Maternal Birth Weight Research Articles

Periconceptional maternal homocysteine and birth weight outcomes in offspring: a prospective cohort study

Objective: To quantify the associations between periconceptional maternal homocysteine (HCY) and offspring's birth weight and risk of small for gestational age (SGA) infant. Methods: The 19 984 mother-child pairs in this prospective cohort study were recruited from the Shanghai preconception cohort; the infants were delivered from 1st September 2016 to 11th November 2022. A standardized questionnaire was used to collect the mothers' demographic information, medical history, dietary supplement use, and maternal complications during pregnancy, and their serum samples were collected. Serum HCY, folate, and vitamin B12 were measured using chemiluminescent microparticle immunoassay based on serum sample drawn at enrollment. Birth weight data were obtained from medical records. Multiple imputation methods were applied to handle missing data in key variables. Multivariable linear regression and Poisson regression models were used to analyze the relationship between maternal HCY concentration during the periconceptional period and the birth weight and SGA risk of the offspring. Results: A total of 9 452 pairs were enrolled preconceptionally and the remaining 10 532 pairs were enrolled in early pregnancy. The proportion of mothers whose pregnancy age was greater than 35 years was 9.2% (1 832/19 984), the proportion of primiparous women was 76.5% (15 283/19 984), the proportion of pre-pregnancy overweight and obesity was 14.0% (2 804/19 984), the proportion of using folic acid supplements before pregnancy was 21.4% (4 272/19 984), and the proportion of those who supplemented with folic acid during early pregnancy was 85.2% (8 976/10 532); gestational diabetes mellitus was in 6.2% (1 245/19 984), gestational hypertensive syndrome in 3.6% (711/19 984). The birth weight of the offspring was (3 297±468) g, and there were 1 962 SGA children (9.8%). The HCY concentration in the overall population in appropriate for gestational age during the periconceptional period was (7.9±3.2) μmol/L, with (8.3±3.7) μmol/L in the preconception subgroup and (7.3±2.4) μmol/L in the early pregnancy subgroup. After adjustment for the covariates of perinatal demographic information, adverse pregnancy outcomes, serum folate and vitamin B12, increased maternal periconceptional HCY was significantly associated with lower offspring birth weight (β=-2.30, 95%CI -4.43--0.16, P=0.035). Only the early pregnancy subgroup was significantly associated with lower offspring birth weight (β=-7.39, 95%CI-11.50--3.21, P<0.001). No association was found between peripregnancy HCY and offspring SGA risk. However, elevated HCY in early pregnancy was associated with an increased risk of SGA in the offspring (RR=1.05, 95%CI 1.01-1.08, P=0.002). Periconceptional vitamin B12 was a mediator of the association between HCY and offspring birth weight, accounting for 16.5%, 41.2% and 5.4% of its total effect in the overall periconceptional population, the pre-pregnancy subgroup and the early pregnancy subgroup, respectively. Conclusions: Maternal periconceptional HCY level is associated with lower birth weight in offspring, but not with the risk of SGA. Elevated maternal HCY in early pregnancy subgroup may be associated with increased risk of SGA in offspring.

Factors associated with perineal pain on the first postnatal day after vaginal delivery: a cross-sectional study of primiparous women.

Many women report postpartum perineal pain due to perineal trauma after vaginal delivery. Perineal pain after giving birth declines over time; however, perineal trauma and pain negatively impact on the women's quality of life and their ability to care for their children. The degree of perineal trauma and instrument delivery with episiotomy are associated with perineal pain. Nevertheless, no studies have examined factors related to postpartum perineal pain, including weight changes during pregnancy as well as the course of delivery so far. We aimed to elucidate obstetric factors associated with perineal pain after vaginal delivery on the first postnatal day in Japanese primiparous women. A cross-sectional study conducted in five maternity hospitals in Japan included 142 primiparous women who vaginally delivered full-term and singleton infants. Perineal pain on the first postnatal day was evaluated using a visual analog scale. The final analysis included 92 participants with a mean age of 30.3 ± 4.6 years. The median visual analog scale score was 54.0 mm. Multiple linear regression analysis demonstrated that gestational weight gain above the recommended Japanese range was positively and significantly associated with perineal pain on the first postnatal day, independent of maternal age, episiotomy, painkiller use, and neonatal birth weight. This finding may provide additional evidence regarding gestational weight gain within the recommended range based on the pre-pregnancy body mass index to reduce perineal pain on the first postnatal day.

