Association of Maternal Obesity and Pregnancy Outcomes

Background: The prevalence of obesity is increasing globally, causing various possible disorders and complications. Maternal and perinatal morbidity and mortality might potentially be affected by maternal obesity. This study aimed to evaluate the association between maternal obesity and pregnancy outcomes.Methods: This retrospective cohort study was part of a larger cohort study performed from July 2016 to July 2017 in West Java, including 223 pregnant women with normal fetuses, who were obese or non-obese pre-pregnancy. Underweight women were excluded. Data on pregnancy outcomes consisting of Caesarean section, preeclampsia, premature rupture of membrane (PROM), preterm birth, post-term birth, small for gestational age (SGA), and large for gestational age (LGA) were collected. The association with maternal obesity was analyzed using the Fisher’s Exact Test to determine the association with a 95% confidence interval, and a p-value <0.05 was considered significant.Results: There was an association between maternal obesity and Caesarean section, with an increased risk in obese mothers compared to non-obese mothers (RR 2.398 CI 1.328-4.329). There was no significant association between maternal obesity and preeclampsia, PROM, preterm birth, post-term birth, SGA, and LGA.Conclusion: Maternal obesity is associated with Caesarean section. A more comprehensive approach is essential for obese pregnant women to ensure the health of both the mother and the infant

Prevalence of Urinary Incontinence in Women aged 20–59 years in Community Dwellings

Background: Urinary incontinene (UI) is the symptomof involuntary leakage of urine. Three types of urinary incontinence are stress UI, urge UI, and mixed UI. This study was aimed to determine the prevalence of urinary UI in women and to identify the most common type of UI.Methods: A descriptive study was conducted to 191 women age 20–59 in two villages in West Java, Indonesia. Subjects were visited door-to-door and interviewed using a standardized questionnaire for data collection. The study was conducted in February 2014. The variables of this study were age, parity, and the prevalence of urinary incontinence. The collected data were presented using frequency tabulation and percentage.Results: From 191 respondents, thirty eight subjects had UI. The prevalence of urinary incontinence was 19.90% which consisted of prevalence of stress UI (7.33%), urgency UI (9.43%), and mixed UI (3.14%). The prevalence of UI in 20–29 year age group was 3.23%, 30–39 year age group was 9.72%, 40–49 year age group was 27.69%, and 50–59 year age group was 52.17%. Prevalence of UI in nulliparous women was 5%, primiparous was 10.25%, multiparous with 2 childbirths was 23.61%, and multiparous with 3 childbirths or more was 26.67%.Conclusions: Prevalence of UI in women in community dwelling is 19.90%, which is higher than previous study from Indonesia and other Asian countries. Urgency UI is the most common type of UI. Prevalence of UI increases with age and parity. DOI: 10.15850/amj.v4n2.107

Relationship between Maternal Vitamin D Level and Small for Gestational Age Infant in West Java, Indonesia

