Maternal Birth Weight Research Articles

The relationship between family environmental factors and child sensory integration

Objective: To investigate the relationship between child sensory integration and family environmental factors.Methods: This was a cross-sectional study. The sample (n = 130) was recruited from children attending the outpatient department of a pediatric hospital located in central part of China. Sensory integration of the child was reported by either parent from using a Chinese version of the Sensory Integration and Praxis Test.Results: Approximately 17.69%-24% of the participating children experienced impairments in different dimensions of sensory integration. Severe impairment occurred in 3%-5% of the participating children. Paternal-child interaction had a significant effect on vestibular function of the child, after controlling for the effect of covariates including maternal obstetric history and low birth weight status of the child. Family functioning was found significantly related to tactile sensation, proprioception. and learning ability of the children.Conclusions: It appears that family environment plays a significant role in sensory integration outcomes of older children.

Mediation by Placental DNA Methylation of the Association of Prenatal Maternal Smoking and Birth Weight.

Prenatal maternal smoking is a risk factor for lower birth weight. We performed epigenome-wide association analyses of placental DNA methylation (DNAm) at 720,077 cytosine-phosphate-guanine (CpG) sites and prenatal maternal smoking among 441 mother-infant pairs (2010-2014) and evaluated whether DNAm mediates the association between smoking and birth weight using mediation analysis. Mean birth weight was 3,443 (standard deviation, 423) g, and 38 mothers (8.6%) reported smoking at a mean of 9.4 weeks of gestation. Prenatal maternal smoking was associated with a 175-g lower birth weight (95% confidence interval (CI): -305.5, -44.8) and with differential DNAm of 71 CpGs in placenta, robust to latent-factor adjustment reflecting cell types (Bonferroni-adjusted P < 6.94 × 10-8). Of the 71 CpG sites, 7 mediated the association between prenatal smoking and birth weight (on MDS2, PBX1, CYP1A2, VPRBP, WBP1L, CD28, and CDK6 genes), and prenatal smoking × DNAm interactions on birth weight were observed for 5 CpG sites. The strongest mediator, cg22638236, was annotated to the PBX1 gene body involved in skeletal patterning and programming, with a mediated effect of 301-g lower birth weight (95% CI: -543, -86) among smokers but no mediated effect for nonsmokers (β = -38 g; 95% CI: -88, 9). Prenatal maternal smoking might interact with placental DNAm at specific loci, mediating the association with lower infant birth weight.

Which modifiable prenatal factors mediate the relation between socio-economic position and a child's weight and length at birth?

Although several studies have shown a positive association between socio-economic position and size at birth, not enough is known about the modifiable factors that may be involved. We aimed to investigate whether maternal prepregnancy body mass index (BMI), smoking, diet, and depression during pregnancy mediate the positive association between maternal education and birth size. Weight and length z-scores specific for gestational age and sex were calculated for 1,500 children from the EDEN mother-child cohort. A mediation analysis of the associations between maternal education and birth size was conducted with a counterfactual method, adjusted for recruitment centre, parity, maternal height, and age. In the comparison of children of mothers with low versus intermediate education levels, maternal smoking during pregnancy explained 52% of the total effect of education on birth weight. Similar findings were observed with birth length z-score (37%). The comparison of children of mothers with high versus intermediate education levels yielded a non-significant total effect, which masked opposite mediating effects by maternal BMI and smoking during pregnancy on both birth weight and length. Prepregnancy BMI and maternal smoking during pregnancy mediate the positive association between maternal education and birth weight and length z-scores. These mediators, however, act in opposite directions, thereby masking the extent to which healthy prenatal growth is socially differentiated.

