1
|
Togatorop VE, Rahayuwati L, Susanti RD, Tan JY. Stunting predictors among children aged 0-24 months in Southeast Asia: a scoping review. Rev Bras Enferm 2024; 77:e20220625. [PMID: 38747809 PMCID: PMC11095948 DOI: 10.1590/0034-7167-2022-0625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 11/29/2023] [Indexed: 05/18/2024] Open
Abstract
OBJECTIVE To identify predictors of stunting among children 0-24 months in Southeast Asia. METHODS This scoping review focused on articles with observational study design in English published from 2012 to 2023 from five international databases. The primary keyword used were: "stunting" OR "growth disorder" AND "newborn" AND "predict" AND "Southeast Asia". RESULTS Of the 27 articles selected for the final analysis there are thirteen predictors of stunting in seven Southeast Asia countries. The thirteen predictors include the child, mother, home, inadequate complementary feeding, inadequate breastfeeding, inadequate care, poor quality foods, food and water safety, infection, political economy, health and healthcare, water, sanitation, and environment, and social culture factor. CONCLUSION All these predictors can lead to stunting in Southeast Asia. To prevent it, health service providers and other related sectors need to carry out health promotion and health prevention according to the predictors found.
Collapse
|
2
|
Pai SR, Padmanabha R, Kamalakar S, Aravind JV, Puttaswamy D, Pn Rao S, Jois SK, Kamath A, Kuriyan R. Comparison of growth patterns in the first year of life between term small for gestational age and appropriate for gestational age South Indian infants. BMJ Paediatr Open 2024; 8:e002477. [PMID: 38719565 PMCID: PMC11086450 DOI: 10.1136/bmjpo-2023-002477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 04/08/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Early life growth trajectories of Indian small for gestational age (SGA) infants are sparse. This study aimed to compare longitudinal growth in appropriate for gestational age (AGA) and SGA infants during their first year of life. METHODS Apparently healthy term infants (52 SGA, 154 AGA) were recruited at birth and followed up till 1 year. Parental, sociodemographic characteristics and feeding patterns were recorded. Anthropometric measurements were assessed at birth, 3, 6, 9 and 12 months of age; Z scores and growth velocity at 3-month intervals were computed. Longitudinal measurements were compared between the two groups, using the two-way Friedmans test. Median regression with mixed effects was used to adjust covariates; p value <0.05 was considered statistically significant. RESULT AGA infants had significantly higher median weight (kg) (2.87 (2.67, 3.04) vs 2.39 (2.25, 2.54)) at birth, (7.08 (6.50, 7.54) vs 6.49 (6.13, 6.78)) at 6 months, (8.64 (7.92, 9.14) vs 7.90 (7.36, 8.54)) at 12 months, median length (cm) ((48.10 (47.20, 49.30) vs 46.75 (45.43, 47.50)) at birth, (65.50 (64.23, 66.98) vs 63.33 (62.26, 65.28)) at 6 months, (73.30 (71.58, 74.66) vs 71.55 (70.00, 73.30)) at 12 months. SGA infants had comparable weight velocity at all intervals except 9-12 months (6.62 (6.45, 6.79) vs (6.70 (6.51, 6.85)), being significantly higher than AGA infants. Differences in skinfold thicknesses between groups were observed only at birth. Exclusivity of breast feeding was significantly higher at 3 months in AGA, compared to SGA infants (80.9% vs 57.8%). Length velocity was comparable at all ages between groups. Sexual dimorphism was observed in the growth velocities of both groups. CONCLUSION SGA infants grew in parallel to AGA infants, having significantly lower anthropometric measurements at all time points. However, growth velocities were similar; SGA infants had significantly higher weight velocity from 9 to 12 months. Longitudinal studies beyond 1 year of age, using body composition are needed to determine the quality of growth in Indian infants.
Collapse
Affiliation(s)
- Shruti R Pai
- Division of Nutrition, St John's Research Institute, (Centre for Doctoral Studies, Manipal Academy of Higher Education (MAHE) and Recognised Research Centre of Mysore University), St. John's National Academy of Health Sciences, Bengaluru, Karnataka, India
| | - Ramya Padmanabha
- Division of Nutrition, St John's Research Institute, (Centre for Doctoral Studies, Manipal Academy of Higher Education (MAHE) and Recognised Research Centre of Mysore University), St. John's National Academy of Health Sciences, Bengaluru, Karnataka, India
| | - Sanjana Kamalakar
- Division of Nutrition, St John's Research Institute, St. John's National Academy of Health Sciences, Bengaluru, Karnataka, India
| | - Jini V Aravind
- Division of Nutrition, St John's Research Institute, St. John's National Academy of Health Sciences, Bengaluru, Karnataka, India
| | - Deepa Puttaswamy
- Division of Nutrition, St John's Research Institute, St. John's National Academy of Health Sciences, Bengaluru, Karnataka, India
| | - Suman Pn Rao
- Department of Neonatology, St John's Medical College Hospital, Bengaluru, Karnataka, India
| | - Srinivas K Jois
- Department of Obstetrics and Gynaecology, Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India
| | - Asha Kamath
- Department of Data Science, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Rebecca Kuriyan
- Division of Nutrition, St John's Research Institute, St. John's National Academy of Health Sciences, Bengaluru, Karnataka, India
| |
Collapse
|
3
|
M N N, J K, S R S, Raavi V. Methylation Status of IGF-Axis Genes in the Placenta of South Indian Neonates with Appropriate and Small for Gestational Age. Fetal Pediatr Pathol 2024; 43:5-20. [PMID: 37975569 DOI: 10.1080/15513815.2023.2280660] [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: 08/05/2023] [Accepted: 11/01/2023] [Indexed: 11/19/2023]
Abstract
OBJECTIVE Altered methylation patterns of insulin-like growth factor (IGF)-axis genes in small for gestational age (SGA) have been reported in different populations. In the present study, we analyzed the methylation status of IGF-axis genes in the placenta of appropriate for gestational age (AGA) and SGA neonates of South Indian women. METHODS Placental samples were collected from AGA (n = 40) and SAG (n = 40) neonates. The methylation of IGF-axis genes promoter was analyzed using MS-PCR. RESULTS IGF2, H19, IGF1, and IGFR1 genes promoter methylation was 2.5, 1.5, 5, and 7.5% lower in SGA compared to AGA, respectively. Co-methylation of IGF-axis genes promoter was 40% and 20% in AGA and SGA, respectively. IGF-axis gene promoter methylation significantly (p < 0.05) influenced the levels of IGFBP3 protein, birth weight, mitotic index, gestational weeks, and IGFR1 and IGFR2 gene expression. CONCLUSION IGF-axis genes methylation was lower in SGA than in AGA, and the methylation significantly influenced the IGF-axis components.
Collapse
Affiliation(s)
- Nithya M N
- Department of Cell Biology and Molecular Genetics, Sri Devaraj Urs Academy of Higher Education and Research (Deemed to be University), Kolar, Karnataka, India
| | - Krishnappa J
- Department of Paediatrics, Sri Devaraj Urs Medical College, Sri Devaraj Urs Academy of Higher Education and Research (Deemed to be University), Kolar, Karnataka, India
| | - Sheela S R
- Department of Obstetrics and Gynaecology, Sri Devaraj Urs Medical College, Sri Devaraj Urs Academy of Higher Education and Research (Deemed to be University), Kolar, Karnataka, India
| | - Venkateswarlu Raavi
- Department of Cell Biology and Molecular Genetics, Sri Devaraj Urs Academy of Higher Education and Research (Deemed to be University), Kolar, Karnataka, India
| |
Collapse
|
4
|
Li H, Wang Y, Zhang Q, Huang X, Tang Z, Liu Z. The association of maternal serum uric acid with the risk of small for gestational age newborn: a retrospective cohort study. J Matern Fetal Neonatal Med 2023; 36:2286738. [PMID: 38083844 DOI: 10.1080/14767058.2023.2286738] [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: 06/13/2023] [Accepted: 11/16/2023] [Indexed: 12/18/2023]
Abstract
PROBLEM Prior results on the association between serum uric acid (UA) levels in the early trimester and the risk of small for gestational age (SGA) remain unclear. This study evaluated the association of maternal first-, second-, and third-trimester UA levels with the risk of SGA infants. METHOD OF STUDY A total of 23, 194 singleton mothers from the International Peace Maternity and Child Health Hospital between January 2014 and January 2017 were included. Maternal UA levels were measured at 12.1 ± 1.08th (UA1) and 32.2 ± 1.03th (UA2) gestational weeks. △UA was calculated as the difference between UA2 and UA1. Logistic regression and restricted cubic spline (RCS) were performed to evaluate the association between maternal UA and △UA during pregnancy and SGA. Receiver operating characteristic (ROC) analysis was employed to assess the serum uric acid prediction value. RESULTS Women in the higher quartiles of UA1 had a significantly higher risk of SGA. A clear increased risk for SGA was observed with higher quartiles for UA2 (p for trend <0.05). An approximately "J-shaped" relationship was observed between UA2 and △UA, and the risk of SGA was observed. When compared with those with a lower level of UA in the first trimester, those with a higher level of UA1, the more increase in the later UA levels were associated with a higher risk of SGA [adjusted odds ratio (aOR) = 1.67, 95% CI:1.37-2.05]. The ROC curve areas were 0.525 for UA1, 0.582 for UA2 and 0.576 for △UA. CONCLUSIONS The findings suggested that non-preeclamptic and non-hypertensive women who experienced early pregnancy with high UA levels had an elevated risk of SGA. Moreover, a high maternal UA level in the earlier trimester may be an early predictor of SGA.
