Preconception Period Research Articles

Organic acids in the evaluation of cell mitochondrial function in underground pregnancy

Objective: to determine prognostic significance of low molecular weight metabolites in women with missed abortion. Material and methods: the research included 100 women of reproductive age, 79 of them with missed abortion diagnosed by ultrasound and 21 with progressive pregnancy who were admitted for an artificial abortion. All women underwent immunohistochemical studies of the endometrium and organic acids in blood serum and endometrium were determined by HPLC. Reliably significant organic acids in blood serum and endometrium, associated with metabolic disorders of fatty acids, amino acids, as well as intermediate metabolites in the Krebs cycle. Statistical analysis of the obtained data was performed using the STATISTICA® for Windows, Release 6.0 module package from StatSoft® Inc., USA (2003), serial number AXAR802D898511FA. Results: statistically significant changes were revealed in the profile of organic acids in the studied women at the levels of lactic, pyruvic and 4-hydroxyphenylpyruvic acids. In women with missed abortion, the change in the lactate / pyruvate. In all women with missed abortion, 4-hydroxyphenylacetic were determined, in contrast to women with a progressing pregnancy, combined with morpho-immuno-histochemical features (pronounced focal necrosis, venous fullness, lymphohistiocytic infiltration, increased levels of HLA-DR, CD 16, CD20 expression, reduced VEGF and LIF expression). Conclusion: missed abortion is associated with the accumulation of intermediate metabolites of tyrosine catabolism (4-hydroxyphenyacetic, 4-hydroxyphenylpyruvic and homogentizic acids), which, despite normal levels of TSH and T4, may reflect organ dysfunction. Timely correction of iodine deficiency in the pre-conception period after missed abortion can be a criterion for a successful subsequent pregnancy. Overcoming iodine deficiency potentiates the possibility of a conceptual restoration of fertility after a previous NB.

Lifestyle care for transformation of medical care using an early life course approach

It is well known that a healthy lifestyle plays a key role in maintaining reproductive and general health, and preventing lifestyle-related diseases throughout the entire life course. Lifelong health is shaped during the preconception period and the first 1000 days of life. The importance of a healthy lifestyle during these periods can be emphasized by introducing the concept of the early life course, which covers from 100 days before conception until 1000 days thereafter. Although awareness of the benefits of a healthy lifestyle has grown, adherence is disappointing and the implementation of lifestyle interventions in medical care is scarce. Hence, we are convinced that now is the right time to turn the tide. The focus should shift from cure to prevention and promotion of health. The new concept of lifestyle care includes lifestyle interventions that support the adoption of a healthy lifestyle to optimize health and prevent lifestyle-related diseases, including subfertility and adverse pregnancy outcomes. In this paper, we advocate for the implementation of lifestyle care in medical care, define the early life course, elaborate on lifestyle care as part of lifestyle medicine, and provide examples towards the successful implementation of blended lifestyle care, which can be more widely implemented and transform medical care.

Continuity Of Care Of Mrs. D During Preconception, Term I, II And III Of Pregnancy, Labour, Postpartum, Newborn And Family Planning Services In Pmb Kurao Padang

Maternal Mortality Rate is the ratio of maternal mortality during pregnancy, childbirth and postpartum caused by pregnancy, childbirth, and postpartum in every 100,000 live births. The maternal mortality rate (MMR) in the world in 2015 was estimated at 216 per 100,000 live births or an estimated 303,000 deaths. The target of the 2030 Sustainable Development Goals (SDGs) is to reduce the Maternal Mortality Rate (MMR) below 70 per 100,000live births. The RPJMN target in 2019 is 306 per 100,000 live births (Ministry of Health, 2019). Meanwhile, the IMR in the world is 10,000,000 people per year. IMR in Indonesia reaches 22 per 1,000 live births. The purpose ofmidwifery continuity of care is to provide continuous care starting from the preconception period, pregnancy, childbirth, postpartum and family planning. The research method is a description, the form of case study research,the subject of pregnant women Mrs. D is 26 years old at PMB with Kurao. The technique of collecting data is by interviewing and observing (observation) and using data analysis techniques in the field. The instruments used in this study were the format of midwifery care, interviewguidelines, examination tools and the MCH Handbook. The results showed that the care given to Mrs. D is 26 years old starting from the preconception period, pregnancy, childbirth, postpartum, and newborn and family planning is going well, the mother and baby are in good health. In conclusion, midwifery continuity of care provided with care starting from pregnancy, childbirth, postpartum, and newborns can provide benefits to mothersand babies in the process. Continuity of care midwifery care can optimize the detection of high-risk maternal and neonatal.

