454 research outputs found
A principal components approach to parent-to-newborn body composition associations in South India
Get PDFBackground: size at birth is influenced by environmental factors, like maternal nutrition and parity, and by genes. Birth weight is a composite measure, encompassing bone, fat and lean mass. These may have different determinants. The main purpose of this paper was to use anthropometry and principal components analysis (PCA) to describe maternal and newborn body composition, and associations between them, in an Indian population. We also compared maternal and paternal measurements (body mass index (BMI) and height) as predictors of newborn body composition.Methods: weight, height, head and mid-arm circumferences, skinfold thicknesses and external pelvic diameters were measured at 30 ± 2 weeks gestation in 571 pregnant women attending the antenatal clinic of the Holdsworth Memorial Hospital, Mysore, India. Paternal height and weight were also measured. At birth, detailed neonatal anthropometry was performed. Unrotated and varimax rotated PCA was applied to the maternal and neonatal measurements.Results: rotated PCA reduced maternal measurements to 4 independent components (fat, pelvis, height and muscle) and neonatal measurements to 3 components (trunk+head, fat, and leg length). An SD increase in maternal fat was associated with a 0.16 SD increase (?) in neonatal fat (p < 0.001, adjusted for gestation, maternal parity, newborn sex and socio-economic status). Maternal pelvis, height and (for male babies) muscle predicted neonatal trunk+head (? = 0. 09 SD; p = 0.017, ? = 0.12 SD; p = 0.006 and ? = 0.27 SD; p < 0.001). In the mother-baby and father-baby comparison, maternal BMI predicted neonatal fat (? = 0.20 SD; p < 0.001) and neonatal trunk+head (? = 0.15 SD; p = 0.001). Both maternal (? = 0.12 SD; p = 0.002) and paternal height (? = 0.09 SD; p = 0.030) predicted neonatal trunk+head but the associations became weak and statistically non-significant in multivariate analysis. Only paternal height predicted neonatal leg length (? = 0.15 SD; p = 0.003).Conclusion: principal components analysis is a useful method to describe neonatal body composition and its determinants. Newborn adiposity is related to maternal nutritional status and parity, while newborn length is genetically determined. Further research is needed to understand mechanisms linking maternal pelvic size to fetal growth and the determinants and implications of the components (trunk v leg length) of fetal skeletal growt
Anthropometry, glucose tolerance and insulin concentrations in South Indian children: relationships to maternal glucose tolerance during pregnancy
No full textEarlier studies have shown that individuals whose mothers were diabetic when they were in utero, have an increased risk of early obesity, and impaired glucose tolerance (lGT) and type 2 diabetes in adult life. This study was designed to test whether adiposity, glucose tolerance and insulin concentrations are altered in Indian children born to mothers with gestational diabetes (GDM), and are related to maternal glucose and insulin concentrations in pregnancy even in the absence of GDM.830 pregnant women attending the antenatal clinics of the Holdsworth Memorial Hospital (HMH), Mysore, India underwent an Oral Glucose Tolerance Test (OGTT) at 30±2 weeks. 674 of these women delivered at HMH. Detailed anthropometry was performed on the offspring at birth, and annually thereafter. 585 mothers returned with their offspring at 5 years of age for detailed investigations including OGTT for glucose and insulin concentrations, bio-impedance for fat estimation and blood pressure measurement. OGTT was administered to mothers and fasting plasma glucose and insulin concentrations were measured in fathers.The Mysore babies were small compared to UK neonates, but the deficit varied for different body measurements. While birthweight (-1.1 SD) was considerably lower, crown-heel length (-0.3 SD) and subscapular skinfold thickness (-0.2 SD) were relatively spared. At five years, subscapular skinfold thickness was larger than the UK standards (+0.23 SD, p<0.001) despite all other body measurements being significantly smaller. Findings at 5 years were similar in comparison with another standard, based on Dutch children. At 5 years, girls in the cohort had higher insulin concentrations and were more insulin resistant. Body fat was the strongest predictor of glucose and insulin concentrations independent of other body components and parental characteristics.Newborns of the mothers with gestational diabetes were larger in all body measurements than control neonates (born to non-GDM mothers and non-diabetic fathers). At one year, these differences had diminished and were not statistically significant. At five years, female, but not male offspring of diabetic mothers had larger subscapular and triceps skinfolds (P=0.01) and higher 30- and 120-minute insulin concentrations (P<0.05) than control females. Even in the control offspring maternal insulin area-under-the-curve