Vitamin D deficiency/insufficiency is prevalent among pregnant women. Factors causing this epidemic need investigation. Promoting consumption of vitamin D-fortified foods and supplements among pregnant women is suggested.

Objective:To examine the (1) normal ranges of anthropometric and insulin resistance/sensitivity indices (homeostatic model assessment for insulin resistance, homeostatic model assessment for insulin sensitivity, and quantitative insulin sensitivity check index) for Iranian pregnant women and their newborns and (2) associations between maternal anthropometric and metabolic values and infants’ birth weights among Iranian women.Methods:Anthropometric and metabolic values of 163 singleton non-diabetic pregnant women in Tehran, Iran (2014) were collected before and during pregnancy and at delivery. Linear regression, multivariable regression, and Student t tests were used to evaluate correlations between birth weight and maternal variables.Results:Linear regression modeling suggested that maternal serum glucose (p = 0.2777) and age (p = 0.6752) were not associated with birth weight. Meanwhile, maternal weight and body mass index before pregnancy (p = 0.0006 and 0.0204, respectively), weight at delivery (p = 0.0036), maternal height (p = 0.0118), and gestational age (p = 0.0016) were positively associated with birth weight, while serum insulin (p = 0.0300) and homeostatic model assessment for insulin resistance (p = 0.0334) were negatively associated with infant’s birth weight. Using multivariate modeling, we identified severalconfounders: parity (multipara mothers delivered heavier babies compared to first-time mothers) explained as much as 24% of variation in birth weight (p = 0.005), maternal height explained 20.7% (p = 0.014), gestational age accounted for 19.7% (p = 0.027), and maternal body mass index explained 19.1% (p = 0.023) of the variation in the infant’s birth weight. Maternal serum insulin and infant’s sex were not observed to be associated with birth weight (p = 0.342 and 0.669, respectively) in the overall model.Conclusion:Overweight/obese women may experience higher incidence of delivering larger babies. Multivariable regression analyses showed that maternal body mass index and height, parity, and gestational age are associated with newborn’s birth weight.

Although the Coronavirus Disease 2019 (COVID-19) has been found to have multiple routes of transmission, limited data exist on whether the vertical transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can occur from asymptomatic infected mothers to their newborns during pregnancy. We report a full-term newborn girl who was found to be positive for COVID-19 at 24 hours of life and subsequently symptomatic with fever, tachycardia, tachypnea, elevated lactate dehydrogenase, and elevated total bilirubin. The newborn was delivered by a mother who was not suspected of having COVID-19 before giving birth, but who developed fever and dyspnea five hours after delivery and was found to be positive for COVID-19. Upon further history collection, the mother reported recent mild nasal congestion in the days prior to delivery. This case highlights that the vertical transmission of COVID-19 to a newborn may occur late during the third trimester from a mother who was not suspected of having the infection. All pregnant women may need to be screened for COVID-19 symptoms, including non-specific symptoms, prior to admission for labor and delivery floors in order to perform diagnostic tests and recommended safety precautions to keep newborns and hospital personnel safe.

There is an association between congenital malformation in newborns and maternal zinc deficiency.

Objectives: To compare the effects of a single dose of clofibrate on the serum bilirubin level in full-term non-hemolytic icteric neonates when it is administered in addition to phototherapy, and to evaluate its possible side effects. Methods: In a randomized-controlled clinical trial in 2016, 90 term icteric neonates were divided into groups of 30. One group took a single dose of 50 mg/kg while another group took a single dose of 100 mg/kg of clofibrate. All neonates were under phototherapy and were compared to a control group who took a placebo. Serum bilirubin levels were measured at admission and then after 6, 12, 24, and 48 hours of treatment. Clofibrate's side effects were assessed by measuring hepatic enzymes (AST/ALT) and lipid profiles (TG/Chol) at admission and after 48 hours. Results: In neonates with jaundice who were under phototherapy, a single dose of 100 mg/kg of clofibrate decreased the level of serum bilirubin more rapidly compared to the control group (t (58) =-2.73, P = 0.043), or even the group who took a single dose of 50 mg/kg clofibrate (t (58) =-4.261, P = 0.000). A single dose of 50 mg/kg clofibrate did not decrease the serum bilirubin levels more rapidly compared to the control group. Compared to the control group, in the group who took a single dose of 50 mg/kg clofibrate, after 48 hours, a higher number of neonates showed an increase in serum triglyceride (30% versus 63%) and/or cholesterol levels (27% versus 57%). Conclusions: A single dose of 100 (not 50) mg/kg clofibrate better decreased the serum bilirubin.

