Supplementation In Pregnant Women Research Articles

Identifying priority double-duty actions to tackle the double burden of malnutrition in infants and young children in Peru: Assessment and prioritisation of government actions by national experts.

Multiple forms of malnutrition coexist in infants and young children (IYC) in Peru. The World Health Organization has proposed double-duty actions (DDAs) to simultaneously address undernutrition and overweight/obesity. We assessed current implementation of- and priority for- government-level actions to tackle multiple forms of malnutrition in IYC in Peru. Mapping of current policy activity was undertaken against 47 indicators of good practice for five DDAs (exclusive breastfeeding, complementary feeding, food marketing, maternal nutrition, preschool nutrition; assessed by 27 indicators) and for the enabling policy environment, i.e., 'infrastructure support' (health in all policies, platforms for interactions, financing, monitoring, governance, leadership; assessed by 20 indicators). Interviews with 16 national experts explored views on the level of and barriers to implementation of DDAs and infrastructure support, as well as their prioritisation based on likely impact and feasibility. The level of implementation of actions was categorised into two groups (agenda setting/formulation vs. implementation/evaluation). Mean scores were generated for prioritisation of DDAs and infrastructure support. Deductive qualitative analysis was undertaken to identify barriers that influence policy implementation. Only 5/27 DDA indicators were reported as fully implemented by all national experts (international code that regulates the marketing of breastmilk substitutes, iron supplementation for IYC, micronutrient powders in IYC, iron/folic acid supplementation in pregnant women, paid maternity leave). Only 1/20 infrastructure support indicator (access to nutrition information) was rated as fully implemented by all experts. Barriers to implementing DDAs and infrastructure support included: legal feasibility or lack of regulations, inadequate monitoring/evaluation to ensure enforcement, commercial influences on policymakers, insufficient resources, shifting public health priorities with the COVID-19 pandemic and political instability. The experts prioritised 12 indicators across all five DDAs and eight infrastructure support indicators. Experts highlighted the need to improve implementation of all DDAs and identified ways to strengthen the enabling policy environment.

Use of Thiamine Supplementation in Pregnant Women Diagnosed With Hyperemesis Gravidarum and Wernicke Encephalopathy

Hyperemesis gravidarum is the most common condition requiring hospital care for women during the first 20 weeks of pregnancy and may lead to malnutrition, dehydration, and vitamin deficiencies. Depletion of vitamins such as thiamine may result in the development of Wernicke encephalopathy, a severe neurological disorder that can increase the risk for mortality and morbidity for the mother and fetus. A lack of awareness regarding the relationship of hyperemesis gravidarum and Wernicke encephalopathy may result in delayed treatment and disease management. Glucose administration in the presence of thiamine deficiency may induce Wernicke encephalopathy; protocols are needed to ensure dextrose is used for women with hyperemesis gravidarum in times of prolonged vomiting and poor oral intake only after first administering thiamine. This article includes a discussion of best practices for thiamine supplementation with hyperemesis gravidarum and Wernicke encephalopathy.

Considerations for Correction of Micronutrient Deficiencies Through Supplementation in Pregnant Women and Children Under-5 in Latin America.

Micronutrient deficiencies in Latin America are a public health concern, nonetheless, lack of information still exists in many countries, so that the true magnitude of the problem remains uncertain. To summarise experiences that can inform the development of policies and programs to address micronutrient deficiencies throung supplementation in pregnant women and chlidren under five years of age in Latin American. Review of the most evidence on the effects of micronutrients supplementation, focusing on pregnant women and children under five years of age. Certain population groups, as women of reproductive age and children under 2 years of age, are at increased risk for deficiency due to their high micronutrient requirements. This is compounded by the limited access to micronutrient-rich foods for many people living in vulnerable situations. Micronutrient supplementation is an effective intervention to prevent and treat deficiency and to mitigate its adverse effects on health, nutrition, and pregnancy outcomes in micronutrient-deficient populations. The potential benefits of supplementation programs, however, are realized only when they reach those who have the potential to benefit, that is, with inadequate intakes of micronutrients from dietary sources, and when the quality of design and delivery of the programs aresufficient to reach that population timely, regularly, and effectively to enable and motivate consumption. Several resources and experiences exist that can help favor the development of programs that can realize this biological and programmatic potential. There is need for continuous efforts to augment coverage and achieve results that can translate into economic benefits for individuals, families, and nations.

