Proportion with low birth weight infants in an Indian population and its relationship with maternal age and parity.

The overall proportion of low birth weight infants is found to be relatively higher in the Indian population. Data collected from two hospitals in Calcutta, India indicate that although the proportion of infants weighing less than 2,001 g is approximately 10%, the dependence of this proportion on maternal age and parity is similar to the studies conducted elsewhere, suggesting a definite biological significance of the phenomenon. The proportion of low birth weight infants is found to be the greatest for the first and late pregnancies, the minimum being at the third birth rank. Young mothers showed a tendency to have an increasing proportion of low birth weight infants with increasing birth order; whereas for older mothers a general U-shaped dependence of the proportion on parity is suggest from the analysis.     

Detecting bacteriuria in a primary maternal and child health care programme

Urinary tract infection in pregnancy has not been adequately dealt with in developing countries, though its consequences are well recognised. This is primarily because of constraints on resources coupled with a lack of technological infrastructure. An evaluation of the Griess test for the mass screening of urinary tract infection among antenatal women was carried out prospectively using a case-control method.The Griess test was found to be a valid, reliable, and economical screening test for urinary tract infection which can be integrated into a primary maternal and child health care programme.     

Breast-feeding, birth interval and child mortality in Bangladesh

The 1975-76 Bangladesh Fertility Survey data show little evidence that breast-feeding is the intermediate factor through which birth intervals influence child survival in Bangladesh. Preceding birth interval, subsequent pregnancy and breast-feeding duration each have an independent influence on early mortality risk. Within a specific interval the risk of dying decreases with increase in duration of breast-feeding, and also with an increase in the time between the index birth and the next pregnancy. The death of the immediately preceding child in infancy has a significant negative effect on the survival chance of the index child at ages 1-5 months. However, death of the preceding child appears to have a significantly positive effect on the survival chance of the index child between ages 9 months and 5 years; this may be related to competition between siblings.     

Proportion of low birth weight infants in Visakhapatnam (India) and its relationship with maternal age, parity and infants survival

The percentage of low birth weight infants (LBWI) weighing less than 2270 g in Visakhapatnam (Andhra Pradesh) is relatively higher (12.8%) than in other parts of India. The frequency of LBWI is high at birth order 1 and 2. Thereafter the curve does not show any consistency although the mean per cent of LBWI is lesser than in birth order 1 and 2. The minimum frequency is at birth order 3. The maternal classes less than or equal to 20-29 years show a gradual decrease in the frequency of LBWI with increasing age. For mothers of greater than or equal to 30-39 years of age a general U-shaped relation is found. The overall distribution of neonatal deaths is bimodal, with a peak at less than 1350 g and at 1810 g.     

Survey of health visiting in antenatal care.

The range of the health visitor''s work is expanding. To find out what antenatal work health visitors actually carry out and what their attitudes towards such work are we surveyed general practitioners, midwives, and health visitors in three district health authorities. The results indicate that health visitors are qualified and willing to work with women in the antenatal period.     

Genetic determinism for within-litter birth weight variation and its relationship with litter weight and litter size in the Ripollesa ewe breed

Birth weight plays a central role in lamb survival and growth, and the knowledge of its genetic determinism has become essential in worldwide selection programmes. Within this context, within-litter birth weight variation (BWV) has been suggested as an attractive trait to homogenise litters in prolific species, although it has not been analysed in sheep. The objective of this study was to ascertain whether maternal additive genetic variance exists for BWV in Ripollesa ewes, and to study its genetic, permanent environmental and residual relationships with litter weight (LW) and litter size (LS) at birth. Data were recorded in the Ripollesa experimental flock of the Universitat Autònoma of Barcelona, between 1986 and 2005, and included 1 662 litters from 380 ewes, with 712 records of BWV and 1 530 records of LW. Traits were analysed with a multivariate animal model solved through Bayesian methodologies, and with a threshold characterisation of LS. Additionally, the effect of BWV on lamb survival was studied. Additive genetic variance was observed for BWV (h² = 0.061), as well as for LW (h² = 0.200) and LS (h² = 0.141). Nevertheless, genetic correlations among those traits were not substantial (BWV and LW = 0.151; BWV and LS = − 0.219; LW and LS = − 0.320) and suffered from a high degree of uncertainly, with the null correlation included within the highest posterior interval at 95%. Within-litter birth weight variation and LS showed a negative and large permanent environmental correlation ( − 0.872), and LW and LS were negatively correlated due to residual ( − 0.762) and permanent environmental ( − 0.449) random sources of variation. Within-litter birth weight variation influenced lamb mortality during the first 7 days of life (P < 0.05), increasing and decreasing survivability in heavier and lighter littermates, respectively. Nevertheless, stillbirths and lambs died after the 1st week of life were not affected by BWV (P>0.05). The low heritability found indicates that slow genetic progress may be expected from selecting for BWV. Close to zero genetic correlations suggest that this selection will probably not affect LS and LW, although some significant permanent and residual correlations must be taken into account. Further studies are needed to understand better the genetic architecture among these three reproductive traits.     