Collapse
Affiliation(s)
- Haiyuan Li
- Department of Neonatology, The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Key Laboratory of Embryo Original Disease, Shanghai, China
- Shanghai Municipal Key Clinical Specialty, Shanghai, China
| | - Yi Wang
- Department of Neonatology, The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Key Laboratory of Embryo Original Disease, Shanghai, China
- Shanghai Municipal Key Clinical Specialty, Shanghai, China
| | - Qianqian Zhang
- Department of Neonatology, The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Key Laboratory of Embryo Original Disease, Shanghai, China
- Shanghai Municipal Key Clinical Specialty, Shanghai, China
| | - Xiaoyi Huang
- Department of Neonatology, The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Key Laboratory of Embryo Original Disease, Shanghai, China
- Shanghai Municipal Key Clinical Specialty, Shanghai, China
| | - Zheng Tang
- Department of Neonatology, The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Key Laboratory of Embryo Original Disease, Shanghai, China
- Shanghai Municipal Key Clinical Specialty, Shanghai, China
| | - Zhiwei Liu
- Department of Neonatology, The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Key Laboratory of Embryo Original Disease, Shanghai, China
- Shanghai Municipal Key Clinical Specialty, Shanghai, China
| |
Collapse
|
5
|
Elif Öztürk M, Yabancı Ayhan N. Evaluation of malnutrition and screening tools in hospitalized children. Clin Nutr ESPEN 2023; 57:770-778. [PMID: 37739737 DOI: 10.1016/j.clnesp.2023.08.031] [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: 04/18/2023] [Revised: 07/29/2023] [Accepted: 08/25/2023] [Indexed: 09/24/2023]
Abstract
BACKGROUND & AIMS Detecting malnutrition and its related risk factors are crucial, in hospitalized children. Anthropometric z scores are used to assess malnutrition. Screening tools also aim to detect the presence of malnutrition and the developing risk of malnutrition in hospitalized children to determine who may benefit from nutritional support. Therefore, the aims of the study are to detect malnutrition and its related demographic and clinical risk factors in hospitalized children and determining the sensitivity of Screening Tool for the Assessment of Malnutrition in Pediatrics (STAMP) and Pediatric Yorkhill Malnutrition Score (PYMS) screening tools. METHODS A total of 130 hospitalized children aged between 0 and 18 years were included in to study. A survey including demographic and clinical characteristics, STAMP and PYMS were applied to parents of the children. Patients were classified into nutritional risk groups through screening tools. Anthropometric measurements (body weight, length/height, and middle upper arm circumference (MUAC) of the children were taken. Body mass index-for-age and height-for-age z scores were calculated to assess acute and chronic malnutrition prevalence. MUAC-for-age z scores were calculated as well. To detect independent risk factors for acute and chronic malnutrition multivariable logistic regression models were constructed. RESULTS A total of 14.6% of hospitalized children had acute malnutrition, 21.5% of children had chronic malnutrition and 27.7% of them had low MUAC standard deviation score (SDS) (less than -2). The independent risk factors for acute malnutrition were younger maternal age at birth and long length of stay (p < 0.05). The independent risk factors for chronic malnutrition were being female, younger maternal age at birth, longer illness duration and having urological or allergy and immunological diseases (p < 0.05). However, MUAC for age SDS groups were not related to any demographic and clinical factors, in children of all ages (p > 0.05). Regarding the screening tools, PYMS displayed 100% sensitivity against acute malnutrition. While PYMS displayed better sensitivity to identify acute malnutrition than STAMP, STAMP was more sensitive than PYMS to detect chronic malnutrition and low MUAC SDS. CONCLUSIONS Low MUAC for age SDS was not related to any demographic and clinical factors, in hospitalized children of all ages, unlike acute and chronic malnutrition, in this study. Pediatric screening tools mainly PYMS did not have high sensitivity to detect chronic malnutrition and low MUAC SDS, in hospitalized children. Therefore, the tools have to be used along with z scores of anthropometric parameters.
Collapse
Affiliation(s)
- Meryem Elif Öztürk
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Karamanoğlu Mehmetbey University, Karaman, Turkey.
| | - Nurcan Yabancı Ayhan
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Ankara University, Ankara, Turkey.
| |
Collapse
|
6
|
Kumala Putri DS, Widodo Y, Gunardi H, Kusharisupeni, Besral, Djahari AB, Syafiq A, Achadi EL, Bhutta ZA. When did the substantial loss of child linear growth occur? PLoS One 2023; 18:e0291176. [PMID: 37708204 PMCID: PMC10501671 DOI: 10.1371/journal.pone.0291176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 08/23/2023] [Indexed: 09/16/2023] Open
Abstract
BACKGROUND Epidemiological studies show that the height-for-age Z-scores (HAZ) falter dramatically shortly after birth until the end of the first two years. Understanding these changes in linear growth in the first two years can help us understand the critical period of child linear growth and propose interventions. OBJECTIVES This study objectives were to describe the pattern of linear growth faltering and analyze the changes in length-for-age Z-scores (LAZs) throughout the first two years based on birthweight and length status. METHODS This study analyzed 408 children, participants in Longitudinal Study on Child Growth and Development in Bogor, Indonesia. The linear growth pattern was described based on birthweight and length status. Birthweight and length status was categorized into normal and Small for Gestational Age (SGA). Changes in LAZs (Δ LAZs) in 0-6 months, 6-12 months, and 12-23 months were calculated. General Linear Model Univariate analysis was conducted to analyze the difference of Δ LAZ between SGA and normal children. RESULTS Though full-term SGA children have significantly higher linear growth velocity during the first 6 months of the infancy period, full-term SGA children could not catch up with the attained growth/height of normal children throughout the first two years. Thus, full-term SGA children ended up with a higher prevalence of stunted. Both in SGA and normal children, the substantial loss of LAZ occurred between 0-6 months. CONCLUSION The finding in this study showed that the first 1000 days of life is still the best period in stunting prevention; however, the stunting prevention program should start earlier, focusing on the first 500 days of life, and potentially the prenatal period.
Collapse
Affiliation(s)
- Dwi Sisca Kumala Putri
- National Research and Innovation Agency, Health Research Organization, Jakarta, Indonesia
| | - Yekti Widodo
- National Research and Innovation Agency, Health Research Organization, Jakarta, Indonesia
| | - Hartono Gunardi
- Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Kusharisupeni
- Faculty of Public Health, Universitas Indonesia, Depok, Indonesia
| | - Besral
- Faculty of Public Health, Universitas Indonesia, Depok, Indonesia
| | | | - Ahmad Syafiq
- Faculty of Public Health, Universitas Indonesia, Depok, Indonesia
| | - Endang L. Achadi
- Faculty of Public Health, Universitas Indonesia, Depok, Indonesia
| | - Zulfiqar A. Bhutta
- Centre for Global Child Health, Hospital for Sick Children, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Center of Excellence in Women and Child Health, the Aga Khan University, Karachi, Pakistan
| |
Collapse
|
7
|
Thahir AIA, Li M, Holmes A, Gordon A. Exploring Factors Associated with Stunting in 6-Month-Old Children: A Population-Based Cohort Study in Sulawesi, Indonesia. Nutrients 2023; 15:3420. [PMID: 37571357 PMCID: PMC10421344 DOI: 10.3390/nu15153420] [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: 06/26/2023] [Revised: 07/30/2023] [Accepted: 07/31/2023] [Indexed: 08/13/2023] Open
Abstract
Stunting in children under the age of two is a significant global concern, particularly in low- and middle-income countries like Indonesia. Intervention efforts often come too late as many of the underlying causal factors have already occurred earlier. While antenatal multiple micronutrient supplements (MMS) have demonstrated positive effects on pregnancy outcomes, their impact on infant growth in the first six months remains inadequately explored in epidemiological studies. This study aims to identify factors associated with stunting at six months in infants whose mothers received MMS. A population-based cohort study was conducted in four subdistricts of Banggai, Indonesia. Pregnant women were recruited in their third trimester and followed up until their children were six months of age. Validated questionnaires were employed to gather data on social determinants of health and diet, and standardised methods were utilised for anthropometric measurements. Stunting was determined based on the WHO child growth standards. The analysis comprised data from 152 mother-child pairs. The prevalence of stunting during early infancy (first two months) was 18.4%, which decreased to 15.8% in later infancy (at six months). Factors such as small-for-gestational-age (AOR = 11.29; 2.73-46.66), preterm birth (AOR = 6.33; 1.25-31.97), short birth length (AOR = 4.31; 1.11-16.78), maternal mid-upper arm circumference (MUAC) below 23.5 cm, and female infants (AOR = 3.27; 95%CI: 1.04-10.27) were associated with stunting at six months. This study highlights that stunting in the first six months is present at birth, with small-for-gestational-age (SGA) as a strong predictor. In addition, there was a trend to improved growth (-0.30 [-0.79 to 0.18]) in infants born to mothers who received MMS supplementation pre-pregnancy rather than during pregnancy, although it was not statistically significant.
