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1.
Rev Lat Am Enfermagem ; 29: e3480, 2021.
Artigo em Inglês, Português, Espanhol | MEDLINE | ID: mdl-34495191

RESUMO

OBJECTIVE: to investigate associations between depressive symptoms during pregnancy, low birth weight, and prematurity among women with low-risk pregnancies assisted in public Primary Health Care services. METHOD: prospective cohort with 193 pregnant women, using the Edinburgh Postnatal Depression Scale, telephone interviews, and medical records available in the health services. Associations of interest were obtained using the Cox regression model. RESULTS: the participants were aged 24.9 years old (median) and had 11 years of schooling (median); 82.4% lived with their partners, and gestational age at the birth was 39 weeks (median). Twenty-five percent of the participants scored ≥13 on the Edinburgh scale. Depressive symptoms did not appear associated with low birth weight (RR=2.06; CI95%=0.56-7.61) or prematurity (RR=0.86; CI95%=0.24-3.09) in the adjusted analysis. However, premature labor increased the risk of low birth weight (RR=4.81; CI95%=1.01-23.0) and prematurity (RR=7.70; CI95%=2.50-23.7). Additionally, each week added to gestational age decreased the risk of low birth weight (RR=0.76; CI95%=0.61-0.95). CONCLUSION: the presence of depressive symptoms among women with low-risk pregnancies was not associated with low birth weight or prematurity.


Assuntos
Depressão , Gestantes , Adulto , Peso ao Nascer , Depressão/epidemiologia , Depressão/etiologia , Feminino , Serviços de Saúde , Humanos , Recém-Nascido de Baixo Peso , Recém-Nascido , Gravidez , Atenção Primária à Saúde , Estudos Prospectivos , Adulto Jovem
2.
J Glob Health ; 11: 13003, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34484710

RESUMO

Background: Adequate antenatal care (ANC) utilization is recognized as one of the important drivers of safe childbirth and positive birth outcomes. The usage of ANC services fluctuates with various personal, socio-economic, and cultural characteristics and in resource-poor settings, adolescent mothers are at a particularly high risk of insufficient ANC utilization. Objectives: This paper investigates whether the usage of ANC services and institutional delivery as well as newborn birth weight differ systematically between adolescent and adult mothers in West and Central Africa. Moreover, we explore to what extent differences in birth weight are explained by ANC usage, adolescence, and select socio-economic characteristics of the mother. Methods: We pooled cross-sectional data from all Demographic and Health Surveys (DHS) and Multi Indicator Cluster Surveys (MICS) conducted in countries in West and Central Africa region between 1986 and 2017 to estimate measures of ANC usage and qualified delivery assistance (along with a combined measure of "adequate maternal healthcare" aggregating these two factors) and newborn birth weight by maternal age group. We estimated various regression models to analyze a) the association between adolescence and adequate prenatal and maternal health care controlling for select socio-economic maternal characteristics as well as the local environment and b) between adolescence, adequate maternal health care, and newborn birth weight outcomes, also controlling for maternal characteristics and the local environment. All regressions were linear probability models for binary outcomes and simple linear models for continuous outcomes. Results: Adequate maternal health care provision was lowest among adolescent mothers: 23.0% among adolescents vs an average of 29.2% across all other age groups. Moreover, we found maternal education and wealth to be positively and significantly associated with receiving adequate maternal health care. Adolescent mothers had the highest risk of low infantile birth weight with 14.5% (95% confidence interval (CI) = 13.6%-15.5%), which is roughly 1.5-2 times higher than in older mothers. We found that adolescence is still strongly associated with low birth weight even when adequate maternal health care and various socio-economic factors as well as the local environment are controlled for. Conclusions: Our findings suggest that ANC supply in resource-poor settings should be particularly tailored to adolescent mothers' needs and that further research is necessary to explore what individual maternal characteristics beyond socio-economic and physical (eg, BMI) factors drive the prevalence of low birth weight. Moreover, the currently used measures of maternal care quality are heavily dependent on pure quantitative measures (number of ANC visits). New indicators incorporating measures of factual quality and scope ought to be developed and incorporated into large routine household surveys such as DHS and MICS.


Assuntos
Serviços de Saúde Materna , Cuidado Pré-Natal , Adolescente , Adulto , Idoso , Peso ao Nascer , Estudos Transversais , Feminino , Humanos , Lactente , Recém-Nascido , Saúde Materna , Aceitação pelo Paciente de Cuidados de Saúde , Gravidez , Fatores Socioeconômicos
3.
Rev Assoc Med Bras (1992) ; 67(4): 529-535, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-34495056

RESUMO

OBJECTIVE: The aim of this study was to describe the motor development (MD) and growth of infants born with low birth weight (LBW) versus adequate birth weight (ABW) by using the Alberta Infant Motor Scale (AIMS). METHODS: The cross-sectional study including LBW infants (aged 6-12 months) followed at an outpatient clinic from a University Hospital in Brazil and a group of infants of the same age with ABW. The variables were recorded as maternal, birth, and infant conditions. The infants were assessed for MD using the AIMS. RESULTS: In total, 98 infants (38 LBW versus 60 ABW) were evaluated and no statistically significant differences were found in demographic characteristics and in the AIMS results. The AIMS results of the total sample were suspicious or abnormal MD in 44 (45%) of total infants. Higher frequency of suspected or abnormal motor behavior was found in the age group between 9 and 12 (54.6%) months. CONCLUSIONS: A frequency of 45% of suspected or abnormal behavior was observed in the evaluated infants, with a higher frequency of occurrence in those aged 9-12 months (54.6%).


