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Risk factors for under-immunisation in hospitalised preschool children

Mariana, D., Quah, B.S., Mazidah, A.R.

Malaysian Journal of Paediatrics and Child Health, 2005;14(1):33-40.
MyJurnal

Even though vaccines are effective for prevention of diseases, compliance with recommended schedules of immunisation in early childhood is not always complete. Identification of potential risk factors associated with under-immunisation may help increase vaccination uptake. The objectives of this study were to determine the prevalence and risk factors of under-immunisation in hospitalised preschool children in Universiti Sains Malaysia Hospital (HUSM). Children aged 1 month to 2 years admitted between December 1998 and December 2000 in medical paediatric wards at HUSM were studied. Parents/guardians were interviewed during admission regarding immunisation status and potential risk factors. Children who did not have home-based cards during admission were excluded. Among 401 children, 37.9% had complete immunisation, 43.4% had delayed immunisation and 34.9% had incomplete immunisation. The uptake of BCG, DPT/OPV 1, DPT/OPV2, Hepatitis B3, DPT/OPV3, and measles were 98.5%, 90.7%, 83.2%, 81.4%,79.2% and 72.9% respectively. Vaccines scheduled to be given at later ages were significantly less likely to be taken (p=0.002) compared with vaccines scheduled to be given at an earlier age. Significant independent risk factors for under-immunisation were elderly mothers (3 40 years old) (OR 3.0, 95% CI: 1.2-8.0), low birth weight £2.0 kg (OR 6.2; 95% CI: 1.8-21.4) and presence of chronic illness in the child (OR 4.5; 95% CI: 2.5-7.9). In children whose father's education was low (primary school or no education), low maternal education was significantly associated with lower rate of under-immunisation (p = 0.005, OR 0.11 95%CI 0.02-0.51).
In conclusion this study showed that a large proportion of hospitalised preschool children were under-immunised, and vaccines scheduled to be given at a later age had lower uptakes. The situation can be rectified if every opportunity is taken to immunise all children, who have lapsed in their immunisation schedule.

Matched MeSH terms: Infant, Low Birth Weight
Fulltext Urinary tract infections in pregnancy

Loh KY, Sivalingam N

Malays Fam Physician, 2007;2(2):54-57.
MyJurnal

Urinary tract infections frequently affect pregnant mothers. This problem causes significant morbidity and healthcare expenditure. Three common clinical manifestations of UTIs in pregnancy are: asymptomatic bacteriuria, acute cystitis and acute pyelonephritis. Escherichia coli remains the most frequent organism isolated in UTIs. All pregnant mothers should be screened for UTIs in pregnancy and antibiotics should be commenced without delay. Urine culture and sensitivity is the gold standard in diagnosing UTIs. Without treatment, asymptomatic bacteriuria in pregnancy is associated with preterm delivery, intrauterine growth retardation, low birth weight, maternal hypertension, pre-eclampsia and anaemia. Acute pyelonephritis can lead to maternal sepsis. Recurrent UTIs in pregnancy require prophylactic antibiotic treatment.

Matched MeSH terms: Infant, Low Birth Weight
The effect of providing expressed breast milk on infection rates, mortality and breast feeding of preterm babies

Ram, S.P., Zabidi Azhar M Hussin

Malaysian Journal of Child Health, 1997;9(1):83-87.
MyJurnal

Two active interventions were carried out in order to encourage breast feeding of low birth weight (LBW) neonates who were admitted to the neonatal intensive care unit (NICU), Universiti Sains Malaysia. These were the establishment of (a) an effective transport system for conveying expressed breast milk (EBM) from the motherk home to the neonatal intensive care unit and (b) providing rooming-infacilities in the neonatal ward. The EBM was transported by a male health assistant, by the parents themselves or by the local bus company. A total of 473 babies were admitted from April 1994 to September 1995. Thirty-three babies weighed between 540-1000g and 440 were between 1001-2000g. A total of 226 (47.8%) babies were given mixed formula (less than 20% of daily needs) and EBM feeds (Group A) and 247 (52.2%) were given only formula feeds (Group B). A total of 79 babies died of which 5 were in Group A and 74 were in group B. (P value is 0.00). In Group A, 45 babies had clinical sepsis, 9 of whom were blood culture positive. Four of these babies died. In group B, out of 108 babies with clinical sepsis 36 were blood culture positive. 29 died because of the sepsis This study shows that by providing an effective transport system for breast milk expressed at home and the availability of roomingfacilities in the neonatal ward a significant number of LBW babies admitted to the NICU continue to receive their mothers' milk. The incidence of nosocomial sepsis and the over all mortality due to sepsis was significantly higher in those on full formulafeeding compared to those given mixed formula and expressed breast milk.