Collapse
Affiliation(s)
- Andi Imam Arundhana Thahir
- Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney 2006, Australia;
- Department of Nutrition, Faculty of Public Health, Hasanuddin University, Makassar 90245, Indonesia
| | - Mu Li
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney 2006, Australia;
| | - Andrew Holmes
- School of Life and Environmental Science, Faculty of Science, The University of Sydney, Sydney 2006, Australia;
- Charles Perkins Centre, Faculty of Medicine and Health, The University of Sydney, Sydney 2006, Australia
| | - Adrienne Gordon
- Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney 2006, Australia;
- Charles Perkins Centre, Faculty of Medicine and Health, The University of Sydney, Sydney 2006, Australia
- The Royal Prince Alfred Hospital (RPA), Newborn Care, Sydney Local Health District, Sydney 2050, Australia
| |
Collapse
|
8
|
Mistry JN, Silvennoinen S, Zaman F, Sävendahl L, Mariniello K, Hall C, Howard SR, Dunkel L, Sankilampi U, Guasti L. The crosstalk between FGF21 and GH leads to weakened GH receptor signaling and IGF1 expression and is associated with growth failure in very preterm infants. Front Endocrinol (Lausanne) 2023; 14:1105602. [PMID: 37251684 PMCID: PMC10213667 DOI: 10.3389/fendo.2023.1105602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 03/28/2023] [Indexed: 05/31/2023] Open
Abstract
Background Fibroblast growth factor 21 (FGF21) is an essential metabolic regulator that adapts to changes in nutritional status. Severe childhood undernutrition induces elevated FGF21 levels, contributing to growth hormone (GH) resistance and subsequent linear growth attenuation potentially through a direct action on chondrocytes. Methods In this study, we assessed expression of the components of both GH and FGF21 pathways in rare and unique human growth plates obtained from children. Moreover, we investigated the mechanistic interplay of FGF21 on GH receptor (GHR) signaling in a heterologous system. Results Chronic FGF21 exposure increased GH-induced GHR turnover and SOCS2 expression, leading to the inhibition of STAT5 phosphorylation and IGF-1 expression. The clinical significance of FGF21 signaling through GH receptors was tested in nutritionally driven growth failure seen in very preterm (VPT) infants right after birth. VPT infants display an immediate linear growth failure after birth followed by growth catch-up. Consistent with the in vitro model data, we show that circulating FGF21 levels were elevated during deflection in linear growth compared to catch-up growth and were inversely correlated with the length velocity and circulating IGF1 levels. Conclusions This study further supports a central role of FGF21 in GH resistance and linear growth failure and suggests a direct action on the growth plate.
Collapse
Affiliation(s)
- Jayna N. Mistry
- Centre for Endocrinology, William Harvey Research Institute, Barts and the London Faculty of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Sanna Silvennoinen
- Department of Pediatrics, Kuopio University Hospital and University of Eastern Finland, Kuopio, Finland
| | - Farasat Zaman
- Department of Women’s and Children’s Health, Karolinska Institutet and Karolinska University, Solna, Sweden
| | - Lars Sävendahl
- Department of Women’s and Children’s Health, Karolinska Institutet and Karolinska University, Solna, Sweden
| | - Katia Mariniello
- Centre for Endocrinology, William Harvey Research Institute, Barts and the London Faculty of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Charlotte Hall
- Centre for Endocrinology, William Harvey Research Institute, Barts and the London Faculty of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Sasha R. Howard
- Centre for Endocrinology, William Harvey Research Institute, Barts and the London Faculty of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Leo Dunkel
- Centre for Endocrinology, William Harvey Research Institute, Barts and the London Faculty of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Ulla Sankilampi
- Department of Pediatrics, Kuopio University Hospital and University of Eastern Finland, Kuopio, Finland
| | - Leonardo Guasti
- Centre for Endocrinology, William Harvey Research Institute, Barts and the London Faculty of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| |
Collapse
|
9
|
M N N, J K, S R S, Raavi V. The Role of Insulin-like Growth Factor-Axis and Mitotic Index in South Indian Neonates with Small for Gestational Age. Fetal Pediatr Pathol 2023; 42:216-226. [PMID: 35712880 DOI: 10.1080/15513815.2022.2086950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVE IGF-axis and mitotic capacity of cells play a vital role in fetal growth. We compared IGF1, IGF2, and IGFBP3 protein levels, mitotic indices, IGFR1 and IGFR2 mRNA expression in appropriate for gestational age (AGA) and small for gestational age (SGA) neonates of Indian women. METHODS Cord blood (n = 80) and placental samples (n = 40) were collected from AGA and SGA neonates. Plasma IGF1, IGF2, and IGFBP3 proteins were measured by ELISA. IGFR1 and IGFR2 mRNA expression in the placenta were analyzed by qRT-PCR. Cord blood was cultured in vitro and mitotic index was obtained. RESULTS IGF1 (p = 1), and IGF2 (p = 0.69) protein levels did not differ, whereas IGFBP3 (p = 0.02) was significantly less in SGA compared to AGA neonates. Down-regulation of IGFR1 (3.9-folds) and IGFR2 (2.8-folds) mRNA and reduced mitotic index of lymphocytes was observed in SGA (p = 0.001) compared to AGA neonates. CONCLUSION Our results showed that, SGA neonates displayed down-regulated IGFR1 and IGFR2 mRNA, decreased IGFBP3 protein and mitotic index.
Collapse
Affiliation(s)
- Nithya M N
- Department of Cell Biology and Molecular Genetics, Sri Devaraj Urs Academy of Higher Education and Research (Deemed to be University), Kolar 563 103, Karnataka, India
| | - Krishnappa J
- Department of Paediatrics, Sri Devaraj Urs Medical College, Sri Devaraj Urs Academy of Higher Education and Research (Deemed to be University), Kolar 563 103, Karnataka, India
| | - Sheela S R
- Department of Obstetrics and Gynaecology, Sri Devaraj Urs Medical College, Sri Devaraj Urs Academy of Higher Education and Research (Deemed to be University), Kolar 563 103, Karnataka, India
| | - Venkateswarlu Raavi
- Department of Cell Biology and Molecular Genetics, Sri Devaraj Urs Academy of Higher Education and Research (Deemed to be University), Kolar 563 103, Karnataka, India
| |
Collapse
|
10
|
Chen Y, Liu M, Zhang Y, Chen Z, Mei H, Liu Y, Wu H, Zhou A. Gestational weight gain and neonatal outcomes in different zygosity twins: a cohort study in Wuhan, China. BMJ Open 2023; 13:e056581. [PMID: 36627159 PMCID: PMC9835877 DOI: 10.1136/bmjopen-2021-056581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
OBJECTIVE To evaluate whether twin zygosity influences the association between neonatal outcomes and gestational weight gain (GWG) based on the Chinese guidelines in twin-pregnancy women. DESIGN A retrospective cohort study. And it is not a clinical trial. SETTING Women with twin pregnancies living in Wuhan, China. PARTICIPANTS A total of 5140 women who delivered live and non-malformed twins from 1 January 2011 to 31 August 2017 were included in this study. MAIN OUTCOME MEASURE The primary neonatal outcomes included paired small for gestational age (SGA, <10 th percentile birth weight for gestational age and sex), low birth weight (LBW, <2500 g) and gestational age (<33 weeks and <37 weeks). The association between GWG and neonatal outcomes was examined by Logistic regression analyses. RESULTS A total of 5140 women were included, of whom 22.24%, 54.78% and 22.98% were below, within and above the Chinese guidelines, respectively. Among the including 10 280 infants, 26.28% of them were monozygotic (MZ) twins and 73.72% of them were dizygotic (DZ) twins. Women with low GWG had a significantly higher proportion of LBW/LBW and LBW/NBW infants, a greater likelihood of SGA/SGA and SGA/appropriate for gestational age (AGA) infants and a higher incidence of preterm birth. The associations persisted both in MZ and DZ twins, and twin zygosity influenced the degree of association between GWG and SGA, LBW and preterm birth. High GWG was associated with significant risk reductions in SGA/AGA pairs, LBW/LBW or LBW/NBW pairs, and less than 33 gestational weeks. However, high GWG was only associated with reduced risk of LBW/LBW pairs both in MZ and DZ twins. CONCLUSIONS GWG below the Chinese recommendations increased the risk of SGA, LBW and preterm birth in both MZ and DZ twins. The effect was more pronounced in MZ twins than that in DZ twin pairs. A high GWG only reduced the risk of LBW/LBW pairs both in MZ and DZ twins.
Collapse
Affiliation(s)
- Yawen Chen
- Health Care Department, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Mingzhu Liu
- Health Care Department, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yiming Zhang
- Information Department, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhong Chen
- Health Care Department, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hong Mei
- Institute of Maternal and Child Health, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yan Liu
- Health Care Department, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hongling Wu
- Health Care Department, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - AiFen Zhou
- Health Care Department, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| |
Collapse
|
11
|
Nyofane M, Hoffman M, Mulol H, Botha T, Vannevel V, Pattinson R, Feucht U. Early Childhood Growth Parameters in South African Children with Exposure to Maternal HIV Infection and Placental Insufficiency. Viruses 2022; 14:v14122745. [PMID: 36560749 PMCID: PMC9782627 DOI: 10.3390/v14122745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 11/24/2022] [Accepted: 12/07/2022] [Indexed: 12/13/2022] Open
Abstract
Maternal HIV exposure and intrauterine growth restriction (IUGR) due to placental insufficiency both carry major risks to early child growth. We compared the growth outcomes of children aged 18 months who had abnormal umbilical artery resistance indices (UmA-RI), as a marker of placental insufficiency, with a comparator group of children with normal UmA-RI during pregnancy, as mediated by maternal HIV infection. The cross-sectional study included 271 children, grouped into four subgroups based on HIV exposure and history of normal/abnormal UmA-RI, using available pregnancy and birth information. Standard procedures were followed to collect anthropometric data, and z-scores computed as per World Health Organization growth standards. Lower length-for-age z-scores (LAZ) were observed in children who were HIV-exposed-uninfected (CHEU) (-0.71 ± 1.23; p = 0.004) and who had abnormal UmA-RI findings (-0.68 ± 1.53; p < 0.001). CHEU with abnormal UmA-RI had lower LAZ (-1.3 ± 1.3; p < 0.001) and weight-for-age z-scores (WAZ) (-0.64 ± 0.92; p = 0.014) compared to the control group. The prevalence of stunting was 40.0% in CHEU with abnormal UmA-RI and 16.0% in CHEU with normal UmA-RI (p < 0.001; p = 0.016, respectively). In conclusion, maternal HIV exposure and placental insufficiency are independent risk factors for childhood stunting, with this risk potentiated when these two risk factors overlap.