Birth defects in Taiwan: A 10-year nationwide population-based, cohort study

Birth defects (BDs) are main causes of mortality and disability in infants and children. The aims of this study were to analyze the prevalence, types and risk factors of BDs in Taiwan. Data of all births (including live and stillbirths), types, characteristics, and associated risk factors of BDs were obtained from the National Birth Registry and National Health Insurance Research Data base in Taiwan between 2005 and 2014. Birth defects were coded according to International Classification of Diseases 9th Revision-Clinical Modification codes 740-759. A total of 55,299 infants were diagnosed as having BDs among 2,033,004 births. The prevalence of BDs was 271.66 per 10,000 births. The prevalence of BDs did not change significantly between 2005 and 2014, there was a higher birth rate and lower BDs in 2012 (year of dragon) in Taiwan. The most common type of BDs was cardiovascular abnormalities, and ventricular septal defect was the most common disease. Extreme maternal age (<18 years or ≧30 years), preterm, and low birth weight were associated with BDs. Maternal diseases associated with BDs included hypertension, cardiovascular diseases, renal diseases, genitourinary infections, anemia, mental disorders, and diabetes mellitus. The prevalence of BDs was 271.66 per 10,000 births. The most common types of BDs were cardiovascular abnormalities. If we can reduce maternal chronic diseases, we will decrease the prevalence of BDs.

Maternal Marijuana Exposure and Birth Weight: An Observational Study Surrounding Recreational Marijuana Legalization.

This study aimed to study the relationship between prenatal marijuana and infant birth weight using natural cohorts established before, during and after the 20-month lapse between legalization and legal recreational sales in Washington State. Over 5 years, 5,343 pregnant women with documented urine drug screen (UDS) results delivered at Tacoma General Hospital or Good Samaritan Hospital. Maternal medical data were extracted for three delivery cohorts established based on before (T1), during (T2), and after legalization (T3) of recreational marijuana and legalized availability. Univariate and multivariate models were created to study marijuana exposure on infants' birth weight. Marijuana exposure increased the risk of low birth weight (LBW; odds ratio [OR] = 1.42, 95% confidence interval [CI]: 1.01-2.01). This was more pronounced in full-term babies (OR = 1.72, 95% CI: 1.10-2.69), and was independently associated with a higher risk for small for gestational age (SGA; OR = 1.51, 95% CI: 1.49-1.53). The associations between marijuana exposure and SGA were maintained in cohort-specific models (OR = 1.53, 95% CI: 1.01-2.32 for T2, and OR = 1.43, 95% CI: 1.01-2.02 for T3, respectively). Marijuana exposure verified by UDS was associated with LBW and SGA. However, recreational marijuana legalization and availability did not have direct impact on newborns' risk of LBW or SGA.

Impact of Submicroscopic Plasmodium falciparum Parasitaemia on Maternal Anaemia and Low Birth Weight in Blue Nile State, Sudan.

The aim of the present study was to investigate the prevalence of submicroscopic infections and to assess its impact on maternal anaemia and low birth weight. A cross-sectional study was carried out with 1149 consented pregnant women who delivered at 3 main hospitals in the Blue Nile State, between January 2012 and December 2015. From a matched maternal peripheral, placental maternal side, and cord blood sample, blood films and dried spots were prepared for microscopic examination and nested polymerase chain reaction (n-PCR), respectively. 107 out of 447 negative blood films were found to have submicroscopic infection detected using n-PCR in any of the three compartments. Placental samples had a significantly higher prevalence (142) of submicroscopic infections compared with the peripheral (6.5%) and cord (8.1%) samples. The mean (SD) of the maternal haemoglobin (Hb) was significantly lower in cases with submicroscopic parasitaemia (10.9 (0.8) vs. 12.1 (0.7) g/dl, P < 0.001) compared with those who had no submicroscopic parasitaemia. Submicroscopic malaria infection was associated with anaemia (OR 19.7, (95% CI, 10.3–37.8)). Thirty-eight babies born to women with submicroscopic infections were low birth weight (LBW) and was significantly lower in submicroscopic parasitaemia (2.663 (0.235) vs. 2.926 (0.341) kg, P < 0.001). Submicroscopic malaria infection was associated with LBW (OR = 2.7, (95% CI, 1.2–5.6)). There is a high incidence of submicroscopic infections in any of the three compartments regardless of age or parity. Submicroscopic infection is a risk of maternal anaemia and low birth weight in women in this area of high seasonal malaria transmission.

