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Rold LS, Jensen AM, Arenholt L, Leutscher PDC, Ovesen PG, Hagstrøm S, Sørensen S. Identifying microbiome-based changes and biomarkers prior to disease development in mother and child, with a focus on gestational diabetes mellitus: protocol for the DANish Maternal and Offspring Microbiome (DANMOM) cohort study. BMJ Open 2024; 14:e083358. [PMID: 39242166 PMCID: PMC11381651 DOI: 10.1136/bmjopen-2023-083358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/09/2024] Open
Abstract
INTRODUCTION The human gut microbiota is associated with gestational diabetes mellitus (GDM), which imposes a risk of developing long-term health problems for mother and child. Most studies on GDM and microbiota have been cross-sectional, which makes it difficult to make any conclusions on causality. Furthermore, it is important to assess if a dysbiotic microbiota is passed from the mother to the child, and then being at risk of developing metabolic health problems later in life. The DANish Maternal and Offspring Microbiome study aims to identify gut microbiota-related factors involved in metabolic dysfunction in women with GDM and their offspring. Importantly, the study design allows for early detection of biological changes associated with later development of metabolic disease. This could provide us with unique tools to support early diagnosis or implement preventative measures. METHODS AND ANALYSIS Pregnant women are included in the study after the 11-14 weeks' prenatal ultrasound scan and followed throughout pregnancy with enrolment of the offspring at birth. 202 women and 112 children have been included from North Denmark Regional Hospital and Aalborg University Hospital in Denmark. Mother and child are followed until the children reach the age of 5 years. From the mother, we collect faeces, urine, blood, saliva, vaginal fluid and breast milk samples, in addition to faeces and a blood sample from the child. Microbiota composition in biological samples will be analysed using 16S rRNA gene sequencing and compared with demographic and clinical data from medical charts, registers and questionnaires. Sample and data collection will continue until July 2028. ETHICS AND DISSEMINATION The study protocol has been approved by the North Denmark Region Committee on Health Research Ethics (N20190007). Written informed consent is obtained from all participants prior to study participation. Study results will be published in international peer-reviewed journals and presented at international conferences. The results will also be presented to the funders of the study and study participants.
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Affiliation(s)
- Louise Søndergaard Rold
- Centre for Clinical Research, North Denmark Regional Hospital, Hjørring, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Ann-Maria Jensen
- Centre for Clinical Research, North Denmark Regional Hospital, Hjørring, Denmark
| | - Louise Arenholt
- Centre for Clinical Research, North Denmark Regional Hospital, Hjørring, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
- Department of Gynecology and Obstetrics, North Denmark Regional Hospital, Hjørring, Denmark
| | - Peter Derek Christian Leutscher
- Centre for Clinical Research, North Denmark Regional Hospital, Hjørring, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Per Glud Ovesen
- Department of Gynecology and Obstetrics, Aarhus University Hospital, Aarhus, Denmark
- Steno Diabetes Center Aarhus, Aarhus, Denmark
| | - Søren Hagstrøm
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
- Department of Pediatrics and Adolescent Medicine, Aalborg University Hospital, Aalborg, Denmark
- Steno Diabetes Center North Denmark, Aalborg, Denmark
| | - Suzette Sørensen
- Centre for Clinical Research, North Denmark Regional Hospital, Hjørring, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
- Steno Diabetes Center North Denmark, Aalborg, Denmark
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Wu J, Gan J, Zeng G, Luo X, Yang N, Zhang Z, Sun Y, Shen J, Wei W, Yan J, Zhu J, Ludwig T, Stahl B, Zhao X, Wang Z. Investigation of Human Milk as a Biological System in a Multicenter Mother-Infant Cohort: Protocol Design and Cohort Profile of the Phoenix Study. Nutrients 2024; 16:2892. [PMID: 39275208 PMCID: PMC11397531 DOI: 10.3390/nu16172892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2024] [Revised: 08/24/2024] [Accepted: 08/26/2024] [Indexed: 09/16/2024] Open
Abstract
Breastfeeding and human milk are the gold standard for infant feeding. Studying human milk with a systems biology approach in a large longitudinal cohort is needed to understand its complexity and health implications. The Phoenix study is a multicenter cohort study focusing on the interactions of maternal characteristics, human milk composition, infant feeding practices, and health outcomes of Chinese mothers and infants. A total of 779 mother-infant dyads were recruited from November 2021 to September 2022, and 769 mother-infant dyads were enrolled in the study. Scheduled home visits took place at 1, 4, 6, and 12 months postpartum, and 696 dyads (90.5% participants) completed the 12-month visit. At each visit, maternal and infant anthropometry was assessed. Questionnaires were administered to collect longitudinal information on maternal characteristics and lifestyle, infant feeding, and health. Digital diaries were used to record maternal dietary intake, infant feeding, and stool character. Human milk, maternal feces, infant feces, and infant saliva were collected. An external pharmaceutical-level quality assurance approach was implied to ensure the trial quality. Multi-omics techniques (including glycomics, lipidomics, proteomics, and microbiomics) and machine learning algorithms were integrated into the sample and data analysis. The protocol design of the Phoenix study provides a framework for prospective cohort studies of mother-infant dyads and will provide insights into the complex dynamics of human milk and its interplay with maternal and infant health outcomes in the Chinese population.
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Affiliation(s)
- Jieshu Wu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - Junai Gan
- Danone Open Science Research Center, Shanghai 201204, China
| | - Guo Zeng
- West China School of Public Health, Sichuan University, Chengdu 610041, China
| | - Xiaoqin Luo
- Department of Nutrition and Food Safety, School of Public Health, Xi'an Jiaotong University, Xi'an 710061, China
| | - Nianhong Yang
- Department of Nutrition and Food Hygiene, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology, Wuhan 430030, China
| | - Zheqing Zhang
- Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Nutrition and Food Hygiene, School of Public Health, Southern Medical University, Guangzhou 510515, China
| | - Yongye Sun
- Department of Nutrition and Food Hygiene, School of Public Health, Qingdao University, Qingdao 266071, China
| | - Jian Shen
- Key Laboratory of Systems Biomedicine (Ministry of Education), Shanghai Center for Systems Biomedicine, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Wei Wei
- State Key Laboratory of Food Science and Resources, Jiangnan University, Wuxi 214122, China
- Collaborative Innovation Center of Food Safety and Quality Control in Jiangsu Province, School of Food Science and Technology, Jiangnan University, Wuxi 214122, China
| | - Jingyu Yan
- Key Laboratory of Separation Science for Analytical Chemistry, Dalian Institute of Chemical Physics, Chinese Academy of Sciences, Dalian 116023, China
- University of Chinese Academy of Sciences, Beijing 100049, China
| | - Jing Zhu
- Institute of Biotechnology and Health, Beijing Academy of Science and Technology, Beijing 100094, China
| | - Thomas Ludwig
- Danone Global Research & Innovation Center, Uppsalalaan 12, 3584 CT Utrecht, The Netherlands
| | - Bernd Stahl
- Danone Global Research & Innovation Center, Uppsalalaan 12, 3584 CT Utrecht, The Netherlands
- Chemical Biology and Drug Discovery, Utrecht Institute for Pharmaceutical Sciences, University of Utrecht, 3584 CS Utrecht, The Netherlands
| | - Xianfeng Zhao
- Danone Open Science Research Center, Shanghai 201204, China
| | - Zhixu Wang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China
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Dikgale B, Dlakavu F, Masenge A, De Gouveia S, Adam S. Pregnant women's dietary patterns and knowledge of gestational weight gain: A cross-sectional study. Int J Gynaecol Obstet 2024; 166:871-878. [PMID: 38523434 DOI: 10.1002/ijgo.15462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 12/18/2023] [Accepted: 02/26/2024] [Indexed: 03/26/2024]
Abstract
OBJECTIVE Excess gestational weight gain (GWG) is a risk factor for various unfavorable maternal and neonatal outcomes that may be preventable. Maintaining a healthy lifestyle while pregnant can help prevent uncontrollable weight gain. The aim of this study was to assess pregnant women's knowledge on weight, GWG, diet, and knowledge of obesity-related complications among women who seek care at our semi-urban, regional setting. METHODS A prospective observational study was conducted at the prenatal clinic at Kalafong Academic Hospital. Prospective participants completed a questionnaire on their perception of GWG, attitudes toward GWG, knowledge of GWG, associated complications of obesity, and food choices. Data analysis was performed using SAS version 9.4. RESULTS The majority of the 500 individuals were overweight or obese prior to pregnancy. By the end of the third trimester, this increased by 10.1% (n = 420; 86.1%). Nearly half (n = 240; 48.78%) of the overweight and obese women underestimated their weight. Only 26.53% (n = 26) of women who checked their body mass index (BMI, calculated as weight in kilograms divided by the square of height in meters) gained weight according to recommendations. However, less than half (n = 96; 30.5%) gained weight within the recommended range, despite the fact that the majority of them (n = 315; 64%) were aware of the harmful effects of obesity on the cardiovascular system and the effects of high calories on weight gain (n = 321; 65%). CONCLUSION Despite basic knowledge of the impact of high-caloric intake on weight gain and cardiovascular complications, less than half of the study population gained weight within the recommended range.