Collapse
Affiliation(s)
- Mothusi Nyofane
- Department of Consumer and Food Sciences, University of Pretoria, Pretoria 0002, South Africa
- Department of Nutrition, National University of Lesotho, Maseru 100, Lesotho
- Centre for Maternal, Fetal, Newborn and Child Health Care Strategies, University of Pretoria, Kalafong Provincial Tertiary Hospital, Pretoria 0001, South Africa
- Research Unit for Maternal and Infant Health Care Strategies, South African Medical Research Council, Pretoria 0001, South Africa
- Correspondence: ; Tel.: +266-5775-1718
| | - Marinel Hoffman
- Department of Consumer and Food Sciences, University of Pretoria, Pretoria 0002, South Africa
- Centre for Maternal, Fetal, Newborn and Child Health Care Strategies, University of Pretoria, Kalafong Provincial Tertiary Hospital, Pretoria 0001, South Africa
- Research Unit for Maternal and Infant Health Care Strategies, South African Medical Research Council, Pretoria 0001, South Africa
| | - Helen Mulol
- Centre for Maternal, Fetal, Newborn and Child Health Care Strategies, University of Pretoria, Kalafong Provincial Tertiary Hospital, Pretoria 0001, South Africa
- Research Unit for Maternal and Infant Health Care Strategies, South African Medical Research Council, Pretoria 0001, South Africa
- Department of Paediatrics, University of Pretoria, Pretoria 0002, South Africa
| | - Tanita Botha
- Department of Statistics, University of Pretoria, Pretoria 0002, South Africa
| | - Valerie Vannevel
- Centre for Maternal, Fetal, Newborn and Child Health Care Strategies, University of Pretoria, Kalafong Provincial Tertiary Hospital, Pretoria 0001, South Africa
- Research Unit for Maternal and Infant Health Care Strategies, South African Medical Research Council, Pretoria 0001, South Africa
- Department of Obstetrics and Gynaecology, University of Pretoria, Pretoria 0002, South Africa
| | - Robert Pattinson
- Centre for Maternal, Fetal, Newborn and Child Health Care Strategies, University of Pretoria, Kalafong Provincial Tertiary Hospital, Pretoria 0001, South Africa
- Research Unit for Maternal and Infant Health Care Strategies, South African Medical Research Council, Pretoria 0001, South Africa
- Department of Obstetrics and Gynaecology, University of Pretoria, Pretoria 0002, South Africa
| | - Ute Feucht
- Centre for Maternal, Fetal, Newborn and Child Health Care Strategies, University of Pretoria, Kalafong Provincial Tertiary Hospital, Pretoria 0001, South Africa
- Research Unit for Maternal and Infant Health Care Strategies, South African Medical Research Council, Pretoria 0001, South Africa
- Department of Paediatrics, University of Pretoria, Pretoria 0002, South Africa
| |
Collapse
|
12
|
Albahri AS, Hamid RA, Zaidan AA, Albahri OS. Early automated prediction model for the diagnosis and detection of children with autism spectrum disorders based on effective sociodemographic and family characteristic features. Neural Comput Appl 2022. [DOI: 10.1007/s00521-022-07822-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
|
13
|
Cord blood adiponectin and leptin are associated with a lower risk of stunting during infancy. Sci Rep 2022; 12:15122. [PMID: 36068284 PMCID: PMC9448758 DOI: 10.1038/s41598-022-19463-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 08/30/2022] [Indexed: 11/08/2022] Open
Abstract
Undernutrition is responsible for up to 45% of deaths in children under five, with low- and middle-income countries disproportionately affected. Adipokines are known modulators of metabolism and have been linked to growth rates and neurocognition during infancy. We examined the relationship(s) between cord blood adiponectin and leptin and both longitudinal growth and cognition during the first year of life using generalized estimating equations. Infants were classified as underweight (weight-for-age z-score [WAZ]), stunted (height-for-age z-score [HAZ]) or wasted (weight-for-height z-score [WHZ]) using WHOAnthro software. Cord blood adiponectin and leptin levels were highly correlated (r = 0.35, P < 0.0001) and positively associated with birth WAZ (r = 0.34 and r = 0.45, P < 0.0001, respectively). Adipokines were independently, inversely associated with weight gain. Infants in the highest quintile of adipokine production had a lower risk of being stunted, while neither was associated with lower WAZ or WHZ in final adjusted models. Cognition was not found to be independently related to cord blood leptin or adiponectin. The negative association with adipokines and rate of weight gain during infancy may reflect heightened nutritional status at birth rather than a direct hormonal influence. The relationship between leptin or adiponectin and longitudinal length gains suggests that both adipokines may promote linear growth during infancy.
Collapse
|
14
|
Hazel EA, Mohan D, Zeger S, Mullany LC, Tielsch JM, Khatry SK, Subedi S, LeClerq SC, Black RE, Katz J. Demographic, socio-economic, obstetric, and behavioral factors associated with small-and large-for-gestational-age from a prospective, population-based pregnancy cohort in rural Nepal: a secondary data analysis. BMC Pregnancy Childbirth 2022; 22:652. [PMID: 35986258 PMCID: PMC9389767 DOI: 10.1186/s12884-022-04974-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 08/09/2022] [Indexed: 03/01/2023] Open
Abstract
BACKGROUND In South Asia, a third of babies are born small-for-gestational age (SGA). The risk factors are well described in the literature, but many studies are in high-and-middle income countries or measure SGA on facility births only. There are fewer studies that describe the prevalence of risk factors for large-for-gestational age (LGA) in low-income countries. We aim to describe the factors associated with SGA and LGA in a population-based cohort of pregnant women in rural Nepal. METHODS This is a secondary data analysis of community-based trial on neonatal oil massage (22,545 women contributing 39,479 pregnancies). Demographic, socio-economic status (SES), medical/obstetric history, and timing of last menstruation were collected at enrollment. Vital signs, illness symptoms, and antenatal care (ANC) attendance were collected throughout the pregnancy and neonatal weight was measured for live births. We conducted multivariate analysis using multinomial, multilevel logistic regression, reporting the odds ratio (OR) with 95% confidence intervals (CIs). Outcomes were SGA, LGA compared to appropriate-for-gestational age (AGA) and were multiply imputed using birthweight recalibrated to time at delivery. RESULTS SGA was associated with nulligravida (OR: 2.12 95% CI: 1.93-2.34), gravida/nulliparous (OR: 1.86, 95% CI: 1.26-2.74), interpregnancy intervals less than 18 months (OR: 1.16, 95% CI: 1.07-1.27), and poor appetite/vomiting in the second trimester, (OR: 1.27, 95% CI: 1.19-1.35). Greater wealth (OR: 0.78, 95% CI: 0.69-0.88), swelling of hands/face in the third trimester (OR: 0.81, 95% CI: 0.69-0.94) parity greater than five (OR: 0.77, 95% CI: 0.65-0.92), male fetal sex (OR: 0.91, 95% CI: 0.86-0.98), and increased weight gain (OR: 0.93 per weight kilogram difference between 2nd and 3rd trimester, 95% CI: 0.92-0.95) were protective for SGA. Four or more ANC visits (OR: 0.53, 95% CI: 0.41-0.68) and respiratory symptoms in the third trimester (OR: 0.67, 95% CI: 0.54-0.84) were negatively associated with LGA, and maternal age < 18 years (OR: 1.39, 95% CI: 1.03-1.87) and respiratory symptoms in the second trimester (OR: 1.27, 95% CI: 1.07-1.51) were positively associated with LGA. CONCLUSIONS Our findings are in line with known risk factors for SGA. Because the prevalence and mortality risk of LGA babies is low in this population, it is likely LGA status does not indicate underlaying illness. Improved and equitable access to high quality antenatal care, monitoring for appropriate gestational weight gain and increased monitoring of women with high-risk pregnancies may reduce prevalence and improve outcomes of SGA babies. TRIAL REGISTRATION The study used in this secondary data analysis was registered at Clinicaltrials.gov NCT01177111.