Economic inequalities in maternal health care: prenatal care and skilled birth attendance in India, 1992-2006

Background

The use of maternal health care is limited in India despite several programmatic efforts for its improvement since the late 1980''s. The use of maternal health care is typically patterned on socioeconomic and cultural contours. However, there is no clear perspective about how socioeconomic differences over time have contributed towards the use of maternal health care in India.

Methodology/Principal Findings

Using data from three rounds of National Family Health Survey (NFHS) conducted during 1992–2006, we analyse the trends and patterns in utilization of prenatal care (PNC) in first trimester with four or more antenatal care visits and skilled birth attendance (SBA) among poor and nonpoor mothers, disaggregated by area of residence in India and three contrasting provinces, namely, Uttar Pradesh, Maharashtra and Tamil Nadu. In addition, we investigate the relative contribution of public and private health facilities in meeting the demand for SBA, especially among poor mothers. We also examine the role of salient socioeconomic, demographic and cultural factors in influencing aforementioned outcomes. Bivariate analyses, concentration curve and concentration index, logistic regression and multinomial logistic regression models are used to understand the trends, patterns and predictors of the two outcome variables. Results indicate sluggish progress in utilization of PNC and SBA in India and selected provinces during 1992–2006. Enormous inequalities in utilization of PNC and SBA were observed largely to the disadvantage of the poor. Multivariate analysis suggests growing inequalities in utilization of the two outcomes across different economic groups.

Conclusions

The use of PNC and SBA remains disproportionately lower among poor mothers in India irrespective of area of residence and province. Despite several governmental efforts to increase access and coverage of delivery services to poor, it is clear that the poor (a) do not use SBA and (b) even if they had SBA, they were more likely to use the private providers.     

Amniotic fluid cell morphology in early antenatal prediction of abortion and low birth weight.

The morphology of rapidly adherent (RA) amniotic fluid cells was examined in 201 pregnant women referred for amniocentesis because of two sequential high serum alpha-fetoprotein (AFP) concentrations. Out of 43 amniotic fluid samples containing increased amounts of AFP, 42 had neural or peritoneal cells predominating among the RA cells, the outcome being an infant with a neural-tube defect or exomphalos. In the other case with a raised amniotic fluid AFP concentration but only anterior placental cells the infant was normal. In 25 amniotic fluid samples containing normal amounts of AFP distinctive new patterns of RA cells were observed, termed fetal distress cells. These pregnancies resulted in five spontaneous abortions and 20 infants with birth weights under 2500 g. Fetal distress cells were not detected in any of the remaining 133 samples. One pregnancy was terminated because of a chromosomal abnormality, and there were seven twin pairs not recognised on ultrasonography before amniocentesis. The remaining 125 pregnancies went to term, resulting in infants with birth weights exceeding 2500 g. The results suggest that RA-cell morphology will prove to be of value in the early antenatal prediction of spontaneous abortion and low birth weight.     

Effect of training on the dose-response relationship for insulin action in men

Seven endurance-trained subjects [maximal O2 consumption (VO2max) 64 +/- 1 (SE) ml.min-1.kg-1] were subjected to three sequential hyperinsulinemic euglycemic clamps 15 h after having performed their last training session (T). Results were compared with findings in seven untrained subjects (VO2max 44 +/- 2 ml.min-1.kg-1) studied both at rest (UT) and after 60 min of bicycle exercise at 150 W (UT-ex). In T and UT-ex compared with UT, sensitivity for insulin-mediated whole-body glucose uptake was higher [insulin concentrations eliciting half-maximal glucose uptake being 44 +/- 2 (T) and 43 +/- 4 (UT-ex) vs. 52 +/- 3 microU/ml (UT), P less than 0.05] and responsiveness was higher [13.4 +/- 1.2 (T) and 10.9 +/- 0.7 (UT-ex) vs. 9.5 +/- 0.7 mg.min-1.kg-1 (UT), P less than 0.05]. Furthermore, responsiveness was higher (P less than 0.05) in T than in UT-ex. Insulin-stimulated O2 uptake and maximal glucose oxidation rate were higher in T than in UT and UT-ex. Insulin-stimulated conversion or glucose to glycogen and muscle glycogen synthase was higher in T than in UT and UT-ex. However, glycogen storage in vastus lateralis muscle was found only in UT-ex. No change in any glucoregulatory hormone or metabolite could explain the increased insulin action in trained subjects. It is concluded that physical training induces an adaptive increase in insulin responsiveness of whole-body glucose uptake, which does not reflect increased glycogen deposition in muscle.(ABSTRACT TRUNCATED AT 250 WORDS)     

