Maternal Birth Weight Research Articles

Maternal Education and Low Birth Weight in Low- and Middle-Income Countries: Systematic Review and Meta-Analysis.

Adverse birth outcomes, including low birth weight (LBW), remain the leading causes of child morbidity and mortality in many low- and middle-income countries (LMICs). We carried out a systematic review and meta-analysis to assess the strength and consistency of the association between maternal education and LBW in LMICs. We conducted an electronic search of studies published between 2000 and 2014 in four databases using three MeSH keywords - birth outcomes including LBW; individual-level socioeconomic measures including maternal education; and a list of LMICs. The methodological quality of each eligible study was evaluated following the GRADE approach. A total of 26 studies were entered into meta-analysis. Subgroup analyses were performed to account for heterogeneity in the measurement of exposure and country development level. The meta-analysis revealed a statistically significant pooled estimate (OR = 0.67; 95% CI = 0.61-0.74) indicating that maternal education is protective against LBWin LMICs. Heterogeneity was found high in subgroup analyses in studies from lower-middle income countries and in those measuring maternal education in academic classes, but drops considerably in studies from low-income countries and those measuring it in number of years of schooling. The quality of the overall body of evidence is moderate due to high observed heterogeneity in some subgroup analyses and the presence of studies with high risk of bias. Higher maternal education associates with a moderate but statistically significant decrease in the risk of delivering a LBW infant in LMICs. Enhancing girls' and women's access to education operates through a number of pathways to improve birth outcomes and reduce LBW in LMICs.

Association between Drinking Water Treatment and Diarrhea Among Under-Five Years Children

Diarrhea is still a health problem in the world, especially in developing countries. The World Health Organization (WHO) explained that the cause of death in infants and toddlers is diarrhea, which ranks second. Meanwhile, based on Indonesia's health profile in 2015, there were 18 outbreaks of diarrhea in 11 provinces, 18 districts / cities, with 1,213 sufferers and 30 deaths (CFR 2.47%). Several factors related to the incidence of diarrhea are maternal care, birth weight and environmental sanitation. This study aims to determine the relationship between maternal parenting, birth weight and environmental sanitation with the incidence of diarrhea in children under five in Selagalas Village, the working area of ​​Cakranegara Health Center. This study used a cross-sectional quantitative design on 104 toddlers who were selected by systematic random sampling in three selected environments in Selagalas Village. Data were collected by structured interviews using questionnaires and observation sheets. Data analysis was carried out bivariately using logistic regression to see the relationship between family drinking water management and the incidence of diarrhea. 64.42% of children under five were found to have experienced diarrhea. The variable related to the incidence of diarrhea was the lack of drinking water management with a value of P = 0.03. The management of family drinking water is still lacking so it is necessary to make health promotion efforts for the family to improve the management of family drinking water that meets the requirements so that it can improve the behavior of a clean and healthy life.

Labor epidural analgesia versus without labor epidural analgesia for multiparous women: a retrospective case control study

BackgroundLabor epidural analgesia (LEA) effectively relieves the labor pain, but it is still not available consistently for multiparous women in many institutions because of their obviously shortened labor length.MethodsA total of 811 multiprous women were retrospective enrolled and firstly divided into two groups: LEA group or non-LEA group. And then they were divided into seven subgroups and analyzed according to the use of LEA and cervical dilation. The primary outcomes (time intervals, blood loss and Apgar scores) and secondary outcomes (maternal demographic characteristics and birth weight) were collected by checking electronic medical records.ResultsThe prevalence of using LEA in multiprous women was 54.5 %. Using LEA significantly lengthened the duration of labor stage by 56 min (P < 0.001), increased the blood loss (P < 0.001) and lowered Apgar scores (P = 0.001). In the comparison of sub-group analysis, using LEA can obviously prolong the duration of first-second stage in women with 2 cm cervical dilation (P < 0.001) and 3 cm cervical dilation (P = 0.014), while there was no significant difference with 4 cm or more cervical dilation (P = 0.69). Using LEA can significantly increased the blood loss when the initiation of LEA in the women with 2 cm cervical dilation (P < 0.001) and 3 cm cervical dilation (P = 0.035), meanwhile there were no significantly differences in the women with 4 cm or more cervical dilation (P = 0.524). Using LEA can significantly lower the Apgar scores when the initiation of LEA in the women with 2 cm cervical dilation (P = 0.001) and 4 cm or more cervical dilation (P = 0.025), while there were no significantly differences in the women with 3 cm cervical dilation (P = 0.839).ConclusionsLabor epidural analgesia for the multiparous woman may alter progress of labor, increase postpartum blood loss and lower Apgar scores. Early or late initiation of LEA should be defined as with cervical dilatation of less or more than 3 cm and the different effect should be understand.Trial registrationChiCTR2100042746. Registered 27 January 2021-Prospectively registered, http://www.chictr.org.cn.

