Maternal Anthropometry Research Articles

Factors related to insomnia and sleepiness in the late third trimester of pregnancy

To assess the presence of insomnia and sleepiness and related factors in the late third trimester of pregnancy. A total of 370 singleton gravids completed a general questionnaire containing personal data, the Insomnia Severity Index (ISI) and the Epworth Sleepiness Scale (ESS). In addition, maternal anthropometry was recorded upon survey. Median [interquartile range] maternal age and gestational age upon survey was of 31 [7.0] years and 39 [1.8] weeks, respectively. A 73.5% of women displayed some degree of insomnia (Total ISI score 8-28) and 22.2% sleepiness (Total ESS score ≥10). Determined rho Spearman coefficients showed significant correlations between ISI scores and gestational age at survey and survey to birth interval (weeks) and between ESS scores and maternal weight and arm circumference at survey and neonatal birth weight. Multiple linear regression analysis found that smoking habit, higher blood pressure and shorter survey to birth interval (weeks) significantly predicted higher ISI scores, and hence a higher risk of insomnia. Employed status, increased arm circumference and neonatal weight predicted higher ESS scores (sleepiness). Insomnia and sleepiness were prevalent in the late third trimester of pregnancy in which lifestyle factors and maternal and neonatal body composition were significant predictors.

MAVIDOS Maternal Vitamin D Osteoporosis Study: study protocol for a randomized controlled trial. The MAVIDOS Study Group

MAVIDOS is a randomised, double-blind, placebo-controlled trial (ISRCTN82927713, registered 2008 Apr 11), funded by Arthritis Research UK, MRC, Bupa Foundation and NIHR.BackgroundOsteoporosis is a major public health problem as a result of associated fragility fractures. Skeletal strength increases from birth to a peak in early adulthood. This peak predicts osteoporosis risk in later life. Vitamin D insufficiency in pregnancy is common (31% in a recent Southampton cohort) and predicts reduced bone mass in the offspring. In this study we aim to test whether offspring of mothers supplemented with vitamin D in pregnancy have higher bone mass at birth than those whose mothers were not supplemented.Methods/DesignWomen have their vitamin D status assessed after ultrasound scanning in the twelfth week of pregnancy at 3 trial centres (Southampton, Sheffield, Oxford). Women with circulating 25(OH)-vitamin D levels 25-100 nmol/l are randomised in a double-blind design to either oral vitamin D supplement (1000 IU cholecalciferol/day, n = 477) or placebo at 14 weeks (n = 477). Questionnaire data include parity, sunlight exposure, dietary information, and cigarette and alcohol consumption. At 19 and 34 weeks maternal anthropometry is assessed and blood samples taken to measure 25(OH)-vitamin D, PTH and biochemistry. At delivery venous umbilical cord blood is collected, together with umbilical cord and placental tissue. The babies undergo DXA assessment of bone mass within the first 14 days after birth, with the primary outcome being whole body bone mineral content adjusted for gestational age and age. Children are then followed up with yearly assessment of health, diet, physical activity and anthropometric measures, with repeat assessment of bone mass by DXA at age 4 years.DiscussionAs far as we are aware, this randomised trial is one of the first ever tests of the early life origins hypothesis in human participants and has the potential to inform public health policy regarding vitamin D supplementation in pregnancy. It will also provide a valuable resource in which to study the influence of maternal vitamin D status on other childhood outcomes such as glucose tolerance, blood pressure, cardiovascular function, IQ and immunology.

Effect of maternal anthropometry and metabolic parameters on fetal growth

Objective:The aim of this study was to determine the effect of maternal anthropometry and metabolic parameters on neonatal anthropometry.Materials and Methods:This observational cross-sectional study was conducted from January 2008 to June 2009 at a single tertiary care center. Maternal anthropometry and metabolic parameters like fasting serum insulin, lipid profile, and random blood glucose were estimated in 50 pregnant women at term. Detailed anthropometry of the neonates was performed.Results:Large for gestational age (LGA) babies had higher maternal body mass index (BMI), fasting serum insulin, and cord blood insulin levels, and lower maternal high density lipoprotein (HDL) compared to appropriate for gestational age (AGA) group (P < 0.001). Among the maternal parameters, BMI, gestational age, fasting serum insulin, and random blood sugar (RBS) had significant positive correlation, while HDL had negative correlation with birth weight (P < 0.05). However, only maternal BMI was the significant predictor of neonatal birth weight on multiple regression analysis (ß = 0.340, P = 0.01).Conclusion:The BMI of glucose-tolerant mother is more important than metabolic parameters in determining the birth weight of term babies.