Nutritional Status of Pregnant Women Aged Less Than 20 Years is a Risk Factor For The Incidence of Babies With Low Birth Weight (LBW)

Low birth weight (LBW) is influenced by various factors, such as maternal education, gestational age, maternal nutritional status, and economic level. The high pregnancy rate in adolescent mothers is in line with pregnancy complications experienced, one of which is giving birth to LBW babies. The aim of this study was to analyze the risk factors most associated with the incidence of LBW babies in mothers aged less than 20 years old in Wagir District, Malang Regency. The data collection method was used cross-sectional. The inclusion criteria in this study were mothers who were less than 20 years old, had given birth to a baby with LBW, and were domiciled in Wagir District. The data was analysed by logistic regression test. A total of 106 respondents participated in this study. The results showed that the factors that were significantly related were nutritional status (p-value 0.012), economic level (p-value 0.030), and gestational age (p-value 0.046). The dominant factor was nutritional status (p-value 0,012; OR 0,666). Nutritional status is the most influential thing for the health of both mother and baby, so the role of health workers in educating women during the preconception period regarding nutrition and the risk of pregnancy is essential.

"It seemed like my fault for wanting to become a mother …"-Experiences and perceptions related to motherhood in women with severe mental illness.

Women with mental illness experience unique challenges during their motherhood. However, little is known about their own perceptions and unmet needs in the process of childbearing. A qualitative study design with a social constructivist paradigm was used to explore lived experiences of mothers with severe mental illness (SMI) during the childbearing period. Semi-structured in-depth interviews were conducted with 30 mothers recruited through purposive sampling. This was followed by inductive thematic analysis. Rigor was established through triangulation and respondent validation. This paper focuses on the perceptions during the pre-conception and pregnancy period. Emergent categories (themes) were thoughts/feelings about childbearing (ambivalence about being a mother/having a baby, fantasies about childbearing/rearing, guilt about pregnancy), the impact of mental illness (stigma, effect of symptoms on their self-care including healthcare, concerns about effect of medications on fetus), unmet needs (lack of emotional support, unanswered doubts about effects of illness on pregnancy, child and motherhood, wanting to be considered as "potential mothers"), and caregivers' reactions (discrimination, anger/abuse, selective support). The centrality of motherhood and balancing the "dual role" of a patient and mother were the overarching categories after analysis. Mothers with SMI prize motherhood but navigate through it with various adverse experiences. The results of this study, grounded in their voices, provide critical insights for service and policy provisions in perinatal psychiatry.

Multigenerational Exposure to Uranium Changes Sperm Metabolome in Rats.

Male infertility is a major public health issue that can be induced by a host of lifestyle risk factors such as environment, nutrition, smoking, stress, and endocrine disruptors. Regarding the human population exposed to uranium, it is necessary to explore these effects on male reproduction in multigenerational studies. The sensitivity of mass spectrometry (MS)-based methods has already proved to be extremely useful in metabolite identification in rats exposed to low doses of uranium, but also in human sperm. We applied this method to rat sperm over three generations (F0, F1 and F2) with multigenerational uranium exposure. Our results show a significant content of uranium in generation F0, and a reduction in the pregnancy rate only in generation F1. Based on principal component analysis (PCA), we observed discriminant profiles between generations. The partial least squares discriminant analysis (PLS-DA) of the 48 annotated variables confirmed that parental exposure of generation F0 (during both the preconceptional and prenatal periods) can have metabolic effects on spermatozoa for the next two generations. Metabolomics applied to epididymal spermatozoa is a novel approach to detecting the multigenerational effects of uranium in an experimental model, but could be also recommended to identify potential biomarkers evaluating the impact of uranium on sperm in exposed infertile men.