Collapse
Affiliation(s)
- Elizabeth A. Hazel
- grid.21107.350000 0001 2171 9311Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St. Room W5504, Baltimore, MD 21205 USA
| | - Diwakar Mohan
- grid.21107.350000 0001 2171 9311Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St. Room W5504, Baltimore, MD 21205 USA
| | - Scott Zeger
- grid.21107.350000 0001 2171 9311Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St. Room W5504, Baltimore, MD 21205 USA
| | - Luke C. Mullany
- grid.21107.350000 0001 2171 9311Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St. Room W5504, Baltimore, MD 21205 USA
| | - James M. Tielsch
- grid.21107.350000 0001 2171 9311George Washington University Milken Institute School of Public Health, Washington, DC USA
| | - Subarna K. Khatry
- grid.21107.350000 0001 2171 9311Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St. Room W5504, Baltimore, MD 21205 USA ,Nepal Nutrition Intervention Project-Sarlahi, Sarlahi, Nepal
| | - Seema Subedi
- grid.21107.350000 0001 2171 9311Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St. Room W5504, Baltimore, MD 21205 USA
| | - Steven C. LeClerq
- grid.21107.350000 0001 2171 9311Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St. Room W5504, Baltimore, MD 21205 USA
| | - Robert E. Black
- grid.21107.350000 0001 2171 9311Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St. Room W5504, Baltimore, MD 21205 USA
| | - Joanne Katz
- grid.21107.350000 0001 2171 9311Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St. Room W5504, Baltimore, MD 21205 USA
| |
Collapse
|
15
|
Nurani N, Wibowo T, Susilowati R, Hastuti J, Julia M, Van Weissenbruch MM. Growth of exclusively breastfed small for gestational age term infants in the first six months of life: a prospective cohort study. BMC Pediatr 2022; 22:73. [PMID: 35105325 PMCID: PMC8805422 DOI: 10.1186/s12887-021-03080-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 12/10/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Compared to their appropriate-for-gestational-age (AGA) peers, small-for-gestational-age (SGA) infants are prone to growth deficits. As the first 6 months of exclusive breastfeeding is generally recommended, it is essential to understand how this intervention might impact SGA infants' growth. This study aims to assess growth of exclusively breastfed SGA term infants in the first 6 months of life. METHODS A prospective cohort study was conducted on term infants born in Dr. Sardjito General Hospital and two private hospitals in Yogyakarta, Indonesia. SGA was defined as birth weight less than the 10th percentile according to Fenton criteria. Weight, length, and head circumference (HC) were measured at birth and monthly until 6 months old. RESULTS A total of 39 AGA and 17 SGA term infants who were exclusively breastfed in their first 6 months were included and followed. In SGA compared to AGA, birth weight, length, and HC (mean ± SD) were significantly lower (p < 0.001). During the first 6 months, the SGAs grew in weight and length in parallel with the AGAs. At sixth months of age, the weight and length (mean ± SD) of the SGAs were significantly lower compared to the AGAs (p < 0.001). However, HC (mean ± SD) of SGAs grew significantly faster than the AGAs (p < 0.005). At sixth months of age, there were no significant differences in HC between the two groups (p = 0.824). CONCLUSIONS In the first 6 months, exclusively breastfed SGA term infants, in contrast to weight and length, only show catch up growth in HC, leading to HC comparable to their AGA peers at the age of 6 months.
Collapse
Affiliation(s)
- Neti Nurani
- Department of Child Health, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/ Dr. Sardjito General Hospital, Yogyakarta, Indonesia.
| | - Tunjung Wibowo
- Department of Child Health, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/ Dr. Sardjito General Hospital, Yogyakarta, Indonesia
| | - Rina Susilowati
- Department of Histology and Cell Biology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Janatin Hastuti
- Department of Health Nutrition, Laboratory of Bioanthropology & Paleoanthropology, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Madarina Julia
- Department of Child Health, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/ Dr. Sardjito General Hospital, Yogyakarta, Indonesia
| | - Mirjam M Van Weissenbruch
- Department of Neonatology, Emma Children's Hospital, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, 1081 HV, The Netherlands
| |
Collapse
|
16
|
Barry MA, Colt S, Vargas Z, Barry CV, Tallo V, Sagliba MJ, Amoylen AJ, Friedman JF, McDonald EA. Impaired Intrauterine Growth in the Context of Maternal Hookworm Infection During Gestation. J Infect Dis 2022; 225:1856-1860. [PMID: 35091745 PMCID: PMC9113511 DOI: 10.1093/infdis/jiac025] [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: 11/04/2021] [Accepted: 01/25/2022] [Indexed: 01/31/2023] Open
Abstract
Hookworm infection is associated with poor nutritional outcomes, anemia, and impaired cognitive performance. We examined the association between maternal hookworm infection and birth outcomes in a cohort of women in Leyte, Philippines. We observed poor intrauterine growth characteristics associated with maternal hookworm only among male offspring, with lower birth weight, head circumference, and placental surface area. Male neonates also had higher insulin-like growth factor 2 (IGF-2) and lower adiponectin in cord blood. These data intriguingly suggest nutritional impacts of maternal hookworm infection during pregnancy may be divergent based on sex of the offspring.
Collapse
Affiliation(s)
- Meagan A Barry
- Center for International Health Research, Rhode Island Hospital, Providence, Rhode Island, USA
| | - Susannah Colt
- Center for International Health Research, Rhode Island Hospital, Providence, Rhode Island, USA
| | - Zorimel Vargas
- Center for International Health Research, Rhode Island Hospital, Providence, Rhode Island, USA
| | - Christopher V Barry
- Warren Alpert Medical School, Brown University, Providence, Rhode Island, USA
| | - Veronica Tallo
- Research Institute of Tropical Medicine, Manila, Philippines
| | | | | | - Jennifer F Friedman
- Center for International Health Research, Rhode Island Hospital, Providence, Rhode Island, USA,Warren Alpert Medical School, Brown University, Providence, Rhode Island, USA
| | - Emily A McDonald
- Center for International Health Research, Rhode Island Hospital, Providence, Rhode Island, USA,Warren Alpert Medical School, Brown University, Providence, Rhode Island, USA,Correspondence: Emily McDonald, PhD, Center for International Health Research, Rhode Island Hospital, Warren Alpert Medical School, Brown University, 55 Claverick Street, Room 320, Providence, RI 02903 ()
| |
Collapse
|
17
|
Kohlmann K, Sudfeld CR, Garba S, Guindo O, Grais RF, Isanaka S. Exploring the relationships between wasting and stunting among a cohort of children under two years of age in Niger. BMC Public Health 2021; 21:1713. [PMID: 34548050 PMCID: PMC8454021 DOI: 10.1186/s12889-021-11689-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 08/08/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Wasting and stunting, physical growth manifestations of child undernutrition, have historically been considered separately with distinct interventions at the program, policy, and financing levels despite similar risk factors, overlapping burdens and multiplicative risk of death when the conditions are concurrent. The aim of this study was to elucidate shared risk factors and the temporal relationship between wasting and stunting among children under 2 years of age in rural Niger. METHODS From August 2014 to December 2019, anthropometric data were collected every 4 weeks from 6 to 8 weeks to 24 months of age for 6567 children comprising 139,529 visits in Madarounfa, Niger. Children were defined as wasted if they had a weight-for-length Z-score < - 2 and stunted if they had a length-for-age Z-score < - 2 using the 2006 World Health Organization child growth standards. Parental, child, and socioeconomic risk factors for wasting and stunting at 6 and 24 months of age and the relationship between episodes of wasting, stunting and concurrent wasting-stunting were assessed using general estimating equations. RESULTS Half of children (50%) were female, and 8.3% were born low birthweight (< 2500 g). Overall, at 24 months of age, 14% of children were wasted, 80% were stunted and 12% were concurrently wasted-stunted. We found that maternal short stature, male sex, and low birthweight were risk factors for wasting and stunting at 6 and 24 months, whereas higher maternal body mass index and household wealth were protective factors. Wasting at 6 and 24 months was predicted by a prior episodes of wasting, stunting, and concurrent wasting-stunting. Stunting at 6 and 24 months was similarly predicted by prior episodes of stunting and concurrent wasting-stunting at any prior age but only by prior episodes of wasting after 6 months of age. CONCLUSIONS These data support a complex and dynamic bi-directional relationship between wasting and stunting in young children in rural Niger and an important burden of concurrent wasting-stunting in this setting. Further research to better understand the inter-relationships and mechanisms between these two conditions is needed in order to develop and target interventions to promote child growth. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT02145000 .
Collapse
Affiliation(s)
- Kristin Kohlmann
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, USA
| | - Christopher R Sudfeld
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, USA
- Department of Global Health and Population, Harvard T. H. Chan School of Public Health, Boston, USA
| | | | | | | | - Sheila Isanaka
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, USA.
- Department of Global Health and Population, Harvard T. H. Chan School of Public Health, Boston, USA.
- Epicentre, 14-34 Avenue Jean Jaurès, 75019, Paris, France.
| |
Collapse
|
18
|
Poudel K, Kobayashi S, Miyashita C, Ikeda-Araki A, Tamura N, Ait Bamai Y, Itoh S, Yamazaki K, Masuda H, Itoh M, Ito K, Kishi R. Hypertensive Disorders during Pregnancy (HDP), Maternal Characteristics, and Birth Outcomes among Japanese Women: A Hokkaido Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18073342. [PMID: 33804885 PMCID: PMC8038052 DOI: 10.3390/ijerph18073342] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 03/17/2021] [Accepted: 03/22/2021] [Indexed: 12/14/2022]
Abstract
Hypertension during pregnancy causes a greater risk of adverse birth outcomes worldwide; however, formal evidence of hypertensive disorders during pregnancy (HDP) in Japan is limited. We aimed to understand the association between maternal characteristics, HDP, and birth outcomes. In total, 18,833 mother-infant pairs were enrolled in the Hokkaido study on environment and children’s health, Japan, from 2002 to 2013. Medical records were used to identify hypertensive disorders and birth outcomes, namely, small for gestational age (SGA), SGA at full term (term-SGA), preterm birth (PTB), and low birth weight (LBW). The prevalence of HDP was 1.9%. Similarly, the prevalence of SGA, term-SGA, PTB, and LBW were 7.1%, 6.3%, 7.4%, and 10.3%, respectively. The mothers with HDP had increased odds of giving birth to babies with SGA (2.13; 95% Confidence Interval (CI): 1.57, 2.88), PTB (3.48; 95%CI: 2.68, 4.50), LBW (3.57; 95%CI: 2.83, 4.51) than normotensive pregnancy. Elderly pregnancy, low and high body mass index, active and passive smoking exposure, and alcohol consumption were risk factors for different birth outcomes. Therefore, it is crucial for women of reproductive age and their families to be made aware of these risk factors through physician visits, health education, and various community-based health interventions.
