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Radwan H, Naja F, Abbas N, Kharma JA, Obaid RS, Al Ghazal H, Abdelrahim DN, Saqan R, Alameddine M, Al Hilali M, Hasan H, Hashim M. Influence of maternal characteristics and infant feeding patterns on infant growth from birth till 18 months: The MISC study. Pediatr Obes 2024; 19:e13106. [PMID: 38383983 DOI: 10.1111/ijpo.13106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Revised: 12/06/2023] [Accepted: 12/15/2023] [Indexed: 02/23/2024]
Abstract
BACKGROUND The growth and development of infants during the first 1000 days of life are crucial for their health. OBJECTIVES This study aims to assess the impact of maternal characteristics and infant feeding patterns on infant growth from birth to 18 months. METHODS Data were derived from the 2-year perspective Mother Infant Study Cohort (MISC) study which included six visits from the third trimester of pregnancy until 18 months postpartum. A convenient sample of 256 pregnant women aged 19-40 years was recruited from Sharjah, Dubai and Ajman in the United Arab Emirates. RESULTS Amongst mothers' characteristics, Arab nationality, pre-pregnancy overweight/obesity, higher gestational weight gain and lower physical activity were found to increase the likelihood of infants being overweight at 6, 12 and 18 months. Exclusive breastfeeding was positively correlated with reduced odds of the infant being overweight at 18 months (aOR = 0.31, 95% CI: 0.12-0.81). Breastfeeding for up to 6 months and the introduction of solid foods after 6 months was associated with reduced odds of the infant being overweight at 12 months old (aOR = 4, 95% CI: 1.1-14.6; aOR = 2.97, 95% CI: 1.09-8.08, respectively). CONCLUSION The findings spotlight the influence of maternal characteristics and infant feeding on infant growth. This asserts the need for evidence-based programmes targeting mothers to promote optimal feeding practices and foster healthy child growth.
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Affiliation(s)
- Hadia Radwan
- College of Health Sciences, Department of Clinical Nutrition and Dietetics, Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
- Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Farah Naja
- College of Health Sciences, Department of Clinical Nutrition and Dietetics, Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
- Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Nada Abbas
- Department of Nutrition and Food Sciences, Faculty of Agriculture and Food Sciences, American University of Beirut, Beirut, Lebanon
| | - Joelle Abi Kharma
- Nutrition Program, Department of Natural Sciences, School of Arts and Sciences, Lebanese American University, Beirut, Lebanon
| | - Reyad Shaker Obaid
- College of Health Sciences, Department of Clinical Nutrition and Dietetics, Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
- Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Hessa Al Ghazal
- Sharjah Child-Friendly Office-Sharjah Health Authority, Sharjah, United Arab Emirates
| | - Dana N Abdelrahim
- Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Roba Saqan
- Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | | | - Marwa Al Hilali
- Clinical Nutrition Department, Al Qassimi Hospital, Emirates Health Services, Sharjah, United Arab Emirates
| | - Hayder Hasan
- College of Health Sciences, Department of Clinical Nutrition and Dietetics, Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
- Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Mona Hashim
- College of Health Sciences, Department of Clinical Nutrition and Dietetics, Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
- Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
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Radwan H, Fakhry R, Boateng GO, Metheny N, Bani Issa W, Faris ME, Obaid RS, Al Marzooqi S, Al Ghazal H, Dennis CL. Translation and Psychometric Evaluation of the Arabic Version of the Breastfeeding Self-Efficacy Scale-Short Form Among Women in the United Arab Emirates. J Hum Lact 2023; 39:40-50. [PMID: 35363102 DOI: 10.1177/08903344221084623] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Breastfeeding self-efficacy as a construct has been theoretically and empirically linked to exclusive breastfeeding in studies globally using the Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF). However, its application in the Middle East and North Africa region is limited, as it has not been validated. RESEARCH AIMS To psychometrically validate the BSES-SF among a sample of mothers in the United Arab Emirates. METHODS We psychometrically evaluated the Arabic version of the BSES-SF using a sample of mothers (N = 457) residing in the United Arab Emirates. We used translation techniques, item-test and item-total correlations, confirmatory factor analysis, tests of reliability, and tests of validity. RESULTS Item-test correlations of scale items ranged from 0.67 to 0.84, while item-total correlations ranged from 0.58 to 0.81. The confirmatory factor model assessed the 14-item scale to be unidimensional with satisfactory model fit indices. Our findings suggested the Arabic-language version of the BSES-SF was a reliable measure (α = 0.95) with strong construct and discriminant validity. BSES-SF scores significantly predicted exclusive breastfeeding (aOR = 1.04; 95% CI [1.02, 1.08]) and exclusive duration (β = .06; 95% CI [0.4, 0.08]), which suggested strong predictive, validity after adjusting for parity, maternal age, maternal education, and study site. CONCLUSIONS We have provided rigorous evidence that the BSES-SF is a valid and reliable measure of breastfeeding self-efficacy among Arabic-speaking women in the UAE. Interventions designed specifically to increase breastfeeding self-efficacy among Arabic-speaking women may be a mechanism to increase the suboptimal rates of breastfeeding exclusivity occurring in much of the MENA region.
