ObjectivesWe aim to evaluate the impact of moringa leaf powder on maternal and infant nutrition, milk output, and intestinal health.MethodsThis was a single-blinded cluster-randomized controlled trial of 20g of moringa in corn porridge versus porridge alone taken daily for 3 months by exclusively breastfeeding women of term infants (>36 weeks gestational age) enrolled within 30 days of birth in Kisumu, Kenya. At enrollment and exit, we collected 24-hour pumped milk output, milk, maternal and infant fecal and capillary samples, and Hemoglobin by HemoCue©. We performed monthly infant and maternal anthropometrics. We will perform biosample analysis for markers of vitamin A and iron status, IGF-1, and inflammatory markers; milk/fecal microbiome; milk composition; and intestinal inflammation/markers of environmental enteric dysfunction. Data is analyzed via IBM SPSS v.27 with univariate and multivariate analysis for primary and secondary outcomes.ResultsN = 50 mother-infant pairs (infants 44% female). Most infants were appropriate for gestational age (GA) (27, 54%) with 19 (38%) large for GA and 1 small for GA. Mothers’ were initially 14% wasted (MUAC < 23cm), with MUAC 26.2 ± 2.7cm overall, n = 49. Wasting resolved in all. Maternal 24-hour milk output did not differ at enrollment between clusters (502.5,303.8–896.3, n = 24 vs. 525.0,363.8–693.8 mL, n = 24; p = 1.0) but did increase dramatically at exit in the cluster receiving moringa (control: 648.81 ± 324.1, n = 21 vs. intervention: 981.09 ± 368.3 mL, n = 23; p = 0.003). Infant growth (average daily weight gain, total weight gain, WLZ, WAZ, or LAZ) and maternal MUAC and BMI did not differ between clusters at enrollment or exit. Maternal and infant hemoglobin (hgb) did not differ between clusters at enrollment; maternal anemia (hgb < 11 g/dL) trended higher in the control at enrollment (40% vs. 12.5%, n = 49, p = 0.05); at exit this difference resolved. Infant hgb was higher at exit in the intervention group (11.3 ± 0.8 vs. 10.7 ± 1.0, p = 0.02). No participants experienced adverse effects.Conclusions20g daily moringa leaf powder for three months increases maternal milk output but has no impact on growth in a sample of Kenyan infants and mothers with a low rate of initial undernutrition.Funding SourcesThis research was funded by an NIH K award and an NIH BIRCWH Award as well as early investigator startup funds from the University of Kentucky.

Sex-dependent influence of maternal predictors on fetal anthropometry in pregnancies with gestational diabetes mellitus

BackgroundThird trimester fetal anthropometric parameters are known to predict neonatal complications. A better understanding of predictors of adverse fetal parameters might help to personalize the use and frequency of fetal ultrasound. The objectives of this study were:(a) to evaluate the utility of maternal sociodemographic, anthropometric and metabolic predictors to predict 3rd trimester fetal anthropometric parameters in women with gestational diabetes mellitus (GDM),(b) to assess whether the impact of these maternal predictors is fetal sex-dependent, and(c) to provide a risk stratification for markers of fetal overgrowth (fetal weight centile (FWC) and fetal abdominal circumference centile (FACC) depending on prepregnancy BMI and gestational weight gain (GWG) until the 1st GDM visit.MethodsThis prospective study included 189 women with GDM. Maternal predictors were age, ethnicity, prepregnancy BMI, GWG and excessive weight gain until the 1st GDM visit, fasting, 1-hour and 2-hour blood glucose oral glucose tolerance test values, HbA1c at the 1st visit and medical treatment requirement. Fetal outcomes included FWC, FWC >90% and <10%, FACC, FACC >90% and <10%, at 29 0/7 to 35 6/7 weeks of gestational age. We performed univariate and multivariate regression analyses and probability analyses.ResultsIn multivariate analyses, prepregnancy BMI was associated with FWC, FWC > 90% and FACC. GWG until the 1st GDM visit was associated with FWC, FACC and FACC > 90% (all p ≤ 0.045). Other maternal parameters were not significantly associated with fetal anthropometry in multivariate analyses (all p ≥ 0.054). In female fetuses, only GWG was associated with FACC (p= 0.044). However, in male fetuses, prepregnancy BMI was associated with FWC, FWC > 90% and FACC and GWG with FWC in multivariate analyses (all p ≤ 0.030). In women with a prepregnancy BMI of ≥ 25 kg/m2 and a GWG until the 1st GDM visit ≥ 10.3 kg (mean GWG), the risk for FWC > 90% and FACC > 90% was 5.3 and 4 times higher than in their counterparts.ConclusionsA personalized fetal ultrasound surveillance guided by fetal sex, prepregnancy BMI and GWG may be beneficial in reducing adverse fetal and neonatal outcomes.