Greater Maternal Weight Gain During Pregnancy Predicts a Large but Lean Fetal Phenotype: A Prospective Cohort Study

The objective of this study is to describe the fetal phenotype in utero and its associations with maternal pre-pregnancy weight and gestational weight gain. This prospective longitudinal cohort included 179 Australian women with singleton pregnancies. Serial ultrasound measurements were performed at 19, 25, 30 and 36 (±1) weeks gestation and maternal anthropometry were collected concurrently. The ultrasound scans included the standard fetal biometry of head circumference, biparietal diameter, abdominal circumference, and femur length, and body composition at the abdomen and mid-thigh, including fat and lean mass cross-sectional areas. Maternal gestational weight gain was compared to current clinical guidelines. The participants had an average of 3.7 ± 0.8 scans and birth data were available for 165 neonates. Fifty four per cent of the cohort gained weight in excess of current recommendations, according to pre-pregnancy body mass index (BMI). Maternal gestational weight positively predicted fetal abdominal circumference (P 0.029) and lean abdominal mass area (P 0.046) in linear mixed model regression analysis, adjusted for known and potential confounders. At any pre-pregnancy BMI gaining weight above the current recommendations resulted in a larger fetus according to standard biometry, because of significantly larger lean muscle mass at the abdomen (P 0.024) and not due to an increase in fat mass (P 0.463). We have demonstrated the importance of maternal weight gain, independent of pre-pregnancy BMI, to support the growth of a large but lean fetus. Prenatal counselling should focus on achieving a healthy BMI prior to conception so that gestational weight gain restrictions can be minimised.

Breastfeeding duration, age of starting solids and high BMI risk and adiposity in Indian children

This study utilized data from a prospective birth cohort study on 568 Indian children, to determine whether a longer duration of breastfeeding and later introduction of solid feeding were associated with a reduced higher body mass index (BMI) and less adiposity. Main outcomes were high BMI (>90th within-cohort sex-specific BMI percentile) and sum of skinfold thickness (triceps and subscapular) at age 5. Main exposures were breastfeeding (six categories from 1-4 to ≥21 months) and age of starting regular solid feeding (four categories from ≤3 to ≥6 months). Data on infant-feeding practices, socio-economic and maternal factors were collected by questionnaire. Birthweight, maternal and child anthropometry were measured. Multiple regression analysis that accounted for potential confounders demonstrated a small magnitude of effect for breastfeeding duration or introduction of solid feeds on the risk of high BMI but not for lower skinfold thickness. Breastfeeding duration was strongly negatively associated with weight gain (0-2 years) [adjusted β = -0.12 standard deviation, 95% confidence interval (CI): -0.19 to -0.05 per category change in breastfeeding duration, P = 0.001], and weight gain (0-2 years) was strongly associated with high BMI at 5 years (adjusted odds ratio = 3.8, 95% CI: 2.53-5.56, P < 0.001). In our sample, findings suggest that longer breastfeeding duration and later introduction of solids has a small reduction on later high BMI risk and a negligible effect on skinfold thickness. However, accounting for sampling variability, these findings cannot exclude the possibility of no effect at the population level.

An Investigation into the Influence of Socioeconomic Variables on Gestational Body Mass Index in Pregnant Women Living in a Peri-Urban Settlement, South Africa