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Affiliation(s)
- Hadia Radwan
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, Research Institute of Medical and Health Sciences(RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| | - Randa Fakhry
- Department of Nursing, College of Health Sciences, Research Institute of Medical and Health Sciences(RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| | - Godfred O Boateng
- Department of Kinesiology, College of Nursing and Health Innovation, The University of Texas at Arlington, Arlington, TX, USA
| | - Nick Metheny
- School of Nursing and Health Studies, University of Miami, Coral Gables, FL, USA.,Affiliate Scientist, MAP Centre for Urban Health Solutions, St Michael's Hospital, Toronto, ON Canada
| | - Wegdan Bani Issa
- Department of Nursing, College of Health Sciences, Research Institute of Medical and Health Sciences(RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| | - MoezAlIslam E Faris
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, Research Institute of Medical and Health Sciences(RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| | - Reyad Shaker Obaid
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, Research Institute of Medical and Health Sciences(RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| | - Suad Al Marzooqi
- Department of Psychology, Al Ain, United Arab Emirates University, Al Ain, Abu Dhabi, United Arab Emirates
| | - Hessa Al Ghazal
- Sharjah Child-Friendly Office, Sharjah, United Arab Emirates
| | - Cindy-Lee Dennis
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
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Radwan H, Fakhry R, Metheny N, Baniissa W, Faris MAIE, Obaid RS, Al Marzooqi S, Al Ghazal H, ElHalik M, Dennis CL. Prevalence and multivariable predictors of breastfeeding outcomes in the United Arab Emirates: a prospective cohort study. Int Breastfeed J 2021; 16:79. [PMID: 34641934 PMCID: PMC8507212 DOI: 10.1186/s13006-021-00428-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 09/28/2021] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Despite considerable policy actions at the national and hospital levels, rates of breastfeeding in the Middle East and North Africa (MENA) region remain below the global average. There is a need to explore the modifiable factors of breastfeeding such as maternal breastfeeding self-efficacy (BSE), support, and mental health among women in this region to guide interventions in the United Arab Emirates (UAE). The aim of this study was to examine the maternal predictors of any and exclusive breastfeeding in a cohort of Emirati and expatriate women residing in the UAE with a specific focus on modifiable factors. METHODS Using a prospective cohort design, Emirati and expatriate women were recruited in the immediate postpartum period (N = 374) and followed at three and 6 months postpartum between February 2018 and July 2019. Questionnaires with validated tools were used to collect information on sociodemographic characteristics, breastfeeding practices, BSE, postnatal depression, and anxiety. The main outcomes in the study were Any Breastfeeding and exclusivity practices, which were assessed at three and 6 months postpartum by asking the mother about her breastfeeding behaviour during the past 7 days. Multilevel, multivariate logistic regression was used to estimate the association of different variables with breastfeeding outcomes. RESULTS Almost all women reported initiating breastfeeding during their stay at the hospital (n = 357), while only 263 (70.3%) initiated breastfeeding within the first hour of delivery. At 6 months postpartum, 301 (81.5%) women continued to breastfeed of whom 100 (26.7%) were doing so exclusively. Older mothers who initiated breastfeeding within 1 h of birth and were satisfied with the breastfeeding support they received from family and friends had significantly greater odds of any breastfeeding at 6 months. Whereas a clinically significant Edinburgh Postnatal Depression Scale (EPDS) score, low BSE score as well as employment outside the home were associated with significantly lower odds of exclusive breastfeeding and any breastfeeding at 6 months postpartum. CONCLUSION This study highlights the need to develop effective education strategies and support programs targeting these modifiable variables to improve breastfeeding outcomes among women in the UAE.