Vaporized Δ9-THC in utero results in reduced birthweight, increased locomotion, and altered wake-cycle activity dependent on dose, sex, and diet in the offspring

AimsPreclinical studies have found that chronic ∆9-tetrahydrocannabinol (THC) treatment is directly associated with weight gain when introduced during adolescence and adulthood, but the effect of prenatal THC is unclear. Clinical studies have demonstrated prenatal exposure to THC is a prospective predictor of increased health risks associated with obesity. Our study aims to examine prenatal THC impact on obesity risks in males and females throughout adolescence using a clinically relevant inhalation model. MethodsPregnant rats were exposed to one of the following from gestational day 2 through birth: 10 mg THC, 40 mg THC, or air. Daily 10-min inhalations were conducted in each animal from 0900 to 1200. Offspring from each treatment group were given either a high-fat diet (HFD) or a normal diet (ND). Food and bodyweights were collected daily, while circadian activity, locomotion, and exercise were measured periodically (PND 21–60). Pregnancy weight gain and birth weight were collected to determine early-life developmental effects. ResultsRats prenatally treated with low-dose THC (LDTHC) generally had lower dark-cycle activity compared with control counterparts, but this altered activity was not observed at the higher dose of THC (HDTHC). In terms of open-field activity, THC doses displayed a general increase in locomotion. In addition, the LDTHC male rats in the ND showed significantly greater exploratory behavior. Prenatal THC had dose-dependent effects on maternal weight gain and birth weight. ConclusionsOverall, our findings indicate there are some activity-related and developmental effects of prenatal THC, which may be related to obesity risks later in life.

Maternal birth weight is an indicator of preterm delivery: the Japan environment and children's study.

This study aimed to investigate the association between maternal birth weight (MBW) with preterm delivery (PTD) in the Japanese population. To this end, a total of 78,972 Japanese pregnant women were included in a prospective birth cohort study. Multiple logistic regression and multinominal logistic regression models were applied to investigate the associations of MBW with PTD (delivery from 22 to < 37 weeks of gestation), early PTD (delivery from 22 to < 34 weeks), and late PTD (delivery from 34 to < 37 weeks). The results showed that MBW was inversely associated with PTD, early PTD, and late PTD (p-for-trend < 0.0001, 0.0014, and < 0.0001, respectively). The adjusted odds ratios per each 500 g of MBW decrease were 1.167 (95% confidence interval [CI]: 1.118-1.218) for PTD, 1.174 (95% CI: 1.070-1.287) for early PTD and 1.151 (95% CI: 1.098-1.206) for late PTD. The effect size of the association of MBW with early PTD was similar to that with late PTD. This study demonstrated for the first time an association of a low MBW with PTD, early PTD, and late PTD in a Japanese nationwide cohort.

Alteration in maternal serum uric acid levels in pre-eclampsia and associated perinatal outcomes: a cross-sectional study in Ghana.

pre-eclampsia (PE) is a multisystemic pregnancy-specific hypertensive disorder associated with significant adverse maternal and perinatal outcomes. Maternal serum uric acid level is hypothesized as a reliable marker for predicting the severity and adverse outcomes of pre-eclampsia and facilitating clinical decisions. This study explored the association between maternal serum uric acid and adverse pregnancy outcomes in pre-eclampsia. a cross-sectional study involving women diagnosed with pre-eclampsia was conducted at Korle-Bu Teaching Hospital (KBTH), a tertiary hospital in Ghana. Descriptive analyses were performed and multivariable logistic regression model was used to explore the association between maternal serum uric acid levels and pregnancy outcomes using R software. we included 100 women with pre-eclampsia comprising 79% and 21% preterm and term pre-eclampsia respectively and with mean gestational age (GA) at diagnosis of 32.35±2.66 weeks and 35.96±1.94 weeks respectively. The mean maternal age of preterm and term pre-eclampsia groups was 29.81±5.29 years and 29.46±5.78 years respectively. Hyperuricemia (serum uric acid >375 µmol/L) occurred in 61% of the pre-eclamptic women. The mean gestational age (in weeks) at diagnosis was significantly lower in the pre-eclamptic women with hyperuricemia compared with those with normal levels of uric acid (33.51±3.03 versus 34.80±2.71). There was a significant negative association (moderate correlation) between maternal serum uric acid levels and birth weight (R= -0.34, p < 0.001) in pre-eclampsia; the statistical significance was limited to preterm only (Pearson R= -0.39, p-value <0.001) but not term pre-eclampsia. Hyperuricemia was significantly associated with low birth weight [aOR: 3.222 (95% CI: 1.098, 10.393)], caesarean section [aOR: 2.281 (95% CI: 1.084, 7.568)] and severe diastolic pressure at birth [aOR: 3.517 (95% CI: 1.123, 11.939)]. hyperuricemia in pre-eclampsia was significantly associated with both maternal (caesarean section and severe hypertension) and neonatal (low birth weight) adverse outcomes. Hyperuricemia seems clinically useful in predicting pregnancy outcomes, especially in preterm pre-eclampsia. Further longitudinal study is recommended in exploring the clinical significance of maternal uric acid levels and pregnancy outcomes in pre-eclampsia.