Matched MeSH terms: Infant, Low Birth Weight
Risk factors for acute lower respiratory tract infections in hospitalised children in Kelantan

Choo, C.M., Quah, B.S., Rostenberghe, H.V., Choo, K.E.

Malaysian Journal of Paediatrics and Child Health, 1998;10(2):1-7.
MyJurnal

A case control study was conducted to identify the risk factors for acute lower respiratory tract infections (ALRI) in hospitalised children in Kelantan. One hun-dred and twenty children aged one month to five years hospitalised for ALRI were matched by age with 120 children as controls. Data on demography and expo-sure to putative risk factors were collected by interview-ing parents or caretakers. Anthropometric measure-ments were also carried out to assess the nutritional sta-tus of the children. For each risk factor studied, the odds ratios for exposure and disease were calculated by using univariate analysis followed by multiple logistic regression analysis to determine those factors which remained significant.
The presence of sibling(s) who coughed at home (OR 12.1, 95% CI 5.2-28.1), crowding in bedroom (OR 4.4, 95% CI 2.1-9.0), weight-for-age < 3rd percentile (OR 9.0, 95% CI 3.1-25.8), lack of breast feeding (OR 9.4, 95% CI 2.3-38.4) and incomplete immunisation (OR 4.5, 95% CI 1.7-12.1) were significant indepen-dent risk factors for ALRI. Other factors like poverty, maternal education level, male sex, low birth weight, history of atopy, family history of asthma and indoor air pollution were not associated with an increased risk of ALRI.
This study showed that poor nutritional status, inap-propriate child care practices and poor living conditions, particularly those related to crowding, predispose to ALRI in Kelantanese children necessitating hospital admission. A change in these factors may reduce the morbidity and mortality of childhood ALRI in Kelantan.

Matched MeSH terms: Infant, Low Birth Weight
Association Between Preconception Care and Birth Outcomes

Jourabchi Z, Sharif S, Lye MS, Saeed A, Khor GL, Tajuddin SHS

Am J Health Promot, 2019 03;33(3):363-371.
PMID: 30011998 DOI: 10.1177/0890117118779808

PURPOSE: To evaluate the association between preconception care and the risk of adverse birth outcomes.
DESIGN: A quasi-experimental study comparing 2 groups: (1) integrated maternal health care (MHC) program (with preconception care) and (2) standard MHC program (without preconception care).
SETTING: Maternal health-care clinics in Alvand and Qazvin cities in Qazvin Province, Iran.
PARTICIPANTS: A total of 152 and 247 Iranian women aged 16 to 35 years were enrolled in the integrated MHC and standard MHC program, respectively.
MEASURES: The birth outcomes measured included low birth weight, preterm birth, maternal and neonatal complications, and mode of delivery (normal vaginal delivery and cesarean delivery).
ANALYSIS: Multiple logistic regression was performed to determine the impact of preconception care and risk of adverse birth outcomes with adjusted odds ratios (ORs) as effect sizes.
RESULTS: One hundred forty-seven women in integrated MHC and 218 women in standard MHC completed this study. Preconception care was associated with reduced risk of preterm birth (OR = 0.298; 95% confidence interval [CI] = 0.120-0.743; P = .009), low birth weight (OR = 0.406; 95% CI = 0.169-0.971; P = .043), maternal complication (OR = 0.399; 95% CI = 0.241-0.663; P < .001), and neonatal complications (OR = 0.460; 95% CI = 0.275-0.771; P = .003).
CONCLUSION: The findings of the present study revealed advantages of preconception care with reduced adverse birth outcomes.