Prevalence of preconception risk factors for adverse pregnancy outcome among women from tribal and non-tribal blocks in Nashik district, India: a cross-sectional study

BackgroundAlthough critical, the preconception phase in women’s lives is comparatively ignored. The presence of some risk factors during this phase adversely affects the wellbeing of the woman and the pregnancy outcome. The study objectives were to measure the prevalence of various known risk factors for adverse pregnancy outcome in the preconception period of women and their comparison between blocks.MethodsThis was a community-based cross-sectional study in two tribal and two non-tribal blocks each in Nasik district, Maharashtra, India. The study included married women desiring to conceive within 1 year. Trained Accredited Social Health Activists (field level health worker) collected information from women using a validated interview schedule through house-to-house visits and obtained women’s anthropometric measurements in a standard manner. The study assessed the presence of 12 documented risk factors.ResultsThe study enlisted 7875 women desiring pregnancy soon. The mean age of women was 23.19 (± 3.71) years, and 16% of them were adolescents. Women’s illiteracy was higher in tribal areas than non-tribal (p < 0.001). About two-thirds of women have at least one risk factor, and 40.0% have a single risk factor. The most common risk factor observed was no formal education (44.35%). The prevalence of selected risk factors was significantly higher among women from tribal areas. The mean BMI of women was 19.73 (± 3.51), and a higher proportion (40.5%) of women from tribal areas had BMI < 18.5. Despite being of high parity status (≥ 4), about 7.7% of women from the tribal area and 3% from non-tribal desired pregnancy. Tobacco and alcohol consumption was higher among tribal women. The majority of women consumed meals with family members or husbands. Protein and calorie intake of about 1.4% of women was less than 50% of the recommended daily allowance; however, most of them perceived to have abundant food.ConclusionsHealth risks, namely younger age, illiteracy, high parity, consumption of tobacco, low protein, and calorie intake, were quite prevalent, and the risks were significantly more among women from tribal areas. “Continuum of care” must comprise preconception care inclusive of Behavioral Change Communication, particularly for easily modifiable risk factors and specially for tribal women.

The Use of the Target Trial Approach in Perinatal Pharmacoepidemiology: A Scoping Review Protocol.

Background: Pregnant and postpartum women have been historically excluded from clinical trials, with data on the safety of drugs relying on observational research. Methodological concerns regarding the timing and dosing of medications, data sources, study designs, and methods used for estimating associations are still problematic in observational studies. Answering causal questions is even more complex. Despite the increased interest in emulating target trials using observational data, little is known about this approach in perinatal pharmacoepidemiology. Objective: This scoping review protocol aims to describe the methodology for assessing the available literature concerning emulating target trials for studying outcomes in women exposed to medications in the preconception, perinatal, or postpartum periods. Methods and Analysis: We will follow the methods detailed in the Joanna Briggs Institute reviewer’s manual. We will adopt the six-stage framework recommended by Arksey and O'Malley and Levac and others. Web scraping techniques will be used for identifying relevant studies. Two authors will select articles based on the title and abstract, with discrepancies resolved by consensus, by a third reviewer. Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews flow diagram will be presented to reflect the search process. We will use existing statements to identify quality gaps in the current literature. Variables related to the content for perinatal pharmacoepidemiologic research will be included. The Risk Of Bias In Non-randomised Studies - of Interventions (ROBINS-I) will guide the assessment of the target trial emulation (i.e., treatment strategies compared, assignment procedures, follow-up period, outcome, and causal contrasts). Discussion: Data regarding the safety of drugs taken, prior to and during pregnancy and while lactating are lacking and it is necessary to understand how we can answer these questions using rigorous methods in observational research. Through this scoping review, we intend to understand to what extent the target trial approach is being used in perinatal pharmacoepidemiology and provide recommendations to improve its use in this field. Ethics and Dissemination: Secondary data from published scientific articles will be used, not requiring approval by the Research Ethics Committee with human beings. Findings will be submitted to a peer-reviewed journal.