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Affiliation(s)
- Busisiwe Dikgale
- Department of Obstetrics and Gynaecology, University of Pretoria, Pretoria, South Africa
| | - Fuziwe Dlakavu
- Department of Obstetrics and Gynaecology, University of Pretoria, Pretoria, South Africa
| | - Andries Masenge
- Department of Statistics, University of Pretoria, Pretoria, South Africa
| | | | - Sumaiya Adam
- Department of Obstetrics and Gynaecology, University of Pretoria, Pretoria, South Africa
- Diabetes Research Centre, University of Pretoria, Pretoria, South Africa
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Goodchild C, Symington EA, Baumgartner J, Zandberg L, Wise AJ, Smuts CM, Malan L. Anaemia at mid-pregnancy is associated with prehypertension in late pregnancy among urban women. Health SA 2024; 29:2610. [PMID: 38962297 PMCID: PMC11220126 DOI: 10.4102/hsag.v29i0.2610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 04/11/2024] [Indexed: 07/05/2024] Open
Abstract
Background Antenatal iron deficiency and anaemia are associated with gestational hypertension and diabetes mellitus, but so are elevated iron stores and haemoglobin. In South Africa, pregnant women receive routine iron supplementation regardless of iron status. Aim This study aimed to assess associations of antenatal iron status and anaemia with blood pressure in pregnant women in urban South Africa. Secondary to this, associations with heart rate, fasting glucose and glucose tolerance were also investigated. Setting Johannesburg, South Africa. Methods A total of 250 pregnant women, aged 27 (24-32) years, were recruited using consecutive sampling. The authors measured biomarkers of iron status and anaemia at < 18 and ± 22 weeks', blood pressure and heart rate at ± 36 weeks', and fasting glucose and glucose tolerance between 24 and 28 weeks' gestation. Associations were determined using multivariable regression models adjusted for confounders. Results The odds of prehypertension in late pregnancy among women with anaemia at ± 22 weeks' gestation were three times higher than among women without anaemia (odds ratio [OR]: 3.01, 95% confidence interval [CI]: 1.22, 7.42). Participants with anaemia at ± 22 weeks' gestation had 2.15 times higher odds of having elevated mean arterial pressure than women without anaemia (OR: 2.15, 95% CI: 1.01, 4.60). Conclusion Anaemia at mid-pregnancy could be a predictor of hypertensive disorders in pregnancy. The cause of antenatal anaemia may need further investigation apart from iron deficiency. The effective management of anaemia in pregnant women living in urban South Africa remains a challenge. Contribution This study provides evidence about the health impact of pregnant women regarding antenatal supplementation practices in South Africa.
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Affiliation(s)
- Caylin Goodchild
- Centre of Excellence for Nutrition, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa
| | - Elizabeth A. Symington
- Department of Life and Consumer Sciences, School of Agriculture and Life Sciences, University of South Africa, Johannesburg, South Africa
| | - Jeannine Baumgartner
- Centre of Excellence for Nutrition, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa
- Department of Nutritional Sciences, King’s College London, London, United Kingdom
| | - Lizelle Zandberg
- Centre of Excellence for Nutrition, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa
| | - Amy J. Wise
- Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
- Empilweni Services and Research Unit, University of the Witwatersrand, Johannesburg, South Africa
| | - Cornelius M. Smuts
- Centre of Excellence for Nutrition, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa
| | - Linda Malan
- Centre of Excellence for Nutrition, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa
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Chimhashu TL, Verhoef H, Symington EA, Zandberg L, Baumgartner J, Malan L, Smuts CM, Feskens EJM, Melse-Boonstra A. Comparison of test performance of two commonly used multiplex assays to measure micronutrient and inflammatory markers in serum: results from a survey among pregnant women in South Africa. Br J Nutr 2024; 131:248-255. [PMID: 37560803 PMCID: PMC10751947 DOI: 10.1017/s0007114523001782] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 07/07/2023] [Accepted: 08/07/2023] [Indexed: 08/11/2023]
Abstract
The combined sandwich-ELISA (s-ELISA; VitMin Lab, Germany) and the Quansys Q-Plex™ Human Micronutrient Array (7-Plex) are multiplex serum assays that are used to assess population micronutrient status in low-income countries. We aimed to compare the agreement of five analytes, α-1-acid glycoprotein (AGP), C-reactive protein (CRP), ferritin, retinol-binding protein 4 (RBP4) and soluble transferrin receptor (sTfR) as measured by the 7-Plex and the s-ELISA. Serum samples were collected between March 2016 and December 2017. Pregnant women (n 249) were recruited at primary healthcare clinics in Johannesburg, and serum samples were collected between March 2016 and December 2017. Agreement between continuous measurements was assessed by Bland-Altman plots and concordance measures. Agreement in classifications of deficiency or inflammation was assessed by Cohen's kappa. Strong correlations (r > 0·80) were observed between the 7-Plex and s-ELISA for CRP and ferritin. Except for CRP, the 7-Plex assay gave consistently higher measurements than the s-ELISA. With the exception of CRP (Lin's ρ = 0·92), there was poor agreement between the two assays, with Lin's ρ < 0·90. Discrepancies of test results difference between methods increased as the serum concentrations rose. Cohen's kappa for all the five analytes was < 0·81 and ranged from slight agreement (vitamin A deficiency) to substantial (inflammation and Fe deficiency) agreement. The 7-Plex 1.0 is a research and or surveillance tool with potential for use in low-resource laboratories but cannot be used interchangeably with the s-ELISA. Further optimising and validation is required to establish its interchangeability with other validated methods.
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Affiliation(s)
- Tsitsi Letwin Chimhashu
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, The Netherlands
- Centre of Excellence for Nutrition, North-West University, Potchefstroom, South Africa
| | - Hans Verhoef
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, The Netherlands
| | - Elizabeth A. Symington
- Department of Life and Consumer Sciences, University of South Africa, Johannesburg, South Africa
| | - Lizelle Zandberg
- Centre of Excellence for Nutrition, North-West University, Potchefstroom, South Africa
| | - Jeannine Baumgartner
- Centre of Excellence for Nutrition, North-West University, Potchefstroom, South Africa
- Department of Nutritional Sciences, King’s College, London, UK
| | - Linda Malan
- Centre of Excellence for Nutrition, North-West University, Potchefstroom, South Africa
| | | | - Edith J. M. Feskens
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, The Netherlands
| | - Alida Melse-Boonstra
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, The Netherlands
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Tesfa E, Munshea A, Nibret E, Gizaw ST. Determinants of pre-eclampsia among pregnant women attending antenatal care and delivery services at Bahir Dar public hospitals, northwest Ethiopia: A case-control study. Health Sci Rep 2023; 6:e1440. [PMID: 37519426 PMCID: PMC10372301 DOI: 10.1002/hsr2.1440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 05/09/2023] [Accepted: 07/12/2023] [Indexed: 08/01/2023] Open
Abstract
Background and Aims Pre-eclampsia (PE) is a pregnancy-related syndrome that occurs after 20 weeks of pregnancy. The current study was designed to evaluate the determinants of PE in pregnant women following antenatal and delivery services. Methods An institution-based case-control study was performed in governmental hospitals of Bahir Dar city. The data were collected using an interview-administered questionnaire and analyzed by SPSS version 20 software. Bivariate and multivariable logistic regression models were utilized for the analysis of variables. A p < 0.05 was used to declare the level of significance. Results In this study, the mean ages (in years) of cases and controls were 28.20 ± 5.66 and 27.52 ± 4.70, respectively. Factors such as: being primiparous (adjusted odds ratio [AOR]: 3.19 at 95% confidence interval [CI]: 1.71, 5.97), family history of hypertension (HTN) (AOR: 4.14 at 95% CI: 1.71, 10.05), previous history of PE (AOR: 7.97 at 95% CI: 2.42, 26.63), number of antenatal care (ANC) visits (AOR: 5.43 at 95% CI: 2.86, 10.33), not taking iron and folic acid supplement (AOR: 4.46 at 95% CI: 1.59, 12.48), body mass index ≥25 kg/m2 (AOR: 3.47 at 95% CI: 1.78, 6.77), not consuming vegetables (AOR: 1.99 at 95% CI: 1.07, 3.69) and not consuming egg, milk and milk products (AOR: 3.00 at 95% CI: 1.47, 6.11) were the determinants of PE. Conclusion In this study, different determinants of PE were identified. Hence, special attention should be given for primiparous women, women having previous history of PE and family history of HTN. Moreover, nutritional counseling should be given for pregnant women during ANC visits. Besides, higher officials should design an appropriate strategy to increase the number of mothers to complete their ANC visits and to take iron and folic acid supplements. Furthermore, to verify the determinants of PE, community-based cohort studies are warranted.
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Affiliation(s)
- Endalamaw Tesfa
- Department of Medical Biochemistry, College of Medicine and Health SciencesBahir Dar UniversityBahir DarEthiopia
- Division of Health Biotechnology, Institute of BiotechnologyBahir Dar UniversityBahir DarEthiopia
| | - Abaineh Munshea
- Division of Health Biotechnology, Institute of BiotechnologyBahir Dar UniversityBahir DarEthiopia
- Department of BiologyBahir Dar UniversityBahir DarEthiopia
| | - Endalkachew Nibret
- Division of Health Biotechnology, Institute of BiotechnologyBahir Dar UniversityBahir DarEthiopia
- Department of BiologyBahir Dar UniversityBahir DarEthiopia
| | - Solomon Tebeje Gizaw
- Department of Medical Biochemistry, College of Health ScienceAddis Ababa UniversityAddis AbabaEthiopia
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Soepnel LM, Mabetha K, Draper CE, Silubonde TM, Smuts CM, Pettifor JM, Norris SA. A Cross-Sectional Study of the Associations between Biomarkers of Vitamin D, Iron Status, and Hemoglobin in South African Women of Reproductive Age: the Healthy Life Trajectories Initiative, South Africa. Curr Dev Nutr 2023; 7:100072. [PMID: 37180853 PMCID: PMC10134444 DOI: 10.1016/j.cdnut.2023.100072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 02/27/2023] [Accepted: 03/24/2023] [Indexed: 04/03/2023] Open
Abstract
Background Vitamin D deficiency and anemia impact the health of women of reproductive age. Evidence suggests an inverse relationship between serum vitamin D (25-hydroxyvitamin D [25(OH)D]) and anemia/iron deficiency, but less is known about these associations in women of reproductive age, in particular in a setting with a combined burden of micronutrient deficiency, food insecurity, and obesity. Objective We aimed to assess the associations between 25(OH)D and biomarkers of iron and anemia in a cohort of women of reproductive age from Soweto, South Africa. The prevalence of vitamin D deficiency was also assessed. Methods In this cross-sectional substudy of the Healthy Life Trajectories Initiative (HeLTI) South Africa pilot trial, 25(OH)D, iron markers (ferritin and soluble transferrin receptor [sTFR]), and altitude-adjusted hemoglobin (Hb) were measured in 493 women aged 18 to 25 years. Associations between iron deficiency/anemia and vitamin D status were evaluated using multivariable logistic regression, adjusting for confounders including fat mass index (FMI). Structural equation modeling (SEM) was performed to evaluate direct and indirect pathways between 25(OH)D, iron and anemia markers, and covariates. Results Of 493 participants, 136 (27.6%) had vitamin D insufficiency (25(OH)D ≥12-20 ng/mL), whereas 28 (5.6%) had vitamin D deficiency (<12 ng/mL). Anemia and iron deficiency were not significantly associated with vitamin D category (25(OH)D<20 ng/mL compared with ≥20 ng/mL) in multivariable logistic regression analyses. In SEM, log-transformed 25(OH)D was not significantly associated with Hb, ferritin, or sTFR, but it was significantly associated with season of data collection, hormonal contraceptive use, and FMI (total effects: B = 0.17, 95% CI: 0.104, 0.236, P < 0.001; B: 0.10, 95% CI: 0.041, 0.154, P < 0.001; B: -0.01, 95%CI: -0.016, -0.003, P = 0.003, respectively). Conclusion No significant association between vitamin D (25(OH)D), anemia (Hb), and iron markers was found. The inverse relationship between FMI and vitamin D status emphasizes the overlap between adiposity and micronutrient deficiencies in young South African women, exacerbating their risk of disease development.
