1,721,008 research outputs found
Why are rural Indian women so thin? Findings from a village in Maharashtra
Get PDFObjective: To identify social, behavioural and cultural factors that explain the thinness of young women relative to their men in rural Maharashtra, India.Design: Twelve focus group discussions were conducted to explore the villagers' understanding of why women in their area might be thinner than men.Setting: Pabal village and surrounding hamlets, in the Pune district of Maharashtra, India.Subjects: Samples of young mothers and fathers, grandmothers and grandfathers were selected from families in the village with children below 10 years of age.Results: Four factors were identified that the villagers felt contributed to the disparity in thinness. First, marriage isolated girls from their own families and villages, and brought the expectation of early motherhood. Young brides were often unable to relax and eat adequately. Second, marriage increased the workload of young women. They were expected to do the heaviest household chores as well as farm work in this predominantly agricultural community. Third, women had no financial autonomy or freedom of movement, and were therefore denied access to supplementary food sources available to men. Fourth, young women felt responsible for their household's health and success. They were encouraged to fast regularly to ensure this. Despite feeling responsible, young women had no control over factors that might affect the household's well being. This made them anxious and worried a great deal of the time.Conclusions: Interventions to improve the nutritional status of young women in this region need to recognise the roles and responsibilities taken up by young bride
Contribution of the umbilical cord and membranes to untrimmed placental weight
No full textThe extent of placental trimming before weighing varies within and between obstetric units. Quantification of the contribution of the umbilical cord and membranes to placental weight is required to enable measurements to be compared across populations. In a sample of 50 neonates born in Southampton, placentae of liveborn singletons were weighed three times; after removing any obvious blood clots, after cutting the umbilical cord, and after stripping both the foetal and maternal membranes.The correlation between untrimmed and trimmed placental weight was 0.98. Since the combined weight of the cord and membranes increased with increasing trimmed weight (correlation=0.54), the percentage rather than absolute difference between untrimmed and trimmed weight was calculated. The median difference between untrimmed and trimmed weight was 16 per cent. No association was found between the percentage difference and infant sex, duration of gestation, birthweight, maternal age, labour onset and duration, and presentation at delivery. However, the mode of delivery had a significant effect on this difference; medians for vaginal and Caesarean section deliveries were 19 per cent and 14 per cent respectively
Association between maternal vitamin D status during pregnancy and offspring cognitive function during childhood and adolescence
No full textBackground: Animal studies have demonstrated poor cognitive outcomes in offspring in relation to maternal vitamin D deficiency before and/or during pregnancy. Human studies linking maternal vitamin D status during pregnancy with offspring cognitive function are limited. We aimed to test the hypothesis that lower maternal vitamin D status during pregnancy is associated with poor offspring cognitive ability in an Indian population.Methods: Cognitive function was assessed in children from the Mysore Parthenon birth cohort during childhood (age 9-10 years; n=468) and adolescence (age 13-14 years; n=472) using 3 core tests from the Kaufman Assessment Battery for children and additional tests measuring learning, long-term retrieval/storage, short-term memory, reasoning, verbal fluency, visuo-spatial ability, and attention and concentration. Maternal serum 25-hydroxyvitamin D concentration was measured at 30±2 weeks of gestation. Results: During pregnancy 320 (68%) women had ‘vitamin D deficiency’ (serum 25-hydroxyvitamin D concentration <50 nmol/L). Girls scored better than boys in tests of short-term memory, reasoning, verbal fluency, and attention (p<0.05 for all). Maternal vitamin D status (low as well as across the entire range) was unrelated to offspring cognitive function at both ages, either unadjusted or after adjustment for the child’s current age, sex, maternal age, parity, season at the time of blood sampling, gestational age, the child’s birth and current size, socio-economic status, parents’ education, maternal intelligence and home environment.Conclusions: In this population, despite a high prevalence of vitamin D deficiency during pregnancy, there was no evidence of an association between maternal vitamin D status and offspring cognitive function.<br/
Truncal Adiposity is Present at Birth and in Early Childhood in South Indian Children
