Maternal Birth Weight Research Articles

Maternal nutritional status during pregnancy as a predictor of Ponderal index and body proportionality at birth, in term neonates

Background: It is well established that maternal body mass index (BMI) and haemoglobin (Hb) level has an impact on foetal growth. Various studies have concluded that intrauterine growth as reflected by the Ponderal index (PI) is strongly influenced by various maternal factors. Therefore, we undertake this study to address the evidence gap to establish the strength of association between maternal nutritional status as indicated by her pre-pregnancy BMI and haemoglobin levels and neonatal PI.Methods: A hospital based cross-sectional, observational study was conducted that included 236 normal newborns and their mothers. A predesigned questionnaire was used to collect relevant socio-demographic data and obstetric history. Details regarding the maternal pre-pregnancy weight were collected from antenatal records, maternal height was measured and BMI was calculated. Neonatal birth weight and recumbent length was measured. PI was calculated and co-related with the maternal BMI and haemoglobin values.Results: 11.9% of the mothers were underweight and 51.3% had normal BMI. Majority of the mothers (62.7%) had normal Hb levels and 0.4% were found to have severe anemia (Hb <7 mg/dl). We saw a significant positive correlation (p<0.05) between BMI and birth weight, BMI and PI that is, with decrease in BMI there was a significant decrease in the birth weight and PI of the newborn. There was no significant correlation between haemoglobin level and PI.Conclusions: Our study showed a positive association between maternal pre-pregnancy BMI and birth weight, BMI and PI. Therefore, interventions aimed at improving the nutritional status of the mother have a direct impact on the foetal growth outcomes.

Direct and correlated responses to selection for autumn lambing in sheep

BackgroundSeasonal reproduction limits productivity, flexibility, and profitability in commercial sheep production. Hormonal and (or) photoperiodic manipulation can be used to control estrous cycles in sheep and reduce limitations that are imposed by the seasonal anestrous but are often impractical or incompatible with the extensive management systems preferred for ruminant livestock. Thus, the current study investigated the use of selection to improve realized fertility (i.e., the proportion of ewes that lambed) following an out-of-season spring joining period (May and June) in a crossbred sheep population.ResultsOver 17 years, estimated breeding values (EBV) for fertility in selected (S) ewes increased by 0.175 (0.01 per year). The mean EBV for fertility of S ewes was greater than that of control ewes by year 10 (P = 0.02), and the fertility of adult (≥ 3 years old) ewes reached 0.88 ± 0.05 by year 17. Lambing began approximately 140 days after the introduction of rams, and 64% of the S ewes that lambed did so in the first 17 days of the potential lambing season, which indicated that most of the S ewes were cycling at the time of ram introduction and were not induced to cycle by the introduction of breeding males (i.e., the so-called “ram effect”). Animals in the S line had modest increases in body weight and scrotal circumference. A modest negative trend in the additive maternal effect on birth weight was observed but was reversed by additional selection on EBV for maternal birth weight. The heritability of litter size in autumn lambing was low (0.04) and could potentially limit the response to selection for this trait.ConclusionsSelection improved realized ewe fertility in out-of-season mating, with absolute increases of approximately 1% per year in the percentage of joined ewes that lambed in the autumn. Genetic antagonisms with other performance traits were generally small. A modest antagonism with maternal breeding values for birth weight was observed but it could be accommodated by selection on EBV for maternal birth weight. Our results support results of previous studies that indicate that these selected ewes had one of the shortest seasonal anestrous periods reported for temperate sheep breeds and that spring-lambing lactating ewes from the selection line were capable of relatively rapid rebreeding in the spring.

Exploring the association between adverse maternal circumstances and low birth weight in neonates: a nationwide population-based study in Bangladesh

ObjectiveThis study is concerned with helping to improve the health and care of newborn babies in Bangladesh by exploring adverse maternal circumstances and assessing whether these are contributing towards low...