Assuntos
Recém-Nascido de Baixo Peso , Peso ao Nascer , Brasil/epidemiologia , Estudos Transversais , Humanos , Lactente , Recém-Nascido
4.
Anim Sci J ; 92(1): e13611, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34431165

RESUMO

Covariance components were estimated for growth traits (BW, birth weight; WW, weaning weight; YW, yearling weight), visual scores (BQ, breed quality; CS, conformation; MS, muscling; NS, navel; PS, finishing precocity), hip height (HH), and carcass traits (BF, backfat thickness; LMA, longissimus muscle area) measured at yearling. Genetic gains were obtained and validation models on direct and maternal effects for BW and WW were fitted. Genetic correlations of growth traits with CS, PS, MS, and HH ranged from 0.20 ± 0.01 to 0.94 ± 0.01 and were positive and low with NS (0.11 ± 0.01 to 0.20 ± 0.01) and favorable with BQ (0.14 ± 0.02 to 0.37 ± 0.02). Null to moderate genetic correlations were obtained between growth and carcass traits. Genetic gains were positive and significant, except for BW. An increase of 0.76 and 0.72 kg is expected for BW and WW, respectively, per unit increase in estimated breeding value (EBV) for direct effect and an additional 0.74 and 1.43, respectively, kg per unit increase in EBV for the maternal effect. Monitoring genetic gains for HH and NS is relevant to maintain an adequate body size and a navel morphological correction, if necessary. Simultaneous selection for growth, morphological, and carcass traits in line with improve maternal performance is a feasible strategy to increase herd productivity.


Assuntos
Peso ao Nascer/genética , Constituição Corporal/genética , Estatura/genética , Bovinos/crescimento & desenvolvimento , Bovinos/genética , Estudos de Associação Genética/veterinária , Característica Quantitativa Herdável , Animais , Cruzamento , Feminino , Humanos , Masculino , Herança Materna/genética , Fenótipo
5.
Theriogenology ; 174: 149-159, 2021 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-34454320

RESUMO

Our objectives were to determine the effects of dam body condition score (BCS), age of dam, and calf sex on placental size and the relationships between dam body weight (BW) and calf size with placental size. Expelled placentas and calf size at birth were collected from crossbred beef heifers and cows during four experiments (n = 22 to 39/experiment). Placentas deemed complete by visual inspection were dissected; dry weights were determined for cotyledonary and intercotyledonary tissues. Mixed linear models were used to individually determine main effects of peripartum BCS category [Thin (<5), Moderate (=5), or Fleshy (≥6)], age of dam category [Primiparous (2 yr), Young (3-4 yr), or Mature (≥5 yr)], and calf sex on placental measures. Correlations were determined for placental characteristics with prepartum dam BW, gestation length, and calf size. Thin BCS dams had lower (P ≤ 0.05) cotyledonary, total placental, and average cotyledon weights and greater placental efficiency (calf birth BW/placental weight) than moderate and fleshy dams. Intercotyledonary weight was lower (P < 0.01) in thin BCS dams compared with fleshy dams. Thin and moderate BCS dams had smaller (P ≤ 0.04) calf birth BW than fleshy dams. Primiparous dams had lower (P ≤ 0.05) total placental and average cotyledon weights than young and mature dams, yet calf birth BW was unaffected (P = 0.17). Male calves were heavier (P = 0.01) than females, yet there were no differences (P ≥ 0.59) in placental weights. Calf birth BW and heart girth had moderate positive correlations (P < 0.01) and shoulder to rump length and abdominal girth had weak positive correlations (P < 0.01) with all placental weights. Dam prepartum BW and calf flank girth had moderate positive correlations (P < 0.01) with total placental weights and weak positive correlations (P < 0.01) with cotyledonary and average cotyledon weights. Intercotyledonary weight had moderate positive correlations (P < 0.01) with gestation length and calf flank girth and a weak positive correlation (P < 0.01) with dam prepartum BW. Gestation length had a weak positive correlation (P = 0.02) with total placental weight. Number of cotyledons was not correlated (P ≥ 0.28) with any dam or offspring characteristics. In conclusion, these data suggest that both maternal age and BCS affected placental size. Calf size at birth and placental weight were positively correlated, but it is still unknown which controls and signals for the growth of the other.


Assuntos
Período Periparto , Placenta , Animais , Peso ao Nascer , Bovinos , Feminino , Feto , Masculino , Gravidez
6.
Nutrients ; 13(8)2021 Aug 12.
Artigo em Inglês | MEDLINE | ID: mdl-34444927

RESUMO

The rise in prevalence of obesity in women of reproductive age in developed and developing countries might propagate intergenerational cycles of detrimental effects on metabolic health. Placental lipid metabolism is disrupted by maternal obesity, which possibly affects the life-long health of the offspring. Here, we investigated placental lipid metabolism in women with pre-gestational obesity as a sole pregnancy complication and compared it to placental responses of lean women. Open profile and targeted lipidomics were used to assess placental lipids and oxidised products of docosahexaenoic (DHA) and arachidonic acid (AA), respectively, neuroprostanes and isoprostanes. Despite no overall signs of lipid accumulation, DHA and AA levels in placentas from obese women were, respectively, 2.2 and 2.5 times higher than those from lean women. Additionally, a 2-fold increase in DHA-derived neuroprostanes and a 1.7-fold increase in AA-derived isoprostanes were seen in the obese group. These changes correlated with a 70% decrease in placental FABP1 protein. Multivariate analyses suggested that neuroprostanes and isoprostanes are associated with maternal and placental inflammation and with birth weight. These results might shed light on the molecular mechanisms associated with altered placental fatty acid metabolism in maternal pre-gestational obesity, placing these oxidised fatty acids as novel mediators of placental function.