Choline supplementation mitigates effects of bilirubin in cerebellar granule neurons in vitro.

Premature infants may suffer from high levels of bilirubin that could lead to neurotoxicity. Bilirubin has been shown to decrease L1-mediated ERK1/2 signaling, L1 phosphorylation, and L1 tyrosine 1176 dephosphorylation. Furthermore, bilirubin redistributes L1 into lipid rafts (LR) and decreases L1-mediated neurite outgrowth. We demonstrate that choline supplementation improves L1 function and signaling in the presence of bilirubin. Cerebellar granule neurons (CGN) were cultured with and without supplemental choline, and the effects on L1 signaling and function were measured in the presence of bilirubin. L1 activation of ERK1/2, L1 phosphorylation and dephosphorylation were measured. L1 distribution in LR was quantified and neurite outgrowth of CGN was determined. Forty µM choline significantly reduced the effect of bilirubin on L1 activation of ERK1/2 by 220% (p = 0.04), and increased L1 triggered changes in tyrosine phosphorylation /dephosphorylation of L1 by 34% (p = 0.026) and 35% (p = 0.02) respectively. Choline ameliorated the redistribution of L1 in lipid rafts by 38% (p = 0.02) and increased L1-mediated mean neurite length by 11% (p = 0.04). Choline pretreatment of CGN significantly reduced the disruption of L1 function by bilirubin. The supplementation of pregnant women and preterm infants with choline may increase infant resilience to the effects of bilirubin. This article establishes choline as an intervention for the neurotoxic effects of bilirubin on lipid rafts. This article provides clear evidence toward establishing one intervention for bilirubin neurotoxicity, where little is understood. This article paves the way for future investigation into the mechanism of the ameliorative effect of choline on bilirubin neurotoxicity.

Comparison of the effectiveness of probiotic supplementation in glucose metabolism, lipid profile, inflammation and oxidative stress in pregnant women.

Objective: The optimal probiotic supplementation in pregnant women has not been thoroughly evaluated. By employing a network meta-analysis (NMA) approach, we compared the effectiveness of different probiotic supplementation strategies for pregnant women. Methods: A comprehensive search across multiple databases was performed to identify studies comparing the efficacy of probiotic supplements with each other or the control (placebo) among pregnant women. Results: This NMA, including 32 studies, systematically evaluated 6 probiotic supplement strategies: Lactobacillus, Lacticaseibacillus rhamnosus and Bifidobacterium (LRB), Lactobacillus acidophilus and Bifidobacterium (LABB), Lactobacillus acidophilus, Lacticaseibacillus casei, and Bifidobacterium bifidum (LLB), multi-combination of four probiotics (MP1), and multi-combination of six or more probiotics (MP2). Among these strategies, LLB, MP1, and MP2 all contain LABB. The NMA findings showed that MP1 was the most effective in reducing fasting blood sugar (FBS) (surface under the cumulative ranking curve [SUCRA]: 80.5%). In addition, MP2 was the most efficacious in lowering the homeostasis model assessment of insulin resistance (HOMA-IR) (SUCRA: 89.1%). LABB was ranked as the most effective in decreasing low-density lipoprotein cholesterol (LDLC) (SUCRA: 95.5%), total cholesterol (TC) (SUCRA: 95.5%), and high-sensitivity C-reactive protein (hs-CRP) (SUCRA: 94.8%). Moreover, LLB was ranked as the most effective in raising total antioxidant capacity (TAC) (SUCRA: 98.5%). Conclusion: Multi-combination of probiotic strains, especially those strategies containing LABB, may be more effective than a single probiotic strain in glycolipid metabolism, inflammation, and oxidative stress of pregnant women.

Digital versus non-digital health interventions to improve iron supplementation in pregnant women: a systematic review and meta-analysis.