Association of the previous history of maternal depression with post-partum depression, anxiety, and stress in the neonatal intensive care unit

Background A history of depression in post-partum women who have infants admitted to the neonatal intensive care unit (NICU), is associated with higher risk for anxiety and stress. These conditions, which can be harmful to neonates, may be missed if maternal mental health screening is confined to depression. Objective To determine if the history of a previously diagnosed depression would be associated with an increased risk of both postpartum depression and other stress-related disorders (i.e. anxiety and stress) among mothers with infants in the NICU. Design Prospective survey questionnaire-based study conducted over a period of 9 months. Setting Urban inpatient hospital-based setting, serving mainly low-income population. Participants A total of 118 mothers of newborns who had been in the NICU for 7–29 days were approached for enrollment. Out of 118, 96 mothers consented to be screened and were asked to fill out the 21-item Depression Anxiety and Stress Scale-21 (DASS-21) questionnaire. Outcome Primary outcome was to determine whether the history of a previously diagnosed depression is associated with an increased risk of both postpartum depression and other stress-related disorders (i.e. anxiety and stress). Results Out of the 96 subjects, 36 (37.5%) had a previous history of depression before delivery (Group A) while 60/96 (62.5%) did not (Group B) and 46/96 (48%) of the mothers were positive for either depression, anxiety, or stress. This included 22/96 (22.9%) mothers who screened positive for depression; 37/96 (38.5%) who screened positive for anxiety; and 32/96 (33.3%) who screened positive for stress. After adjusting for maternal drug abuse, birth weight and maternal gravidity, the association between a previous history of depression and current depression scores were statistically significant (p = .04), as were the associations between previous depression and current anxiety and stress scores (p = .02 and p = .003, respectively). Conclusions and relevance A history of depression, documented in the antepartum medical record, identifies post-partum women who are at higher risk for anxiety and stress. Screening for depression alone may lead to missing these mental health issues.

Comparing The Anthropometric Measurements of Intra-Extra Uterine Period between Stunting and Non-stunting Children Aged 6-24 Months Old in Bogor Tengah Subdistrict, Bogor City, West Java

Introduction: The prevalence of stunting in children under two years old is high in developing country. Stunting in the early of life has many negative health consequences in later life, while the positive view is stunting could be prevent earlier by detecting a predisposing factors in intrauterine and extrauterine periode. Anthropometry of intrauterine predisposing factors (IntraPF) and Extrauterine predisposing factors (ExtraPF) could detect growth retardation. These study aim was to prove that there were significant different of IntraPF and ExtraPF between stunting and non stunting children aged 6-24 months.Methods: This comparative cross sectional study was nested to (Bogor longitudinal study on child growth and development (BLSCGD) held by National Health Research and Development (NHRD), Health Ministry of Indonesia. Subjects who defined as stunting if their height for age was more than two standard deviations below the WHO Child Growth standards median. There were 38 stunting and 46 non-stunting aged 6-24 months who met the study criteria. Independent variable was (1)IntraPF follow as maternal height, weight and length of neonatal, (2)ExtraPF: weight gain and body length gain at first six months of neonatal. Primary and secondary data collection was carried out from July 2017 to Februari 2018, held at the BLSCGD. All of body measurement using WHO standard. Appropriate statistical analysis was used to compare the stunting and non-stunting groups with a significance limit of p &lt;0.05.Results: Statistical analysis tests showed that: significantly different and lower IntraPF in the stunting group was maternal height, birth weight and length of the subjects compare to non-stunting and there were significant different and lower of ExtraPF follow as weight gain in the first six months, average weight gain per month in the first six months, increase in body length in the first six months, average increase in body length every month in the first six monthssignificantly lower in stunting children compare to non stunting children.Conclusion: The antropometric of intrauterine, extrauterine predisposing factors have been showed to have an impact on the child's height. It is important to monitor the anthropometry of the mother before pregnancy and provide nutritional interventions in the first 1000 days

Evaluation of Maternal Exposure to PM2.5 and Its Components on Maternal and Neonatal Thyroid Function and Birth Weight: A Cohort Study.

