Association Between Iron, Folate, and Zinc Deficiencies During Pregnancy and Low Birth Weight: Systematic Review of Cohort Studies.

CONTEXT: Iron, folate, and zinc deficiencies during the gestational period may be associated with negative perinatal outcomes, such as low birth weight (LBW), but these relationships are not yet fully established in the scientific literature and require further investigation. OBJECTIVE: To systematically review the scientific production to investigate the association between iron, folate, and zinc deficiencies during pregnancy and LBW. DATA SOURCES: The search was carried out using high-sensitivity descriptors in the English, Portuguese, and Spanish languages, combined with Boolean operators, adapted to each of the following indexed databases: MEDLINE via PubMed, Embase, LILACS via BVS, CENTRAL, and Web of Science. The eligibility criteria followed the PECOS (population, exposure, comparator, outcome, study) strategy. DATA EXTRACTION: Data extraction was performed using an Excel spreadsheet with the study variables of interest. Subsequently, the information was analyzed and summarized in a table. The Newcastle-Ottawa Scale was used to perform the risk-of-bias analysis. DATA ANALYSIS: A total of 21 042 references were identified, of which 7169 related to folate, 6969 to iron, and 6904 to zinc. After eligibility criteria application, 37 articles were included in this study, of which 18 referred to zinc nutritional status, 10 related to iron, and 9 related to folate. Studies of iron (40%), folate (66.66%), and zinc (50%) revealed a positive association between deficiencies of these micronutrients and LBW. The overall methodological quality of the studies included in this review was considered high. CONCLUSIONS: Iron, folate, and zinc deficiencies are still present during gestation. Nevertheless, the association between deficiencies of these micronutrients and LBW is still contradictory, and more studies are needed, as is efficient nutritional monitoring before and during gestation. SYSTEMATIC REVIEW REGISTRATION: PROSPERO registration no. CRD42021284683.

Evaluation of fecal microbiota and its correlation with inflammatory, hormonal, and nutritional profiles in women.

The present study evaluated the gut microbiota profiles of 40 women and correlated them with their nutritional, inflammatory, and hormonal profiles. Stool and blood samples were collected, and anthropometric measurements were obtained from 20 women diagnosed with obesity ("case" group) and 20 women with weight in the normal range ("control" group). Bacteria belonging to two phyla, Firmicutes and Bacteroidetes, one class, Mollicutes, and four genera were evaluated by real-time polymerase chain reaction. Levels of 18 inflammatory cytokines were measured using the Luminex assay, and ghrelin and leptin levels were measured using enzymatic immunoadsorption assay. Mollicutes proportion differed significantly between the case and control groups, and a significant positive association was detected between the presence of Mollicutes and obesity. Statistically significant differences were observed between the proportions of Firmicutes and Bacteroidetes in the two groups, with a higher proportion of Firmicutes/Bacteroidetes ratio among the gut microbiota of women in the case group compared to those of the control group. Higher counts of Escherichia coli and Clostridium spp. were observed in the control group than in the case group, whereas higher counts of Lactobacillus spp. and Bacteroides spp. were detected in the case group than in the control group. There was a positive correlation between interleukin-6 (IL-6) and interferon-γ (IFN-γ) levels and the anthropometric variables and a negative correlation between IL-10 and these variables. Leptin and ghrelin concentrations differed significantly between the two groups and showed positive and negative correlation with obesity predictors, respectively. Therefore, gut microbiota was associated with obesity in women from this study group. Moreover, this microbiota was associated with inflammatory profiles and alterations in ghrelin and leptin levels.

Effect of Acetaminophen use during pregnancy on adverse pregnancy outcomes: a systematic review and meta-analysis.