A correlative study between maternal hemoglobin concentration during third trimester and fetal birth weight of babies born at Kathmandu Medical College and Teaching Hospital

Background: Anemia is one of the commonest health problems faced by pregnant women in both developing and developed countries. Maternal anemia is a potential risk factor for fatal outcomes like low birth weight and preterm delivery. This study intended at comparing the birth weight of the babies who were born to mothers with and without anemia during the third trimesters.
 Materials and methods: This study is a descriptive, cross-sectional study conducted at Kathmandu Medical College, Teaching Hospital from July 2019 to June 2020. The third-trimester hemoglobin of mothers was recorded along with the birth weight of their respective babies. Mothers with regular antenatal care visits at this hospital were included and the known causes for anemia like renal disorders, twin pregnancies, and others were excluded from the study. The third-trimester hemoglobin level of all pregnant females was correlated with the birth weight of the babies.
 Results: Out of a total of 2417 pregnant women, 317 (13%) had anemia. The overall prevalence of low birth weight was 12%. Out of 317 anemic mothers, 99 (31%) delivered low birth weight babies. Among those 99 low birth weight babies, 30 (30%) were preterm and 69 (70%) were term babies with the prevalence of low birth weight in anemic mothers being 31%. The correlation between maternal hemoglobin and birth weight was found to be statistically significant.
 Conclusions: Despite regular antenatal care, maternal anemia still prevails, affecting neonatal birth weight. There was a statistically significant correlation between maternal hemoglobin and birth weight (p-value <0.0001).

Faktor Risiko Kurang Energi Kronis (KEK) pada Ibu Hamil di Cikembar Kabupaten Sukabumi

One of the nutritional problems in Indonesia is Chronic Energy Deficiency (CED) among pregnant women, which is the cause of the high maternal mortality rate and low birth weight. This study aims to analyze the risk factors of CED in pregnant women with cross-sectional study design. The subject in this research were 70 pregnant women with and without CED (normal) at Cikembar Health Center Sukabumi district. CED group had less nutrition and health knowledge in comparison to the normal group. The level of energy and protein sufficiency in both groups was generally in the deficit category. Most of the CED group food security was in food insecurity while the normal group was in food vulnerable conditions. Based on the results of logistic regression analysis, it shows that there is a significant relationship between maternal knowledge and household food security with the incidence of CED in pregnant women (p <0.05), but between the level of energy and protein adequacy shows an insignificant relationship (p> 0.05). The multiple logistic regression analysis results indicate that the factor affecting the incidence of CED in pregnant women is household food security. Besides, the level of knowledge of nutrition and health, food consumption, and household food security in CED pregnant women is low or deficit compared to the normal pregnant women.

The impact of maternal stress on offspring birth weight and the mediating effect of dietary patterns: the Shanghai Maternal-Child Pairs Cohort study

BackgroundMaternal stress and nutrition during pregnancy are two of the most commonly studied factors in the context of fetal development. However, few investigators have considered the combined effects of stress and diet in pregnant women and their offspring. AimsTo determine the impact of maternal stress on offspring birth weight, and the potential mediating role of maternal dietary patterns. MethodsA total of 3542 pregnant women and their singleton live births were recruited from Shanghai Maternal-Child Pairs Cohort (Shanghai MCPC). Maternal stress was assessed using the Life Event Scale for Pregnant Women (LESPW) in early and late pregnancy. Food frequency questionnaire (FFQ) was performed to evaluate maternal diet in late pregnancy. Multiple linear regression was conducted to estimate the associations between maternal stress and child birth weight. Logistic regression was performed to calculate the association between maternal stress and small for gestational age (SGA)/large for gestational age (LGA). The bootstrap method was used to investigate the mediating effects of maternal dietary patterns. ResultsMaternal subjective events stress (β = 0.367) and total stress (β = 0.079) in early pregnancy, and positive objective life events stress (β = 0.275) in late pregnancy, were positively associated with birth weight. Maternal dietary pattern of “high-fat and sugar” mediated the associations between subjective events stress and total stress during early pregnancy and birth weight. An increased risk for LGA was observed among women exposed to relatively higher stress during early pregnancy (OR, 1.416; 95% CI, 1.035-1.937). No statistically significant associations were found between maternal stress during late pregnancy and child birth weight or SGA/LGA. ConclusionsMaternal life events stress during early pregnancy significantly increases neonatal birth weight and risk for LGA, which may mediate by a “high-fat and sugar” dietary pattern. LimitationsThe lack of biological markers limits the explanation of the mechanism. The assessment of diet used food intake frequency to evaluate dietary characteristics, which may miss information of energy intake.

