Early registration for antenatal care was associated with improved birth outcomes in a low-income community in Harare

Abstract Background : The World Health Organization (WHO) recommends early registration, regular and consistent attendance of antenatal care (ANC) sessions for all pregnant women. Specifically, if ANC services promote evidence-based practices this improves pregnancy outcomes and reduce maternal mortality. Yet there are worrying gaps in knowledge of antenatal care services in Zimbabwe. Objectives: To determine the relationship between early registration and frequency of ANC visits on birth weight, birth length, head circumference, Apgar score, birth complications, delivery mode, preterm birth and duration of labour among women aged 15-49 from Hatcliffe Polyclinic, Harare. Methods: This was a health facility based analytical cross-sectional study. An interviewer administered questionnaire was used to collect data. Data was entered and analysed using SPSS version 20. Descriptive statistics, and associations between dependent and independent variables were determined using Pearson’s Chi-square and Fisher’s exact test. Ethical approval was granted from the Medical Research Council of Zimbabwe (MRCZ/B/1438). Results: A total of 75 mother child pairs were interviewed. Most (77.3%) had more than four ANC visits. Only 36% registered early (during first trimester). Most of the children had normal birth weight ≥2500g (80.3%), birth length ≥47cm, (76%), head circumference ≥33cm (80%), and Apgar score ≥7 (96%). A positive association was observed between number of ANC visits and birth weight [Odds ratio (OR) 7.6; 95% Confidence Interval (CI) 1.6, 36.4 (p=0.013)], birth length [OR 6.1; 95%CI 1.8, 20.1 (p=0.010)], and head circumference [OR 4.3; 95% CI 1.3, 14.8 (p=0.013)]. Positive associations were also observed between timing of registration and birth weight [OR 1.2; 95% 1.05, 1.36 (p=0.045)], birth length [OR 0.16; 95% CI 0.03, 0.76 (p=0.012)]. Conclusions: In this study increased frequency and early registration for ANC visits had a positive relationship with birth weight, birth length and head circumference. These findings show the need for improving the uptake of ANC services, early registration for ANC in the first trimester and adoption of community wide strategies to ensure that pregnant women attend all recommended visits for improved birth outcomes in this and related settings.

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Heat Stress-Associated Growth Retardation in the First 1000 Days Is Mitigated by Preconception Nutritional Supplementation

Current Developments in Nutrition ◽

10.1093/cdn/nzab060_006 ◽

2021 ◽

Vol 5 (Supplement_2) ◽

pp. 88-88

Author(s):

Kartik Shankar ◽

Meghan Ruebel ◽

Jennifer Kemp ◽

Jamie Westcott ◽

Puujee Jambal ◽

...

Keyword(s):