Associations of ultra-processed food intake with maternal weight change and cardiometabolic health and infant growth

BackgroundExcessive intake of ultra-processed foods, formulated from substances extracted from foods or derived from food constituents, may be a modifiable behavioral risk factor for adverse maternal and infant health outcomes. Prior work has predominately examined health correlates of maternal ultra-processed food intake in populations with substantially lower ultra-processed food intake compared to the US population. This longitudinal study investigated relations of ultra-processed food intake with maternal weight change and cardiometabolic health and infant growth in a US cohort.MethodsMothers in the Pregnancy Eating Attributes Study were enrolled at ≤12 weeks gestation and completed multiple 24-Hour Dietary Recalls within six visit windows through one-year postpartum (458 mothers enrolled, 321 retained at one-year postpartum). The NOVA (not an acronym) system categorized food and underlying ingredient codes based on processing level. Maternal anthropometrics were measured throughout pregnancy and postpartum, and infant anthropometrics were measured at birth and ages 2 months, 6 months, and 1 year. Maternal cardiometabolic markers were analyzed from blood samples obtained during the second and third trimesters.ResultsHolding covariates and total energy intake constant, a 1-SD greater percent energy intake from ultra-processed foods during pregnancy was associated with 31% higher odds of excessive gestational weight gain (p = .045, 95% CI [1.01, 1.70]), 0.68±0.29 mg/L higher c-reactive protein during pregnancy (p = .021, 95% CI [0.10, 1.26]), 6.7±3.4% greater gestational weight gain retained (p = .049, 95% CI [0.03, 13.30]), and 1.09±0.36 kg greater postpartum weight retention (p = .003, 95% CI [0.38, 1.80]). No other significant associations emerged.ConclusionsUltra-processed food intake during pregnancy may be a modifiable behavioral risk factor for adverse maternal weight outcomes and inflammation. Randomized controlled trials are needed to test whether targeting ultra-processed food intake during pregnancy may support optimal maternal health.Trial registrationClinicaltrials.gov. Registration ID – NCT02217462. Date of registration – August 13, 2014.

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.

Maternal short stature, household socio-economic status and stunting among under-two children attending an immunization clinic at a tertiary hospital in Kathmandu, Nepal

Stunting or poor linear growth affects about 25% of children under five globally. Poor linear growth may occur due to lack of nutrients or due to hormonal influences. This study has investigated the relationship between maternal stature, household socio-economic status and linear growth among children below two years of age visiting the immunization clinic at an urban tertiary hospital in Kathmandu, Nepal. An observational cross-sectional analytical study was carried out through a face-to-face interview of mothers with a pretested standardized proforma. Anthropometric measurement of mother and child dyads was carried out to assess the nutritional status. Nutritional anthropometry tool in Epi-Info version 7.2.0.2 was used to calculate height-for-age z-scores (HAZ) based on the WHO 2007 reference data. A cut-off of –2 z-scores was used to define stunting (&lt;-2HAZ). Linear regression was used to study the correlation between maternal anthropometric indices and HAZ scores. Univariate logistic regression was used to assess potential predictors. Among 396 mother-child dyads, with 186 female children, the prevalence of low birth weight was 7% (95% CL: 5.1% to 10.3%) and stunting was 4.5% (95% CL: 2.9 to 7.0). Proportion of mothers with short stature (&lt;145 cm) was 7.5% (95% CL: 5.3% to 10.5%). Maternal height had a higher correlation with HAZ in comparison to weight (r 0.24, P&lt;0.0001 vs 0.09, P=0.04). The mean HAZ score among infants (&lt;6 months) was 1.25, 0.22 among those aged 6-11 months and -0.15 among those 12 months and above. Preterm birth (P=0.03), low birthweight (P&lt;0.001) and being underweight (P=0.001) were associated with stunting. Though a low prevalence of stunting was seen, the downward shift in HAZ indicated a deficit in linear growth at the population level. This reflected the utility of HAZ as a population level marker for child undernutrition. As the prevalence of stunting among under-five children has continued to decline in Nepal, eliminating the downward shift in linear growth among under-two children can be prioritized. Potential areas of research include identification of appropriate cut-offs for maternal short stature and exploration of the epidemiological association between ponderal and linear growth among children in the local context. A consistent access to care during the antenatal period, child delivery and improved child feeding practices may have helped to improve the nutritional status among the under-two children. Assessment of linear growth along with weight gain needs to be emphasized during growth monitoring.