Naseh A, Nourbakhsh S, Tohidi M, Sarkhail P, Najafian B, Azizi F. Associations between anthropometric characteristics and insulin markers in mothers and their neonates and with neonate`s birth weight: An observational cohort study. Turk J Pediatr 2017; 59: 625-635. This study aimed to identify possible associations between anthropometric characteristics and insulin markers of mothers and 1) their neonate`s birth weight, and 2) those markers of neonates. A prospective observational cohort of 100 healthy mothers who came to a hospital in Tehran in 2014 from pregnancy to delivery as well as their term neonates comprised the study population. Only newborns with weight within normal range were included. Anthropometric indices and serum glucose and insulin levels were measured in both mothers and neonates. Correlations between maternal body and serum indices and neonate`s serum indices and birth weight were assessed. Maternal weight before pregnancy (r= 0.3, p=0.001), at time of delivery (r= 0.3, p=0.001), and maternal body mass index (BMI) before pregnancy (r= 0.2, p=0.04) positively associated with neonate`s birth weight. For the neonates with normal birth weight, there was no correlation between maternal serum glucose and insulin levels and neonate`s serum glucose and insulin levels or birth weight. Neonate`s serum glucose correlated positively with insulin levels (r= 0.3, p=0.006) and HOMA-IR (r= 0.6, p < 0.0001); and negatively with HOMA-S (r= -0.6, p < 0.0001) and QUICKI (r= -0.5, p < 0.0001). Neonate`s insulin correlated positively with HOMA-IR (r= 0.9, p < 0.0001), and negatively with HOMA-S (r= -0.9, p < 0.0001), QUICKI (r= -0.9, p < 0.0001), gestational age (r= -0.2, p=0.03) and with glucose-insulin (GI) ratio (r= -0.9, p < 0.0001). Neonate`s GI ratio correlated positively with gestational age (r= 0.2, p=0.01). Maternal serum glucose and insulin showed positive correlation (r= 0.4, p < 0.0001). The lowest maternal insulin quartile had dominantly male and the highest quartile had dominantly female neonates (p=0.006). In conclusion, maternal anthropometric measures correlate with neonates` birth weight. Advancing health promotion to normalize these maternal parameters may reduce the incidence of abnormal birth weights among newborns.

Objective: The present study was conducted to evaluate the risk factors that reduce the rate of breastfeeding among Iranian women in the first six months after delivery. Materials and Methods: This cross sectional study was performed on 542 mothers with infants less than six months old who came to Taleghani Hospital, Tehran, Iran, for vaccination follow up, from 2012 to 2014. Trained examiners filled a predesigned questionnaire including information about breastfeeding and factors that may affect the mode of infant feeding. The results were analyzed using SPSS software. Results: Out of 542 breastfeeding infants 53.2% were female; the average birth weight was 3217 ± 40 gr and 57.7% were first born. The age of mothers was from 17 to 43 years with the average of 27.7 ± 4.9. Among mothers 58.1% had a high school diploma or less education and 41.9% had higher education. The rate of cesarean section was 62.2%. The rate of breastfeeding showed a reducing trend from the first month after birth to the sixth month: 91.7% of mothers reported breastfeeding in the first month which was reduced to 70.1% in the sixth month. Multivariate analysis using logistic regression analysis showed the risk factors reducing the rate of breastfeeding as follow: use of pacifier (P < 0.000, OR = 3.695, CI 95% = 2.460-5.553), cesarean section delivery (p < 0.000, OR = 2.717, CI 95% = 1.690-4.369), lack of breastfeeding training (P = 0.004, OR = 2.347, CI 95% = 1.354-4.063), and mothers' higher education (P = 0.029, OR = 1.614, CI 95% = 1.014-2.569). Conclusion: Use of pacifiers, cesarean section, lack of breastfeeding training, and mothers' higher education were the risk factors for reduced breastfeeding among Iranian mothers.

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