Assuntos
Proteínas de Ligação a Ácido Graxo/metabolismo , Isoprostanos/metabolismo , Fenômenos Fisiológicos da Nutrição Materna/genética , Neuroprostanos/metabolismo , Obesidade Materna/metabolismo , Adulto , Peso ao Nascer , Feminino , Humanos , Inflamação , Metabolismo dos Lipídeos , Placenta/metabolismo , Gravidez
7.
J Anim Sci ; 99(8)2021 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-34343280

RESUMO

It is of interest to evaluate crossbred pigs for hot carcass weight (HCW) and birth weight (BW); however, obtaining a HCW record is dependent on livability (LIV) and retained tag (RT). The purpose of this study is to analyze how HCW evaluations are affected when herd removal and missing identification are included in the model and examine if accounting for the reasons for missing traits improves the accuracy of predicting breeding values. Pedigree information was available for 1,965,077 purebred and crossbred animals. Records for 503,716 commercial three-way crossbred terminal animals from 2014 to 2019 were provided by Smithfield Premium Genetics. Two pedigree-based models were compared; model 1 (M1) was a threshold-linear model with all four traits (BW, HCW, RT, and LIV), and model 2 (M2) was a linear model including only BW and HCW. The fixed effects used in the model were contemporary group, sex, age at harvest (for HCW only), and dam parity. The random effects included direct additive genetic and random litter effects. Accuracy, dispersion, bias, and Pearson correlations were estimated using the linear regression method. The heritabilities were 0.11, 0.07, 0.02, and 0.04 for BW, HCW, RT, and LIV, respectively, with standard errors less than 0.01. No difference was observed in heritabilities or accuracies for BW and HCW between M1 and M2. Accuracies were 0.33, 0.37, 0.19, and 0.23 for BW, HCW, RT, and LIV, respectively. The genetic correlation between BW and RT was 0.34 ± 0.03, and between BW and LIV was 0.56 ± 0.03. Similarly, the genetic correlation between HCW and RT was 0.26 ± 0.04, and between HCW and LIV was 0.09 ± 0.05, respectively. The positive and moderate genetic correlations between BW and other traits imply a heavier BW resulted in a higher probability of surviving to harvest. Genetic correlations between HCW and other traits were lower due to the large quantity of missing records. Despite the heritable and correlated aspects of RT and LIV, results imply no major differences between M1 and M2; hence, it is unnecessary to include these traits in classical models for BW and HCW.


Assuntos
Hibridização Genética , Modelos Genéticos , Animais , Peso ao Nascer , Peso Corporal , Feminino , Paridade , Linhagem , Fenótipo , Gravidez , Suínos/genética
8.
Zhonghua Er Ke Za Zhi ; 59(8): 665-671, 2021 Aug 02.
Artigo em Chinês | MEDLINE | ID: mdl-34333919

RESUMO

Objective: To investigate the physical indices and growth status of preterm children aged 0 to 4 years with different birth weight. Methods: Following the real world research approach, the current study retrospectively collected e-chart information of 8 496 preterm children from the child health care system of the Children's Hospital of Chongqing Medical University from December 2010 to December 2017, with 203 123 full-term children followed up during the same period as controls. Premature children were divided into normal birth weight (NBW) group, low birth weight (LBW) group, and very low birth weight (VLBW) group based on their birth weights. The weight and length development within 48 months of age of preterm boys and girls in each group were measured and recorded to establish a numerical table and analyze the growth levels, growth rate, and proportionality. The t-test or chi-square test was used for between-group comparison. Results: Of the 8 496 preterm children, 4 839 were girls and 3 657 boys, including 525 in the VLBW group, with an average birth weight of (1.28±0.14) kg, 3 862 in the LBW group, with an average birth weight of (2.07±0.28) kg, and 4 109 in the NBW group, with an average birth weight of (2.86±0.35) kg. The weight at the actual age of 2-<3 months ((5.61±0.96) vs. (5.64±0.78) kg in boys, (5.11±0.67) vs. (5.18±0.71) kg in girls) and the length at the actual age of 8-<10 months ((70.3±2.4) vs. (70.6±2.4) cm in boys, (68.9±2.2) vs. (68.9±2.4) cm in girls) in the NBW group reached the average weight and length of full-term children. The difference of physical growth before 24 months of age between LBW and control group decreased as children age, with that of LBW group approaches the average of full-term children after 24 months of age, with a weight difference of 0.64-0.95 kg and height difference of 1.3-1.7 cm. The weight and height of the VLBW group were lower than those of full-term infants (2.80-2.86 kg and 3.3-4.3 cm, respectively) at 48 months of age. During 2-12 months of age, the corresponding values of the VLBW group were higher than that of the LBW and NBW groups by 0.35 kg and 0.71 kg, respectively. However, the corresponding values of the VLBW group were lower than that of the LBW and NBW groups(0.64 kg and 0.76 kg at 0-2 months of age, 1.04 kg and 1.49 kg at 12-48 months of age, respectively). The rates of delayed development, underweight, and emaciation were the highest in the VLBW group (all P<0.01), while the rates of overweight and obesity were the highest in the NBW group, with that of the VLBW group being lower than LBW group (P<0.01) at the age of 24-<36 months. Conclusions: Prior to 4 years of age, the time for preterm children to reach the average physical indices of full-term children differ by birth weights, hence warranting further examination of the corrected gestational age for preterm children. Normal birth weight preterm children present with the highest incidence of overweight and obesity and very low birth weight preterm children present with the highest incidence of growth disorders, marking both groups at high risks of malnutrition.