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Affiliation(s)
- Hadia Radwan
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates.
| | - Randa Fakhry
- Department of Nursing, College of Health Sciences, Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Nick Metheny
- School of Nursing and Health Studies, University of Miami, Miami, USA
| | - Wegdan Baniissa
- Department of Nursing, College of Health Sciences, Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Moez Al Islam E Faris
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Reyad Shaker Obaid
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Suad Al Marzooqi
- Department of Psychology, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Hessa Al Ghazal
- Sharjah Child-Friendly Office, Sharjah, United Arab Emirates
| | - Mahmoud ElHalik
- Department of Neonatology, Latifa Women and Children Hospital, Dubai, United Arab Emirates
| | - Cindy-Lee Dennis
- Department of Psychiatry, University of Toronto, Toronto, Canada.
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Itani L, Radwan H, Hashim M, Hasan H, Obaid RS, Ghazal HA, Al Hilali M, Rayess R, Mohamed HJJ, Hamadeh R, Al Rifai H, Naja F. Dietary patterns and their associations with gestational weight gain in the United Arab Emirates: results from the MISC cohort. Nutr J 2020; 19:36. [PMID: 32316972 PMCID: PMC7175557 DOI: 10.1186/s12937-020-00553-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 04/06/2020] [Indexed: 02/06/2023] Open
Abstract
Background Suboptimum weight gain during pregnancy may carry long term health consequences for the infant or mother. Nutritional imbalances are well recognized as a determinant of gestational weight gain. Few studies examined the effect of dietary patterns on gestational weight gain, especially in countries undergoing nutrition transition, such as the United Arab Emirates. Objectives To characterize dietary patterns among pregnant women living in the UAE and examine their associations with gestational weight gain and gestational weight rate. Methodology Data were drawn from the Mother-Infant Study Cohort, a two-year prospective cohort study of pregnant women living in the United Arab Emirates, recruited during their third trimester (n = 242). Weight gain during pregnancy was calculated using data from medical records. The Institute of Medicine’s recommendations were used to categorize gestational weight gain and gestational weight gain rate into insufficient, adequate, and excessive. During face-to-face interviews, dietary intake was assessed using an 89-item culture-specific semi-quantitative food frequency questionnaire that referred to usual intake during pregnancy. Dietary patterns were derived by principal component analysis. Multiple logistic regression analyses were used to evaluate the associations of derived dietary patterns with gestational weight gain/gestational weight gain rate. Results Two dietary patterns were derived, a “Diverse” and a “Western” pattern. The “Diverse” pattern was characterized by higher intake of fruits, vegetables, mixed dishes while the “Western” pattern consisted of sweets and fast food. The “Western” pattern was associated with excessive gestational weight gain (OR:4.04,95% CI:1.07–15.24) and gestational weight gain rate (OR: 4.38, 95% CI:1.28–15.03) while the “Diverse” pattern decreased the risk of inadequate gestational weight gain (OR:0.24, 95% CI:0.06–0.97) and gestational weight gain rate (OR:0.28, 95% CI:0.09–0.90). Conclusion The findings of this study showed that adherence to a “Diverse” pattern reduced the risk of insufficient gestational weight gain/gestational weight gain rate, while higher consumption of the “Western” pattern increased the risk of excessive gestational weight gain/gestational weight gain rate. In view of the established consequences of gestational weight gain on the health of the mother and child, there is a critical need for health policies and interventions to promote a healthy lifestyle eating through a life course approach.
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Affiliation(s)
- Leila Itani
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University, Beirut, Lebanon
| | - Hadia Radwan
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, Research Institute of Medical and Health Sciences(RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| | - Mona Hashim
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, Research Institute of Medical and Health Sciences(RIMHS), University of Sharjah, Sharjah, United Arab Emirates.,Nutrition and Dietetics Program, Universiti Sains Malaysia, Kelantan, Malaysia
| | - Hayder Hasan
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, Research Institute of Medical and Health Sciences(RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| | - Reyad Shaker Obaid
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, Research Institute of Medical and Health Sciences(RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| | - Hessa Al Ghazal
- Sharjah Child Friendly Office, Sharjah, United Arab Emirates
| | - Marwa Al Hilali
- Clinical Nutrition Department, Al Qassimi Hospital-Ministry of Health and Prevention, Sharjah, United Arab Emirates
| | - Rana Rayess
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, Research Institute of Medical and Health Sciences(RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| | | | - Rena Hamadeh
- Department of Nutrition and Food Sciences, Faculty of Agriculture and Food Sciences, American University of Beirut, Beirut, Lebanon
| | - Hiba Al Rifai
- Department of Nutrition and Food Sciences, Faculty of Agriculture and Food Sciences, American University of Beirut, Beirut, Lebanon
| | - Farah Naja
- Department of Nutrition and Food Sciences, Faculty of Agriculture and Food Sciences, American University of Beirut, Beirut, Lebanon.