Electrolytes and pH of Mammary Gland Secretions Assessments to Detect Impending Parturition and Associations With Placental and Neonate Features in Donkeys

The objectives of this study were to determine (i) the usefulness of serial assessment of mammary gland electrolytes concentrations and correspondent pH to detect impending parturition in jennies; and (ii2) the associations between mammary gland secretions, and gestation length, foal sex, maternal, placental, and foal birth weights. Multiparous jennies (n = 37) were monitored daily from 350 to 355 days of gestation until parturition. The pH of mammary gland secretions was assessed daily with a hand-held device. Aliquots of mammary secretions were frozen daily and then retrospectively assessed for electrolyte concentrations (Ca2+, Mg2+, K+, and Na+) with an automated analyzer from five days until the last sampling pre-partum. Mammary gland electrolytes and pH were analyzed with mix-models. The gestational length, newborn, maternal, and fetal membranes weights were analyzed with t-test grouped by foal's sex. Associations across all variables were assessed with Pearson's coefficient of correlation. Sensitivity, specificity, and negative predictive value (NPV) and positive predictive values (PPV) were evaluated for pH (≤ 6.4), Ca2+ (>10 mmol/L), and a combination of both. Each jenny had pH profiles assessed visually and classified as fast pH drop (1), slow pH drop (2), and alkaline pH (3) as previously described for horses. The overall gestation length was 374 ± 8.7 days, ranging from 357 to 390 days. There were no differences for gestation lengths for jennies delivering colts (374 ± 2.1 range 357–385 days), versus the ones delivering fillies (373 ± 2.3 range 358–390 days) (P > .05). Of all the foals, there were 61.8% colts and 38.2% fillies. The ratio of foal birthweight with the dam's bodyweight was 9.7%, and the ratio with fetal membranes was 11%. The majority of parturitions happened during the night (91.9%). There was a significant reduction in Na+ and an increase in Ca2+, Mg2+, and K+ concentrations leading to foaling. The pH showed a 90% sensitivity for foaling within 24 hours, whereas the specificity was 70%, and the PPV and NPV values were 40% and 97%. Of interest, Ca2+ (>10 mmol/l) displayed a sensitivity and specificity of 71% and 85%, whereas the PPV and NPV were 72% and 84%. In the present study, jennies exhibited profiles 1 to 3 as previously described for mares. Herein, 65% of the jennies displayed profile 2 and foaled with a mean acidic pH of 6.4 ± 0.02. Conversely, 32% of the jennies showed a fast reduction in the pH of mammary secretion (profile 1) from day -1 (7.3 ± 0.2) to the day of foaling with an average pH of 6.6 ± 0.08. One jenny foaled with high and alkaline pH (i.e., 7.5). There were weak and negative correlations between pH and Ca2+, Mg2+, and K+ (P < .05). In addition, Ca2+ displayed a weak but significant correlation with Mg2+, Na+, and K+. In conclusion, daily pH measurements of the mammary gland secretions can predict foaling in jennies, whereas Ca2+ was not as useful. Contrary to horses that most mares present a fast pH profile, most jennies showed a slow pH profile. The sex of foal did not affect the gestational length and fetal/maternal and fetal membrane proportions in donkeys.

Maternal sleep duration and neonate birth weight: Apopulation-based cohort study.