The Level of Maternal Knowledge about Complications in Pregnancy toward the Increase of Low Birth Weight Cases

Background: Based on Metro City Health Office reports, there was an increase in the proportion of LBW cases from 75 cases per 1.000 live births in 2015 to 87 cases per 1.000 live births in 2016. Metro City Health Service stated that one of the causes was the low level of maternal knowledge, especially regarding the consumption of balanced nutrition during pregnancy. This study aimed to investigate the relationship between the level of maternal knowledge and Low Birth Weight (LBW). Method: The study design was case-control, where low birth weight as a case and normal weight as a control. Study sample was 102, consisting of 51 cases and 51 control. Dependent variable was low birth weight, independent variable was the level of maternal knowledge. Data was obtained by interviewing the mothers, and secondary data was collected from community health center records. Data was analysed by bivariate and multivariate analysis. Results: Bivariate analysis showed that the OR level of maternal knowledge was 2,598 (95% CI: 1,126-5,995). The results of multivariate analysis showed that OR level of maternal knowledge was 2,646 (95% CI: 1,092-6,410). Conclusion: Mother's level of knowledge is a risk factor for LBW in Metro City.

Association of Maternal Plasma Total Cysteine and Growth among Infants in Nepal: A Cohort Study.

Cysteine is a semi-essential amino acid that has been positively associated with growth in children. However, transgenerational effects remain unclear. The aim of this analysis was to assess whether maternal plasma total cysteine (tCys) concentration is associated with various growth indicators in infants living in peri-urban settings in Bhaktapur, Nepal. We used data from the 561 mothers enrolled in an ongoing randomized controlled trial. We built linear regression models to evaluate the associations between maternal tCys and birth weight, length-for-age Z-scores (LAZ) and weight-for-length Z-scores (WLZ) at birth and six months of age. Maternal tCys was inversely associated with birth weight among boys after adjusting for confounders (p < 0.05). In addition, there was a negative association between maternal tCys and LAZ at birth (p < 0.01). No associations between maternal tCys and the other anthropometric indicators were found significant, although there was a tendency for maternal tCys to be associated positively with WLZ at birth among girls (p < 0.10). This is a first study evaluating transgenerational relation of tCys on growth in infants. Further, larger and more comprehensive studies are needed to determine if and how maternal tCys alters child growth.

Maternal altitude and risk of low birthweight: A systematic review and meta-analyses

BackgroundPrevious studies conducted in high altitude regions showed that maternal altitude was associated with low birth weight. The effect size of birth weight reduction is inclusive with unknown effects due to preterm birth. We systematically reviewed the literature and synthesize evidence on associations between altitude elevation from sea level and birth weight. MethodWe searched MEDLINE/PubMed, Embase, Scopus, Web of Science, and Cochrane database, from inception to May 5, 2020 for studies that reported maternal altitude and birth weight. Bayesian multilevel effect models were employed to estimate the effect size on birth weight (and gestational age) associated with altitude. Bayesian multilevel effect models were employed to estimate the effect size on birth weight (and gestational age) associated with altitude. ResultsThe systematic search identified 1020 articles, with 52 articles meeting the inclusion criteria providing 207 estimates for the association of altitude and birth weight (n = 4,428,563), and with 22 articles providing 71 estimates for gestational age (n = 2,149,627). A reduction in mean birth weight of 96.98 g was associated with every 1000 m increase in altitude across 52 studies. A statistically significant but numerically minimal effect of maternal altitude elevation was observed on the gestational age (0.3 days), corresponding to a negligible estimation of 5 g lower birth weight. A relatively high heterogeneity of between-study association (I2>84.1%) and small study effect was found. ConclusionA clinically meaningful birth weight reduction was associated with maternal altitude elevation beginning from sea level. Future longitudinal studies are needed to elucidate the causal association and to understand the late effect of maternal altitude.

Moringa oleifera leaf powder supplementation improved the maternal health and birth weight: a randomised controlled trial in pregnant women

Moringa oleifera leaf powder supplementation improved the maternal health and birth weight: a randomised controlled trial in pregnant women

Prenatal Maternal Cortisol Levels and Infant Birth Weight in a Predominately Low-Income Hispanic Cohort.