Evaluation of the Predictive Role of Neutrophil Lymphocyte Ratio and Mean Platelet Volume in Preterm Deliveries: A Cross-sectional Study

Introduction: Preterm birth is associated with high perinatal morbidity and mortality. Identifying women at risk for preterm labour early in pregnancy may improve pregnancy outcomes. Neutrophil-Lymphocyte Ratio (NLR) and Mean Platelet Volume (MPV) can be helpful in predicting preterm labour, as infection is an important factor in early preterm deliveries, with immunity playing a key role in preterm labour. Aim: To evaluate the predictive role of the NLR and MPV in preterm deliveries. Materials and Methods: This cross-sectional study was conducted in a tertiary care and research hospital from August 2022 to October 2023. Haematological and clinical data were retrieved for preterm deliveries (n=79, group I) and term deliveries (n=151, group II). The two groups were compared in terms of demographic characteristics, obstetric and laboratory findings, including maternal age, gravida, parity, birth weight, NLR, MPV, and haemoglobin levels. The data were analysed using Statistical Package for the Social Sciences (SPSS) version 29.0. One-way Analysis of Variance (ANOVA) was used to compare the mean values among different groups. Categorical values were evaluated with Pearson’s Chi-square test. Receiver Operating Characteristic (ROC) curve was used to assess the diagnostic properties of the tests. Results: The two groups showed no statistical difference in terms of demographic parameters such as the mother’s age (p-value=0.611), parity (p-value=0.798), and gravida (p-value=0.583). The NLR was higher in group I (5.8±5.01) compared to group II (4.3±1.75), and this difference was statistically significant with a p-value of &lt;0.001. MPV was observed to be lower in group II (8.7±0.96) compared to group I (8.9±1.07); however, this difference was not statistically significant (p-value=0.128). The mean baby weight and mean maternal haemoglobin in group I were significantly lower compared to group II. Conclusion: In this study, the NLR value was significantly higher in patients with preterm deliveries compared to term deliveries. This study highlights the role of NLR as an emerging predictor of preterm deliveries and emphasises that NLR, obtained from an inexpensive and routinely conducted haemogram, has the potential to be used as an early indicator of preterm deliveries.

Calorie Intake of Pregnant Women in Different Trimesters and Its Impact on Maternal Weight and Newborn Weight

During pregnancy, increase energy demands for metabolism and intrauterine growth, these challenges for pregnant mothers to intake adequate calorie. A cross-sectional analytical study was conducted to evaluate the calorie intake of pregnant women in different trimesters and its impact on maternal weight and birth weight. This study period was three years duration from January 2019 to December 2021. A pretested, semi-structured, standard questionnaire and randomized sampling technique was used to collect the data, the number of calculated sample size was 407. Study found that average age of the pregnant mothers was 26.063.08 years and average monthly income was 18527.40 5801.44 BDT. Study revealed that average calorie intake of pregnant mothers of 1st, 2nd and 3rd trimester were 1779.6596.88, 1986.6069.60 and 2179.6577.47, whereas average weight gain of pregnant mothers of 1st trimester was 0.520.60 Kg, 2nd trimester was 3.231.29 Kg and 3rd trimester was 7.362.50 Kg. It was observed that 0.50% of the pregnant mothers’delivered low birth weight baby and 99.50% normal weight baby with their average birth weight was 3.040.30 Kg. Calorie intake and body weight gain of different trimesters of pregnant mothers positively correlate with birth weight. Calorie intake influenced maternal weight and newborn weight.

