scholarly journals Maternal Iodine Status and Associations with Birth Outcomes in Three Major Cities in the United Kingdom

Nutrients ◽  
2019 ◽  
Vol 11 (2) ◽  
pp. 441 ◽  
Author(s):  
Charles Snart ◽  
Claire Keeble ◽  
Elizabeth Taylor ◽  
Janet Cade ◽  
Paul Stewart ◽  
...  
Keyword(s):  
Birth Weight ◽  
Preterm Birth ◽  
Pregnant Women ◽  
Birth Outcomes ◽  
Inductively Coupled Plasma ◽  
Urinary Iodine ◽  
World Health ◽  
Spontaneous Preterm Birth ◽  
Foetal Development ◽  
Iodine Status

Severe iodine deficiency in mothers is known to impair foetal development. Pregnant women in the UK may be iodine insufficient, but recent assessments of iodine status are limited. This study assessed maternal urinary iodine concentrations (UIC) and birth outcomes in three UK cities. Spot urines were collected from 541 women in London, Manchester and Leeds from 2004–2008 as part of the Screening for Pregnancy End points (SCOPE) study. UIC at 15 and 20 weeks’ gestation was estimated using inductively coupled plasma-mass spectrometry (ICP-MS). Associations were estimated between iodine status (UIC and iodine-to-creatinine ratio) and birth weight, birth weight centile (primary outcome), small for gestational age (SGA) and spontaneous preterm birth. Median UIC was highest in Manchester (139 μg/L, 95% confidence intervals (CI): 126, 158) and London (130 μg/L, 95% CI: 114, 177) and lowest in Leeds (116 μg/L, 95% CI: 99, 135), but the proportion with UIC <50 µg/L was <20% in all three cities. No evidence of an association was observed between UIC and birth weight centile (−0.2% per 50 μg/L increase in UIC, 95% CI: −1.3, 0.8), nor with odds of spontaneous preterm birth (odds ratio = 1.00, 95% CI: 0.84, 1.20). Given the finding of iodine concentrations being insufficient according to World Health Organization (WHO) guidelines amongst pregnant women across all three cities, further studies may be needed to explore implications for maternal thyroid function and longer-term child health outcomes.

scholarly journals Iodine deficiency in pregnant women living in the South East of the UK: the influence of diet and nutritional supplements on iodine status

2014 ◽  
Vol 111 (9) ◽  
pp. 1622-1631 ◽  
Author(s):  
Sarah C. Bath ◽  
Alan Walter ◽  
Andrew Taylor ◽  
John Wright ◽  
Margaret P. Rayman
Keyword(s):  
Pregnant Women ◽  
Iodine Deficiency ◽  
Urinary Iodine ◽  
World Health ◽  
The South ◽  
Childbearing Age ◽  
Iodine Status ◽  
Supplement Use ◽  
Iodine Excretion ◽  
The Uk

Iodine is a key component of the thyroid hormones which are crucial for brain development. Adequate intake of iodine in pregnancy is important as in utero deficiency may have lifelong consequences for the offspring. Data on the iodine status of UK pregnant women are sparse, and there are no such data for pregnant women in the South East of the UK. A total of 100 pregnant women were recruited to a cross-sectional study carried out at the Royal Surrey County Hospital, Guildford, at their first-trimester visit for an ultrasound scan. The participants provided a spot-urine sample (for the measurement of urinary iodine concentration (UIC) and creatinine concentration) and 24 h iodine excretion was estimated from the urinary iodine:creatinine ratio. Women completed a general questionnaire and a FFQ. The median UIC (85·3 μg/l) indicated that the group was iodine deficient by World Health Organisation criteria. The median values of the iodine:creatinine ratio (122·9 μg/g) and of the estimated 24 h iodine excretion (151·2 μg/d) were also suggestive of iodine deficiency. UIC was significantly higher in women taking an iodine-containing prenatal supplement (n 42) than in those not taking such a supplement (P< 0·001). In the adjusted analyses, milk intake, maternal age and iodine-containing prenatal supplement use were positively associated with the estimated 24 h urinary iodine excretion. Our finding of iodine deficiency in these women gives cause for concern. We suggest that women of childbearing age and pregnant women should be given advice on how to improve their iodine status through dietary means. A national survey of iodine status in UK pregnant women is required.

scholarly journals Dietary patterns before and during pregnancy and birth outcomes: a systematic review