Matched MeSH terms: Infant, Low Birth Weight
Fulltext Influence of maternal factors on growth parameters in low-birth-weight babies with kangaroo mother care

Lumbanraja, SN

JUMMEC, 2016;19(2):17-25.
MyJurnal

Background: Kangaroo mother care (KMC) in low birth weight newborns has been found to be beneficial, but
studies have shown that maternal factors might be of concern in the successful application of KMC.
Aim: To study the influence of maternal factors on growth parameters in low-birth-weight babies with KMC.
Methods: This is a prospective cohort study of 40 low birth weight newborns in our institutions. We randomly
assigned the newborns to the group which received KMC and to the group which received conventional care.
Maternal factors were recorded. We measured weight, length, and head circumferences of newborns daily
for thirty days. Data was processed by SPSS x22.0.
Results: A total of 40 newborns were recruited into the study. Weight parameters were significantly higher
in the KMC group than in the conventional group except for the Z scores. Regarding maternal characteristics,
only gestational age was found to influence the initial and the last head circumference (p=0.035). There were
no differences in maternal age, parity, maternal education, mode of delivery, fetal sex, and initial Apgar score
with any of the growth parameters.
Conclusion: There were no maternal and fetal differences in the growth parameters of the groups, except in
the delayed growth of head circumferences in preterm infants.
Keywords: Growth parameters, KMC method, low birth weight

Matched MeSH terms: Infant, Low Birth Weight
Fulltext Knowledge, attitudes and practice behaviours of healthcare professionals on association between periodontal disease and preterm and/or low birth weight infants: a malaysian study

Nik Azis NM, Zainol Abidin K

Malaysian Journal of Public Health Medicine, 2016;16(1):45-52.
MyJurnal

Our study aimed to assess the knowledge, attitudes and practice behaviours of primary healthcare professionals in government Maternal and Child Healthcare Clinics (MCHC) on the association between oral health and pregnancy outcomes namely pre-term and/or low birth weight (PT/LBW) infants and to identify the barriers of utilisation of oral healthcare services by pregnant mothers. Questionnaires were distributed to government healthcare professionals working at all seven government MCHC in the Manjung District, Malaysia. 136 out of 158 questionnaires were returned completed yielding a 92% response rate. The questionnaire covers respondents characteristics, attitude and practice behaviours related to oral health and barriers faced when referring pregnant mothers to the dental clinic. 65% of respondents noticed dental/ gum problems in the pregnant mothers that they encountered. The two most frequent response for outcome of delivery linked to gum/ dental problems were premature delivery (49%) responses and low birth weight (27%). Although 95% of the respondents believed that regular dental check-ups is compulsory for pregnant mothers, only 69% regularly refer pregnant mothers for dental check-ups. There was a significance between healthcare professionals that receive continuing dental education and their referrals of antenatal mothers for dental check-ups .
Study site: Maternal and Child Health Clinics (Klinik Kesihatan), Manjung District, Perak, Malaysia.

Matched MeSH terms: Infant, Low Birth Weight
Fulltext Factors associated psychological well-being of mothers with low birth weight (LBW) infants who are admitted at neonatal intensive care units (NICU)

Rusnani Ab Latif

The Malaysian Journal of Nursing, 2018;9(3):39-45.
MyJurnal

Psychological well-being is relatively complex notions with a variety of components that may contribute to it. Individuals differ in their overall levels of psychological health and well-being. Mother with low birth weight (LBW) babies required hospitalization especially in the Neonatal Intensive Care Unit (NICU) more exposed to the experience of anxious symptoms. Therefore, it would become a stressful event that might cause psychological distress or even emotional crisis in mother's when their infants were LBW especially premature. Health promotion is very important to prevent this problem. Health promotion efforts aimed at improving infant health status must do so by improving women's health. Improving women's health before, during, and after pregnancy is the key to reduce the human and economic costs associated with infant mortality and morbidity. To improve both women's and infants' health, efforts should include an emphasis on preventive health care services, family-oriented work site options, changes in social norms, and individual behavior modification. Therefore, it is important for health care professionals in NICU to be able to assess the factors associated psychological well-being of mother's with LBWinfant.

Matched MeSH terms: Infant, Low Birth Weight
Fulltext Impact of maternal antepartum depressive and anxiety symptoms on birth outcomes and mode of delivery: a prospective cohort study in east and west coasts of Malaysia

Nasreen HE, Pasi HB, Rifin SM, Aris MAM, Rahman JA, Rus RM, et al.