Background: Particulate matter (PM) air pollution is an environmental risk to public health. The prevalence of thyroid disease during pregnancy has increased rapidly in recent decades, but the available data on the relationships among air pollution, thyroid function, and birth outcomes in pregnant women, particularly in China, are scarce. We aimed to evaluate the association between maternal exposure to PM2.5 and its components and maternal and neonatal thyroid function and to investigate whether thyroid function acts as a mediator between air pollution and birth weight. Methods: In this prospective birth cohort study, the levels of maternal exposure to PM2.5 and its components during the first trimester were assessed in 433 pregnant women in Nanjing, China, enrolled during 2014-2015. We evaluated the levels of maternal exposure to PM2.5 and its six main constituents-organic matter (OM), black carbon (BC), sulfate (SO42-), nitrate (NO3-), ammonium (NH4+), and soil dust-using the V4.CH.02 product of the Dalhousie University Atmospheric Composition Analysis Group. The maternal serum-free thyroxine (fT4), thyrotropin (TSH), and thyroid peroxidase antibody (TPOAb) levels during the second trimester were measured through electrochemiluminescent microparticle immunoassays. The neonatal TSH levels were detected using an AutoDELFIA Neonatal TSH kit within 72 hours after birth, and the birth weight Z-score of each newborn was estimated. Results: Higher exposure to maternal PM2.5 and some components (BC and NH4+) decreased the maternal fT4 level (p < 0.05), and the birth weight Z-score was decreased (p < 0.05) by higher exposure to maternal PM2.5 and some components (OM, BC, NO3-, and NH4+). A mediation analysis clarified that the maternal fT4 levels explained 15.9%, 18.4%, and 20.9% of the associations of maternal PM2.5, BC, and NH4+ exposure with the birth weight Z-score, respectively (p < 0.05). After additional sensitivity analyses including only nonpreterm participants (n = 418) and non-TPOAb-positive participants (n = 415), the models remained stable. Conclusions: Our results suggest an inverse association between maternal exposure to PM2.5 and its components and the maternal fT4 levels. Maternal fT4 might act as a mediator between exposure to PM2.5 and its components and birth weight.

Trends in pediatric cancer mortality and survival in the United States

We investigated the association between social and nutritional adversities in childhood and increased arterial stiffness in adulthood, according to race/skin color.We used baseline data (2008–2010) from 13,365 adults (aged 34–75 years) from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Arterial stiffness was assessed by carotid-femoral pulse wave velocity (cfPWV). Childhood social and nutritional adversities were assessed by maternal education and birth weight. Race/skin color was self-reported.The lower the maternal education, the higher the cfPWV in adulthood in Whites, Browns, and Blacks. This association was no longer significant after adjusting for the participant's education level in Whites, but it persisted after full adjustment among Browns (low vs. high maternal education: β = 0.18, 95% confidence interval: 0.01; 0.34) and Blacks (low vs. high maternal education: β = 0.44, 95% confidence interval: 0.18; 0.70). On the other hand, the association between low birth weight and higher cfPWV was found only among Whites.Our findings regarding the association between maternal education and arterial stiffness are consistent with the disproportionate burden of cardiovascular disease-related morbidity and mortality in Blacks and Browns. The fact that the association between birth weight and arterial stiffness was only present in Whites may have reflected a survival bias.

Maternal blood pressure mediates the association between maternal obesity and infant weight gain in early postpartum.

It is unknown to what extent higher maternal blood pressure (BP) in early postpartum impacts the relationship between higher maternal weight status and greater infant weight gain in early postpartum. To evaluate the mediating role of higher maternal BP at 1 month postpartum on the association between higher maternal weight status at 1 month postpartum and greater infant weight gain over 6 months postpartum. Participants were 169 Hispanic mother-infant pairs. Maternal body mass index (BMI) and BP were assessed at 1 month postpartum. Infant weight was measured at 1 and 6 months postpartum to calculate weight-for-age z scores (WAZ). Multiple linear regression models were used for prediction, and Sobel test was used to determine mediation. Controlling for maternal pre-pregnancy BMI, age, delivery mode, infant sex, and infant birth weight revealed that both maternal BMI (β = .29) and BP (β = .32) predicted infant WAZ gain (both P ≤ .03). However, the relationship between infant WAZ gain and maternal BMI was no longer significant after further adjustment for maternal BP, which remained significant (P < .05). Maternal BP explained 23.6% (Sobel T = 2.01) of the association between maternal BMI at 1 month and infant WAZ gain over 6 months. Our data suggest that higher maternal weight status at 1 month postpartum is related to greater infant weight gain over 6 months postpartum, and this relationship is mediated by higher maternal BP at 1 month postpartum.

