HUBUNGAN BODY MASS INDEX (BMI) IBU HAMIL DENGAN PENAMBAHAN BERAT BADAN SELAMA KEHAMILAN DI PMB BD. W KAB. BANDUNG BARAT TAHUN 2021

Masalah gizi seimbang di Indonesia masih merupakan masalah yang cukup berat. Pada hakikatnya berpangkal pada keadaan ekonomi yang kurang dan terbatasnya pengetahuan tentang nilai gizi dan makanan yang ada. Kekurangan atau kelebihan makanan pada masa hamil dapat berakibat kurang baik bagi ibu, janin yang dikandung serta jalannya persalinan. Oleh karena itu, perhatian terhadap gizi dan pengawasan berat badan (BB) selama hamil merupakan salah satu hal penting dalam pengawasan kesehatan pada masa hamil. Untuk mengetahui “ Hubungan status gizi ibu sebelum hamil dengan penambahan berat badan selama hamil”. Jenis penelitian yang digunakan adalah hasil desain penelitian deskriftif yang bertujuan untuk mengetahui hubungan status gizi ibu sebelum hamil dengan penambahan berat badan selama hamil. Populasi ibu hamil trimester III di wilayah kerja PMB Bidan W yaitu sebanyak 55 orang yang berkunjung ke PMB Bidan W. Untuk mendapatkan jumlah responden peneliti melakukan pengumpulan dengan tekhnik rancangan penelitian Cross Sectional Study dengan seluruh ibu hamil trimester III. Kemudian peneliti akan menghitung menggunakan rumus BMI yaitu Berat (badan dalam kg) : Kuadrat tinggi badan (dalam ukuran meter). BMI = (BB) / (TB) x (TB). Dilanjutkan dengan analisa data melalui beberapa tahap yang dimulai dengan editing, coding, tabulasi.Hasil : Hasil penelitian yang didapatkan Dari 55 responden status gizi ibu hamil bahwa hampir setengah dari responden status gizi ibu hamil dengan kategori normal sebanyak 22 orang dengan presentasi 40%. Dari 55 responden penambahan berat badan ibu selama hamil bahwa hampir setengah dari responden penambahan berat badan dengan kategori baik sebanyak 20 orang presentasi 36,4%. Ada hubungan status gizi ibu sebelum hamil dengan penambahan berat badan selama hamil di PMB Bd Warsah Kabupaten Bandung Barat. Hal tersebut dapat dibuktikan dengan hasil uji statistik menggunakan Chi – square dalam penelitian ini menunjukkan p = ,000 < 0,05.The problem of balanced nutrition in Indonesia is still a serious problem. Essentially stems from a lack of economic conditions and limited knowledge about nutrition in Indonesia. Lack or excess of food during pregnancy can have a negative effect on the mother, the fetus and the course of delivery. Therefore, attention to nutrition and control of body weight (BB) during pregnancy is of the important things in health surveillance during pregnancy. To determine the relationship between maternal nutritional status before pregnancy and weight gain during pregnancy. The type of research used is the result of a descriptive research design that aims to determine the relationship between maternal nutritional status before pregnancy and weight gain during pregnancy. The population of thitd trimester III pregnant women in the PMB Midwife W working area, west bandung district, was 55 people. To get the number of respondents, the research was was collected using a cross sectional study design technique with all 3 trimester pregnant women checking their weight and height.Then The researcher will calculate using BMI formula, namely body weight (in kg) : height squared (in maters). Followed by data analysis through several stages starting with editing, coding, tabulation. The results of the study obtained from 55 respondents of the nutritional status of pregnant women that almost half of the respondents of the nutritional status of pregnant women in the normal category were 22 people with a presentation of 40%. Of the 55 respondents who gained weight in the good category, 20 people had a percentage of 36.4%. There is a relationship between maternal nutritional status before preganancy at PMB Midwife W West Bandung Regency. This can be proven by the results of stastical test using Chi – square in this study showing p =, 000 < 0.05

Epigenetics in the Uterine Environment: How Maternal Diet and ART May Influence the Epigenome in the Offspring with Long-Term Health Consequences

The societal burden of non-communicable disease is closely linked with environmental exposures and lifestyle behaviours, including the adherence to a poor maternal diet from the earliest preimplantation period of the life course onwards. Epigenetic variations caused by a compromised maternal nutritional status can affect embryonic development. This review summarises the main epigenetic modifications in mammals, especially DNA methylation, histone modifications, and ncRNA. These epigenetic changes can compromise the health of the offspring later in life. We discuss different types of nutritional stressors in human and animal models, such as maternal undernutrition, seasonal diets, low-protein diet, high-fat diet, and synthetic folic acid supplement use, and how these nutritional exposures epigenetically affect target genes and their outcomes. In addition, we review the concept of thrifty genes during the preimplantation period, and some examples that relate to epigenetic change and diet. Finally, we discuss different examples of maternal diets, their effect on outcomes, and their relationship with assisted reproductive technology (ART), including their implications on epigenetic modifications.