Heat Stress ◽

Birth Weight ◽

Birth Outcomes ◽

Head Circumference ◽

Protein Biosynthesis ◽

Heat Exposure ◽

First Trimester ◽

Negative Association ◽

Birth Length ◽

Z Scores

Abstract Objectives Understanding the interactions between nutrition and climate-driven health outcomes is increasingly necessary. Employing data from the Women First trial conducted in Thatta, Pakistan, we examined the interactions between maternal nutritional deficits and heat stress (HS) on birth outcomes. Methods Women of child-bearing age either consumed a small quantity lipid-based nutrition supplement (sqLNS) prior to conception (Arm 1), from 12 wk of gestation until delivery (Arm 2); or were not supplemented with sqLNS (Arm 3). At the Pakistan site, samples sizes with birth outcomes obtained within 48 h of delivery for Arms 1, 2 and 3 were 157,150 and 138, respectively. Daily maximal air temperatures were used to were compute the average daily maximal temperatures (Tmax) for each infant over four 90-day windows representing each trimester of gestation and 3 mo preconception. The number of days in each period when the Tmax was > 39°C was computed to assess ‘heat stress days’. Results Linear regression models assessing the associations between heat exposure and outcome variables (gestational age adjusted Z-scores of birth length (LGAZ), birth weight (WGAZ) and head circumference (HCGAZ) revealed a striking negative association of both ambient temperature and HS days in the first trimester on birth length (LGAZ) and head circumference (HCGAZ) (p < 0.005). For each 5°C increase in the Tmax in the first trimester, LGAZ decreased by 0.15 z-scores and HCGAZ decreased by 0.11 z-scores. Heat exposure (Tmax) in the second trimester also associated with HCGAZ (p = 0.02 and z-score of −0.11 for every 5°C) but not with birth length or birth weight. RNA-sequencing of placenta indicated a robust association of 1st trimester HS with genes involved in protein targeting to ER, protein biosynthesis, and cytoplasmic translation. Finally, while non-intervention groups (Arms 2 and 3) showed a robust negative association of excessive HS with LGAZ (p < 0.05), preconception intervention with sqLNS (Arm 1) significantly mitigated heat-associated decreases in birth length. Conclusions These findings indicate that excessive HS in the first trimester is associated with decreased linear growth in utero. Importantly, sqLNS mitigated growth restriction in newborns implicating nutritional status as a driving force in resilience to HS. Funding Sources Supported by The BMGF and NICHD.

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Physical birth outcomes in neonates prenatally exposed to buprenorphine - our first experiences

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh171213105s ◽

2019 ◽

Vol 147 (11-12) ◽

pp. 724-728

Author(s):

Natasha Simonovska ◽

Beti Zafirova-Ivanovska ◽

Aleksandra Babulovska

Keyword(s):

Birth Weight ◽

Birth Outcomes ◽

Apgar Score ◽

Length Of Hospital Stay ◽

Opioid Use Disorder ◽

Chest Circumference ◽

Birth Length ◽

Comprehensive Treatment ◽

Prenatally Exposed ◽

Opioid Use

Introduction/Objective. Buprenorphine appears generally similar to, and in some cases superior to, methadone in terms of maternal, fetal, and neonatal outcomes. The objective of the study was to assess some physical birth outcomes in neonates prenatally exposed to buprenorphine. Methods. During a seven-year period, nine patients have been treated with buprenorphine during their pregnancy. All women underwent interview, clinical investigations, biochemical analysis, toxicological screening, viral markers for hepatitis B, C, HIV, with regular check-ups by an obstetrician and a psychiatrist. Newborn outcomes included: birth weight in grams, birth length in centimeters, physical anomalies, head/chest circumference in centimeters, Apgar score at 1 minute / 5 minutes, gestational age (weeks), newborn length of hospital stay in days, breast-feeding, the newborn?s need for pharmacologic treatment after delivery. Results. The mean birth weight was 2,991.11 ? 37 g; birth length was 49.44 ? 2.29 cm; head circumference was 33.11 ? 0.78 cm; chest circumference was 32.33 ? 1 cm; first minute Apgar score was 8.22, fifth minute 9.22; age at delivery was 38.77 ? 1.09 weeks; hospitalization after delivery 4.44 ? 1.13 days. None of the newborns had physical anomalies. Six of the newborns were breastfed. Conclusion. Buprenorphine is a safe and important part of a complete comprehensive treatment approach in pregnant women with opioid use disorder. Buprenorphine treatment of maternal opioid use disorder indicated a low risk of preterm birth, normal birth weight and length, head and chest circumference, Apgar score, short hospitalization after delivery.

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First trimester maternal upper arm circumference correlated to placental size and neonatal anthropometry

Medical Journal of Indonesia ◽

10.13181/mji.oa.192950 ◽

2020 ◽

Vol 29 (1) ◽

pp. 38-41

Author(s):

Noroyono Wibowo ◽

Rima Irwinda ◽

Lazuardy Rachman

Keyword(s):