To investigate the effects of digital health interventions for improving adherence to oral iron supplementation in pregnant women. Five databases were searched from their inception to October 2023 with no date restrictions. Randomized controlled trials (RCTs) that assessed the effects of digital health interventions on adherence to oral iron supplementation (e.g., tablets and capsules) compared to non-digital health interventions for pregnant women were eligible. We calculated standardized mean differences (SMDs) and mean differences (MDs) with 95% confidence intervals (CIs) for continuous variables using the inverse variance method. We calculated odds ratios (OR) with 95%CI for categorical variables using the Mantel-Haenszel model. The certainty of the evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. The risk of bias of the included RCTs was assessed using the Cochrane risk of bias tool 2.0. Ten trials with 1,633 participants were included. Based on 7 trials, digital health interventions can improve objective adherence rate comparing with non-digital health interventions (1,289 participants, OR = 4.07 [2.19, 7.57], p < 0.001, I2 = 69%) in pregnant women. Digital health interventions can improve subjective adherence behavior comparing with non-digital health interventions (3 trials, 434 participants, SMD = 0.82 [0.62, 1.01], p < 0.001, I2 = 0%) in pregnant women. Based on 3 trials, digital health interventions can improve tablets consumption comparing with non-digital health interventions (333 participants, SMD = 1.00 [0.57, 1.42], p < 0.001, I2 = 66%) in pregnant women. Digital health interventions can improve hemoglobin level comparing with non-digital health interventions (7 trials, 1,216 participants, MD = 0.59 [0.31, 0.88], p < 0.001, I2 = 93%) in pregnant women. Digital health interventions were effective at improving adherence to oral iron supplementation and hemoglobin levels in pregnant women.

The Effect of Vitamin D Supplementation in Pregnant Women with Overweight and Obesity: A Randomised Controlled Trial.

The impact of vitamin D supplementation on 25-hydroxyvitamin D (25OHD) levels, metabolic status, and pregnancy outcomes in pregnant women with overweight and obesity (OW/OB) is uncertain. This study aimed to examine whether administrating 800 IU of vitamin D3 orally would improve maternal serum 25OHD levels, lipid profile, and pregnancy outcomes compared to 400 IU. This was a two-arm, parallel, non-blinded randomised controlled trial involving 274 pregnant women recruited from KK Women's and Children's Hospital, with a body mass index of ≥25 kg/m2 within 16 weeks gestation. The participants were randomly assigned to receive 800 IU/day (intervention group) or 400 IU/day (control group) of oral vitamin D3 supplements. The primary outcomes were maternal serum 25OHD and lipid levels at 24-28 weeks gestation. The secondary outcomes included maternal and birth outcomes. Compared with controls (n = 119), the intervention group (n = 112) exhibited higher 25OHD levels at 24-28 weeks gestation (adjusted mean difference 6.52 nmol/L; 95% confidence interval 2.74, 10.31). More women in the intervention group achieved sufficient 25OHD levels (77.7% vs. 55.5%; p < 0.001). No differences were observed in lipid profiles or maternal or birth outcomes between the groups. An additional 400 IU of oral vitamin D3 supplementation increased serum 25OHD levels but did not impact lipid profiles or pregnancy outcomes.

Effect of multiple micronutrient supplementation in pregnant women on infant birth weight

The nutritional requirements of pregnant women increase with the gestational age. A low nutritional status is poor for both mothers and infants. Infant birth weight is influenced by nutritional intake during pregnancy. Therefore, multiple micronutrients (MMN) are needed for mothers during pregnancy to prevent low birth weight. This study aimed to determine the effect of MMN on infant birth weight at the Asian Waluyo Jati Clinic. The research method used a quasi-experimental design, with a posttest-only control group design involving 50 pregnant women (25 intervention and 25 control groups). This study was conducted at the Asih Waluyo Jati Clinic, Yogyakarta, in 2022. The intervention group received MMN supplementation starting in the 2nd trimester and standardized prenatal care, whereas the control group received standardized prenatal care throughout pregnancy. Both groups were monitored during the 2nd trimester of pregnancy until delivery. Data were analyzed using the Mann–Whitney U test. The results showed a difference in the mean birth weight of the infants in both groups (1,64 grams). MMN supplementation in the intervention group and standard pregnancy care effectively increased the infants' birth weight by 1,64 grams (p= 0,000). In conclusion, MMN supplementation increased the average birth weight of infants.

Acceptability of a balanced energy protein (BEP) supplement for pregnant women in Bangladesh.