Maternal and child mortality rates are still unacceptably high in South Africa. The health status of women in peri-urban areas has been influenced by political and socio-economic factors. Examining socio-economic variables (SEV) in a population aids in the explanation of the impact of social structures on an individual. Risk factors can then be established and pregnant women in these higher risk groups can be identified and given additional support during pregnancy. The aim of this study was to investigate the association between SEV and gestational Body Mass Index (GBMI) in a peri-urban settlement, South Africa. This was a sub-study of the Philani Mentor Mothers' Study (2009-2010). Maternal anthropometry and SEV were obtained from 1,145 participants. Multinomial regression was used to analyse the data. Household income was the only SEV that was significantly associated with GBMI. The odds of being underweight rather than normal weight during pregnancy increase by a factor of 2.145 (P<0.05) for those who had a household income lower than R2000 per month. All other SEV were not significant. Logistic regression was therefore not carried out. Women who had a lower income were at risk of having a lower GBMI during pregnancy. This can lead to adverse birth outcomes such as premature birth, low birth weight, height and head circumference. Public health policy needs to be developed to include optimal nutrition health promotion strategies targeting women with a low income ante and post-natally. Once implemented, they need to be evaluated to assess the impact on maternal and child mortality.

Twinning propensity and offspring in utero growth covary in rural African women.

In humans and other mammals, some females are more likely to experience twin pregnancies than others, but the reasons behind such individual variation are poorly understood. One hypothesis invokes variation in the dynamics of the insulin-like growth factor (IGF) system, which also regulates foetal growth. Using data from a rural African population living in a highly seasonal environment, we test a novel prediction generated by this hypothesis, that maternal twinning status predicts offspring birthweight. We found that among singleton offspring who experience a favourable in utero environment (born January-June), births before and after twins are, respectively, associated with a 134.07 g and 226.41 g increase in birthweight compared with those born to non-twinning mothers. These results were not mediated by maternal anthropometry. This is consistent with a role for the IGF system in individual variation in twinning propensity, a possibility with implications for understanding mechanisms of life-history variation in humans and other vertebrates.

Prenatal Lead Exposure and Weight of 0- to 5-Year-Old Children in Mexico City

Background: Cumulative prenatal lead exposure, as measured by maternal bone lead burden, has been associated with smaller weight of offspring at birth and 1 month of age, but no study has examined whether this effect persists into early childhood.Objective: We investigated the association of perinatal maternal bone lead, a biomarker of cumulative prenatal lead exposure, with children’s attained weight over time from birth to 5 years of age.Methods: Children were weighed at birth and at several intervals up until 60 months. Maternal tibia and patella lead were measured at 1 month postpartum using in vivo K-shell X-ray fluorescence. We used varying coefficient models with random effects to assess the association of maternal bone lead with weight trajectories of 522 boys and 477 girls born between 1994 and 2005 in Mexico City.Results: After controlling for breast-feeding duration, maternal anthropometry, and sociodemographic characteristics, a 1-SD increase in maternal patella lead (micrograms per gram) was associated with a 130.9-g decrease in weight [95% confidence interval (CI), –227.4 to –34.4 g] among females and a 13.0-g nonsignificant increase in weight among males (95% CI, –73.7 to 99.9 g) at 5 years of age. These associations were similar after controlling for concurrent blood lead levels between birth and 5 years.Conclusions: Maternal bone lead was associated with lower weight over time among female but not male children up to 5 years of age. Given that the association was evident for patellar but not tibial lead levels, and was limited to females, results need to be confirmed in other studies.

Changes in skinfolds and mid‐upper arm circumference during pregnancy in Argentine women

This investigation describes the pattern of changes in mid-upper arm circumference (MUAC), triceps, biceps and subscapular skinfold thicknesses during the course of pregnancy, and its relationship with maternal and newborn outcomes. A prospective cohort of 1066 pregnant women were selected in seven different urban regions in Argentina. Measurements of MUAC were carried out at 16, 28 and 36 gestational weeks. In a subsample of 488 women, triceps, biceps and subscapular skinfold thicknesses were measured. Mean total increase in subscapular, tricipital and bicipital skinfolds from 16 to 36 weeks of gestation were 4.5, 3.6 and 2.6 mm, respectively. MUAC showed a mean increase of 1.7 cm in the same period. Overweight or obese women at the start of pregnancy had lower increases in all measurements compared with women with normal or low body mass index. Maternal anthropometry was related to birthweight; women who gave birth to infants of less than 3000 g had lower average values in all measurements than those who had normal birthweight infants. LMS curves for MUAC and skinfolds by gestational age are presented, which can be used as a reference to assess maternal nutrition status during pregnancy. MUAC, tricipital and subscapular skinfold for gestational age curves are proposed for monitoring maternal nutritional status during pregnancy. MUAC cut-off points of 24.5, 25.5 and 26.5 cm for 16, 28 and 36 weeks of gestation, respectively, are also proposed as a proxy to detect low birthweight.