Efficacy of a Novel Site of Tactile Stimulation (Partha’s site) for Neonatal Resuscitation – A Prospective Interventional Study

ABSTRACT Background: Traditional tactile stimulation methods in neonatal resuscitation involve stroking or tapping the back of the infant. However, a recent study has investigated additional tactile stimulation areas, such as the baby’s feet, with a high concentration of nerve endings. In this connection, the primary author has selected a bilateral inguinal crease as an alternate site for tactile stimulation. This study examines the effectiveness of this novel stimulation site in generating crying in noncrying neonates. Methodology: A prospective interventional study was conducted in an established obstetric hospital from February to November 2023. The study population comprised 100 noncrying infants who did not respond to conventional tactile stimulation. The outcome variables included maternal age, gestational age, birth weight, grimace and respiration scores of Apgar, and the time taken to achieve the maximum score after stimulation. Results: Most neonates (71%) achieved a grimace score of 2 after stimulation, and the mean time to achieve this response was 1.39 (2) s. Seventy-six percent of neonates achieved a respiration score of 2 after stimulation, and the mean time to achieve it was 2.24 (0.5) s. Furthermore, 98% of infants had a favorable outcome without further invasive interventions. Conclusion: The novel site of bilateral inguinal stroking is an effective tactile stimulation site in neonatal resuscitation. The findings suggest that this approach may provide a quicker and more consistent response, reducing the need for positive pressure ventilation and potentially improving neonatal outcomes.

HUBUNGAN FAKTOR IBU SAAT HAMIL TERHADAP BERAT BADAN LAHIR DI PRAKTIK MANDIRI BIDAN (PMB) SYAFRIANI KECAMATAN NIBONG KABUPATEN ACEH UTARA

Background: A baby's birth weight at birth is an important indicator of a child's vulnerability to disease, risk of disease, occurrence of disease in children and also predicts the child's health, growth, psychosocial development and chances of survival. Low birth weight babies are at risk of stunting. Risk factors associated with the incidence of LBW include socio-economic and maternal characteristics.Method: This research is an observational study with a cross-sectional approach which aims to analyze the relationship between maternal factors and birth weight in the Syafriani Independent Midwife Practice (PMB), Nibong District, North Aceh Regency. The sample in this study consisted of 41 post-partum mothers, where the sampling technique was determined by total sampling, namely all post-partum mothers recorded in medical records from January to February 2023. The sample criteria were mothers who gave birth to live babies and gestational age at term at the time of delivery.Results: From the results of analysis tests carried out, maternal factors including age, family income, complaints during pregnancy and parity were related to the baby's birth weight where the p-value was &lt;0.05. The variables of maternal education, maternal occupation, history of miscarriage and pregnancy examination were not related to the baby's birth weight with a p-value &gt;0.05. From the results of the multivariate analysis test using multiple logistic regression, it was found that only mothers who experienced complaints during pregnancy had a partial effect on birth weight with a p-value &lt;0.05.Conclusion: The results of the study concluded that maternal factors related to birth weight included age, family income, complaints during pregnancy and parity. Keywords: Birth Weight, During pregnancy,Maternal Factors,

Associations between maternal syphilis infection during pregnancy and low birth weight and preterm birth: a prospective cohort study.

In recent years, syphilis is still the most common sexually transmitted disease worldwide. Pregnant women infected with syphilis can transmit it to the fetus in utero through mother-to-child transmission, which can directly lead to adverse pregnancy outcomes. The aim of this study was to investigate the associations between maternal syphilis infection and low birth weight and preterm birth in offspring. Multinomial logistic regression model was used to analyze the associations between maternal syphilis infection and low birth weight and preterm birth, and to explore its stability through subgroup analysis. A total of 34,074 subjects were included in the study. After adjusting for potential confounders, maternal syphilis infection during pregnancy was associated with a 2.60-fold (95% CI 1.83-3.69) increased risk of low birth weight and a 1.91-fold (95% CI 1.35-2.69) increased risk of preterm birth. Subgroup analysis showed that the association was stable. We found that maternal syphilis infection during pregnancy was significantly associated with an increased risk of low birth weight and preterm birth. The implementation of reasonable syphilis screening and standardized treatment and follow-up of pregnant syphilis may have important practical significance in reducing the low birth weight and preterm birth rate in offspring.

The impact of maternal and paternal birth weights on infant birth weights: the Japan environment and children's study.