Exercise and Physical Activity Levels and Associated Factors Among High-Risk Pregnant Women.

To assess the levels of physical activity and exercise practice, and examine the associated maternal characteristics; as well as the anxiety levels of high-risk pregnant women. A cross-sectional study conducted with pregnant women at a High-risk Prenatal Clinic (HRPC) in a tertiary maternity. Pregnant women of 18 to 40-years-old, with a single fetus, and with gestational age up to 38 weeks were included. The level of physical activity and exercise practice of the study's participants were investigated using the Pregnancy Physical Activity Questionnaire (PPAQ). Maternal sociodemographic, anthropometric, and medical data were investigated using a specific form. For anxiety levels, the short version of the State-Trait Anxiety Inventory (STAI) was applied. We used the Student t-test, chi-square test, odds ratio (OR) with 95% confidence interval (95% CI) and multiple logistic regression. The significance level was 5%. Among the 109 pregnant women included, 82 (75.2%) were classified as sedentary/little active. The higher energy expenditure were for domestic activities (133.81 ± 81.84 METs), followed by work-related activities (40.77 ± 84.71 METs). Only 19.3% women exercised during pregnancy (4.76 ± 12.47 METs), with slow walking being the most reported exercise. A higher level of education was the most important factor associated with women being moderately or vigorously active (OR = 29.8; 95% CI 4.9-117.8). Nulliparity (OR = 3.1; 95% CI 1.0-9.1), low levels of anxiety (OR = 3.6; 95% CI 1.2-10.7), and unemployment (OR = 4.8; 95% CI 1.1-19.6) were associated with the practice of exercise during pregnancy. Most women with high-risk pregnancies exhibited a sedentary pattern, with low prevalence of physical exercise practice. Recognizing factors that hinder the adoption of a more physically active lifestyle is essential for an individualized guidance regarding exercise during pregnancy.

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 anthropometric variables and clinical factors shape neonatal microbiome

Recent studies indicate the existence of a complex microbiome in the meconium of newborns that plays a key role in regulating many host health-related conditions. However, a high variability between studies has been observed so far. In the present study, the meconium microbiome composition and the predicted microbial metabolic pathways were analysed in a consecutive cohort of 96 full-term newborns. The effect of maternal epidemiological variables on meconium diversity was analysed using regression analysis and PERMANOVA. Meconium microbiome composition mainly included Proteobacteria (30.95%), Bacteroidetes (23.17%) and Firmicutes (17.13%), while for predicted metabolic pathways, the most abundant genes belonged to the class “metabolism”. We observed a significant effect of maternal Rh factor on Shannon and Inverse Simpson indexes (p = 0.045 and p = 0.049 respectively) and a significant effect of delivery mode and maternal antibiotic exposure on Jaccard and Bray–Curtis dissimilarities (p = 0.001 and 0.002 respectively), while gestational age was associated with observed richness and Shannon indexes (p = 0.018 and 0.037 respectively), and Jaccard and Bray–Curtis dissimilarities (p = 0.014 and 0.013 respectively). The association involving maternal Rh phenotype suggests a role for host genetics in shaping meconium microbiome prior to the exposition to the most well-known environmental variables, which will influence microbiome maturation in the newborn.