To investigate the association between maternal sleep duration (an important health indicator) and neonate birth weight. The study included 2536 mother-neonate pairs of a Spanish birth cohort (2004-2006, INMA project). The exposures were questionnaire-based measures of sleep duration before and during pregnancy. The primary outcome was neonate birth weight score (g) standardized to 40weeks of gestation. In women sleeping for <7h/day before pregnancy, each additional hour of sleep increased birth weight score by 44.7g (P=0.049) in the minimally adjusted model, although findings were not statistically significant after considering other potential confounders (P>0.05). However, increasing sleep duration for the group of mothers who slept for more than 9h/day decreased birth weight score by 39.2g per additional hour (P=0.001). Findings were similar after adjusting for several sociodemographic confounders and maternal depression-anxiety clinical history as an intermediate factor. Similar but attenuated associations were observed with sleep duration in the second trimester of pregnancy. The relationship between maternal sleep duration before and during pregnancy and neonate birth weight is an inverse U-shaped curve. Excessive sleep duration may adversely affect neonate health through its impact on birth weight.

Maternal sleep duration and neonatal birth weight: the Japan Environment and Children\u2019s Study

BackgroundThe adequate maternal sleep duration required for favorable obstetric outcomes is unknown. We evaluated the association between maternal sleep duration and low birth weight infants, small for gestational age infants, and macrosomia.MethodsParticipants enrolled in the Japan Environment and Children’s Study, a nationwide birth cohort study, with singleton pregnancies after 22 weeks, who gave birth between 2011 and 2014 were enrolled and categorized into five groups according to maternal sleep duration during pregnancy: < 6.0 h, 6.0–7.9 h, 8.0–8.9 h, 9.0–9.9 h, and 10.0–12.0 h. We evaluated the association between maternal sleep duration and the incidence of low birth weight infants (< 2500 g), very low birth weight infants (< 1500 g), small for gestational age infants, and macrosomia (> 4000 g), with women with maternal sleep duration of 6.0–7.9 h as the reference, using a multiple logistic regression model.ResultsIn total, 82,171 participants were analyzed. The adjusted odds ratios (95% confidence intervals) for low birth weight infants in women with maternal sleep duration of 9.0–9.9 h and 10.0–12.0 h and for small for gestational age infants in women with maternal sleep duration of 9.0–9.9 h were 0.90 (0.83–0.99), 0.86 (0.76–0.99), and 0.91 (0.82–0.99), respectively, before adjusting for excessive gestational weight gain. No significant association was observed between maternal sleep duration and these outcomes after adjusting for excessive gestational weight gain. Among women with appropriate gestational weight gain, the adjusted odds ratios (95% confidence intervals) for low birth weight infants and for small for gestational age infants with sleep duration of 9.0–9.9 h were 0.88 (0.80–0.97) and 0.87 (0.78–0.97), respectively.ConclusionsMaternal sleep duration of 9.0–9.9 h was significantly associated with the decreased incidence of low birth weight infants and small for gestational age infants in pregnant women with appropriate gestational weight gain, compared with that of 6.0–7.9 h. Care providers should provide proper counseling regarding the association between maternal sleep duration and neonatal birth weight and suggest comprehensive maternal lifestyle modifications to prevent low birth weight and small for gestational age infants.

Maternal serum IL-22 concentrations are significantly upregulated in patients with preterm premature rupture of membranes.

This study aimed to compare the serum IL-22 levels between preterm premature rupture of membranes (PPROM) patients and the control group with intact membranes. We also hypothesized whether serum IL-22 upregulation might contribute to defense against inflammatory responses and improve the pregnancy outcomes. We performed this prospective case-control study between 24-34 weeks of pregnancy. We enrolled 40 singleton pregnant patients with PPROM and 40 healthy gestational age- and gravidity-matched patients without PPROM. The degree of association between variables and IL-22 were calculated by Spearman correlation coefficients where appropriate. Scatter plots were given for statistically significant correlations. ROC curve was constructed to illustrate the sensitivity and specificity performance characteristics of IL-22, and a cutoff value was estimated by using the index of Youden. Maternal serum IL-22 levels were significantly higher in PPROM patients (60.34 ± 139.81 pg/mL) compared to the participants in the control group (20.71 ± 4.36 pg/mL, p < 0.001). When we analyze the area under the ROC curve (AUC), the IL-22 value can be considered a statistically significant parameter for diagnosing PPROM. According to the Youden index, a 23.86 pg/mL cut-off value of IL-22 can be used to diagnosing PPROM with 72% sensitivity and 61.5% specificity. There was no positive correlation between serum IL-22 levels and maternal C-reactive protein (CRP) value, procalcitonin value, latency period, birth week, birth weight, and umbilical cord blood pH value. Maternal serum IL-22 levels were significantly higher in PPROM patients than healthy pregnant women with an intact membrane. We suggest that IL-22 might be a crucial biomarker of the inflammatory process in PPROM.