Balanced energy protein (BEP) supplementation in pregnancy is recommended in the context of undernutrition for the reduction of small-for-gestational age neonates and stillbirths. To inform an effectiveness trial, we evaluated the acceptability of a packaged, ready-to-eat fortified BEP product among women of reproductive age and their health care providers (HCPs) in rural Bangladesh and explored the feasibility of adhering to daily supplementation. We implemented a formative study using focus groups discussions with women (n = 29) and HCPs (n = 17) to introduce the product and investigate components of acceptability. A "trials of improved practice" activity was conducted in subset of women (n = 16) to evaluate adherence to BEP over a 2-week period, followed by focus group discussions to identify challenges with adherence and strategies employed. Contributors to BEP acceptability included the product's sensory attributes, such as taste, smell and texture; the attractive packaging and informative labelling; and the perceived benefits of use. Participants also identified household and community level factors influencing the adoption of BEP, such as trust in the provider, cultural beliefs on supplement use in pregnancy, and family member tasting and approval. Over the 2-week period, women consumed over 80% of the supplements provided to them and identified strategies for adherence, including visual aids and reminders from family members or providers. HCPs recommended targeted communication messages for mothers-in-law to foster a supportive home environment. Findings informed changes to the BEP product to improve acceptability and shaped the content of communication messages to optimise adherence in a forthcoming effectiveness trial.

Anemia in Pregnancy: Study Phenomenology

Introduction: The prevalence of anemia in pregnant women in Indonesia remains high. This condition is concerning because the government has run a program of giving iron tablets to pregnant women since 1970. This study aimed to determine socioenvironmental factors that cause anemia in pregnant women. Methods: This qualitative research used phenomenological methods. In-depth interviews were conducted with 20 mothers with anemia and 12 focus group discussion (FGD) informants. Qualitative data analysis was applied to analyze the data. Results: The study found three factors: anemia in the preconception period, diets that cause a lack of iron consumption, and knowledge and consumption of iron tablets in pregnant women. Anemia in pregnant women is a continuous cycle of anemia which begins in the preconception period. Adolescent eating behavior and supplementation programs for pregnant women integrated with antenatal care are still problematic. Discussion and Conclusion: The findings of this study provide important information for preventing anemia in pregnant women, increasing counseling, and evaluating the implementation of iron supplementation in pregnant women. The policy of administering iron tablets to pregnant women to prevent anemia is not effective in reducing the prevalence of anemia. This government policy must be accompanied by a community movement program because the findings of this study show the problems that exist in the individual factors of the mother.

The effect of Chlorella supplementation in pregnant women with low-grade inflammation.

Pregnancy dramatically changes maternal metabolism and the microbiome. Low-grade inflammation can cause maternal complications and fetal abnormalities. The objective of this open-label, randomized, controlled study was to evaluate the efficacy and safety of orally administered Chlorella, a green alga that is commercially available as a dietary supplement with rich nutrients and dietary fiber for pregnant women with low-grade inflammation. Patients with C-reactive protein levels >0.05 mg/dL (16 weeks gestation, n = 22) were enrolled and randomly allocated to the Chlorella group (n = 10) or control group (n = 12). We conducted blood biochemical tests at 25, 30, and 35 weeks gestation and evaluated the evacuation status (symptoms depending on the Rome IV C2 criteria and laxative usage), side effects, and complications throughout the investigation. We also monitored the status of the offspring. The Chlorella group (n = 0) showed a significantly lower rate of constipation than the control group (n = 8). This study demonstrated the beneficial effects and safety of Chlorella supplementation in pregnant women, which prevented constipation and unnecessary laxative administration.

Effect of Oral High Molecular Weight Hyaluronic Acid (HMWHA), Alpha Lipoic Acid (ALA), Magnesium, Vitamin B6 and Vitamin D Supplementation in Pregnant Women: A Retrospective Observational Pilot Study.

Background-Pregnancy represents a nutritional challenge, since macro- and micronutrients intake can affect mother' health and influence negative outcomes. The aim of this retrospective pilot study is to evidence whether the oral supplementation with high molecular weight hyaluronic acid (HMWHA), in association with alpha lipoic acid (ALA), magnesium, vitamin B6 and vitamin D, in pregnant women, could reduce adverse effects, such as PTB, pelvic pain, contraction and hospitalization. Methods-Data were collected from n = 200 women treated daily with oral supplements of 200 mg HMWHA, 100 mg ALA, 450 mg magnesium, 2.6 mg vitamin B6 and 50 mcg vitamin D (treatment group) and from n = 50 women taking with oral supplements of 400 mg magnesium (control group). In both groups, supplementation started from the 7th gestational week until delivery. Results-Oral treatment with HMWHA, in association with ALA, magnesium, vitamin B6 and vitamin D in pregnant women, significantly reduced adverse events, such as PTB (p < 0.01), pelvic pain and contractions (p < 0.0001), miscarriages (p < 0.05) and admission to ER/hospitalization (p < 0.0001) compared with the control group. Conclusions-Despite HMWHA having been poorly used as a food supplement in pregnant women, our results open a reassuring scenario regarding its oral administration during pregnancy.

