Media counseling of breastfeeding practice improved newborn growth outcomes in Ngombol Public Health Center, Purworejo-Indonesia

Exclusive breastfeeding practice in Ngombol public health center is below the regency target which was only 54.4% from 80% in Purworejo in 2019. Program to improve exclusive breastfeeding such as counseling is one of the best ways to increase community participation as this is a crucial phase to fulfill newborn nutrition needs. The aim of this study was to determine the effect of media counseling on increasing breastfeeding practice and improving newborn weight in the first-month-old. We created a quasi-experimental design with one group pre-test and a post-test with a control group design. Of 40 post-partum mothers and newborns were recruited in this study. Data collection was gathered such as socio-demography, breastfeeding observation form, and newborn’s weight both before and after the one-month intervention. The intervention group had been counseled with media such as leaflets, breastfeeding flipcharts, breast props, and newborn dolls. On the other hand, the control group had no received counseling with media. A statistical paired t-test test was created to find the association between those variables using SPSS 20.0 for windows. The mean average of newborn weight after the intervention was 1,005.55 g and 964,50 g for the intervention and control group, respectively. There were differences before and after a month of giving exclusive breastfeeding between the control and intervention groups (p<0.001). Mothers in the intervention group had 80% achieved minimum recommended weight gain (≥800 g/month). Exclusive breastfeeding counseling with media has an impact on improving newborn weight at the first-month-old in Ngombol Public health Center, Purworejo-Indonesia. Using media during breastfeeding counseling regularly may help the awareness and knowledge of exclusive breastfeeding for mothers, yet improve breastfeeding practice.

Risk Factors for Sepsis in the Neonatal Intensive Care Unit of a Tertiary Hospital in Mexico

Neonatal Sepsis (NS) is a systemic infection caused by bacteria, fungi, or viruses during the first month of life. Although various studies have identified the factors associated with NS, it is a public health problem due to its high morbidity and mortality. The study aimed to identify the risk factors associated with neonatal sepsis in the Neonatal Intensive Care Unit (NICU) of a tertiary hospital in Mexico. A case-control study was carried out using records of neonates (with sepsis 39 and without sepsis 39) from January to December 2017. The risk factors studied were the sociodemographic and clinical characteristics of the mother and clinics of the neonate. The data were analyzed using the Chi2 test, Fisher's exact test, Student's t-test, and the Odds Ratio (OR). The risk factors associated with NS were gestational age (OR 0.77, CI 95% = 0.64-0.91, p = 0.004), newborn weight (OR 0.45, CI95% = 0.23-0.86, p = 0.017) and days of hospital stay (OR 1.06, CI95% = 1.02-1.10, p = 0.0014). The mother's sociodemographic and clinical factors were not associated with NS. Risk factors associated with NS were gestational age, newborn weight, and days of hospital stay.

Learning Disabilities in Reading and Writing and Type of Delivery in Twin Births

The aim of this study was to analyse the relationship between the type of delivery (vaginal or caesarean), as a risk factor, and the likelihood of having learning disabilities in reading (reading accuracy) and writing (phonetic and visual orthography), controlling for the interaction and/or confounding effect of gestational, obstetric, and neonatal variables (maternal age at delivery, gestational age, foetal presentation, Apgar 1, and newborn weight) among six-year-old children born in twin births. In this retrospective cohort study, the exposed and non-exposed cohorts consisted of children born by caesarean section and vaginal delivery, respectively. A total of 124 children born in twin births were evaluated in year one of primary education. Intelligence was measured using the K-BIT test; reading and writing variables were evaluated using the Evalúa-1 battery of tests, and clinical records were used to measure gestational, obstetric, and neonatal variables. Binary logistic regressions applied to each dependent variable indicated that caesarean delivery is a possible independent risk factor for difficulties in reading accuracy and phonetic and visual orthography. Future research using larger samples of younger children is required to analyse the relationship between obstetric and neonatal variables and the different basic indicators of reading and writing.