2019 ◽  
Vol 109 (Supplement_1) ◽  
pp. 729S-756S ◽  
Author(s):  
Ramkripa Raghavan ◽  
Carol Dreibelbis ◽  
Brittany L Kingshipp ◽  
Yat Ping Wong ◽  
Barbara Abrams ◽  
...  
Keyword(s):  
Birth Weight ◽  
Preterm Birth ◽  
Birth Outcomes ◽  
Gestational Age ◽  
Dietary Patterns ◽  
Access To Health Care ◽  
Spontaneous Preterm Birth ◽  
Weight Outcomes ◽  
Age And Sex ◽  
Pregnancy And Birth

ABSTRACTBackgroundMaternal diet before and during pregnancy could influence fetal growth and birth outcomes.ObjectiveTwo systematic reviews aimed to assess the relationships between dietary patterns before and during pregnancy and 1) gestational age at birth and 2) gestational age- and sex-specific birth weight.MethodsLiterature was searched from January, 1980 to January, 2017 in 9 databases including PubMed, Embase, and Cochrane. Two analysts independently screened articles using predetermined inclusion and exclusion criteria. Data were extracted from included articles and risk of bias was assessed. Data were synthesized qualitatively, a conclusion statement was drafted for each question, and evidence supporting each conclusion was graded.ResultsOf the 9103 studies identified, 11 [representing 7 cohorts and 1 randomized controlled trial (RCT)] were included for gestational age and 21 (representing 19 cohorts and 2 RCTs) were included for birth weight. Limited but consistent evidence suggests that certain dietary patterns during pregnancy are associated with a lower risk of preterm birth and spontaneous preterm birth. These protective dietary patterns are higher in vegetables; fruits; whole grains; nuts, legumes, and seeds; and seafood (preterm birth, only), and lower in red and processed meats, and fried foods. Most of the research was conducted in healthy Caucasian women with access to health care. No conclusion can be drawn on the association between dietary patterns during pregnancy and birth weight outcomes. Although research is available, the ability to draw a conclusion is restricted by inconsistency in study findings, inadequate adjustment of birth weight for gestational age and sex, and variation in study design, dietary assessment methodology, and adjustment for key confounding factors. Insufficient evidence exists regarding dietary patterns before pregnancy for both outcomes.ConclusionsMaternal dietary patterns may be associated with a lower preterm and spontaneous preterm birth risk. The association is unclear for birth weight outcomes.

scholarly journals Mediterranean-Style Diet and Birth Outcomes in an Urban, Multiethnic, and Low-Income US Population

Nutrients ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 1188
Author(s):  
Dong Keun Rhee ◽  
Yuelong Ji ◽  
Xiumei Hong ◽  
Colleen Pearson ◽  
Xiaobin Wang ◽  
...  
Keyword(s):  
African American ◽  
Birth Weight ◽  
Preterm Birth ◽  
African American Women ◽  
Birth Outcomes ◽  
Low Income ◽  
Spontaneous Preterm Birth ◽  
Hispanic White ◽  
Pregnancy And Birth

Findings on the role of Mediterranean-style diet (MSD) on duration of pregnancy and birth weight have been inconsistent and based largely on Non-Hispanic white populations, making it unclear as to whether they could extend to African Americans who are at a higher risk of unfavorable birth outcomes. Our study addresses this gap using a large urban, multiethnic, predominantly low-income cohort of mother-infant dyads from Boston, MA, USA. Dietary information was obtained via food frequency questionnaires; health information including birth outcomes were extracted from medical records. A Mediterranean-style diet score (MSDS) was formulated based on intake history, and linear and log-binomial regressions were performed to assess its association with birth outcomes. After adjustment, the lowest MSDS quintile from the overall sample was found to be associated with an increased relative risk (RR) of overall preterm birth (RR 1.18; 95% CI: 1.06–1.31), spontaneous preterm birth (1.28; 1.11–1.49), late preterm birth (1.21; 1.05–1.39), and low birth weight (1.11; 1.01–1.22), compared to the highest quintile. The findings were similar for the African American sample. Our study adds to the current understanding of the diet’s influence on birth outcomes by demonstrating that adherence to MSD may improve birth outcomes for African American women.

scholarly journals Insufficient iodine status as a consequence of dietary changes

