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Fulltext Risk factors for low birth weight among rural and urban Malaysian women

Kaur S, Ng CM, Badon SE, Jalil RA, Maykanathan D, Yim HS, et al.

BMC Public Health, 2019 Jun 13;19(Suppl 4):539.
PMID: 31196034 DOI: 10.1186/s12889-019-6864-4

BACKGROUND: Low birth weight prevalence in Malaysia remains high. Socioeconomic background may lead to differences in physical activity and maternal nutritional status, which may play an important role in birth outcomes.
METHODS: This prospective cross-sectional study aimed to identify rural-urban differences in risk factors for low birth weight among women in Malaysia. Pregnant women at ≥20 weeks of gestation in urban and rural Malaysia (n = 437) completed questionnaires on sociodemographic characteristics and physical activity. Weight and middle-upper arm circumference were measured. Infant birth outcomes were extracted from medical records.
RESULTS: The overall prevalence of low birth weight infants was 6.38%. Rural women had more low birth weight infants than urban women (9.8% vs 2.0%, p = 0.03). Findings showed rural women were less sedentary (p = 0.003) and participated in more household/caregiving activities (p = 0.036), sports activities (p = 0.01) and less occupational activity (p birth weight infants in rural, but not in urban women.
CONCLUSIONS: We observed differences in risk factors for low birth weight between urban and rural pregnant women. Age, malnutrition and low parity were risk factors for low birth weight among rural pregnant women. Our findings suggest that rural pregnant women with low nutritional status should be encouraged to monitor their middle-upper arm circumference consistently throughout pregnancy. Improving nutritional status in rural pregnant women may reduce the risk of low birth weight infants in this population.

Matched MeSH terms: Birth Weight; Infant, Low Birth Weight*
Relationship of periodontal disease to pre-term low birth weight infants in a selected population--a prospective study

Ali TB, Abidin KZ

Community Dent Health, 2012 Mar;29(1):100-5.
PMID: 22482259

To assess effect of periodontal status of antenatal mothers on pregnancy outcomes in a selected population in Malaysia.

Matched MeSH terms: Birth Weight; Infant, Low Birth Weight*
Fulltext Risk factors associated with necrotising enterocolitis in very low birth weight infants in Malaysian neonatal intensive care units

Boo NY, Cheah IG

Singapore Med J, 2012 Dec;53(12):826-31.
PMID: 23268157

This study aimed to identify the risk factors associated with necrotising enterocolitis (NEC) in very low birth weight (VLBW; weight < 1,501 g) infants in Malaysian neonatal intensive care units (NICUs).

Matched MeSH terms: Birth Weight; Infant, Very Low Birth Weight*
Fulltext Oral health problem among pregnant mothers: age and attitude do matter

Karimah Hanim Abd Aziz, Nurjasmine Aida Jamani, Zurainie Abllah

International Medical Journal Malaysia, 2017;16(21):31-31.
MyJurnal

Oral health care during pregnancy is greatly important as it is crucial to the health
and well-being to both pregnant mother and baby. Studies showed that mothers with oral health
problem have greater risk of prematurity and low birth weight babies. This study aimed to measure
the associated factors of oral health problem among pregnant mothers. (Copied from article).

Matched MeSH terms: Infant, Low Birth Weight
A review of the nutritional status of the Indian community in Peninsular Malaysia

Mirnalini K

Family Practitioner, 1982;5:39-43.

A review of recent data available on the nutritional health of Indian children seems to suggest that malnutrition is a major problem among poor Indian preschool and school children. Examination of indirect indicators of malnutrition reveals that for Indians, the annual percentage decrease in TMR is the lowest and incidence of low birth weight and perinatal mortality rate the highest. While there is very little documentation in the extent and severity of protein-malnutrition among Indian children, hospital admission returns for severe PEM show a predominance of Indian preschool children. This suggest that moderate forms of malnutrition may even be more widely prevalent amongst this group of the population thus posing a great problem from the public health point of view. The prevalence of moderate PEM as represented by acute ("wasting") and chronic forms ("stunting") was found to be the highest among Indian urban and rural children. Biochemical studies indicate widespread prevalence of anemia, vitamin A and B deficiencies especially among Indian preschool children. The presence of high parasitic infections may exacerbate such deficiencies. The causes of malnutrition are multiple and complex. Low family income as a consequence of high unemployment rate (8%) and low wages, lack of basic sanitation and adequate housing, large family size, alcoholism and apathy among parents, ignorance of good nutrition and disturbed conditions in the home environment have been identified as some of the factors that may contribute towards malnutrition in this community. Thus the viscous cycle of malnutrition appears to have gained a foothold in the poor Indian community. As has been well documented, the social implications of malnutrition are many, the most important being its effect on education. It is now well known that malnutrition hinders intellectual development; it interferes with a child's motivation, ability to concentrate, and ability to learn and cope with the school situation. Malnutrition thus could be one of the contributory factors to the generally poor performance in studies, to the low aspiration for higher education and to the alarming drop-out rate (60%) found among Indian school children. While this review attempts to highlight some of the nutritional problems confronting the Indian poor, it is clearly essential from a national view-point that community level surveys should be further undertaken to assess the nutritional health of this group. The problem of malnutrition among poor Indian children is real and needs urgent recognition and remedial measures from both public and political sectors alike.

