Effect of Dietary Diversity on the Nutritional Status in Pregnant Women and in Turn its Effect on Birth Weight of the Baby

Background: Nutrient intake is important to the well-being of pregnant women and the fetus. Most of the previous studies points nutrition status based on energy and protein intake. However there are few studies indicate the use of dietary diversity as a marker of assessing the nutrition status. Healthy diets include the most diverse foods, and balance in eating food provides maternal and fetal health and reduces the prevalence of Low birthweight. Objectives: The objectives of the present study are to find out the association between Dietary diversity score with the nutrition status of the Pregnant Women (Gestational weight gain and nutritional anaemia.) And to find out the effects of gestational weight gain and nutritional anemia on the birth weight of the baby. Methods: An Institutional ethical clearance was obtained and the present Hospital based study was carried out in the OBG department of tertiary care centre of North Karnataka between December 2019 to February 2020. Sample size was estimated to be 120. Results: In the present study, a total of 120 women participated in the study. The Mean age of the study participants was 25.2±3.4, and the study found mean DDS was 7.04±1.58, with the scores ranging from 3 to 12. Association between the Dietary diversity score (DDS) and birthweight of the baby was found to be statistically significant (p=0.03) There is a statistically significant difference in DDS mean score between anaemic and normal pregnant women (p=0.007). There was a statistically significant positive correlation between Gestational weight gain and birth weight of the baby (p=0.03). There were positive correlation between the DDS and the Birthweight and Gestational weight gain, though it was statistically non-significant. Conclusion: Nutrition education for pregnant women should include the facts about the different food groups, it advantages will help to include diverse food items in their diet. Keywords: Dietary diversity score, Gestational weight gain, Birth weigh

Misoprostol for primary versus secondary prevention of postpartum haemorrhage: A cluster-randomised non-inferiority community trial

© 2015 RCOG. Objective: To assess whether secondary prevention, which preemptively treats women with above-average postpartum bleeding, is non-inferior to universal prophylaxis. Design: A cluster-randomised non-inferiority community trial. Setting: Healt

Re: The association of viral infection and chronic allograft nephropathy with graft dysfunction after renal transplantation [3] (multiple letters)

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Misoprostol for primary versus secondary prevention of postpartum haemorrhage: a cluster‐randomised non‐inferiority community trial

OBJECTIVE: To assess whether secondary prevention, which preemptively treats women with above‐average postpartum bleeding, is non‐inferior to universal prophylaxis. DESIGN: A cluster‐randomised non‐inferiority community trial. SETTING: Health sub‐centres and home deliveries in the Bijapur district of Karnataka, India. POPULATION: Women with low‐risk pregnancies who were eligible for delivery with an Auxiliary Nurse Midwife at home or sub‐centre and who consented to be part of the study. METHODS: Auxiliary Nurse Midwifes were randomised to secondary prevention using 800 mcg sublingual misoprostol administered to women with postpartum blood loss ≥350 ml or to universal prophylaxis using 600 mcg oral misoprostol administered to all women during the third stage of labour. MAIN OUTCOME MEASURES: Postpartum haemoglobin ≤7.8 g/dl, mean postpartum blood loss and postpartum haemoglobin, postpartum haemorrhage rate, transfer to higher‐level facilities, acceptability and feasibility of the intervention. RESULTS: Misoprostol was administered to 99.7% of women as primary prevention. In secondary prevention, 92 (4.7%) women had postpartum bleeding ≥350 ml, of which 90 (97.8%) received misoprostol. The proportion of women with postpartum haemoglobin ≤7.8 g/dl was 5.9 and 8.8% in secondary and primary prevention clusters, respectively [difference −2.9%, one‐sided 95% confidence interval (CI) <1.3%]. Postpartum transfer and haemorrhage rates were low (<1%) in both groups. Shivering was more common in primary prevention clusters (P = 0.013). CONCLUSION: Secondary prevention of postpartum haemorrhage with misoprostol is non‐inferior to universal prophylaxis based on the primary outcome of postpartum haemoglobin. Secondary prevention could be a good alternative to universal prophylaxis as it medicates fewer women and is an acceptable and feasible strategy at the community level. TWEETABLE ABSTRACT: Secondary prevention of postpartum haemorrhage with misoprostol is non‐inferior to universal prophylaxis