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Radwan H, Fakhry R, issa W, Hanach N, Obaid R, E. Faris MI, Al Marzooqi S, Al Ghazal H, ElHalik M, DSuza D, Al Hilali M, Rayess R, Shihadeh N, Dennis CL. Maternal mental health and infant feeding practices cohort protocol: Methodology and baseline characteristics. Hamdan Med J 2020. [DOI: 10.4103/hmj.hmj_13_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Hashim M, Radwan H, Hasan H, Obaid RS, Al Ghazal H, Al Hilali M, Rayess R, Chehayber N, Mohamed HJJ, Naja F. Gestational weight gain and gestational diabetes among Emirati and Arab women in the United Arab Emirates: results from the MISC cohort. BMC Pregnancy Childbirth 2019; 19:463. [PMID: 31795984 PMCID: PMC6892062 DOI: 10.1186/s12884-019-2621-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Accepted: 11/22/2019] [Indexed: 02/06/2023] Open
Abstract
Background Nutritional status of women during pregnancy has been considered an important prognostic indicator of pregnancy outcomes. Objectives To investigate the pattern of gestational weight gain (GWG) and gestational diabetes mellitus (GDM) and their risk factors among a cohort of Emirati and Arab women residing in the United Arab Emirates (UAE). A secondary objective was to investigate pre-pregnancy body mass index (BMI) and its socio-demographic correlates among study participants. Methods Data of 256 pregnant women participating in the cohort study, the Mother-Infant Study Cohort (MISC) were used in this study. Healthy pregnant mothers with no history of chronic diseases were interviewed during their third trimester in different hospitals in UAE. Data were collected using interviewer-administered multi-component questionnaires addressing maternal sociodemographic and lifestyle characteristics. Maternal weight, weight gain, and GDM were recorded from the hospital medical records. Results Among the study participants, 71.1% had inadequate GWG: 31.6% insufficient and 39.5% excessive GWG. 19.1% reported having GDM and more than half of the participants (59.4%) had a pre-pregnancy BMI ≥ 25 kg/m2. The findings of the multiple multinomial logistic regression showed that multiparous women had decreased odds of excessive gain as compared to primiparous [odds ratio (OR): 0.17; 95% CI: 0.05–0.54]. Furthermore, women with a pre-pregnancy BMI ≥ 25 kg/m2 had increased odds of excessive gain (OR: 2.23; 95%CI: 1.00–5.10) as compared to those with pre-pregnancy BMI < 25 kg/m2. Similarly, women who had a pre-pregnancy BMI ≥ 25 kg/m2 were at higher risk of having GDM (OR: 2.37; 95%CI: 1.10–5.12). As for the associations of women’s characteristics with pre-pregnancy BMI, age and regular breakfast consumption level were significant predictors of higher pre-pregnancy BMI. Conclusions This study revealed alarming prevalence rates of inadequate, mainly excessive, GWG and GDM among the MISC participants. Pre-pregnancy BMI was found a risk factor for both of these conditions (GWG and GDM). In addition, age and regular breakfast consumption were significant determinants of pre-pregnancy BMI. Healthcare providers are encouraged to counsel pregnant women to maintain normal body weight before and throughout pregnancy by advocating healthy eating and increased physical activity in order to reduce the risk of excessive weight gain and its associated complications.
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Affiliation(s)
- Mona Hashim
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, Research Institute of Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| | - Hadia Radwan
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, Research Institute of Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| | - Hayder Hasan
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, Research Institute of Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| | - Reyad Shaker Obaid
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, Research Institute of Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| | - Hessa Al Ghazal
- Family Health Promotion Center, Sharjah, United Arab Emirates
| | - Marwa Al Hilali
- Al Qassimi Hospital, Ministry of Health and Prevention, Sharjah, United Arab Emirates
| | - Rana Rayess
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, Research Institute of Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| | - Noor Chehayber
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, Research Institute of Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| | | | - Farah Naja
- Department of Nutrition and Food Sciences, American University of Beirut, Beirut, Lebanon.