Assessment of the Relationship between Vitamin D Deficiency and the Development of Hyperemesis Gravidarum

Object: Hyperemesis gravidarum, the leading cause of hospitalization in the first trimester, is observed in 0.3% to 3.6% of all pregnant women worldwide. Vitamin D is a significant vitamin for human health, and vitamin D deficiency in the pregnant women population in Turkey is a common pathology. In this context, this study was carried out to assess the relationship between vitamin D deficiency and the development of hyperemesis gravidarum. Methods: The population of this prospective, single-center, case-controlled study consisted of pregnant women diagnosed with hyperemesis gravidarum. In the end, 23 pregnant women with hyperemesis gravidarum were included in the patient group, and 30 healthy pregnant women with demographic characteristics that match those with hyperemesis gravidarum were included in the control group. The Vitamin D and hematocrit levels were compared between the two groups. Results: There was no significant difference between the patient and control groups in the serum vitamin D (p = 0.760) and hematocrit (p = 0.149) levels. Overall, only 9 (17%) of the 53 pregnant women had sufficient (&amp;gt; 20 ng / ml) vitamin D. There was no significant difference between the patient and control groups in the number of patients with vitamin D deficiency. Conclusion: The study findings did not indicate a correlation between vitamin D deficiency and hyperemesis gravidarum. Further large-scale studies are needed to establish the absence of a relationship between vitamin D deficiency and hyperemesis gravidarum. On the other hand, the fact that only 17% of the pregnant women who participated in this study had sufficient vitamin D revealed the need to emphasize using vitamin D supplements in pregnant women as early as possible in the first trimester.

The Effects of Vitamin D Supplementation on glycemic indices, lipid profile and blood pressure of pregnant women with Vitamin D deficiency: A Single arm Clinical Trial

Introduction: Vitamin D Deficiency (VDD) is a global problem among pregnant women in many populations. There is an association between VDD and some pregnancy outcomes, as well as gestational diabetes mellitus (GDM) and pre-eclampsia. We aimed to evaluate the effect of vitamin D supplementation on metabolic status (Fasting Blood Sugar (FBS), insulin, Homeostasis model of assessment-insulin resistance (HOMA-IR) and lipid profile) and blood pressure (BP) among pregnant women with VDD. Methods: A clinical trial was carried out on 30 pregnant women with VDD referring to the Gynecology &amp; Obstetrics Clinic of Baqiyatallah Hospital, Tehran, Iran. The present study had two phases of vitamin D3 supplementation (50000 IU / week for 12 weeks and then 50000 IU / month for three months). Serum total cholesterol, triglyceride, Low Density Lipoprotein (LDL), High Density Lipoprotein (HDL), 25-hydroxyvitamin D (25(OH) D) level, insulin, Fasting Blood Sugar (FBS) and both systolic and diastolic blood pressure were measured. Homeostasis model of assessment-insulin resistance (HOMA-IR) was also determined. Results: The results showed that mean levels of Insulin (F=6, p=0.010), HOMA-IR (F=4.6, p=0.020), 25-hydroxyvitamin D level (F=179, p=0.001), cholesterol (F=69.7, p=0.001), triglyceride (F=69.9, p=0.001) and LDL (F=29.9, p=0.001) significantly increases during study period. However, Diastolic and systolic blood pressure, FBS, and HDL levels did not change significantly over time. Conclusion: The results of this investigation showed that weekly and monthly vitamin D3 supplementation in pregnant women with VDD had beneficial effects on glycemic status, lipid profile and blood pressure. Trial registration: The protocol of the present study has been registered in IRCT (Registration number: IRCT2014091619162N5, Registration date: 2015-03-26, https://en.irct.ir/trial/17219).

Pregnancy, Breastfeeding, and Vitamin D.

Exclusive breastfeeding is considered the ideal food in the first six months of life; however, paradoxically, vitamin D content in human breast milk is clearly low and insufficient to obtain the recommended intake of 400 IU daily. This article summarizes the extraordinary metabolism of vitamin D during pregnancy and its content in human breast milk. The prevalence of hypovitaminosis D in pregnant women and/or nursing mothers and its potential maternal-fetal consequences are analyzed. The current guidelines for vitamin D supplementation in pregnant women, nursing mothers, and infants to prevent hypovitaminosis D in breastfed infants are detailed. Low vitamin D content in human breast milk is probably related to active changes in human lifestyle habits (reduced sunlight exposure).