Cord blood ASP is predicted by maternal lipids and correlates with fetal birth weight

Background: The acylation stimulating protein (ASP) is a potent lipogenic adipokine that correlates with postprandial triglyceride (TG) clearance and is linked to the pathophysiology of obesity and related disorders. Objective: To investigate ASP levels in cord blood and its relation to maternal and cord blood lipid parameters and fetal birth weight. Methods and Procedures: Thirty nondiabetic pregnant women, their newborns, and thirty‐three nonpregnant controls were included in this study. Fasting maternal and cord blood ASP, TGs, nonesterified fatty acids (NEFAs), cholesterol, glucose levels, in addition to maternal BMI and fetal birth weight were measured. Results: No significant difference was found between cord blood ASP (16.3 ± 0.96 nmol/l) and ASP levels in the adult controls (15.7 ± 1.0 nmol/l). Cord blood ASP, however, was lower than maternal plasma ASP levels (25.4 ± 1.6 nmol/l, P < 0.001). Yet, lipid levels in cord blood, particularly TGs were markedly decreased compared to control and maternal TG levels (threefold and 7.4‐fold, P < 0.001 respectively). Maternal TGs significantly correlated with fetal birth weight (r = 0.54, P = 0.002). Multiple regression analysis showed that maternal TGs (β = 0.57, P = 0.01) and NEFAs (β = 0.43, P = 0.024) predicted 45% variation in cord blood ASP levels, independent of all measured maternal and cord blood parameters. Cord blood ASP showed a positive correlation with fetal birth weight (r = 0.524, P = 0.037) in neonates above average fetal birth weight of the studied population. Discussion: This is the first study investigating ASP in cord blood. We suggest that maternal hypertriglyceridemia is associated with increased fetal ASP production, thus enhancing fetal fat storage independent of maternal glucose variations in nondiabetic women.     

Relation between maternal haemoglobin concentration and birth weight in different ethnic groups.

OBJECTIVE--To assess the relation of the lowest haemoglobin concentration in pregnancy with birth weight and the rates of low birth weight and preterm delivery in different ethnic groups. DESIGN--Retrospective analysis of 153,602 pregnancies with ethnic group and birth weight recorded on a regional pregnancy database during 1988-91. The haemoglobin measurement used was the lowest recorded during pregnancy. SETTING--North West Thames region. SUBJECTS--115,262 white women, 22,206 Indo-Pakistanis, 4570 Afro-Caribbeans, 2642 mediterraneans, 3905 black Africans, 2351 orientals, and 2666 others. MAIN OUTCOME MEASURES--Birth weight and rates of low birth weight (< 2500 g) and preterm delivery (< 37 completed weeks). RESULTS--Maximum mean birth weight in white women was achieved with a lowest haemoglobin concentration in pregnancy of 85-95 g/l; the lowest incidence of low birth weight and preterm labour occurred with a lowest haemoglobin of 95-105 g/l. A similar pattern occurred in all ethnic groups. CONCLUSIONS--The magnitude of the fall in haemoglobin concentration in pregnancy is related to birth weight; failure of the haemoglobin concentration to fall below 105 g/l indicates an increased risk of low birth weight and preterm delivery. This phenomenon is seen in all ethnic groups. Some ethnic groups have higher rates of low birth weight and preterm delivery than white women, and they also have higher rates of low haemoglobin concentrations. This increased rate of "anaemia," however, does not account for their higher rates of low birth weight, which occurs at all haemoglobin concentrations.     

The relationship of birth weight with longitudinal changes in body composition in adult women

Most research on birth weight and adult health status has reported adult measures at a single time point. This study examined the relationship of self‐reported birth weight to longitudinal changes in adult body composition in 587 women of the Michigan Bone Health and Metabolism Study, followed from 1992 to 2007 and aged 24–50 years at baseline. Linear mixed models were used to estimate the association between three birth weight categories and women's 15‐year changes in adult weight, height, BMI, waist and hip circumference, waist‐to‐hip ratio, and fat, lean, and skeletal muscle mass. Body composition measures increased in all women over the 15‐year study period. At their adult baseline, high birth weight women weighed 13% more and had waist circumference and lean mass measures that were 5.51 cm and 3.91 kg larger, respectively, than normal birth weight women. No differences were observed in adult body composition between low and normal birth weight women and rates of change in the adult measures did not vary across the birth weight groups. Women heavier at birth continued to be heavier through adulthood, corroborating previous reports based on single measures of adult body composition. Research to address whether higher adult body composition in high birth weight women increases the longitudinal risk for obesity‐related chronic diseases is needed.     