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Affiliation(s)
- Larske M. Soepnel
- SA MRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Khuthala Mabetha
- SA MRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
| | - Catherine E. Draper
- SA MRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
| | - Takana Mary Silubonde
- SA MRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
| | - Cornelius M. Smuts
- Centre of Excellence for Nutrition, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa
| | - John M. Pettifor
- SA MRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
| | - Shane A. Norris
- SA MRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
- Global Health Research Institute, School of Human Development and Health, University of Southampton, Southampton, United Kingdom
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Osuna E, Symington EA, Malan L, Ricci C, Zandberg L, Smuts CM, Baumgartner J. Higher n-3 polyunsaturated fatty acid status during early pregnancy is associated with lower risk for depression at 12 months postpartum: The NuPED study. Prostaglandins Leukot Essent Fatty Acids 2023; 190:102528. [PMID: 36716632 DOI: 10.1016/j.plefa.2022.102528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 11/30/2022] [Accepted: 12/23/2022] [Indexed: 01/15/2023]
Abstract
Perinatal depression can negatively affect the health of the mother and her offspring. N-3 polyunsaturated fatty acids (PUFA) may play a role in the aetiology of depression. Therefore, we investigated the association of n-3 PUFA status during early pregnancy with perinatal depression among women living in urban Johannesburg, South Africa. For this prospective analysis, we analysed red blood cell (RBC) total phospholipid fatty acid (FA) composition (% of total FA) of 242 pregnant women at <18 weeks' gestation. We used the Edinburgh Postnatal Depression Scale (EPDS) to identify women at risk for depression (EPDS score ≥9) at <18, 22 and 36 weeks' gestation, and at 6 and 12 months postpartum. RBC EPA status was negatively (β=-0.22, p<0.05), and the AA/EPA ratio positively (β=0.24, p<0.05) associated with EPDS scores at 12 months postpartum. Higher RBC DHA and n-3 index were further associated with lower odds (OR=0.56 [95% CI: 0.32-0.91]; OR=0.63 [95% CI: 0.39-0.94]), while higher n-6/n-3 PUFA and AA/EPA ratios early in pregnancy were associated with higher odds for depression at 12 months postpartum ((OR=2.34 [95% CI: 1.12-4.97]; OR=1.02 [95% CI: 1.00-1.05]). Our results suggest that women with a higher RBC n-3 PUFA status during early pregnancy may be at lower risk for depression at 12 months postpartum.
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Affiliation(s)
- Ester Osuna
- Laboratory of Human Nutrition, Institute of Food, Nutrition and Health, ETH Zurich, Switzerland
| | - Elizabeth A Symington
- Department of Life and Consumer Sciences, University of South Africa, Johannesburg, South Africa
| | - Linda Malan
- Centre of Excellence for Nutrition, North-West University, Potchefstroom, South Africa
| | - Cristian Ricci
- Africa Unit for Transdisciplinary Health Research (AUTHER), North-West University, Potchefstroom, South Africa
| | - Lizelle Zandberg
- Centre of Excellence for Nutrition, North-West University, Potchefstroom, South Africa
| | - Cornelius M Smuts
- Centre of Excellence for Nutrition, North-West University, Potchefstroom, South Africa
| | - Jeannine Baumgartner
- Laboratory of Human Nutrition, Institute of Food, Nutrition and Health, ETH Zurich, Switzerland; Centre of Excellence for Nutrition, North-West University, Potchefstroom, South Africa; Department of Nutritional Sciences, King's College London, London, United Kingdom.
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Talarico F, Liu YS, Metes D, Wang M, Wearmouth D, Kiyang L, Wei Y, Gaskin A, Greenshaw A, Janus M, Cao B. Risk factors for developmental vulnerability: Insight from population-level surveillance using the Early Development Instrument. Digit Health 2023; 9:20552076231210705. [PMID: 37928328 PMCID: PMC10624014 DOI: 10.1177/20552076231210705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/03/2023] [Indexed: 11/07/2023] Open
Abstract
Objectives Population-level studies may elucidate the most promising intervention targets to prevent negative outcomes of developmental vulnerability in children. This study aims to bridge the current literature gap on identifying population-level developmental vulnerability risk factors using combined social and biological/health information. Methods This study assessed developmental vulnerability among kindergarten children using the 2016 Early Development Instrument (EDI) and identified risk factors of developmental vulnerability using EDI data cross-linked to a population-wide administrative health dataset. A total number of 23,494 children aged 5-6 were included (48% female). Prenatal, neonatal, and early childhood risk factors for developmental vulnerability were investigated, highlighting the most important ones contributing to early development. Results The main risk factors for developmental vulnerability were children with a history of mental health diagnosis (risk ratio = 1.46), biological sex-male (risk ratio = 1.51), and poor socioeconomic status (risk ratio = 1.58). Conclusion Our study encompasses both social and health information in a populational-level representative sample of Alberta, Canada. The results confirm evidence established in other geographic regions and jurisdictions and demonstrate the association between perinatal risk factors and developmental vulnerability. Based on these results, we argue that the health system should adopt a multilevel prevention and intervention strategy, targeting individual, family, and community together.
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Affiliation(s)
| | - Yang S Liu
- Department of Psychiatry, University of Alberta, Edmonton, Canada
| | - Dan Metes
- Ministry of Health, Government of Alberta, Edmonton, Canada
| | - Mengzhe Wang
- Ministry of Health, Government of Alberta, Edmonton, Canada
| | - Dori Wearmouth
- Ministry of Health, Government of Alberta, Edmonton, Canada
| | | | - Yifeng Wei
- Department of Psychiatry, University of Alberta, Edmonton, Canada
| | - Ashley Gaskin
- Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada
| | - Andrew Greenshaw
- Department of Psychiatry, University of Alberta, Edmonton, Canada
| | - Magdalena Janus
- Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada
| | - Bo Cao
- Department of Psychiatry, University of Alberta, Edmonton, Canada
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Effects of Nutritional and Social Factors on Favorable Fetal Growth Conditions Using Structural Equation Modeling. Nutrients 2022; 14:nu14214642. [PMID: 36364904 PMCID: PMC9656558 DOI: 10.3390/nu14214642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 10/26/2022] [Accepted: 10/31/2022] [Indexed: 11/06/2022] Open
Abstract
Poor birth outcomes such as low birth weight, low birth length and short gestational age, are public health concern issues in South Africa (SA). This study utilized structural equation modeling (SEM) to explore how nutritional and social factors contribute to favorable fetal growth conditions (FFGC) in pregnant women living with and without human immunodeficiency virus (HIV), in the Free State Province of SA. Sociodemographic characteristics, stress, health and nutrition-related information, and birth outcomes data were collected and analyzed from a subsample of 305 women enrolled in a cohort study from 2018−2020. Descriptive statistics were analyzed in R version 4.1.2 and SEM was conducted in Lavaan version 0.6−5. Higher gestational body mass index (GBMI) and income levels were associated with higher FFGC (p < 0.05). Household incomes were positively associated with dietary micronutrient quality (p = 0.002), GBMI (p = 0.012) and food security (p = 0.001). Low incomes (p = 0.004) and food insecurity (p < 0.001) were associated with higher stress, while social support was positively associated with food security status (p = 0.008). These findings highlight the complex interconnections between the social and nutritional factors that are associated with fetal growth conditions. Multisectoral community-based programs may be a useful strategy to address these challenges.
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Robb L, Jordaan EM, Joubert G, Ngounda J, Walsh CM. Sociodemographic Indicators, Household Food Security and Associations with Choline Intake in Pregnant Women: The NuEMI Study. Ecol Food Nutr 2022; 61:669-686. [PMID: 36083168 DOI: 10.1080/03670244.2022.2118734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Higher sociodemographic status is associated with adequate nutrient intake and food security. Adequate choline intake is vital during pregnancy to support fetal development. In this cross-sectional study, information was obtained from 682 pregnant women attending an ante-natal clinic in Bloemfontein, South Africa. Sociodemographic indicators that were bivariately significantly associated with a choline intake below the adequate intake level (AI) included a higher household density ratio, no access to own flush toilets at home, household not owning a refrigerator or microwave, as well as a lower level of education. Approximately one-third of participants were severely food-insecure. Logistic regression analysis, adjusted for energy intake, showed that household overcrowding increased the odds of a choline intake below the AI (OR 1.71).