Assuntos
Recém-Nascido de muito Baixo Peso , Desnutrição , Peso ao Nascer , Criança , Pré-Escolar , Feminino , Transtornos do Crescimento , Humanos , Lactente , Recém-Nascido , Masculino , Estudos Retrospectivos
9.
Cochrane Database Syst Rev ; 8: CD012322, 2021 08 19.
Artigo em Inglês | MEDLINE | ID: mdl-34415568

RESUMO

BACKGROUND: There is presently no certainty about the ideal feeding intervals for preterm infants. Shorter feeding intervals of, for example, two hours, have the theoretical advantage of allowing smaller volumes of milk. This may have the potential to reduce the incidence and severity of gastro-oesophageal reflux. Longer feeding intervals have the theoretical advantage of allowing more gastric emptying between two feeds. This potentially provides periods of rest (and thus less hyperaemia) for an immature digestive tract. OBJECTIVES: To determine the safety of shorter feeding intervals (two hours or shorter) versus longer feeding intervals (three hours or more) and to compare the effects in terms of days taken to regain birth weight and to achieve full feeding. SEARCH METHODS: We used the standard search strategy of Cochrane Neonatal to run comprehensive searches in CENTRAL (2020, Issue 6) and Ovid MEDLINE and Epub Ahead of Print, In-Process & Other Non-Indexed Citations, Daily and Versions, and CINAHL on 25 June 2020. We searched clinical trials databases and the reference lists of retrieved articles for randomised controlled trials (RCTs) and quasi-RCTs. SELECTION CRITERIA: We included RCTs and quasi-RCTs comparing short (e.g. one or two hours) versus long (e.g. three or four hours) feeding intervals in preterm infants of any birth weight, all or most of whom were less than 32 weeks' gestation. Infants could be of any postnatal age at trial entry, but eligible infants should not have received feeds before study entry, with the exception of minimal enteral feeding. We included studies of nasogastric or orogastric bolus feeding, breast milk or formula, in which the feeding interval is the intervention. DATA COLLECTION AND ANALYSIS: We used standard methodological procedures expected by Cochrane. We used the GRADE approach to assess the certainty of evidence. Our primary outcomes were days taken to achieve full enteral feeding and days to regain birth weight. Our other outcomes were duration of hospital stay, episodes of necrotising enterocolitis (NEC) and growth during hospital stay (weight, length and head circumference). MAIN RESULTS: We included four RCTs, involving 417 infants in the review. One study involving 350 infants is awaiting classification. All studies compared two-hourly versus three-hourly feeding interval. The risk of bias of the included studies was generally low, but all studies had high risk of performance bias due to lack of blinding of the intervention. Three studies were included in meta-analysis for the number of days taken to achieve full enteral feeding (351 participants). The mean days to achieve full feeds was between eight and 11 days. There was little or no difference in days taken to achieve full enteral feeding between two-hourly and three-hourly feeding, but this finding was of low certainty (mean difference (MD) ‒0.62, 95% confidence interval (CI) ‒1.60 to 0.36). There was low-certainty evidence that the days taken to regain birth weight may be slightly longer in infants receiving two-hourly feeding than in those receiving three-hourly feeding (MD 1.15, 95% CI 0.11 to 2.20; 3 studies, 350 participants). We are uncertain whether shorter feeding intervals have any effect on any of our secondary outcomes including the duration of hospital stay (MD ‒3.36, 95% CI ‒9.18 to 2.46; 2 studies, 207 participants; very low-certainty evidence) and the risk of NEC (typical risk ratio 1.07, 95% CI 0.54 to 2.11; 4 studies, 417 participants; low-certainty evidence). No study reported growth during hospital stay. AUTHORS' CONCLUSIONS: The low-certainty evidence we found in this review suggests that there may be no clinically important differences between two- and three-hourly feeding intervals. There is insufficient information about potential feeding complications and in particular NEC. No studies have looked at the effect of other feeding intervals and there is no long-term data on neurodevelopment or growth.


Assuntos
Nutrição Enteral/métodos , Recém-Nascido Prematuro/crescimento & desenvolvimento , Recém-Nascido de muito Baixo Peso/crescimento & desenvolvimento , Leite Humano , Ganho de Peso , Peso ao Nascer , Nutrição Enteral/efeitos adversos , Enterocolite Necrosante/epidemiologia , Enterocolite Necrosante/prevenção & controle , Humanos , Lactente , Fórmulas Infantis , Recém-Nascido , Fatores de Tempo , Resultado do Tratamento
10.
Neuroimage Clin ; 31: 102776, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34371238

RESUMO

Birth weight, an indicator of fetal growth, is associated with cognitive outcomes in early life (which are predictive of cognitive ability in later life) and risk of metabolic and cardiovascular disease across the life course. Brain health in older age, indexed by MRI features, is associated with cognitive performance, but little is known about how variation in normal birth weight impacts on brain structure in later life. In a community dwelling cohort of participants in their early seventies we tested the hypothesis that birth weight is associated with the following MRI features: total brain (TB), grey matter (GM) and normal appearing white matter (NAWM) volumes; whiter matter hyperintensity (WMH) volume; a general factor of fractional anisotropy (gFA) and peak width skeletonised mean diffusivity (PSMD) across the white matter skeleton. We also investigated the associations of birth weight with cortical surface area, volume and thickness. Birth weight was positively associated with TB, GM and NAWM volumes in later life (ß ≥ 0.194), and with regional cortical surface area but not gFA, PSMD, WMH volume, or cortical volume or thickness. These positive relationships appear to be explained by larger intracranial volume, rather than by age-related tissue atrophy, and are independent of body height and weight in adulthood. This suggests that larger birth weight is linked to more brain tissue reserve in older life, rather than age-related brain structural features, such as tissue atrophy or WMH volume.