Small for gestational age (SGA) infants is one of the unfavorable outcomes of pregnancy that needs to be prevented. There are not many studies available on the association of maternal vitamin D levels during pregnancy and SGA infants. This study aimed to discover the association between maternal vitamin D level and SGA infants in West Java. A cohort study was performed from February 2018 to January 2019 by recruiting 304 pregnant women in Bandung, Cimahi, Waled, and Sukabumi, West Java Province, Indonesia. Of that number, 203 women were followed until the delivery date. Data were collected from the results of serial ultrasonography examinations and maternal vitamin D level measurements. Bivariate analysis and logistic regression were then performed to determine the relationship between variables. This study showed that 30 of 203 (14.78%) infants were born as SGA infants. The mothers of these SGA infants had a lower maternal vitamin D level at the beginning of the second trimester and smaller anthropometric measurements at the beginning of the third trimester. However, no significant difference was found between normal infants and SGA infants when the overall values for all trimesters were compared. It can be inferred that the maternal vitamin D level has a negative relationship with SGA infants in West Java, Indonesia. Further studies are required to prove the relationship between maternal vitamin Dl level and SGA infants.Hubungan Kadar Vitamin D Ibu dan Bayi Kecil Masa Kehamilan di Jawa BaratBayi kecil masa kehamilan (KMK) adalah luaran kehamilan yang perlu dicegah. Informasi tentang hubungan kadar vitamin D ibu dengan kejadian bayi KMK di Indonesia masih terbatas. Kadar vitamin D dan karakteristik ibu diduga berpengaruh dalam kejadian bayi KMK. Tujuan penelitian ini adalah mengetahui hubungan kadar vitamin D ibu dengan kejadian KMK pada bayi. Studi kohort dilakukan dari Februari 2018 hingga Januari 2019 dengan merekrut 304 ibu hamil di Bandung, Cimahi, Waled, dan Sukabumi, Provinsi Jawa Barat, Indonesia.  Dari jumlah 203 orang diantaranya berhasil diikuti sejak trimester satu hingga persalinan dan terpilih menjadi  subjek penelitian kasus kontrol. Pemeriksaan ultrasonografi, kadar vitamin D dan hemoglobin ibu dilakukan serial tiap trimester. Dilakukan analisis bivariat dan regresi logistik untuk menentukan hubungan antar variabel yang diteliti. Dari penelitian ini didapatkan sebanyak 30 dari 203 (14,78%) persalinan  dengan luaran bayi KMK.  Bayi KMK cenderung  mempunyai riwayat kadar vitamin  D yang lebih rendah pada awal trimester kedua dan hasil antropometri yang lebih rendah pada awal trimester tiga, namun secara statistik tidak berbeda signifikan. Simpulan penelitian ini bahwa kadar vitamin D ibu hamil memiliki korelasi negatif dengan bayi KMK. Penelitian lebih lanjut diperlukan untuk membuktikan hubungan antara kadar vitamin D ibu dan bayi KMK.

Relationship between Maternal Vitamin D Level and Small for Gestational Age Infant in West Java, Indonesia

Small for gestational age (SGA) infants is one of the unfavorable outcomes of pregnancy that needs to be prevented. There are not many studies available on the association of maternal vitamin D levels during pregnancy and SGA infants. This study aimed to discover the association between maternal vitamin D level and SGA infants in West Java. A cohort study was performed from February 2018 to January 2019 by recruiting 304 pregnant women in Bandung, Cimahi, Waled, and Sukabumi, West Java Province, Indonesia. Of that number, 203 women were followed until the delivery date. Data were collected from the results of serial ultrasonography examinations and maternal vitamin D level measurements. Bivariate analysis and logistic regression were then performed to determine the relationship between variables. This study showed that 30 of 203 (14.78%) infants were born as SGA infants. The mothers of these SGA infants had a lower maternal vitamin D level at the beginning of the second trimester and smaller anthropometric measurements at the beginning of the third trimester. However, no significant difference was found between normal infants and SGA infants when the overall values for all trimesters were compared. It can be inferred that the maternal vitamin D level has a negative relationship with SGA infants in West Java, Indonesia. Further studies are required to prove the relationship between maternal vitamin Dl level and SGA infants.Hubungan Kadar Vitamin D Ibu dan Bayi Kecil Masa Kehamilan di Jawa BaratBayi kecil masa kehamilan (KMK) adalah luaran kehamilan yang perlu dicegah. Informasi tentang hubungan kadar vitamin D ibu dengan kejadian bayi KMK di Indonesia masih terbatas. Kadar vitamin D dan karakteristik ibu diduga berpengaruh dalam kejadian bayi KMK. Tujuan penelitian ini adalah mengetahui hubungan kadar vitamin D ibu dengan kejadian KMK pada bayi. Studi kohort dilakukan dari Februari 2018 hingga Januari 2019 dengan merekrut 304 ibu hamil di Bandung, Cimahi, Waled, dan Sukabumi, Provinsi Jawa Barat, Indonesia.  Dari jumlah 203 orang diantaranya berhasil diikuti sejak trimester satu hingga persalinan dan terpilih menjadi  subjek penelitian kasus kontrol. Pemeriksaan ultrasonografi, kadar vitamin D dan hemoglobin ibu dilakukan serial tiap trimester. Dilakukan analisis bivariat dan regresi logistik untuk menentukan hubungan antar variabel yang diteliti. Dari penelitian ini didapatkan sebanyak 30 dari 203 (14,78%) persalinan  dengan luaran bayi KMK.  Bayi KMK cenderung  mempunyai riwayat kadar vitamin  D yang lebih rendah pada awal trimester kedua dan hasil antropometri yang lebih rendah pada awal trimester tiga, namun secara statistik tidak berbeda signifikan. Simpulan penelitian ini bahwa kadar vitamin D ibu hamil memiliki korelasi negatif dengan bayi KMK. Penelitian lebih lanjut diperlukan untuk membuktikan hubungan antara kadar vitamin D ibu dan bayi KMK.