INTRODUCTION: A high number of women are exposed to acetaminophen during pregnancy worldwide. This drug safety during pregnancy regarding preterm birth, birth weight, and fetal development has not been well described. This study investigated the effect of acetaminophen use during pregnancy on selected adverse pregnancy outcomes. AREAS COVERED: Databases were searched to identify studies reporting the effects of acetaminophen use during pregnancy on preterm birth, low birth weight, and small for gestational age. The studies' quality was assessed by the Newcastle-Ottawa Scale and the Methodological Index for Non-Randomized Studies. Risk ratios with 95% confidence intervals were estimated using a fixed or random-effects model. Six studies were included for final review, four cohort and two case-control studies. We found no increased risk of preterm birth (RR 0.97; 95% CI 0.59-1.58), and decreased risks of low birth weight (RR 0.65; 95% CI 0.59-0.72) and small for gestational age (RR 0.69; 95% CI 0.50-0.97). Acetaminophen exposure during the third trimester revealed non-significantly in the outcomes. EXPERT OPINION: Exposure to acetaminophen during pregnancy appears to not increase the risk of the outcomes analyzed. However, there is a lack of information regarding the exposure dose and frequency of acetaminophen use.

Vitamin D deficiency and anemia in pregnant women: a systematic review and meta-analysis.

CONTEXT: Epidemiological studies suggest an association between vitamin D deficiency and anemia. Evidence of this relationship in pregnant women, however, is scarce. OBJECTIVE: The aim of this systematic review was to investigate the association between vitamin D deficiency and gestational anemia through observational studies. DATA SOURCES: The PubMed, Scopus, Web of Science, ScienceDirect, Embase, and Virtual Health Library databases were searched from inception to April 2021. STUDY SELECTION: Original articles reporting observational studies that investigated the association between vitamin D deficiency and gestational anemia were included. Articles that did not have an abstract, as well as reviews articles, experimental studies, and editorials, were excluded. Two reviewers independently performed study selection, data extraction, and assessment of study quality. Disagreements between the reviewers were resolved by a third reviewer. DATA EXTRACTION: Study quality was assessed by 2 scales. Data were extracted from eligible studies and arranged in a 2 × 2 table. Odds ratios with 95% confidence intervals for the risk of the outcome were estimated using a fixed-effect model. RESULTS: In total, 985 studies were retrieved, of which 17 were included in the systematic review: 11 cohort studies, 3 case-control studies, and 3 cross-sectional studies. For the meta-analysis, 8 studies with a total of 6530 women were included. There was a 61% increase in the odds of anemia in pregnant women with vitamin D deficiency (OR = 1.61; 95%CI, 1.41-1.83; I2 = 48%). CONCLUSIONS: Vitamin D deficiency may be a risk factor for anemia in pregnant women. SYSTEMATIC REVIEW REGISTRATION: PROSPERO registration no. CRD42020182697.

Relative validation of a food frequency questionnaire to assess dietary fatty acid intake / Validación relativa de un cuestionario de frecuencia de alimentos para evaluar la ingesta dietaria de ácido graso

OBJECTIVES: This study aimed to develop and validate a Food Frequency Questionnaire (FFQ) for assessing consumption of fatty acids among pregnant women. METHODS: Two lists of foods were created according to percent contribution of each nutrient estimated by three 24-hour recalls: a long and short version FFQ to estimate long-chain polyunsaturated fatty acids (LCPUFAs). Student paired t-test and Pearson correlation coefficients were used to verify the differences in mean consumption of nutrients from the FFQ and 24-hour recall. The concordance between the consumption values of the two methods was assessed using the Bland-Altman method and quartiles concordance. RESULTS: For the FFQ - long version, correlation values ranged from 0.33 (<0.05) to 0.62 (<0.01) for docosahexaenoic acid (DHA) and linoleic acid (LA), respectively. Eicosapentaenoic acid (EPA) and docosapentaenoic acid (DPA) were not correlated. Exact concordance ranged from 49.0% (energy) to 22.4% (EPA), and discordance ranged from 14.3% (DPA) to 2.0% (Saturated). The FFQ - short version had high correlations for LCPUFAs. Exact concordance ranged from 36.7% (n-3 LCPUFA) to 16.3% (DHA); and discordance from 12.2% (DPA) to 2.0% (arachidonic acid). Bland-Altman analysis showed good concordance for both versions. CONCLUSION: This nutrient-specific FFQ is a valid instrument to be used to estimate the level of consumption of fatty acids among pregnant women.

