status and provision of good health care facilities also play a key role. Growth pattern in children with CP Cerebral palsy is a disorder of posture and movement. [15] These children grow poorly throughout their lives. [2,16,17] They have significantly lower mean height, [18-20] weight, [7,18-20] skinfold thickness, [7,19] and mid upper arm circumference (MUAC) [7,18] as compared to general population. Communitybased cross-sectional surveys in Philippines, [21] Nigeria, [22] Bangladesh, [15] and India [19] have also reported similar findings [Table 1]. Overweight and obesity have also been reported by various researches conducted mostly in developed countries [Table 2]. Prevalence of overweight found to vary from 2% in Nigeria [18] to 16% in Norway. [9] Overweight and obesity are more prevalent among spastic bilateral CP than spastic unilateral CP. [9] This could be because children with spastic unilateral CP are more mobile as compared to those with spastic bilateral CP, and they have less feeding problems due to which they have a greater chance of gaining weight. The objective of this work was to review the studies conducted among developing and developed countries to assess the growth pattern and nutritional status of children with cerebral palsy. It also aimed at summarizing the key factors responsible for high prevalence of undernutrition among them. Significant reductions in the anthropometric parameters were found in children with cerebral palsy as compared to their nondisabled counterparts. This deviation from normal growth can be attributed to inadequate dietary intake, feeding problems, decreased weight bearing, and several nonnutritional factors including abnormal endocrine function, socioeconomic status, disease severity, and age. Also, it was seen that undernutrition was more prevalent among developing countries as compared to developed countries. Besides undernutrition, various studies conducted among developed countries have reported a high prevalence of overweight and obesity among this population. This could be attributed to a decrease in the motor function because of the underlying condition and an increase in the gastrostomy feeding owing to availability of better health care facilities.
Aim: To estimate the prevalence of vitamin D deficiency in third trimester and itscorrelation with feto-maternal outcome Material and Methods: Present study was conducted 200 pregnant women who were admitted to the labor room in the third trimester in the department of Obstetrics & Gynecology of Maharishi Markandeshwar Medical College and Hospital, Solan (H.P.) for delivery after fulfilling the inclusion & exclusion criteria. Detailed history including complete demographic information, past medical history, dietary history, previous menstrual & obstetric history, any antenatal complications. Delivery details including mode of delivery, birth weight and APGAR scores were recorded on the proforma. Serum vitamin D was estimated fromthe maternal blood sample. Vitamin D deficiency was defined as 25(OH) D levels in blood less than 20 ng/ml, and insufficiency of vitamin D was defined as 25(OH) D levels between 20-30 ng/ml.Results: In this study, there was a high prevalence of vitamin D deficiency (93.5%) in the pregnant women though there was no significant difference in socio-demographic factors in the deficient and non-deficient group. Present study showed that the proportion of vitamin D deficient pregnant women having maternal complications and NICU admission was statistically significant as compared to the non-deficient group (p=0.0109) and (p=0.0384) respectively. Conclusion: Maternal complications, increased cesarean section rate and NICU admission weremore associated with hypovitaminosis D but any causal relationship between vitaminD deficiency and pregnancy complications was not found in this study design. Wepropose that vitamin D supplementation is simple and economical, and hence weshould incorporate vitamin D testing, increase its awareness and treat its deficiency inadolescence, pre-conceptional period or 1st trimester to avoid maternal complicationsand poor fetal outcome. Keywords: Vitamin D Deficiency, Third trimester, Fetal outcome, Maternal outcomex
INTRODUCTION: Obesity is a global health problem characterised as a pandemic issue by the World Health Organization (WHO), with a higher prevalence in females than males. During pregnancy, it is considered a high-risk state because it is associated with maternal complications like preeclampsia, gestational diabetes, obstetric interventions like caesarean delivery, postpartum haemorrhage; and fetal complications like macrosomia, poor apgar scores. BMI is a commonly used indicator which can be used to classify subjects on the basis of weight.AIM: This study aims to find the prevalence of normal weight, overweight and obese pregnant women defined by body mass index (BMI) according to the WHO classification and to study the associations between maternal BMI, the mode of delivery and neonatal outcome.MATERIAL AND METHODS: 200 pregnant women admitted for delivery in the department of Obstetrics & Gynaecology were studied, height and weight were recorded from reliable antenatal records (recorded within two months of gestation). The Body Mass Index was calculated and patients were divided into four categories: Category I: underweight; Category II: normal BMI; Category III: Overweight; Category IV: Obese. The feto-maternal outcomes were studied.RESULTS: On evaluation of 200 nulliparous antenatal women with singleton term gestation, 1.5% were underweight, 33% had normal BMI, 56% were overweight and 9.5% were obese. The prolongation of labour was seen in subjects with BMI more than 25 kg/m2. Overweight patients had more instrumental deliveries and obese patients had a higher tendency for prolonged labour and caesarean deliveries. Neonatal outcomes were poor for obese and overweight patients as compared to normal BMI because more neonates required resuscitation at birth, had low Apgar scores and were small for gestational age. Maternal complications like Hypothyroidism, preeclampsia and gestational diabetes occurred more commonly in the obese category.CONCLUSION: In our institution, majority of patients were found to be overweight. Adverse perinatal outcomes were seen more often in the obese patients. Hence, obesity must be identified as a risk factor for adverse pregnancy outcomes.
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