scholarly journals Maternal Characteristics Affect Fetal Growth Response in the Women First Preconception Nutrition Trial

Nutrients ◽  
2019 ◽  
Vol 11 (10) ◽  
pp. 2534 ◽  
Author(s):  
K Michael Hambidge ◽  
Carla M. Bann ◽  
Elizabeth M. McClure ◽  
Jamie E. Westcott ◽  
Ana Garcés ◽  
...  
Keyword(s):  
Fetal Growth ◽  
Economic Status ◽  
Secondary Analysis ◽  
Nutrition Intervention ◽  
Effect Modifier ◽  
Mixed Effect ◽  
Maternal Characteristics ◽  
Effect Regression ◽  
Z Scores ◽  
Newborn Size

The objective of this secondary analysis was to identify maternal characteristics that modified the effect of maternal supplements on newborn size. Participants included 1465 maternal–newborn dyads in Guatemala, India, and Pakistan. Supplementation commenced before conception (Arm 1) or late 1st trimester (Arm 2); Arm 3 received usual care. Characteristics included body mass index (BMI), stature, anemia, age, education, socio-economic status (SES), parity, and newborn sex. Newborn outcomes were z-scores for length (LAZ), weight (WAZ), and weight to length ratio-for-age (WLRAZ). Mixed-effect regression models included treatment arm, effect modifier, and arm * effect modifier interaction as predictors, controlling for site, characteristics, and sex. Parity (para-0 vs. para ≥1), anemia (anemia/no anemia), and sex were significant effect modifiers. Effect size (95% CI) for Arm 1 vs. 3 was larger for para-0 vs. ≥1 for all outcomes (LAZ 0.56 (0.28, 0.84, p < 0.001); WAZ 0.45 (0.20, 0.07, p < 0.001); WLRAZ 0.52 (0.17, 0.88, p < 0.01) but only length for Arm 2 vs. 3. Corresponding effects for para ≥1 were >0.02. Arm 3 z-scores were all very low for para-0, but not para ≥1. Para-0 and anemia effect sizes for Arm 1 were > Arm 2 for WAZ and WLRAZ, but not LAZ. Arm 1 and 2 had higher WAZ for newborn boys vs. girls. Maternal nulliparity and anemia were associated with impaired fetal growth that was substantially improved by nutrition intervention, especially when commenced prior to conception.

scholarly journals Maternal Characteristics Affect Fetal Growth Response to Maternal Supplements in the Women First Preconception Trial (WF) (P10-017-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Michael Hambidge ◽  
Carla Bann ◽  
Elizabeth McClure ◽  
Jamie Westcott ◽  
Ana Garces ◽  
...  
Keyword(s):  
Fetal Growth ◽  
Maternal Nutrition ◽  
Secondary Analysis ◽  
Effect Modifier ◽  
Mixed Effect ◽  
Maternal Characteristics ◽  
Funding Sources ◽  
Effect Regression ◽  
Female Effect ◽  
Gates Foundation

Abstract Objectives Determine if maternal characteristics modified newborn anthropometric outcomes in the WF trial (ClinicalTrials.gov NCT01883193). Methods Secondary analysis included combined data for all 1465 maternal infant dyads in WF sites in Guatemala, India, and Pakistan who had 1st trimester ultrasounds and newborn anthropometry with the three WF arms maintained: Arm 1 commenced a comprehensive nutrition supplement ≥3 months prior to conception; Arm 2 commenced the same supplement in the 1st trimester, and Arm 3 received no trial supplements. Maternal characteristics included were: baseline, BMI, hemoglobin, age, education, SES, and parity plus newborn sex. Newborn outcomes were Z-scores for length (LAZ), weight (WAZ), and weight-to-length ratio (WLRZ). Mixed effect regression models were fit for each outcome, including treatment arm, effect modifier, and treatment arm x effect modifier interaction as predictors and controlling for study site, maternal characteristics, and newborn sex. Results Parity, anemia and newborn sex were significant effect modifiers favoring para 0 vs para ≥1, anemia vs non anemia, and newborn male vs female. Effect of Arm 1 vs 3 was significantly larger for para 0 vs ≥1 women on length and weight (Table). Arm 2 vs 3 was not associated with improvements for para 0 in weight (P = 0.273) or WLRZ (P = 0.710). Arms 1 and 2 (vs 3) were associated with significantly higher length, weight, and WLRZ for anemic women. For parity and anemia, effect sizes for Arm 1 were greater than for Arm 2 for WAZ and WLZ (P < 0.05), but not LAZ. Arm 1 and 2 were associated with significantly higher weight and WLRZ for male vs female newborn. Conclusions In diverse low resource populations, impaired fetal growth (weight and length) is substantially improved in nulliparous and in anemic women but minimally or not at all in parous and in non-anemic women. Correction of weight decrements is most pronounced with improvement in maternal nutrition commencing prior to conception. Funding Sources Bill & Melinda Gates Foundation; NIH, NICHD and ODS. Supporting Tables, Images and/or Graphs