Maternal Obesity and Risk of Low Birth Weight, Fetal Growth Restriction, and Macrosomia: Multiple Analyses.

The associations between maternal pre-pregnancy obesity and low birth weight (LBW, <2500 g) remain inconclusive. Therefore, birth weight in a Polish prospective cohort of 912 mothers was investigated depending on the pre-pregnancy body mass index (BMI). The whole cohort and the subgroup of gestational weight gain (GWG) in the range of the Institute of Medicine (IOM) recommendations, as well as ‘healthy’ women (who did not develop diabetes or hypertension in this pregnancy) were investigated. Adjusted odds ratios (AOR) of the newborn outcomes (with 95% confidence intervals, CI) for obesity (BMI ≥ 30 kg/m2) vs. normal BMI (18.5−24.9 kg/m2) were calculated using multiple logistic regression. Risk profiles (in the Lowess method) were presented for BMI values (kg/m2) and threshold BMI values were calculated. (1) In the cohort, LBW affected 6.6% of pregnancies, fetal growth restriction (FGR) 2.3%, and macrosomia 10.6%. (2) The adjusted risk of macrosomia was more than three-fold higher for obesity compared to normal BMI in the whole cohort (AOR = 3.21 (1.69−6.1), p < 0.001) and the result was maintained in the subgroups. A 17-fold higher adjusted LBW risk for obesity was found (AOR = 17.42 (1.5−202.6), p = 0.022), but only in the normal GWG subgroup. The FGR risk profile was U-shaped: in the entire cohort, the risk was more than three times higher for obesity (AOR = 3.12 (1.02−9.54), p = 0.045) and underweight (AOR = 3.84 (1.13−13.0), p = 0.031). (3) The risk profiles showed that the highest BMI values were found to be associated with a higher risk of these three newborn outcomes and the threshold BMI was 23.7 kg/m2 for macrosomia, 26.2 kg/m2 for LBW, and 31.8 kg/m2 for FGR. These results confirm the multidirectional effects of obesity on fetal growth (low birth weight, fetal growth restriction, and macrosomia). The results for LBW were heavily masked by the effects of abnormal gestational weight gain.

Placenta pathology in recipient versus donor oocyte derivation for in vitro fertilization in a setting of hypertensive disorders of pregnancy and IUGR

IntroductionAssisted reproductive technology including in vitro fertilization (IVF) and oocyte donation (OD) may increase risk for placenta-mediated diseases. Comprehensive analysis of histopathological placental lesions according to source of oocytes used in the IVF procedure – recipient derived (RD-IVF) vs oocyte donation (OD-IVF), has not been conducted in a population with a hypertensive disorder of pregnancy (HDP) and/or intrauterine growth restriction (IUGR). MethodsA retrospective cohort study of archived placenta specimens from RD-IVF and OD-IVF pregnancies affected by HDP and/or IUGR was conducted with blinded histopathological placental examination. Three categories of lesions were differentiated and defined as main outcomes: maternal vascular malperfusion (MVM), chronic inflammation, and fetal vascular malperfusion (FVM). To determine the relationship between conception method and placental lesions, multivariable regressions were performed with maternal age, gestational age, HDP, birth and placental weight percentiles as model covariates. Results115 placentas were included 83 (72.2%) RD-IVF, 32 (27.8%) OD-IVF. Adjusted OR (aOR) for conception method was 5.05 (95%CI 0.58–43.90, p=0.142) for MVM, 1.87 (95%CI 0.68–5.15, p=0.228) for chronic inflammatory and 0.61 (95%CI 0.15–2.37, p=0.471) for FVM lesions. Multiple gestation demonstrated borderline association with MVM (aOR=0.24, 95%CI 0.04–1.51, p=0.129) and total pathology score (aRR=0.79, 95%CI 0.62–1.01, p=0.058). Subgroup analysis suggested greater odds of villitis of unknown etiology (VUE) for OD-IVF (aOR=2.98, 95%CI 1.12–7.93, p=0.029). DiscussionSource of oocyte derivation demonstrated no evidence of association with main outcomes in cases of HDP and/or IUGR. Subgroup analysis demonstrated increased rates of inflammatory lesions for OD-IVF. Multiple gestation may be associated with decreased MVM and total lesions.