Effect of pre-conceptional nutrition and season on fetal growth during early pregnancy in sheep

Gestational age in sheep can be closely predicted through ultrasonographic measurement of fetal bones when correlated to standardized fetal growth curves. However, these standardized curves do not account for factors that are known modulators of fetal growth, such as maternal nutrition or health status. Despite being seasonal breeders, and studies reporting an effect of season on birth weight, the influence of season on fetal growth has not been well characterized. In this study, we hypothesized that season of conception will affect fetal growth curves during mid-gestation and that pre-conceptional nutrition would have no effect. We investigated this by provisioning treatments of low, control, and high planes of nutrition during the lactation and flushing pre-conceptional periods to multiparous Dorset x Polypay and Dorset ewes over two seasons (the optimal breeding season [n = 97] and the suboptimal breeding season [n = 104]). Females were mated naturally with mating dates recorded, fetal biparietal diameter measured via ultrasound between gestational days 35–71, and newborn weights recorded at lambing. Pre-conceptional nutritional treatments did not affect fetal biparietal diameter. However, low vs. high nutrition in the pre-conceptional lactation (but not flushing) period resulted in reduced lamb birth weights (P < 0.001). Early fetal growth tended to be faster in the suboptimal breeding season than in the optimal breeding season (P < 0.061) with lambs being heavier at birth in the optimal breeding season (P < 0.001). There was no effect of fetal sex or litter size on fetal biparietal diameter during the first half of pregnancy, however both sex and litter size influenced lamb birth weight (P < 0.001) with males being heavier than females and singletons being heavier than twins and triplets. Mating date within the flushing period had a significant effect on lamb birth weight regardless of season and independent of treatment, with ewes that conceived later in the flushing period having heavier lambs at birth (P = 0.007). These findings suggest that pre-conceptional under- or overnutrition resulting in substantial changes in body condition does not affect fetal growth during the first half of pregnancy. However, the reduction in lamb birth weight indicates that pre-conceptional maternal nutrition during the previous lactation period may affect fetal growth later in pregnancy.

A Golden Thread approach to transforming Maternal and Child Health in Singapore

Maternal and child health (MCH) in Singapore is entering a new phase, with challenges different to those faced 50 years ago. The advancement of medical technologies and access to MCH resources have led to a dramatic fall in maternal and infant mortality rates. However, there has been a steep rise in the rates of obesity and related metabolic diseases. Alongside this is an emerging mental wellness challenge, with one in ten women experience depression across pre-, during and post-pregnancy. Maternal obesity and mental disorders before and during pregnancy not only increase a woman’s risk of pregnancy complications, but also result in increased risks in the offspring of childhood obesity, behavioral disorders and later life metabolic disease, catalyzing vicious cycles of disease. Thus, there is a pressing need to transform the current MCH system to address a burgeoning metabolic and mental health challenge for Singapore. Initiating interventions during preconception and continuing into the postpartum has the potential to confer long-term maternal-child benefits, promoting virtuous cycles of health. However, the current MCH system emphasizes antenatal care and lacks focus on the equally, if not more important, preconception, postpartum and inter-pregnancy stages. We describe a new model-of-care framework that integrates a life-course approach to health across preconception, pregnancy and postpartum phases, with the social-ecological model comprising individual, interpersonal, institutional, community and policy as the major targets for health promotion interventions. This “golden thread” approach is being established at the Singapore KK Women’s and Children’s Hospital (KKH), to address both metabolic and mental health challenges to achieve the goal of a thriving, healthy nation. This new model-of-care is set up in KKH as a pilot program known as Healthy Early Life Moments in Singapore (HELMS). HELMS will reach out to women planning to conceive through coordinated interventions across preconception, pregnancy and postpartum periods. A mobile health platform is being developed to facilitate interventions and engage participants in the program through a digital, personalized and interactive approach. This new model-of-care is designed to secure a population with healthy life cycles, by influencing each life-course, early-in-life, to provide the best start for generations to come.

