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Usha Ramakrishnan - One of the best experts on this subject based on the ideXlab platform.
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Role of maternal preconception nutrition on offspring growth and risk of stunting across the first 1000 days in Vietnam: A prospective cohort study.
PloS one, 2018Co-Authors: Melissa F. Young, Phuong Nguyen, Son Nguyen, Reynaldo Martorell, Ines Gonzalez Casanova, O. Yaw Addo, Lan Mai Tran, Usha RamakrishnanAbstract:Growing evidence supports the role of preconception maternal nutritional status (PMNS) on birth outcomes; however, evidence of relationships with child growth are limited. We examined associations between PMNS (height, weight and body mass index- BMI) and offspring growth during the first 1000 days. We used prospective cohort data from a randomized-controlled trial of preconception micronutrient supplementation in Vietnam, PRECONCEPT (n = 1409). Poisson regression models were used to examine associations between PMNS and risk of offspring stunting (
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Timing of Gestational Weight Gain on Fetal Growth and Infant Size at Birth in Vietnam.
PloS one, 2017Co-Authors: Melissa F. Young, Phuong Nguyen, Hoa Pham, Son Nguyen, Reynaldo Martorell, O. Yaw Addo, Usha RamakrishnanAbstract:OBJECTIVE To examine the importance of timing of gestational weight gain during three time periods: 1: ≤ 20 weeks gestation), 2: 21-29 weeks) and 3: ≥ 30 weeks) on fetal growth and infant birth size. METHODS Study uses secondary data from the PRECONCEPT randomized controlled trial in Thai Nguyen province, Vietnam (n = 1436). Prospective data were collected on women starting pre-pregnancy through delivery. Maternal conditional weight gain (CWG) was defined as window-specific weight gains, uncorrelated with pre-pregnancy body mass index and all prior body weights. Fetal biometry, was assessed by ultrasound measurements of head and abdomen circumferences, biparietal diameter, and femoral length throughout pregnancy. Birth size outcomes included weight and length, and head, abdomen and mid upper arm circumferences as well as small for gestational age (SGA). Adjusted generalized linear and logistic models were used to examine associations. RESULTS Overall, three-quarters of women gained below the Institute of Medicine guidelines, and these women were 2.5 times more likely to give birth to a SGA infant. Maternal CWG in the first window (≤ 20 weeks), followed by 21-29 weeks, had the greatest association on all parameters of fetal growth (except abdomen circumference) and infant size at birth. For birth weight, a 1 SD increase CWG in the first 20 weeks had 3 times the influence compared to later CWG (≥ 30 weeks) (111 g vs. 39 g) and was associated with a 43% reduction in SGA risk (OR (95% CI): 0.57 (0.46-0.70). CONCLUSION There is a need to target women before or early in pregnancy to ensure adequate nutrition to maximize impact on fetal growth and birth size. TRIAL REGISTRATION ClinicalTrials.gov, NCT01665378.
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A Qualitative Study of Factors Influencing Initiation and Adherence to Micronutrient Supplementation Among Women of Reproductive Age in Vietnam.
Food and nutrition bulletin, 2016Co-Authors: Meredith Nechitilo, Ines Gonzalez-casanova, Phuong Nguyen, Reynaldo Martorell, Aimee Webb-girard, Ann M. Digirolamo, Usha RamakrishnanAbstract:Background and objectives:Initiation and adherence are both critical challenges for micronutrient supplementation programs, especially during the preconceptional period. This study examines factors influencing initiation of supplement use and continued adherence among women participating in PRECONCEPT, a double-blind randomized controlled trial of preconception micronutrient supplementation.Methods:In-depth interviews were conducted with 39 participants during different periods (prepregnancy [n = 15], pregnancy [n = 8], postpartum [n = 8], and dropouts [n = 8]). We examined participants’ knowledge about nutritional needs and micronutrient deficiencies, individual experience with nutritional supplements, and perceived benefits and side effects of supplements. Four focus groups were conducted with 24 village health workers (VHWs) to collect information on VHWs’ perceptions of factors influencing participants’ adherence and logistics of supplement distribution. Influences on initiation and adherence were exa...
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The relative influence of maternal nutritional status before and during pregnancy on birth outcomes in Vietnam.
