Impact of GSTT1 AND GSTM1 variants and hair mercury concentration in maternal blood pressure among coastal pregnant women in Central Java, Indonesia.

The GSTT1 and GSTM1 genes have a role in mercury metabolism and excretion, as well as blood pressure response, impacting birth outcomes. The present study assesses whether GSTT1 and GSTM1 deletion variants and maternal hair Hg concentration are associated with blood pressure and birth outcomes among the Indonesian coastal pregnant mother population. A cross-sectional study was conducted on 139 pregnant women in the Jepara coastal area of Central Java, Indonesia. Maternal characteristics during pregnancy, including blood pressure and birth outcomes, were collected. GSTT1 and GSTM1 gene variants were detected using polymerase chain reaction (PCR). Hair Hg levels were measured using the reducing-vaporization mercury analyzer. The mean maternal hair Hg concentration was 0.727±0.558 µg/g. GSTT1 genotype homozygous deletion was found in 41.7% of subjects, while no GSTM1 deletion was found. No statistically significant difference was found between deletion and non-deletion groups for hair Hg. GSTT1 deletion genotype shows protection but is inconclusive toward diastolic hypertension (p=0.048, OR 0.285, CI 0.077-1.052) and insignificant with birth outcomes (all p>0.05). High hair Hg concentration and positive history of cardiovascular diseases increase the risk of systolic and diastolic hypertension during pregnancy with OR 6.871 (CI 95% 1.445-32.660) and 8.518 (CI 95% 2.126-34.125), respectively, while not in birth outcomes. Maternal Hg exposure and history of cardiovascular diseases are independent risk factors for pregnant hypertension, whereas the GSTT1 homozygous deletion genotype has no role in diastolic hypertension and birth outcomes among the Indonesian coastal pregnant mother population.

Determinants of length for age Z scores among children aged 6-23 months in Central Java, Indonesia: a path analysis.

Introduction: Length for Age Z (LAZ) score determinants are complex and vary among different areas, but it is important for designing effective and efficient strategies to decrease stunting prevalence among children under 2 years. This study aimed to investigate the determinants of LAZ scores among children under 2 years in Central Java, Indonesia. Methods: This study was conducted on the 2021 Indonesian Nutritional Status Study (INSS) dataset, which was a cross-sectional survey. Data on 3,430 children aged 6-23 months from Central Java province were derived from the 2021 INSS data. After missing data elimination, 3,238 subjects were included in the analysis. Determinant factors included direct and indirect factors. Direct factors were the mother's age, birth weight Z score (BWZ), birth length Z score (BLZ), exclusively breastfed history, dietary diversity scores (DDS), empty calorie drink consumption, unhealthy snacks consumption, and infections. Indirect factors were early initiation of breastfeeding (EIBF) and posyandu (integrated health post) utilization. Underlying factors were socioeconomic status (SES) and the mother's education. Bivariate analyses and multiple linear regressions were conducted. A path analysis with a hypothesized model based on the UNICEF conceptual framework was also performed. Results: Stunting, wasting and underweight proportions among the subjects were 19.1%, 7.6% and 12.3%, respectively. The mean LAZ scores were -0.95 ± 1.22; the mother's age was 29.7 ± 5.95 years; BWZ was -0.47 ± 0.97; BLZ was -0.55 ± 1.05; and DDS was 4.45 ± 1.51. The infection proportion among the subjects was 28%. BWZ and BLZ were positively correlated to LAZ scores, with r = 0.267 (p < 0.01) and r = 0.260 (p < 0.01), respectively. The mother's age was negatively correlated to LAZ scores with r = -0.041 (p < 0.05). Maternal education was positively correlated to SES but had no direct effect on LAZ scores. LAZ score determinants of BLZ (p < 0.001) and SES (p < 0.001) showed positive direct associations with LAZ scores, but the mother's age (p = 0.039), exclusively breastfed history (p < 0.001), and empty calorie drinks consumption (p < 0.001) had negative associations with LAZ scores. Conclusion: To prevent stunting among children aged 6-23 months in Central Java, Indonesia, intervention programs to increase the nutritional status of women at child-bearing age and nutrition education on child feeding practices should be conducted more efficiently and effectively.