was positively associated with 30-minute insulin concentrations, after adjusting for sex and maternal skinfolds (P<0.001). Offspring of diabetic fathers (n=41) were lighter at birth than controls; they showed no differences in anthropometry at five years.In conclusion, Maternal GDM is associated with adiposity and higher insulin concentrations in female offspring at 5 years. The absence of similar associations in offspring of diabetic fathers suggests a programming effect of the diabetic intra-uterine environment. With increasing levels of obesity and IGT among Indian mothers, these effects may be contributing to the rise of type 2 diabetes in India. Our continuing follow-up aims to study the long-term effects of higher maternal glucose concentrations in the absence of GDM
Linear growth and fat and lean tissue gain during childhood: associations with cardiometabolic and cognitive outcomes in adolescent Indian children
No full textBackground: We aimed to determine how linear growth and fat and lean tissue gain during discrete age periods from birth to adolescence are related to adolescent cardiometabolic risk factors and cognitive ability.Methods: Adolescents born to mothers with normal glucose tolerance during pregnancy from an Indian birth cohort (N = 486, age 13.5 years) had detailed anthropometry and measurements of body fat (fat%), fasting plasma glucose, insulin and lipid concentrations, blood pressure and cognitive function. Insulin resistance (HOMA-IR) was calculated. These outcomes were examined in relation to birth measurements and statistically independent measures (conditional SD scores) representing linear growth, and fat and lean tissue gain during birth-1, 1–2, 2–5, 5–9.5 and 9.5–13.5 years in 414 of the children with measurements at all these ages.Results: Birth length and linear growth at all ages were positively associated with current height. Fat gain, particularly during 5–9.5 years was positively associated with fat% at 13.5 years (0.44 SD per SD [99.9% confidence interval: 0.29,0.58]). Greater fat gain during mid-late childhood was associated with higher systolic blood pressure (5–9.5 years: 0.23 SD per SD [0.07,0.40]) and HOMA-IR (5–9.5 years: 0.24 [0.08,0.40], 9.5–13.5 years: 0.22 [0.06,0.38]). Greater infant growth (up to age 2 years) in linear, fat or lean components was unrelated to cardiometabolic risk factors or cognitive function.Conclusion: This study suggests that factors that increase linear, fat and lean growth in infancy have no adverse cardiometabolic effects in this population. Factors that increase fat gain in mid-late childhood may increase cardiometabolic risk, without any benefit to cognitive abilities
Cardiometabolic risk markers in Indian children: comparison with UK Indian and white European children
No full textObjective: UK Indian adults have higher risks of coronary heart disease and type 2 diabetes than Indian and UK European adults. With growing evidence that these diseases originate in early life, we compared cardiometabolic risk markers in Indian, UK Indian and white European children.Methods: Comparisons were based on the Mysore Parthenon Birth Cohort Study (MPBCS), India and the Child Heart Health Study in England (CHASE), which studied 9–10 year-old children (538 Indian, 483 UK Indian, 1375 white European) using similar methods. Analyses adjusted for study differences in age and sex.Results: Compared with Mysore Indians, UK Indians had markedly higher BMI (% difference 21%, 95%CI 18 to 24%), skinfold thickness (% difference 34%, 95%CI 26 to 42%), LDL-cholesterol (mean difference 0.48, 95%CI 0.38 to 0.57 mmol/L), systolic BP (mean difference 10.3, 95% CI 8.9 to 11.8 mmHg) and fasting insulin (% difference 145%, 95%CI 124 to 168%). These differences (similar in both sexes and little affected by adiposity adjustment) were larger than those between UK Indians and white Europeans. Compared with white Europeans, UK Indians had higher skinfold thickness (% difference 6.0%, 95%CI 1.5 to 10.7%), fasting insulin (% difference 31%, 95%CI 22 to 40%), triglyceride (% difference 13%, 95%CI 8 to 18%) and LDL-cholesterol (mean difference 0.12 mmol/L, 95%CI 0.04 to 0.19 mmol/L).Conclusions: UK Indian children have an adverse cardiometabolic risk profile, especially compared to Indian children. These differences, not simply reflecting greater adiposity, emphasize the need for prevention strategies starting in childhood or earlier
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/
Effectiveness of Pranayama in Reduction of Stress among Nursing Students in Selected School of Nursing at Kanyakumari District
Get PDF“A Quasi experimental study to assess the effectiveness of pranayama in reduction of stress among nursing students in selected School of Nursing at Kanyakumari district” was done by Mrs. K.S. Krishnaveni as a partial fulfillment of the requirement for the degree of Master of Science in Nursing at Sri. K. Ramachandran Naidu College of nursing, Thirunelveli under the Tamil Nadu Dr. M.G.R medical university, Chennai during the year of april 2012.