European journal of obstetrics gynecology and reproductive biology, 2015Co-Authors: Melissa F. Young, Phuong Nguyen, Hieu Nguyen, Hoa Pham, Reynaldo Martorell, O. Yaw Addo, Wei Hao, Usha RamakrishnanAbstract:Abstract Objective This study aimed to: (1) examine the role of multiple measures of prepregnancy nutritional status (weight, height, body composition) on birth outcomes (low birth weight (LBW), small for gestational age (SGA), preterm, birth weight, birth length, infant head circumference and mid-upper arm circumference (MUAC)); (2) assess relative influence of maternal nutritional status before and during (gestational weight gain) pregnancy on birth outcomes. Study design We used prospective data on maternal body size and composition collected from women who participated in a randomized controlled trial evaluating the impact of preconceptional micronutrient supplements (PRECONCEPT) on birth outcomes in Thai Nguyen province, Vietnam (n = 1436). Anthropometric measurements were obtained before conception through delivery by trained health workers. The relationship between prepregnancy nutritional status indicators, gestational weight gain (GWG) and birth outcomes were examined using generalized linear models, adjusting for potential confounding factors. Results Maternal prepregnancy weight (PPW) was the strongest anthropometric indicator predicting infant birth size. A 1 standard deviation (SD) increase in PPW (5.4 kg) was associated with a 283 g (95%CI: 279–286) increase in birthweight. A similar and independent association was observed with birthweight for an increase of 1 SD in gestational weight gain (4 kg) (250 g; 95% CI: 245–255). Women with a PPW Conclusions These findings indicate that clinical care and programs aimed at improving birth outcomes will have the greatest impact if they address maternal nutrition both before and during pregnancy. Women with a PPW Trial registration NCT01665378 ( https://clinicaltrials.gov/show/NCT01665378 ).
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Maternal Glycemia and Preterm Birth in the PRECONCEPT Cohort in Vietnam
The FASEB Journal, 2015Co-Authors: Nicole D. Ford, Phuong Nguyen, Usha Ramakrishnan, Reynaldo MartorellAbstract:Objective: Studies on gestational glycemia have focused primarily on developed country and predominantly overweight populations. Despite low prevalence of traditional risk factors, Vietnamese women...
Reynaldo Martorell - One of the best experts on this subject based on the ideXlab platform.
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Role of maternal preconception nutrition on offspring growth and risk of stunting across the first 1000 days in Vietnam: A prospective cohort study.
PloS one, 2018Co-Authors: Melissa F. Young, Phuong Nguyen, Son Nguyen, Reynaldo Martorell, Ines Gonzalez Casanova, O. Yaw Addo, Lan Mai Tran, Usha RamakrishnanAbstract:Growing evidence supports the role of preconception maternal nutritional status (PMNS) on birth outcomes; however, evidence of relationships with child growth are limited. We examined associations between PMNS (height, weight and body mass index- BMI) and offspring growth during the first 1000 days. We used prospective cohort data from a randomized-controlled trial of preconception micronutrient supplementation in Vietnam, PRECONCEPT (n = 1409). Poisson regression models were used to examine associations between PMNS and risk of offspring stunting (
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Timing of Gestational Weight Gain on Fetal Growth and Infant Size at Birth in Vietnam.
PloS one, 2017Co-Authors: Melissa F. Young, Phuong Nguyen, Hoa Pham, Son Nguyen, Reynaldo Martorell, O. Yaw Addo, Usha RamakrishnanAbstract:OBJECTIVE To examine the importance of timing of gestational weight gain during three time periods: 1: ≤ 20 weeks gestation), 2: 21-29 weeks) and 3: ≥ 30 weeks) on fetal growth and infant birth size. METHODS Study uses secondary data from the PRECONCEPT randomized controlled trial in Thai Nguyen province, Vietnam (n = 1436). Prospective data were collected on women starting pre-pregnancy through delivery. Maternal conditional weight gain (CWG) was defined as window-specific weight gains, uncorrelated with pre-pregnancy body mass index and all prior body weights. Fetal biometry, was assessed by ultrasound measurements of head and abdomen circumferences, biparietal diameter, and femoral length throughout pregnancy. Birth size outcomes included weight and length, and head, abdomen and mid upper arm circumferences as well as small for gestational age (SGA). Adjusted generalized linear and logistic models were used to examine associations. RESULTS Overall, three-quarters of women gained below the Institute of Medicine guidelines, and these women were 2.5 times more likely to give birth to a SGA infant. Maternal CWG in the first window (≤ 20 weeks), followed by 21-29 weeks, had the greatest association on all parameters of fetal growth (except abdomen circumference) and infant size at birth. For birth weight, a 1 SD increase CWG in the first 20 weeks had 3 times the influence compared to later CWG (≥ 30 weeks) (111 g vs. 39 g) and was associated with a 43% reduction in SGA risk (OR (95% CI): 0.57 (0.46-0.70). CONCLUSION There is a need to target women before or early in pregnancy to ensure adequate nutrition to maximize impact on fetal growth and birth size. TRIAL REGISTRATION ClinicalTrials.gov, NCT01665378.
