BackgroundGrowing evidence suggests that maternal prepregnancy weight and gestational weight gain are risk factors for perinatal complications and subsequent maternal and child health. Postpartum weight retention is also associated with adverse birth outcomes and maternal obesity. Clinical guidelines addressing healthy weight before, during, and after pregnancy have been introduced in some countries, but at present a systematic accounting for these policies has not been conducted. The objective of the present study was to conduct a cross-national comparison of maternal weight guidelines.MethodsThis cross sectional survey administered a questionnaire online to key informants with expertise on the subject of maternal weight to assess the presence and content of preconceptional, pregnancy and postpartum maternal weight guidelines, their rationale and availability. We searched 195 countries, identified potential informants in 80 and received surveys representing 66 countries. We estimated the proportion of countries with guidelines by region, income, and formal or informal policy, and described and compared guideline content, including a rubric to assess presence or absence of 4 guidelines: encourage healthy preconceptional weight, antenatal weighing, encourage appropriate gestational gain, and encourage attainment of healthy postpartum weight.ResultsFifty-three countries reported either a formal or informal policy regarding maternal weight. The majority of these policies included guidelines to assess maternal weight at the first prenatal visit (90%), to monitor gestational weight gain during pregnancy (81%), and to provide recommendations to women about healthy gestational weight gain (62%). Guidelines related to preconceptional (42%) and postpartum (13%) weight were less common. Only 8% of countries reported policies that included all 4 fundamental guidelines. Guideline content and rationale varied considerably between countries, and respondents perceived that within their country, policies were not widely known.ConclusionsThese results suggest that maternal weight is a concern throughout the world. However, we found a lack of international consensus on the content of guidelines. Further research is needed to understand which recommendations or interventions work best with respect to maternal weight in different country settings, and how pregnancy weight policies impact clinical practices and health outcomes for the mother and child.

The effects on pregnancy outcome and maternal iron status of powdered milk (PUR) and a milk-based fortified product (V-N) were compared in a group of underweight gravidas. These take-home products were distributed during regular prenatal visits. Women in the V-N group had greater weight gain (12.29 vs 11.31 kg, p less than 0.05) and mean birth weights (3178 vs 3105 g, p less than 0.05) than those in the PUR group. Values for various indicators of maternal Fe status were also higher in the V-N group. Compared with self-selected noncompliers, similar in all control variables to compliers, children of women who consumed powdered milk or the milk-based fortified product had mean birth weights that were higher by 258 and 335 g, respectively. Data indicate a beneficial effect of the fortified product on both maternal nutritional status and fetal growth.

ABSTRACT. Disorders of the scalp often result in severe cosmetic interference with quality of life, creating the need for optimal medical surveillance. We tested the latest generation of ultrasound machines in patients with scalp pathology and prepared a cross-sectional library encompassing a wide assortment of conditions. Normative data on the sonographic anatomy of scalp and human hair, and important methodological considerations, are also included. To improve the medical approach to diseases of the scalp, we evaluated colour Doppler ultrasound, a technique already applied to the study of localised lesions of the skin [2]. We screened 12 461 ultrasound examinations performed over the past 8 years at a national skin sonography referral centre, and selected 221 patients (168 male, 53 female) with scalp lesions. Sonograms were also performed on 33 healthy volunteers (31 male, 2 female). We then prepared a pictorial presentation highlighting sonographic characteristics of scalp skin, scalp hair and eyelashes, and archetypal scalp pathology

The weight gain chart for pregnant women, developed by Rosso and Mardones (RM chart, 1997), is analysed and compared with other charts in terms of its usefulness for targeting nutritional interventions aimed at preventing low or high birth weights. The RM chart defines categories of maternal nutritional status in early gestation based on weight/height, expressed either as percentage of standard weight (PSW) or body mass index (BMI), and desirable gestational weight gains for each of these categories. Weight gain recommendations of the RM chart are proportional to maternal height. For underweight women the weight recommendation was derived from actual data, while for overweight and obese women it is based on data extrapolations. Since 1987 the Chilean National Health Service has used the RM chart as a standard in prenatal care in all its clinics, covering approximately 70% of the country's population, mostly middle and low income women. During the 1987-2001 period the proportion of underweight pregnant women and infants with birth weight < 3000 g decreased significantly and proportionally. Nevertheless, the proportion of obese pregnant women and infants with birth weight > or = 4000 g increased during this period. Multifactorial social changes including a decade of substantial economic growth in the country with improved family income, precludes the possibility of determining the efficacy of the RM chart in this group. However, the widespread use of the RM chart indicates that it is a helpful and easy-to-use instrument in the field. Further, by its clear graphical presentation of maternal nutritional status it helps draw the attention of health personnel to women who need special nutritional advice and support.