OBJECTIVES:
• To assess the pre test level of stress among the nursing students in experimental group and control group.
• To assess the effectiveness of pranayama to reduce stress among the experimental group and control group.
• To compare the pre and post test level of stress among experimental group.
• To associate the post test level of stress among nursing students in experimental group and control group with their selected demographic variable.
HYPOTHESES:
H1: The mean post test level of stress among nursing students in experimental group was lower than the mean post test level of control group.
H2: The mean post test level of stress among nursing students in experimental group was lower than their mean pre test level of stress.
H3: There was a significant association between the post test level of stress among experimental group with their selected demographic variables.
H4: There was a significant association between the post test level of stress among control group with their selected demographic variables.
The study was based on Sister Calista Roy's stress adaptation model. The quantitative approach was used in this study. The study was conducted in Grace School of Nursing at Kanyakumari district. The design adopted for this study was quasi experimental pre test and post test control group design to evaluate the effectiveness of pranayama to reduce stress of nursing students. The quata sampling technique was used to select 30 samples for experimental group and 30 samples for control group.
The data collection tool used for the study was the Lovibond stress assessment scale. The content validity of the tool was obtained from five clinical experts. The reliability of tool (r=0.87) was established by test retest method. The tool was accepted as reliable by the clinical experts Pilot study was conducted to find out the feasibility of the study and to plan for data analysis. Data collection was done and the data obtained were analyzed in both in terms of descriptive and inferential statistics.
THE MAJOR FINDINGS OF THE STUDY
Exposure to maternal gestational diabetes is associated with higher cardiovascular responses to stress in adolescent indians
No full textContext:Altered endocrinal and autonomic nervous system responses to stress may link impaired intra-uterine growth with later cardiovascular disease.Objective:To test the hypothesis that offspring of gestational diabetic mothers (OGDM) have high cortisol and cardiosympathetic responses during the Trier Social Stress Test for Children (TSST-C).Design:Adolescents from a birth cohort in India (n = 213; mean age, 13.5 y), including 26 OGDM, 22 offspring of diabetic fathers (ODF), and 165 offspring of nondiabetic parents (controls) completed 5 minutes each of public speaking and mental arithmetic tasks in front of two unfamiliar “evaluators” (TSST-C). Salivary cortisol concentrations were measured at baseline and at regular intervals after the TSST-C. Heart rate, blood pressure (BP), stroke volume, cardiac output, and total peripheral resistance were measured continuously at baseline, during the TSST-C, and for 10 minutes after the test using a finger cuff; the beat-to-beat values were averaged for these periods.Results:Cortisol and cardiosympathetic parameters increased from baseline during stress (P < .001). OGDM had greater systolic BP (mean difference, 5.6 mm Hg), cardiac output (0.5 L/min), and stroke volume (4.0 mL) increases and a lower total peripheral resistance rise (125 dyn · s/cm5) than controls during stress. ODF had greater systolic BP responses than controls (difference, 4.1 mm Hg); there was no difference in other cardiosympathetic parameters. Cortisol responses were similar in all three groups.Conclusions:Maternal diabetes during pregnancy is associated with higher cardiosympathetic stress responses in the offspring, which may contribute to their higher cardiovascular disease risk. Further research may confirm stress-response programming as a predictor of cardiovascular risk in OGDM.<br/
Childhood cognitive ability: relationship to gestational diabetes mellitus in India