BMC Pregnancy Childbirth, 2019 Jun 14;19(1):201.
PMID: 31200677 DOI: 10.1186/s12884-019-2349-9

BACKGROUND: Antepartum depressive and anxiety symptoms (ADS and AAS) are prevalent in Malaysia. Prior evidence linking maternal ADS and AAS with adverse birth outcomes and caesarean section (CS) or instrumental delivery is conflicting. There is no research in Malaysia on the association between maternal mental disorders and adverse birth outcomes and mode of delivery. This study aims to investigate the independent effect of maternal ADS and AAS on low birth weight (LBW), preterm birth (PTB) and CS or instrumental delivery among women in east and west coasts of Malaysia.
METHODS: We used data from a prospective cohort study of 799 pregnant women from health clinics of two states in east and west coasts of Malaysia. Baseline data were measured at the third trimester of pregnancy on ADS, AAS, socioeconomic condition, anthropometric status, reproductive history and intimate partner violence. Birth outcomes and mode of delivery were determined at the time of delivery. Univariate and multiple Cox's regressions were applied to assess the association between ADS and AAS and LBW, PTB and CS or instrumental delivery.
RESULTS: ADS was significantly associated with an increased risk of giving birth to LBW babies in both east coast (RR = 3.64; 95% CI 1.79-7.40) and west coast (RR = 3.82; 95% CI 1.86-7.84), but not with PTB. AAS was associated with increased risk of both LBW (RR = 2.47; 95% CI 1.39-4.38) and PTB (RR = 2.49; 95% CI 1.16-5.36) in the east coast, but not in west coast. The risk of CS or instrumental delivery was evident among women with ADS (RR = 2.44; 95% CI 1.48-4.03) in west coast only.
CONCLUSION: ADS predicts LBW in both coasts, AAS predicts LBW and PTB in east coast, and ADS predicts CS or instrumental delivery in west coast. Policies aimed at detection and management of ADS and AAS during antenatal check-up in health clinics may help improve birth outcomes and reduce obstetric interventions.

Matched MeSH terms: Infant, Low Birth Weight
A population-based study of birth defects in Malaysia

Thong MK, Ho JJ, Khatijah NN

Ann Hum Biol, 2005 Mar-Apr;32(2):180-7.
PMID: 16096215 DOI: 10.1080/03014460500075332

Birth defects are one of the leading causes of paediatric disability and mortality in developed and developing countries. Data on birth defects from population-based studies originating from developing countries are lacking. One of the objectives of this study was to determine the epidemiology of major birth defects in births during the perinatal period in Kinta district, Perak, Malaysia over a 14-month period, using a population-based birth defect register. There were 253 babies with major birth defects in 17,720 births, giving an incidence of 14.3/1000 births, a birth prevalence of 1 in 70. There were 80 babies with multiple birth defects and 173 with isolated birth defects. The exact syndromic diagnosis of the babies with multiple birth defects could not be identified in 18 (22.5%) babies. The main organ systems involved in the isolated birth defects were cardiovascular (13.8%), cleft lip and palate (11.9%), clubfeet (9.1%), central nervous system (CNS) (including neural tube defects) (7.9%), musculoskeletal (5.5%) and gastrointestinal systems (4.7%), and hydrops fetalis (4.3%). The babies with major birth defects were associated with lower birth weights, premature deliveries, higher Caesarean section rates, prolonged hospitalization and increased specialist care. Among the cohort of babies with major birth defects, the mortality rate was 25.2% during the perinatal period. Mothers with affected babies were associated with advanced maternal age, birth defects themselves or their relatives but not in their other offspring, and significantly higher rates of previous abortions. The consanguinity rate of 2.4% was twice that of the control population. It is concluded that a birth defects register is needed to monitor these developments and future interventional trials are needed to reduce birth defects in Malaysia.

Matched MeSH terms: Infant, Low Birth Weight
Fulltext Effectiveness of a simple heated water-filled mattress for the prevention and treatment of neonatal hypothermia in the labour room

Boo NY, Selvarani S

Singapore Med J, 2005 Aug;46(8):387-91.
PMID: 16049607

This study aimed to determine the proportions of normothermic infants who remained normothermic, and hypothermic infants who became normothermic following the use of a heated water-filled mattress (HWM) in the labour room.