Matched MeSH terms: Birth Weight
Total nucleated cell count and cd34+ cell is reduced in preeclampsia and gestational diabetes mellitus pregnancies: viable affix criteria for cord blood banking

Mohd Razif Mohd Idris, Fazlina Nordin, Fadilah Abd Wahid S, Zaleha Abdullah Mahdy

Sains Malaysiana, 2018;47:2491-2499.

The aim of this study to determine the numbers of CD34+ cells and total nucleated cell (TNC) in umbilical cord blood (UCB)
collected from pregnant mothers with gestational diabetes mellitus (GDM) and preeclampsia (PE), following statistical
analysis of both maternal and perinatal factors which affect UCB parameters. Most of studies explored the influence of
obstetric factors on the number of UCB cell collection and only a few looked at the effects on UCB haematopoietic stem
cell (UCB-HSC) of common disorders complicating pregnancy. A total of 112 UCB samples (32 PE, 42 GDM and 38 nondiseased) were collected. CD34+ cell and NC count were enumerated using FACS Calibur. The TNC and CD34+ cells were
significantly reduced in both PE and GDM groups as compared to the control group. The PE group shows significantly
lower birth weight and higher BP which led to a lower UCB volume and CD34+ count. Gestational age shows significant
correlation with nucleated cell count (NCC) and TNC. GDM group shows significantly lower systolic BP, NCC and TNC count,
including low placental weight and birth weight. Conclusively, some obstetrics factors have significant influences to the
numbers and quality of UCB-HSC in both PE and GDM groups, which could guide in the selection criteria for CB banking.

Matched MeSH terms: Birth Weight
Nutritional therapies in the neonatal intensive care unit and post-natal growth outcomes of preterm very low birthweight Asian infants

Lee LY, Lee J, Niduvaje K, Seah SS, Atmawidjaja RW, Cheah FC

J Paediatr Child Health, 2020 Mar;56(3):400-407.
PMID: 31618507 DOI: 10.1111/jpc.14634

AIM: A collaborative study was conducted between two Southeast Asian university hospitals to compare the nutritional intervention and growth outcomes and evaluate the extent of post-natal growth faltering (PNGF) among very low birthweight (VLBW) infants.
METHODS: Data of all infants admitted during the 2011-2012 period to the two hospitals at Singapore (SG) and Malaysia (MY) were pooled and analysed.
RESULTS: Of the 236 infants, SG infants received lower total protein and energy intake than MY infants (2.69 vs. 3.54 g/kg/day and 92.4 vs. 128.9 kcal/kg/day respectively; P weight z-score from birth to 36 weeks corrected age was significantly different (SG,-2.2 (0.9) vs. MY, -1.4 (0.7); P = 0.001). More SG than MY extremely low birthweight (ELBW) infants had severe PNGF >-2 SDS (55 vs. 16%; P = 0.001). The greater use of a diuretic in SG to treat haemodynamically significant patent ductus arteriosus (hsPDA) may have contributed to the higher PNGF rate. Mean growth velocity of at least 15 g/kg/day was attained by VLBW infants only from Day 14 and by ELBW infants only from Day 28 post-natally. Overall, severe PNGF rates (z-score change >-2 SDS at 36 weeks' corrected age) were 28.8 and 36.5% for VLBW and ELBW infants, respectively.
CONCLUSIONS: Being very preterm, ELBW with hsPDA and receiving insufficient protein and energy were risk factors for severe PNGF. Increasing protein and energy content, augmenting fortification of breast milk and concentrating feed volumes, especially if there is an hsPDA, may curb severe PNGF among these infants.