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Affiliation(s)
- Liska Robb
- Department of Nutrition and Dietetics, School of Health and Rehabilitation Sciences, Faculty of Health Sciences, University of the Free State, Bloemfontein, Republic of South Africa
| | - Elizabeth Margaretha Jordaan
- Department of Nutrition and Dietetics, School of Health and Rehabilitation Sciences, Faculty of Health Sciences, University of the Free State, Bloemfontein, Republic of South Africa
| | - Gina Joubert
- Department of Biostatistics, School of Biomedical Sciences, Faculty of Health Sciences, University of the Free State, Bloemfontein, Republic of South Africa
| | - Jennifer Ngounda
- Department of Nutrition and Dietetics, School of Health and Rehabilitation Sciences, Faculty of Health Sciences, University of the Free State, Bloemfontein, Republic of South Africa
| | - Corinna May Walsh
- Department of Nutrition and Dietetics, School of Health and Rehabilitation Sciences, Faculty of Health Sciences, University of the Free State, Bloemfontein, Republic of South Africa
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12
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Yang J, Wang M, Tobias DK, Rich-Edwards JW, Darling AM, Abioye AI, Pembe AB, Madzorera I, Fawzi WW. Gestational weight gain during the second and third trimesters and adverse pregnancy outcomes, results from a prospective pregnancy cohort in urban Tanzania. Reprod Health 2022; 19:140. [PMID: 35710384 PMCID: PMC9204988 DOI: 10.1186/s12978-022-01441-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 05/18/2022] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Appropriate gestational weight gain (GWG) is important for optimal pregnancy outcomes. This study prospectively evaluated the associations between GWG during the second and third trimesters of pregnancy and adverse pregnancy outcomes in an urban Tanzanian pregnancy cohort. METHODS We used data from a randomized clinical trial conducted among pregnant women recruited by 27 weeks of gestation in Dar es Salaam, Tanzania (N = 1230). Women's gestational weight was measured at baseline and at monthly antenatal visits. Weekly GWG rate during the second and third trimesters was calculated and characterized as inadequate, adequate, or excessive, in conjunction with measured or imputed early-pregnancy BMI status according to the 2009 Institute of Medicine (IOM) GWG guidelines. We used multivariable Poisson regression with a sandwich variance estimator to calculate risk ratios (RR) for associations of GWG with low birth weight, preterm birth, small for gestational age (SGA), and large for gestational age (LGA). Degree of appropriate GWG defined using additional metrics (i.e., percentage of adequacy, z-score) and potential effect modification by maternal BMI were additionally evaluated. RESULTS According to the IOM guidelines, 517 (42.0%), 270 (22.0%), and 443 (36.0%) women were characterized as having inadequate, adequate, and excessive GWG, respectively. Overall, compared to women with adequate GWG, women with inadequate GWG had a lower risk of LGA births (RR = 0.54, 95% CI: 0.36-0.80) and a higher risk of SGA births (RR = 1.32, 95% CI: 0.95-1.81). Women with inadequate GWG as defined by percentage of GWG adequacy had a higher risk of LBW (OR = 1.93, 95% CI: 1.03-3.63). In stratified analyses by early-pregnancy BMI, excessive GWG among women with normal BMI was associated with a higher risk of preterm birth (RR = 1.59, 95% CI: 1.03-2.44). CONCLUSIONS A comparatively high percentage of excessive GWG was observed among healthy pregnant women in Tanzania. Both inadequate and excessive GWGs were associated with elevated risks of poor pregnancy outcomes. Future studies among diverse SSA populations are warranted to confirm our findings, and clinical recommendations on optimal GWG should be developed to promote healthy GWG in SSA settings. TRIAL REGISTRATION This trial was registered as "Prenatal Iron Supplements: Safety and Efficacy in Tanzania" (NCT01119612; http://clinicaltrials.gov/show/NCT01119612 ).
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Affiliation(s)
- Jiaxi Yang
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, 677 Huntington Ave, Boston, MA, 02115, USA.
- Global Center for Asian Women's Health, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
| | - Molin Wang
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, 677 Huntington Ave, Boston, MA, 02115, USA
- Department of Biostatistics, Harvard T. H. Chan School of Public Health, 677 Huntington Ave, Boston, MA, 02115, USA
| | - Deirdre K Tobias
- Department of Nutrition, Harvard T. H. Chan School of Public Health, 677 Huntington Ave, Boston, MA, 02115, USA
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, 900 Commonwealth Avenue, Boston, MA, 02115, USA
| | - Janet W Rich-Edwards
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, 677 Huntington Ave, Boston, MA, 02115, USA
- Channing Division of Network Medicine, Division of Women's Health, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 900 Commonwealth Avenue, Boston, MA, 02115, USA
| | - Anne Marie Darling
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA, 02115, USA
| | - Ajibola I Abioye
- Department of Nutrition, Harvard T. H. Chan School of Public Health, 677 Huntington Ave, Boston, MA, 02115, USA
| | - Andrea B Pembe
- Department of Obstetrics and Gynecology, School of Medicine, Muhimbili University of Health and Allied Sciences, P. O. Box 65117, Dar es Salaam, Tanzania
| | - Isabel Madzorera
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA, 02115, USA
| | - Wafaie W Fawzi
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, 677 Huntington Ave, Boston, MA, 02115, USA
- Department of Nutrition, Harvard T. H. Chan School of Public Health, 677 Huntington Ave, Boston, MA, 02115, USA
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA, 02115, USA
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Saleem T, Saleem S, Shoib S, Shah J, Ali SAEZ. A rare phenomenon of pregorexia in Pakistani women: need to understand the related behaviors. J Eat Disord 2022; 10:74. [PMID: 35597970 PMCID: PMC9124428 DOI: 10.1186/s40337-022-00589-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 05/03/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND In Pakistan, for a decade or so, there has been a huge increase in body ideals, and thinness and eating disorders reported during pregnancy. The purpose of the present research was to study the lived experiences and behaviors characterized by pregorexia in Pakistani young women. METHOD A phenomenological approach was used to study eating disorder-related behaviors among pregnant women. A criterion sample of 15 women (22-34 years of age) having difficulty with their body image, the decline in caloric intake, skipping meals, and extensive exercise from a private gynae clinic of Islamabad was selected. The participants were screened on the DSM-5 criteria of anorexia nervosa. They were also asked questions about their diet intake, behaviors executed to lose or maintain weight, use of any medical or chemical substance to control weight, any social activities/behaviors, type of exercise if any, duration or frequency of exercise, and behaviors that made them feel better. RESULTS The findings revealed that 93.33% of women met the complete criteria of Anorexia nervosa. 86.6% had never been diagnosed or treated with anorexia nervosa, however, 13.33% were diagnosed with anorexia nervosa comorbid with depression. Results indicated a likelihood of having anorexic tendencies in 40% of women and the other 60% developed the symptoms during pregnancy only. Behaviors related to pregorexia were found to be: skipping meals, eating small portions, control on calorie intake, following diet plans available on YouTube, taking fat burn tea, avoiding the presence of elders of the family while taking meals, eating alone to limit food portion, taking laxatives or medicine to control weight, induced vomiting after eating, eating to match the norm of eating (supervised eating by elders) being pregnant and later self-induced vomiting, or eating slowly and consuming more time, pretending to eat the suitable amount of food. Women also engaged in fast walking, light exercise, and intensive cardio to control weight and stay in body shape. Around 86% reported that controlling weight, calorie intake, and exercising made them feel better. CONCLUSION There is a need to understand and differentiate pregorexia from other eating behaviors and problems among pregnant women with respect to cultural context.
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Affiliation(s)
- Tamkeen Saleem
- Department of Psychology, International Islamic University, Islamabad, 44000, Pakistan
| | - Shemaila Saleem
- Department of Physiology, Federal Medical and Dental College, Islamabad, 44000, Pakistan
| | - Sheikh Shoib
- Department of Psychiatry, Jawaharlal Nehru Memorial Hospital (JLNMH), Rainawari, Srinagar, Jammu and Kashmir, 190003, India
| | - Jaffer Shah
- Medical Research Center, Kateb University, Kabul, Afghanistan.
- Department of Health Services, New York State Department of Health, New York, USA.
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Tesfaye A, Sisay G, Kabthymer RH, Tesfaye T. Under-nutrition and associated factors among pregnant women in public health care hospitals of Gedeo Zone, southern Ethiopia: A cross-sectional study. Heliyon 2022; 8:e09511. [PMID: 35647358 PMCID: PMC9136312 DOI: 10.1016/j.heliyon.2022.e09511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 11/03/2021] [Accepted: 05/16/2022] [Indexed: 10/31/2022] Open
Abstract
Background Balanced and adequate nutritious food during pregnancy helps to improve maternal weight and for the healthy growth of the fetus. There has been little progress in reducing pregnant undernutrition in Ethiopia; it has been too slow. Objective The objective of this study was to assess the prevalence of undernutrition and associated factors among pregnant women in public health care hospitals of Gedeo Zone, Southern Ethiopia. Method A cross-sectional study design was used in public hospitals of Gedeo Zone, Southern Ethiopia from February 01 to March 01, 2019. Pretested structure questionnaire was used to collect data on the socio-economic and demographic characteristics of the study participants. Epi-data was used to code and enter the data and SPSS-25 was used to analyse and interpret the data. To assess the relationship between the dependent and the independent variables, bi-variable and multivariable logistic regression analysis was done. Results In this study, the prevalence of undernutrition among pregnant women was 21% (95% CI: 20.8-21.2). After controlling other co-variables, the multivariable logistic regression model revealed that average monthly income, women's educational status, nutrition education and counseling, and parity were found to have a significant association with pregnant women's nutritional status. The odds of under-nutrition among pregnant women whose monthly income is <800 ETB were 2.8 times higher than those whose monthly incomes were >1500 (AOR: 2.89; 95%CI: 1.49-5.6). Conclusion In this study the magnitude of undernutrition among pregnant women was found to be higher than the previously reported findings. Average household monthly income, family size, mother's educational status, nutrition education and counseling, current health condition of the mother, and parity were factors significantly associated with undernutrition of pregnant mothers. Therefore, Interventions should be initiated in earlier stages of pregnancy to prevent the high level of undernutrition during the second and third trimester in this study area.