OBJETIVO: Este estudio tuvo como objetivo desarrollar y validar un cuestionario de frecuencia de consumo de alimentos para evaluar el consumo de ácidos grasos en gestantes. MÉTODOS: Dos listas de alimentos fueron creadas de acuerdo con la contribución porcentual de cada nutriente estimado por 3 recordatorios de 24 horas: CFC - versión larga y CFC - versión corta para estimar ácidos grasos poliinsaturados de cadena larga (AGPICL). La prueba de t pareada de Student y el coeficiente de correlación de Pearson se utilizaron para verificar las diferencias entre el consumo medio de nutrientes de del CFC y el recordatorio de 24 horas. La concordancia entre los valores de consumo de los dos métodos se evaluó mediante el método de Bland-Altman y la concordancia de cuartiles. RESULTADOS: En CFC - versión larga, los valores de correlación oscilaron entre 0.33 (<0.05) y 0.62 (<0.01) para ácido docosahexaenoico (DHA) y ácido linoleico (LA), respectivamente. Ácido eicosapentaenoico (EPA) y ácido docosapentaenoico (DPA) no presentaron correlación. La concordancia exacta varió de 49,0% (energía) a 22,4% (EPA), y la discordancia varió de 14,3% (DPA) a 2,0% (saturado). CFC: la versión corta mostró los mejores valores de correlaciones para los AGPICL. La concordancia exacta varió de 36,7 (n-3 LCPUFA) a 16,3% (DHA); y discordancia de 12,2% (DPA) a 2,0% (ácido araquidónico). El análisis de Bland-Altman mostró una buena concordancia para ambas versiones. CONCLUSIÓN: Este método CFC específico de nutrientes es un instrumento válido que se utiliza para estimar el nivel de consumo de ácidos grasos en mujeres gestantes.

Polymorphism in the vitamin D receptor gene is associated with maternal vitamin D concentration and neonatal outcomes: A Brazilian cohort study.

OBJECTIVES: This study evaluated the associations between single-nucleotide polymorphisms (SNPs) of the vitamin D receptor (VDR) gene, maternal vitamin D concentration, and gestational outcomes. METHODS: The cohort consisted of 270 pregnant women who received prenatal services at basic public healthcare centers in the city of Santo Antônio de Jesus, Bahia, Brazil. For statistical analysis, multiple linear regression was used. RESULTS: A mean of 72.62 (SD = 31.51) nmol/L for 25-hydroxyvitamin D (25(OH)D) concentrations was found. The mean birth weight was 3.340 g (SD = 0.545 g), and the mean duration of gestation was 38.66 (SD = 1.83) weeks. Pregnant women who were homozygous for the low-frequency allele GG of SNP TaqI had a higher concentration of vitamin D during gestation (ß = 14.09 nmol/L; 95% CI = 0.85, 27.34) than the higher frequency homozygotes AA (ß = 3.33 nmol/L; 95% CI = -4.37, 11.05). The children of heterozygous women for the ApaI SNP (GA) were born with a lower weight (ß = -131.99 g, 95% CI = -258.50, -5.47, P = .04). The heterozygote genotype of the SNP TaqI (CA) decreased the risk of short duration of gestation (ß = 0.54 weeks, 95% CI = 0.09, 0.99, P = .01), and the homozygote for the lower frequency allele in the SNP ApaI (CC) showed a negative effect, decreasing the duration of gestation (ß = -0.69 weeks, 95% CI = -1.35, -0.26, P = .04). CONCLUSIONS: The VDR gene is an important genetic predictor of a higher concentration of vitamin D during gestation, low birth weight, and decreasing duration of gestation.

Study of the association between the interleukin-1 ß c.3954C>T polymorphism and periodontitis in a population sample from Bahia, Brazil.