Collapse
Affiliation(s)
- Kritika Poudel
- Faculty of Health Sciences, Hokkaido University, Sapporo 060-0812, Japan;
| | - Sumitaka Kobayashi
- Center for Environmental and Health Sciences, Hokkaido University, Sapporo 060-0812, Japan; (S.K.); (C.M.); (A.I.-A.); (N.T.); (Y.A.B.); (S.I.); (K.Y.); (H.M.); (M.I.); (K.I.)
| | - Chihiro Miyashita
- Center for Environmental and Health Sciences, Hokkaido University, Sapporo 060-0812, Japan; (S.K.); (C.M.); (A.I.-A.); (N.T.); (Y.A.B.); (S.I.); (K.Y.); (H.M.); (M.I.); (K.I.)
| | - Atsuko Ikeda-Araki
- Center for Environmental and Health Sciences, Hokkaido University, Sapporo 060-0812, Japan; (S.K.); (C.M.); (A.I.-A.); (N.T.); (Y.A.B.); (S.I.); (K.Y.); (H.M.); (M.I.); (K.I.)
| | - Naomi Tamura
- Center for Environmental and Health Sciences, Hokkaido University, Sapporo 060-0812, Japan; (S.K.); (C.M.); (A.I.-A.); (N.T.); (Y.A.B.); (S.I.); (K.Y.); (H.M.); (M.I.); (K.I.)
| | - Yu Ait Bamai
- Center for Environmental and Health Sciences, Hokkaido University, Sapporo 060-0812, Japan; (S.K.); (C.M.); (A.I.-A.); (N.T.); (Y.A.B.); (S.I.); (K.Y.); (H.M.); (M.I.); (K.I.)
| | - Sachiko Itoh
- Center for Environmental and Health Sciences, Hokkaido University, Sapporo 060-0812, Japan; (S.K.); (C.M.); (A.I.-A.); (N.T.); (Y.A.B.); (S.I.); (K.Y.); (H.M.); (M.I.); (K.I.)
| | - Keiko Yamazaki
- Center for Environmental and Health Sciences, Hokkaido University, Sapporo 060-0812, Japan; (S.K.); (C.M.); (A.I.-A.); (N.T.); (Y.A.B.); (S.I.); (K.Y.); (H.M.); (M.I.); (K.I.)
| | - Hideyuki Masuda
- Center for Environmental and Health Sciences, Hokkaido University, Sapporo 060-0812, Japan; (S.K.); (C.M.); (A.I.-A.); (N.T.); (Y.A.B.); (S.I.); (K.Y.); (H.M.); (M.I.); (K.I.)
| | - Mariko Itoh
- Center for Environmental and Health Sciences, Hokkaido University, Sapporo 060-0812, Japan; (S.K.); (C.M.); (A.I.-A.); (N.T.); (Y.A.B.); (S.I.); (K.Y.); (H.M.); (M.I.); (K.I.)
| | - Kumiko Ito
- Center for Environmental and Health Sciences, Hokkaido University, Sapporo 060-0812, Japan; (S.K.); (C.M.); (A.I.-A.); (N.T.); (Y.A.B.); (S.I.); (K.Y.); (H.M.); (M.I.); (K.I.)
- Faculty of Health Sciences, Hokkaido University of Science, Sapporo 060-0812, Japan
| | - Reiko Kishi
- Center for Environmental and Health Sciences, Hokkaido University, Sapporo 060-0812, Japan; (S.K.); (C.M.); (A.I.-A.); (N.T.); (Y.A.B.); (S.I.); (K.Y.); (H.M.); (M.I.); (K.I.)
- Correspondence: ; Tel.: +81-11-706-4746; Fax: +81-11-706-4725
| |
Collapse
|
19
|
Liu H, Li H, Li C, Chen L, Zhang C, Liu Z, Wu Y, Huang H. Associations between Maternal Sleep Quality Throughout Pregnancy and Newborn Birth Weight. Behav Sleep Med 2021; 19:57-69. [PMID: 31830816 DOI: 10.1080/15402002.2019.1702551] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Objective: Poor sleep quality is common during pregnancy. Although a few studies have investigated the associations between maternal sleep quality and fetal birth weight (BW), no evidence has been clearly demonstrated. Our aim was to investigate the effects of sleep quality during pregnancy on the newborn BW z-scores. Participants: 1466 mother-infant pairs were included in the present study based on an ongoing prospective cohort. Methods: Questionnaires including the Pittsburgh Sleep Quality Index (PSQI) and scales for psychosocial status were administered at each trimester. BW z-scores were calculated based on the INTERGROWTH-21st standard. A generalized estimating equation model was applied to evaluate the associations between trimester-specific sleep quality and newborn BW after adjusting for potential confounders. Multivariable logistic regression models were applied to examine the impacts of maternal sleep quality on small-for-gestational-age (SGA) or low birth weight (LBW). Results: We found that maternal PSQI scores in the first and third trimesters were negatively associated with BW z-scores among female newborns (β = -0.032, 95% CI: -0.063, -0.001, P= .043; β = -0.031, 95% CI: -0.060, -0.003, P= .033, respectively). However, no relationship was observed between maternal sleep quality and BW in male neonates. Additionally, poor sleep quality in late pregnancy was a risk factor for LBW (OR = 1.501, 95% CI: 1.082-2.082). Conclusions: The BW z-scores of female newborns decreased as maternal sleep quality in the first and third trimesters worsened. This finding suggests that sleep during pregnancy may influence fetal weight in a trimester- and gender-specific manner.
Collapse
Affiliation(s)
- Han Liu
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University , Shanghai, China.,Shanghai Key Laboratory of Embryo Original Diseases , Shanghai, China.,Shanghai Municipal Key Clinical Specialty , Shanghai, China
| | - Hong Li
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University , Shanghai, China.,Shanghai Key Laboratory of Embryo Original Diseases , Shanghai, China.,Shanghai Municipal Key Clinical Specialty , Shanghai, China
| | - Cheng Li
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University , Shanghai, China.,Shanghai Key Laboratory of Embryo Original Diseases , Shanghai, China.,Shanghai Municipal Key Clinical Specialty , Shanghai, China
| | - Lei Chen
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University , Shanghai, China.,Shanghai Key Laboratory of Embryo Original Diseases , Shanghai, China.,Shanghai Municipal Key Clinical Specialty , Shanghai, China
| | - Chenjie Zhang
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University , Shanghai, China.,Shanghai Key Laboratory of Embryo Original Diseases , Shanghai, China.,Shanghai Municipal Key Clinical Specialty , Shanghai, China
| | - Zhiwei Liu
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University , Shanghai, China.,Shanghai Key Laboratory of Embryo Original Diseases , Shanghai, China.,Shanghai Municipal Key Clinical Specialty , Shanghai, China
| | - Yanting Wu
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University , Shanghai, China.,Shanghai Key Laboratory of Embryo Original Diseases , Shanghai, China.,Shanghai Municipal Key Clinical Specialty , Shanghai, China
| | - Hefeng Huang
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University , Shanghai, China.,Shanghai Key Laboratory of Embryo Original Diseases , Shanghai, China.,Shanghai Municipal Key Clinical Specialty , Shanghai, China
| |
Collapse
|
20
|
Flynn J, Alkaff FF, Sukmajaya WP, Salamah S. Comparison of WHO growth standard and national Indonesian growth reference in determining prevalence and determinants of stunting and underweight in children under five: a cross-sectional study from Musi sub-district. F1000Res 2020; 9:324. [PMID: 32551096 PMCID: PMC7281657 DOI: 10.12688/f1000research.23156.4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/04/2021] [Indexed: 11/25/2022] Open
Abstract
Background: Determination of stunting and wasting always uses the WHO growth standard in Indonesia. However, it is believed that Indonesian children are “below” the global standard, thus the WHO standard is not reliable to present the actual prevalence. This study aims to compare the prevalence and determinants of stunting and underweight using WHO growth standard and national Indonesian growth reference. Methods: This was a cross-sectional study carried out in Musi sub-district, East Nusa Tenggara province in July 2019. East Nusa Tenggara province had the highest prevalence of stunting and underweight in Indonesia. The study population were children under five, and total sampling method was used for this study. Length/height-for-age and weight-for-age were plotted using WHO standard and national Indonesian reference. Univariate and multivariate binomial logistic regression were used for statistical analysis. Results: The prevalence of stunting and underweight were higher for the WHO standard than the national reference (53.9% vs 10.7% and 29.17% vs 17.7%; all p < 0.001). After adjusted for confounding factors, when the WHO standard was used, determinants of stunting were maternal mid-upper arm circumference below 23.5cm and maternal height below 150cm; determinants of underweight were intrauterine growth restriction, young maternal age during pregnancy, and multiple parities. When the national reference was used, no determinants was found for stunting; the determinants of underweight were intrauterine growth restriction and maternal education. Conclusions: The WHO standard is not suitable for representing child growth in Musi sub-district. Future studies should be done to re-evaluate the prevalence and determinants of stunting and underweight nationwide using the national Indonesian reference.
