Factors affecting neonatal birth weight in Sidotopo Wetan Health Centre: A cross-sectional study

Birth weight serves as an indicator of a newborn’s health status. It is associated with mortality rate in the first year, developmental problems in childhood and risk of various diseases in adulthood. Even in modern era, it continues to be a health concern globally, especially in developing countries. In Indonesia, the prevalence of low birth weight has increased from 2013 to 2018, swaying further from the national target. Low birth weight is often caused by insufficient nutrients supplied by the mother to the fetus. In Indonesia, chronic energy deficiency status is diagnosed in the first antenatal care visit by measuring maternal middle-upper arm circumference with a cut-off point of 23.5cm. Meanwhile, iron level is measured via assessing hemoglobin level will be measured in the first antenatal care visit and in trimester III. This study aims to describe the factors that may influence neonatal birth weight. It is a quantitative study with a cross sectional approach conducted at Sidotopo Wetan Public Health Centre. 97 samples are collected from medical records and analysed using bivariate correlative test. Result shows that maternal age (0.20), chronic energy deficiency status (0.026) and antenatal care visit minimal of 4 times (0.49) increase the risk of low-birth-weight incidence. On the other hand, educational level, maternal parity and anemia status does not acts as risks. In conclusion, maternal age, energy status and visits to antenatal care acts as risk factors in causing low birth weight.

Pregnancy Complications in Women with PCOS: A Meta-Analysis

Polycystic ovary syndrome (PCOS) is a hormonal disorder which affects women in their reproductive ages. There might have association between maternal and neonatal complications with PCOS. The goal of this study is to look for the association between polycystic ovary syndromes (PCOS) and obstetric complications through meta-analysis on the basis of previously published studies from 2000 to 2019. In the current endeavour 17 studies involving 1975 women with PCOS and 10812 controls were selected for pooling. During pregnancy period women who have PCOS showed a significantly higher risk of developing gestational diabetes mellitus (GDM) (RR 2.51; 95% CI: 1.71-3.65), pregnancy induced hypertension (PIH) (RR 2.76; 95% CI: 2.04-3.72), preeclampsia (RR 2.14; 95% CI: 1.34-3.40), preterm birth (RR 1.41; 95% CI: 1.08-1.85) compared to controls. Neonatal birth weight is significantly lower (SMD -0.18; 95% CI: -0.33 to -0.03) compared to controls. It is concluded that women who have PCOS have greater chance of having pregnancy complications as well as risk of neonatal complications such as having low birth weight. Dhaka Univ. J. Sci. 69(2): 82-87, 2021 (July)

Thyroxine Supplementation in Pregnant Women After Thyroidectomy for Thyroid Cancer and Neonatal Birth Weight

Patients are often supplemented with a sufficient dose of thyroxine after thyroidectomy for thyroid cancer. However, the influence of thyroxine supplementation on fetal growth in pregnant women after thyroidectomy for thyroid cancer remains unclear. The aim of this study was to investigate the effect of thyroxine supplementation on neonatal birth weight. This cohort study included 49,896 pregnant women (278 patients with a history of thyroidectomy for thyroid cancer and 39,363 control cases after exclusion). Thyroid parameters were examined in pregnant women and their newborns. The associations between maternal thyroid function and neonatal birth weight and small for gestational age were studied using regression analyses. In the levothyroxine supplementation group, free thyroxine (FT4) levels were significantly higher in both early pregnancy (P < 0.001) and late pregnancy (P < 0.001) groups than in the control group. Furthermore, levels of neonatal thyroid stimulating hormone (P = 0.032) and birth weight (P = 0.043) were significantly lower than those in the control group. We also observed a significant inverse association between maternal FT4 levels in early pregnancy and neonatal birth weight (P=0.028), especially in male newborns (P=0.036). In summary, after thyroidectomy for thyroid cancer, a sufficient dose of thyroxine supplementation in early pregnancy is significantly associated with reduced birth weight and may need to be monitored.

Assessment of pregnancy dietary intake and association with maternal and neonatal outcomes

Background Maternal dietary habits are contributors of maternal and fetal health; however, available data are heterogeneous and not conclusive. Methods Nutrient intake during pregnancy was assessed in 503 women with uncomplicated pregnancies, using the validated Food Frequency Questionnaire developed by the European Prospective Investigation into Cancer and Nutrition (EPIC-FFQ). Results In all, 68% of women had a normal body mass index at the beginning of pregnancy, and 83% of newborns had an appropriate weight for gestational age. Maternal pre-pregnancy body mass index (BMI), gestational weight gain (GWG), and placental weight were independently correlated with birth weight. GWG was not related to the pre-pregnancy BMI. EPIC-FFQ evaluation showed that 30% of women adhered to the European Food Safety Authority (EFSA) ranges for macronutrient intake. In most pregnant women (98.1%), consumption of water was below recommendations. Comparing women with intakes within EFSA ranges for macronutrients with those who did not, no differences were found in BMI, GWG, and neonatal or placental weight. Neither maternal nor neonatal parameters were associated with the maternal dietary profiles. Conclusions In our population, maternal pre-pregnancy BMI, GWG, and placental weight are determinants of birth weight percentile, while no association was found with maternal nutrition. Future studies should explore associations through all infancy. Impact Maternal anthropometrics and nutrition status may affect offspring birth weight. In 503 healthy women, maternal pre-pregnancy body mass index (BMI), gestational weight gain (GWG), and placental weight were independently correlated to neonatal birth weight. GWG was not related to the pre-pregnancy BMI. In all, 30% of women respected the EFSA ranges for macronutrients. Neither maternal nor neonatal parameters were associated with maternal dietary profiles considered in this study. Maternal pre-pregnancy BMI, GWG, and placental weight are determinants of neonatal birth weight percentile, while a connection with maternal nutrition profiles was not found.