Matched MeSH terms: Infant, Very Low Birth Weight
Term breech trial and its consequences on practice: a retrospective study of the University of Malaya Medical Centre's experience

Noor Azmi MA, Aniza A

JUMMEC, 2005;8:39-44.

To see the trend in managing singleton breech pregnancy after the term breech trial. Secondly to compare the safety of different modes of delivery for term, singleton breeches by looking at the immediate neonatal outcome, based on our own experience. Breech infants were identified by examining computer-stored maternal discharge records of hospitalization for the years 1990 and 2000 respectively. Parameters studied included planned mode of delivery, actual mode of delivery, parity, previous vaginal delivery, Apgar score at five minute, birth weight, referral to special care nursery and neonatal morbidity. Of 6,496 deliveries in 1990 and 5,081 in 2000, there were 220 (3.4%) and 148 (2.9%) term breech infants respectively, of which 115 (for 1990) and 102 (for 2000) case records were available. In 1990, 62.6% of the women had trial of vaginal breech delivery but only 24.5% of the women in 2000 were allowed to do so (p < 0.05). Caesarean section rate for singleton breeches increased from 51.3% in 1990 to 84.3% in 2000 (p < 0.05). Mean Apgar score at five minutes was significantly lower after vaginal breech delivery (9.40 ± 1.36) compared to after Caesarean section (9.72 ± 0.712) but there was no clinical significance. There was a noticeable trend towards Caesarean section and less trial of vaginal delivery. Neonatal outcomes of babies born abdominally were statistically better than those born vaginally but there was little clinical impact. Perhaps in properly selected cases, a planned vaginal breech delivery still has a role to play. KEYWORDS: Breech deliveries, Caesarean section, Apgar score

Matched MeSH terms: Birth Weight
Fulltext Characteristics of Malaysian infants with biliary atresia and neonatal hepatitis

Karnameedi S, Lim CT

Med J Malaysia, 1997 Dec;52(4):342-7.
PMID: 10968111

Cholestatic disorders of infancy (viz neonatal hepatitis and biliary atresia) have not been well studied in Malaysia. In a retrospective study in the Department of Paediatrics, University Hospital, Kuala Lumpur from January 1982 through December 1991, a total of ninety-three infants with such conditions were identified: 35 (38%) had biliary atresia, 58 (62%) neonatal hepatitis. There was a statistically significant male preponderance in the neonatal hepatitis group (P = 0.020). There was no significant difference in the racial distribution and in the proportions of low birthweight infants between the two groups of disorders. When the biliary atresia group was compared with the neonatal hepatitis group, significant differences were observed in the age of presentation (mean +/- SD) 9.8 +/- 6.8 VS 20 +/- 17.3 weeks (P < 0.001), proportion of infants with prolonged jaundice (> seven weeks) 28/35 (80%) VS 20/58 (34.5%) (P < 0.00001), occurrence of alcoholic stools 26/35 (74.3%) VS 27/58 (46.6%) (P = 0.020), liver size (mean +/- SD): 4.3 (1.6 cm VS 3.3 +/- 1.8 cm (P < 0.01) and splenic size: 2.5 (1.8 cm VS 1.4 (1.2 cm (P < 0.001). There was however considerable overlap between the two groups in these features at presentation, making clinical differentiation between the two conditions difficult. Infants with cholestasis tended to present late, compromising the chance of survival. In order to improve the medical care of these patients, these conditions must be emphasised during the training of medical practitioners, and efforts to increase public awareness of these conditions must be created.

Matched MeSH terms: 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: Birth Weight*; Infant, Low Birth Weight*
Fulltext Effects of environment on the growth of children

Chen ST

Med J Malaysia, 1986 Mar;41(1):72-6.
PMID: 3796354

A child's growth achievement depends on his genetic endowment and the environment in which he lives; Comparative studies of children of similar racial origin but growing under different environmental conditions have shown differences in their body size and shape. In general higher income families produce offspring with higher mean birth weight. This is largely due to better nutrition and care of mothers during pregnancy and childhood. Children from higher socioeconomic groups are on an average larger in size in terms of weight, height, head circumference, midarm circumference, crown-rump length and leg length. This is largely due to a better home environment including sanitation, nutrition, health and care enjoyed by the better-off children. .Generally urban children are larger than rural children mainly due to economic differences between the two areas. In most countries the secular trend to children getting larger still continues reflecting an improvement of living conditions with time. Unlike body size, body shape is less influenced by the environment and the change in body proportion brought about by environment is not permanent. In developing countries, children from higher socioeconomic families have generally thicker skinfolds. On the average, infants and preschool children of European ancestry have thicker triceps skinfolds compared with Negroes and Asians living in comparable environments. It is possible that this is due to long term adaptation to different climatic conditions.