Assuntos
Encéfalo , Substância Branca , Adulto , Idoso , Envelhecimento , Peso ao Nascer , Encéfalo/diagnóstico por imagem , Humanos , Imageamento por Ressonância Magnética , Substância Branca/diagnóstico por imagem
11.
BMC Pediatr ; 21(1): 360, 2021 08 25.
Artigo em Inglês | MEDLINE | ID: mdl-34433439

RESUMO

BACKGROUND: The association between a slower physical growth and poorer neurodevelopment has been established in infants born preterm or small for gestational age. However, this association is inconsistent in term-born infants, and detailed investigations in infancy, when intervention is most beneficial for improving outcomes, are lacking. We therefore examined this association separately by sex during the first year of life in term-born infants. METHODS: Using data collected until children reached 12 months old in an ongoing prospective cohort of the Japan Environment and Children's Study, we analyzed 44,264 boys and 42,541 girls with singleton term-birth. The exposure variables were conditional variables that disentangle linear growth from weight gain relative to linear growth, calculated from the length and weight at birth and 4, 7 and 10 months old. Neurodevelopmental delay was identified using the Japanese-translated version of Ages & Stages Questionnaires, third edition. RESULTS: A reduced risk of neurodevelopmental delay at 6 months old was observed in children with a higher birth weight (adjusted relative risks [aRRs]: 0.91 and 0.93, 95 % confidence intervals [95 % CIs]: 0.87-0.96 and 0.88-0.98 in boys and girls, respectively) and increased linear growth between 0 and 4 months old (aRRs: 0.85 and 0.87, 95 % CIs: 0.82-0.88 and 0.83-0.91 in boys and girls, respectively). A reduced risk at 12 months was found in children with an increased linear growth between 0 and 4 months (aRRs: 0.92 and 0.90, 95 % CIs: 0.87-0.98 and 0.84-0.96 in boys and girls, respectively), boys with an increased relative weight gain between 0 and 4 months (aRR: 0.90, 95 % CI: 0.84-0.97), and girls with a higher birth weight (aRR: 0.89, 95 % CI: 0.83-0.96). CONCLUSIONS: These results suggest that a slow physical growth by four months old may be a predictor of neurodevelopmental delay during infancy.


Assuntos
Desenvolvimento Infantil , Peso ao Nascer , Criança , Estudos de Coortes , Feminino , Humanos , Lactente , Recém-Nascido , Japão/epidemiologia , Masculino , Estudos Prospectivos
12.
J Int Med Res ; 49(8): 3000605211033193, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34344218

RESUMO

OBJECTIVE: We aimed to explore the effect of individualized medical nutrition guidance on pregnancy outcomes among older pregnant women. METHODS: This was a prospective study using a randomized controlled trial design. We selected 820 older pregnant women and randomly divided them into a study group and control group (410 women each). The control group was given routine health education and nutrition guidance; the study group was provided individualized medical nutrition guidance. Gestational diabetes mellitus, hypertensive disorders of pregnancy, vaginal delivery rate, postpartum hemorrhage rate, gestational body weight, neonatal birth weight, and neonate transfer to the neonatal intensive care unit (NICU) were compared between the groups. RESULTS: The incidence of gestational diabetes in the study group was significantly lower and the rate of vaginal delivery was significantly higher than those in the control group. The incidence of macrosomia, rate of neonatal transfer to the NICU, and rate of neonatal hyperbilirubinemia were significantly lower in the study group than those in the control group. CONCLUSIONS: Individualized nutritional intervention for older pregnant women can effectively reduce the incidence of complications during pregnancy and childbirth and improve maternal and child outcomes.


Assuntos
Diabetes Gestacional , Resultado da Gravidez , Idoso , Peso ao Nascer , Criança , Diabetes Gestacional/epidemiologia , Feminino , Humanos , Recém-Nascido , Gravidez , Gestantes , Estudos Prospectivos
13.
Nutrients ; 13(8)2021 Jul 26.
Artigo em Inglês | MEDLINE | ID: mdl-34444719

RESUMO

Low birthweight (LBW) is associated with metabolic complications, such as glucose and lipid metabolism disturbances in early life. The objective of this study was to assess: (1) the effect of dietary tryptophan (Trp) on glucose and fat metabolism in an LBW piglet model, and (2) the role peripheral 5-hydroxytryptamine type 3 (5HT3) receptors in regulating the feeding behavior in LBW piglets fed with Trp-supplemented diets. Seven-day-old piglets were assigned to 4 treatments: normal birthweight-0%Trp (NBW-T0), LBW-0%Trp (LBW-T0), LBW-0.4%Trp (LBW-T0.4), and LBW-0.8%Trp (LBW-T0.8) for 3 weeks. Compared to LBW-T0, the blood glucose was decreased in LBW-T0.8 at 60 min following the meal test, and the triglycerides were lower in LBW-T0.4 and LBW-T0.8. Relative to LBW-T0, LBW-T0.8 had a lower transcript and protein abundance of hepatic glucose transporter-2, a higher mRNA abundance of glucokinase, and a lower transcript of phosphoenolpyruvate carboxykinase. LBW-T0.4 tended to have a lower protein abundance of sodium-glucose co-transporter 1 in the jejunum. In comparison with LBW-T0, LBW-T0.4 and LBW-T0.8 had a lower transcript of hepatic acetyl-CoA carboxylase, and LBW-T0.4 had a higher transcript of 3-hydroxyacyl-CoA dehydrogenase. Blocking 5-HT3 receptors with ondansetron reduced the feed intake in all groups, with a transient effect on LBW-T0, but more persistent effect on LBW-T0.8 and NBW-T0. In conclusion, Trp supplementation reduced the hepatic lipogenesis and gluconeogenesis, but increased the glycolysis in LBW piglets. Peripheral serotonin is likely involved in the regulation of feeding behavior, particularly in LBW piglets fed diets supplemented with a higher dose of Trp.