Objective: To test the hypothesis that maternal food fortification with omega-3 fatty acids and multiple micronutrients increases birth weight and gestation duration, as primary outcomes. Design: Non-blinded, randomised controlled study. Setting: Pregnant women received powdered milk during their health check-ups at 19 antenatal clinics and delivered at two maternity hospitals in Santiago, Chile. Subject: Pregnant women were assigned to receive regular powdered milk (n 5 477) or a milk product fortified with multiple micronutrients and omega-3 fatty acids (n 5 495). Results: Intention-to-treat analysis showed that mean birth weight was higher in the intervention group than in controls (65.4 g difference, 95% confidence interval (CI) 5-126 g; P 5 0.03) and the incidence of very preterm birth (,34 weeks) was lower (0.4% vs. 2.1%; P 5 0.03). On-treatment analysis showed a mean birth weight difference of 118 g (95% CI 47-190 g; P 5 0.001) and a relative fall in both the proportion of birth weight #3000 g (P 5 0.015) and the incidence of preeclampsia (P 5 0.015). Compliance with the experimental product was apparent from a haematological study of red-blood-cell folate at the end of pregnancy, which was performed in a sub-sample. In both types of analyses, positive differences were also present for mean gestation duration, birth length and head circumference. Nevertheless, the relatively small sample sizes allowed a statistical power of .0.80 just for mean birth weight and birth length in the on-treatment analysis; birth length in that analysis had a difference of 0.57 cm (95% CI 0.19-0.96 cm; P 5 0.003). Conclusions:The new intervention resulted in increased mean birth weight. Associations with gestation duration and most secondary outcomes need a larger sample size for confirmation.

Taller and stunted children had higher obesity risk than normal height for age children. This association did not change when controlling for the influence of perinatal data; post-natal influences may be playing an independent role. Although BW was linearly associated with obesity, short and premature babies also had a higher risk of obesity.

El estudio tuvo como objetivo identificar los factores maternos asociados con el peso al nacer, en Colombia, entre 2002-2011. Fue un estudio descriptivo, basado en información del Registro de Nacido Vivo de Colombia del Departamento Administrativo de Estadísticas Vitales, se clasificó el peso al nacer como: bajo peso al nacer < 2.500g, peso insuficiente 2.500-2.999g, peso adecuado 3.000-3.999g y macrosomía ≥ 4.000g. Para el análisis se utilizó la U Mann-Whitney, Kruskall Wallis y un modelo de regresión logística multinomial. Las mujeres con mayor probabilidad de recién nacidos con bajo peso fueron las de 35 años o más (OR = 1,4; IC95%: 1,39-1,4), con bajo nivel educativo (OR = 1,1; IC95%: 1,1-1,1), solteras (OR = 1,1; IC95%: 1,1-1,2), sin asistencia a controles prenatales (OR = 1,9; IC95%: 1,9-2,0) y de la zona rural (OR = 1,2; IC95%: 1,1-1,2). Las mujeres con mayor prevalencia de recién nacidos macrosómicos fueron de 35 años o más (OR = 1,1; IC95%: 1,1-1,1) y de 4 hijos o más (OR = 2,1; IC95%: 2,0-2,1). El peso insuficiente tuvo un comportamiento similar al bajo peso al nacer. En conclusión, los factores sociodemográficos y maternos influencian el peso al nacer de recién nacidos de mujeres colombianas.

In late pregnancy, fat-free mass was the most important maternal body component associated with birth weight. The implementation of longitudinal studies could shed more light on the influence of maternal body composition on birth weight.