Infant birth weight influences numerous health outcomes throughout the life course including childhood obesity and metabolic morbidities. Maternal experience of stress, both before and during pregnancy, has been hypothesized to influence fetal growth and birth outcomes. However, these associations currently are not fully understood, due to conflicting results in the published literature. Salivary cortisol is often used as a biological biomarker to assess the diurnal pattern of the hypothalamic–pituitary–adrenal axis (HPA-axis) functioning. Cortisol metrics include both the total cortisol concentration secreted during waking hours, reflected by the area under the curve (AUC), and cortisol dynamics, which include the diurnal cortisol slope (DCS) and the cortisol awakening response (CAR). This study examined the association of these cortisol metrics measured during the third trimester of pregnancy and infant birth weight among 240 mother-infant dyads participating in the Maternal and Developmental Risks from Environmental and Social Stressors (MADRES) pregnancy cohort study, which is predominately comprised of Hispanic low-income women. There were no significant associations with the maternal biological stress response and infant birth weight in this study. More research is needed in larger studies to better understand how the biological stress response influences birth weight in populations facing health disparities.

INFANT BIRTH WEIGHT AND MATERNAL BMI: GENETIC VS EPIGENETIC CONTRIBUTIONS

The prevalence of obesity is increasing worldwide. Obesity has been shown to have a negative effect on reproductive outcomes in both spontaneous and IVF pregnancies. Studies on the effect of maternal BMI on pregnancy success rates in donor oocyte IVF cycles are conflicting. Few studies have examined the effect of maternal BMI on neonatal outcomes. While increasing maternal BMI is associated with increased infant birth weight in both spontaneous and autologous IVF pregnancies, it is unclear whether this is primarily a genetic or epigenetic phenomenon. To our knowledge, this is the first study to examine the effect of donor BMI on infant birth weight in donor oocyte IVF cycles. The purpose of this study is to assess the relationship between infant birth weight and recipient and donor BMI in donor oocyte IVF cycles in order to determine the relative genetic (oocyte) and epigenetic (endometrial) contributions. IRB-approved retrospective cohort study. We conducted a retrospective cohort study of 130 donor oocyte IVF cycles resulting in a singleton live birth at a single IVF center from 2012-2018. Pearson correlation coefficients were calculated to examine the relationship between recipient and donor BMI and infant birth weight. ANOVA was conducted to compare infant weight among various BMI subgroups. Linear regression was used to adjust for the type of embryo transfer (fresh vs frozen), diabetes or gestational diabetes status, hypertension in pregnancy, gestational age, and infant sex. Recipients were >35 years of age on average and predominantly Caucasian. Decreased ovarian reserve was the most common etiology of infertility diagnosis. Forty-four percent of recipients were normal weight and 56% were overweight or obese. The mean age of oocyte donors was 26.7 ± 3.15 (Range 20-39) years. Seventy-eight percent of oocyte donors were normal weight and oocyte donors were predominantly Caucasian. There was no correlation between recipient BMI and infant birth weight (r=0; p=0.99). In contrast, there was a weakly positive, but non-significant, correlation between donor BMI and infant birth weight (r=0.02; p=0.76). This relationship persisted after adjusting for potential confounders. Several studies have shown a clear association between maternal BMI and infant birth weight in autologous IVF cycles. In this study we examined the relative contribution of donor and recipient BMIs to infant birth weight in donor oocyte IVF cycles. The lack of correlation observed between recipient BMI and infant birth weight along with the weak although not significant correlation between donor BMI and infant birth weight suggests that oocyte or genetic components may play a greater role in infant birth weight compared to epigenetic or endometrial factors. This study is limited by the relatively small sample size and lack of information on paternal BMI. Future studies aim to examine metabolic health outcomes in oocyte donor-conceived children.

Effect of stop smoking during the first trimester on Low birth weight: A MCBR Study