Assuntos
Suplementos Nutricionais , Glucose/metabolismo , Metabolismo dos Lipídeos , Fígado/metabolismo , Triptofano/administração & dosagem , Tecido Adiposo Branco/metabolismo , Animais , Animais Recém-Nascidos , Peso ao Nascer , Glicemia/análise , Peso Corporal , Colesterol/sangue , Dieta , Hipotálamo/metabolismo , Insulina/sangue , Mucosa Intestinal/anatomia & histologia , Mucosa Intestinal/crescimento & desenvolvimento , Intestino Delgado/anatomia & histologia , Intestino Delgado/crescimento & desenvolvimento , Modelos Animais , Ondansetron/farmacologia , Antagonistas do Receptor 5-HT3 de Serotonina/farmacologia , Suínos/crescimento & desenvolvimento , Triglicerídeos/sangue
14.
Nutrients ; 13(7)2021 Jul 18.
Artigo em Inglês | MEDLINE | ID: mdl-34371966

RESUMO

Medical nutrition therapy is an integral part of gestational diabetes mellitus (GDM) management; however, the prescription of optimal energy intake is often a difficult task due to the limited available evidence. The present pilot, feasibility, parallel, open-label and non-randomized study aimed to evaluate the effect of a very low energy diet (VLED, 1600 kcal/day), or a low energy diet (LED, 1800 kcal/day), with or without personalized exercise sessions, among women with GDM in singleton pregnancies. A total of 43 women were allocated to one of four interventions at GDM diagnosis: (1) VLED (n = 15), (2) VLED + exercise (n = 4), (3) LED (n = 16) or (4) LED + exercise (n = 8). Primary outcomes were gestational weight gain (GWG), infant birth weight, complications at delivery and a composite outcomes score. Secondary outcomes included type of delivery, prematurity, small- for-gestational-age (SGA) or large-for-gestational-age (LGA) infants, macrosomia, Apgar score, insulin use, depression, respiratory quotient (RQ), resting metabolic rate (RMR) and middle-upper arm circumference (MUAC). GWG differed between intervention groups (LED median: 12.0 kg; VLED: 5.9 kg). No differences were noted in the type of delivery, infant birth weight, composite score, prevalence of prematurity, depression, RQ, Apgar score, MUAC, or insulin use among the four groups. Regarding components of the composite score, most infants (88.4%) were appropriate-for-gestational age (AGA) and born at a gestational age of 37-42 weeks (95.3%). With respect to the mothers, 9.3% experienced complications at delivery, with the majority being allocated at the VLED + exercise arm (p < 0.03). The composite score was low (range 0-2.5) for all mother-infant pairs, indicating a "risk-free" pregnancy outcome. The results indicate that adherence to a LED or VLED induces similar maternal, infant and obstetrics outcomes.


Assuntos
Restrição Calórica , Diabetes Gestacional/dietoterapia , Peso ao Nascer , Exercício Físico , Estudos de Viabilidade , Feminino , Idade Gestacional , Ganho de Peso na Gestação , Humanos , Recém-Nascido , Complicações do Trabalho de Parto , Projetos Piloto , Gravidez , Resultado da Gravidez
15.
Nutrients ; 13(7)2021 Jul 04.
Artigo em Inglês | MEDLINE | ID: mdl-34371812

RESUMO

There is growing evidence that bone health may be programmed in the first years of life. Factors during the prenatal period, especially maternal nutrition, may have an influence on offspring's skeletal development and thus the risk of osteoporosis in further life, which is an increasing societal, health and economic burden. However, it is still inconclusive which early life factors are the most important and to what extent they may affect bone health. We searched through three databases (PubMed, Google Scholar, Cochrane Library) and after eligibility criteria were met, the results of 49 articles were analyzed. This narrative review is an overall summary of up-to-date studies on maternal diet, nutritional status, and birth-related factors that may affect offspring bone development, particularly bone mineral density (BMD). Maternal vitamin D status and diet in pregnancy, anthropometry and birth weight seem to influence BMD, however other factors such as subsequent growth may mediate these associations. Due to the ambiguity of the results in the analyzed studies, future, well-designed studies are needed to address the limitations of the present study.