Iron supplements in pregnant women with normal iron status: A systematic review and meta-analysis.

Effects of daily iron supplementation in iron replete pregnancy are unclear. This systematic review aimed to assess benefits and harms of oral iron supplements in pregnant women without anemia and iron deficiency. We predefined and registered a protocol in PROSPERO (CRD42020186210) and performed the review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology. We searched for randomized clinical trials (RCTs) and observational studies comparing daily oral iron supplementation with no iron supplements in non-anemic iron replete pregnant women. Searches were conducted in MEDLINE (by PubMed), EMBASE (by OVID), Cochrane Library, and ClinicalTrials.gov from inception to September 2022 without language restrictions. Two authors independently screened records, extracted data, and assessed risk of bias using the revised Cochrane risk of bias tool (RoB2). One author read full-texts, assessed certainty of evidence by GRADE and conducted meta-analyses using a random-effects model. Primary outcomes included iron deficiency anemia, iron deficiency, hemoglobin >130 g/L, elevated iron status, small for gestational age newborns, low birthweight newborns, preterm birth, and congenital anomalies. Eight RCTs (2822 women) but no observational studies were eligible for inclusion. Daily oral iron supplementation in pregnancy probably reduces iron deficiency anemia at term (risk ratio [RR]: 0.51, 95% confidence interval [CI]: 0.38-0.70; 4 RCTs, 1670 women; I2 = 13%; moderate-certainty evidence) and the incidence of low birthweight babies (RR: 0.30, 95% CI: 0.13-0.68; 2 RCTs, 361 infants; I2 = 0%; moderate-certainty evidence). In addition, it may reduce iron deficiency at term (RR: 0.74, 95% CI: 0.60-0.92; 4 RCTs, 1663 women; I2 = 58%; low-certainty evidence) and the incidence of small for gestational age babies (RR: 0.39, 95% CI: 0.17-0.86; 1 RCT, 213 infants; I2 not estimable; low-certainty evidence). Daily iron supplementation in iron replete non-anemic pregnant women probably reduces the risk of maternal iron deficiency anemia at term and low birthweight.

The Influence of Calcium and Iron Supplementation in Pregnant Women to Affect Newborn Body Length in Bengkulu

The Influence of Calcium and Iron Supplementation in Pregnant Women to Affect Newborn Body Length in Bengkulu

Post Hoc Analysis of National Institute of Child Health and Human Development Vitamin-D Pregnancy Cohort and The Role of Functional Vitamin-D Deficiency in Pregnancy.

Our objective was to conduct a secondary, post hoc analysis of the National Institute of Child Health and Human Development (NICHD) vitamin D (vitD) pregnancy study by Hollis et al, which reported on the effect of vitD supplementation in pregnant women and determine the potential interaction between intact parathyroid hormone (iPTH) concentrations, vitD status, and various comorbidities associated with pregnancy. Women with low 25-hydroxy vitamin D (25(OH)D) concentrations and high iPTH concentrations during pregnancy, known as functional vitamin-D deficiency (FVDD), were more likely to acquire complications also affecting their neonates. This post hoc analysis of data collected from a diverse group of pregnant women participating in the NICHD vitD pregnancy study was applied to investigate the applicability of the concept of FVDD in pregnancy (Hemmingway, 2018) in identifying potential risks for certain comorbidities of pregnancy. This analysis defines FVDD as maternal serum 25(OH)D concentrations below 20 ng/mL and iPTH concentrations above 65 pg/mL creating a definitive ratio number, 0.308, to classify mothers as having FVDD prior to delivery (PTD). Statistical analyses were performed using SAS 9.4 (Cary, NC). In total, 281 women (85 African American, 115 Hispanic, and 81 Caucasian) with 25(OH)D and iPTH concentrations measured at monthly visits were included in this analysis. No statistically significant association was found between mothers classified as having FVDD at baseline or 1-month PTD and hypertensive disorders of pregnancy, infection, or admittance to the neonatal intensive care unit. When combining all comorbidities of pregnancy in this cohort, results showed those with FVDD at baseline, 24 weeks' gestation, and 1-month PTD were more likely to experience a comorbidity (p = 0.001; p = 0.001; p = 0.004, respectively). Those with FVDD 1-month PTD were 7.1 times (confidence interval [CI]: 1.71-29.81) more likely to have preterm birth (<37 weeks) than women without FVDD. Participants were more likely to have experienced preterm birth if they met the criteria for FVDD. This study supports the importance of FVDD during pregnancy. · Functional vitamin D deficiency (FVDD) is defined as the ratio of 25(OH)D divided by iPTH concentration ≤0.308.. · At a minimum, it is recommended that vitamin D status be kept in the healthy range based on current recommendations for pregnant individuals.. · FVDD is a more sensitive predictor of pregnancy risk than 25(OH)D alone.. · FVDD identified those with greater risk of preterm birth in this cohort..