Abstract Background Tobacco smoking is a public health problem. Even though this habit is less common among women than men in Russia, it appears to be on the increase among women aged ≥15 years. Smoking during pregnancy leads to adverse pregnancy and birth outcomes. Compared to the number of studies on maternal smoking and birth weight, the influence of stop smoking on low birth weight is not well documented. The aim of the study was to assess an effect of quitting smoking during the first trimester on low birth weight. Methods The study is based on the Murmansk County Birth registry. Women who delivered a singleton pregnancy after 37 weeks of gestation were comprised to the study (N = 44,486). Smoking information was assessed at the first antenatal visit during pregnancy and self-reported and. Low birth weight was defined in according to the World Health Organization as Mean value minus 2 standard deviations for girls and boys separately. Using logistic regressions, we adjusted for maternal age, residence, ethnicity, education, marital status, alcohol abuse, year of delivery, body mass index, pregnancy diabetes, gestational age, and excessive weight gain. Results The prevalence of low birth weight was 1.1%. This adverse birth outcome was more prevalent in women who smoked during pregnancy (2.5%) in compared to those who stopped do it during pregnancy (0.8%) or did not smoke before and during pregnancy (0.9%) (p &amp;lt; 0.001). Compared to non-smokers, quitting smoking during the first trimester had no significant impact on the low birth weight, even after adjustment for confounders (ORcrude = 0.97 with 95%CI 0.64-1.47 and ORadj = 0.89 with 95%CI 0.58-1.36). Conclusions We observed that women who stop smoking during the first trimester are at no greater risk of having a term baby with low birth weight. Our findings underline a continued need for actions against smoking during pregnancy. Key messages Women who stop smoking during the first trimester are at no greater risk of having a term baby with low birth weight. Our findings underline a continued need for actions against smoking during pregnancy.

Pre- and post-natal factors and physical activity in childhood: The Norwegian Mother, Father and Child Cohort study.

Few studies have examined the possibility that pre- and post-natal factors may be non-linearly associated with later physical activity. We used data from the Norwegian Mother, Father and Child Cohort study (MoBa) and the Medical Birth Registry of Norway (MBRN), including 48672 children with available data on leisure time physical activity (LTPA) at child's age 7years. Restricted cubic and linear splines or linear regression was used to examine the associations between maternal pre-pregnancy BMI, birth weight for gestational age, and infant weight gain from birth to 1year with LTPA (frequency/wk) in 7-year-old children. The results suggest no associations between maternal pre-pregnancy BMI, birth weight, and infant weight gain on subsequent LTPA in girls. Maternal pre-pregnancy BMI and birth weight may be non-linearly associated with LTPA in 7-year-old boys. Infant weight gain (change in weight z-score from birth to 1year) may be weakly linearly associated with LTPA in boys. Pre- and post-natal factors may therefore influence LTPA in childhood differently in boys and girls. Maternal pre-pregnancy BMI and birth weight are positively associated with LTPA at the lower ends of the maternal pre-pregnancy BMI and birth weight continuums in boys. The negative associations at the higher ends of the continuums and the positive association between infant weight gain and LTPA in boys may not be important and needs further replication.

The association between prenatal exposure to polycyclic aromatic hydrocarbons and birth weight: A meta-analysis.

BackgroundPolycyclic aromatic hydrocarbons (PAHs) are a kind of endocrine disruptors, which can enter human body by the inhalation of PAH-containing matter and the ingestion of PAH-containing foodstuffs. Studies showed that PAHs can cross the placental barrier and might cause adverse effects on the fetus.ObjectivesThis meta-analysis aimed to estimate the associations between prenatal exposure to PAHs and birth weight.MethodsArticles published in English until May 8, 2020 and reported the effects of prenatal exposure to PAHs on birth weight were searched in multiple electronic databases including PubMed, the Web of Science, EMBASE and the Cochrane Library. The included studies were divided into three groups in accordance with the measurement of PAHs exposure. Then coefficient was extracted, conversed and synthesized by random-effects meta-analysis. And risk of bias was assessed for each study.ResultsA total of 3488 citations were searched and only 11 studies were included finally after double assessment. We found that there were no association between PAH-DNA adducts in cord blood (low/high) (OR: 1.0, 95%CI: 0.97, 1.03), 1-hydroxy pyrene (1-HP) concentration in maternal urine (OR: 1.0, 95%CI: 0.97, 1.03) and prenatal maternal airborne PAHs exposure (OR: 0.97, 95%CI: 0.93, 1.01) and birth weight. However, we observed ethnicity may change the effects of PAHs exposure on birth weight.ConclusionsThere is no significant relationship between prenatal exposure to PAHs and birth weight in our meta-analysis. Further studies are still needed for determining the effects of prenatal PAHs exposure on birth weight.

Malaria preventive practices and delivery outcomes: A cross-sectional study of parturient women in a tertiary hospital in Eastern Uganda.