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A Qualitative Study of Factors Influencing Initiation and Adherence to Micronutrient Supplementation Among Women of Reproductive Age in Vietnam.
Food and nutrition bulletin, 2016Co-Authors: Meredith Nechitilo, Ines Gonzalez-casanova, Phuong Nguyen, Reynaldo Martorell, Aimee Webb-girard, Ann M. Digirolamo, Usha RamakrishnanAbstract:Background and objectives:Initiation and adherence are both critical challenges for micronutrient supplementation programs, especially during the preconceptional period. This study examines factors influencing initiation of supplement use and continued adherence among women participating in PRECONCEPT, a double-blind randomized controlled trial of preconception micronutrient supplementation.Methods:In-depth interviews were conducted with 39 participants during different periods (prepregnancy [n = 15], pregnancy [n = 8], postpartum [n = 8], and dropouts [n = 8]). We examined participants’ knowledge about nutritional needs and micronutrient deficiencies, individual experience with nutritional supplements, and perceived benefits and side effects of supplements. Four focus groups were conducted with 24 village health workers (VHWs) to collect information on VHWs’ perceptions of factors influencing participants’ adherence and logistics of supplement distribution. Influences on initiation and adherence were exa...
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The relative influence of maternal nutritional status before and during pregnancy on birth outcomes in Vietnam.
European journal of obstetrics gynecology and reproductive biology, 2015Co-Authors: Melissa F. Young, Phuong Nguyen, Hieu Nguyen, Hoa Pham, Reynaldo Martorell, O. Yaw Addo, Wei Hao, Usha RamakrishnanAbstract:Abstract Objective This study aimed to: (1) examine the role of multiple measures of prepregnancy nutritional status (weight, height, body composition) on birth outcomes (low birth weight (LBW), small for gestational age (SGA), preterm, birth weight, birth length, infant head circumference and mid-upper arm circumference (MUAC)); (2) assess relative influence of maternal nutritional status before and during (gestational weight gain) pregnancy on birth outcomes. Study design We used prospective data on maternal body size and composition collected from women who participated in a randomized controlled trial evaluating the impact of preconceptional micronutrient supplements (PRECONCEPT) on birth outcomes in Thai Nguyen province, Vietnam (n = 1436). Anthropometric measurements were obtained before conception through delivery by trained health workers. The relationship between prepregnancy nutritional status indicators, gestational weight gain (GWG) and birth outcomes were examined using generalized linear models, adjusting for potential confounding factors. Results Maternal prepregnancy weight (PPW) was the strongest anthropometric indicator predicting infant birth size. A 1 standard deviation (SD) increase in PPW (5.4 kg) was associated with a 283 g (95%CI: 279–286) increase in birthweight. A similar and independent association was observed with birthweight for an increase of 1 SD in gestational weight gain (4 kg) (250 g; 95% CI: 245–255). Women with a PPW Conclusions These findings indicate that clinical care and programs aimed at improving birth outcomes will have the greatest impact if they address maternal nutrition both before and during pregnancy. Women with a PPW Trial registration NCT01665378 ( https://clinicaltrials.gov/show/NCT01665378 ).
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Maternal Glycemia and Preterm Birth in the PRECONCEPT Cohort in Vietnam
The FASEB Journal, 2015Co-Authors: Nicole D. Ford, Phuong Nguyen, Usha Ramakrishnan, Reynaldo MartorellAbstract:Objective: Studies on gestational glycemia have focused primarily on developed country and predominantly overweight populations. Despite low prevalence of traditional risk factors, Vietnamese women...
Son Nguyen - One of the best experts on this subject based on the ideXlab platform.
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Role of maternal preconception nutrition on offspring growth and risk of stunting across the first 1000 days in Vietnam: A prospective cohort study.
