RESUMO
CONTEXT: Vitamin D deficiency is widely prevalent throughout the world. Pregnant women, neonates and infants form most vulnerable groups for vitamin D deficiency. OBJECTIVE: (1) To find prevalence of vitamin D deficiency in pregnant women. (2) To evaluate the effect of supplementation with cholecalciferol in improving vitamin D levels in pregnant women and evaluate its correlation with feto-maternal outcome. DESIGN: Randomized control trial from years 2010 to 2012. SETTING: Tertiary care centre, Delhi, India. PARTICIPANTS: One-hundred and eighty pregnant women. Study population divided randomly into two groups: group A: nonintervention (60 women) and group B: intervention (120 women). INTERVENTION: The intervention group received supplementation of vitamin D in dosages depending upon 25(OH)-D levels. MAIN OUTCOME MEASURES: Risk of maternal complications such as preterm labour, pre-eclampsia and gestational diabetes associated with vitamin D deficiency and risk of low birthweight and poor Apgar score in infants of mothers with vitamin D deficiency. RESULTS: Adjusted serum 25(OH)-D concentration was lower in group A as compared to group B (mean 46·11 ± 74·21 nmol/l vs 80 ± 51·53 nmol/l). Forty-four percent patients in group A and 20·3% patients in group B developed preterm labour/pre-eclampsia/gestational diabetes. Newborns of mothers in group A had lower cord blood levels of 25(OH)-D levels as compared to group B (mean 43·11 ± 81·32 nmol/l vs 56·8 ± 47·52 nmol/l). They also had lower birthweight of mean 2·4 ± 0·38 kg as compared to group B 2·6 ± 0·33 kg. CONCLUSIONS: Vitamin D supplementation reduces risk of maternal comorbidities and helps improve neonatal outcomes.
Assuntos
Deficiência de Vitamina D/tratamento farmacológico , Vitamina D/uso terapêutico , Peso ao Nascer/fisiologia , Índice de Massa Corporal , Suplementos Nutricionais , Feminino , Humanos , Gravidez , Complicações na Gravidez/tratamento farmacológico , Complicações na Gravidez/prevenção & controle , Deficiência de Vitamina D/sangue , Deficiência de Vitamina D/epidemiologiaRESUMO
OBJECTIVE: To evaluate intergenerational change in anthropometric indices of children and their predictors. DESIGN: Prospective cohort. PARTICIPANTS: New Delhi Birth Cohort participants (F1), born between 1969 and 1972, were followed-up for anthropometry at birth and 6-monthly intervals until 21 years. Their children (F2) below 10 years were evaluated anthropometrically. OUTCOME MEASURE: Intergenerational change (F2-F1) in height, weight and body mass index (BMI) of children in comparison to their parents at corresponding ages. RESULTS: 432 F2-F1 pairs were analyzed in age-groups of 0-5 (26.9%) and 5-10 (73.1%) years. Children were considerably taller (0-5 years 0.99 SD; 5-10 years 1.17 SD) and heavier (0-5 years 0.77 SD; 5-10 years 1.52 SD) while only those aged 5-10 years were broader (had a higher BMI; 1.03 SD), than their parents. These increases for 0-5 and 5-10 years, respectively corresponded to 3.9 and 6.4 cm for height, 1.3 and 5.4 kg for weight and 0.2 and 1.9 kg/m2 for BMI. Lower parents' anthropometric indices and poor water supply and sanitation facilities; higher age of parents at child birth and of children when measured (for height and weight); and more parental education (for weight and BMI), were associated with greater intergenerational gains in children. CONCLUSION: Over one generation in an urban middle-class population, whose general living conditions had improved, under-five children have become considerably taller and heavier, and 5-10 year old children have additionally become broader, than their parents at corresponding ages. Child populations probably 'grow up' before 'growing out'.