No full textObjectives: muscle-thin but adipose (‘thin-fat’) body composition of south Asian adults contributes to their high risk of type 2 diabetes. Studies in Pune, India showed that this phenotype is present at birth. We aimed to determine if south Indian babies have a ‘thin-fat’ phenotype and if this persists in childhood. Design: prospective cohort study. Setting: Holdsworth Memorial Hospital, Mysore, India Subjects: children (n = 663) whose mothers were recruited from the antenatal clinics. Methods: weight, length, head, mid-upper-arm, abdominal circumferences; triceps and subscapular skinfolds were measured at birth, one and four years, and compared with white Caucasian babies born in Southampton, UK (birth), and UK and Dutch growth standards (one and four years). Results: Mysore babies were lighter (2983g vs 3472 g; –1.10 SD, CI –1.16, –1.02) and smaller in all body measurements than UK neonates (P<0.001). The deficit was greatest for mid-upper- arm (–1.07 SD), head (-0.89 SD) and abdominal circumferences (–0.73 SD), and least for length (–0.25 SD) and subscapular skinfold thickness (–0.19 SD). Predictors of skinfold thickness were maternal body mass index (P<0.001) and socio-economic status (P = 0.05). At four years, subscapular skinfold thickness was larger than UK (+0.18 SD, CI +0.11, +0.25; P<0.001) and Dutch standards (+0.61 SD, CI +0.51, +0.71; P<0.001), despite all other body measurements remaining smaller. Predictors of 4-year skinfold thickness were neonatal skinfold thickness (P = 0.001) and maternal insulin concentrations (P = 0.05). Conclusions: Mysore newborns have a ‘thin-fat’ phenotype. This may reflect the action of genes and/or the ‘maternal environment’. The phenotype persists in childhood, and may be the forerunner of a diabetogenic adult phenotype
Growth hormone predicts bone density in elderly women
No full textEvidence is accumulating that the risk of osteoporosis may be influenced by environmental factors during intrauterine and early postnatal life; such programming might be mediated through modification of the GH/IGF-1 axis during critical periods in its development. To address this issue, we explored the relationships among birth weight, circulating GH profile, bone density, and bone loss rate in a group of British women. The study population consisted of 38 women 60–75 years old resident in Hertfordshire for whom detailed birth records were available. Twenty-four-hour circulating GH profiles were obtained during an inpatient stay on a metabolic ward, after an overnight rest. The circulating profile of GH was characterised by estimating the peak, median, trough, and total concentrations from 72 samples measured sequentially over 24 h in each subject. Bone mineral density was assessed at the lumbar spine and femoral neck at baseline and at follow-up 4 years later. Lumbar spine bone mineral content (BMC) and density (BMD) were positively associated with all measures of GH concentration, although relationships were strongest for BMC with trough GH (r = 0.47, P < 0.01). Associations persisted after adjustment for age, body mass index, smoking, alcohol consumption, physical activity, and osteoarthritis score in multiple regression models. However, associations of GH concentration with femoral neck BMC were weak, and there was no association between any measure of GH concentration and bone loss at either site. Total (integrated) daily GH concentration tended to increase (P = 0.08) with rising birth weight, while IGF-1 concentration fell (P = 0.05) with rising birth weight, suggesting a role for the GH/IGF-1 axis in the programming of adult bone mass among women
Patterns of fetal growth in a rural Indian cohort and a comparison with a western European population: data from the Pune Maternal Nutrition Study
No full textThe purpose of this study was to describe fetal size on sonography in a rural Indian population and compare it with those in European and urban Indian populations. Methods. Participants were from the Pune Maternal Nutrition Study of India. Fetal growth curves were constructed from serial ultrasound scans at approximately 18, 30, and 36 weeks’ gestation in 653 singleton pregnancies. Measurements included femur length (FL), abdominal circumference (AC), biparietal diameter (BPD), and occipitofrontal diameter, from which head circumference (HC) was estimated. Measurements were compared with data from a large population-based study in France and a study of urban mothers in Vellore, south India. Results. Fetal AC and BPD were smaller than the French reference at 18 weeks’ gestation (–1.38 and –1.30 SD, respectively), whereas FL and HC were more comparable (–0.77 and –0.59 SD). The deficit remained similar at 36 weeks for AC (–0.97 SD), FL (–0.43 SD), and HC (–0.52 SD) and increased for BPD (–2.3 SD). Sonography at 18 weeks underestimated gestational age compared with the last menstrual period date by a median of –1.4 (interquartile range, –4.6, 1.8) days. The Pune fetuses were smaller, even at the first scan, than the urban Vellore sample. Conclusions. Fetal size was smaller in a rural Indian population than in European and urban Indian populations, even in mid pregnancy. The deficit varied for different fetal measurements; it was greatest for AC and BPD and least for FL and H