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;

Nexus between maternal underweight and child anthropometric status in South and South-East Asian countries

ObjectivesMaternal underweight and childhood malnutrition are life-threatening public health concerns in several South and South-East Asian nations. The aim of this study was to better design interventions and prevent malnutrition of children in the region by exploring the association of maternal underweight with children's anthropometric status. MethodsThe Demographic and Health Survey's (DHS) most recent nationally representative data from eight South and South-East Asian states, collected between 2014 and 2018, were pooled for the present study. A multivariable logistic regression model was designed to explore the association between maternal underweight and child anthropometric status. Owing to the hierarchical structure of the DHS data, the study also employed the multilevel logistic regression technique. ResultsAmong the total participants (N = 213 730), 22.66% of women were found to be underweight, whereas 39.03%, 35.88%, and 22.11% of their children had stunting, underweight, and wasting, respectively. The logistic regression model showed that the children from underweight mothers were 1.27 (95% confidence interval [CI]. 1.24–1.30), 1.69 (95% CI, 1.65–1.73), and 1.48 (95% CI, 1.45–1.52) times more likely to experience stunting, underweight, and wasting, respectively, than those with healthy-weight mothers. The significant association between maternal underweight and stunting, underweight, as well as wasting was additionally established by the multilevel logistic regression analysis. ConclusionsFindings indicate that maternal underweight is positively associated with children's anthropometric status, such as stunting, underweight, and wasting. The information from this research will guide actors and policymakers to scale up interventions with all-inclusive nutritional issues and promote healthier weight status among mothers to ensure higher odds of healthier anthropometric status in their children in the South and South-East Asian countries.

Chronic hypertension and risk of preterm delivery: National Longitudinal Study of Adolescents to Adult Health.

Chronic hypertension during pregnancy is associated with increased risk of adverse birth outcomes. In 2017, the American College of Cardiology and American Heart Association (ACC/AHA) lowered thresholds to classify hypertension in non-pregnant adults to SBP≥130mmHg and DBP≥80mmHg (ie stage I hypertension), resulting in an additional 4.5-million reproductive-aged women meeting criteria for hypertension. Little is known about effects of pre-pregnancy blood pressure (BP) in this range. To examine the effect of pre-pregnancy maternal BP on preterm delivery. We analysed the data from two waves of the National Longitudinal Study of Adolescent to Adult Health, including participants that had measured BP at Wave IV (2008-09) and a pregnancy that resulted in a singleton live birth between Waves IV and V (2016-18; n=2038). We categorised BP using ACC/AHA cut-offs: normal (SBP<120mmHg and DBP<80mmHg), elevated (SBP 120-129mmHg and DBP<80mmHg), hypertension stage I (SBP 130-139mmHg or DBP 80-89mmHg) and hypertension stage II (SBP≥140mmHg or DBP≥90mmHg). We estimated risk ratios (RR) with log-binomial regression adjusting for maternal demographics, anthropometrics and medication use. The prevalence of preterm delivery was 12.6%. A standard deviation (SD) increment in SBP (SD=12.2mmHg) and DBP (SD=9.3mmHg) was associated with a 14% (95% confidence interval [CI] 2, 27) and 20% (95% CI 4, 37) higher risk of preterm delivery. Compared to normotensive controls, stage I (RR 1.33, 95% CI 1.01, 1.74) and stage II (RR 1.34, 95% CI 0.89, 2.00) hypertension were associated with increased risk. We observed greater risk of preterm delivery among women with higher pre-pregnancy BP. Women with stage I hypertension during pregnancy may benefit from increased BP monitoring. Additional studies on the utility of foetal surveillance in this group are warranted.

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.