Collapse
Affiliation(s)
- Jeannie Flynn
- Oeolo Primary Healthcare, Jln. Tetu Neno, Timor Tengah Utara District, East Nusa Tenggara Province, 85662, Indonesia
| | - Firas Farisi Alkaff
- Department of Pharmacology, Faculty of Medicine, Universitas Airlangga, Jl. Mayjend Prof. Dr. Moestopo No 47, Surabaya, East Java, 60132, Indonesia
| | - William Putera Sukmajaya
- Department of Orthopedics and Traumatology, Faculty of Medicine, Brawijaya University, Jl. Jaksa Agung Suprapto No 2, Malang, East Java, 65111, Indonesia
| | - Sovia Salamah
- Department of Public Health and Preventive Medicine, Faculty of Medicine, Universitas Airlangga, Jl. Mayjend Prof. Dr. Moestopo No 47, Surabaya, East Java, 60132, Indonesia
| |
Collapse
|
21
|
Stunting: an overlooked problem in Myanmar – an economic evaluation. Int J Technol Assess Health Care 2020; 36:167-172. [DOI: 10.1017/s0266462319003520] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractObjectivesStunting increases a child's susceptibility to diseases, increases mortality, and is associated over long term with reduced cognitive abilities, educational achievement, and productivity. We aimed to assess the most effective public health nutritional intervention to reduce stunting in Myanmar.MethodsWe searched the literature and developed a conceptual framework for interventions known to reduce stunting. We focused on the highest impact and most feasible interventions to reduce stunting in Myanmar, described policies to implement them, and compared their costs and projected effect on stunting using data-based decision trees. We estimated costs from the government perspective and calculated total projected cases of stunting prevented and cost per case prevented (cost-effectiveness). All interventions were compared to projected cases of stunting resulting from the current situation (e.g., no additional interventions).ResultsThree new policy options were identified. Operational feasibility for all three options ranged from medium to high. Compared to the current situation, two were similarly cost-effective, at an additional USD 598 and USD 667 per case of stunting averted. The third option was much less cost-effective, at an additional USD 27,741 per case averted. However, if donor agencies were to expand their support in option three to the entire country, the prevalence of 22.5 percent would be reached by 2025 at an additional USD 667 per case averted.ConclusionsA policy option involving immediate expansion of the current implementation of proven nutrition-specific interventions is feasible. It would have the highest impact on stunting and would approach the WHO 2025 target.
Collapse
|
22
|
Liu J, Zhang Z, Xu J, Song X, Yuan W, Miao M, Liang H, Du J. Genome-wide DNA methylation changes in placenta tissues associated with small for gestational age newborns; cohort study in the Chinese population. Epigenomics 2019; 11:1399-1412. [PMID: 31596135 DOI: 10.2217/epi-2019-0004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Aim: To investigate DNA methylation changes in placenta tissues associated with small for gestational age (SGA). Materials & methods: A prospective cohort study consisting of 1292 pregnant women from China (including 39 SGA with placenta tissues) was performed, microarray and pyrosequencing were conducted. Results: Total 2012 methylation variable positions stood out from all probes (p < 0.05; Δβ > 0.2). In SGA cases, a CpG site within ANKRD20B showed lower methylation level (p = 0.032) than appropriate for gestational age in validation cohort. Five sites within FAM198A (p = 0.047, 0.050, 0.039, 0.026 and 0.043, respectively) had a reduced methylation in male newborns whose mother had preconception folic acid supplementation. Conclusion: DNA methylation changes in placenta tissues may be associated with SGA, maternal preconception folic acid supplementation status and also be fetal sex-specific.
Collapse
Affiliation(s)
- Junwei Liu
- NHC Key Lab of Reproduction Regulation (Shanghai Institute of Planned Parenthood Research), School of Pharmacy, Fudan University, Shanghai 200032, China
| | - Zhaofeng Zhang
- NHC Key Lab of Reproduction Regulation (Shanghai Institute of Planned Parenthood Research), School of Pharmacy, Fudan University, Shanghai 200032, China
| | - Jianhua Xu
- NHC Key Lab of Reproduction Regulation (Shanghai Institute of Planned Parenthood Research), School of Pharmacy, Fudan University, Shanghai 200032, China
| | - Xiuxia Song
- NHC Key Lab of Reproduction Regulation (Shanghai Institute of Planned Parenthood Research), Fudan University, Shanghai 200032, China
| | - Wei Yuan
- NHC Key Lab of Reproduction Regulation (Shanghai Institute of Planned Parenthood Research), Fudan University, Shanghai 200032, China
| | - Maohua Miao
- NHC Key Lab of Reproduction Regulation (Shanghai Institute of Planned Parenthood Research), Fudan University, Shanghai 200032, China
| | - Hong Liang
- NHC Key Lab of Reproduction Regulation (Shanghai Institute of Planned Parenthood Research), Fudan University, Shanghai 200032, China
| | - Jing Du
- NHC Key Lab of Reproduction Regulation (Shanghai Institute of Planned Parenthood Research), School of Pharmacy, Fudan University, Shanghai 200032, China
| |
Collapse
|
23
|
Abstract
Over the past 20 years, RNAS+ has been generating research results from highly collaborative projects meant to promote and advance understanding in various aspects of schistosomiasis. Epidemiological studies in endemic countries like the Philippines, the People's Republic of China (PR China), the Lao People's Democratic Republic (Lao PDR) and Cambodia clarified the role of reservoir hosts in transmission and the use of spatio-temporal methods such as remote sensing and geographical information systems (GIS) in surveillance of schistosomiasis. Morbidity studies proposed factors that might influence development of fibrosis, anaemia and malnutrition in schistosomiasis. Immune responses in schistosomiasis continue to be an interesting focus in research to explain possible development of resistance with age. Results of evaluation of candidate vaccine molecules are also presented. New diagnostics are continually being developed in response to the call for more sensitive and field applicable techniques that will be used for surveillance in areas nearing elimination of the disease. Several studies presented here show the insufficiency of mass drug administration (MDA) with praziquantel in eliminating the disease. Emphasis is given to an integrated control approach that can be accomplished through intensive and extensive intersectoral collaboration.
Collapse
|
24
|
Choudhary TS, Srivastava A, Chowdhury R, Taneja S, Bahl R, Martines J, Bhan MK, Bhandari N. Severe wasting among Indian infants <6 months: Findings from the National Family Health Survey 4. MATERNAL AND CHILD NUTRITION 2019; 15:e12866. [PMID: 31240836 DOI: 10.1111/mcn.12866] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Revised: 06/06/2019] [Accepted: 06/18/2019] [Indexed: 11/28/2022]
Abstract
Burden and risk factors for wasting in the first 6 months of life among Indian children are not well documented. We used data from India's National Family Health Survey 4 to estimate the prevalence of severe wasting (weight for length < -3 SD) among 18,898 infants under 6 months of age. We also examined the association of severe wasting with household, maternal, and child-related factors using multivariable logistic regression analysis. Prevalence of severe wasting among infants less than 6 months of age was 14.8%, ranging from 3.5 to 21% across states. Low birth weight (<2,500 g; adjusted odds ratio [AOR] 1.40, 95% CI [1.19, 1.65]), nonutilization of supplementary nutrition by mother during lactation (AOR 1.23, 95% CI [1.05, 1.43]), and anthropometric assessment during summer (AOR 1.37, 95% CI [1.13, 1.65]) and monsoon months (AOR 1.53, 95% CI [1.20, 1.95]) were associated with higher odds of severe wasting. Infants aged 2 to 3 months (AOR 0.78, 95% CI [0.66, 0.93]) and 4 to 5 months (AOR 0.65, 95% CI [0.55, 0.73]) had lower odds of severe wasting as compared with the 0- to 1-month category. This analysis reveals a high burden of severe wasting in infants less than 6 months in India. Preventive interventions must be targeted at reducing low birth weight due to fatal growth restriction and prematurity. Appropriate care practices at facilities and postdischarge with extra attention to those born small and sick can prevent further deterioration in nutritional status.