Prevalence of functional gastrointestinal disorders in infants and young children in China

BackgroundThe prevalence of functional gastrointestinal disorders (FGIDs) in children, particularly from Asia, is largely unknown. There are not many studies done in Asia especially using the Rome IV criteria. The aim of this study is to assess the prevalence of FGIDs in infants and young children in a representative sample in China.MethodsA prospective, cross-sectional, community-based survey was conducted among healthy infants and young children between the ages of 0–4 years in Jinhua and Shanghai, China. A total of 2604 subjects (1300 subjects from Jinhua and 1304 subjects from Shanghai) completed a validated questionnaire on pediatric gastrointestinal symptoms. FGIDs in infants and young children were diagnosed using the Rome IV criteria.ResultsAccording to the Rome IV criteria, the prevalence of having a FGID in Chinese infants and young children is 27.3%. Infant regurgitation (33.9%) was the most common FGID among the 0–6 months old while functional constipation (7.0%) was the most common among the 1–4 years old. Risk factor analysis revealed that prevalence of infantile colic was higher with better maternal education and low birth weight. Prevalence of infantile regurgitation was significantly greater in males, living in a rural area, being exclusively breast fed at least up to 4 months and starting formula feeds within the first month. The risk of functional constipation was lower for infants who were delivered vaginally.ConclusionsInfantile regurgitation was the most common FGID in Chinese infants while functional constipation was most prevalent among young Chinese children.Trial registrationNetherlands Trial Registry Identifier: NL6973/NTR7161.

Maternal and fetal factors contributing to neonatal outcome in Al-Tibri Medical College and Hospital

Background: The study was done to identify the maternal and fetal factors contributing to neonatal outcome and to evaluate the correlation between risk factors and adverse neonatal outcome.&#x0D; Subjects and methods: This prospective observational study was conducted on 126 mothers and their neonates fulfilling the selection criteria at Al-Tibri Medical College and Hospital. A self-designed Performa was used to enter data of subjects. Sick neonates were referred to neonatal intensive care unit for admission and management. The results were analyzed by using SPSS version 22. A p-values &lt;0.05 was considered as significant.&#x0D; Results: Out of 126 enrolled subjects, 81% mothers were multigravidas, 31% were unbooked, 13.5% had gestational comorbidities, 15% were drug addict, 2% were Hepatitis B positive. 22.2% underwent emergency LSCS while 31.7% delivered babies by elective LSCS. Regarding fetal factors contributing to sick babies, IUGR (20%), twin fetuses (15.4%), prematurity (47.7%) were significant. 65 were sick babies. Adverse neonatal outcomes observed were prematurity in 25.4%, IUGR in 11.1%, NICU admission in 33.3%, and neonatal death in 2%. Risk factors associated with adverse neonatal outcomes were positive maternal drug addiction (p-value = 0.028), preterm delivery (p-value&lt;0.001), NICU admission (p-value&lt;0.001) and low birth weight (p-value &lt;0.001).&#x0D; Conclusion: Compromised maternal antenatal care has profound deleterious effect on fetus and neonate. Obstetricians, perinatologists and neonatologists need to work in concord to improve maternal antenatal care hence improving neonatal outcome. In our study adverse neonatal outcome was associated with unbooked cases, delivery by EmLSCS, addicted mother, preterm delivery, LBW and neonates requiring NICU admission.