Risk factors for obstetric anal sphincter injury among adolescents

ObjectiveData regarding the risk factors for obstetrical anal sphincter injury (OASI) among nulliparous adolescent women are scarce. We aimed to evaluate these risk factors. Study designA retrospective case-control study of nulliparous women aged ≤ 21 who delivered vaginally between 3/2011 and 6/2021. Maternal and intrapartum characteristics were compared between OASI and no-OASI groups. ResultsOf 1,342 deliveries, 22 (1.6%) cases of OASI were diagnosed. Maternal anthropometric and demographic characteristics did not vary between study groups. Gestational comorbidity (diabetic and hypertensive disorders) was associated with an increased risk for an OASI [OR 95% CI 3.1 (1.1–8.6)]. The rate of prolonged second stage was associated with an OASI [OR 95% CI 2.5 (1.1–6.5)]. The mode of delivery was similar in both groups. There were no forceps deliveries in the OASI group. Birthweight and the proportion of newborns weighing more than 4,000 g were similar in both study groups. All sonographic biometric measurements did not vary between study groups. Women with an OASI had higher rate of blood transfusion [OR 95% CI 11.4 (3.1–42.0)].In a multivariable regression analysis, including birthweight, vacuum assisted delivery, prolonged second stage and gestational comorbidity - gestational comorbidity was the only independent factor associated with the occurrence of an OASI [adjusted OR 95% CI 2.9 (1.05–8.17)]. ConclusionGestational comorbidity is the only predictor of OASI among nulliparous adolescent women.

Maternal anthropometric measurements and correlation to maternal and fetal outcomes in late pregnancy.

Background:Body mass index does not distinguish between lean and fat body mass; therefore, its utility defining body composition is limited in pregnancy. Anthropometric measurements may better represent variation in body composition among women who are overweight or obese. We sought to examine body fat composition using maternal anthropometric measurements in late pregnancy and correlate with mode of delivery.Methods:A prospective study of pregnant patients who were overweight (body mass index: 25–29.9 kg/m2) or obese (body mass index ⩾ 30 kg/m2) with singleton pregnancies who underwent anthropometric measurements between 27 weeks, 0 days to 34 weeks, 6 days gestation. Maternal skinfold thicknesses from eight sites were used to estimate body fat mass. Correlation of skinfold thickness, anthroprometric measurements, and estimated body fat percentage on mode of delivery were analyzed with p < .05 as significant.Results:A total of 41 women with overweight (34.1%) or obese (65.9%) body habitus were included. Mean age was 29.9 years, and the majority (43.9%) were Black and 31.7% identified Hispanic/Latinx. The average gestational age at recruitment was 30 weeks, 2 days and 38 weeks, 6 days at delivery. A greater weight at recruitment (94.2 vs 81.8 kg, p = .023), waist circumference (47.1 vs 43.5 inches, p = .010), Huston–Presley body fat percentage (36.4% vs 31.8%, p = .030), triceps skinfold thickness (20.1 vs 15.7 mm, p = .030), biceps skinfold thickness (18.6 vs 15.0 mm, p = .042), and skinfold thickness, as well as sum of skinfold sites (83.3 vs 68.8 mm, p = .049) were associated with cesarean delivery compared to vaginal delivery on univariate analysis.Conclusion:Third-trimester anthropometric measurements may help predict increased risk for c-section in women with obesity. Further research may elucidate utility in nutritional counseling and delivery planning.

Association Of Socioeconomic Status With Preeclampsia In Pakistani Females

Introduction: To identify whether there is an association between maternal socioeconomic status as in living style, and preeclampsia in women from Pakistan, and if so, to what extent it increases the risk of developing preeclampsia. Methods: This is a case-control study, consisting of 74 normal pregnant and 76 already diagnosed preeclamptic Pakistani females, recruited from various hospitals in Karachi. Their socioeconomic status was assessed through the standard of living index (SLI) using the National Family Health Surveys (NFHS) criteria, which considers different living facilities as an indicator of socioeconomic status. Odds ratios of preeclampsia were calculated for low, middle and high socioeconomic status and other maternal anthropometric parameters. Results: Based on their groups, it appeared that the highest percentage of preeclamptic females (n= 65; 43.3%) and the lowest of control patients (n=14; 9.3%) lie in lower socioeconomic groups and the results were highly significantly different. Study observed that having lower socioeconomic status (P&lt;0.001) significantly increase risk of having preeclampsia by 9% and middle socioeconomic status has no role in prevalence of preeclampsia shown by 0.0 odds ratio. In addition, odds ratio of age and PreBMI for the preeclamptic females were found as 1.37 (P&lt;0.001) and 1.55 (P&lt;0.001) respectively, which shows that each year increase in age, increases risk of preeclampsia by 1.37 times and 1.55 times with each increased in BMI. Conclusion: Living facilities are indications of socioeconomic status and are strong risk factors of preeclampsia