Collapse
Affiliation(s)
- Tarun Shankar Choudhary
- Knowledge Integration and Translational Platform (KnIT), Centre for Health Research and Development, Society for Applied Studies, New Delhi, India
| | - Akanksha Srivastava
- Knowledge Integration and Translational Platform (KnIT), Centre for Health Research and Development, Society for Applied Studies, New Delhi, India
| | - Ranadip Chowdhury
- Knowledge Integration and Translational Platform (KnIT), Centre for Health Research and Development, Society for Applied Studies, New Delhi, India
| | - Sunita Taneja
- Knowledge Integration and Translational Platform (KnIT), Centre for Health Research and Development, Society for Applied Studies, New Delhi, India
| | - Rajiv Bahl
- Department of Maternal, Newborn, Child and Adolescent Health, World Health Organisation, Geneva, Switzerland
| | - Jose Martines
- Centre for Intervention Science in Maternal and Child Health, Centre for International Health, University of Bergen, Bergen, Norway
| | - Maharaj Kishan Bhan
- National Science Professor, Indian Institute of Technology, New Delhi, India.,Knowledge Integration and Translational Platform (KnIT), Biotechnology Industry Research Assistance Council (BIRAC), New Delhi, India
| | - Nita Bhandari
- Knowledge Integration and Translational Platform (KnIT), Centre for Health Research and Development, Society for Applied Studies, New Delhi, India
| |
Collapse
|
25
|
Maternal, placental and cord blood cytokines and the risk of adverse birth outcomes among pregnant women infected with Schistosoma japonicum in the Philippines. PLoS Negl Trop Dis 2019; 13:e0007371. [PMID: 31188820 PMCID: PMC6590831 DOI: 10.1371/journal.pntd.0007371] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Revised: 06/24/2019] [Accepted: 04/08/2019] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND The objectives of this study were to 1) evaluate the influence of treatment with praziquantel on the inflammatory milieu in maternal, placental, and cord blood, 2) assess the extent to which proinflammatory signatures in placental and cord blood impacts birth outcomes, and 3) evaluate the impact of other helminths on the inflammatory micro environment. METHODS/FINDINGS This was a secondary analysis of samples from 369 mother-infant pairs participating in a randomized controlled trial of praziquantel given at 12-16 weeks' gestation. We performed regression analysis to address our study objectives. In maternal peripheral blood, the concentrations of CXCL8, and TNF receptor I and II decreased from 12 to 32 weeks' gestation, while IL-13 increased. Praziquantel treatment did not significantly alter the trajectory of the concentration of any of the cytokines examined. Hookworm infection was associated with elevated placental IL-1, CXCL8 and IFN-γ. The risk of small-for-gestational age increased with elevated IL-6, IL-10, and CXCL8 in cord blood. The risk of prematurity was increased when cord blood sTNFRI and placental IL-5 were elevated. CONCLUSIONS Our study suggests that fetal cytokines, which may be related to infectious disease exposures, contribute to poor intrauterine growth. Additionally, hookworm infection influences cytokine concentrations at the maternal-fetal interface. CLINICAL TRIAL REGISTRY NUMBER AND WEBSITE ClinicalTrials.gov (NCT00486863).
Collapse
|
26
|
Growth in syphilis-exposed and -unexposed uninfected children from birth to 18 months of age in China: a longitudinal study. Sci Rep 2019; 9:4416. [PMID: 30867463 PMCID: PMC6416265 DOI: 10.1038/s41598-019-40134-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Accepted: 01/30/2019] [Indexed: 11/09/2022] Open
Abstract
Early infant growth and development has attracted worldwide attention. Although numerous studies have demonstrated that maternal syphilis increases the risk of adverse pregnancy outcomes and congenital syphilis, the subsequent growth pattern and morbidity of syphilis-exposed uninfected infants are less understood. We conducted a longitudinal study to compare the growth pattern and disease distribution of syphilis-exposed and syphilis-unexposed uninfected children, and World Health Organization (WHO) reference standards from birth to 18 months of age. We obtained data from a prospective cohort study in three representative regions of Zhejiang Province in China. A total of 333 syphilis-uninfected children born to women with syphilis were recruited at birth and matched with 333 syphilis-uninfected children born to women without syphilis during pregnancy. Children were followed-up by medical staff every 3 months until 18 months of age. The mixed-effects model was used to compare changes in growth patterns and influencing factors between the two groups. Mean weight, length, and head circumference of children, as well as disease prevalence, were similar between the groups. Multilevel analysis indicated that, after controlling confounders, growth velocities were comparable in both weight and length measures from birth to 18 months old between the two groups; however, low birth weight had a negative impact on weight gain in both groups. There was no significant negative association between syphilis exposure and early growth and health in children, under 18 months in a setting with universal coverage of therapeutic interventions for maternal syphilis. These findings may contribute to improving prevention efforts for mother-to-child transmission of syphilis, such as early screening for syphilis in pregnant women, universal coverage of treatment, and interventions for exposed children. Children with low birth weight should be given priority as this is a risk factor for weight gain.
Collapse
|
27
|
Chen Y, Liu Y, Zhang Y, Hu R, Qian Z, Xian H, Vaughn MG, Liu M, Cao S, Gan Y, Zhang B. Gestational Weight Gain per Pre-Pregnancy Body Mass Index and Birth Weight in Twin Pregnancies: A Cohort Study in Wuhan, China. Sci Rep 2018; 8:12496. [PMID: 30131497 PMCID: PMC6104075 DOI: 10.1038/s41598-018-29774-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Accepted: 07/18/2018] [Indexed: 02/07/2023] Open
Abstract
To assess the relationship between gestational weight gain (GWG) of twin-pregnancy women and twin birth weights, as well as to evaluate whether pre-pregnancy body mass index (BMI) influences this relationship. A cohort study was conducted in Wuhan, China, between 1/01/2011 and 8/31/2017. Women with twin pregnancies who delivered live and non-malformed twins were included (6,925 women and 13,850 infants), based on the Wuhan Maternal and Child Health Management Information System. Logistic regression models were employed to examine the association between GWG and paired small for gestational age (SGA, defined as birth weight <10th percentile for gestational age and sex)/SGA and linear regression models were utilized to explore the relationship between GWG and sum of birth weights. The associations of GWG based on both the IOM and Chinese recommendations and SGA/SGA pairs were obtained, as well as the stratified analyses by pre-pregnancy BMI. Additionally, the sum birth weight of one twin pair increased by 15.88 g when the GWG increased by 1 kg. GWG below the IOM and Chinese recommendations was associated with an increased risk of SGA/SGA pairs in all pre-pregnancy BMI categories. However, in underweight, overweight, and obese women, the association between GWG above the IOM and Chinese recommendations and SGA/SGA pairs changed with adjustment.
Collapse
Affiliation(s)
- Yawen Chen
- Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, No. 100 Hongkong Road, Wuhan, 430014, Hubei, People's Republic of China
| | - Yan Liu
- Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, No. 100 Hongkong Road, Wuhan, 430014, Hubei, People's Republic of China
| | - Yiming Zhang
- Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, No. 100 Hongkong Road, Wuhan, 430014, Hubei, People's Republic of China
| | - Ronghua Hu
- Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, No. 100 Hongkong Road, Wuhan, 430014, Hubei, People's Republic of China
| | - Zhengmin Qian
- Department of Epidemiology and Biostatistics, College for Public Health and Social Justice, Saint Louis University, 3545 Lafayette Avenue, Saint Louis, MO, 63104, United States of America
| | - Hong Xian
- Department of Epidemiology and Biostatistics, College for Public Health and Social Justice, Saint Louis University, 3545 Lafayette Avenue, Saint Louis, MO, 63104, United States of America
| | - Michael G Vaughn
- School of Social Work, College for Public Health and Social Justice, Saint Louis University, Tegeler Hall, 3550 Lindell Boulevard, Saint Louis, MO, 63103, United States of America
| | - Mingzhu Liu
- Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, No. 100 Hongkong Road, Wuhan, 430014, Hubei, People's Republic of China
| | - Shiyi Cao
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, NO. 13 Hangkong Road, Wuhan, 430030, Hubei, People's Republic of China
| | - Yong Gan
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, NO. 13 Hangkong Road, Wuhan, 430030, Hubei, People's Republic of China
| | - Bin Zhang
- Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, No. 100 Hongkong Road, Wuhan, 430014, Hubei, People's Republic of China.
| |
Collapse
|
28
|
Ruchob R, Rutherford JN, Bell AF. A Systematic Review of Placental Biomarkers Predicting Small-for-Gestational-Age Neonates. Biol Res Nurs 2018; 20:272-283. [DOI: 10.1177/1099800418760997] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Background: Neonates born small for gestational age (SGA) face increased risk of neonatal mortality, childhood developmental problems, and adult disease. The placenta is a key factor in SGA development because of its multiple biological processes that underlie fetal growth. However, valid and reliable placental biomarkers of SGA have not been determined. Objectives: The objective of this article was to systematically identify and review studies examining associations between placental biomarkers and SGA and assess those biomarkers’ predictive value. Methods: Use of the matrix method and the PRISMA guidelines ensured systematic identification of relevant articles based on selection criteria. PubMed, CINAHL, and EMBASE were searched for English articles published in 2005–2016 that addressed relationships between placental biomarkers and SGA. Results: The search captured 466 articles; 13 met selection criteria. The review identified 14 potential placental biomarkers for SGA, with placental growth factor and soluble fms-like tyrosine kinase 1 being the most commonly studied. However, findings for these and other biomarkers have often been contradictory. Thus, no placental biomarkers have been confirmed as reliable for predicting SGA. Conclusion: The inconsistent findings suggest low placental biomarker reliability, perhaps due to the multifactorial nature of SGA. This review is novel in its focus on identifying potential placental biomarkers for SGA, producing a better understanding of how placental function underlies fetal growth. Nevertheless, use of placental biomarkers alone may not be adequate for predicting SGA. Therefore, combinations of biomarkers and other predictive tests should be evaluated for their ability to predict risk of SGA.
Collapse
Affiliation(s)
- Rungnapa Ruchob
- College of Nursing, University of Illinois at Chicago, Chicago, IL, USA
| | - Julienne N. Rutherford
- Department of Women, Children & Family Health Science, College of Nursing, University of Illinois at Chicago, Chicago, IL, USA
| | - Aleeca F. Bell
- Department of Women, Children & Family Health Science, College of Nursing, University of Illinois at Chicago, Chicago, IL, USA
| |
Collapse
|