M-SAKHI-Mobile health solutions to help community providers promote maternal and infant nutrition and health using a community-based cluster randomized controlled trial in rural India: A study protocol.

Reduction of childhood stunting is difficult to achieve by interventions that focus only on improving nutrition during infancy. Comprehensive interventions that extend through the continuum of care from pregnancy to infancy are needed. Mobile phones are now successfully being used for behaviour change communication to improve health. We present the methodology of an mHealth intervention "Mobile Solutions Aiding Knowledge for Health Improvement" (M-SAKHI) to be delivered by rural community health workers or Accredited Social Health Activists (ASHAs) for rural women, below or up to 20weeks of pregnancy through delivery until their infant is 12months of age. This protocol paper describes the cluster randomized controlled trial to evaluate the effectiveness of M-SAKHI. The primary objective of the trial is to reduce the prevalence of stunting (height-for-age<-2 z-score) in children at 18months of age by 8% in the intervention as compared with control. The secondary objectives include evaluating the impact on maternal dietary diversity, birth weight, infant and young child feeding practices, infant development, and child morbidity, along with a range of intermediate outcomes for maternal, neonatal, and infant health. A total of 297 ASHAs, five trained counsellors, and 2,501 participants from 244 villages are participating in this study. The outcome data are being collected by 51 field research officers. This study will provide evidence regarding the efficacy of M-SAKHI to reduce stunting in young children in rural India, and if effective, the cost-effectiveness of M-SAKHI.

Maternal Health Status and Birth Weight of the Newborn

Maternal Health Status and Birth Weight of the Newborn

Impact of Physical Health Status of Antenatal Mothers on their Neonates

INTRODUCTION: Newborn health is closely related to that of their mothers. The simple indicators of the mother like haemoglobin level, height, weight, gestational age of the mother will give the first hand information of deviated health of the neonates.&#x0D; MATERIAL AND METHODS: Descriptive correlation study was conducted to assess the impact of physical health status of antenatal mothers on their neonates, 170 antenatal mothers and their born neonates were selected by using purposive sampling. Semi-structured interview schedule, observation of record review and measurement of physical health parameters were used for data collection. A descriptive and inferential statistics were used to investigate the relationships between the variables of antenatal mothers with their neonates with SPSS software version 16.&#x0D; RESULTS: The study findings revealed that the weight of the neonates has statistically significant correlation with the maternal weight, height, hemoglobin and maternal gestational weeks; length of the neonates has statistically significant correlation with the maternal height, maternal weight and maternal age; Gestational age (Ballard score) with the maternal gestational weeks and neonates birth weight; neonates head circumference has statistically significant with the maternal height, gestational weeks and maternal weight; chest circumference of the neonates has statistically significant with the maternal height and maternal weight.&#x0D; CONCLUSION: The study concluded that there was a significant correlation between the selected maternal weight, height, hemoglobin and gestational weeks with neonatal weight; maternal height, weight, age with neonatal length, head circumference, chest circumference and maternal gestational weeks with neonate gestation age by Ballard score.

Maternal and cord blood homocysteine, vitamin B12, folate, and B-type natriuretic peptide levels at term for predicting congenital heart disease of the neonate: A case-control study