Comparison of high and low stunting reduction groups using IFE-EFE matrix analysis in Central Java Province, Indonesia.

Background: The results of the 2021 Indonesian Nutritional Status Study (Studi Status Gizi Indonesia, SSGI) showed a 6.8% declining prevalence of stunting in Central Java from 2019 to 2021. However, the prevalence decreases in the regency level of Central Java varied from 0.1 to 20.3%. This study aimed to analyze the external and internal factors that influenced the stunting reduction prevalence in Central Java Province, Indonesia. Methods: This qualitative study was conducted over 2 months, from April to May 2022. In-depth interviews were used to explore the supporting factors (external, internal, and strategies) and the challenges (internal, external, and solutions) in implementing stunting reduction acceleration programs. The supporting factors and challenges were compared between the groups with high Gro, Sra, Kla, and Pek (GSKP) and low Sur, Mag, Teg, and Pat (SMTP) reduction prevalence. Data were analyzed using internal factor evaluation (IFE) and external factor evaluation (EFE). Results: In quadrant II, the high-reduction group (GSKP) had IFE and EFE scores of 2.61 and 2.76, respectively. In quadrant IV, the low-reduction group (SMTP) had IFE and EFE scores of 1.86 and 1.62, respectively. The high-reduction group (GSKP) was better than the low-reduction group (SMTP) in using external opportunities and internal strengths by avoiding external threats and minimizing the weakness in the stunting reduction acceleration program in each area. The existence of superior programs and innovations were the strengths that differentiated the high and low groups. Conversely, the low-stunting reduction group struggled to overcome major challenges, especially lacking leadership capacity. From the outside, lack of program sustainability at the village level and budget restraint were the threats found in both groups. Conclusion: Compared with the low-stunting reduction group, the high group could maximize their strengths and use the opportunities to implement stunting reduction programs.

The First Exposure Assessment of Mercury Levels in Hair among Pregnant Women and Its Effects on Birth Weight and Length in Semarang, Central Java, Indonesia.

(1) Background: Methylmercury (MeHg) exposure during pregnancy is an important issue due to its possible adverse health effects on fetus. To contribute the development of assessment system of Hg exposure through fish consumption and health effects on children, we examined the hair Hg levels in pregnant women and birth weight and length. (2) Methods: In 2018, a cohort study was conducted on 118 pregnant women-infant pairs from six community health centers in the northern coastal area in Central Java Indonesia. Data on mothers' characteristics during pregnancy, birth outcomes, and fish consumption were collected. Total Hg concentrations were determined from hair samples. (3) Results: The median (min-max) of the maternal hair Hg level was 0.434 (0.146-8.105) µg/g. Pregnant women living in lowland areas, near the sea, showed higher hair Hg concentration and fish consumption than those in highland areas {[0.465 (0.146-8.105) vs. 0.385 (0.150-1.956) µg/g; p = 0.043] and [(85.71 (0-500.0) vs. 49.76 (0.0-428.57) g/day; p < 0.01], respectively}. The maternal hair Hg level had no association with baby's birth weight and length. (4) Conclusions: The median maternal hair Hg is at a low level and had no association with infant birth weight and length in this study subjects.

The role of glutathione peroxidase maternal serum level in late onset of severe preeclampsia.

OBJECTIVE: This study was done to investigate the association between maternal serum glutathione peroxidase (GP) and late onset of severe preeclampsia. METHODS: Cross-sectional study was undertaken comparing normal pregnancy and severe preeclampsia at 37-42 weeks of gestational age. Maternal venous blood was taken to assess the level of GP. RESULT: Twenty normal pregnancy and 20 severe preeclampsia patients were investigated. The median (max-min) of GP level for preeclampsia was 4.31 (0.03-327.41) mU/mL significantly lower than in normal pregnancy 318.90 (6.46-694.11) mU/mL (p < 0.001). A receiver operating characteristics (ROC) analysis showed that the cutoff point for GP to differentiate between normal pregnancy and severe preeclampsia was 41.74 mU/mL. Multivariate analysis was done to investigate the impact of BMI and parity showed that a low level of GP will increase the risk of severe preeclampsia. CONCLUSION: Low level of GP was associated with the diagnosis of severe preeclampsia.