Assuntos
Densidade Óssea , Dieta/efeitos adversos , Exposição Materna/efeitos adversos , Fenômenos Fisiológicos da Nutrição Materna , Efeitos Tardios da Exposição Pré-Natal/fisiopatologia , Adulto , Peso ao Nascer , Desenvolvimento Ósseo , Criança , Pré-Escolar , Estudos de Coortes , Feminino , Humanos , Lactente , Recém-Nascido , Estado Nutricional , Estudos Observacionais como Assunto , Osteoporose/etiologia , Osteoporose/fisiopatologia , Gravidez , Efeitos Tardios da Exposição Pré-Natal/etiologia , Ensaios Clínicos Controlados Aleatórios como Assunto
16.
J Anim Sci ; 99(9)2021 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-34343289

RESUMO

Sows mated in summer produce a greater proportion of born-light piglets (<1.1 kg) which contributes to increased carcass fatness in the progeny population. The reasons for the low birth weight of these piglets remain unclear, and there have been few successful mitigation strategies identified. We hypothesized that: 1) the low birth weight of progeny born to sows mated in summer may be associated with weight loss during the previous summer lactation; and 2) increasing early gestation feed allowance for the sows with high lactational weight loss in summer can help weight recovery and improve progeny birth weight. Sows were classified as having either low (av. 1%) or high (av. 7%) lactational weight loss in their summer lactation. All the sows with low lactational weight loss (LLStd) and half of the sows with high lactational weight loss received a standard gestation feeding regime (HLStd) (2.6 kg/d; day 0-30 gestation), whereas the rest of the sows with high lactational weight loss received a compensatory feed allowance (HLComp) (3.5 kg/d; day 0-30 gestation). A comparison of LLStd (n = 75) versus HLStd sows (n = 78) showed that this magnitude of weight loss over summer lactation did not affect the average piglet or litter birth weight, but such results may be influenced by the higher litter size (P = 0.030) observed in LLStd sows. A comparison of HLStd versus HLComp (n = 81) sows showed that the compensatory feeding increased (P = 0.021) weight gain of gestating sows by 6 kg, increased (P = 0.009) average piglet birth weight by 0.12 kg, tended to reduce (P = 0.054) the percentage of born-light piglets from 23.5% to 17.1% but reduced the litter size by 1.4 (P = 0.014). A subgroup of progeny stratified as born-light (0.8-1.1 kg) or -normal (1.3-1.7 kg) from each sow treatment were monitored for growth performance from weaning until 100 kg weight. The growth performance and carcass backfat of progeny were not affected by sow treatments. Born-light progeny had lower feed intake, lower growth rate, higher G:F, and higher carcass backfat than born-normal progeny (all P < 0.05). In summary, compensatory feeding from day 0 to 30 gestation in the sows with high weight loss during summer lactation reduced the percentage of born-light progeny at the cost of a lower litter size, which should improve growth rate and carcass leanness in the progeny population born to sows with high lactational weight loss.


Assuntos
Ração Animal , Perda de Peso , Ração Animal/análise , Animais , Peso ao Nascer , Dieta/veterinária , Feminino , Lactação , Tamanho da Ninhada de Vivíparos , Gravidez , Suínos , Desmame
18.
Nutrients ; 13(7)2021 Jul 20.
Artigo em Inglês | MEDLINE | ID: mdl-34371987

RESUMO

It was previously observed that in a population of a high-income country, dietary multiple micronutrient supplementation in pregnancy was associated with an increased risk of gestational diabetes (GDM) and increased offspring size at birth. In this follow-up study, we investigated whether similar changes are observed with dietary iron supplementation. For this we used the prospective Cambridge Baby Growth Study with records of maternal GDM status, nutrient supplementation, and extensive offspring birth size measurements. Maternal iron supplementation in pregnancy was associated with GDM development (risk ratio 1.67 (1.01-2.77), p = 0.048, n = 677) as well as offspring size and adiposity (n = 844-868) at birth in terms of weight (ß' = 0.078 (0.024-0.133); p = 0.005), head circumference (ß' = 0.060 (0.012-0.107); p = 0.02), body mass index (ß' = 0.067 (0.014-0.119); p = 0.01), and various skinfold thicknesses (ß' = 0.067-0.094; p = 0.03-0.003). In a subset of participants for whom GDM statuses were available, all these associations were attenuated by adjusting for GDM. Iron supplementation also attenuated the associations between multiple micronutrient supplementation and these same measures. These results suggest that iron supplementation may mediate the effects associated with multiple micronutrient supplementation in pregnancy in a high-income country, possibly through the increased risk of developing GDM.


Assuntos
Peso ao Nascer/efeitos dos fármacos , Suplementos Nutricionais , Ferro na Dieta/efeitos adversos , Fenômenos Fisiológicos da Nutrição Materna/efeitos dos fármacos , Micronutrientes/efeitos adversos , Adiposidade/efeitos dos fármacos , Adulto , Índice de Massa Corporal , Diabetes Gestacional/induzido quimicamente , Diabetes Gestacional/fisiopatologia , Feminino , Seguimentos , Humanos , Recém-Nascido , Ferro na Dieta/administração & dosagem , Masculino , Micronutrientes/administração & dosagem , Gravidez , Estudos Prospectivos , Pregas Cutâneas
19.
Nutrients ; 13(7)2021 Jul 09.
Artigo em Inglês | MEDLINE | ID: mdl-34371854

RESUMO

The aim of the study was to assess the relationships between maternal insulin and insulin-like growth factor-1 (IGF-1) concentration and food consumption frequency and the birth parameters of the newborn. A total of 157 mother-newborn pairs participated in the study. The study showed that more frequent consumption of sweet and salty snacks as well as fruit and fruit or vegetable juices may promote greater weight gain in pregnancy and higher newborn birth weight. A significantly higher insulin concentration was found among overweight women according to body mass index (BMI), and a significantly lower concentration of IGF-1 was demonstrated among women ≥35 years of age. There was no significant correlation between the concentration of insulin and IGF-1 in the mother's blood plasma and the birth weight and length of the newborn. A significant relationship was only found between the concentration of IGF-1 in the mother's blood and the Ponderal index of the newborn. A woman's eating habits during pregnancy have a significant impact on the mother's health and on the proper growth and development of the foetus.