Uganda ranks third in the number of deaths attributable to malaria and has some of the highest recorded malaria transmission rates in the general population. Malaria in Pregnancy is associated with detrimental effects for the mother and unborn baby and these effects seem to have long term effects and consequences on the life of the baby. Despite the preventive measures put in place by the World Health Organization in antenatal care, the burden of malaria in pregnancy is still high. We determined the use of malaria preventive strategies during pregnancy and the presence of plasmodium infection, anemia, and low birth weight babies at delivery among parturient women at Mbale regional referral hospital in eastern Uganda. A cross-sectional study was conducted among 210 women delivering at MRRH between July 2017 and January 2018. Information on demographics, antenatal care, and prevention practices was collected using an interviewer-administered questionnaire. Maternal venous blood and cord blood samples were screened for Plasmodium infection by both microscopy of Giemsa-stained blood films and Plasmodium falciparum rapid diagnostic test (pf. HPR2 mRDT). Polymerase Chain Reaction (PCR) was done on cord blood. The presence of anemia was determined by the use of an automated hemoglobin analyzer. Data were analyzed using descriptive and analytical statistics. Of the 210 women, 3 (1.4%) and 19(9.1%) tested positive for malaria by using Giemsa stained blood smear microscopy and malaria rapid diagnosticMRDT tests respectively. PCR detected 4(%) of Plasmodium in cord blood. Twenty-nine percent of the women had anaemia and 11 (5.2%) had low birth weight babies. Only 23.3% of the women received at least three doses of IPTp-SP and 57.9% reported sleeping under an Insecticide Treated Net the night before the survey. The women who reported sleeping under a mosquito net the previous night (OR 0.67, 95% CI: 0.24-1.86) and those who reported taking fansidar as a directly observed therapy (OR 0.31, 95% CI: 0.04-2.39) appeared to have few chances of getting plasmodium infection though the findings were not statistically significant. The effective use of malaria preventive strategies (IPT-SP and Insecticide Treated Nets) was generally low. Most of the women took less than three doses of SP and there was no strict adherence to the recommended directly observed therapy. The prevalence of Plasmodium infection during pregnancy was low though maternal anaemia and low birth weight were relatively high.

Maternal exposure to air pollution and the risk of low birth weight: A meta-analysis of cohort studies

Previous studies have evaluated the relationship between prenatal air pollution exposure and low birth weight, but the results are inconsistent. The purpose of this meta-analysis is to quantitatively analyze the relationship between maternal air pollutant exposure and low birth weight (LBW). PubMed and Web of Science databases were searched to obtain the studies on the relationship between the prenatal exposure of air pollutants and LBW that published as of June 2020. The pooled effects of air pollutant exposure and LBW were calculated using random-effect model (for studies with significant heterogeneity) or fixed-effect model (for studies without significant heterogeneity). Totally, 54 studies were included in this meta-analysis. The pooled effect of PM2.5, PM10, NO2, CO, SO2, and O3 exposure on LBW were 1.081 (95% CI: 1.043, 1.120), 1.053 (95% CI: 1.030, 1.076), 1.030 (95% CI: 1.008, 1.053), 1.007 (95% CI: 1.001, 1.014), 1.125 (95% CI: 1.017, 1.244), and 1.045 (95% CI: 1.005, 1.086), respectively. NO2 (per 10 ppb increase) and CO (per 100 ppb increase) exposure in the first trimester were positively correlated with LBW, of which the pooled effect was 1.022 (95% CI: 1.009, 1. 035) and 1.008 (95% CI: 1.004, 1.012), respectively. PM2.5 (per 10 μg/m3 increase) exposure in the third trimester significantly affected the LBW, of which the pooled effect was 1.053 (95% CI: 1.010, 1.097). In addition, PM10 (per 10 μg/m3 increase) exposure in the second trimester also significantly affected the LBW, with the pooled effect of 1.011 (95% CI: 1.005, 1.017). Prenatal exposure of the major air pollutants during the entire pregnancy could increase the risk of LBW, while the susceptible window of the pollutants varied.

Does Enoxaparin treatment have any effects on the placenta in women with unexplained histories of habitual abortion? A case control study.