Birth Weight ◽

Nutritional Status ◽

Head Circumference ◽

First Trimester ◽

Birth Length ◽

Abdominal Circumference ◽

High Birth Weight ◽

Upper Arm ◽

Maternal Nutritional Status ◽

Arm Circumference

BACKGROUND First maternal nutrition, represented by anthropometrics, is an important factor for fetal growth. This study aimed to determine the correlation between maternal nutritional status of first trimester pregnant women with placental size and neonatal anthropometry. METHODS A retrospective cohort study (N = 134) was conducted in Jakarta and Riau during August–September 2017. Correlation between first trimester maternal nutritional status, placental size (placental weight and volume), and neonatal anthropometry (birth weight, birth length, head circumference, and abdominal circumference) were examined using Spearman correlation test. RESULTS High maternal body mass index and upper arm circumference (UAC) are weakly correlated with high birth weight (r = 0.281, p<0.001 and r = 0.271, p<0.001), birth length (r = 0.176, p = 0.022 and r= 0.238, p = 0.002), head circumference (r = 0.251, p = 0.001 and r = 0.297, p<0.001), abdominal circumference (r = 0.227, p = 0.003 and r = 0.226, p = 0.003), placental weight (r = 0.198, p = 0.01 and r = 0.228, p<0.001), and placental volume (r = 0.194, p = 0.01 and r = 0.203, p = 0.008). In addition, high maternal height is also weakly correlated with high birth weight (r = 0.157, p = 0.043) and birth length (r = 0.158, p = 0.041). CONCLUSIONS UAC can be reliably used to assess the nutritional status of pregnant women and to predict placental and newborn sizes.

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Maternal to fetal transfer of vitamin C and vitamin E: effect on birth outcome in a Nigerian population

Asian Journal of Medical Sciences ◽

10.3126/ajms.v7i4.14372 ◽

2016 ◽

Vol 7 (4) ◽

pp. 49-54

Author(s):

Ikechukwu Chidiebere Ikaraoha ◽

Nkeiruka Chigaekwu Mbadiwe ◽

John Ibhagbemien Anetor ◽

Constance Nnedimma Nwadike ◽

Isreal Ojareva Oforofuo

Keyword(s):

Birth Weight ◽

Vitamin E ◽

Vitamin C ◽

Birth Outcomes ◽

Head Circumference ◽

Birth Outcome ◽

Serum Vitamin ◽

Birth Length ◽

Antioxidant Vitamin ◽

Cord Serum

Background: New evidence suggests that excessive production of reactive oxygen species give rise to oxidative stress which could impair fetal growth. Antioxidant vitamin C and vitamin E have vital role in physiological process of pregnancy and health of the developing fetus.Aims and Objectives: To determine the concentrations of vitamin C and vitamin E in pair-matched maternal and cord serum of newborns and to determine the relationship between maternal/cord serum vitamin C and vitamin E at delivery and birth outcomes.Materials and Methods: A total of 209 maternal and cord blood samples were collected during delivery for serum vitamin C and E determination. Birth outcomes; birth weight, birth length, head circumference, and Apgar score were determined.Result: Newborns had significantly higher levels of vitamin C as compared to their mothers, but had non-significant lower level of vitamin E. Levels of vitamin C and E in both maternal and cord serum were positively correlated to birth weight, birth length, head circumference and Apgar score.Conclusion: Maternal vitamin C and E had significant effects on birth outcomes. A positive correlation of vitamin C and E indicates that their status in mother does influence newborns status.Asian Journal of Medical Sciences Vol.7(4) 2016 49-54

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An Evaluation of Birth Outcomes in Overweight and Obese Pregnant Women Who Exercised during Pregnancy

Sports ◽

10.3390/sports6040138 ◽

2018 ◽

Vol 6 (4) ◽

pp. 138 ◽

Cited By ~ 1

Author(s):

Palee Myrex ◽

Lorie Harper ◽

Sara Gould

Keyword(s):