Assuntos
Antropometria , Tamanho Corporal/fisiologia , Estatura , Índice de Massa Corporal , Peso Corporal , Criança , Pré-Escolar , Estudos de Coortes , Feminino , Humanos , Índia/epidemiologia , Lactente , Recém-Nascido , Masculino , PaisRESUMO
OBJECTIVE: To evaluate the relationship between maternal age at child birth, and perinatal and under-five mortality. DESIGN: Prospective birth cohort. SETTING: Urban community. PARTICIPANTS: 9169 pregnancies in the New Delhi Birth Cohort resulted in 8181 live births. These children were followed for survival status and anthropometric measurements at birth (+3 days), 3,6,9 and 12 months (7 days), and every 6 months thereafter until 21 years age. Information on maternal age at child birth and socio-demographic profile was also obtained. OUTCOME MEASURES: Offspring mortality from 28 weeks gestation till 5 years age. RESULTS: Offspring mortality (stillbirths - 5 years; n=328) had a U-shaped association with maternal age (P<0.001). Compared to the reference group (20-24 years), younger (≤19 years) and older (≥35 years) maternal ages were associated with a higher risk of offspring mortality (HR: 1.68; 95% CI 1.16, 2.43 and HR 1.48; 95% CI 1.01, 2.16, respectively). In young mothers, the increased risk persisted after adjustment for socio-economic confounders (maternal education, household income and wealth; HR 1.51; 95% CI 1.03, 2.20) and further for additional behavioral (place of delivery) and biological mediators (gestation and birthweight) (HR 2.14; 95% CI 1.25,3.64). Similar associations were documented for post-perinatal deaths but for perinatal mortality the higher risk was not statistically significant (P >0.05). In older mothers, the increased mortality risk was not statistically significant (P >0.05) after adjustment for socio-economic confounders. CONCLUSION: Young motherhood is associated with an increased risk of post-perinatal mortality and measures to prevent early childbearing should be strengthened.
Assuntos
Mortalidade da Criança , Idade Materna , Mortalidade Perinatal , Adolescente , Pré-Escolar , Feminino , Humanos , Índia/epidemiologia , Lactente , Mortalidade Infantil , Recém-Nascido , Gravidez , Gravidez na Adolescência , Fatores de Risco , Fatores SocioeconômicosRESUMO
Objective: To evaluate the relationship between maternal age at child birth, and perinatal and under-five mortality. Design: Prospective birth cohort. Setting: Urban community. Participants: 9169 pregnancies in the New Delhi Birth Cohort resulted in 8181 live births. These children were followed for survival status and anthropometric measurements at birth (+3 days), 3,6,9 and 12 months (7 days), and every 6 months thereafter until 21 years age. Information on maternal age at child birth and socio-demographic profile was also obtained. Outcome measures: Offspring mortality from 28 weeks gestation till 5 years age. Results: Offspring mortality (stillbirths – 5 years; n=328) had a U-shaped association with maternal age (P<0.001). Compared to the reference group (20-24 years), younger (£19 years) and older (³ 35 years) maternal ages were associated with a higher risk of offspring mortality (HR: 1.68; 95% CI 1.16, 2.43 and HR 1.48; 95% CI 1.01, 2.16, respectively). In young mothers, the increased risk persisted after adjustment for socio-economic confounders (maternal education, household income and wealth; HR 1.51; 95% CI 1.03, 2.20) and further for additional behavioral (place of delivery) and biological mediators (gestation and birthweight) (HR 2.14; 95% CI 1.25,3.64). Similar associations were documented for post-perinatal deaths but for perinatal mortality the higher risk was not statistically significant (P >0.05). In older mothers, the increased mortality risk was not statistically significant (P >0.05) after adjustment for socio-economic confounders. Conclusion: Young motherhood is associated with an increased risk of post-perinatal mortality and measures to prevent early childbearing should be strengthened.
RESUMO
The Clinical Trials Registry-India (CTRI) was launched on July 20, 2007 and since then has grown to become a significant contributor to the global pool of accessible clinical trial data. Trial registration in the CTRI is now mandatory. Currently more than 1,800 trials are registered in the CTRI.