Matched MeSH terms: Birth Weight
Reproduction research and health part II--Fetal health

Sinnathuray TA

Med J Malaysia, 1979 Dec;34(2):176-80.
PMID: 548724
Matched MeSH terms: Infant, Low Birth Weight
Observations on Banteng cattle in Sabah

Copland RS

Trop Anim Health Prod, 1974 May;6(2):89-94.
PMID: 4414876
Matched MeSH terms: Birth Weight
Effect of rooming in on length of hospital stay and weight gain of infants in a neonatal unit

Deng, C.T., Lim, N.L., Sham Kasim, M., Weller, V.

Malaysian Journal of Child Health, 1994;6(1):40-43.
MyJurnal

The neonatal Intensive Care Unit (NICU) in the Maternity Hospital Kuala Lumpur (MHKL) was frequently understaffed and overcrowded. A separate special care nursery (called K5) was set up in July 1991 for the purpose of providing non-intensive neonatal care for infants. Mothers were simultaneously admitted and they provided a major bulk of feeding and nursing care. Case records for 2 months prior to and 2 months after opening of the ward were studied. The average duration of hospital stay per neonate was shorter in the later period (9.18 days vs 11.05 days, p < 0.05). Also the very low birth weight infants (VLBW) gained weight faster (28 grams a day) compared to similar infants in the earlier period (22 grams a day, p < 0.05).

Matched MeSH terms: Infant, Very Low Birth Weight
A review of perinatal mortality in Peninsular Malaysia from 1980 to 1989

Musa Mohd Nordin, Mohd Sham Kasim, Wong, Swee Lan

Malaysian Journal of Child Health, 1993;5(1):9-19.
MyJurnal

An analysis of perinatal statistics in Peninsular Malaysia from 1980 — 1989 was undertaken. The Perinatal Mortality Rate showed a 42% decrease over the 10 year period. The Perinatal Mortality Rate was higher among the Indian and Malay ethnic groups compared to the Chinese. This was largely contributed by the higher Stillbirth rate in the former 2 ethnic groups. The Indians have the highest rate of low birthweight babies. There is a decline in the rate of low birthweight babies born over the studied decade. The major causes of early neonatal mortality included problems asociated with prematurity, asphyxia neonatorum, septicaemia and congenital anomalies. Further epi-demiological research is required to identify other riskfactors which contribute to this ethnic biased perinatal mortality rates. Besides intensifying and upgrading current multifaceted approaches, interventional strategies need to be directed to the identified high risk groups. (Copied from article).

Matched MeSH terms: Infant, Low Birth Weight
The effect of thyroxine on the renal function of asphyxiated neonates

Rostenberghe, H.V., Haider, D., Abdullah, Y., Amir, H., Abdul Razak, A.R.

Malaysian Journal of Paediatrics and Child Health, 1998;10(2):19-23.
MyJurnal

Thyroxine has been shown to have a beneficial effect on renal function in cases of impending renal failure in ani-mal studies.'5 Studies of the use of thyroxine in humans in impending renal failure are scarce. The aim of this study was to assess the effect of oral thyroxine on the renal function of asphyxiated term neonates who often have renal impairment.
A randomised control trial was conducted, involving 30 term asphyxiated neonates. The study group (n=15) was given thyroxine (50 pg) orally on days 1, 2 and 3 of life and placebo was given to the control group (n=15). Renal function was studied on day 1 and day 4 of life. The two groups did not differ significantly as regards gestational age, birth weight, severity of asphyxia, preg-nancy or delivery complications, fluids administered and drugs used. There was no significant difference in urine output, creatinine clearance and fractional excretion of sodium on day 1 but there was a trend towards a worse renal function on day 1 in the treatment group. The creatinine clearance was significantly better in the treat-ment group on day 4 (p = 0.017). Urine output and fractional excretion of sodium on day 4 were better in the treatment group but the differences did not reach statistical significance (p = 0.14 and 0.057 respectively). Statistical analysis on the differences between day 4 and day 1 showed statistical significance only for creatinine clearance: creatinine clearance day 4 minus creatinine clearance day 1 was 52.6 (±32.4) for the thyroxine group and 7.3 (±7.8) for the controls (p= 0.006).
These data support the hypothesis that thyroxine may have a significant beneficial effect on the renal function in term neonates with perinatal asphyxia. Thyroxine may be proven useful in future for patients with impending renal failure.