Growth in utero and cognitive function in adult life: follow up study of people born between 1920 and 1943
No full textOBJECTIVES--To examine the relation between fetal growth and cognitive function in adult life. DESIGN--A follow up study of men and women whose birth weights and other measurements of body size had been recorded at birth. SETTING--Hertfordshire, Preston, and Sheffield. SUBJECTS--1576 men and women born in Hertfordshire, Sheffield, or Preston between 1920 and 1943. MAIN OUTCOME MEASURES--Intelligence quotient as measured by the AH4 test and amount of decline in cognitive function with age as estimated by the difference between score on the Mill Hill vocabulary test and score on the AH4 test. RESULTS--Score on the intelligence test was higher in people who had a large biparietal head diameter at birth, but it was not related to any other measure of body size or proportions. No association was found between decline in cognitive function and any measure of size or proportions at birth. CONCLUSION--Impaired fetal growth was not associated with poorer cognitive performance in adult life. Adaptations made by the fetus in response to conditions that retard its growth seem to be largely successful in maintaining brain development
Does birth weight predict adult serum cortisol concentrations? Twenty-four-hour profiles in the United Kingdom 1920-1930 Hertfordshire birth cohort
No full textLow birth weight and weight in infancy are associated with adult insulin resistance and type 2 diabetes. A proposed mechanism is programming of the hypothalamic-pituitary-adrenal axis by intrauterine undernutrition, leading to persistently elevated cortisol concentrations. We examined 24-h serum cortisol profiles (samples every 20 min) in 83 healthy elderly men and women whose birth weight and infant weight were recorded. Variables derived from these profiles included trough, peak, and area under the curve concentrations; the time of onset, rate of rise, duration, and peak of the early morning cortisol rise; postprandial secretion; and regularity of secretion (approximate entropy). None of these parameters was related to birth weight, weight at 1 yr, or change in weight SD score between birth and 1 yr. Consistent with other studies, 0730–0900 h cortisol concentrations were higher in men and women of lower birth weight, although this was not statistically significant (P = 0.08). Our findings do not support the hypothesis that reduced intrauterine and infant growth are associated with continuously raised cortisol concentrations in old age. Programmed effects on the hypothalamic-pituitary-adrenal axis may influence reactivity rather than resting secretion
Response to comment on: Hardikar et al. spuriously high prevalence of prediabetes diagnosed by HbA1c in young indians partly explained by hematological factors and iron deficiency anemia
No full textBody size and body composition: a comparison of children in India and the UK through infancy and childhood
No full textBackgroundIndian babies are characterised by the ‘thin-fat phenotype’ which comprises a ‘muscle-thin but adipose’ body composition compared with European babies. This body phenotype is of concern because it is associated with an increased risk of diabetes and cardiovascular disease. We examined whether the ‘thin-fat phenotype’ persists through early childhood, comparing Indian children with white Caucasians in the UK at birth, infancy and childhood, using comparable measurement protocols.MethodsWe used data from two cohorts, the Pune Maternal Nutrition Study (N=631) and the Southampton Women's Survey (N=2643). Measurements of weight, head circumference, mid-upper arm circumference, height, triceps and subscapular skinfold thickness were compared at birth, 1, 2, 3 and 6?years of age. SD scores were generated for the Pune children, using the Southampton children as a reference. Generalised estimating equations were used to examine the changes in SD scores across the children's ages.ResultsThe Indian children were smaller at birth in all body measurements than the Southampton children and became relatively even smaller from birth to 2?years, before ‘catching up’ to some extent at 3?years, and more so by 6?years. The deficit for both skinfolds was markedly less than for other measurements at all ages; triceps skinfold showed the least difference between the two cohorts at birth, and subscapular skinfold at all ages after birth.ConclusionsThe ‘thin-fat phenotype’ previously found in Indian newborns, remains through infancy and early childhood. Despite being shorter and lighter than UK children, Indian children are relatively adipose
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