Matched MeSH terms: Infant, Low Birth Weight
The National Family Planning Program: its impact on perinatal mortality

Arshat H, Kader HA, Ali J, Noor Laily Abu Bakar

Malays J Reprod Health, 1984 Dec;2(2):83-95.
PMID: 12280343
Matched MeSH terms: Infant, Low Birth Weight*
Impact of maternal marital status on birth outcomes among young Malaysian women: a prospective cohort study

Mohd Zain N, Low WY, Othman S

Asia Pac J Public Health, 2015 Apr;27(3):335-47.
PMID: 25005933 DOI: 10.1177/1010539514537678

This study evaluated the impact of maternal marital status on birth outcomes among young Malaysian women and investigated other risk factors influencing the birth outcomes. Pregnant women with and without marital ties at the point of pregnancy diagnosis were invited to participate in this study. Participants were interviewed using a structured questionnaire at pregnancy diagnosis and shortly after childbirth. From a total of 229 unmarried and 213 married women who participated, marital status was significantly associated with preterm birth (odds ratio [OR], 1.66; 95% confidence interval [CI], 1.05-2.61) and low birth weight (OR, 3.61; 95% CI, 1.98-6.57). Other factors significantly associated with birth outcomes was prenatal care (OR, 4.92; 95% CI, 1.43-16.95), "use of drugs" (OR, 10.39; 95% CI, 1.14-94.76), age (OR, 1.12; 95% CI, 1.07-1.16), and number of prenatal visits (OR, 1.03; 95% CI, 1.00-1.07). Promoting access to prenatal care and social support programs for unmarried mothers may be important to reduce adverse pregnancy outcomes.

Matched MeSH terms: Infant, Low Birth Weight
Laparoscopic localization and microlaparotomy for focal isolated perforation in necrotizing enterocolitis: an alternative approach to a challenging problem

Nah SA, Tan HL, Tamba RP, Aziz DA, Azzam N

J Pediatr Surg, 2011 Feb;46(2):424-7.
PMID: 21292104 DOI: 10.1016/j.jpedsurg.2010.11.045

Necrotizing enterocolitis has a wide clinical spectrum of manifestation. We report a novel method of managing focal isolated perforation in necrotizing enterocolitis by using diagnostic laparoscopy to localize the site of perforation and by making a microincision over the perforation to perform exteriorization or limited resection and primary anastomosis.

Matched MeSH terms: Infant, Low Birth Weight
Observations on obstetric practice in a multicultural setting

TambyRaja RL

Matern Child Health J, 1999 Jun;3(2):111-3.
PMID: 10892419

Singapore provides a rich environment for investigations into ethnic differences in pregnancy outcome, as it is populated by Malays, Indians, and Chinese. Years of clinical practice and obstetric research in this environment have affirmed the observation that many factors interact in determining length of gestation and birth weight, and that these factors have differential affects among these three different ethnic groups. Although technological advances have furthered our understanding of obstetrical outcomes and provided essential tools to promote the survival of premature infants, the persistent use of uniform growth standards hampers our ability to assure positive outcomes for women of different ethnicity. Recognition of ethnic differences has resulted in declines in certain negative pregnancy outcomes for women in Singapore. The development of race-specific uterine growth curves will enhance the provision of perinatal care for all women.

Matched MeSH terms: Infant, Low Birth Weight
Fulltext Update on the prevalence of malnutrition among children in Asia

Khor GL

Nepal Med Coll J, 2003 Dec;5(2):113-22.
PMID: 15024783

Approximately 70.0% of the world's malnourished children live in Asia, resulting in the region having the highest concentration of childhood malnutrition. About half of the preschool children are malnourished ranging from 16.0% in the People's Republic of China to 64.0% in Bangladesh. Prevalence of stunting and underweight are high especially in South Asia where one in every two preschool children is stunted. Besides protein-energy malnutrition, Asian children also suffer from micronutrient deficiency. Iron deficiency anaemia affects 40.0-50.0% of preschool and primary school children. Nearly half of all vitamin A deficiency and xeropthalmia in the world occurs in South and Southeast Asia, with large numbers of cases in India (35.3 million), Indonesia (12.6 million) and China (11.4 million). Another major micronutrient problem in the region is iodine deficiency disorders, which result in high goiter rates as manifested in India, Pakistan and parts of Indonesia. While under-nutrition problem persists, overweight problem in children has emerged in Asia, including Taiwan, Singapore and urban China and Malaysia. The etiology of childhood malnutrition is complex involving interactions of multiple determinants that include biological, cultural and socio-economic influences. Protein-energy malnutrition and micronutrient deficiency leading to early growth failure often can be traced to poor maternal nutritional and health care before and during pregnancy, resulting in intrauterine growth retardation and children born with low birth weight. While significant progress has been achieved over the past 30 years in reducing the proportion of malnourished children in developing countries, nonetheless, malnutrition persists affecting large numbers of children. The socio-economic cost of the malnutrition burden to the individual, family and country is high resulting in lower cognitive outcomes in children and lower adult productivity. Interventions that are cost-effective and culturally appropriate for the elimination of childhood malnutrition deserve the support of all.