Asthma in a prospective cohort of rural pregnant women from Sri Lanka: Need for better care during the pre-conceptional and antenatal period.

To describe the epidemiology and the effect of asthma on pregnancy outcomes in pregnant women from a rural geography. We conducted a prospective cohort study in Anuradhapura district, Sri Lanka enrolling all eligible pregnant women registered in the maternal care program. An interviewer-administered questionnaire-based symptom analysis and clinical assessment was conducted in the first and second trimesters. We recruited 3374 pregnant women aged 15-48 years at conception. Self-reported physician-diagnosed asthma prevalence was 6.6% (n = 223) with only 41.7% (n = 93) on regular medical follow-up for asthma. The prevalence of wheeze reduced from pre-pregnancy (67.0%) to the first (46.4%) and second trimesters (47.7%; p<0.01). Of the 73 asthmatic women who did not have wheeze in the last 3 months preceding pregnancy, new-onset wheeze was reported by 6(8.2%) and 12(16.4%) in the first and second trimester, respectively. Pregnant women who sought medical care for asthma in the private sector had a lower likelihood of developing new-onset wheeze in the first trimester (p = 0.03; unadjusted OR = 0.94;95%CI 0.89-0.99). Thirty-four (33.3%) pregnant women had at least one hospital admission due to exacerbation of wheeze during the first and second trimester. The prevalence of low birth weight (16.0%) was higher among pregnant asthmatic women. This study reports the high prevalence of asthma and asthma-associated pregnancy outcomes in women from a rural geography signifying the importance of targeted management.

Preferences of women with a vulnerable health status towards nudging for adequate pregnancy preparation as investment in health of future generations: a qualitative study

BackgroundWomen with a vulnerable health status, as determined by a low socioeconomic status and poor lifestyle behaviours, are at risk for adverse pregnancy outcomes. Offering tailored preconception lifestyle care can significantly help to improve pregnancy outcomes. We hypothesize that so-called ‘nudges’ can be a successful way of increasing the uptake of preconception lifestyle care. A nudge is a behavioural intervention that supports healthy choices by making them easier to choose. Nudging, however, raises many moral questions. Effectiveness and respect for autonomy are, among other criteria, required for a nudge to be morally permissible. In general, the target group knows best what they find permissible and what would motivate them to change their lifestyle. Therefore, this study – conducted in women with a vulnerable health status – aimed to identify their preferences towards a nudge, provided via a mobile application that aims to help them adopt healthy lifestyle behaviours by offering rewards. MethodsWe conducted semi-structured interviews with twelve women with a vulnerable health status. A framework approach was used to analyse the data. A thematic content analysis was conducted on five themes: (1) “Usefulness of an app as an integral information source”, (2) “Permissibility and effects of offering rewards”, (3) “Preferences regarding content”, (4) “Preferences regarding type of rewards and system of allocation”, and (5) “Barriers”.ResultsOf the 12 participants, 11 deemed an app as integral information source concerning the preconception period useful. None of the participants objected to being nudged i.e., being rewarded for healthy behaviour. All participants stated that they would like the app to contain information on healthy nutrition and 8 participants wanted to know how to get pregnant quickly. Furthermore, participants stated that the freedom to choose the timing and content of the reward would increase the probability of successful behavioural change, and having to pay or contact a healthcare provider to access the app may prevent women using the app.ConclusionsThese insights into the preferences of women with a vulnerable health status towards nudging will inform the design of an effective app-based nudge. This may help to improve prepregnancy health as investment in health of current and future generations.