Programming of obesity and pediatric metabolic syndromes: a review in light of epigenetic modulation

Obesity is a multifactorial health problem characterized by the excessive accumulation of fat in the body and affects approximately 338 million children and adolescents worldwide. For this reason, this study consisted of a literature review to investigate how the causes and treatments of pediatric obesity are being addressed in light of epigenetic modulation as a factor in metabolic programming. For this, preferentially original articles published in English between the years 2017 to 2021 in the PubMed and Scholar Google databases were searched using the epigenetics descriptors; epigenetic modulation; child obesity; metabolic syndrome, combined with each other. A total of 54,000 articles were returned to searches in PubMed and 16,107,000 in Scholar Google. Fewer than 500 studies jointly addressed epigenetics and aspects of obesity or metabolic syndromes in childhood. Only 14 works matched the search criteria. The most discussed epigenetic mechanism in the literature is DNA methylation, whose rates observed mainly in CpG islands of promoter regions in several genes contribute to the prevention and early diagnosis of obesity and other pediatric comorbidities even before birth, based on the correlation between the epigenetic marks, maternal and paternal health and anthropometric indices. Although experimental studies on infant metabolic programming are scarce, existing knowledge suggests that environmental, nutritional, and energy expenditure changes are capable of modulating the epigenome and reversing marks that induce susceptibility to metabolic comorbidities.

Child nutritional status as screening tool for identifying undernourished mothers: an observational study of mother–child dyads in Mogadishu, Somalia, from November 2019 to March 2020

BackgroundActive screening of only pregnant and lactating mothers (PLMs) excludes other mothers of reproductive age susceptible to undernutrition. Our analysis evaluated if mothers presenting with wasted children were more likely...

THE STUDY OF ANTHROPOMETRIC MEASUREMENTS ON INCIDENCE OF HYPOTENSION IN PARTURIENT'S UNDERGOING CESAREAN SECTION UNDER SPINALANAESTHESIA

Background Hypotension following spinal anaesthesia is one of the most common complication leading to poor maternal and fetal outcomes. This study is designed to assess the association between anthropometric parameters and incidence of hypotension in parturient's undergoing cesarean section under spinal anaesthesia. Aim and objectives The aim of this study is to evaluate if maternal anthropometric parameters like abdominal circumference, vertebral column length and symphysiofundal height has any effect on incidence of hypotension during cesarean section under spinal anaesthesia. Methods 100 term pregnant women aged between 18-45 years, ASA-PS grade 1-2 undergoing cesarean section under spinal anaesthesia were included in the study.The preoperative anthropometric parameters - Abdominal circumference(AC), symphysiofundal height(SFH) and vertebral column length (VC)were recorded. Spinal Anaesthesia was induced with 2ml of 0.5% Heavy Bupivacaine at the level of L2-L3. The haemodynamic parameters were recorded every 2 minutes up to 10 minutes and thereafter every 5 minutes up to 20 minutes after spinal anesthesia. Correlation analysis (Spearman's rank test) was performed to nd the correlations of AC , VC length and SFH with the incidence of hypotension. Statistical analysis was done using Chi square test, t test and one way ANOVA . P &lt; 0.05 was considered statistically signicant . ResultsThe incidence of hypotension was directly proportional with increasing SFH and AC. The incidence of hypotension was 83% with SFH of 36–40 cm, 57% with AC 95–99cm, 78% with VC length of 50-55 cms and 22% with VC length of 56-60 cms which was statistically signicant ( P &lt; 0.001). Conclusions The anthropometric measurements like AC, VC length and SFH can be a reliable predictor of hypotension and level of sensory blockade and can help in optimising the dose of spinal anesthetic drug .