BACKGROUND: Periodontitis is an inflammatory disease characterized by the loss of connective tissue and alveolar bone. Different factors are associated with the onset and prognosis of this disease, both environmental and genetic. The latter particularly relate to molecules secreted as a function of the host immune response, such as pro-inflammatory cytokines. Studies indicate that the polymorphism c. 3954C > T in the interleukin-1 ß encoding gene (IL1B) can be considered as an aggravating factor in the periodontitis condition. AIMS: This study aimed to evaluate whether there is an association between the IL1B c. 3954C > T gene polymorphism and the prevalence of periodontitis in the population from Vitória da Conquista-Bahia, Brazil. MATERIALS AND METHODS: A total of 347 subjects (134 cases and 213 controls) who provided epithelial tissue of the oral cavity and saliva samples for DNA extraction and quantification of IL1B, respectively, were selected. Genotyping was performed by polymerase chain reaction-restriction fragment length polymorphism followed by electrophoresis in agarose gel. The evaluation of the cytokine concentration was performed by enzyme-linked immunosorbent assay. STATISTICAL ANALYSIS: Statistical calculations involved in this work include Chi-square test, Fisher Exact test, Mann-Whitney and Kruskal-Wallis tests. RESULTS: Our findings revealed that: (i) No statistically significant relationship between periodontitis and the polymorphism studied was observed; (ii) no significant difference between the concentrations of IL1B in saliva between the case and control subjects and between the genotypes of these individuals and the concentrations of this cytokine. CONCLUSIONS: We conclude that, in the sample evaluated, the IL1B c. 3954C > T polymorphism did not present as an etiological factor for periodontitis.

Produtos naturais utilizados para tratamento de asma em crianças residentes na cidade de Salvador-BA, Brasil / Natural products used for asthma treatment in children living in Salvador-BA, Brazil

O conhecimento popular é o passo inicial para a investigação científica de atividades terapêuticas de remédios caseiros. Diversas patologias podem ser tratadas ou amenizadas através de preparações de origem natural e muitos fármacos disponíveis são oriundos de fontes naturais. Este trabalho tem como objetivo avaliar o uso de remédios caseiros derivados de plantas para tratamento de asma em crianças residentes no município de Salvador. Os dados foram obtidos a partir de estudo realizado em Salvador sobre fatores de risco, uso de medicações e vias imunológicas relacionadas à asma em crianças. Foram calculadas as freqüências de uso de preparações caseiras para tratamento de asma por esta população e realizado uma revisão bibliográfica sobre os efeitos das plantas mais usadas. Dentre as espécies mais citadas, destacam-se o Allium sativum (alho) que teve a maior freqüência de utilização na preparação dos remédios caseiros (25 por cento), seguido da Allium cepa (cebola, 19,74 por cento). Após a revisão crítica de literatura, constatou-se que a maioria das espécies é utilizada com base em relatos fundamentados no saber popular, sendo assim carente de evidências científicas para as atividades farmacoterapêuticas esperadas. Neste sentido, há necessidade de mais estudos farmacológicos para comprovação das atividades terapêuticas peculiares a cada produto de origem natural bem como para avaliar possíveis efeitos tóxicos destes produtos.

The popular knowledge is the initial step for the scientific inquiry of therapeutical activities of herb-based remedies. Several pathologies can be treated or brightened up through this kind of preparations and also many of the available drugs in the market have natural sources. The objective of this work was to evaluate the use of herb-based remedies for treatment of asthma in children in the city of Salvador. Data were collected by a standard questionnaire during a transversal study carried out in Salvador on risk factors, use of medications and immunological pathways involved in asthma. Among the most frequently mentioned species, the Allium sativum had the highest frequency of use in the preparation of home remedies (25 percent), followed by the Allium cepa (19.74 percent). The literature review showed that the majority of the species is empirically used based on popular knowledge and lacks on scientific evidences that prove their pharmacotherapeutic activities and safety for human use. In this way, this work not only new species unexplored in the context of anti-asthmatic drugs but it also highlights the need for new pharmacological studies in order to identify and prove the popular use of herb-based remedies.