A review of guidelines, recommendations, and framework of men’s preconception care

The focus of men’s health is within the context of preconception health and primary care, which involves a new method of engaging men’s attention to their preconception and general health. The aim of this review research is to offer health care practitioners a complete framework for men’s preconception care. From 2000 to October 2021, researchers examined electronic databases such as Web of Science, PubMed, Scopus, ScienceDirect, ProQuest, Cochrane, SAGE, Springer, UpToDate, and Google Scholar for published papers on men’s preconception care. Two independent authors assessed the quality of the included studies using techniques suitable for this type of investigation. Only 14 of the 835 studies that were found in the original search matched the inclusion criteria. Individual responsibility across the life span (evaluation of reproductive life plan, acquiring information about contraception) and risk assessment (age, medical and surgical history, medications, family history and genetic risks, social history, sexual health assessment, physical examination, laboratory testing, mental health, and intimate partner violence) are the two main topics of preconception care in men according to a review of studies. Our findings clearly demonstrated the critical components of a comprehensive preconception care approach for men. Therefore, preconception care for men remains a developing concept. Further research is required to develop standards for evaluating males during the preconception period.

Determinants of pre-eclampsia among women attending delivery services in public health institutions of Debre Tabor Town: a case–control study

BackgroundThe burden of pre-eclampsia has been continued as a public health importance in both developed and developing countries. However, the consequence of the disease is significantly high in developing countries, where treatment may be unsuccessful due to unclear etiology and late presentation of cases. The determinants of pre-eclampsia are not well known in the Ethiopian population specifically in the study area. Therefore, this study was aimed to identify the determinant factors of pre-eclampsia among women attending delivery services in public health institutions of Debre Tabor Town.MethodsUnmatched case–control study was conducted from December 1, 2020, to January 15, 2021, among 264 mothers (88 cases and 176 controls). A case–control incidence density sampling technique was applied and data were collected using an interviewer-administered pre-tested questionnaire. Data were entered using Epi-data version 4.2 and analyzed by statistical package for social science (SPSS) version 23. Bivariate and multivariable logistic regression analyses were conducted. Finally, a significant association was declared at a p-value of ≤ 0.05 with 95% CI.ResultsYoung age at menarche (10–15 years) (AOR: 7.69; 95% CI: 3.10–25.29), status of the current pregnancy (AOR: 5.88; 95% CI:2.93–22.42), new partner (AOR: 4.16; 95% CI: 3.49–17.03), family history of pre-eclampsia (AOR: 1.52; 95% CI: 1.40–4.18), and alcohol drinking (AOR: 2.18; 95% CI: 2.04–11.79) were found to be significantly associated with pre-eclampsia.ConclusionsThe current study identified that young age at menarche, the status of current pregnancy, new partner, family history of pre-eclampsia, and alcohol drinking were some of the determinant factors of pre-eclampsia. We suggested that health care providers should use these identified factors as a screening means for prediction, early diagnoses, and timely interventions of pre-eclampsia. Health care professionals should also deliver information regarding the risk of alcohol drinking during pregnancy in the preconception period and at early antenatal care services.

The preconception period as a platform for preventing diabetes and non‐communicable diseases

Increasing evidence suggests that parental risk factors for non‐communicable diseases (NCDs) in the period before conception could affect their lifelong health and increase the risk of NCDs in the offspring. While many of these risks such as obesity, smoking and dietary patterns are influenced by wider socio‐economic factors, screening and identification of risk factors can be conducted in the clinical setting to provide appropriate preventive interventions. This article discusses the role of health care practitioners in preventing the risk of NCDs and opportunities for action in the preconception period.

Maternal steroids during pregnancy and their associations with ambient air pollution and temperature during preconception and early gestational periods.