This study aimed to evaluate the association between parental and infant birth weights in Japan. In total, 37,504 pregnant Japanese women and their partners were included in this birth cohort study. A multinomial logistic regression model was used to evaluate the associations of parental birth weights with small-for-gestational-age (SGA) or large-for-gestational-age (LGA) infants. Associations between parental birth weight and low birth weight (LBW) infants or macrosomia were also examined, and linear associations between parental birth weight and SGA or LGA were found. The adjusted odds ratios (aORs) for SGA infants per 500 g decrease in maternal and paternal birth weights were 1.50 (95% confidence interval [CI],1.43-1.58) and 1.31 (95% CI, 1.25-1.38), respectively. The aORs for LGA infants per 500 g increase in maternal and paternal birth weights were 1.53 (95% CI, 1.47-1.60) and 1.41 (95% CI, 1.35-1.47), respectively. The association between parental birth weight and LBW infants or macrosomia was also linear. The aORs for LBW infants per 500 g decrease in maternal and paternal birth weights were 1.47 (95% CI, 1.40-1.55) and 1.25 (95% CI, 1.19-1.31), respectively. The aORs for macrosomia per 500 g increase in maternal and paternal birth weights were 1.59 (95% CI, 1.41-1.79) and 1.40 (95% CI, 1.23-1.60), respectively. Parental birth weight was found to be associated with infant birth weight even after adjusting for various parental factors. Furthermore, maternal birth weight was more strongly associated with infant birth weight than with paternal birth weight.

Changes in anthropometry in full-term breastfed newborns and associated factors for the first month.

We aim to assess the changes and associated factors in newborn anthropometry in the first month for full-term, healthy, and exclusive-breastfed infants. Neonatal anthropometric measurements were taken on day 5, day 15, and day 30 after delivery. Generalized estimating equations (GEE) analyzed the changes. From 169 mother-newborn pairs, GEE showed that weight gain during the first month was influenced by maternal body mass index (BMI), delivery type, birth weight, and jaundice after adjusting confounding factors (p < .05). The neonatal length was affected by the smoking status of parents, gestational maternal health problems, maternal height, birth weight, and jaundice (p < .05). Neonatal head circumference was influenced by the smoking status of parents, gestational maternal health problems, maternal BMI, delivery type, maternal height, and birth weight. Adverse perinatal factors including mother's smoke exposure, maternal obesity and diabetes, cesarean birth, and neonatal hyperbilirubinemia influence anthropometry in the first months of life.

Heat Stress-Induced Fetal Intrauterine Growth Restriction Is Associated with Elevated LPS Levels Along the Maternal Intestine-Placenta-Fetus Axis in Pregnant Mice.

The exacerbation of the greenhouse effect has made heat stress (HS) an important risk factor for the occurrence of intrauterine growth restriction (IUGR). The experiment aims to uncover the effects of maternal HS on IUGR and its mechanisms. The results showed that HS leads to decreased maternal and fetal birth weights, accompanied by increased serum oxidative stress and cortisol levels. Moreover, HS inflicted significant damage to both the intestinal and placental barriers, altering maternal gut microbiota and increasing intestinal LPS levels. As a result, LPS levels increased in maternal serum, placenta, and fetus. Furthermore, HS damaged the intestinal structure, intensifying inflammation and disrupting the redox balance. The placenta exposed to HS exhibited changes in the placental structure along with disrupted angiogenesis and decreased levels of nutritional transporters. Additionally, the leakage of LPS triggered placental JNK and ERK phosphorylation, ultimately inducing severe placental inflammation and oxidative stress. This study suggests that LPS translocation from the maternal intestine to the fetus, due to a disrupted gut microbiota balance and compromised intestinal and placental barrier integrity, may be the primary cause of HS-induced IUGR. Furthermore, increased LPS leakage leads to placental inflammation, redox imbalance, and impaired nutrient transport, further restricting fetal growth.

