The implications of Zika Virus exposure in pregnancy for early infant growth remains poorly described. The main goal of this study is to compare the growth, body composition, and feeding modality of infants in the first three months of life by prenatal Zika Virus exposure status. We selected an analytical cohort of 115 infants born without microcephaly, comprising 56 infants with qRT-PCR confirmed exposure to ZIKV during gestation and 59 infants born to women with presumptively no evidence of ZIKV in pregnancy. Infants were evaluated at birth, 1 and 3 months of age in terms of anthropometrics, body composition All the results were adjusted by maternal age, maternal BMI and gestational age. We observe no differences between anthropometric measurements at birth. Mothers in exposed group showed higher BMI. At 1 month and 3 months of age there were differences in mid arm circumference, arm muscle circumference and fat free mass. Weight and length was less in the ZIKV exposed in pregnancy infants and statistically different at 3 month of age. The findings of this investigation provide new evidence that ZIKV exposure in pregnancy may be associated with differences in body composition.
Background: To evaluate the potential factors associated with the nutritional composition of human milk of puerperal women. Methods: cross-sectional study, conducted between March 2016 and August 2017, with 107 women, selected in a Tertiary Health Care Tertiary Health Facility of the Unified Health System (SUS) in the Municipality of Rio de Janeiro. Data were collected two months after delivery. The dependent variable of the study was the nutritional composition of human milk. We divided the independent variables into hierarchical levels: distal (age, schooling, parity and pregestational nutritional status), intermediate (number of prenatal visits and gestational weight gain) and proximal (alcohol consumption, smoking, diabetes mellitus and hypertension). For data analysis, we applied the multiple linear regression, centered on the hierarchical model. Only the variables associated with the nutritional composition of breast milk remained in the final model at a 5% level of significance. Results: The nutritional composition of human milk yielded by women with pregestational overweight, smokers and hypertensive had higher amounts of lipids and energy. Conversely, women with gestational weight gain below the recommended had lower amounts of these components. Conclusion: The evaluation of factors associated with the nutritional composition of human milk is extremely important to assist post-partum care practices. In this study, we observed that lipid and energy contents were associated to pregestational nutritional status, gestational weight gain, smoking and hypertension.
Background
The association between gestational weight gain and neonatal body composition has been inconsistent, exposing the need for further research. The aim of this study was to evaluate whether gestational weight gain influences the body composition of full-term newborns and infants up to 4 months old.
Methods
A cohort study was performed with 124 participants divided into categories of gestational weight gain according to the 2009 Institute of Medicine guidelines. The anthropometric and body composition data of newborns and infants acquired using air displacement plethysmography (PeaPod®) were collected at 96 h, 1 month, 2 months and 4 months of life. In the statistical analysis, the chi-square test was used to analyze categorical variables, and ANOVA was used to analyze numerical variables. Univariate analysis was performed, and the absolute and relative frequencies of the categorical variables, as well as mean and standard deviation of the numerical variables, were obtained. Bivariate analysis was performed for the categories of gestational weight gain and gestational and neonatal characteristics. When adjustments to gestational hypertension, gestational diabetes, and pregestational body mass index (BMI) were analyzed by linear regression, gestational weight gain remained a significant variable for newborn percent fat mass. For all analyses, a significance level of 5% was adopted.
Results
Gestational weight gain was adequate in 33.8% of the participants, excessive in 41.1% and insufficient in 25%. Women with excessive weight gain had higher pregestational BMIs and a higher incidence of gestational hypertension. Their newborns had a higher body mass, body fat mass in grams and percent fat mass than the infants born to mothers with adequate or insufficient gestational weight gain. No significant differences were observed in body composition at 1, 2 and 4 months of life during infant follow-up.
Conclusion
Excessive gestational weight gain may alter the body composition of newborns at birth. Further studies are required to better evaluate infant follow-up.
Trial registration
Clinical Trial Registry:
NCT00875251
on April 3, 2009.
OBJECTIVE: To evaluate the implementation of the 2010 Centers for Disease Control and Prevention (CDC) guidelines by the obstetrics and neonatology teams of a tertiary public hospital located in Rio de Janeiro, Brazil. METHODS: This retrospective study included the medical records of pregnant women who underwent vaginal-rectal swabs at the hospital between Nov. 1, 2014 and Oct. 31, 2015. Of the 595 included swabs, 122 were positive for Group B Streptococcus (GBS). After excluding incomplete medical records, malformations, and women who delivered at other hospitals, 85 pregnant women with positive swabs and 92 newborns were included. RESULTS: The prevalence of maternal colonization was 20.5%. The time to vaginal/rectal swab collection ranged from 18 to 39 weeks of gestation, with a mean of 34.9 weeks. Thirty-three of the 85 included pregnant women (38.9%) were not properly managed, since in 19 cases delivery occurred within less than four hours of antibiotic administration, and in 14 prophylaxis was not initiated when indicated. Five of the 92 included newborns (5.4%) were not properly managed, mainly due to unnecessary screening for infection; screening was incomplete in one case, since blood culture was not ordered although the guidelines in effect required it. Of the 86 newborns with management considered adequate, 53 (61.6%) had mothers who were also adequately managed. Thirty-three (57.75%) of the newborns managed adequately had mothers submitted to inadequate obstetric management. CONCLUSIONS: Although the 2010 CDC guidelines for prevention of early sepsis by GBS has been implemented in the hospital, we have detected failures in maternal intrapartum prophylaxis and newborn assessment. Failure to adhere to the established guidelines yields missed opportunities to prevent early-onset GBS sepsis.
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