Objective: To investigate the effectiveness of the metabolic markers homocysteine, vitamin B12, folate, and B-type natriuretic peptide in maternal and cord blood for detecting congenital heart disease.Methods: Homocysteine, vitamin B12, folate, and B-type natriuretic peptide concentrations in maternal and cord blood samples at term were measured in the case (n = 42) and control (n = 43) groups with and without fetal congenital heart disease, respectively. Additionally, newborns with congenital heart disease were divided into two subgroups: those with (n = 30) and without (n = 8) 6-month infant survival. The case and control groups and case subgroups were compared with each other with respect to maternal age, gravidity, parity, gestational age at delivery, birth weight, maternal and cord blood levels of homocysteine, vitamin B12, folate, and B-type natriuretic peptide, and arterial cord blood pH and base excess values. Statistical analyses were performed using SPSS for Windows, version 22.0. The Student’s t-test, the Mann–Whitney U test, and the χ2 test were used where appropriate. A p value of < .05 was considered statistically significant.Results: Mean maternal age, birth weight and median gravidity, parity and gestational age at delivery were not significantly different between the case and control groups, as well as between the case subgroups (all p > .05). Concentrations of metabolic markers in maternal blood were not significantly different between the two groups (p > .05). Homocysteine and B-type natriuretic peptide levels in cord blood samples were significantly higher, whereas folate levels were significantly lower in the case group compared with the control group (all p < .05). Cord blood B-type natriuretic peptide levels were significantly higher (p < .05) and arterial cord blood pH values were significantly lower (p < .05) in the case subgroup without 6-month infant survival compared with the case subgroup with 6-month infant survival.Conclusion: High cord blood B-type natriuretic peptide and homocysteine levels and low cord blood folate levels at term may be useful for predicting congenital heart disease in the neonate. Neonates with congenital heart disease who have high cord blood B-type natriuretic peptide and low pH values may have adverse outcomes.

Association Between Maternal Thyroid Hormones and Birth Weight at Early and Late Pregnancy

Previous studies suggest that maternal thyroid function affects fetal growth, but the association between combined thyroid hormones from early to late pregnancy and newborn birth weight remains unknown. To explore the association of maternal thyroid function during early and late pregnancy with birth weight. A large prospective cohort study of a Chinese population. This study recruited pregnant women who underwent first-trimester prenatal screenings at the International Peace Maternity and Child Health Hospital between January 2013 and December 2016. This study enrolled 46,186 mothers in whom TSH, free thyroxine (FT4), T3, and thyroid peroxidase antibody concentrations were measured in the first and third trimesters and in whom data on birth weight were available. Birth weight, small for gestational age, large for gestational age (LGA). A higher TSH or FT4 concentration, or a lower T3 concentration, during the first or third trimester was associated with a lower birth weight. The lowest percentiles of maternal FT4 (FT4 < 2.5th percentile) in both trimesters were associated with a 0.34-SD higher birth weight. The effect estimates were greater in those in the first trimester (0.23 SD) or in the third trimester (0.17 SD). The association of maternal TSH and FT4 with birth weight differed according to fetal sex. Persistently low FT4 concentrations throughout pregnancy were associated with higher birth weight and an increased risk of LGA. Based on these findings, we recommend monitoring mildly altered concentrations of thyroid hormone throughout pregnancy.

Steroid Hormones in Cord Blood Mediate the Association Between Maternal Prepregnancy BMI and Birth Weight.

Maternal overweight has been associated with increasing offspring birth weight, but epidemiological data on potential biological mechanisms are limited. This study aimed to examine whether steroid hormones mediate the association between maternal prepregnancy BMI (pre-BMI) and birth weight. This study involving 2,039 participants was conducted from an ongoing cohort study in Wuhan, China. Mediation analysis was used to identify the extent to which steroid hormones mediated associations. Each one-unit increase in pre-BMI was significantly associated with lower log2 -transformed cord blood levels of cortisol and corticosterone. Levels of cortisol and corticosterone were also negatively associated with birth weight. It was estimated that corticosterone mediated 3.48% of the association between pre-BMI and birth weight, and no significant mediation effect was observed in cortisol. After stratification by maternal gestational weight gain (GWG; within or in excess of the Institute of Medicine [IOM] guidelines), the associations of pre-BMI with cortisol and corticosterone levels were significant in the women with GWG > IOM but not in women with GWG ≤ IOM. When the mediation analysis in the women with GWG > IOM was limited, the mediation effects of cord blood cortisol and corticosterone were both significant (P < 0.05). Cord blood cortisol and corticosterone partially mediate the association of increased maternal pre-BMI with higher birth weight.