Placental IGF‐I, IGFBP‐1, zinc, and iron, and maternal and infant anthropometry at birth

To correlate placental protein levels of insulin-like growth factor (IGF)-I and insulin-like growth factor binding protein (IGFBP)-1, with previously determined levels of IGF-I and IGF-II mRNA expression, and the micronutrients zinc and iron, and maternal and newborn anthropometry. Placental samples were collected from rural field sites in Pakistan. Samples were divided into small and large for gestational age groups (SGA and LGA, respectively). IGFBP-1 levels were assessed using Western immunoblotting. IGF-I protein levels were assessed using ELISA techniques. IGF mRNA expression, zinc, and iron, were quantified as previously described and were used for comparative purposes only. Thirty-three subjects were included (SGA, n = 12; LGA n = 21). Higher levels of IGFBP-1 were seen in the SGA group (p < 0.01). IGFBP-1 correlated positively with maternal and infant triceps skin-fold thickness in the LGA and SGA groups, respectively (p < 0.05). Significantly lower IGF-I protein levels were seen in the SGA group. IGF-I levels correlated significantly with maternal and newborn anthropometry. IGFBP-1 correlated significantly with IGF-II mRNA expression (p < 0.05). Placental protein levels of IGF-I and IGFBP-1 appear to be associated with maternal anthropometry. Maternal anthropometry may thus influence IGFBP-1 and IGF-I levels and may possibly be used for screening of pregnancies, with the potential for timely identification of these high-risk pregnancies.

Maternal Anthropometry as a Predictor of Birth Weight

Maternal nutritional status is closely associated with birth weight of the newborn and perinatal morbidity and mortality. The usefulness of maternal anthropometric parameters i.e. maternal weight (WT), maternal height (HT) and maternal body mass index (BMI) as predictors of low birth weight (LBW) was studied in 563 full term babies selected from 2056 singleton live births. The sample included normotensive adult pregnant women who had their first visit to the clinics ≤13 weeks of gestation. Most of the pregnant mothers (80%) were between 20 and 34 years of age. Over one third of the mothers were nulliparous, while 12% were multiparous (parity ≥4). The incidence of LBW was 8.7% among the studied sample. The mean WT, HT and BMI of the sample were 53 kg, 155 cm and 22 kgm-2 respectively. Significant positive correlations were observed with birth weight (BW) and WT (r=0.27), BW and BMI (r=0.24) and BW and HT (r=0.11). Polynomial regression analysis predicted LBW significantly with the critical limits of WT, HT and BMI at 50.3 kg, 154 cm and 21.1 kgm^-2, with the sensitivity of 54%, 45% and 60% respectively. Logistic regression analysis showed the risk ratio (RR) for critical limits. Mothers with low WT (&lt;50.3 kg), HT (&lt;154 cm) and BMI (&lt;21.1 kgm^-2) showed 1.5, 1.4 and 1.8 fold LBW respectively than mothers having values above the cut-off. At the highest sensitivity of 80% WT, HT and BMI have a RR of 1.8, 0.9 and 2.1 respectively but only the BMI reached a significant level. The best predictor of birth weight with 80% sensitivity was BMI of 23.7 kgm^-2 at or below 13 weeks of gestation. <br /><br /> DOI: <a href="http://dx.doi.org/10.4038/tar.v21i1.2590">http://dx.doi.org/10.4038/tar.v21i1.2590</a> <br /><em>Tropical Agricultural Research</em> Vol. 21(1): 89-98 (2009)

Food insecurity and perceived stress but not HIV infection are independently associated with lower energy intakes among lactating Ghanaian women