Hormones play critical roles in facilitating pregnancy progression and the onset of parturition. Several classes of environmental contaminants, including fine particulate matter (PM2.5) and ambient temperature, have been shown to alter hormone biosynthesis or activity. However, epidemiologic research has not considered PM2.5 in relation to a broader range of steroid hormones, particularly in pregnant women. Using metabolomics data collected within 20-40weeks of gestation in an ethnically diverse pregnancy cohort study, we identified 42 steroid hormones that we grouped into five classes (pregnenolone, androgens, estrogens, progestin, and corticosteroids) based on their biosynthesis type. We found that exposure to PM2.5 during the pre-conception and early prenatal periods was associated with higher maternal androgen concentrations in late pregnancy. We also detected a positive association between early pregnancy PM2.5 exposure and maternal pregnenolone levels and a marginal positive association between early pregnancy PM2.5 exposure and progestin levels. When considering each hormone metabolite individually, we found positive associations between early pregnancy PM2.5 exposure and five steroids, two of which survived multiple comparison testing: 11beta-hydroxyandrosterone glucuronide (a pregnenolone steroid) and adrosteroneglucuronide (a progestin steroid). None of the steroid classes were statistically significant associated with ambient temperature. In sex-stratified analyses, we did not detect any sex differences in our associations. This is the first study showing that exposure to fine particulate matter during the pre-conception and early prenatal periods can lead to altered steroid adaptation during the state of pregnancy, which has been shown to have potential consequences on maternal and child health.

A Cross-sectional Study on Prevalence and Determinants of Preconception Anemia in Women of Reproductive Age Group at Gandhinagar, Gujarat, India

Introduction : Nutritional anemia is a major public health issue that affects women of all ages, notably those of reproductive age (15-49 years). Anemia has an adverse effect on the outcome of pregnancy including miscarriage, intrauterine growth retardation, low birth weight, post-partum hemorrhages and stillbirth. Objectives:It is to estimate prevalence of anemia and to investigate socio-demographic and obstetric factors associated with the prevalence of anemia during preconception period. Method: We conducted a crosssectional study among 306 reproductive age group (15-49 years) women who were residing in field practice area of Urban Health Training Center (UHTC) in sector-24, Gandhinagar, Gujarat, India who are planning to conceive within a year. Study participants were selected from the records of the female health worker according to our inclusion and exclusion criteria for the study. Results: Out of 306 participant women, 76% were found to be anemic, out of which, 31% had mild, 55% had moderate and 14% had severe level of anemia. Education level significantly associated (P &lt; 0.05) with presence of anemia as women with lower level of education had higher presence of anemia – 81.97% in primary education group and 79.17% among illiterate women. BMI, parity and family type was also found to be significantly (P &lt; 0.05) associated with the severity of anemia. Conclusion: Nearly three fourth Women who planned to conceive within a year had anemia. Out of women who had anemia, nearly three fourth had moderate to severe anemia. Education had significant association with presence of anemia and low BMI, Parity and type of family had significant association with severity of anemia.

Prenatal Exposure to Ambient Air Pollution and Epigenetic Aging at Birth in Newborns.

In utero air pollution exposure has been associated with adverse birth outcomes, yet effects of air pollutants on regulatory mechanisms in fetal growth and critical windows of vulnerability during pregnancy are not well understood. There is evidence that epigenetic alterations may contribute to these effects. DNA methylation (DNAm) based age estimators have been developed and studied extensively with health outcomes in recent years. Growing literature suggests environmental factors, such as air pollution and smoking, can influence epigenetic aging. However, little is known about the effect of prenatal air pollution exposure on epigenetic aging. In this study, we leveraged existing data on prenatal air pollution exposure and cord blood DNAm from 332 mother-child pairs in the Early Autism Risk Longitudinal Investigation (EARLI) and Markers of Autism Risk in Babies-Learning Early Signs (MARBLES), two pregnancy cohorts enrolling women who had a previous child diagnosed with autism spectrum disorder, to assess the relationship of prenatal exposure to air pollution and epigenetic aging at birth. DNAm age was computed using existing epigenetic clock algorithms for cord blood tissue—Knight and Bohlin. Epigenetic age acceleration was defined as the residual of regressing chronological gestational age on DNAm age, accounting for cell type proportions. Multivariable linear regression models and distributed lag models (DLMs), adjusting for child sex, maternal race/ethnicity, study sites, year of birth, maternal education, were completed. In the single-pollutant analysis, we observed exposure to PM2.5, PM10, and O3 during preconception period and pregnancy period were associated with decelerated epigenetic aging at birth. For example, pregnancy average PM10 exposure (per 10 unit increase) was associated with epigenetic age deceleration at birth (weeks) for both Knight and Bohlin clocks (β = −0.62, 95% CI: −1.17, −0.06; β = −0.32, 95% CI: −0.63, −0.01, respectively). Weekly DLMs revealed that increasing PM2.5 during the first trimester and second trimester were associated with decelerated epigenetic aging and that increasing PM10 during the preconception period was associated with decelerated epigenetic aging, using the Bohlin clock estimate. Prenatal ambient air pollution exposure, particularly in early and mid-pregnancy, was associated with decelerated epigenetic aging at birth.