Updates on the Status of Vitamin D as a Risk Factor for Respiratory Distress Syndrome

To update the guidelines regarding vitamin D status in respiratory distress syndrome, we reviewed recent human and animal studies on the benefits of vitamin D in respiratory distress. We searched PubMed and ProQuest for studies on the use of vitamin D from 2009 to 2017. The common parameters in these studies included the use of lung tissue, phospholipids, blood, and plasma to assess the effects of vitamin D on respiratory syndrome. The metabolized form of vitamin D used in these studies was 1,25(OH)2D3 in animal studies and 25(OH)D in human studies. Vitamin D supplementation decreases the risk of respiratory distress syndrome, improves the quality of life, and is relatively effective and safe for preterm neonates as well as during lung maturation. However, although vitamin D supplementation may offer benefits for respiratory distress syndrome, the optimal dosing strategies for specific types of risk factors in the lungs must be clarified to confirm the therapeutic efficacy

Asuhan kebidanan nifas dan menyusui

xix, 247 hlm. : ilus. ; tab. ; 24 cm

Correlation between Cord Blood Vitamin D Levels and Problem-Solving Neurodevelopment in Early Childhood: A Cohort Study in Rural Indonesia

Vitamin D influence on brain development and subsequent postnatal neurodevelopment remains controversial. We explored the correlation between cord blood vitamin D levels and longitudinal neurodevelopment in early childhood. A cohort study was conducted on term infants with no congenital abnormalities, born from pregnant women from a cohort study. Cord blood samples were collected to measure vitamin D. Neurodevelopment was examined three times in infants aged 6, 12 and 24 months using the Ages and Stages Questionnaire-3, which comprises 30 questions of five developmental domains: gross motor, fine motor, communication, problem-solving and social–personal. Statistical analysis was conducted with Spearman’s rank correlation and multiple linear regression. Of the 141 babies born from previous cohort studies, only 116 participants were included. The mean level of cord blood vitamin D was 16.2 ng/mL. The percentage participants with vitamin D deficiency and insufficiency were 12.9 and 65.5, respectively. Cord blood vitamin D and the problem-solving domain for infant aged 12 and 24 months were correlated (r = 0.217 and 0.414, respectively). Multiple linear regression showed a decreased problem-solving domain score of 0.641 associated with decreased vitamin D levels. In conclusion, cord blood vitamin D levels correlated with infant neurodevelopmental status