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Affiliation(s)
- Adane Tesfaye
- Department of Human Nutrition, College of Medicine and Health Science, Dilla University, Ethiopia
| | - Gizaw Sisay
- School of Public Health, College of Medicine and Health Science, Dilla University, Ethiopia
| | - Robel Hussen Kabthymer
- Department of Human Nutrition, College of Medicine and Health Science, Dilla University, Ethiopia
| | - Tizalegn Tesfaye
- School of Public Health, College of Medicine and Health Science, Dilla University, Ethiopia
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Mekhoa TM, Mooi NM, Baloyi OB. Knowledge, attitudes and practices of nurses regarding maternal nutrition in pregnant women at a large hospital and filter clinics, Lesotho. Health SA 2022; 27:1768. [PMID: 35281282 PMCID: PMC8905416 DOI: 10.4102/hsag.v27i0.1768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Accepted: 12/08/2021] [Indexed: 11/08/2022] Open
Abstract
Background Adequate nutritional knowledge, positive attitudes, and good practices of nurses regarding maternal nutrition of women during pregnancy are fundamental for maternal and foetal well-being. Aim This study aimed to determine the knowledge, attitudes, and practices of nurses regarding maternal nutrition in pregnant women. Setting A large hospital and its filter clinics in Lesotho. Methods A descriptive cross-sectional research design was used for this study. The data were collected from 120 nurses working in the reproductive health department of a large hospital and filter clinics, using a self-administered questionnaire. The research was conducted in accordance with the Declaration of Helsinki. Results The nurses showed good knowledge and practices, and positive attitudes regarding maternal nutrition, 88.3%, 99.2% and 62.5%, respectively. There was a significant relationship between attitude and practice, with a correlation coefficient of r = 296, n = 120, and p = 0.001. Conclusion The results of this study show that nurses' practices were associated with their attitudes regarding maternal nutrition, meaning their attitudes regarding maternal knowledge transcends their related knowledge. Contribution The study contributes to the body of literature about the knowledge, attitudes and practices of nurses related to maternal nutrition. It has the potential to lead to the betterment of nursing care, which in turn results in improved pregnancy outcomes in women.
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Affiliation(s)
- Tsiame M Mekhoa
- Department of Nursing, Faculty of Health Sciences, Walter Sisulu University, Mthatha, South Africa
| | - Nomaxabiso M Mooi
- Department of Nursing, Faculty of Health Sciences, Walter Sisulu University, Mthatha, South Africa
| | - Olivia B Baloyi
- Department of Nursing, Faculty of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
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Robb L, Joubert G, Jordaan EM, Ngounda J, Walsh CM. Choline intake and associations with egg and dairy consumption among pregnant women attending a high-risk antenatal clinic in South Africa: the NuEMI study. BMC Pregnancy Childbirth 2021; 21:833. [PMID: 34906117 PMCID: PMC8670152 DOI: 10.1186/s12884-021-04314-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 12/01/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The importance of adequate choline intake during pregnancy has been well documented, but low intake is common. Total choline intake, main food sources of choline, as well as associations between choline intake and egg and dairy consumption were determined in a sample of pregnant women attending the high-risk antenatal clinic at a regional hospital in Bloemfontein, South Africa. METHODS A cross-sectional study design was used. Trained fieldworkers collected dietary intake data using a validated quantified food frequency questionnaire (QFFQ), after which all food items were matched to foods in the USDA Database for the Choline Content of Common Foods (Release 2) to quantify choline intake. Logistic regression with backward selection (p < 0.05) was used to determine whether egg and dairy consumption were independently associated with a choline intake below the adequate intake (AI) level. RESULTS The median daily intake of choline was 275 mg (interquartile range 185 mg - 387 mg) (N = 681). Most participants (84.7%) consumed less than the AI of 450 mg/day for choline. Meat and meat products, cereals, eggs and dairy contributed mostly to choline intake. Food items that contributed most to choline intake included full-cream milk, maize porridge, brown bread, deep-fried potatoes and deep-fried dough (vetkoek). A choline intake below the AI was significantly associated with lower egg and dairy intakes (p < 0.0001 and p = 0.0002 respectively). CONCLUSION Most pregnant women in the current study had choline intakes below the AI. It is recommended that public health messaging targeted at pregnant women promote the consumption of foods that can significantly contribute to choline intake, such as eggs and dairy.
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Affiliation(s)
- Liska Robb
- Department of Nutrition and Dietetics, School of Health and Rehabilitation Sciences, Faculty of Health Sciences, University of the Free State, PO Box 339, internal box G24, Bloemfontein, 9300, Free State, Republic of South Africa.
| | - Gina Joubert
- Department of Biostatistics, School of Biomedical Sciences, Faculty of Health Sciences, University of the Free State, Bloemfontein, Republic of South Africa
| | - Elizabeth Margaretha Jordaan
- Department of Nutrition and Dietetics, School of Health and Rehabilitation Sciences, Faculty of Health Sciences, University of the Free State, PO Box 339, internal box G24, Bloemfontein, 9300, Free State, Republic of South Africa
| | - Jennifer Ngounda
- Department of Nutrition and Dietetics, School of Health and Rehabilitation Sciences, Faculty of Health Sciences, University of the Free State, PO Box 339, internal box G24, Bloemfontein, 9300, Free State, Republic of South Africa
| | - Corinna May Walsh
- Department of Nutrition and Dietetics, School of Health and Rehabilitation Sciences, Faculty of Health Sciences, University of the Free State, PO Box 339, internal box G24, Bloemfontein, 9300, Free State, Republic of South Africa
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Azza A, Susilo C. The Cultural Assessment Model as an Evaluation Indicator for Nutritional Adequacy in Pregnant Women with Pre-eclampsia. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.6627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: Pre-eclampsia is one of the complications of pregnancy in many communities with low socioeconomic conditions. The lack of intake of quality nutrition can be a precipitating factor in the occurrence of this complication.
AIM: This study aims to find out the nutritional adequacy for pregnant women through the transcultural model assessment using correlational design and a cross-sectional approach in pregnant women at the third trimester.
MATERIALS AND METHODS: The diagnosis of pre-eclampsia was identified through a blood pressure of 140/90 mmHg and proteinuria. There were 222 samples with purposive sampling. The data were obtained through questionnaires and the interview results were used as secondary data. The data were analyzed using the Chi-square test, odds ratio (OR) with confidence intervals (CI) of 95%, and the alpha value of 0.05.
RESULTS: The analysis of the nutritional adequacy with the incidence of pre-eclampsia confirmed that the carbohydrate with OR of 5.250 (OR = 3.545, 95% CI = 2.098, 13.158), folic acid (OR = 16,838, 95% CI = 2.222, 127.64), and vegetable (OR of 4.00, 95% CI = 1.619, 9.885) which are related to the incidence of pre-eclampsia.
CONCLUSION: The fulfillment of the daily nutrition of pregnant women is greatly influenced by the culture and myth developed in society. An assessment using the transcultural model approach can give a lot of information about the influence of culture in pregnant women’s daily life.
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Hassan B, Rayis DA, Ahmed ABA, ALhabardi N, Adam I. Prevalence and associated factors of undernutrition among pregnant Sudanese women. Trans R Soc Trop Med Hyg 2021; 116:352-358. [PMID: 34415017 DOI: 10.1093/trstmh/trab128] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 05/31/2021] [Accepted: 08/05/2021] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Maternal undernutrition is a global health challenge, and it is associated with significant maternal and perinatal morbidity and mortality. This study aimed to assess the prevalence and the factors associated with undernutrition among pregnant women in Sudan. METHODS A cross-sectional study was carried out in Saad Abuelela Hospital in Khartoum, Sudan, from June to December 2019. Sociodemographic and obstetric characteristics were collected through a questionnaire. Mid-upper arm circumference was measured. Undernutrition was defined as a mid-upper arm circumference of <23 cm. Multiple logistic regression was used to assess the factors associated with maternal undernutrition. RESULTS Of 1801 pregnant women, 226 (12.5%) were undernourished. Multivariable analysis revealed that ≤2 antenatal care clinic visits (adjusted OR [AOR]=3.06, 95% CI 1.68 to 5.58) was associated with undernutrition. Age (AOR=0.90, 95% CI 0.87 to 0.94) and haemoglobin levels (AOR=0.81, 95% CI 0.67 to 0.97) were negatively associated with undernutrition. There was no association between parity, education, interpregnancy interval, occupation and maternal undernutrition. CONCLUSIONS Our findings indicated that 12.5% of the pregnant women in Khartoum were undernourished. More effort and action are need to improve the counselling and future inclusion of a supplemental food supply for undernourished pregnant women.
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Affiliation(s)
- Bahaeldin Hassan
- College of Medicine, King Khalid University, Abha, Kingdom of Saudi Arabia
| | - Duria A Rayis
- Department of Obstetrics and Gynaecology, Faculty of Medicine, University of Khartoum, Khartoum, Sudan
| | - Abdel B A Ahmed
- College of Medicine, King Khalid University, Abha, Kingdom of Saudi Arabia
| | - Nadiah ALhabardi
- Department of Obstetrics and Gynecology, Unaizah College of Medicine and Medical Sciences, Qassim University, Unaizah, Kingdom of Saudi Arabia
| | - Ishag Adam
- Department of Obstetrics and Gynecology, Unaizah College of Medicine and Medical Sciences, Qassim University, Unaizah, Kingdom of Saudi Arabia
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Siro SS, Baumgartner J, Schoonen M, Ngounda J, Malan L, Symington EA, Smuts CM, Zandberg L. Characterization of Genetic Variants in the SLC5A5 Gene and Associations With Breast Milk Iodine Concentration in Lactating Women of African Descent: The NUPED Study. Front Nutr 2021; 8:692504. [PMID: 34368208 PMCID: PMC8342754 DOI: 10.3389/fnut.2021.692504] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 06/22/2021] [Indexed: 11/13/2022] Open
Abstract
Background: The sodium iodide symporter is responsible for the transfer of iodine into breast milk and is encoded for by the SLC5A5 gene. The role of genetic variants in the SLC5A5 gene locus in relation to the transfer of iodine from plasma into breast milk in healthy lactating individuals has, to our knowledge, not been explored. Objective: To identify and characterize possible genetic variants of the SLC5A5 gene in women of African descent living in urban South Africa, and to study associations with breast milk iodine concentrations (BMIC) in lactating women. Methods: This study is affiliated to the Nutrition during Pregnancy and Early Development (NuPED) cohort study (n = 250 enrolled pregnant women). In a randomly selected sub-sample of 32 women, the SLC5A5 gene was sequenced to identify known and novel variants. Of the identified variants, genotyping of selected variants was performed in all pregnant women who gave consent for genetic analyses (n = 246), to determine the frequency of the variants in the study sample. Urinary iodine concentration (UIC) in spot urine samples and BMIC were measured to determine iodine status. Associations of SLC5A5 genetic variants with BMIC were studied in lactating women (n = 55). Results: We identified 27 variants from sequencing of gene exomes and 10 variants were selected for further study. There was a significant difference in BMIC between the genotypes of the rs775249401 variant (P = 0.042), with the homozygous GG group having lower BMIC [86.8 (54.9-167.9) μg/L] compared to the (A) allele carriers rs775249401(AG+AA) [143.9 (122.4-169.3) μg/L] (P = 0.042). Of the rs775249401(GG), 49% had UIC <100 μg/L and 61% had BMIC <100 μg/L. On the other hand, 60% of the rs775249401(AG+AA) carriers had UIC <100 μg/L, and none had a BMIC <100 μg/L. Conclusion: Our results suggest that A-allele carriers of rs775249401(AG+AA) are likely to have higher iodine transfer into breast milk compared to the homozygous GG counterparts. Thus, genetic variations in the SLC5A5 gene may play an important role in the transfer of iodine from plasma into breast milk and may partially explain inter-individual variability in BMIC.