scholarly journals Is frequency of family meals associated with parental encouragement of healthy eating among ethnically diverse eighth graders?

2013 ◽  
Vol 17 (5) ◽  
pp. 998-1003 ◽  
Author(s):  
Natalie S Poulos ◽  
Keryn E Pasch ◽  
Andrew E Springer ◽  
Deanna M Hoelscher ◽  
Steven H Kelder
Keyword(s):  
Healthy Eating ◽  
Fruits And Vegetables ◽  
Economic Status ◽  
Family Meals ◽  
Eating Behaviours ◽  
Mixed Effect ◽  
Parental Encouragement ◽  
Effect Regression ◽  
Eighth Grade Students ◽  
Central Texas

AbstractObjectiveThe purpose of the present study was to explore the relationship between family meals and parental encouragement of healthy eating overall and by ethnicity.DesignFamily meal frequency was measured with one item asking how many times in the past 7 d all or most of the family ate a meal together, which was then categorized to represent three levels of family meals (≤2 times, 3–6 times and ≥7 times). Parental encouragement of healthy eating assessed how often parents encouraged the student to eat fruits and vegetables, drink water, eat wholegrain bread, eat breakfast and drink low-fat milk (never to always). An overall scale of parental encouragement of healthy eating was created. Mixed-effect regression analyses were run controlling for gender, ethnicity, age and socio-economic status. Moderation by ethnicity was explored.SettingMiddle schools.SubjectsParticipants included 2895 US eighth grade students participating in the Central Texas CATCH (Coordinated Approach To Child Health) Middle School Project (mean age 13·9 years; 24·5 % White, 52·7 % Hispanic, 13·0 % African-American, 9·8 % Other; 51·6 % female).ResultsEating more family meals was significantly associated with having parents who encouraged healthy eating behaviours (P for trend <0·001). The number of family meals was positively associated with encouragement of each of the healthy eating behaviours (P for trend <0·0001). There were no differences in the relationships by ethnicity of the students.ConclusionsFamilies who eat together are more likely to encourage healthy eating in general. Interventions which promote family meals may include tips for parents to increase discussions about healthy eating.

Modeling the Effect of Mother's Characteristics on the Weight of a Newborn

2020 ◽  
Vol 10 (4) ◽  
pp. 206-216
Author(s):  
Oluwafemi Samson Balogun ◽  
Donald Douglas Atsa'am ◽  
Toluwalase Janet Akingbade ◽  
Emmanuel Awuni Kolog ◽  
Richard O. Agjei ◽  
...  
Keyword(s):  
Birth Weight ◽  
Fetal Growth ◽  
Secondary Analysis ◽  
Policy Issue ◽  
Multiple Linear Regression Model ◽  
Maternal Weight ◽  
Maternal Characteristics ◽  
Public Policy Issue ◽  
Neonatal Birth Weight ◽  
Antenatal Visits