Hematological Parameters after One Week of Life among Premature Neonates

Background: Hematological parameters can reflect potential morbidity in premature neonates. Complete blood count (CBC) is a common laboratory examination in neonatal wards, including hematological parameters. Changes may occur during the neonatal period due to gestational age (GA)-related physiological mechanisms. The purpose of this study was to examine CBC in premature neonates at birth and in the first week of life.Methods: This prospective study was performed in the neonatal ward of a general hospital in Bandung, Indonesia. A total of 53 premature neonates, including 31 males and 22 females, classified as G1 (with 28-31 weeks of gestation) and G2 (with 32-34 weeks of gestation), were examined for CBC. The sequential blood samples of both cord blood at birth and peripheral venous blood in the first week of life (i.e., days 2-7) were drawn. The obtained data were analyzed based on the GA at birth and in the first week of life. The CBC at birth and in the first week of life were also compared.Results: At birth, younger premature neonates (i.e., G1 group) showed lower platelet counts, compared to the older ones (i.e., G2 group). In the first week of life, the G1 group showed significantly lower platelet counts and eosinophil counts, compared to the G2 group. Both groups demonstrated a significant decrease in hemoglobin, leukocytes, basophils, and neutrophils, but increased platelet counts in the first week of life.Conclusion: Younger premature neonates indicated lower hematological parameters at birth and in the first week of life. All the premature neonates showed a significant reduction in most hematological parameters in the first week of life

The Effect of Menopause Counseling by Counselor Midwives on Attitude and Reduction of Menopause Symptoms in Menopausal Mothers

Eighty percent (80%) of women complaint headache, sexual problem, tachycardia, hot flushes and insomnia, that are significantly decrease the quality of life. Objective of the research is to analyze how much the effect of menopause counseling from counselor midwife towards the attitude of menopause women and reduction of the symptoms. The study is quasi experiment with pre and post design. The samples were 40 respondents that were divided into two groups; 20 respondents were in intervention group who were given counseling from counselor midwife and 20 respondents were in control group that were given counseling from non counselor midwife. In each group counseling was given twice at intervals of 2 weeks, long counseling per client requirements. Measurement posttest mother's attitude menopause and the symptoms of menopause mother performed 4 weeks after the pretest. The instruments employed were MAMES (Multi-dimensional Attitudes Menopause Scale) questionnaire for measuring the attitude of menopause women and MRS (Menopause Rating Scale) questionnaire for measuring the symptoms experienced by menopause women. Non parametric and RR value were performed for statistical test. The result of study indicated that the attitude, the mother menopause who did not receive counseling by a midwife counselor, the risk of having a negative attitude 7 times compared with mothers who received counseling by a midwife counselor (RR 7.0). While menopause mothers who did not receive counseling by a midwife counselor, 2.5 times the risk of having symptoms degree rise or stay when compared with mothers who received counseling by a midwife counselor (RR 2.5). Based on the study, it was concluded that there was effect of counseling from counselor midwife towards the improvement of attitude of menopause women and decrease of menopausal symptoms

Exploring alternative cytokines as potential biomarkers for latent tuberculosis infection in pregnant women.

BackgroundInterferon gamma release assays (IGRAs) are widely used to determine latent tuberculosis infection status. However, its pregnancy-affected performance and cost-expensive nature warrants for different alternatives for pregnant women. This study aims to evaluate the diagnostic performance of several alternative cytokines, including interleukin 2 (IL-2), interleukin 10 (IL-10), and interferon gamma-induced protein 10 (IP-10) to identify latent tuberculosis status in pregnant women.Materials and methods123 pregnant womens were recruited for this study. The IGRA status was determined by using QuantiFERON Gold In-Tube. Meanwhile, we measured the level IL-2, IL-10, and IP-10 by using sandwich-microELISA method. We performed normality and comparison test by SPSS. In addition, receiver-operator characteristic (ROC) analyses and the optimal cutoff scores were identified using the EasyROC webtool.ResultsWe showed that IL-2, IL-10, and IP-10 were able to discriminate between IGRA-negative and IGRA-positive pregnant women. Moreover, IP-10 showed the highest discriminatory and diagnostic performance when compared to IL-2 and IL-10 with area under the curve (AUC) of 0.96 and cutoff point of 649.65 pg/mL.ConclusionsOur study showed that IP-10 can be considered as a promising alternative biomarker for IGRAs to diagnose LTBI in pregnant women