Matched MeSH terms: Infant, Low Birth Weight
Evaluating the quality of antenatal care and pregnancy outcomes using content and utilization assessment

Yeoh PL, Hornetz K, Shauki NIA, Dahlui M

Int J Qual Health Care, 2018 Jul 01;30(6):466-471.
PMID: 29590356 DOI: 10.1093/intqhc/mzy041

Objective: To assess the adequacy of antenatal care (ANC) and its association with pregnancy outcomes using an approach that includes adequacy of both utilization and content.

Design: Retrospective cohort study.

Setting and Participants: Women attending ANC at public-funded primary health clinics where data were extracted from individual records.

Methods: Adequacy of utilization assessment was based on the concept of Adequacy of Prenatal Care Utilization index; adequacy of content assessed the recommended routine care received by the women according to local guidelines. Association between adequacy and pregnancy outcomes was examined using binary logistic regression.

Main Outcome Measures: Pregnancy outcomes included preterm birth and low birth weight.

Results: Sixty-three percent of women showed higher than recommended ANC utilization; 52% had <80% of recommended routine care content. Although not statistically significant, the odds of preterm birth was lower among women with adequate level of utilization compared with inadequate (adjusted odds ratios (aOR) = 2.34, 95% confidence interval (CI) 0.45-12.16) and intensive levels (aOR = 3.27, 95% CI 0.73-14.60). Regarding adequacy of content, women who received inadequate level of care content were associated with higher prevalence of preterm birth (aOR = 3.69, 95% CI 1.60-8.55).

Conclusion: The study shows inadequate content is associated with higher prevalence of preterm birth and suggests that inadequate utilization increases the risk of preterm birth. It demonstrates the relevance of using both utilization and content assessment in evaluating quality of ANC. Further studies are encouraged to review the methods used.

Matched MeSH terms: Infant, Low Birth Weight
Foetal and maternal outcomes in hyperuricaemia pre-eclampsia patients in Hospital Universiti Sains Malaysia

Jummaat F, Adnan AS, Ab Hamid SA, Hor JN, Nik Mustofar NN, Muhammad Asri NA, et al.

J Obstet Gynaecol, 2021 Jan;41(1):38-43.
PMID: 33124936 DOI: 10.1080/01443615.2019.1679731

Preeclampsia patients have frequently been found to experience hyperuricaemia and this may result in poor outcomes compared to those with normal uric acid levels. This study aimed to determine the relationship of hyperuricaemia in pre-eclampsia patients with foetal and maternal outcomes. This prospective cohort study involved 79 patients in a tertiary centre from year 2016 to 2018. Blood samples were taken antenatally and at the 6th week, post-delivery for renal function including serum uric acid level. Our findings indicate that there was a higher incidence of poor maternal and foetal outcomes in the hyperuricaemia group than the normal uric acid group. Serum uric acid has been shown to be a significant predictor for low birth weight and premature delivery in preeclampsia patients. It was also found that there was a significant negative correlation between uric acid level and antenatal creatinine clearance (rs = -0.338, p = .002). The assessment of the serum uric acid level seems to be important to ensure better outcomes in patients with preeclampsia.Impact statementWhat is already known on this subject? Preeclampsia is a serious pregnancy-related complication and remains as one of the most important cause of maternal and foetal morbidity and mortality, affecting 2-8% in all pregnancy. Many studies have established the association between hyperuricaemia and preeclampsia. Besides, numerous studies have found that hyperuricaemia contributed to adverse maternal and foetal outcomes.What the results of this study add? There was a significant increase in adverse foetal and maternal outcomes in the hyperuricaemia group compared to the normal uric acid group. This study revealed that serum uric acid remains a significant predictor for low birth weight and premature delivery in preeclampsia patients.What the implications are of these findings for clinical practice and/or further research? Hyperuricaemia does not merely become an indicator for the severity of disease in preeclampsia patients but also indicates adverse foetal outcomes. Large population-based studies are required to establish the absolute maternal and foetal outcomes in patients with hyperuricaemia. Besides, further studies are recommended on long-term implication of hyperuricaemia which is not limited to only during antenatal period.