Severe malaria in pregnant women hospitalized between 2010 and 2014 in the Department of Antioquia (Colombia)

Introduction: Malaria during pregnancy has a negative impact on maternal-neonatal health, with a high risk of clinic complications and mortality. High endemic areas are specially characterized by maternal anaemia and low birth weight. The clinical spectrum is little known in low endemic areas. Objective: To clinically and epidemiologically characterize malaria episodes in hospitalized pregnant women in the Department of Antioquia (Colombia) in the period 2010-2014. Materials and methods: Retrospective, cross-sectional, descriptive study with medical records of pregnant women with P. falciparum and P. vivax malaria. The WHO severe malaria diagnostic criteria and the Colombian Guía para la atención clínica integral del paciente con malaria (guidelines for comprehensive malaria treatment) were used. Results: We analyzed 111 cases, out of which 13.5% were classified as severe malaria according to the WHO criteria. Following the Colombian Guidelines, the proportion increased to 23.4%. Identified complications included hepatic dysfunction, anaemia, acidosis, and severe thrombocytopenia. No difference in the frequency of complications by Plasmodium species was observed; 39.4% of the cases presented general danger signs, pallor and jaundice being the most frequent; 40.5% showed danger signs for pregnancy, such as persistent headache, abdominal pain, and vaginal bleeding. Conclusions: Severe malaria is a highly frequent event in pregnant women, without differences by Plasmodium species. It shows early recognizable dangers signs. Hospital under-reporting was identified in 88% of severe cases as well as a lack of laboratory tests for a more comprehensive diagnosis. A protocol for the clinical diagnosis of pregnant women with malaria is required.

Correlation between Maternal Hemoglobin Level and Birth Weight

Background : Pregnant women are susceptible to have anemia, marked by hemoglobin level &lt;11gr/dL. Maternal hemoglobin levels may influence the nutritional transfer, oxygenation, and uteroplacental circulation of the babies which may affect the infant’s birth weight. This study aimed to explore the correlation between hemoglobin level and birth weight in pregnant women in rural area in Bandung. Methods : This cross-sectional study was conducted from August to September 2014, recruiting all pregnant women registered in a hospital in a rural areas Bandung. Hemoglobin level was obtained from the medical records and analyzed to correlate with birth weight (Pearson correlation). Results : In total, there were 95 pregnant women included. The mean of maternal hemoglobin level was 11.6±1.2gr/dL and birth weight was 2.927±398gram. The proportion of maternal anemia and low birth weights were 30.5% and 15.8%, respectively. Pearson correlation test showed r=-0.093 and p=0.369 which was not significant. Conclusions : There was no correlation between maternal hemoglobin level and birth weight. Other factors for low maternal hemoglobin need to be further explored.

Prevalence of Teenage Pregnancy in A Community Hospital of Rural Nepal: A Cross-Sectional Study

Teenage pregnancy is a public health concern. Maternal and neonatal health outcomes are negatively impacted in teenage pregnancy. The objective of the study is to find the prevalence of teenage pregnancy in a community hospital of rural Nepal. A descriptive cross-sectional study was conducted at Okhaldhunga Community Hospital, Okhaldhunga, Nepal. Ethical approval was taken from the Institutional Review Committee of the hospital. Data were retrieved from July 2007 to July 2017 from the hospital record books. The total of 7054 records of deliveries were reviewed from the hospital records and whole sampling was done. Subgroup analysis was done on basis of age, ethnicity, gravida, para, period of gestation, mode of delivery, maternal or neonatal complications and birth weight. Data entry was done in Microsoft Excel and point estimate at 95% CI was calculated along with frequancy and proportion for binary data. The total of 7054 deliveries were conducted in ten years among which 2050 (29.06%) were teenage deliveries at the 95% CI (28.52 to 29.06). The highest percentage of teenage delivery was found among Janajati ethnicity of 1056 (53.3%). Amongst teenage delivery, a significant tear was found in 157 (7.9%) as a maternal complication. Perinatal deaths were found in 27 (1.4%). The trend of teenage pregnancy remains almost same over ten years in the Okhaldhunga Community Hospital. The overall prevalence of teenage delivery is higher than the national figure. Low birth weight babies, premature delivery, perineal and cervical tears were the common complications. Further health education and awareness programs might help to reduce the teenage pregnancy rate.