Pregnant Women ◽

Weight Management ◽

Birth Outcomes ◽

Gestational Age ◽

Mode Of Delivery ◽

First Trimester ◽

Delivery Mode ◽

Obese Women ◽

Secondary Outcomes ◽

Exercise During Pregnancy

It is well established that exercise has numerous health benefits, especially in regard to weight management for the obese and overweight population. However, there is limited data to support the safety or effects of exercise in the obese and overweight pregnant population despite the fact that exercise and weight management in this demographic is particularly important. In an effort to establish the safety profile of exercise during pregnancy in this population, we tested the hypothesis that exercise would not result in adverse birth outcomes. We surveyed postpartum women with an average BMI of 34.7 regarding their participation in exercise during pregnancy. Our primary outcome of interest was small for gestational age (SGA). Secondary outcomes included gestational age at delivery, mode of delivery, head circumference, length and birthweight as compared to those who did not exercise. SGA occurred in 12.5% of women who exercised in the first trimester compared to 14.9% in those who did not exercise (p = 0.678). Similar results were seen for women who exercised in the second and third trimesters. Intensity of exercise did not alter these findings and the analysis of secondary outcomes also did not demonstrate a difference between the groups. In conclusion, overweight and obese women who reported exercising during pregnancy did not have a higher incidence of SGA infants. Exercise should not be discouraged in pregnant women due to obesity.

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Physical and Motor Development of Neonates/Infants Prenatally Exposed to Drugs in Utero: A Meta-Analysis

Adapted Physical Activity Quarterly ◽

10.1123/apaq.13.3.269 ◽

1996 ◽

Vol 13 (3) ◽

pp. 269-287 ◽

Cited By ~ 3

Author(s):

Susan J. Tarr ◽

Jean L. Pyfer

Keyword(s):

Birth Weight ◽

Motor Development ◽

Head Circumference ◽

Apgar Score ◽

In Utero ◽

Birth Length ◽

Effect Sizes ◽

Psychomotor Development ◽

Composite Effect ◽

Length Of Gestation

The purpose of this study was to investigate the role of prenatal drug exposure on birth weight, birth length, head circumference, Apgar scores, length of gestation, and motor development (Psychomotor Development Index, PDI) scores. A meta-analytic review was conducted on 56 studies published between 1979 and June 25, 1993. There were 294 effect sizes computed using the means and standard deviations reported in each study. The composite effect sizes calculated for the growth and motor development variables were (a) –.55, p <.01, birth weight; (b) –.74, p < .01, birth length; (c) –.79, p < .01, head circumference; (d) –.45, p < .01, 1-min Apgar score; (e) –.62, p <.01, 5-min Apgar score; (f) –.36, p < .01, length of gestation; (g) –.07, p = .55, PDI score (3 months); (h) –.35, p <.01, PDI score (6 months); (i) –.74, p < .01, PDI score (12 months); (j) –.44, p <.01, PDI score (18 months); and (k) –.23, p <.01, PDI score (24 months). The results of this investigation demonstrated that the use/abuse of illicit substances, alcohol, or both by the mother does significantly affect the physical and motor development of neonates/infants exposed in utero.

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Elevated total bile acid levels during late pregnancy are associated with the risk of small-for-gestational-age infants

10.21203/rs.2.14092/v1 ◽

2019 ◽

Author(s):

Li Li ◽

Wei Chen ◽

Xin-Xin Qin ◽

Li Ma ◽

Zhi-Bing Liu ◽

...

Keyword(s):