It is very common to offer low molecular weight heparin (LMWH) medications to women with unexplained habitual abortion, to increase the livebirth rate. Although no benefit from LMWH has been clearly demonstrated, examination of the effects of enoxaparin on placental structure is lacking. To assess placental structural changes in pregnancies treated with enoxaparin, compared with controls. Case-control study in an obstetrics and gynecology unit of a tertiary-level university hospital in Turkey. Forty patients who had had term pregnancies and live births but also histories of habitual abortion were recruited for this study. Placentas were sampled using a systematic random sampling method. Tissue samples were obtained, embedded and sectioned for routine histological analyses. Hematoxylin and eosin staining was used. Surface area and length estimates from placental components were evaluated by using Image J. Cell proliferation and apoptosis were also assessed via immunohistochemistry. There were no significant differences between the groups regarding maternal age, abortion rate, birth weight or gestational age. Comparison of the enoxaparin and control groups showed that there were no significant differences in terms of surface area and ratios of placental components. We found that Bcl-2 was generally expressed at high levels in the enoxaparin group, while there was no difference in terms of Ki-67 between the groups. This study demonstrates that enoxaparin did not show any significant effect on the placental structure of cases that had histories of habitual abortion.

Prenatal tobacco exposure and psychiatric outcomes in adolescence: is the effect mediated through birth weight?

This study aims to examine the associations between prenatal exposure to maternal smoking, birth weight and persistent offspring psychiatric symptoms. Additionally, we aim to examine whether the relationship between prenatal maternal smoking and persistent offspring psychiatric symptoms is mediated by offspring birth weight. This study used the Growing Up in Ireland (GUI) longitudinal cohort. The GUI is a nationally representative longitudinal study of children which consisted of three data collection waves, at ages 9, 13, and 17years. Logistic regression analysis was used to examine associations between prenatal tobacco exposure, and offspring psychiatric symptoms. Linear regression was used to examine associations between prenatal tobacco exposure and offspring birth weight. We conducted a mediation analysis examining potential etiological pathways linking maternal smoking during pregnancy, offspring birth weight, and later offspring psychiatric symptoms. All analyses were adjusted for confounders including household income, maternal level of education, and family psychiatric history. Additionally, examination of birth weight and subsequent psychiatric symptoms also was controlled for prematurity. We found that the association between prenatal tobacco exposure and later psychiatric symptoms is mediated by birth weight. This work provides further evidence that maternal smoking during pregnancy is an important modifiable lifestyle factor that has an impact not just on the physical health of offspring but also their mental wellbeing. Supporting women with structured smoking cessation programs at the earliest stages of pregnancy should be a public health priority.

Detecting tuberculosis in pregnant and postpartum women in Eswatini.

BackgroundTuberculosis diagnosis in pregnancy is complex because tuberculosis symptoms are often masked by physiological symptoms of pregnancy. Untreated tuberculosis in pregnant and postpartum women may lead to maternal morbidity and low birth weight. Tuberculosis in HIV-positive pregnant women increases the risk of maternal and infant mortality.ObjectiveThis study aimed to determine tuberculosis prevalence stratified by HIV status and identify screening algorithms that maximise detection of active tuberculosis among pregnant and postpartum women in Eswatini.MethodsWomen were enrolled at antenatal and postnatal clinics in Eswatini for tuberculosis screening and diagnostic investigations from 01 April to 30 November 2015 in a cross-sectional study. Sputum samples were collected from all participants for tuberculosis diagnostic tests (smear microscopy, GeneXpert, MGIT culture). Blood and urine samples were collected from HIV-positive women for cluster-of-differentiation-4 cell count, interferon gamma release assay and tuberculosis lateral flow urine lipoarabinomannan tests.ResultsWe enrolled 990 women; 52% were pregnant and 47% were HIV-positive. The prevalence of tuberculosis among HIV-positive pregnant women was 5% (95% confidence interval [CI]: 2–7) and among postpartum women it was 1% (95%CI: -1–3). Tuberculosis prevalence was 2% (95%CI: 0–3) in HIV-negative pregnant women and 1% (95%CI: -1–2) in HIV-negative postpartum women. The national tuberculosis symptom screening tool failed to identify women who tested tuberculosis-culture positive.ConclusionRoutine tuberculosis symptom screening alone is insufficient to rule out tuberculosis in pregnant and postpartum women. Only sputum culture maximised the detection of tuberculosis, indicating a need to balance access and cost in developing countries.