THE EFFECT OF VIDEO EDUCATION AND ANEMIA SCREENING ON INCREASING BEHAVIOR OF PRECONCEPTIVE TREATMENT OF ADOLESCENT GIRLS

ABSTRACT&#x0D; The quality of the baby born is determined by the health of the mother-to-be. The health of prospective mothers can be optimized from a adolescent. Unfortunately, most of the expectant mothers have had poor health since becoming a Adolescent Girls because they are prone to anemia. Anemia in Adolescent Girls needs to be screened early so that anemia can be prevented and treated through the consumption of blood-supplementing tablets as a form of preconception care for Adolescent Girls. The behavior of taking iron tablets in Adolescent Girls can be formed if they have good knowledge about anemia and the importance of taking iron tablets during the preconception period. Video is one of the effective educational media to improve individual knowledge and behavior. This study aims to analyze the effect of video education and anemia screening on the behavior of preconception care for Adolescent Girls. This type of research is a quasi-experimental before and after with control. This research was conducted on Adolescent Girls at SMA Al Islam 1 Surakarta. Data analysis used Mc Nemar and Chi-Square statistical tests with the help of SPSS. The results showed that there was a significant difference in the increase in preconception care behavior between the two groups after the intervention (p=0.004). Respondents who received education with videos and anemia screening had the opportunity to have positive preconception care behavior by consuming iron tablets by 1.714 times compared to respondents who were given education with booklets and anemia screening.&#x0D; Keywords: Adolescent girls, anemia, blood-supplementing tablets, preconception, video

Association of Preconception Blood Pressure with the Risk of Anemia in Children under Five Years of Age: A Large Longitudinal Chinese Birth Cohort.

Hypertension during pregnancy may increase the risk of anemia in the offspring. However, few studies have investigated the effects of elevated blood pressure during the preconception period on childhood anemia. This large population-based birth cohort study was performed to determine whether abnormal preconception blood pressure has long-term consequences for childhood health. Data were obtained from the China–US Collaborative Project for Neural Tube Defect Prevention. The study consisted of 40,638 women with singleton live births who were registered in a monitoring system before pregnancy in southern China during the period 1993–1996. Children were assessed by hemoglobin measurement at approximately 53 months of age. The incidences of childhood anemia were 19.80% in the hypertension group and 16.07% in the non-hypertension group. Compared with the non-hypertension group, the hypertension group had an increased risk of childhood anemia (adjusted risk ratio (RR): 1.25; 95% confidence interval (CI): 1.11–1.41). After categorization according to blood pressure, combined systolic and diastolic hypertension was associated with a significantly increased risk of childhood anemia, compared with normotension (adjusted RR: 1.37; 95% CI: 1.16–1.63). Compared with women who had normal blood pressure, the adjusted RRs for childhood anemia were 1.20 (95% CI: 1.13–1.28), 1.26 (95% CI: 1.08–1.47), and 1.38 (95% CI: 1.14–1.67) among women with prehypertension, stage-1 hypertension, and stage-2 hypertension, respectively. Our results suggest a linear association between prepregnancy hypertension and the risk of childhood anemia in the Chinese population. Interventions targeting preconception blood pressure may have a positive effect on childhood health.