Bile Acid ◽

Birth Weight ◽

Pregnant Women ◽

Gestational Age ◽

Small For Gestational Age ◽

Head Circumference ◽

Late Pregnancy ◽

Total Bile Acid ◽

Chest Circumference ◽

Birth Length

Abstract Background Intrahepatic cholestasis of pregnancy (ICP) is common in pregnant women and is diagnosed by detecting serum total bile acid (TBA) levels. We aimed to investigate the association between serum total bile acid (TBA) levels during late pregnancy and the incidence of small-for-gestational-age (SGA) infants in a Chinese population.Methods The present study was a retrospective cohort study that included 11811 eligible mother-and-singleton-offspring pairs. The correlations between TBA levels and birth sizes, including birth weight, birth length, head circumference and chest circumference, were explored. The relative risk (RR) with 95%CI for SGA infants were estimated among subjects with ICP by multiple logistic regression analysis.Results Serum TBA levels were inversely linked with birth sizes. According to TBA levels, 11120 pregnant women were controls, 563 mild ICP, and 128 severe ICP. Birth sizes in ICP groups were lower than control group, and were the lowest in severe ICP group. Further analysis showed that 24.51% neonates were SGA infants among subjects with mild ICP (adjusted RR: 3.44; 95%CI: 2.72, 4.34) and 39.06% among subjects with severe ICP (adjusted RR: 6.54; 95%CI: 4.27, 10.02), higher than 7.39% among controls. For adjusted models, linear regression analysis showed that each 1μmol/L increase in TBA levels was associated with 11.1g (95%CI: -12.7, -9.5) decrease in birth weight, 0.045cm (95%CI: -0.053, -0.036) decrease in birth length, 0.034cm (95%CI: -0.040, -0.028) decrease in head circumference, and 0.041cm (95%CI: -0.047, -0.034) decrease in chest circumference, respectively.Conclusion Elevated TBA levels during late pregnancy are associated with an increased risk of SGA infants.

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Current status of antenatal care of pregnant women—8 provinces in China, 2018

BMC Public Health ◽

10.1186/s12889-021-11154-4 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Wenling Hu ◽

Huanqing Hu ◽

Wei Zhao ◽

Aiqun Huang ◽

Qi Yang ◽

...

Keyword(s):

Health Services ◽

Antenatal Care ◽

Pregnant Women ◽

Community Health ◽

First Trimester ◽

Community Health Services ◽

Current Status ◽

Categorical Variables ◽

Chi Square ◽

Prenatal Care Visit

Abstract Background Antenatal care (ANC) played a crucial role in ensuring maternal and child safety and reducing the risk of complications, disability, and death in mothers and their infants. The objective of this study was to evaluate the current status of ANC emphasizing the number, timing, and content of examinations on a national scale. Methods The data was collected from maternal and newborn’s health monitoring system at 8 provinces in China. After ethical approval, all pregnant women registered in the system at their first prenatal care visit, we included 49,084 pregnant women who had delivered between January 1, 2018 and December 31, 2018. Descriptive statistics of all study variables were calculated proportions and chi-square for categorical variables. Results Of the 49,084 women included in this study, the mean number of ANC visits was 6.95 ± 3.45. By percentage, 78.79% women received ANC examinations at least five times, 39.93% of the women received ANC examinations at least eight times and 16.66% of the women received ANC examinations at least 11 times. The proportion of first ANC examination in first trimester was 61.87%. The percentage of normative ANC examinations and the percentage of qualified ANC examinations were 30.98 and 8.03% respectively. Only 49.40% of the total women received all six kinds of examination items in first ANC examination: 91.47% received a blood test, 91.62% received a urine test, 81.56% received a liver function examination, 80.52% received a renal function examination, 79.07% received a blood glucose test, and 86.66% received a HIV/HBV/syphilis tests. 50.85% women received the first ANC examination in maternal and child health care (MCH) institutions, 14.07% in a general hospital, 18.83% in a township hospital, 13.15% in a community health services center, and 3.08% in an unspecified place. The proportion of women who received each of the ANC examination items in community health services center was the highest, but that in the MCH institutions was the lowest. Conclusions There is a big difference between the results of this study and the data in official reports, this study found the current status of antenatal care is not optimal in China, findings from this study suggest that the systematization, continuity and quality of ANC examinations need to be improved.

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Maternal bisphenol urine concentrations, fetal growth and adverse birth outcomes: A population-based prospective cohort

Environmental Health ◽

10.1186/s12940-021-00747-6 ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Chalana M. Sol ◽

Charissa van Zwol - Janssens ◽

Elise M. Philips ◽

Alexandros G. Asimakopoulos ◽

Maria-Pilar Martinez-Moral ◽

...