Polymorphic variants in Sweet and Umami taste receptor genes and birthweight

The first thousand days of life from conception have a significant impact on the health status with short, and long-term effects. Among several anthropometric and maternal lifestyle parameters birth weight plays a crucial role on the growth and neurological development of infants. Recent genome wide association studies (GWAS) have demonstrated a robust foetal and maternal genetic background of birth weight, however only a small proportion of the genetic hereditability has been already identified. Considering the extensive number of phenotypes on which they are involved, we focused on identifying the possible effect of genetic variants belonging to taste receptor genes and birthweight. In the human genome there are two taste receptors family the bitter receptors (TAS2Rs) and the sweet and umami receptors (TAS1Rs). In particular sweet perception is due to a heterodimeric receptor encoded by the TAS1R2 and the TAS1R3 gene, while the umami taste receptor is encoded by the TAS1R1 and the TAS1R3 genes. We observed that carriers of the T allele of the TAS1R1-rs4908932 SNPs showed an increase in birthweight compared to GG homozygotes Coeff: 87.40 (35.13–139.68) p-value = 0.001. The association remained significant after correction for multiple testing. TAS1R1-rs4908932 is a potentially functional SNP and is in linkage disequilibrium with another polymorphism that has been associated with BMI in adults showing the importance of this variant from the early stages of conception through all the adult life.

Relationship between placental weight, birth weight, maternal biosocial characteristics and placental-to-birth-weight ratio

Background: Although routine measurements are taken at birth, the derivable benefits from their interpretations have not been maximized in the care of the newborn. &#x0D; Aim: To determine the relationship between placental weight (PW) at birth, maternal biosocial characteristics, birth weight (BW) and placental-to-birth-weight ratio (PBWR) on immediate and follow up care of the newborn.&#x0D; Methods: A cross-sectional study involving parturient who had singleton deliveries at ≥32weeks gestation with comparison of maternal biosocial parameters, PW, BW and PBWR. Deliveries &lt;32weeks gestation, multiple gestation and incomplete placenta were excluded from the study. Data was retrieved from the institutional birth registry; data management included determination and comparison of mean values and ratio of individual parameters using SPSS version 21.0.&#x0D; Result: Among the 8645 participants, the mean PW was 589.2±146g and it increased with maternal age. The mean BW increased with maternal age with a decline from 35years, PBWR declined until age 30years with a rise afterwards. The mean PW increased with parity, the BW increased till the fourth delivery when it began to decline but PBWR did not follow a regular pattern with parity. The PW and BW increased with gestational age while PBWR increased till 36th week, declined from 37th to 42nd week with a rise from 43rd week. The mean PW and BW increased with maternal educational status while booked participants had higher PW and BW but lower PBWR compared to unbooked women.&#x0D; Conclusion: The placental weight is a central index for the interpretation of measurements at birth, detection of associated abnormalities and suggestion for neonatal follow-up.

Congenital Heart Disease in Non-Diabetic Large-for-Gestational-Age (LGA) Neonates.

Congenital heart diseases are the most prevalent congenital abnormalities in the neonates, caused by environmental and genetic factors and contributing to the leading cause of death. This study aims to evaluate the relationship between neonates with large for gestational age and increased risk of congenital heart diseases among non-diabetic mothers. In this study, 179 neonates with large gestational age in Khorramabad were enrolled where heart abnormalities were evaluated using echocardiography. 87 neonates had more than 4000 g of birth weight with no heart abnormalities and 92 (51%) macrosomic neonates had congenital heart diseases. Statistical analysis revealed a significant relationship between birth weight and increased risk of acquiring congenital heart disease between the two groups. There was no significant relationship between birth weight, maternal age, gender, labor type and blood group between the two groups. The highest incidence of congenital heart anomalies was related to 38% of arterial septal defect (ASD) and 15.2% of ASD and VSD, respectively. The most prevalent abnormality was arterial septal ASD. None of these abnormalities were associated with maternal age, birth weight and neonate gender. Future studies for congenital heart disease and neonatal birth weight are, therefore, recommended.