Neonatal Complications in Mothers with Severe Complications or Near-Miss Cases

Background: Maternal complications, particularly maternal near death, may also contribute to the increase in perinatal complications. Consequently, this study investigated the correlation between neonatal complications in mothers with severe pregnancy complications and near-miss cases. Methods: This cross-sectional study was conducted on mothers who gave birth between March 2017 and March 2019 at a Medical Training Hospital and a Private Hospital in Tehran and experienced severe maternal complications or life-threatening conditions. The characteristics of mothers and infants were recorded. Statistical tests were employed to analyze the data (p˂0.05). Resulting: This study evaluated 138 mothers with severe complications, where 32.6% exhibited near-death conditions. The most common causes of severe maternal outcomes were preeclampsia and severe bleeding (50.7% and 36.2%, respectively). Of newborn 48.2% experienced prematurity, 35.6% had low birth weight. 59.9% of the newborns of the mothers who were studied experienced at least one complication. 61.9% infants had respiratory failure, and 14.2% had a severe infection. The neonate mortality rate was 3%, while the stillbirth rate was 3.6%. Although linear/ binomial logistic regression test was not showed the correlation between the mother’s demographic characteristics and perinatal complications but one third of mothers with the underlying disease had neonatal complications and the likelihood of prenatal complications is higher in multiparous women over 30. Conclusion: In severe maternal complications, neonatal complications, prematurity and low birth weight, are more prevalent. Consequently, it appears necessary to equip hospitals with intensive care units and trained personnel who can provide adequate support for mothers and infants.

Maternal birth weight as an indicator of early-onset and late-onset hypertensive disorders of pregnancy: The Japan Environment and Children’s study

ObjectivesThis study aimed to investigate the association between maternal birth weight (MBW) and hypertensive disorders of pregnancy (HDP) according to the gestational age when HDP develops. Study designA total of 77,345 subjects were included in this prospective birth cohort study. The association between MBW and HDP was investigated by a multinomial logistic regression model. Main outcome measuresEarly-onset HDP (EO-HDP), preterm late-onset HDP (preterm LO-HDP), and term late-onset HDP (term LO-HDP). ResultsLower MBW was associated with higher odds of preterm and term LO-HDP (p-values for trend < 0.0001 and = 0.0005, respectively). A linear association between MBW and EO-HDP was observed (p-values for trend = 0.0496). The shape of the association between MBW and preterm LO-HDP was a combination of the associations between MBW with EO-HDP or LO-HDP. The effect size of the association between MBW < 2,500 g and EO-HDP was lower than that of MBW < 2,500 g with preterm or term LO-HDP. The adjusted odds ratios for EO-HDP, preterm LO-HDP, and term LO-HDP in subjects with MBW < 2,500 g were 1.052 (95 % confidence interval [CI]: 0.665–1.664), 1.745 (95 % CI: 1.220–2.496), and 1.496 (95 % CI: 1.154–1.939), respectively. ConclusionsMBW was associated with HDP, regardless of gestational age when HDP developed. Furthermore, the association of MBW < 2,500 g with preterm or term LO-HDP was stronger than that with EO-HDP.

Maternal body mass index, birthweight, and placental glucose metabolism: evidence for a role of placental hexokinase

BackgroundThe principal fetal energy source is glucose provided by placental transfer of maternal glucose. However, the placenta’s glucose consumption exhibits considerable variation. Hexokinase is the first and one of the rate-limiting enzymes of glycolysis that phosphorylates glucose to glucose 6-phosphate. The role of placental hexokinase activity in human placental glucose metabolism is unknown. ObjectivesTo test the hypothesis that placental hexokinase activity is related to maternal body mass index, placental glucose uptake and consumption, and birth weight. Study designSixty-seven healthy pregnant participants at term were included in this study at Oslo University Hospital, Norway. Placental hexokinase activity was measured by using a colorimetric assay. The mass of glucose taken up by the uteroplacental unit and the fetus was obtained by measuring arterio-venous glucose differences combined with Doppler assessment of uterine and umbilical blood flow. Blood samples were obtained from the maternal radial artery, uterine vein, and umbilical artery and vein. The uteroplacental glucose consumption constituted the difference between uteroplacental and fetal glucose uptake. Spearman’s rank correlation was performed for statistical analyses to study the correlation of placental hexokinase activity (mU/mg protein) with prepregnancy body mass index, maternal glucose and insulin, birth weight, uteroplacental glucose uptake and consumption, and fetal glucose uptake (μmol/min). Partial rank correlation analysis was performed when controlling for hours of fasting or placental weight. ResultsHexokinase activity was detectable in all placental tissue samples. Mean (SD) activity was 19.6 (4.64) mU/mg of protein. Placental hexokinase activity correlated positively with prepregnancy body mass index (Spearman’s rho (ρ)=0.33; P=0.006). Upon controlling for hours of fasting, hexokinase activity showed positive correlations with both maternal glucose (r=0.30; P=0.01) and insulin (r=0.28; P=0.02). Hexokinase activity was positively correlated with uteroplacental glucose uptake (ρ=0.31; P=0.01) and consumption (ρ=0.28; P=0.02). Hexokinase activity did not correlate with fetal glucose uptake. Upon controlling for placental weight, hexokinase activity showed a positive correlation with birth weight (r=0.31; P=0.01). ConclusionOur findings suggest that placental hexokinase, being crucial for uteroplacental retention of glucose for own disposition, is related to both maternal body mass index and birth weight independent of placental weight. Placental hexokinase may play a central role in the relationship between maternal glucose dysregulation and fetal growth. Thus, the current study supports the need to develop clinically useful tools to assess the metabolic properties of the placenta.