2020 ◽  
Vol 79 (OCE2) ◽  
Author(s):  
Solveig Adalsteinsdottir ◽  
Ellen Alma Tryggvadottir ◽  
Laufey Hrolfsdottir ◽  
Thorhallur Ingi Halldorsson ◽  
Bryndis Eva Birgisdottir ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Urinary Iodine ◽  
Iodine Concentration ◽  
World Health ◽  
Urinary Iodine Concentration ◽  
Childbearing Age ◽  
Public Health Action ◽  
Iodine Status ◽  
Spot Urine ◽  
Dairy Consumption

AbstractHistorically, Iceland has been an iodine sufficient nation due to notably high fish and dairy consumption. Due to this fact the country does not have a strategy related to iodine status, such as fortification of salt. Iodine status of pregnant women has only been assessed once before in Iceland (in 2009). The median UIC was found to be 180 μg/L, which was in line with the recommended range of 150–249 μg/L defined by the World Health Organization (WHO). Intake of fish and dairy has decreased considerably in the past 10 years. The aim of the present study was to re-evaluate the iodine status of pregnant women in Iceland using data from the PREWICE study (PREgnant Women in ICEland). Subjects were women (n = 983; 73% of the eligible sample) attending their first ultrasound appointment in gestational weeks 11–14 in the period October 2017-March 2018. Spot urine samples were collected for assessment of urinary iodine concentration (UIC) and creatinine. The ratio of iodine to creatinine (I/Cr) was calculated. Diet was assessed using a semi-quantitative food frequency questionnaire (FFQ), which provided information on main dietary sources of iodine in the population studied (dairy and fish). The median UIC (95% CI) and I/Cr of the study population was 89 μg/L (42, 141) and 100 (94, 108) μg/g, respectively. UIC increased with higher frequency of dairy intake, ranging from median UIC of 55 (35, 79) μg/L for women consuming dairy products < 1 time per week to 124 (98, 151) μg/L in the group consuming dairy > 2 times per day (p for trend < 0.001). A small group of women reporting complete avoidance of fish (n = 18) had UIC of 50 (21, 123) μg/L and significantly lower I/Cr compared with those who did not report avoidance of fish (58 (34,134) μg/g vs. 100 (94, 108) μg/g, p = 0.041). Women taking supplements containing iodine (n = 34, 3.5%) had higher UIC compared with those who did not take supplements (141 (77, 263) vs. 87 (82, 94) μg/L, p = 0.037. For the first time, insufficient iodine status is being observed in an Icelandic population. There is an urgent need for a public health action aiming at improving iodine status of women of childbearing age in Iceland.

scholarly journals Pregnant women with COVID-19 and risk of adverse birth outcomes and maternal-fetal vertical transmission: a population-based cohort study in Wuhan, China

BMC Medicine ◽  
2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Rong Yang ◽  
Hui Mei ◽  
Tongzhang Zheng ◽  
Qiang Fu ◽  
Yiming Zhang ◽  
...  
Keyword(s):  
Cohort Study ◽  
Birth Weight ◽  
Preterm Birth ◽  
Cesarean Section ◽  
Pregnant Women ◽  
Birth Outcomes ◽  
Population Based ◽  
Adverse Birth Outcomes ◽  
Cesarean Section Delivery ◽  
Increased Risk

Abstract Background The coronavirus disease 2019 (COVID-19) outbreak is evolving rapidly worldwide. However, little is known about the association between pregnant women with COVID-19 and the risk of adverse birth outcomes. Method We conducted a retrospective cohort study based on the Maternal and Child Health Information System (MCHIMS) of Wuhan, China. All pregnant women with singleton live birth recorded by the system between January 13 and March 18, 2020, were included. The adverse birth outcomes were preterm birth, low birth weight, neonatal asphyxia, premature rupture of membrane (PROM), and cesarean section delivery. Multivariate logistic regression was used to evaluate the associations between maternal COVID-19 diagnosis and adverse birth outcomes. Results Out of 11,078 pregnant women, 65 were confirmed with coronavirus disease 2019 (COVID-19). No deaths occurred from these confirmed cases or their newborns. Compared to pregnant women without COVID-19, pregnant women with a confirmed COVID-19 diagnosis had an increased risk of preterm birth (OR 3.34, 95% CI 1.60–7.00) and cesarean section (OR 3.63, 95% CI 1.95–6.76). There was no statistical difference in low birth weight, neonatal asphyxia, and PROM between the mothers with and without COVID-19. Among these newborns that were born to mothers with confirmed COVID-19, none was tested severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) positive or had abnormal CT results. Only one had diarrhea and three had a fever. Conclusions This population-based cohort study suggests that COVID-19 during the later pregnancy is associated with an increased risk of adverse birth outcomes, including iatrogenic preterm birth and cesarean section delivery. Our data provide little evidence for maternal-fetal vertical transmission of SARS-CoV-2. It is important to monitor the long-term health effects of SARS-CoV-2 infection on pregnant women and their children.

