Generating Personalized Pregnancy Nutrition Recommendations with GPT-Powered AI Chatbot. In: 20th International Conference on Information Systems for Crisis Response and Management

Low socioeconomic status (SES) and inadequate nutrition during pregnancy are linked to health disparities and adverse outcomes, including an increased risk of preterm birth, low birth weight, and intrauterine growth restriction. AI-powered computational agents have enormous potential to address this challenge by providing nutrition guidelines or advice to patients with different health literacy and demographics. This paper presents our preliminary exploration of creating a GPT-powered AI chatbot called NutritionBot and investigates the implications for pregnancy nutrition recommendations. We used a user-centered design approach to define the target user persona and collaborated with medical professionals to co-design the chatbot. We integrated our proposed chatbot with ChatGPT to generate pregnancy nutrition recommendations tailored to patients’ lifestyles. Our contributions include introducing a design persona of a pregnant woman from an underserved population, co-designing a nutrition advice chatbot with healthcare experts, and sharing design implications for future GPT-based nutrition chatbots based on our preliminary findings

Quantifying Breast Milk Retinol Inadequacy and the Impact on Neonatal Outcomes in a Midwestern United States Population of Postpartum Women

Background: Low serum antioxidant concentrations at birth can lead to oxidative stress, bronchopulmonary dysplasia, retinopathy, and necrotizing colitis in infants. Specifically, low retinol (Vitamin A1) levels can cause night blindness and impaired immune system function. Retinol inadequacy is a well-documented nutritional issue in developing countries. According to World Health Organization survey data, low Vitamin A serum levels (less than 300 mcg/L) impact approximately one third of pre-school aged children and more than 15% of pregnant woman in at-risk populations. However, there is a lack of understanding about the prevalence of breast milk retinol inadequacy in developed countries. For vitamin A deficiency to constitute a moderate public health problem by WHO biochemical standards, population retinol must reach between 10-25% for breast milk inadequacy or 10-20% for maternal serum deficiency. Objective: The purpose of this study is to quantify the prevalence of breast milk retinol adequacy (greater than 300 mcg/L), insufficiency (between 200 – 300 mcg/L) and deficiency (less than 200 mcg/L) in a Midwestern United States population of postpartum women. A secondary aim is to identify the relationship amongst breast milk retinol concentrations and birth outcomes. Experimental Design: An IRB approved study enrolled 24 infant-mother pairs. Data analysis was performed on subjects with breast milk nutrient analyses available. Descriptive statistics were run for all variables, including maternal retinol activity equivalents. Spearman correlation coefficients were used to assess the relationship between maternal blood retinol and breast milk retinol, cord blood retinol and breast milk retinol, and breast milk retinol and birth outcomes. Median corrected gestational age statistics and breast milk retinol levels were compared amongst maternal serum retinol groups. Results: In our population of postpartum mothers, only 56% of participants had breast milk retinol adequacy, with 36.4% of participants achieving maternal serum retinol adequacy. Retinol category results are summed up in Table 1. Median maternal retinol activity equivalents was 1740 mcg/L (range=651mcg/L - 3436mcg/L). There was no significant correlation between maternal serum retinol level and breast milk retinol levels (R=0.24, p=0.915). Additionally, there was no significant correlation between maternal retinol activity equivalents and maternal serum retinol level (R=.008, p=0.973) or breast milk retinol level (R=-.192, p=0.381). There was a significant negative correlation between breast milk retinol level and the number of oxygen therapy days during infant admission (R=-0.483, p=0.017). Conclusion: Based on these results, breast milk and maternal serum retinol inadequacies may constitute a serious and moderate public health problem, respectively, for postpartum mothers in the Midwestern United States. These results suggest that breast milk retinol adequacy promotes healthy lung development in neonates. Further, breast milk retinol levels may be independent of maternal serum retinol levels and maternal retinol activity equivalents. Limitations of this study include a small sample size of mothers whose preterm skewed infants were all admitted to the NICU. Future studies should focus on replicating these results with a larger heterogenous sample size.https://digitalcommons.unmc.edu/surp2020/1020/thumbnail.jp

Differences in Maternal and Infant Cord Blood Vitamin D Between Racial/Ethnic Groups

Background: Vitamin D deficiency associated with lower 25-hydroxyvitamin D (25(OH)D) concentration is common among individuals with more melanin pigmentation. Low 25(OH)D levels in pregnant women may be related to increased risk of low birth weight and preterm delivery. Still, few studies have assessed how serum levels of 25(OH)D vary between maternal and infant race/ethnicity. Objective: This study aimed to investigate the relationship between 25(OH)D levels in maternal blood and infant cord blood within certain ethnic groups, prematurity status, and low birth weight. Experimental Design:An IRB-approved study enrolled 86 mother-infant pairs. Maternal blood samples and infant cord blood samples were analyzed for 25(OH)D serum levels. Descriptive statistics and Kruskal-Willis tests comparisons were conducted with the use of IBM SPSS Statistics 28 software to assess the relationship between maternal and cord blood 25(OH)D levels in other race/ethnicity groups, birthweight, and preterm birth. Prematurity was categorized into two groups: premature (weeks) and term (≥37 weeks). Birth weight was categorized into two groups: low birth weight (\u3c 2500 g weeks) and not low birth weight (≥2500 g weeks). A p-value of Results:Median levels of 25(OH)D serum were lower in infant’s cord blood (22.52 ng/mL) than maternal blood (38.06 ng/mL). White participants had significantly higher 25(OH)D levels than African American participants in both maternal blood (40.76 ng/mL vs 27.79, p = Conclusion: Our findings suggest a possible association with lower serum 25-hydroxyvitamin D concentration in darker skin pigmentation, even in a small sample size. These results suggest that prematurity and birth weight should be replicated in larger sample sizes of different Race/Ethnic groups, limiting this finding. Further studies should focus on examining differences with larger and more diverse sample sizes. Such research should include measuring Vitamin D intake in pregnancy and clinical outcomes.https://digitalcommons.unmc.edu/surp2021/1008/thumbnail.jp

The impact of iron supplementation on the preterm neonatal gut microbiome: A pilot study.

ObjectiveThe gastrointestinal microbiome in preterm infants exhibits significant influence on optimal outcomes-with dysbiosis shown to substantially increase the risk of the life-threatening necrotizing enterocolitis. Iron is a vital nutrient especially during the perinatal window of rapid hemoglobin production, tissue growth, and foundational neurodevelopment. However, excess colonic iron exhibits potent oxidation capacity and alters the gut microbiome-potentially facilitating the proliferation of pathological bacterial strains. Breastfed preterm infants routinely receive iron supplementation starting 14 days after delivery and are highly vulnerable to morbidities associated with gastrointestinal dysbiosis. Therefore, we set out to determine if routine iron supplementation alters the preterm gut microbiome.MethodsAfter IRB approval, we collected stool specimens from 14 infants born ResultsWe observed no significant differences in either phyla or key genera relative abundance between pre- and post-iron timepoints. We observed notable shifts in infant microbiome composition based on season of delivery.ConclusionThough no obvious indication of iron-induced dysbiosis was observed in this unique study in the setting of prematurity, further investigation in a larger sample is warranted to fully understand iron's impact on the gastrointestinal milieu