Effect of Maternal Triclosan Exposure on Neonatal Birth Weight and Children Triclosan Exposure on Children's BMI: A Meta-Analysis

Background: Triclosan (TCS) is an environmental chemical with endocrine disrupting effects and can enter the body through the skin or oral mucosa. Human data about the effect of TCS exposure during pregnancy on neonatal birth weight and TCS exposure during childhood on children's growth are scarce.Objectives: To investigate the association between maternal urinary TCS level and neonatal birth weight, as well as children's urinary TCS level and children's body mass index (BMI).Methods: A systematic literature search was conducted using PubMed, Cochrane Library, and Web of Science. Finally, seven epidemiological articles with 5,006 participants from September 25, 2014 to August 10, 2018 were included in the meta-analysis to identify the relationship between maternal exposure to TCS and neonatal birth weight. On the other hand, three epidemiological articles with 5,213 participants from July 22, 2014 to September 1, 2017 were included in another meta-analysis to identify the relationship between children's exposure to TCS and children's BMI. We used Stata 16.0 to test the heterogeneity among the studies and calculating the combined effect value 95% confidence interval (CI) of the selected corresponding models.Results: TCS exposure during pregnancy was not significant associated with neonatal birth weight. The results of forest plots were as follows: ES (Estimate) = 0.41 (95% CI: −11.97–12.78). Children's urinary TCS level was also irrelevant associated with children's BMI: ES = 0.03 (95% CI: −0.54–0.60).Conclusions: This meta-analysis demonstrated that there was no significant association between maternal TCS level and neonatal birth weight, also there has no relationship between children's urinary TCS level and children's BMI.

Anti-epileptic drug exposure during pregnancy and neonatal birth weight outcomes: protocol for a systematic review and meta-analysis

Background The prevalence of epilepsy in pregnant women is estimated at 0.3-1%. Anti-epileptic drug (AED) exposure in-utero has been associated with various adverse health outcomes in neonates, including adverse birth weight outcomes. Objective This review aims to summarize the published evidence on the association between AED exposure in pregnancy and adverse birth weight outcomes Methods Studies assessing AED exposure in pregnancy and neonatal birth weight outcomes, including small for gestational age (SGA), low birth weight (LBW), birth weight (BW), length, head circumference, and cephalization index will be identified in MEDLINE®, EMBASE, Cochrane Library, Scopus, Cumulative Index of Nursing and Allied Health Literature (CINAHL), International Pharmaceutical Abstracts (IPA), and Global Health. Open grey, Theses Canada, and ProQuest Dissertations will be used to locate gray literature. Eligible study designs will include both intervention and non-interventional studies. We will not impose any time limit in the review. We will use the Newcastle-Ottawa Scale to assess the methodological quality of observational studies and quasi-experimental studies included in the review. The risk of bias of experimental studies will be appraised using the Cochrane risk-of-bias tool for randomized trials (RoB 2). A meta-analysis will be conducted using a random-effects model. Discussion The results from this review could improve clinicians’ prescribing decisions by highlighting the safest AEDs for women who are pregnant or planning to conceive based on the evidence currently available. Systematic review registration PROSPERO CRD42020192713

Comparison of birth weights of neonates of mothers receiving vs. not receiving zinc supplement at pregnancy

Background Zinc is an essential element for normal embryogenesis and embryonic and neonatal development. Therefore, we compared the birth weights of neonates born to mothers who consumed zinc supplement during pregnancy with that of neonates born to mothers who did not. Methods In a cross-sectional study, we divided 200 pregnant mothers into two groups: case group (mothers receiving zinc supplement during pregnancy) and control group (mothers not receiving zinc supplement during pregnancy) Then, the neonate’s cord zinc level and mother’s serum level were measured and neonate’s growth charts (weight, height and head circumference)were completed. Results In this study, both groups of mothers were observed to have zinc deficiency; 35% of the mothers who consumed zinc supplements and 81% of the mothers who did not consume zinc supplements (P < 0.001). Based on the results, maternal serum of zinc (P < 0.001), neonatal birth weight (P = 0.008), maternal age (P < 0.001) and parity (P < 0.01) in zinc-supplemented group were higher. Neonatal birth weight was associated moderately with mother’s zinc serum levels and poorly with neonatal serum zinc levels. Conclusion Zinc consumption during pregnancy increases serum zinc level of mother and neonatal weight. Neonatal weight has a higher correlation to maternal serum zinc level.