Matched MeSH terms: Infant, Low Birth Weight
Fulltext Relationship between plasma cord blood zinc and infant birth weight in Fatemieh hospital, Hamadan, Iran

Mojgan, N., Sharifah Zainiyah, S.Y., Munn Sann, L., Zalilah, M.S.

Malaysian Journal of Public Health Medicine, 2012;12(1):49-56.
MyJurnal

The relationship between zinc and infant birth weight is still contradictory and up until today there is still no research on this issue done in Iran. This unmatched case control study to evaluate the association between plasma cord blood zinc and infant birth weight at the time of delivery was carried out in the labor ward, Fatemieh Hospital, Hamadan, Iran from the 6 th December 2009 to 18 October 2010. Plasma venous cord blood zinc was measured by AtomicAbsorption Spectro-photometry (AAS) and the weight of 134 Low Birth Weight (LBW) infants (cases) and 134 normal
weight infants (control) were measured at the time of delivery. All mothers with history of chronic diseases, obstetric complications, anemia, twin pregnancy, smoking, using illicit drugs, and alcohol and infants with any obvious anomalies were excluded from this study. Data were analyzed using SPSS version 16. Logistic regression was used to assess the contribution of other risk factors on infant birth weight. The result showed there was significant relationship between infant birth weight and plasma cord blood zinc. The risk of having LBW infant is more than 12 times in mothers who have severe zinc deficiency (OR=12.234,CI 95% 1.122, 133.392, p-value= 0.040). Also in mothers
who have mild to moderate zinc deficiency the risk of having LBW was more than one (OR=1.148, CI 95% 0.358, 3.900, p-value= 0.797). A significant relationship between maternal pre-pregnancy Body Mass Index (BMI) (p< 0.002), maternal weight gain during pregnancy (p< 0.021), previous LBW (p< 0.016), maternal age (p< 0.034) and parity (p< 0.004) with infant birth weight were also found. Logistic regression showed that zinc deficiency along with maternal pre-pregnancy BMI, maternal weight gain during pregnancy, previous LBW, maternal age and parity were predictors
for infant birth weight.

Matched MeSH terms: Infant, Low Birth Weight
Fulltext Rate of gestational weight gain trajectory is associated with adverse pregnancy outcomes

Yong HY, Mohd Shariff Z, Appannah G, Rejali Z, Mohd Yusof BN, Bindels J, et al.

Public Health Nutr, 2020 Dec;23(18):3304-3314.
PMID: 32814606 DOI: 10.1017/S1368980020002372

OBJECTIVE: To examine the gestational weight gain (GWG) trajectory and its possible association with pregnancy outcomes.
DESIGN: GWG trajectories were identified using the latent class growth model. Binary logistic regression was performed to examine the associations between adverse pregnancy outcomes and these trajectories.
SETTING: Negeri Sembilan, Malaysia.
PARTICIPANTS: Two thousand one hundred ninety-three pregnant women.
RESULTS: Three GWG trajectories were identified: 'Group 1 - slow initial GWG but followed by drastic GWG', 'Group 2 - maintaining rate of GWG at 0·58 kg/week' and 'Group 3 - maintaining rate of GWG at 0·38 kg/week'. Group 1 had higher risk of postpartum weight retention (PWR) (adjusted OR (AOR) 1·02, 95 % CI 1·01, 1·04), caesarean delivery (AOR 1·03, 95 % CI 1·01, 1·04) and having low birth weight (AOR 1·04, 95 % CI 1·02, 1·05) compared with group 3. Group 2 was at higher risk of PWR (AOR 1·18, 95 % CI 1·16, 1·21), preterm delivery (AOR 1·03, 95 % CI 1·01, 1·05) and caesarean delivery (AOR 1·02, 95 % CI 1·01, 1·03), but at lower risk of having small-for-gestational-age infants (AOR 0·97, 95 % CI 0·96, 0·99) compared with group 3. The significant associations between group 1 and PWR were observed among non-overweight/obese women; between group 1 and caesarean delivery among overweight/obese women; group 2 with preterm delivery and caesarean delivery were only found among overweight/obese women.
CONCLUSIONS: Higher GWG as well as increasing GWG trajectories was associated with higher risk of adverse pregnancy outcomes. Promoting GWG within the recommended range should be emphasised in antenatal care to prevent the risk of adverse pregnancy outcomes.

Matched MeSH terms: Infant, Low Birth Weight

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