BACKGROUNDNeonatal mortality related to fetal growth is a public policy issue in Nigeria.METHODTo determine maternal characteristics associated with fetal growth and neonatal birth weight, a secondary analysis of data collected from 701 mothers using a multiple linear regression model was undertaken.FINDINGSMaternal age, parity, and weight were found to be significantly associated with neonatal birth weight. The number of antenatal visits and maternal level of education were not found to be associated with neonatal birth weight.CONCLUSIONSTo the extent that providers might influence maternal weight, education and counselling during pregnancy may impact fetal growth and neonatal birth weight.

scholarly journals Association between calcium in cord blood and newborn size in Bangladesh

2011 ◽  
Vol 106 (9) ◽  
pp. 1398-1407 ◽  
Author(s):  
Mariko Doi ◽  
Rokeya Sultana Rekha ◽  
Sultan Ahmed ◽  
Masafumi Okada ◽  
Anjan Kumar Roy ◽  
...  
Keyword(s):  
Birth Weight ◽  
Cord Blood ◽  
Fetal Growth ◽  
Economic Status ◽  
Birth Length ◽  
Bone Specific Alkaline Phosphatase ◽  
Newborn Weight ◽  
25 Hydroxy Vitamin D ◽  
Newborn Size ◽  
Size At Birth

Ca status in the uterus during pregnancy has been suggested to affect fetal growth and size at birth. In Bangladesh, low Ca levels in pregnant women and low birth weight in infants are common. The present study explored the association between Ca levels in cord blood and newborn size at birth (birth weight and birth length) in Bangladesh. Samples and data included 223 women with live-born singleton deliveries in rural Bangladesh. Newborn weight and length were measured at birth. From cord blood obtained at delivery, Ca, 25-hydroxy vitamin D, bone-specific alkaline phosphatase and intact parathyroid hormone levels were determined. An association between size at birth and Ca levels in cord blood was found (birth weight, P = 0·022; birth length, P = 0·001). Associations between Ca and newborn size were further analysed using multivariate regression analyses. After adjusting for several covariates of characteristics in mothers and newborns (gestational weeks at birth, sex of newborn, socio-economic status, maternal height, BMI, age and season at birth), birth length still exhibited a significant relationship with Ca levels in cord blood (birth length, P = 0·030). The present study indicates that Ca status in cord blood might be associated with the birth length of newborns. Ca levels during gestation may affect fetal growth.

scholarly journals Potential of community-based risk estimates for improving hospital performance measures and discharge planning

2021 ◽  
Vol 10 (2) ◽  
pp. e001230
Author(s):  
Michael Reid ◽  
George Kephart ◽  
Pantelis Andreou ◽  
Alysia Robinson
Keyword(s):  
Discharge Planning ◽  
Care Transitions ◽  
Hospital Setting ◽  
Hospital Performance ◽  
Case Mix ◽  
Readmission Rates ◽  
Mixed Effect ◽  
Adjusted Risk ◽  
Community Risk ◽  
Effect Regression

BackgroundRisk-adjusted rates of hospital readmission are a common indicator of hospital performance. There are concerns that current risk-adjustment methods do not account for the many factors outside the hospital setting that can affect readmission rates. Not accounting for these external factors could result in hospitals being unfairly penalized when they discharge patients to communities that are less able to support care transitions and disease management. While incorporating adjustments for the myriad of social and economic factors outside of the hospital setting could improve the accuracy of readmission rates as a performance measure, doing so has limited feasibility due to the number of potential variables and the paucity of data to measure them. This paper assesses a practical approach to addressing this problem: using mixed-effect regression models to estimate case-mix adjusted risk of readmission by community of patients’ residence (community risk of readmission) as a complementary performance indicator to hospital readmission rates.MethodsUsing hospital discharge data and mixed-effect regression models with a random intercept for community, we assess if case-mix adjusted community risk of readmission can be useful as a quality indicator for community-based care. Our outcome of interest was an unplanned repeat hospitalisation. Our primary exposure was community of residence.ResultsCommunity of residence is associated with case-mix adjusted risk of unplanned repeat hospitalisation. Community risk of readmission can be estimated and mapped as indicators of the ability of communities to support both care transitions and long-term disease management.ConclusionContextualising readmission rates through a community lens has the potential to help hospitals and policymakers improve discharge planning, reduce penalties to hospitals, and most importantly, provide higher quality care to the people that they serve.