Compromised maternal nutritional status in early pregnancy and its relation to the birth size in young rural Indian mothers

Background Low birth weight is highly prevalent in rural India. As a chronic undernutrition problem, poor birth outcomes are closely related to various nutritional factors more prominently the poor maternal anthropometry at conception. The purpose of the study was to identify how compromised maternal nutritional status in early pregnancy affects the birth size of rural Indian mothers. Methods It was a prospective observational study on singleton pregnant women (n = 204) from 14 villages in Mulshi Taluka of Pune District, Maharashtra, India. Maternal weight (Wt), height (Ht), body fat percent (BF%), head circumference (HC), and sitting height (SHT) were measured at early pregnancy (< 13 weeks of gestation) and infants’ weight and length were measured within 24 h of birth. Groups means were tested using a ‘t’ test while the trend in means was tested using ANOVA. Results Mothers were young (21.46 ± 2.09 yrs), thin (46.46 ± 6.1 kg), short (153.39 ± 5.79 cm), and poorly nourished (19.74 ± 2.41 kg/m2). Mean birth weight was low (2655 ± 507 g) and prevalence of LBW and stunting at birth was highest among mothers in the lower tertile of each of the anthropometric indicators. In particular, stunting was significantly higher for mothers in lower tertile compared to higher tertile of Wt (44.6 Vs 64.6%) and was also true for HC (43.7 Vs 60.6%). Risk for LBW and stunting at birth was almost similar and was significant (p < 0.01) for mothers in the lower tertile of Wt, Ht, BMI, SHT, HC, and BF% as compared to those in the higher tertile of these measurements. Conclusion All the anthropometric indicators of current undernutrition at first trimester as well as that in utero reflected by smaller HC, impose risk for LBW and stunting at birth especially among young rural mothers.

Nutritional status and prey energy density govern reproductive success in a small cetacean

A variety of mammals suppress reproduction when they experience poor physical condition or environmental harshness. In many marine mammal species, reproductive impairment has been correlated to polychlorinated biphenyls (PCBs), the most frequently measured chemical pollutants, while the relative importance of other factors remains understudied. We investigate whether reproductively active females abandon investment in their foetus when conditions are poor, exemplified using an extensively studied cetacean species; the harbour porpoise (Phocoena phocoena). Data on disease, fat and muscle mass and diet obtained from necropsies in The Netherlands were used as proxies of health and nutritional status and related to pregnancy and foetal growth. This was combined with published life history parameters for 16 other areas to correlate to parameters reflecting environmental condition: mean energy density of prey constituting diets (MEDD), cumulative human impact and PCB contamination. Maternal nutritional status had significant effects on foetal size and females in poor health had lower probabilities of being pregnant and generally did not sustain pregnancy throughout gestation. Pregnancy rates across the Northern Hemisphere were best explained by MEDD. We demonstrate the importance of having undisturbed access to prey with high energy densities in determining reproductive success and ultimately population size for small cetaceans.

Screening of the Risk Factors for Congenital Anomalies in Pregnant Women Attending Maternity and Obstetric Hospitals at Mosul City

To determine the possible risk factor leading to common congenital anomalies among fetuses and neonatal and assess possibly causes the lead to congenital anomalies A descriptive study (it was cross-sectional) was adopted to achieve the objectives of the current study for the period from October 16 to May 31, 2020. Data were collected from Nineveh Governorate. An objective sample of (120) women who gave birth to children with congenital anomalies in maternity wards was selected in this study. Data were prepared, organized, and entered a computer file; Statistical Package for the Social Science (SPSS, version 26). In a questionnaire for women in maternity wards in maternity hospitals in the city of Mosul, 120 women who gave birth to deformed children were monitored. Most of the risk factors were important in an association between congenital malformations and parental kinship, fever, and maternal nutrition. Malnutrition during pregnancy also shows an association between parental consanguinity and NTD. It was concluded from the available data that there is a significant association between congenital anomalies, parental consanguinity, maternal nutritional status, and high temperature during pregnancy. Support parents who have a deformed baby or are at risk of having a baby with a congenital problem, by doing basic checkups before and during pregnancy to make sure the pregnancy is healthy. Keywords: Risk Factor, Pregnant Woman, Congenital Anomalies.