Matched MeSH terms: Birth Weight
Foetal growth retardation

Paramaesvaran N

Med J Malaya, 1970 Dec;25(2):102-4.
PMID: 4251128
Matched MeSH terms: Birth Weight
Fulltext Long term outcome in unilaterally treated retinopathy of prematurity: a case report

Mushawiahti, M., Rokiah, O., Umi, K.M.N., Leow, S.N.

Medicine & Health, 2014;9(2):134-138.
MyJurnal

Retinopathy of prematurity (ROP) is a disorder describing an immature vascularisation
of a developing retina in low birth weight preterm infants. This condition potentially
leads to blindness. ROP developed as a response of hypoxia of the eye due to
incomplete development of the retinal vessels. ROP is commonly reported as
bilateral disease,a small percentage of infants have asymmetrical changes. We
report a case of long-term outcome of a asymmetry ROP changes with peripheral
retinal ablation in a single eye. This particular case demonstrates the possible longterm
outcome of unilaterally treated ROP which could either be due to the severity
of the disease itself or the treatment she received. It is important to highlight the
possibility of unequal development of the eye in asymmetrical presentation of ROP.

Matched MeSH terms: Infant, Low Birth Weight
Fulltext Infantile Myofibromatosis: A Case Report

Hasniah, A.L., Rohana, J., Boo, N.Y., Thambidorai, C.R., Isa, M.R.

International Medical Journal Malaysia, 2007;6(1):1-6.
MyJurnal

Case: A male infant was born at 36th week period of gestation with a birth weight of 1.99kg following an uneventful intrauterine period. At birth, he was noted to have multiple skin nodules. The largest nodule measuring 4.0 x 2.0 x 1.5 cm was at his pre-auricular area. It was initially fleshy and reddish in color. A few days later, it turned black and subsequently the black skin overlying the mass fell off, leaving a firm underlying mass with the appearance of a cauliflower. Other skin lesions, which were firm in consistency, were found on the medial aspect of his right supraorbital ridge, right mid-arm, right mid-thigh, plantar surface of his right big toe and his scalp. They were either skin-colored or reddish in colour, measuring between 1.0 and 2.0 cm in diameter. He also had hepatomegaly and splenomegaly palpable at 5 cm and 3 cm below the subcostal margins, respectively

Matched MeSH terms: Birth Weight
Fulltext Contaminated milk is a common cause of necrotising enterocolitis: A hypothesis

Boo NY

Malays J Pathol, 2016 Dec;38(3):223-227.
PMID: 28028291 MyJurnal

Necrotising enterocolitis (NEC) is the most commonly acquired gastrointestinal disease of neonates, particularly the very preterm (gestation <32 weeks) and/or very low birth weight (<1500g). It is associated with high morbidity and mortality. Despite improvement in neonatal care and increased use of expressed breast milk (EBM), the incidence remains high in many neonatal intensive care units (NICU), and even shows increasing trend in some countries. Numerous studies have pointed to the infective nature of NEC. Some investigators have reported an increase in the incidence of NEC in their NICU when the percentage of infants with pathogens isolated from their gut increased, and decreased when gut colonisation rate was low. Both bacteria and viruses have been reported to be associated with outbreaks of NEC. The majority (>90%) of the NEC cases occurred in neonates on enteral feeding. Studies have shown that milk (whether EBM or formula) fed to neonates was not sterile and were further contaminated during collection, transport, storage and/or feeding. Other investigators have reported a reduction in the incidence of NEC when they improved infection control measures and hygienic procedures in handling milk. It is, therefore, hypothesised that the most common cause of NEC is due to the feeding of neonates, particularly the vulnerable very preterm small neonates, with milk heavily contaminated during collection at source, transport, storage and/or feeding. Because of the immaturity of the immune system of the neonates, excessive inflammatory response to the pathogen load in the gut leads to the pathogenesis of NEC.

Matched MeSH terms: Infant, Low Birth Weight

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