Assessing the utilization of maternal and child health care among married adolescent women: evidence from India

This study explores the prevalence and factors associated with the utilization of maternal and child health care services among married adolescent women in India using the third round of the National Family Health Survey (2005-06). The findings suggest that the utilization of maternal and child health care services among adolescent women is far from satisfactory in India. A little over 10% of adolescent women utilized antenatal care, about 50% utilized safe delivery services and about 41% of the children of adolescent women received full immunization. Large differences by urban-rural residence, educational attainment, religion, economic status and region were evident. Both gross effect and fixed effect binary logit models yielded statistically significant socioeconomic and demographic factors. Women's education, wealth quintile and region are the most important determinants for the utilization of maternal and child health care services. Health care programmes should focus more on educating adolescents, providing financial support, creating awareness and counselling households with married adolescent women. Moreover, there should be substantial financial assistance for the provision of delivery and child care for married women below the age of 19 years.     

Importance of dam BW change and calf birth weight in double-muscled Belgian Blue cattle and its relationship with parity and calving interval

Factors affecting calving interval (CI) in double-muscled Belgian Blue (DMBB) beef cows were investigated with regard to the BW yield (BWY) of the cow–calf pair, using 834 CI records from 386 females with parities 1 to 6. The effect of parity and CI on BWY was also studied. Cow–calf pair BWY was defined as calf birth weight plus dam BWY per CI. CI (mean±s.e.: 404±1.9 days) was affected by parity, calving season, suckling and calf birth weight/dam weight. Primiparous cows had a shorter CI than cows with three or more calvings (P<0.05), with an intermediate CI for second-calf cows. Spring calvings resulted in a shorter CI than summer and autumn calvings, with intermediate values for winter calvings. Suckling dams had longer CIs than non-suckling dams. There were interactions (P<0.05) between calving season and suckling, and between calving season and mating system. Shortest CIs were observed for spring calvings in case of non-suckling and for summer calvings in case of suckling. Longest CIs were observed for autumn calvings in case of natural service (NS) and for winter calvings in case of artificial insemination (AI). Calf birth weight/dam weight of 6% to 10% resulted in shorter CI than a ratio of <6% (P<0.05). Body condition and mating system (NS v. AI) did not affect CI. Daily cow–calf pair BWY was affected by parity (P<0.001) and CI (P=0.013), with a tendency for an interaction (P=0.094). Daily cow–calf pair BWY did not differ for CIs of <12 to 16 months in primiparous cows and was lowest for a CI of 13 to 15 months in second-calf cows, whereas the effect of CI was more variable in older cows. Dam contribution to cow–calf pair BWY was larger than calf birth weight in first- and second-calf cows, and increased with increasing CI. Dam contribution to cow–calf pair BWY was smaller than calf birth weight in older cows, varying from 0.2 to 1.0 depending on CI. A short CI is advised for DMBB cows because of a larger BWY and more efficient nutrient utilisation.     

早产儿肠道微生态变化及其与胎龄、出生体质量的关系

目的探讨早产儿肠道微生态变化及其与胎龄、出生体质量的关系。方法选取2018年5月至2020年5月我院收治的80例早产儿作为早产组,同期收治的80例足月新生儿作为对照组。收集入组新生儿出生后3 d、3周的粪便,比较2组研究对象粪便标本中细菌丰富度和Shannon Wiener指数;根据早产组胎龄和出生体质量不同分组,分析胎龄、出生体质量与肠道微生态变化的关系。结果(1)出生3 d,早产组新生儿粪便标本的DGGE图谱条带数、Shannon Wiener指数均显著低于对照组(t=3.179、3.521,均P<0.05);(2)出生3 d,胎龄34⁺¹~36⁺⁶周组新生儿粪便标本的DGGE图谱条带数、Shannon Wiener指数显著高于28~30周组、30⁺¹~32周组和32⁺¹~34周组(q=9.653、6.476、4.848和8.796、8.008、6.277,均P<0.05);(3)出生3 d,体质量>2 000 g组新生儿粪便标本的的DGGE图谱条带数、Shannon Wiener指数显著高于≤1 500 g组(q=5.601和4.593,均P<0.05);(4)不同出生体质量、胎龄的早产儿,出生3周粪便标本的DGGE图谱条带数、Shannon Wiener指数相比差异无统计学意义(F=1.577和2.326,均P>0.05)。结论与足月新生儿相比,早产儿出生后细菌定植出现延迟且多样性差,胎龄越小、出生体质量越低的早产儿的肠道菌群的多样性更低、定植延迟的可能性更大,出生3周后其肠道微生态逐渐恢复正常。