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Affiliation(s)
- Sicelosethu S. Siro
- Centre of Excellence for Nutrition, North-West University, Potchefstroom, South Africa
| | - Jeannine Baumgartner
- Centre of Excellence for Nutrition, North-West University, Potchefstroom, South Africa
- Human Nutrition Laboratory, Department of Health Sciences and Technology, Institute of Food, Nutrition and Health, ETH Zurich, Zurich, Switzerland
| | - Maryke Schoonen
- Centre of Excellence for Nutrition, North-West University, Potchefstroom, South Africa
| | - Jennifer Ngounda
- Department of Nutrition and Dietetics, University of the Free State, Bloemfontein, South Africa
| | - Linda Malan
- Centre of Excellence for Nutrition, North-West University, Potchefstroom, South Africa
| | - Elizabeth A. Symington
- Department of Life and Consumer Sciences, University of South Africa, Johannesburg, South Africa
| | - Cornelius M. Smuts
- Centre of Excellence for Nutrition, North-West University, Potchefstroom, South Africa
| | - Lizelle Zandberg
- Centre of Excellence for Nutrition, North-West University, Potchefstroom, South Africa
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20
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Siro SS, Zandberg L, Ngounda J, Wise A, Symington EA, Malan L, Smuts CM, Baumgartner J. Iodine status of pregnant women living in urban Johannesburg, South Africa. MATERNAL AND CHILD NUTRITION 2021; 18:e13236. [PMID: 34196113 PMCID: PMC8710104 DOI: 10.1111/mcn.13236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 05/21/2021] [Accepted: 06/02/2021] [Indexed: 11/28/2022]
Abstract
Adequate intake of iodine is important during pregnancy because of its essential role in foetal growth and neurodevelopment. Data on iodine status of South African pregnant women are scarce, and the salt reduction policy implemented in 2016 may decrease iodine intake of South Africans. This cross-sectional study assessed the iodine status of pregnant women residing in urban Johannesburg, South Africa. A total of 250 pregnant women were enrolled into the 'Nutrition during Pregnancy and Early Development' (NuPED) study and 312 pregnant women into the 'Assessment of dried blood spot thyroglobulin in pregnant women to redefine the range of median urinary iodine concentration that indicates adequate iodine intake, South Africa' (STRIPE-SA) study and were included in this analysis. Urinary iodine concentration (UIC) was analysed in a spot urine sample. Thyroglobulin (Tg) was measured in serum, and thyroid-stimulating hormone (TSH) and total thyroxine (tT4) were measured in dried blood spots. The median [interquartile range (IQR)] UIC of pregnant women was 144 (84-234) μg/L. Women in the first (n = 99), second (n = 262) and third (n = 174) trimester had a median UIC of 133 (81-316), 145 (84-236) and 156 (89-245) μg/L, respectively (p = 0.419). Median TSH, tT4 and Tg were 2.7 (2.3-3.2) mU/L, 202 (163-236) nmol/L and 9.2 (5.4-17.9) μg/L, respectively. Based on the median UIC, pregnant women residing in urban Johannesburg may be borderline iodine deficient. These findings highlight the need for ongoing monitoring of iodine status among vulnerable pregnant women, especially considering the recently introduced salt reduction policy in South Africa.
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Affiliation(s)
- Sicelosethu S Siro
- Centre of Excellence for Nutrition, Faculty of Health Sciences, North-West University (Potchefstroom Campus), Potchefstroom, South Africa
| | - Lizelle Zandberg
- Centre of Excellence for Nutrition, Faculty of Health Sciences, North-West University (Potchefstroom Campus), Potchefstroom, South Africa
| | - Jennifer Ngounda
- Department of Nutrition and Dietetics, University of the Free State (UFS), Bloemfontein, South Africa
| | - Amy Wise
- Department of Obstetrics and Gynaecology, University of the Witwatersrand, Johannesburg, South Africa.,Empilweni Services and Research Unit, University of the Witwatersrand, Johannesburg, South Africa
| | - Elizabeth A Symington
- Department of Life and Consumer Sciences, University of South Africa, Johannesburg, South Africa
| | - Linda Malan
- Centre of Excellence for Nutrition, Faculty of Health Sciences, North-West University (Potchefstroom Campus), Potchefstroom, South Africa
| | - Cornelius M Smuts
- Centre of Excellence for Nutrition, Faculty of Health Sciences, North-West University (Potchefstroom Campus), Potchefstroom, South Africa
| | - Jeannine Baumgartner
- Centre of Excellence for Nutrition, Faculty of Health Sciences, North-West University (Potchefstroom Campus), Potchefstroom, South Africa.,Human Nutrition Laboratory, Department of Health Sciences and Technology, Institute of Food, Nutrition and Health, ETH Zurich, Zurich, Switzerland
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21
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Bone JN, Pickerill K, Woo Kinshella ML, Vidler M, Craik R, Poston L, Stones W, Sevene E, Temmerman M, Koech Etyang A, Roca A, Russell D, Tribe RM, von Dadelszen P, Magee LA. Pregnancy cohorts and biobanking in sub-Saharan Africa: a systematic review. BMJ Glob Health 2021; 5:bmjgh-2020-003716. [PMID: 33243854 PMCID: PMC7692823 DOI: 10.1136/bmjgh-2020-003716] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 09/22/2020] [Accepted: 09/23/2020] [Indexed: 12/17/2022] Open
Abstract
Background Technological advances and high throughput biological assays can facilitate discovery science in biobanks from population cohorts, including pregnant women. Biological pathways associated with health outcomes differ depending on geography, and high-income country data may not generalise to low-resource settings. We conducted a systematic review to identify prospective pregnancy cohorts in sub-Saharan Africa (SSA) that include biobanked samples with potential to enhance discovery science opportunity. Methods Inclusion criteria were prospective data collection during pregnancy, with associated biobanking in SSA. Data sources included: scientific databases (with comprehensive search terms), grey literature, hand searching applicable reference lists and expert input. Results were screened in a three-stage process based on title, abstract and full text by two independent reviewers. The review is registered on PROSPERO (CRD42019147483). Results Fourteen SSA studies met the inclusion criteria from database searches (n=8), reference list searches (n=2) and expert input (n=4). Three studies have ongoing data collection. The most represented countries were South Africa and Mozambique (Southern Africa) (n=3), Benin (Western Africa) (n=4) and Tanzania (Eastern Africa) (n=4); including an estimated 31 763 women. Samples commonly collected were blood, cord blood and placenta. Seven studies collected neonatal samples. Common clinical outcomes included maternal and perinatal mortality, malaria and preterm birth. Conclusions Increasingly numerous pregnancy cohorts in SSA that include biobanking are generating a uniquely valuable resource for collaborative discovery science, and improved understanding of the high regional risks of maternal, fetal and neonatal morbidity and mortality. Future studies should align protocols and consider their added value and distinct contributions.
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Affiliation(s)
- Jeffrey N Bone
- Department of Obstetrics and Gynaecology, The University of British Columbia, Faculty of Medicine, Vancouver, British Columbia, Canada
| | - Kelly Pickerill
- Department of Obstetrics and Gynaecology, The University of British Columbia, Faculty of Medicine, Vancouver, British Columbia, Canada
| | - Mai-Lei Woo Kinshella
- Department of Obstetrics and Gynaecology, The University of British Columbia, Faculty of Medicine, Vancouver, British Columbia, Canada
| | - Marianne Vidler
- Department of Obstetrics and Gynaecology, The University of British Columbia, Faculty of Medicine, Vancouver, British Columbia, Canada
| | - Rachel Craik
- Department of Women and Children's Health, King's College London, School of Life Course Sciences, Faculty of Life Sciences and Medicine, London, UK
| | - Lucilla Poston
- Department of Women and Children's Health, King's College London, School of Life Course Sciences, Faculty of Life Sciences and Medicine, London, UK
| | - William Stones
- Centre for Reproductive Health, University of Malawi College of Medicine, Blantyre, Malawi
| | - Esperanca Sevene
- Centro de Investigação em Saúde de Manhiça, Manhiça, Maputo, Mozambique.,Department of Physiologic Sciences, Faculty of Medicine, Universidade Eduardo Mondlane, Maputo, Mozambique
| | - Marleen Temmerman
- Department of Obstetrics and Gynaecology, Centre of Excellence in Women and Child Health, Aga Khan University, Nairobi, Kenya
| | - Angela Koech Etyang
- Department of Obstetrics and Gynaecology, Centre of Excellence in Women and Child Health, Aga Khan University, Nairobi, Kenya
| | - Anna Roca
- Medical Research Council Unit, The Gambia at the London School of Hygiene and Tropical Medicine, Fajara, The Gambia
| | | | - Rachel M Tribe
- Department of Women and Children's Health, King's College London, School of Life Course Sciences, Faculty of Life Sciences and Medicine, London, UK
| | - Peter von Dadelszen
- Department of Women and Children's Health, King's College London, School of Life Course Sciences, Faculty of Life Sciences and Medicine, London, UK
| | - Laura A Magee
- Department of Women and Children's Health, King's College London, School of Life Course Sciences, Faculty of Life Sciences and Medicine, London, UK
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22
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Ramulondi M, de Wet H, Ntuli NR. Traditional food taboos and practices during pregnancy, postpartum recovery, and infant care of Zulu women in northern KwaZulu-Natal. JOURNAL OF ETHNOBIOLOGY AND ETHNOMEDICINE 2021; 17:15. [PMID: 33743760 PMCID: PMC7981893 DOI: 10.1186/s13002-021-00451-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 03/11/2021] [Indexed: 06/06/2023]
Abstract
BACKGROUND Traditional practices and beliefs influence and support the behavior of women during pregnancy and childbirth in different parts of the world. Not much research has been conducted to examine whether and how cultural traditions continue to shape maternity experiences of Zulu women. The aim of this study is to establish the extent at which women in certain rural communities adhere to traditional food taboos and practices during pregnancy, postpartum recovery, and infants feeding, in comparison to what is recommended by health care workers. METHODS A survey was conducted in the rural northern KwaZulu-Natal between 2017 and 2020. A total of 140 women between the ages of 18 and 90 years were interviewed and they were chosen purposively based on their experiences in pregnancy, postpartum recovery, infant care, and their willingness to share the knowledge. Data were analyzed using descriptive statistics. RESULTS Most (64%) of the participants said that they adhered to these cultural food taboos and practices. The most common foods avoided were certain fruits [mango, naartjie, orange, papaya, and peach], butternut, eggs, sweets (sugar, commercial juice, sweet food, and honey), chili, ice, and alcohol. The most recommended foods during pregnancy were leafy vegetables, fruits (except the avoided ones), liver, and fish. For postpartum recovery, women mostly consumed soft porridge, all fruits and vegetables, beetroot, and tea. Food not allowed for children younger than 2 years included meat, sugar and sweets, and chewable foods. CONCLUSION Differences on food taboos and practices between participants who received formal education and those who did not received it were insignificant. The beliefs about the detrimental effects of some foods were not backed up by scientific research. Restriction of some orange/yellow colored fruits during pregnancy that are rich in vitamin A and/or C may affect daily requirements of these micronutrients, and the foods recommended during pregnancy and postpartum period would not provide all the essential nutrients required for successful pregnancy. However, some of the food taboos would protect women from unhealthy eating. Our findings provide a basis for developing culturally appropriate nutritional mediation programs for Zulu women with a view to provide effective nutritional counseling.
