7 research outputs found

    Effect of supplementation of complex milk lipids in pregnancy on fetal growth: results from the Complex Lipids in Mothers and Babies (CLIMB) randomized controlled trial

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    Background: Gangliosides (GAs) are important for neuronal function and development of the brain, accumulating rapidly in the fetal brain during the last trimester of pregnancy. No study in humans has investigated whether maternal supplementation of GAs during pregnancy has an effect on fetal growth, particularly of the head circumference.Objective: To evaluate the effect of maternal dietary supplementation of complex milk lipids (CML; gangliosides and phospholipids) from the milk fat globule membrane (MFGM) during pregnancy on fetal growth.Design: Double-blind three-arm parallel randomized controlled trial of 1500 pregnant women from the Chongqing Municipality of China, recruited between 11 and 14 weeks of pregnancy. Intervention was in the form of supplementation with: control maternal milk formulation containing a minimum of 2 mg GA per serving (4 mg GA per day) versus a CML-enriched (CML-E) maternal milk formulation containing a minimum of 4 mg GA per serving (8 mg GA per day) versus no maternal milk supplementation, but with standard obstetric care including prenatal folic acid supplementation. Main outcomes and measures were ultrasonographically-derived estimates of fetal growth in head circumference (HC) & biparietal diameter (BPD) (primary outcomes); and abdominal circumference (AC), femur length (FL) and estimated fetal weight (EFW) (secondary outcomes) (Clinical trial registry: ChiCTR-IOR-16007700).Results: Supplementation with CML-E milk had no effects on size at midpregnancy or growth trajectories in any of the fetal biometric dimensions.Conclusions: Supplementation of CML from the MFGM from the end of the first trimester did not have any effects on fetal growth. The absence of any adverse growth outcomes suggests that maternal MFGM supplementation during pregnancy is safe and using CML-E milk formula can be a method of providing an increased GA and phospholipid supply in early life, which has been associated with neurodevelopmental benefits.Clinical trial registry: ChiCTR-IOR-16007700 (http://www.chictr.org.cn/enindex.aspx)</div

    Overview of recommendations.

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    1<p>For all symptoms of acute stress, a previous WHO GDG recommended Psychological First Aid as management strategy.</p>2<p>Strength of recommendations was evaluated in accordance with previous WHO mhGAP guidelines, which is based on GRADE (Grading of Recommendations Assessment, Development, and Evaluation) methodology (Barbui et al, 2010). A strong recommendation means that the guideline development group agreed that the quality of the evidence, combined with certainty about the values, preferences, benefits, and feasibility of this recommendation meant it should be followed in all or almost all circumstances. A standard recommendation means that there was less certainty about the combined quality of evidence and values, preferences, benefits, and feasibility of this recommendation; thus, there may be circumstances in which it will not apply.</p><p>SSRIs: selective serotonin reuptake inhibitors.</p><p>TCAs: tricyclic antidepressants.</p><p>Overview of recommendations.</p

    Epidemiological Data: Numbers of suspected ZIKV cases and suspected microcephaly cases per state and per epidemiological week.

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    Contains 1) CSV file with number suspected ZIKV cases from January 2015 to the end of December 2015; 2) CSV file with number of suspected microcephaly cases from January 2015 to the first week of January 2016. Numbers correspond to suspected microcephaly cases at week 20 of pregnancy; 3) CSV file with codes of state of residence and municipality of residence in Brazil; and 4) R scripts for correlation analysis described in SI Section 1.5

    Sequence data details and alignments for dataset A and B.

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    Contains (1) table with accession numbers, isolate names, cell passage history, publication details, country/location of sampling, sampling dates and (2) Fasta format sequence alignments of datasets A and B

    BEAST XML input file used for genetic analysis.

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    BEAST XML input file used to generate Figure 3 under a strict clock model, a Bayesian skyline coalescent prior and a CTMC prior on the clock rate
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