scholarly journals Efficacy of home visits by public health providers for high-risk pregnant women in Egypt

2021 ◽  
Vol 8 (5) ◽  
pp. 2099
Author(s):  
Rasha S. Elbahrawe ◽  
Lamiaa Saleh ◽  
Eman M. Khalil ◽  
Ahmed M. Abbas ◽  
Marwa Yahia ◽  
...  
Keyword(s):  
Public Health ◽  
Birth Weight ◽  
Preterm Birth ◽  
High Risk ◽  
Pregnant Women ◽  
Birth Outcomes ◽  
Gestational Age ◽  
Home Visit ◽  
Home Visits ◽  
Health Providers

Background: Home visits programs aim to improve care management for high-risk pregnant women. Birth outcomes, such as preterm birth, low birth weight (LBW), and small for gestational age (SGA), are crucial indicators of child development and health. The present study evaluates the efficacy of home visits by public health providers for high-risk pregnant women in Egypt to prevent adverse pregnancy outcome.Methods: This is a cohort study using administrative data collected in obstetrics department, Faculty of Medicine, Beni-Suef University. All women with high risk pregnancy were followed by home visits by public health providers.Results: Birth outcomes were documented and evaluated. Women from the home-visit group had a heavier birth weight 2752.85±286.571, longer gestational age 38.36±1.257, less LBW infants 52 (18.6%), less preterm birth 22 (7.9%), and less SGA infants 27 (9.6%) compared to participants who did not receive the home-visit program.Conclusions: Our findings suggest that home visits by public health nurses for high-risk pregnant women in Egypt might be effective in preventing preterm birth, but not SGA. This study adds to the evidence of the effectiveness of population-based home-visit programs as a public healthcare measure.

Advanced Maternal Age and Adverse Maternal and Neonatal Outcomes in Pregnant Women

2020 ◽  
Vol 16 ◽  
Author(s):  
Reza Omani-Samani ◽  
Saman Maroufizadeh ◽  
Nafise Saedi ◽  
Nasim Shokouhi ◽  
Arezoo Esmailzadeh ◽  
...  
Keyword(s):  
Birth Weight ◽  
Preterm Birth ◽  
Low Birth Weight ◽  
Cesarean Section ◽  
Pregnant Women ◽  
Maternal Age ◽  
Unwanted Pregnancy ◽  
Advanced Maternal Age ◽  
Neonatal Outcomes ◽  
Maternal And Neonatal Outcomes

Background: Advanced maternal age is an important predictor for maternal and neonatal outcomes such as maternal mortality, low birth weight, stillbirth, preterm birth, cesarean section and preeclampsia. Objective: To determine the association of advanced maternal age and adverse maternal and neonatal outcomes in Iranian pregnant women. Methods: In this hospital-based cross-sectional study, 5117 pregnant women from 103 hospitals in Tehran, Iran, were participated in the study in 2015. The required data were gathered from hospitals which equipped to the department of obstetrics and gynecology. Advanced maternal age was considered as an independent variable and unwanted pregnancy, preeclampsia, preterm birth, cesarean section and low birth weight were considered as interested outcomes. Results: In our study, the prevalence of advanced maternal age was 12.08%. Advanced maternal age was significantly associated with higher risk of unwanted pregnancy (OR: 1.39, 95% CI: 1.12-1.73), preterm birth (OR: 1.75, 95% CI: 1.28- 2.39) and cesarean section (OR: 1.34, 95% CI: 1.03-1.74). In our study, there was no significant relationship between advanced maternal age and preeclampsia but this relationship could be clinically important (OR: 1.48, 95% CI: 0.99-2.20, P=0.052), and there is no significant relationship between advanced maternal age and low birth weight (OR: 1.08, 95% CI: 0.67-1.74, P=0.736). Conclusion: Advanced maternal age is associated with higher risk of unintended pregnancy, preterm birth and cesarean section but our findings did not support advanced maternal age as a risk factor associated with low birth weight.

scholarly journals Mass incarceration and public health: the association between black jail incarceration and adverse birth outcomes among black women in Louisiana