Human immunodeficiency virus (HIV) seropositive women living in low-income communities may have difficulty meeting the increased energy requirements that are associated with both lactation and HIV infection. Data on household food security and maternal socio-demographic characteristics, perceived stress, anthropometry, reported illness, dietary intakes and preferences, and exposure to nutrition education were collected from 70 lactating women [16 seropositive (HP), 27 seronegative (HN), and 27 who refused to be tested and had unknown HIV status (HU)]. Diet was assessed with three 24-h recalls (one market day, one weekend day, and one non-market weekday). Data were collected at 8.4 (SD = 4.7) months postpartum. Most women (74.3%) reported being in good health at the time of study. Three-day mean energy intakes did not differ by HIV status [HP: 12,000 kJ (SD = 3600), HN: 12,600 kJ (SD = 5100), and HU: 12,300 kJ (SD = 4800); P = 0.94]. Protein, fat, vitamin A, thiamin, riboflavin, niacin, vitamin C, calcium, iron, and zinc intakes also did not differ by group (P > 0.10). There was a higher proportion of women with high stress levels in food insecure households compared with food secure households (55.6% vs. 26.5%; P = 0.01). Energy intake was independently negatively associated with food insecurity [high: 11,300 kJ (SD = 3500) vs. low: 13,400 kJ (SD = 5400), respectively; P = 0.050] and stress [high: 10,800 kJ (SD = 2800) vs. low: 13,400 kJ (SD = 5300), P = 0.021]. These results suggest the need to integrate multi-dimensional interventions that address economic and mental health constraints which may limit some women's ability to meet their dietary needs.

Energy intake during pregnancy in relation to offspring gender by maternal height

Male newborns are somewhat heavier than female ones and it has been reported, in a Caucasian population, that mothers carrying boys have higher energy intake during pregnancy compared to those carrying girls. In the context of a prospective study comprising 150 Caucasian women in Boston, USA and 243 Asian women in Shanghai China, energy intake at the second trimester of pregnancy was estimated based on center-specific food frequency questionnaires. There was a significant interaction (P=0.01) of maternal height with offspring gender with respect to maternal daily energy intake. Among taller women, male gender of the offspring was associated with higher maternal energy intake (difference 341kcal/day, 95% Confidence Interval 77-604; P=0.01), whereas among shorter women, no significant association existed between offspring gender and maternal daily energy intake (difference -213kcal/day, 95% Confidence Interval -479 to 54; P=0.12). Our findings indicate that the higher somatic growth potential of boys in intrauterine life is realized only when there are no constrains imposed by maternal anthropometry and it is, then, associated with higher maternal energy intake during pregnancy.

Placental IGF-I, Estrogen Receptor, and Progesterone Receptor Expression, and Maternal Anthropometry in Growth-Restricted Pregnancies in the Swedish Population

Background/Aims: Fetal growth restriction is a complex problem of pregnancy arising from multiple etiologies. Key regulatory elements of growth are the insulin-like growth factor (IGF) axis, and estrogen and progesterone receptors. The aims were to determine the relations of expression of IGF-I, estrogen receptors α and β (ERα and ERβ, respectively), and progesterone receptor (PR), with maternal anthropometry, focusing on birth weight outcomes. Methods: Placental samples were obtained from 33 patients following delivery. mRNA expression was determined by a solution hybridization technique. Samples were divided into normal control (NC) and growth-restricted (GR) groups. Results: IGF-I expression was lower in the GR as compared to the NC group. PR levels correlated positively with IGF-I expression, infant anthropometry, and gestational age (GR). ERα correlated positively with PR expression (NC), and maternal BMI at delivery (GR). ERβ correlated positively with maternal delivery weight and gestational age (NC). Conclusion: The differences in placental expression of IGF-I emphasize its key role in birth weight outcomes. We further suggest the importance of PR expression in the pathogenesis of intrauterine growth restriction, as there were direct correlations of PR expression with both IGF-I expression and infant anthropometric parameters, as well as gestational age.

Exactitud diagnóstica de cinco referencias gestacionales para predecir el peso insuficiente al nacer