Effect of Preconception Care Intervention on Maternal Nutritional Status and Birth Outcome in a Low-Resource Setting: Proposal for a Nonrandomized Controlled Trial

Background The provision of preconception care approaches such as maternal assessments and education on healthy lifestyle (including physical activity, nutrition, and dietary supplements such as folic acid), general and sexual health, avoidance of high-risk behavior, and immunizations has been shown to identify and reduce the risk of adverse birth outcomes through appropriate management and preventive measures. Objective The goal of the study is to determine the effect of an integrated preconception care intervention on delivery outcomes, which is a novel challenge for lowering unfavorable birth outcomes in India’s low-resource setting. The main objectives are to investigate the relationship of birth outcomes to both maternal and paternal preconception health and determine the effect of preconception care intervention on improvement of maternal nutritional status and reduction of the risk of adverse birth outcomes such as prematurity, low birth weight, and maternal and neonatal complications. Methods A nonrandomized controlled trial design will be used for comparing 2 groups: preconception care with a standard maternal health care (MHC) program and an integrated MHC program (without preconception care). Two rural field areas of Khordha district, Odisha, will be selected for conducting the study. The study will enroll 782 married women between the ages of 18 and 35 years with their spouses, with 391 women in each group. The couples will receive preconception care based on their health circumstances, and they will be followed up at 3-month intervals before pregnancy. Following pregnancy, they will be followed up for 8 prenatal monitoring and care visits as well as 6 weeks after delivery as part of the standard MCH program. The preconception care intervention package includes couples counseling, contraceptive education and distribution, sex education, lifestyle modification, and nutritional supplementation of iron and folic acid, along with multivitamins if needed. Results The proposal was approved by the institutional ethical committee for conducting the study in June 2020 (Ref No: T/EMF/Nursing/20/6). Participants were enrolled in phase 1 in April 2021, phase 2 of offering preconception services will begin in August 2021, and study outcomes will be measured from 2023 to 2024. Conclusions Through preconception care and counseling, the eligible couples will recognize, embrace, and implement the actions to improve their preconception health. Finally, it is expected that maternal and paternal health will have a significant impact on enhancing maternal nutritional status and birth outcomes. Trial Registration Clinical Trials Registry–India CTRI/2021/04/032836; http://ctri.nic.in/Clinicaltrials/pmaindet2.php?trialid=48239&EncHid=&userName=CTRI/2021/04/032836 International Registered Report Identifier (IRRID) PRR1-10.2196/28148

Blastocyst trophectoderm endocytic activation, a marker of adverse developmental programming

The mouse preimplantation embryo is sensitive to its environment including maternal dietary protein restriction which can alter the developmental programme and affect lifetime health. Previously, we have shown maternal low protein diet (LPD) causes reduction in blastocyst mTORC1 signalling coinciding with reduced availability of branched-chain amino acids (BCAAs) in surrounding uterine fluid. BCAA deficiency leads to increased endocytosis and lysosome biogenesis in blastocyst trophectoderm (TE), a response to promote compensatory histotrophic nutrition. Here, we first investigated the induction mechanism by individual variation in BCAA deficiency in an in vitro quantitative model of TE responsiveness. We found isoleucine (ILE) deficiency as the most effective activator of TE endocytosis and lysosome biogenesis, with less potent roles for other BCAAs and insulin; cell volume was also influential. TE response to low ILE included upregulation of vesicles comprising megalin receptor and cathepsin-B and the response was activated from blastocyst formation. Second, we identified the transcription factor TFEB as mediating the histotrophic response by translocation from cytoplasm to nucleus during ILE deficiency and in response to mTORC1 inhibition. Lastly, we investigated whether a similar mechanism responsive to maternal nutritional status was found in human blastocysts. Blastocysts from women with high body-mass index, but not the method of fertilisation, revealed stimulated lysosome biogenesis and TFEB nuclear migration. We propose TE lysosomal phenotype as an early biomarker of environmental nutrient stress that may associate with long-term health outcome.

Associations of maternal diet and nutritional status with offspring hepatic steatosis in the Avon longitudinal study of parents and children

Background Priming for cardiometabolic diseases, including non-alcoholic fatty liver disease (NAFLD), is hypothesized to begin in utero. The primary objective of this study is to determine whether there is an association between maternal nutritional status and offspring NAFLD. Methods Data come from the Avon Longitudinal Study of Parents and Children (ALSPAC) in the UK. The analytic sample included 3353 participants who had maternal information on pre-pregnancy BMI, gestational weight gain, diabetes, and free sugar intake as percent of total energy and were assessed for mild-severe hepatic steatosis at 24 years by transient elastography (controlled attenuation parameter score ≥ 248 dB/m). Multiple logistic regression was used to evaluate the association between maternal factors and offspring hepatic steatosis at 24 years. Results In confounder-adjusted models the independent associations for each maternal factor with mild to severe vs low hepatic steatosis at 24 years were: pre-pregnancy overweight (OR: 1.84, 95%CL: 1.43–2.38) or obesity (OR: 2.73, 95%CL: 1.84–4.03), more than recommended gestational weight gain (OR: 1.30, 95%CL: 1.04–1.64), diabetes (OR: 1.39, 95%CI: 0.87, 2.21), and high free sugar intake during pregnancy (OR: 1.04, 95% CI: 0.82, 1.33). These associations were largely mediated by BMI at 24 years, but not by birthweight or breastfeeding. Conclusions Our results suggest that maternal nutritional status is associated with the development of NAFLD in their adult offspring, although the relationship is largely mediated by offspring BMI in adulthood.