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McJarrow P, Radwan H, Ma L, MacGibbon AK, Hashim M, Hasan H, Obaid RS, Naja F, Mohamed HJJ, Al Ghazal H, Fong BY. Human Milk Oligosaccharide, Phospholipid, and Ganglioside Concentrations in Breast Milk from United Arab Emirates Mothers: Results from the MISC Cohort. Nutrients 2019; 11:E2400. [PMID: 31597293 PMCID: PMC6835464 DOI: 10.3390/nu11102400] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 09/11/2019] [Accepted: 09/18/2019] [Indexed: 02/07/2023] Open
Abstract
Human milk oligosaccharides (HMOs), phospholipids (PLs), and gangliosides (GAs) are components of human breast milk that play important roles in the development of the rapidly growing infant. The differences in these components in human milk from the United Arab Emirates (UAE) were studied in a cross-sectional trial. High-performance liquid chromatography‒mass spectrometry was used to determine HMO, PL, and GA concentrations in transitional (5-15 days) and mature (at 6 months post-partum) breast milk of mothers of the United Arab Emirates (UAE). The results showed that the average HMO (12 species), PL (7 species), and GA (2 species) concentrations quantified in the UAE mothers' transitional milk samples were (in mg/L) 8204 ± 2389, 269 ± 89, and 21.18 ± 11.46, respectively, while in mature milk, the respective concentrations were (in mg/L) 3905 ± 1466, 220 ± 85, and 20.18 ± 9.75. The individual HMO concentrations measured in this study were all significantly higher in transitional milk than in mature milk, except for 3 fucosyllactose, which was higher in mature milk. In this study, secretor and non-secretor phenotype mothers showed no significant difference in the total HMO concentration. For the PL and GA components, changes in the individual PL and GA species distribution was observed between transitional milk and mature milk. However, the changes were within the ranges found in human milk from other regions.
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Affiliation(s)
- Paul McJarrow
- Fonterra Research and Development Centre, Dairy Farm Road, Private Bag 11029, Palmerston North 4442, New Zealand; (L.M.); (B.Y.F.)
| | - Hadia Radwan
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, Research Institute of Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah 27272, UAE; (H.R.); (M.H.); (H.H.); (R.S.O.)
| | - Lin Ma
- Fonterra Research and Development Centre, Dairy Farm Road, Private Bag 11029, Palmerston North 4442, New Zealand; (L.M.); (B.Y.F.)
| | - Alastair K.H. MacGibbon
- Fonterra Research and Development Centre, Dairy Farm Road, Private Bag 11029, Palmerston North 4442, New Zealand; (L.M.); (B.Y.F.)
| | - Mona Hashim
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, Research Institute of Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah 27272, UAE; (H.R.); (M.H.); (H.H.); (R.S.O.)
- School of Health Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia;
| | - Hayder Hasan
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, Research Institute of Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah 27272, UAE; (H.R.); (M.H.); (H.H.); (R.S.O.)
| | - Reyad Shaker Obaid
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, Research Institute of Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah 27272, UAE; (H.R.); (M.H.); (H.H.); (R.S.O.)
| | - Farah Naja
- Department of Nutrition and Food Sciences, American University of Beirut, Beirut 1107 2020, Lebanon;
| | - Hamid Jan Jan Mohamed
- School of Health Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia;
| | | | - Bertram Y. Fong
- Fonterra Research and Development Centre, Dairy Farm Road, Private Bag 11029, Palmerston North 4442, New Zealand; (L.M.); (B.Y.F.)
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Radwan H, Hashim M, Shaker Obaid R, Hasan H, Naja F, Al Ghazal H, Jan Jan Mohamed H, Rizk R, Al Hilali M, Rayess R, Izzaldin G. The Mother-Infant Study Cohort (MISC): Methodology, challenges, and baseline characteristics. PLoS One 2018; 13:e0198278. [PMID: 29851999 PMCID: PMC5978878 DOI: 10.1371/journal.pone.0198278] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Accepted: 05/16/2018] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND The United Arab Emirates (UAE) exhibits alarming high prevalence of Non-Communicable Diseases (NCDs) and their risk factors. Emerging evidence highlighted the role of maternal and early child nutrition in preventing later-onset NCDs. The objectives of this article are to describe the design and methodology of the first Mother and Infant Study Cohort (MISC) in UAE; present the baseline demographic characteristics of the study participants; and discuss the challenges of the cohort and their respective responding strategies. METHODS The MISC is an ongoing two-year prospective cohort study which recruited Arab pregnant women in their third trimester from prenatal clinics in Dubai, Sharjah and Ajman. Participants will be interviewed six times (once during pregnancy, at delivery, and at 2, 6, 12 and 24months postpartum). Perinatal information is obtained from hospital records. Collected data include socio-demographic characteristics, lifestyle, dietary intake and anthropometry; infant feeding practices, cognitive development; along with maternal and infant blood profile and breast milk profile. RESULTS The preliminary results reported that 256 completed baseline assessment (mean age: 30.5±6.0 years; 76.6% multiparous; about 60% were either overweight or obese before pregnancy). The prevalence of gestational diabetes was 19.2%. Upon delivery, 208 women-infant pairs were retained (mean gestational age: 38.5±1.5 weeks; 33.3% caesarean section delivery; 5.3% low birthweight; 5.7% macrosomic deliveries). Besides participant retention, the main encountered challenges pertained to cultural complexity, underestimation the necessary start-up time, staff, and costs, and biochemical data collection. CONCLUSIONS Despite numerous methodological, logistical and sociocultural challenges, satisfactory follow-up rates are recorded. Strategies addressing challenges are documented, providing information for planning and implementing future birth cohort studies locally and internationally.