The maternal anthropometry is a potentially valuable tool in the evaluation of pregnancy status and prediction of birth weight.Diagnostic accuracy of birth weight was compared for five gestational anthropometric references.Longitudinal study was designed for 245 pregnant Colombian participants. Variables consisted of birth weight, gestational age, maternal height and weight. The references were as follows: gestational weight gain of Fescina (Uruguayan samples), % weight/height and body mass index of Rosso-Mardones (Chilean sample), pregestational weight of the Institute of Medicine (United States sample), and the body mass index of Atalah and colleagues (Chilean sample). The insufficient birth weight (<3,000 g) was defined as the critical threshold value. The following indices, with correspondent confidence intervals (CI 95%) were obtained: diagnostic accuracy, sensitivity, specificity, positive and negative predictive values, and agreement (Kappa index).The ability to predict the weight <3,000 g was higher in the first trimester measurement with the Chilean references, and in the second trimester with the USA and the Uruguayan references. The best concordance was presented between the Chilean references and the least with the Uruguayan. After the second trimester, the Chilean reference of Atalah and colleagues provided the best diagnostic accuracy, specificity and positive predictive value.The gestational anthropometric references that provided the most heterogeneous results were the US Institute of Medicine and the Fescina. Overall, the Atalah reference was the most accurate diagnostic predictor of insufficient weight at birth.

The effect of feto-maternal size and childhood growth on left ventricular mass and arterial stiffness in Afro-Caribbean children

We hypothesized that maternal size, fetal size and childhood growth are associated with childhood blood pressure, left ventricular mass (LVM) and arterial stiffness. The Vulnerable Windows Cohort is a longitudinal study of 569 mothers and their offspring. Anthropometry was measured on each child at birth, at 6 weeks, once in 3 months upto 2 years and then every 6 months. Blood pressure and body composition were assessed in 185 children (age 11.5 years) and echocardiography performed. LVM was not associated with maternal size after adjustment for child's weight. LVM was significantly associated with faster growth in childhood and with current weight, fat mass and lean mass. Systolic blood pressure was not related to maternal, fetal or newborn anthropometry, but was positively associated with infant and childhood growth, as well as current body size and fat mass. The pulse pressure/stroke volume ratio (an index of arterial stiffness) was inversely associated with maternal size, placental volume at 20 weeks, fetal size at 35 weeks and childhood growth even after adjustment for current weight. In conclusion, LVM in childhood is positively associated with maternal height, child's current size and rate of growth. Arterial stiffness is inversely related to maternal, fetal and placental size as well as growth throughout childhood.

Developmental origins of cardiovascular risk in Jamaican children: The Vulnerable Windows Cohort Study

Both intra-uterine and early childhood development contribute to the risk of developing CVD in adult life. We therefore evaluated the maternal, placental, fetal, birth, infant and childhood determinants of cardiovascular risk in a cohort of Afro-Jamaican children. The Vulnerable Windows Cohort is a longitudinal survey of 569 mothers and their offspring recruited from the first trimester. The offspring's anthropometry was measured at birth, at 6 weeks, every 3 months to 1 year and then every 6 months. At mean age 11.5 years, fasting blood was sampled for glucose, insulin and lipids. Analyses were confined to 296 women and their offspring who had complete data. Waist circumference (WC) was related to maternal weight and BMI, placental weight and to the size of the offspring in utero, at birth and the rate of growth in childhood (P < 0.05). Total cholesterol, TAG and glucose concentrations were unrelated to maternal, placental, fetal, neonatal and childhood measurements. Fasting insulin and homeostasis model assessment of insulin resistance were related to maternal weight and BMI (P < 0.05), but not after adjusting for WC. HDL-cholesterol was inversely related to placental and birth weight, and inversely related to weight and BMI throughout childhood (P < 0.001), but not after adjusting for WC. Systolic blood pressure was directly related to maternal weight, child's height, weight and BMI (P < 0.05), but not after adjustment for WC. Systolic blood pressure and fasting glucose concentration were inversely related to birth weight in boys but directly associated in girls. We concluded that maternal anthropometry during pregnancy, fetal size, and childhood growth rate contribute to cardiovascular risk factors in childhood.