Keyword(s):

Birth Outcomes ◽

Fetal Growth ◽

Head Circumference ◽

Lower Risk ◽

First Trimester ◽

Population Based ◽

Third Trimester ◽

Bisphenol S ◽

Fetal Head ◽

Urine Concentrations

Abstract Background Exposure to bisphenols may affect fetal growth and development. The trimester-specific effects of bisphenols on repeated measures of fetal growth remain unknown. Our objective was to assess the associations of maternal bisphenol urine concentrations with fetal growth measures and birth outcomes and identify potential critical exposure periods. Methods In a population-based prospective cohort study among 1379 pregnant women, we measured maternal bisphenol A, S and F urine concentrations in the first, second and third trimester. Fetal head circumference, length and weight were measured in the second and third trimester by ultrasound and at birth. Results An interquartile range increase in maternal pregnancy-averaged bisphenol S concentrations was associated with larger fetal head circumference (difference 0.18 (95% confidence interval (CI) 0.01 to 0.34) standard deviation scores (SDS), p-value< 0.05) across pregnancy. When focusing on specific critical exposure periods, any detection of first trimester bisphenol S was associated with larger second and third trimester fetal head circumference (difference 0.15 (95% CI 0.05 to 0.26) and 0.12 (95% CI 0.02 to 0.23) SDS, respectively) and fetal weight (difference 0.12 (95% CI 0.02 to 0.22) and 0.16 (95% CI 0.06 to 0.26) SDS, respectively). The other bisphenols were not consistently associated with fetal growth outcomes. Any detection of bisphenol S and bisphenol F in first trimester was also associated with a lower risk of being born small size for gestational age (Odds Ratio 0.56 (95% CI 0.38 to 0.74) and 0.55 (95% CI 0.36 to 0.85), respectively). Bisphenols were not associated with risk of preterm birth. Conclusions Higher maternal bisphenol S urine concentrations, especially in the first trimester, seem to be related with larger fetal head circumference, higher weight and a lower risk of being small size for gestational age at birth.

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The association of women’s birth size with risk of molecular breast cancer subtypes: a cohort study

BMC Cancer ◽

10.1186/s12885-021-08027-9 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Marie S. Sandvei ◽

Signe Opdahl ◽

Marit Valla ◽

Pagona Lagiou ◽

Ellen Veronika Vesterfjell ◽

...

Keyword(s):

Breast Cancer ◽

Birth Weight ◽

Breast Cancer Risk ◽

Cancer Risk ◽

Head Circumference ◽

Birth Length ◽

Birth Size ◽

Luminal A ◽

Cancer Subtypes ◽

Luminal B

Abstract Background Because birth size appears to be positively associated with breast cancer risk, we have studied whether this risk may differ according to molecular breast cancer subtypes. Methods A cohort of 22,931 women born 1920–1966 were followed up for breast cancer occurrence from 1961 to 2012, and 870 were diagnosed during follow-up. Archival diagnostic material from 537 patients was available to determine molecular breast cancer subtype, specified as Luminal A, Luminal B (human epidermal growth factor receptor 2 (HER2)-), Luminal B (HER2+), HER2 type, and Triple negative (TN) breast cancer. Information on the women’s birth weight, birth length and head circumference at birth was used to estimate hazard ratios (HR) with 95% confidence intervals (CI) for each molecular subtype, applying Cox regression, and stratified by maternal height. Results Birth length (per 2 cm increments) was positively associated with Luminal A (HR = 1.2, 95% CI, 1.0–1.3), Luminal B (HER2+) (HR = 1.3, 95% CI, 1.0–1.7), and TN breast cancer (HR = 1.4, 95% CI, 1.0–1.9). No clear association was found for birth weight and head circumference. The positive associations of birth length were restricted to women whose mothers were relatively tall (above population median). Conclusion We found a positive association of birth length with risk of Luminal A, Luminal B (HER2+) and TN breast cancer that appears to be restricted to women whose mothers were relatively tall. This may support the hypothesis that breast cancer risk is influenced by determinants of longitudinal growth and that this finding deserves further scrutiny.

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