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Lauren Dyer ◽  
Rachel Hardeman ◽  
Dovile Vilda ◽  
Katherine Theall ◽  
Maeve Wallace
Keyword(s):  
Birth Weight ◽  
Preterm Birth ◽  
Black Women ◽  
Low Birth Weight ◽  
Racial Disparities ◽  
Population Health ◽  
Birth Outcomes ◽  
Mass Incarceration ◽  
Interquartile Range ◽  
Adverse Birth Outcomes

Abstract Background A growing body of evidence is beginning to highlight how mass incarceration shapes inequalities in population health. Non-Hispanic blacks are disproportionately affected by incarceration and criminal law enforcement, an enduring legacy of a racially-biased criminal justice system with broad health implications for black families and communities. Louisiana has consistently maintained one of the highest rates of black incarceration in the nation. Concurrently, large racial disparities in population health persist. Methods We conducted a cross-sectional analysis of all births among non-Hispanic black women in Louisiana in 2014 to identify associations between parish-level (county equivalent) prevalence of jail incarceration within the black population and adverse birth outcomes (N = 23,954). We fit a log-Poisson model with generalized estimating equations to approximate the relative risk of preterm birth and low birth weight associated with an interquartile range increase in incarceration, controlling for confounders. In sensitivity analyses, we additionally adjusted for the parish-level index crime prevalence and analyzed regression models wherein white incarceration was used to predict the risk of adverse birth outcomes in order to quantify the degree to which mass incarceration may harm health above and beyond living in a high crime area. Results There was a significant 3% higher risk of preterm birth among black women associated with an interquartile range increase in the parish-level incarceration prevalence of black individuals, independent of other factors. Adjusting for the prevalence of index crimes did not substantively change the results of the models. Conclusion Due to the positive significant associations between the prevalence of black individuals incarcerated in Louisiana jails and estimated risk of preterm birth, mass incarceration may be an underlying cause of the persistent inequities in reproductive health outcomes experienced by black women in Louisiana. Not only are there economic and social impacts stemming from mass incarceration, but there may also be implications for population health and health inequities, including the persistence of racial disparities in preterm birth and low birth weight.

scholarly journals Maternal exposure to airborne polychlorinated biphenyls (PCBs) and risk of adverse birth outcomes

2021 ◽  
Author(s):  
Ane Bungum Kofoed ◽  
Laura Deen ◽  
Karin Sørig Hougaard ◽  
Kajsa Ugelvig Petersen ◽  
Harald William Meyer ◽  
...  
Keyword(s):  
Birth Weight ◽  
Preterm Birth ◽  
Sex Ratio ◽  
Polychlorinated Biphenyls ◽  
Birth Outcomes ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Maternal Exposure ◽  
Adverse Birth Outcomes ◽  
Secondary Sex Ratio

AbstractHuman health effects of airborne lower-chlorinated polychlorinated biphenyls (LC-PCBs) are largely unexplored. Since PCBs may cross the placenta, maternal exposure could potentially have negative consequences for fetal development. We aimed to determine if exposure to airborne PCB during pregnancy was associated with adverse birth outcomes. In this cohort study, exposed women had lived in PCB contaminated apartments at least one year during the 3.6 years before conception or the entire first trimester of pregnancy. The women and their children were followed for birth outcomes in Danish health registers. Logistic regression was performed to estimate odds ratios (OR) for changes in secondary sex ratio, preterm birth, major congenital malformations, cryptorchidism, and being born small for gestational age. We performed linear regression to estimate difference in birth weight among children of exposed and unexposed mothers. All models were adjusted for maternal age, educational level, ethnicity, and calendar time. We identified 885 exposed pregnancies and 3327 unexposed pregnancies. Relative to unexposed women, exposed women had OR 0.97 (95% CI 0.82, 1.15) for secondary sex ratio, OR 1.13 (95% CI 0.76, 1.67) for preterm birth, OR 1.28 (95% CI 0.81, 2.01) for having a child with major malformations, OR 1.73 (95% CI 1.01, 2.95) for cryptorchidism and OR 1.23 (95% CI 0.88, 1.72) for giving birth to a child born small for gestational age. The difference in birth weight for children of exposed compared to unexposed women was − 32 g (95% CI—79, 14). We observed an increased risk of cryptorchidism among boys after maternal airborne LC-PCB exposure, but due to the proxy measure of exposure, inability to perform dose–response analyses, and the lack of comparable literature, larger cohort studies with direct measures of exposure are needed to investigate the safety of airborne LC-PCB exposure during pregnancy

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