Suivi de l’ancien prématuré : les risques à l’âge adulte

Insulin-like growth factor (IGF)-I is primarily produced by the liver under the stimulation of growth hormone, and has systemic growth effects. Placental growth hormone in maternal circulation increases from early pregnancy and is responsible for the increment in maternal serum IGF-I. The purpose of this study was to evaluate the changes in maternal serum IGF-I during pregnancy and their relationship to maternal anthropometry, including body weight (BW) and body mass index (BMI).We obtained 332 blood samples from 114 expectant mothers at different gestational ages (Gas) without adverse medical history. Serum IGF-I levels were measured by immunoradiometric assay. Linear regression analysis for continuous variables and t test for comparisons of categorical variables were used to test for significance.Maternal serum IGF-I during pregnancy was significantly correlated not only to GA (p < 0.001, r = 0.358), but also to maternal BW (p = 0.001, r = 0.202), and maternal BMI (p < 0.001, r = 0.263). The mean maternal IGF-I was highest in the third trimester [1st vs. 2nd, p < 0.001, 95% confidence interval (CI) = −70.17 to −28.22; 1st vs. 3rd, p < 0.001, 95% CI = −138.02 to −76.94; 1st vs. 3rd, p < 0.001, 95% CI = −88.86 to −27.71].Maternal serum IGF-I is significantly related to GA, maternal BW, and BMI during pregnancy.

Maternal Folate and Cobalamin Status Predicts Vitamin Status in Newborns and 6-Month-Old Infants1–3

Our aim in this longitudinal study was to determine predictors of folate and cobalamin status in infancy. Data were collected from 364 mother-infant pairs with blood measurements from pregnancy (∼18 wk; n = 149), newborns (cord serum; n = 361), and 6-mo-old partially or exclusively breast-fed children (n = 221). Serum/plasma folate, cobalamin, holotranscobalamin (holoTC), holohaptocorrin (holoHC), methylmalonic acid (MMA) and total homocysteine (tHcy) at birth and 6 mo were related to maternal vitamin status, parity, lifestyle variables, and anthropometry. In multivariate analyses, the strongest predictors of folate at birth and 6 mo were maternal folate and cord folate, respectively (P < 0.01). Maternal holoTC best predicted cobalamin status at birth (positively associated with cord cobalamin, holoTC, and holoHC; inversely with MMA and tHcy; P ≤ 0.001), whereas maternal and cord holoHC were the strongest predictors of cobalamin status at 6 mo (positively associated with cobalamin, holoTC, holoHC; inversely with tHcy; P < 0.05). The association between cobalamin status and parity was negative at birth but positive at 6 mo. Birth weight, female sex, and smoking were associated with low cobalamin or high tHcy at birth but showed no or opposite associations at 6 mo. In conclusion, maternal folate and cobalamin status exerts a long-term positive effect on infant vitamin status. The effect of smoking, parity and female sex on cobalamin status did not persist beyond the newborn period. Maternal holoTC was the superior predictor of newborn cobalamin status, while holoHC could be a valuable marker for predicting cobalamin status later in infancy.

Exclusive breastfeeding and postnatal changes in maternal anthropometry.

To evaluate the impact of exclusive breastfeeding (EBFing) practice on maternal anthropometry during the first 6 months of birth. Measurement of weight, height, triceps skin-fold thickness (TST), and mid-arm circumference (MAC) was carried out in a matched cohort of women practicing EBFing and those using other methods of infant feeding (non-EBFing group) in the first six months after delivery. There were 322 women practicing EBFing and 205 in the non-EBFing group. Weight loss was significantly higher among the EBFing group than in the non-EBFing ones during the first six months of EBFing practice (4.13 Vs 1.06kg), p<0.05. This was primarily due to average weight loss of 3.43kg in EBFing mothers in the last 3-6 months of EBFing practice. There was also a significant loss in MAC in the EBFing mothers than in the non-EBFing one (2.78 Vs 0.75cm), (p<0.05). Whereas the non-EBFing group experienced an increase in their TST (2.12mm), the EBFing mothers had a mean net loss of -1.03mm, (p<0.05). A positive correlation was seen between the frequency ofbreastfeeding and maternal weight changes in the EBFing group ( r=0.56, p<0.05), same was also seen between frequency of breastfeeding and maternal changes in TST and MAC losses in the same group of mothers, (r = 0.08 for TST , and 0.28 for the MAC, p<0.05). The weight/height Z scores (WHZ), an index of thinness and body mass index (BMI) that determines the nutritional status of an individual however remained within normal limit for both groups of mothers despite their weight loss ( WHZ of 0.67, and BMI of 22.09 +/- 3.7 kg/m2) for EBFing mothers, and ( WHZ of 0.71 and BMI of 22.82 +/- 3.2 kg/m2) for the non- EBFing mothers. It was concluded that though EBFing enhances more maternal weight loss, the nutritional status of the women practicing it however remained normal limit despite their weight loss.