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Affiliation(s)
- Mmbulaheni Ramulondi
- Department of Botany, University of Zululand, Private bag X1001, KwaDlangezwa, Richards Bay, 3886, South Africa.
| | - Helene de Wet
- Department of Botany, University of Zululand, Private bag X1001, KwaDlangezwa, Richards Bay, 3886, South Africa
| | - Nontuthuko Rosemary Ntuli
- Department of Botany, University of Zululand, Private bag X1001, KwaDlangezwa, Richards Bay, 3886, South Africa
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23
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Food insecurity, diet quality and body composition: data from the Healthy Life Trajectories Initiative (HeLTI) pilot survey in urban Soweto, South Africa. Public Health Nutr 2021; 24:1629-1637. [PMID: 33632371 DOI: 10.1017/s136898002100046x] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To determine whether food security, diet diversity and diet quality are associated with anthropometric measurements and body composition among women of reproductive age. The association between food security and anaemia prevalence was also tested. DESIGN Secondary analysis of cross-sectional data from the Healthy Life Trajectories Initiative (HeLTI) study. Food security and dietary data were collected by an interviewer-administered questionnaire. Hb levels were measured using a HemoCue, and anaemia was classified as an altitude-adjusted haemoglobin level < 12·5 g/dl. Body size and composition were assessed using anthropometry and dual-energy x-ray absorptiometry. SETTING The urban township of Soweto, Johannesburg, South Africa. PARTICIPANTS Non-pregnant women aged 18-25 years (n 1534). RESULTS Almost half of the women were overweight or obese (44 %), and 9 % were underweight. Almost a third of women were anaemic (30 %). The prevalence rates of anaemia and food insecurity were similar across BMI categories. Food insecure women had the least diverse diets, and food security was negatively associated with diet quality (food security category v. diet quality score: B = -0·35, 95 % CI -0·70, -0·01, P = 0·049). Significant univariate associations were observed between food security and total lean mass. However, there were no associations between food security and body size or composition variables in multivariate models. CONCLUSIONS Our data indicate that food security is an important determinant of diet quality in this urban-poor, highly transitioned setting. Interventions to improve maternal and child nutrition should recognise both food security and the food environment as critical elements within their developmental phases.
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24
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A Priori and a Posteriori Dietary Patterns among Pregnant Women in Johannesburg, South Africa: The NuPED Study. Nutrients 2021; 13:nu13020565. [PMID: 33572105 PMCID: PMC7914963 DOI: 10.3390/nu13020565] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 01/29/2021] [Accepted: 02/03/2021] [Indexed: 01/22/2023] Open
Abstract
Dietary pattern analyses allow assessment of the diet as a whole. Limited studies include both a priori and a posteriori dietary pattern analyses. This study aimed to explore the diet of pregnant women in urban South Africa through both a priori and a posteriori dietary pattern analyses and associated maternal and household factors. Dietary data were collected during early pregnancy using a quantified food frequency questionnaire from 250 pregnant women enrolled in the Nutrition During Pregnancy and Early Development (NuPED) cohort. A priori dietary patterns were determined using the Diet Quality Index-International (DQI-I), and a posteriori nutrient patterns using exploratory factor analysis. Based on the DQI-I, the study population followed a borderline low-quality diet. Three a posteriori nutrient patterns were identified: Pattern 1 “plant protein, iron, thiamine, and folic acid”; pattern 2 “animal protein, copper, vitamin A, and vitamin B12”; pattern 3 “fatty acids and sodium”. Pattern 1 was associated with higher dietary quality (p < 0.001), lower maternal educational level (p = 0.03) and socioeconomic status (p < 0.001). Pattern 3 was significantly associated with lower dietary quality. The low dietary quality among pregnant women residing in urban South Africa should be addressed to ensure optimal maternal and offspring health outcomes.
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25
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Jugha VT, Anchang-Kimbi JK, Anchang JA, Mbeng KA, Kimbi HK. Dietary Diversity and Its Contribution in the Etiology of Maternal Anemia in Conflict Hit Mount Cameroon Area: A Cross-Sectional Study. Front Nutr 2021; 7:625178. [PMID: 33614694 PMCID: PMC7889504 DOI: 10.3389/fnut.2020.625178] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 12/21/2020] [Indexed: 12/14/2022] Open
Abstract
Background: In the Mount Cameroon area, maternal anemia remains a major public health concern. We hypothesized that nutrient inadequacy may account for the level of anemia in pregnancy. Thus, this study examined the relative effect of dietary diversity on maternal anemia in the study area. Methods: A total of 1,014 consenting pregnant women were enrolled in this cross-sectional study. Information on socio-demographic, antenatal characteristics, malaria and anemia control measures were documented. Dietary diversity (DD) was evaluated using the 24-h recall method and hemoglobin (Hb) levels (g/dl) measured using a portable Hb meter. Malaria parasitaemia was diagnosed by blood microscopy. Anemia status was trimester specific. Logistic regression analysis was used determine predictors of maternal anemia. Results: Among the pregnant women enrolled, the mean DD score was 3.5±0.8 SD and only 10.4% had adequate dietary diversity. Anemia prevalence was 40.9%. Majority of the women consumed starchy staples (99.3%) while least consumed foods were dairy (4.5%), eggs (8.3%), fruits and vegetable (vitamin A-rich) (8.6%). A significant lower prevalence of anemia was associated with intake of dairy (P < 0.001), animal protein (P = 0.006), vitamin A-rich fruits and vegetables (P < 0.001). Furthermore, mean Hb levels were higher (P < 0.001) among women with diverse diets (12.39 ± 1.34) than in those with less diverse diets (10.85 ± 1.33). Predictors of anemia were as follows: study setting [Odd Ratio (OR) = 1.4, 95% CI: 1.07-1.94], occupation (OR = 1.9, 95% CI: 1.16-3.43), number of clinic visits (OR = 1.9, 95% CI: 1.27-2.91), trimester of pregnancy (OR = 3.2, 95% CI: 1.45-7.38), malaria parasitaemia (OR = 1.8, 95% CI: 1.33-2.68), out of home eating (OR = 1.4, 95% CI: 1.03-2.13), and DD (OR = 9.8, 95% CI: 4.56-20.80). The attributable risk of anemia due to dietary diversity was 82.9%. Conclusion: In the study area, DD is a major risk factor for maternal anemia. This finding underscores the importance of content specific nutrition education during clinic visits to improve intake of protein and iron-rich food in anemia prevention.
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Affiliation(s)
- Vanessa Tita Jugha
- Department of Zoology and Animal Physiology, University of Buea, Buea, Cameroon
| | | | | | | | - Helen Kuokuo Kimbi
- Department of Zoology and Animal Physiology, University of Buea, Buea, Cameroon.,Department of Medical Laboratory Sciences, University of Bamenda, Bamenda, Cameroon
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26
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Palliyaguru DL, Rudderow AL, Sossong AM, Lewis KN, Younts C, Pearson KJ, Bernier M, de Cabo R. Perinatal diet influences health and survival in a mouse model of leukemia. GeroScience 2020; 42:1147-1155. [PMID: 32394346 DOI: 10.1007/s11357-020-00199-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Accepted: 04/29/2020] [Indexed: 11/28/2022] Open
Abstract
The goal of the current study was to determine the role of maternal diet in the perinatal period on the health and survival of the offspring. AKR/J mice, a model described to be susceptible to leukemia development, was used where females were maintained on either standard diet (SD), high sucrose diet, Western diet, or calorie restriction (CR) as they were mated with SD-fed males. Body weights, pregnancy rates, litter size, and litter survival were used as markers of successful pregnancy and pup health. Data indicated that maternal diet had significant effects on litter size, early pup survival, and early pup body weights. As pups matured, the makeup of their respective maternal diet was a predictor of adult metabolic health and survival. Overall, these results suggest that perinatal maternal diet is an important determinant of the health and survival of the offspring and that these effects continue well into adulthood, strongly correlating with lifespan.