Factors Related to Stunting Incidence in Toddlers Aged 24-59 Months in the Working Area of Kambang Community Health Center, Pesisir Selatan District

&lt;div&gt;&lt;table cellspacing="0" cellpadding="0" align="left"&gt;&lt;tbody&gt;&lt;tr&gt;&lt;td align="left" valign="top"&gt;&lt;p align="center"&gt;&lt;em&gt;Stunting is a major nutritional problem in Indonesia, even in the world particularly in developing countries. The purpose of the study was to find out the factors related to stunting in toddlers aged 24-59 months in the Pesisir Selatan District. This study is an analytical survey study with cross sectional design. This research will be conducted in the Kambang Health Center, Lengayang District, in July 2022–January 2023. The population in this study was all mothers who had toddlers aged 24-59 months who were in the Kambang Community Health Center working area in 2021 which numbered 1081 toddlers. Sample used in this study is 180 samples. The sampling technique used in this study is proportional stratified random sampling. Data collection tool using questionnaires. Analysis of the data in this study using Chi-Square test and use multiple logistical regression tests. The results showed that there was a significant relationship between the age of the mother during pregnancy (p-value = 0.040), there was a relationship between the nutritional status of the mother (p-value = 0.003), there was a relationship between parity (p-value=0.034), there is a relationship between psychosocial parenting (p-value = 0.000), there is a relationship between environmental sanitation (p-value=0.000), there is no significant relationship between low birth weight (p-value = 0.071), there is a significant relationship between birth length (p-value = 0.016). Environmental sanitation is the most dominant factor in causing stunting. Environmental sanitation has a 6,512 times chance of causing stunting in toddlers aged 24-59 months in the working area of the Kambang Community Health Center, Pesisir Selatan District. It is recommended for health workers to provide supplements or supplements for pregnant women and toddlers for nutritional improvement and to educate them on nutritional knowledge.&lt;/em&gt;&lt;/p&gt;&lt;p class="TableParagraph"&gt;&lt;em&gt;&lt;br /&gt;&lt;/em&gt;&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;/tbody&gt;&lt;/table&gt;&lt;/div&gt;&lt;strong&gt;&lt;em&gt;Keywords: &lt;/em&gt;&lt;/strong&gt; &lt;strong&gt;&lt;em&gt;Stunting, Mother Factors, Child Factors&lt;/em&gt;&lt;/strong&gt;

Perilaku Ibu Hamil dalam Mengkonsumsi Suplemen Mikronutrien

ABSTRACT&#x0D; Micronutrient supplements are an important supplement for fetal growth and development. However, based on various studies, there are various factors that cause the lack of compliance of mothers in taking micronutrient supplements. The purpose of this study was to identify the behavior of pregnant women in taking micronutrient supplements. The design of this study used quantitative descriptive. The sample in this study was 327 pregnant women, from 3 health centers in Sumedang Regency. Sampling used cluster random sampling technique and sample size is calculated using Yamato's formula. The data of this study was obtained directly from respondents through filling out a structured questionnaire that was distributed using Google Form. The questionnaire contained compliance, frequency/dosage, and maternal habits in taking micronutrient supplements that had been tested for validity with 21 valid questions and a reliability test with Cronbach's Alpha a=0.94. Based on the results of the study, it showed that almost all respondents are pregnant women aged 20-35 years (87.1%). Most respondents behaved poorly in terms of compliance, frequency/dosage, and habits (52%) of taking micronutrient supplements. The conclusion of this study is that the behavior of pregnant women dominated by bad behavior, especially in taking vitamins A and B12. Advice for health workers is to collaborate in assisting the consumption of micronutrient supplements in pregnant women and to develop effective monitoring methods.