Get PDFAims/hypothesis: Our aim was to test the hypothesis that gestational diabetes mellitus (GDM) in mothers is associated with poorer cognitive ability in their offspring in India. Methods: During 1997 to 1998 maternal GDM status was assessed by OGTT at 30?±?2 weeks of gestation. Between 2007 and 2008, at a mean age of 9.7 years, 515 children (32 offspring of GDM mothers [ODM]; 483 offspring of non-GDM mothers [controls]) from the Mysore Parthenon birth cohort underwent cognitive function assessment using tests from the Kaufman Assessment Battery for Children—Second Edition and additional tests measuring learning, long-term storage/retrieval, short-term memory, reasoning, attention and concentration, and visuo-spatial and verbal abilities. Results: Compared with controls, ODM scored higher in tests for learning, long-term retrieval/storage (p?=?0.008), reasoning (p?=?0.02), verbal ability (p?=?0.01), and attention and concentration (p?=?0.003). In multiple regression, adjusted for the child’s age, sex, gestation, neonatal weight and head circumference, maternal age, parity and BMI, and the parent’s socioeconomic status, education and rural/urban residence, this difference remained significant only for learning, long-term retrieval/storage (??=?0.4 SD (95% CI 0.01–0.75); p?=?0.04) and verbal ability (??=?0.5 SD (95% CI 0.09–0.83); p?=?0.02), and not with other test scores. Conclusions/interpretation: In this population of healthy Indian children, there was no evidence of lower cognitive ability in ODM. In fact some cognitive scores were higher in ODM. <br/
Comparing BMI with skinfolds to estimate age at adiposity rebound and its associations with cardio-metabolic risk markers in adolescence
No full textBackground: Body mass index (BMI) reaches a nadir in mid-childhood, known as the adiposity rebound (AR). Earlier AR is associated with a higher risk of cardio-vascular diseases in later life. Skinfolds, which are a more direct measure of adiposity, may give better insight into the relationship between childhood adiposity and later obesity and cardio-metabolic risk. Objective: We aimed to assess whether AR corresponds to a rebound in skinfolds, and compare associations of BMI-derived AR and skinfold-derived AR with cardio-metabolic risk markers in adolescence. Methods: We used penalised splines with random coefficients to estimate BMI and skinfold trajectories of 604 children from the Mysore Parthenon Birth Cohort. Age at AR was identified using differentiation of the BMI and skinfold growth curves between 2 and 10 years of age. At 13.5 years, we measured blood pressure, and glucose, insulin and lipid concentrations. Results: BMI and skinfolds had different growth patterns. Boys reached BMI-derived AR earlier than skinfold-derived AR (estimated difference: 0.41 years; 95% CI:[0.23, 0.56]), whereas the opposite was observed in girls (estimated difference: −0.71 years; 95% CI:[−0.90, −0.54]). At 13.5 years, children with earlier BMI-derived AR had higher BMI (−0.58 SD per SD increase of AR; 95%CI:[−0.65, −0.52]), fat mass (−0.44; 95%CI:[−0.50, −0.37]), insulin resistance (HOMA-IR: −0.20; 95%CI:[−0.28, −0.12]) and systolic blood pressure (−0.20; 95%CI:[−0.28, −0.11]), and lower HDL-cholesterol (0.12; 95%CI:[0.04, 0.21]). The associations were independent of BMI at time of rebound, but were fully explained by fat mass at 13.5 years. Similar associations were found for skinfold-derived AR. Conclusion: BMI-derived adiposity rebound predicts later cardio-metabolic risk markers similarly to that derived from skinfolds, a direct measure of adiposity.</p
Vitamin D insufficiency is common in Indian mothers but is not associated with gestational diabetes or variations in newborn size
No full textBackground/Objectives: Vitamin D is required for bone growth and normal insulin secretion. Maternal hypovitaminosis D may
impair fetal growth and increase the risk of gestational diabetes. We have related maternal vitamin D status in pregnancy to
maternal and newborn glucose and insulin concentrations, and newborn size, in a South Indian population.Subjects/Methods: Serum 25 hydroxy vitamin D (25(OH)D) concentrations, glucose tolerance, and plasma insulin, proinsulin
and 32–33 split proinsulin concentrations were measured at 30 weeks gestation in 559 women who delivered at the Holdsworth
Memorial Hospital, Mysore. The babies’ anthropometry and cord plasma glucose, insulin and insulin precursor concentrations
were measured.Results: In total 66% of women had hypovitaminosis D (25(OH)D concentrations o50 nmol l1) and 31% were below
28 nmol l1. There was seasonal variation in 25(OH)D concentrations (Po0.0001). There was no association between maternal 25(OH)D and gestational diabetes (incidence 7% in women with and without hypovitaminosis D). Maternal 25(OH)D
concentrations were unrelated to newborn anthropometry or cord plasma variables. In mothers with hypovitaminosis D, higher 25(OH)D concentrations were associated with lower 30-min glucose concentrations (P¼0.03) and higher fasting proinsulin concentrations (P¼0.04).Conclusions: Hypovitaminosis D at 30 weeks gestation is common in Mysore mothers. It is not associated with an increased risk of gestational diabetes, impaired fetal growth or altered neonatal cord plasma insulin secretory profile
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