Assuntos
Peso ao Nascer , Estatura , Dieta/efeitos adversos , Fator de Crescimento Insulin-Like I/análise , Insulina/sangue , Terceiro Trimestre da Gravidez/sangue , Adolescente , Adulto , Índice de Massa Corporal , Inquéritos sobre Dietas , Ingestão de Alimentos/fisiologia , Comportamento Alimentar/fisiologia , Feminino , Desenvolvimento Fetal/fisiologia , Ganho de Peso na Gestação , Humanos , Recém-Nascido , Comportamento Materno/fisiologia , Fenômenos Fisiológicos da Nutrição Materna , Polônia , Gravidez , Adulto Jovem
20.
Rev. ecuat. pediatr ; 22(2): 1-10, 31 de agosto del 2021.
Artigo em Espanhol | LILACS | ID: biblio-1284499

RESUMO

Introducción: Objetivo: el objetivo es estimar el peso fetal por métodos clínicos y ecográficos y compararlo con el peso al nacer en recién nacidos a término. Métodos: Se trata de un estudio epidemiológico, observacional, transversal de una cohorte de recién nacidos a término sanos. El tamaño de la muestra fue de 102 neonatos nacidos en el Hospital Pablo Arturo Suárez, en Quito, Ecuador, de noviembre de 2019 a enero de 2020. Resultados: En neonatos a término, la estimación ecográfica fue del 80.00%, mientras que en la valoración clínica fue del 72.29%. El perfil del recién nacido analizado es hombre, mestizo, ecuatoriano, nacido en la región serrana, con una edad gestacional media de 38.67 semanas y un peso medio al nacer de 3.023 gramos, en quienes se estimó el peso fetal mediante ecografía y valoración clínica. La estimación del error absoluto en ambos métodos analizados fue 2.43% para ecografía y -4.65% para valoración clínica, y ambos mostraron concordancia moderada, 78.2% para ecografía y 85.6% para valoración clínica. El análisis multivariado mostró que los recién nacidos con peso modificado por ecografía tienen 13.44 veces más probabilidades de mostrar peso alterado al nacer, mientras que los recién nacidos con peso modificado por la evaluación clínica tienen 11.95 veces más probabilidades de mostrar peso alterado al nacer. Conclusiones: La precisión en la valoración clínica fue siempre mayor que en el método ecográfico, especialmente en los recién nacidos de bajo peso


Introduction: The aim of this trial was to estimate fetal weight by clinical and ultrasound methods and to compare with the weight at birth in full-term newborns. Methods: This is an epidemiological, observational, cross-sectional study of a cohort of healthy full-term newborns. The sample size was 102 neonates born at the Pablo Arturo Suarez Hospital, in Quito, Ecuador, from November 2019 to January 2020. Results: In full-term neonates, the estimate on ultrasound was 80.00%, while in the clinical assessment was 72.29%. The profile of newborn analyzed is man, mestizo, Ecuadorian, born in the highlands region, with a mean gestational age of 38.67 weeks and a mean birth weight of 3,023 grams, in whom it estimated the fetal weight through ultrasound and clinical assessment. The estimation of the absolute error in both methods analyzed was 2.43% to ultrasound and -4.65% to clinical assessment, and both showed moderate concordance, 78.2% to ultrasound, and 85.6% to clinical assessment. Multivariate analysis showed the neo-nates with modified weight by ultrasound are 13.44 times more likely to show altered weight at birth, while neonates with modified weight by the clinical assessment are 11.95 times more likely to show altered weight at birth. Conclusions: Accuracy in the clinical assessment was always higher than in the ultrasound method, especially in low weight newborns.


Introdução: Objetivo: estimar o peso fetal por métodos clínicos e ultrassonográficos e compará-lo com o peso ao nascer em recém-nascidos a termo. Métodos: Este é um estudo epidemiológico, observacional e transversal de uma coorte de recém-nascidos saudáveis ​​a termo. O tamanho da amostra foi de 102 neonatos nascidos no Hospital Pablo Arturo Suárez, em Quito, Equador, de novembro de 2019 a janeiro de 2020. Resultados: Em neonatos a termo, a estimativa ultrassonográfica foi de 80,00%, enquanto na avaliação clínica foi de 72,29%. O perfil do recém-nascido analisado é do sexo masculino, mestiço, equatoriano, nascido na região montanhosa, com idade gestacional média de 38,67 semanas e peso médio ao nascer de 3,023 gramas, sendo o peso fetal estimado por ultrassonografia e avaliação clínica. A estimativa do erro absoluto em ambos os métodos analisados ​​foi de 2,43% para ultrassom e -4,65% para avaliação clínica, e ambos apresentaram concordância moderada, 78,2% para ultrassom e 85,6% para avaliação clínica. A análise multivariada mostrou que os recém-nascidos com peso modificado ultrassonográfico têm 13,44 vezes mais chance de apresentar peso alterado ao nascer, enquanto os recém-nascidos com peso modificado pela avaliação clínica têm 11,95 vezes mais chance de apresentar peso alterado ao nascer. Conclusões: A precisão na avaliação clínica sempre foi maior do que no método ultrassonográfico, principalmente em recém-nascidos de baixo peso.


Assuntos
Humanos , Recém-Nascido , Peso ao Nascer , Ultrassonografia Pré-Natal , Peso Fetal , Recém-Nascido , Estatística como Assunto
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