Association between ambient air pollution exposure in pregnant women with antiphospholipid syndrome in Nanjing, China

Antenatal exposure to air pollutants is thought to be associated with a variety of maternal blood markers as well as adverse birth outcomes. However, the dysgenic influence of air pollutants on the antiphospholipid syndrome (APS) in mothers and their pregnancy outcomes remains unclear. In the current study, 371 mother-infant pairs (189 healthy: 182 APS) from Nanjing Maternal and Child Health Hospital as well as air pollutants concentration from their living environment were used to investigate correlations between air pollution with maternal blood indicators and fetal birth weight in the groups of APS and healthy mothers. Generalized linear model was used to evaluate the contributions of air pollutant exposure during pregnancy to the blood indicators variation. The relationships between birth weight with specific air pollutant and blood index were analyzed using ridge regression. Results showed that APS fetal birth weight was significantly impacted by air pollutant exposure during pregnancy, in particular, the birth weight decreased significantly along with increasing fine particulate matter 2.5 (PM2.5) and fine particulate matter 10 (PM10) exposure concentrations throughout pregnancy. In contrast, birth weight increased significantly with sulfur dioxide (SO2) exposure. In addition, APS-related blood indicators comprised of platelet distribution width (PDW), total bilirubin (TBIL), mean platelet volume (MPV), platelet-larger cell ratio (P_LCR), homocysteine (HCY), alkaline phosphatase (ALP), direct bilirubin (DBIL), basophilic granulocyte (BAS), platelet thrombocytocrit (PCT), preprandial glucose levels (OGTT0), monocytes (MON), and monocytes ratio (MON_ratio) were also strongly related with prenatal exposure to PM2.5 and PM10, in which PDW levels showed most strongly negative impaction on fetal birth weight. Together, we showed that prenatal exposure to air pollutant (PM2.5 and PM10) may exacerbate the poor birth outcomes of low birth weight by impacting APS maternal blood indicators especially for PDW.

Prenatal Exposure to Heavy Metals and Adverse Birth Outcomes: Evidence From an E-Waste Area in China.

Electronic waste that has not been properly treated can lead to environmental contamination including of heavy metals, which can pose risks to human health. Infants, a sensitive group, are highly susceptible to heavy metals exposure. The aim of this study was to investigate the association between prenatal heavy metal exposure and infant birth outcomes in an e-waste recycling area in China. We analyzed cadmium (Cd), chromium (Cr), manganese (Mn), lead (Pb), copper (Cu), and arsenic (As) concentrations in 102 human milk samples collected 4weeks after delivery. The results showed that 34.3% of participants for Cr, which exceeds the World Health Organization (WHO) guidelines, as well as the mean exposure of Cr exceeded the WHO guidelines. We collected data on the birth weight (BW) and length of infants and analyzed the association between metal concentration in human milk and birth outcomes using multivariable linear regression. We observed a significant negative association between the Cd concentration in maternal milk and BW in female infants (β=-162.72, 95% CI=-303.16, -22.25). In contrast, heavy metals did not associate with birth outcomes in male infants. In this study, we found that 34.3% of participants in an e-waste recycling area had a Cr concentration that exceeded WHO guidelines, and there was a significant negative association between prenatal exposure to the Cd and infant BW in females. These results suggest that prenatal exposure to heavy metals in e-waste recycling areas may lead to adverse birth outcomes, especially for female infants.