Socioeconomic inequalities and adverse pregnancy outcomes in the UK and Republic of Ireland: a systematic review and meta-analysis

ObjectiveThere has been an unprecedented rise in infant mortality associated with deprivation in recent years in the United Kingdom (UK) and Republic of Ireland. A healthy pregnancy can have significant...

Factors Affecting Toddlers'Development In Pamekasan Regency

Toddlers require basic needs – stimulation, love, and care – in the process of growth and development. Parents, especially mothers, are the most important factors in performing these three tasks: honing, loving, and fostering. The mother's physical and psychological conditions, including the mother's age at marriage, education, and stimulation, will impact children's development. This study aims to determine the factors that influence toddlers' development in the Pamekasan Regency. The research method used was descriptive-analytic, with a retrospective design. This study consisted of 110 mothers with toddlers by fixed exposure sampling in Waru, Batu Marmar, and Pasen Public Health Center. The dependent variable was the toddlers' development. The independent variables were the mother's age at marriage, family income, stimulation, mother's LILA during pregnancy, and birth weight. The analysis used the path analysis method. The results showed that the toddlers' development was influenced by the mother's age at marriage (b = 0.07, SE = 0.02, p = 0.001), family stimulation (b = 0.02, SE = 0.01, p = &lt;0.001) and birth weight (b = 0.00, SE = 0.00, p = 0.373). This study concludes that maternal marriage age, family stimulation, and birth weight affect toddlers' development.

Progress and Insights Toward an Effective Placental Malaria Vaccine.

In areas where Plasmodium falciparum transmission is endemic, clinical immunity against malaria is progressively acquired during childhood and adults are usually protected against the severe clinical consequences of the disease. Nevertheless, pregnant women, notably during their first pregnancies, are susceptible to placental malaria and the associated serious clinical outcomes. Placental malaria is characterized by the massive accumulation of P. falciparum infected erythrocytes and monocytes in the placental intervillous spaces leading to maternal anaemia, hypertension, stillbirth and low birth weight due to premature delivery, and foetal growth retardation. Remarkably, the prevalence of placental malaria sharply decreases with successive pregnancies. This protection is associated with the development of antibodies directed towards the surface of P. falciparum-infected erythrocytes from placental origin. Placental sequestration is mediated by the interaction between VAR2CSA, a member of the P. falciparum erythrocyte membrane protein 1 family expressed on the infected erythrocytes surface, and the placental receptor chondroitin sulfate A. VAR2CSA stands today as the leading candidate for a placental malaria vaccine. We recently reported the safety and immunogenicity of two VAR2CSA-derived placental malaria vaccines (PRIMVAC and PAMVAC), spanning the chondroitin sulfate A-binding region of VAR2CSA, in both malaria-naïve and P. falciparum-exposed non-pregnant women in two distinct Phase I clinical trials (ClinicalTrials.gov, NCT02658253 and NCT02647489). This review discusses recent advances in placental malaria vaccine development, with a focus on the recent clinical data, and discusses the next clinical steps to undertake in order to better comprehend vaccine-induced immunity and accelerate vaccine development.

Relationship between placental weight, birth weight, maternal biosocial characteristics and placental-to-birth-weight ratio

Background: Although routine measurements are taken at birth, the derivable benefits from their interpretations have not been maximized in the care of the newborn. &#x0D; Aim: To determine the relationship between placental weight (PW) at birth, maternal biosocial characteristics, birth weight (BW) and placental-to-birth-weight ratio (PBWR) on immediate and follow up care of the newborn.&#x0D; Methods: A cross-sectional study involving parturient who had singleton deliveries at ≥32weeks gestation with comparison of maternal biosocial parameters, PW, BW and PBWR. Deliveries &lt;32weeks gestation, multiple gestation and incomplete placenta were excluded from the study. Data was retrieved from the institutional birth registry; data management included determination and comparison of mean values and ratio of individual parameters using SPSS version 21.0.&#x0D; Result: Among the 8645 participants, the mean PW was 589.2±146g and it increased with maternal age. The mean BW increased with maternal age with a decline from 35years, PBWR declined until age 30years with a rise afterwards. The mean PW increased with parity, the BW increased till the fourth delivery when it began to decline but PBWR did not follow a regular pattern with parity. The PW and BW increased with gestational age while PBWR increased till 36th week, declined from 37th to 42nd week with a rise from 43rd week. The mean PW and BW increased with maternal educational status while booked participants had higher PW and BW but lower PBWR compared to unbooked women.&#x0D; Conclusion: The placental weight is a central index for the interpretation of measurements at birth, detection of associated abnormalities and suggestion for neonatal follow-up.