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Affiliation(s)
- Dushani L Palliyaguru
- Translational Gerontology Branch, National Institute on Aging, NIH, 251 Bayview Blvd, Suite 100, Baltimore, MD, 21224, USA
| | - Annamaria L Rudderow
- Translational Gerontology Branch, National Institute on Aging, NIH, 251 Bayview Blvd, Suite 100, Baltimore, MD, 21224, USA
| | - Alex M Sossong
- Translational Gerontology Branch, National Institute on Aging, NIH, 251 Bayview Blvd, Suite 100, Baltimore, MD, 21224, USA
| | - Kaitlyn N Lewis
- Translational Gerontology Branch, National Institute on Aging, NIH, 251 Bayview Blvd, Suite 100, Baltimore, MD, 21224, USA
| | - Caitlin Younts
- Translational Gerontology Branch, National Institute on Aging, NIH, 251 Bayview Blvd, Suite 100, Baltimore, MD, 21224, USA
| | - Kevin J Pearson
- Department of Pharmacology and Nutritional Sciences, University of Kentucky College of Medicine, Lexington, KY, USA
| | - Michel Bernier
- Translational Gerontology Branch, National Institute on Aging, NIH, 251 Bayview Blvd, Suite 100, Baltimore, MD, 21224, USA
| | - Rafael de Cabo
- Translational Gerontology Branch, National Institute on Aging, NIH, 251 Bayview Blvd, Suite 100, Baltimore, MD, 21224, USA.
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Ługowska K, Kolanowski W. The Nutritional Behaviour of Pregnant Women in Poland. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E4357. [PMID: 31717286 PMCID: PMC6888330 DOI: 10.3390/ijerph16224357] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 11/06/2019] [Accepted: 11/07/2019] [Indexed: 12/14/2022]
Abstract
A woman's diet during pregnancy can significantly affect her health, as well as her child's future development and well-being. Unfortunately, many pregnant women do not follow the recommended nutritional guidelines. The reason could be that they have insufficient knowledge about nutritional best practice. Accordingly, the purpose of this study is to investigate the nutritional behaviour of pregnant women in Poland. The research was conducted using a questionnaire to survey a sample of N = 815 pregnant women in first pregnancy. Among the findings were that the subjects ate an excessive amount of sweets, and white bread, and consumed insufficient quantities of fish, milk and fermented milk drinks. Subjects chose white bread more often than wholemeal bread, and fruit rather than vegetables. The study showed that the nutritional behaviour of pregnant women was characterised by many bad practices.
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Affiliation(s)
| | - Wojciech Kolanowski
- Faculty of Medical and Health Sciences, Siedlce University of Natural Sciences and Humanities, Siedlce PL-08-110, Poland;
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28
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Desyibelew HD, Dadi AF. Burden and determinants of malnutrition among pregnant women in Africa: A systematic review and meta-analysis. PLoS One 2019; 14:e0221712. [PMID: 31490956 PMCID: PMC6730925 DOI: 10.1371/journal.pone.0221712] [Citation(s) in RCA: 58] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Accepted: 08/13/2019] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Malnutrition in pregnancy remains unacceptably high across all regions of Africa though promising progresses have been made globally. Primary studies might not be sufficient to portrait a comprehensive picture of malnutrition during pregnancy and its main risk factors. Therefore, we intended to review the burden of malnutrition, for this specific review implies to protein energy malnutrition, during pregnancy in Africa to present its magnitude and determinant factors. METHODS We did a systematic review of observational studies published from January 1/2008 to January 31/2018. The CINAHL(EBSCO), MEDLINE (via Ovid), Emcare, PubMed databases and Google scholar were searched. Articles quality was assessed using the Newcastle-Ottawa Scale and studies with fair to good quality were included. We pooled malnutrition prevalence and an odds ratio estimates for risk factors after checking for heterogeneity and publication bias. This review has been registered in Prospero with a protocol number CRD42018114949. RESULT 23 studies involving 20,672 pregnant women were included. Using a random effect model, the overall pooled prevalence of malnutrition among pregnant women in Africa was 23.5% (95%CI: 17.72-29.32; I2 = 98.5%). Based on the current review pooled odds ratio finding; rural residency (POR = 2.6%; 95%CI: 1.48-4.65; I2 = 0%), low educational status of partners (POR = 1.7%; 95%CI: 1.19-2.53; I2 = 54.8%), multiple pregnancy (POR = 2.15%; 95%CI: 1.27-3.64; I2 = 0%) and poor nutritional indicators (POR = 2.03%; 95%CI: 1.72-2.4, I2 = 0%) were positively determine maternal malnutrition. On contrary, better household economic status (POR = 0.47%; 95%CI: 0.36-0.62; I2 = 24.2%) negatively determine maternal malnutrition. CONCLUSION A significant number of the pregnant population in Africa are suffering of malnutrition, above 10% of the standard acceptable malnutrition rate. Thus, efforts should be renewed to ensure a proper and widespread implementation of programs that would address issues identified in the current review to reduce the burden of malnutrition.
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Affiliation(s)
- Hanna Demelash Desyibelew
- Department of Public Health Nutrition, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Abel Fekadu Dadi
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- College of Medicine and Public Health, School of Public Health, Flinders University, Bedford Park, Australia
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29
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Symington EA, Baumgartner J, Malan L, Wise AJ, Ricci C, Zandberg L, Smuts CM. Maternal iron-deficiency is associated with premature birth and higher birth weight despite routine antenatal iron supplementation in an urban South African setting: The NuPED prospective study. PLoS One 2019; 14:e0221299. [PMID: 31479449 PMCID: PMC6719862 DOI: 10.1371/journal.pone.0221299] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Accepted: 08/02/2019] [Indexed: 02/06/2023] Open
Abstract
Background Recent studies are suggesting a U-shaped relationship between antenatal iron exposure and birth outcomes. Little is known about the iron status and associated birth outcomes of pregnant women in South Africa. Our aim was to assess iron status at early, mid- and late pregnancy, and to determine associations with gestational age and birth weight in women in Johannesburg, South Africa. Methods In this prospective study of 250 pregnant women, we measured haemoglobin, biomarkers of iron status and inflammation at <18, 22 and 36 weeks of gestation, plus birth weight and gestational age at delivery. Associations of anaemia and iron status with birth outcomes were determined using regression models adjusted for confounders. Results At enrolment, the prevalence of anaemia, iron depletion (ID) and iron deficiency erythropoiesis (IDE) was 29%, 15% and 15%, respectively, and increased significantly with pregnancy progression. Anaemia and ID at 22 weeks, as well as IDE at 36 weeks were associated with higher birth weight (β = 135.4; 95% CI: 4.8, 266.1 and β = 205.4; 95% CI: 45.6, 365.1 and β = 178.0; 95% CI: 47.3, 308.7, respectively). Women in the lowest ferritin quartile at 22 weeks gave birth to babies weighing 312 g (95% CI: 94.8, 528.8) more than those in the highest quartile. In contrast, IDE at 22 weeks was associated with a higher risk for premature birth (OR: 3.57, 95% CI: 1.24, 10.34) and women in lower haemoglobin quartiles at <18 weeks had a shorter gestation by 7 days (β = -6.9, 95% CI: -13.3, -0.6) compared to those in the highest quartile. Conclusion Anaemia, ID and IDE prevalence increased during pregnancy despite routine iron supplementation. ID and anaemia at mid-pregnancy were associated with higher birth weight, while IDE was associated with premature birth. These results suggest that current antenatal screening and supplementation practices in South Africa need to be revisited.
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Affiliation(s)
- Elizabeth A. Symington
- Centre of Excellence for Nutrition, North-West University, Potchefstroom, South Africa
- Department of Life and Consumer Sciences, University of South Africa, Johannesburg, South Africa
- * E-mail:
| | - Jeannine Baumgartner
- Centre of Excellence for Nutrition, North-West University, Potchefstroom, South Africa
- Human Nutrition Laboratory, Institute of Food, Nutrition and Health, ETH Zürich, Switzerland
| | - Linda Malan
- Centre of Excellence for Nutrition, North-West University, Potchefstroom, South Africa
| | - Amy J. Wise
- Department of Obstetrics and Gynaecology, University of the Witwatersrand, Johannesburg, South Africa
- Empilweni Services and Research Unit, University of the Witwatersrand, Johannesburg, South Africa
| | - Cristian Ricci
- Centre of Excellence for Nutrition, North-West University, Potchefstroom, South Africa
| | - Lizelle Zandberg
- Centre of Excellence for Nutrition, North-West University, Potchefstroom, South Africa
| | - Cornelius M. Smuts
- Centre of Excellence for Nutrition, North-West University, Potchefstroom, South Africa
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Dadi AF, Desyibelew HD. Undernutrition and its associated factors among pregnant mothers in Gondar town, Northwest Ethiopia. PLoS One 2019; 14:e0215305. [PMID: 31009475 PMCID: PMC6476509 DOI: 10.1371/journal.pone.0215305] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2018] [Accepted: 03/30/2019] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Regardless of significant gains and signs of progress in the last decades, maternal undernutrition remains a major public health concern in Ethiopia. Supporting the progress of interventions being taken in the country with evidence might be important to keep the sustainability of the government effort. We aimed at determining the extent of undernutrition and its associated factors among pregnant mothers in Gondar town, Northwest Ethiopia. METHOD A community-based cross-sectional study was conducted by including 940 selected pregnant mothers through a cluster sampling. A face-to-face interview was administered to pregnant mothers at a household level. We collected data using an Online Data collection kit (ODK) and the collected data was directly downloaded from the Google Cloud platform and finally imported to Stata 14 for further analysis. A multivariable logistic regression model was fitted to identify factors associated with undernutrition. A crude and adjusted odds ratio with their 95% confidence interval was calculated to declare the association and its significance. Model fitness was assured through the Hosmer and Lemeshow goodness of fit test and model classification accuracy. RESULT 14.4% (95%CI: 12.3-16.7) of pregnant mothers were undernourished. After adjusting for the main covariates; as the age of the pregnant mothers increases the odds of being undernourished decreases by 10% (AOR: 0.90; 95%CI: 0.87-0.95) and having a poor marital condition (AOR: 2.18; 95%CI: 1.03-4.59) increased the odds of undernutrition. The risk of undernutrition was also decreased by 43% among those pregnant mothers who consumed coffee sometimes (AOR: 0.57; 95%CI: 0.36-0.89) as compared to daily consumers. CONCLUSION A significant proportion of pregnant mother were undernourished. Integration of nutritional interventions with maternity health services would be highly important to improve the nutritional status of the mothers. It is also important to counsel pregnant mothers about a consequence of frequent coffee drinking during their pregnancy.
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Affiliation(s)
- Abel Fekadu Dadi
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Hanna Demelash Desyibelew
- Department of Public Health Nutrition, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
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