Decreased Monocyte Count is Associated with Gestational Diabetes Mellitus Development, Macrosomia and Inflammation

Objective The immune system plays a central role in the pathophysiology of gestational diabetes mellitus (GDM). Monocytes, the main innate immune cells, are especially important in the maintenance of a normal pregnancy. Here, we investigated the potential effect of monocytes in GDM. Materials and Methods: Monocyte count was monitored throughout pregnancy in 214 women with GDM and 926 women without in a case-control and cohort study. Circulating levels of inflammatory cytokines, placenta-derived macrophages and their products were measured. Results Throughout pregnancy, monocyte count was significantly decreased in women with GDM, and closely associated with glucose level, insulin resistance and newborn weight. First-trimester monocyte count outperformed that of the second and third trimester as a risk factor and diagnostic predictor of GDM and macrosomia in both the case-control and cohort study. In addition, our cohort study showed that as first-trimester monocyte count decreased, GDM and macrosomia incidence, glucose level and newborn weight increased in a stepwise manner. Risk of GDM started to decrease rapidly when first-trimester monocyte count exceeded 0.48 × 10 9/L. Notably, CD206 and IL-10 were significantly lower, while CD80, CD86, TNF-α and IL-6 were higher in both GDM placental tissue and peripheral blood. First-trimester monocyte count was positively related to IL-10 and CD206, but negatively related to CD80, CD86, TNF-α and IL-6. Conclusions Decreased monocyte count throughout pregnancy was closely-associated with the development of GDM, macrosomia and the chronic inflammatory state of GDM. First-trimester monocyte count has great potential as an early diagnostic marker of GDM.

The Choline Metabolite TMAO Inhibits NETosis and Promotes Placental Development in GDM of Humans and Mice

Choline metabolite Trimethylamine N-oxide (TMAO) has been recognized as a risk factor of gestational diabetes mellitus (GDM), but its exact role in GDM has not been reported. In this study, we focused on the placenta development to reveal the role of TMAO in GDM. We found the TMAO levels in peripheral and cord plasma were increased in women with GDM, and TMAO levels were positively correlated with newborn weight and placental thickness. Neutrophil extracellular traps (NETs) in the peripheral and cord plasma and the myeloperoxidase expression in the placenta of women with GDM also increased. NETs could inhibit the proliferation, migration, invasion and angiogenesis of HTR-8/Svneo cells. However, TMAO could not only inhibit the formation of NETs, but also enhance the biological function of HTR-8/Svneo cells. By inducing GDM models in NETs deficient PAD4^-/- and wild-type mice, the placental weight of PAD4^-/- mice increased significantly. TMAO feeding also inhibited the formation of NETs and further increased the weight of the placenta and fetuses, and this increase did not affect the placental structure. Our data indicated that higher TMAO levels and the formation of abnormal NETs were associated with GDM. TMAO could not only promote the development of the placenta and fetuses, but also inhibit the formation of NETs.

The Choline Metabolite TMAO Inhibits NETosis and Promotes Placental Development in GDM of Humans and Mice

Choline metabolite Trimethylamine N-oxide (TMAO) has been recognized as a risk factor of gestational diabetes mellitus (GDM), but its exact role in GDM has not been reported. In this study, we focused on the placenta development to reveal the role of TMAO in GDM. We found the TMAO levels in peripheral and cord plasma were increased in women with GDM, and TMAO levels were positively correlated with newborn weight and placental thickness. Neutrophil extracellular traps (NETs) in the peripheral and cord plasma and the myeloperoxidase expression in the placenta of women with GDM also increased. NETs could inhibit the proliferation, migration, invasion and angiogenesis of HTR-8/Svneo cells. However, TMAO could not only inhibit the formation of NETs, but also enhance the biological function of HTR-8/Svneo cells. By inducing GDM models in NETs deficient PAD4^-/- and wild-type mice, the placental weight of PAD4^-/- mice increased significantly. TMAO feeding also inhibited the formation of NETs and further increased the weight of the placenta and fetuses, and this increase did not affect the placental structure. Our data indicated that higher TMAO levels and the formation of abnormal NETs were associated with GDM. TMAO could not only promote the development of the placenta and fetuses, but also inhibit the formation of NETs.