Obesity and adiposity of 3- to 6-year-old children born to mothers with hyperglycaemia first detected in pregnancy in an urban South African setting

Background Understanding the association between maternal metabolic conditions in pregnancy and the risk of childhood overweight, a growing concern in sub-Saharan Africa (SSA), helps to identify opportunities for childhood obesity prevention. Aim To assess the association between hyperglycaemia first detected in pregnancy (HFDP) (gestational diabetes mellitus [GDM] and diabetes in pregnancy [DIP]) and child obesity and adiposity in pre-school-aged children in South Africa, independently of maternal BMI. Subjects and methods Measurement of anthropometry and fat mass index (FMI) by the deuterium dilution method was done for 102 3–6-year-old children born to mothers with HFDP and 102 HFDP-unexposed children. Hierarchical regression analysis and generalised structural equation modelling (GSEM) were performed. Results The prevalence of overweight/obesity was 10.5% and 11.1% in children exposed to GDM and DIP, respectively, and 3.9% in the HFDP-unexposed group. Log-transformed FMI was significantly higher in the DIP-exposed group (β = 0.166, 95% CI = 0.014–0.217 p= .026), but not when adjusting for maternal pregnancy BMI (β = 0.226, 95% CI = 0.003–0.015, p = .004). GSEM showed significant total effects of maternal BMI and birth weight on FMI/BMI. Conclusions Maternal pregnancy BMI seems to play a greater role in the development of childhood adiposity than maternal hyperglycaemia, requiring further research and identifying maternal BMI as a relevant prevention target in our setting.

Maternal Resources, Pregnancy Concerns, and Biological Factors Associated to Birth Weight and Psychological Health.

Cognitive maternal adaptation during pregnancy may influence biological variables, maternal psychological, and neonatal health. We hypothesized that pregnant women with numerous general resources and less negative emotions would have a better coping with a positive influence on neonatal birth weight and maternal psychological health. The study included 131 healthy pregnant women. A blood sample was obtained in the first trimester to assess biological variables (polyphenols, hematological and biochemical parameters). Psychological variables (negative affect, anxiety, optimism, resilience, family–work conflicts, pregnancy concerns, general resources, and life satisfaction) were evaluated at several time points along gestation, and birth weight was recorded. Hierarchical linear regression models were used to associate the above parameters with maternal psychological outcome at the end of gestation (depression, resilience, and optimism) and neonatal outcome (birth weight). Maternal depression was associated with leukocytes (β = 0.08 ± 0.03, p-value = 0.003), cholesterol (β = 0.01 ± 0.002, p-value = 0.026), and pregnancy concerns (β = 0.31 ± 0.09, p-value = 0.001). Maternal resilience was associated with leukocytes (β = −0.14 ± 0.09, p-value = 0.010) and life satisfaction (β = 0.82 ± 0.08, p-value = 0.001), and maternal optimism was associated with polyphenol levels (β = 0.002 ± 0.001, p-value = 0.018) and life satisfaction (β = 0.49 ± 0.04, p-value = 0.001). Birth weight was associated with maternal resilience (β = 370.2 ± 97.0, p-value = 0.001), red blood cells (β = 480.3 ± 144.4, p-value = 0.001), and life satisfaction (β = 423.3 ± 32.6, p-value = 0.001). We found associations between maternal psychological, blood variables, and birth weight and maternal depression. This study reveals the relevance of psychological health during pregnancy for maternal and neonatal outcome, and it emphasizes the need to consider it in preventive policies in the obstetric field.