Relationship between Maternal Factors and Low Birth Weight (LBW) at PKU Muhammadiyah Gamping Hospital

Background: In 2020, the number of Infant Mortality Rates reached 2.4 million people due to LBW (34.5%). LBW contributes 60 to 80% of all infant deaths. LBW is babies born weighing less than 2500 grams. LBW has problems if the baby does not die at the time of birth, it will have a risk of growing and developing slowly, stunting, affected by non-communicable diseases, anemia, and impaired heart function. Purpose: To determine the relationship between maternal factors and the incidence of LBW at PKU Muhammadiyah Gamping Hospital. Methods: This research used a quantitative analytic survey with a case-control approach. This study used medical record data and maternal cohorts. The population in this study was 604 newborn babies at PKU Muhammadiyah Gamping Hospital with a total sample of 142 respondents. The sampling technique used is purposive sampling. This study employed the master table as a data collection method. The data analysis used is the chi-square test. Results: Based on the results of chi-square analysis, maternal parity (p-value = 0.228) with OR = 1.518, gestational age (0.000) OR = 15.200, multiple pregnancies (0.009) and OR = 10.161, and preeclampsia (0.164) and OR = 0.571. Conclusion: There is a significant relationship between gestational age and multiple pregnancies with the incidence of LBW. Meanwhile, parity and preeclampsia do not have a significant relationship with the incidence of LBW. It is recommended for every pregnant woman to carry out routine check-ups during pregnancy to prevent the occurrence of LBW

Intrauterine Growth and Offspring Neurodevelopmental Traits

Conventional epidemiological analyses have suggested that lower birth weight is associated with later neurodevelopmental difficulties; however, it is unclear whether this association is causal. To investigate the relationship between intrauterine growth and offspring neurodevelopmental difficulties. MoBa is a population-based pregnancy cohort that recruited pregnant women from June 1999 to December 2008 included approximately 114 500 children, 95 200 mothers, and 75 200 fathers. Observational associations between birth weight and neurodevelopmental difficulties were assessed with a conventional epidemiological approach. Mendelian randomization analyses were performed to investigate the potential causal association between maternal allele scores for birth weight and offspring neurodevelopmental difficulties conditional on offspring allele scores. Birth weight and maternal allele scores for birth weight (derived from genetic variants robustly associated with birth weight) were the exposures in the observational and mendelian randomization analyses, respectively. Clinically relevant maternal ratings of offspring neurodevelopmental difficulties at 6 months, 18 months, 3 years, 5 years, and 8 years of age assessing language and motor difficulties, inattention and hyperactivity-impulsivity, social communication difficulties, and repetitive behaviors. The conventional epidemiological sample included up to 46 970 offspring, whereas the mendelian randomization sample included up to 44 134 offspring (median offspring birth year, 2005 [range, 1999-2009]; mean [SD] maternal age at birth, 30.1 [4.5] years; mean [SD] paternal age at birth, 32.5 [5.1] years). The conventional epidemiological analyses found evidence that birth weight was negatively associated with several domains at multiple offspring ages (outcome of autism-related trait scores: Social Communication Questionnaire [SCQ]-full at 3 years, β = -0.046 [95% CI, -0.057 to -0.034]; SCQ-Restricted and Repetitive Behaviors subscale at 3 years, β = -0.049 [95% CI, -0.060 to -0.038]; attention-deficit/hyperactivity disorder [ADHD] trait scores: Child Behavior Checklist [CBCL]-ADHD subscale at 18 months, β = -0.035 [95% CI, -0.045 to -0.024]; CBCL-ADHD at 3 years, β = -0.032 [95% CI, -0.043 to -0.021]; CBCL-ADHD at 5 years, β = -0.050 [95% CI, -0.064 to -0.037]; Rating Scale for Disruptive Behavior Disorders [RS-DBD]-ADHD at 8 years, β = -0.036 [95% CI, -0.049 to -0.023]; RS-DBD-Inattention at 8 years, β = -0.037 [95% CI, -0.050 to -0.024]; RS-DBD-Hyperactive-Impulsive Behavior at 8 years, β = -0.027 [95% CI, -0.040 to -0.014]; Conners Parent Rating Scale-Revised [Short Form] at 5 years, β = -0.041 [95% CI, -0.054 to -0.028]; motor scores: Ages and Stages Questionnaire-Motor Difficulty [ASQ-MOTOR] at 18 months, β = -0.025 [95% CI, -0.035 to -0.015]; ASQ-MOTOR at 3 years, β = -0.029 [95% CI, -0.040 to -0.018]; and Child Development Inventory-Gross and Fine Motor Skills at 5 years, β = -0.028 [95% CI, -0.042 to -0.015]). Mendelian randomization analyses did not find any evidence for an association between maternal allele scores for birth weight and offspring neurodevelopmental difficulties. This study found that the maternal intrauterine environment, as proxied by maternal birth weight genetic variants, is unlikely to be a major determinant of offspring neurodevelopmental outcomes.