scholarly journals Limited not lazy: a quasi-experimental secondary analysis of evidence quality evaluations by those who hold implausible beliefs

2020 ◽  
Vol 5 (1) ◽  
Author(s):  
Kristy A. Martire ◽  
Bethany Growns ◽  
Agnes S. Bali ◽  
Bronte Montgomery-Farrer ◽  
Stephanie Summersby ◽  
...  
Keyword(s):  
Secondary Analysis ◽  
Past Research ◽  
Linear Mixed Effect Model ◽  
High Quality ◽  
Mixed Effect ◽  
High Quality Evidence ◽  
Effect Model ◽  
Evidence Quality ◽  
Quasi Experimental ◽  
Quality Evidence

AbstractPast research suggests that an uncritical or ‘lazy’ style of evaluating evidence may play a role in the development and maintenance of implausible beliefs. We examine this possibility by using a quasi-experimental design to compare how low- and high-quality evidence is evaluated by those who do and do not endorse implausible claims. Seven studies conducted during 2019–2020 provided the data for this analysis (N = 746). Each of the seven primary studies presented participants with high- and/or low-quality evidence and measured implausible claim endorsement and evaluations of evidence persuasiveness (via credibility, value, and/or weight). A linear mixed-effect model was used to predict persuasiveness from the interaction between implausible claim endorsement and evidence quality. Our results showed that endorsers were significantly more persuaded by the evidence than non-endorsers, but both groups were significantly more persuaded by high-quality than low-quality evidence. The interaction between endorsement and evidence quality was not significant. These results suggest that the formation and maintenance of implausible beliefs by endorsers may result from less critical evidence evaluations rather than a failure to analyse. This is consistent with a limited rather than a lazy approach and suggests that interventions to develop analytical skill may be useful for minimising the effects of implausible claims.

scholarly journals Lens densitometry for assessment and prediction of cataract progression after pars plana vitrectomy with C3F8-gas for retinal detachment

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0254370
Author(s):  
Philipp Schindler ◽  
Luca Mautone ◽  
Eileen Bigdon ◽  
Vasyl Druchkiv ◽  
Martin Stefan Spitzer ◽  
...  
Keyword(s):  
Retinal Detachment ◽  
Regression Model ◽  
Pars Plana Vitrectomy ◽  
Quantitative Model ◽  
Average Deviation ◽  
Mixed Effect ◽  
Lens Opacification ◽  
Effect Regression ◽  
Pars Plana ◽  
Mixed Effect Regression Model

Purpose Lens opacification is a common complication after pars plana vitrectomy (PPV) and knowing its progression would facilitate consulting patients. The purpose of this study was to evaluate a quantitative model for lens-status-monitoring after PPV with C3F8 gas. Our model was evaluated in rhegmatogenous retinal detachment (RRD) patients of various age and lens densitometry (LD). Methods Data between March 2018 and March 2020 were evaluated retrospectively. LD measurements of the PentacamHR® Nucleus Staging mode (PNS) were used to quantify lens opacification over time. A mixed-effect regression model was designed, to enable LD predictions at any time postoperatively. Calculations were based on patient’s age and baseline LD as dependent variables. Six patients were randomly excluded during model development, to be used for testing its power afterwards. Results 34 patients (male 19 [55.9%], female 15 [44.1%]) matched the inclusion criteria. Average age was 58.5 years (32–77;±4.3) and average follow-up was 7.2 months (3,4–23.1;±1,8). Mean baseline LD of the treated and fellow eye before surgery were 10.9% (8.7%-14.8%;±0.8) and 10.7% (8.5%-14.1%;±0.6), respectively. Using our prediction model, LD values for the six pre-selected patients closely match the observed data with an average deviation of 1.07%. Conclusions Evaluation of age and baseline LD using a mixed-effect regression model might predict cataract progression in RRD patients treated with PPV and C3F8-gas. Such a tool could be considered during cataract surgery consultation in these patients.

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