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Affiliation(s)
- Hadia Radwan
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, Research Institute of Medical and Health Sciences(RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| | - Mona Hashim
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, Research Institute of Medical and Health Sciences(RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| | - Reyad Shaker Obaid
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, Research Institute of Medical and Health Sciences(RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| | - Hayder Hasan
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, Research Institute of Medical and Health Sciences(RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| | - Farah Naja
- Department of Nutrition and Food Sciences, American University of Beirut, Beirut, Lebanon
| | - Hessa Al Ghazal
- Family Health Promotion Center, Sharjah, United Arab Emirates
| | | | - Rana Rizk
- Department of Health Services Research, Maastricht University, Maastricht, The Netherlands
- Institut National de Santé Publique, d’Épidémiologie Clinique et de Toxicologie (INSPECT-LB), The Lebanese University, Beirut, Lebanon
| | - Marwa Al Hilali
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, Research Institute of Medical and Health Sciences(RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| | - Rana Rayess
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, Research Institute of Medical and Health Sciences(RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| | - Ghamra Izzaldin
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, Research Institute of Medical and Health Sciences(RIMHS), University of Sharjah, Sharjah, United Arab Emirates
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Abstract
INTRODUCTION Breastfeeding promotion, protection, and support are one of the most cost-effective public health interventions to advance maternal and child health. The World Health Organization, the United Nations International Children's Emergency Fund, and numerous health organizations have recommended exclusive breastfeeding for the first 6 months of life, which is a key indicator of breastfeeding promotion programs worldwide. Despite the recommendations and various initiatives to promote breastfeeding, most women do not reach the exclusive breastfeeding target in both developed and developing countries. Such has been the case in the United Arab Emirates (UAE). MATERIALS AND METHODS Therefore, based on the decree for breastfeeding promotion, protection, and support by the ruler of the Emirate of Sharjah, UAE, H.H. Sheikh Doctor Sultan Al Qasimi, a multisectorial, multidirectional breastfeeding campaign--the Sharjah Baby-Friendly Campaign--was launched in March 2012 by H.E. Sheikha Bodour Al Qasimi, under her patronage. It consisted of four initiatives-namely, Baby-Friendly Health Facility, Mother-Friendly Workplace, Breastfeeding-Friendly Nursery, and Mother-Baby Friendly Public Place. Once an organization met the criteria for any of these initiatives, it was awarded the designation or accreditation of that initiative. RESULTS The campaign initiatives worked through capacity building of healthcare workers, provided professional support and facilitation for the accreditation process, developed breastfeeding education content and resources, and organized and conducted breastfeeding promotion seminars in health facilities and community, as well as community outreach through social media and an innovative mobile mother' room. CONCLUSIONS The positive impact of the campaign on breastfeeding promotion, protection, and support is evident by the increased exclusive breastfeeding rate at 6 months and decreased bottle feeding rates at both 4 and 6 months.
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Affiliation(s)
- Hessa Al Ghazal
- 1 Sharjah Baby-Friendly Campaign , Sharjah, United Arab Emirates .,2 Maternal and Child Health , Ministry of Health, Sharjah, United Arab Emirates
| | - Shehnaz Rashid
- 1 Sharjah Baby-Friendly Campaign , Sharjah, United Arab Emirates
| | - Evelyne Ruf
- 1 Sharjah Baby-Friendly Campaign , Sharjah, United Arab Emirates .,2 Maternal and Child Health , Ministry of Health, Sharjah, United Arab Emirates
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