PloS one, 2018Co-Authors: Melissa F. Young, Phuong Nguyen, Son Nguyen, Reynaldo Martorell, Ines Gonzalez Casanova, O. Yaw Addo, Lan Mai Tran, Usha RamakrishnanAbstract:Growing evidence supports the role of preconception maternal nutritional status (PMNS) on birth outcomes; however, evidence of relationships with child growth are limited. We examined associations between PMNS (height, weight and body mass index- BMI) and offspring growth during the first 1000 days. We used prospective cohort data from a randomized-controlled trial of preconception micronutrient supplementation in Vietnam, PRECONCEPT (n = 1409). Poisson regression models were used to examine associations between PMNS and risk of offspring stunting (
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Impact of preconceptional micronutrient supplementation on maternal mental health during pregnancy and postpartum: results from a randomized controlled trial in Vietnam
BMC Women's Health, 2017Co-Authors: Phuong H. Nguyen, Ines Gonzalez-casanova, Hieu Nguyen, Hoa Pham, Truong V Truong, Son Nguyen, Ann M. Digirolamo, Kimberly B Harding, Wei Hao, Gregory A ReinhartAbstract:Background Micronutrient malnutrition has been associated with maternal depressive symptoms (MDS), but little is known about the effects of preconceptional micronutrient supplementation. This paper examined the effects of preconceptional micronutrient supplementation on MDS during pregnancy and postpartum. Methods We used data from a double-blind controlled trial (PRECONCEPT) in which 5011 Vietnamese women were randomized to receive weekly supplements containing either a) multiple micronutrients (MM) b) iron and folic acid (IFA) or c) folic acid (FA) until conception ( n = 1813). Maternal mental health was assessed using the Center for Epidemiologic Studies Depression Scale (CES-D) at baseline (preconception), and the Edinburgh Postnatal Depression Scale (EPDS) during pregnancy and 3 months postpartum. Elevated MDS was defined as EPDS score ≥ 4. All group comparisons were done using ANOVA or chi-square tests of proportions intention to treat and per protocol analyses (women consumed supplements ≥26 weeks before conception). We also conducted stratified analyses by preconception CES-D scores, underweight, or anemia status using generalized linear models. Results Baseline CES-D scores were similar across treatment groups. The proportion of women experiencing elevated MDS was 11.3, 8.1 and 4.9% at first, second and third trimesters of pregnancy, respectively, and 3.6% at 3 mo postpartum. Mean EPDS scores at first (1.5 ± 2.7), second (1.1 ± 2.4), and third trimester of pregnancy (0.7 ± 2.0) and early postpartum (0.6 ± 1.8) were low and did not differ by treatment group. However, among women in the highest tertile of CES-D scores at preconception, mean EPDS scores in the first and second trimesters of pregnancy were lower in the MM and IFA groups compared to FA only ( P
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Timing of Gestational Weight Gain on Fetal Growth and Infant Size at Birth in Vietnam.
PloS one, 2017Co-Authors: Melissa F. Young, Phuong Nguyen, Hoa Pham, Son Nguyen, Reynaldo Martorell, O. Yaw Addo, Usha RamakrishnanAbstract:OBJECTIVE To examine the importance of timing of gestational weight gain during three time periods: 1: ≤ 20 weeks gestation), 2: 21-29 weeks) and 3: ≥ 30 weeks) on fetal growth and infant birth size. METHODS Study uses secondary data from the PRECONCEPT randomized controlled trial in Thai Nguyen province, Vietnam (n = 1436). Prospective data were collected on women starting pre-pregnancy through delivery. Maternal conditional weight gain (CWG) was defined as window-specific weight gains, uncorrelated with pre-pregnancy body mass index and all prior body weights. Fetal biometry, was assessed by ultrasound measurements of head and abdomen circumferences, biparietal diameter, and femoral length throughout pregnancy. Birth size outcomes included weight and length, and head, abdomen and mid upper arm circumferences as well as small for gestational age (SGA). Adjusted generalized linear and logistic models were used to examine associations. RESULTS Overall, three-quarters of women gained below the Institute of Medicine guidelines, and these women were 2.5 times more likely to give birth to a SGA infant. Maternal CWG in the first window (≤ 20 weeks), followed by 21-29 weeks, had the greatest association on all parameters of fetal growth (except abdomen circumference) and infant size at birth. For birth weight, a 1 SD increase CWG in the first 20 weeks had 3 times the influence compared to later CWG (≥ 30 weeks) (111 g vs. 39 g) and was associated with a 43% reduction in SGA risk (OR (95% CI): 0.57 (0.46-0.70). CONCLUSION There is a need to target women before or early in pregnancy to ensure adequate nutrition to maximize impact on fetal growth and birth size. TRIAL REGISTRATION ClinicalTrials.gov, NCT01665378.
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Patterns of Fetal Growth based on Ultrasound Measurement and its Relationship to Small-for-Gestational Age at birth in Vietnam
The FASEB Journal, 2015Co-Authors: Phuong Nguyen, Ines Gonzalez-casanova, Hieu Nguyen, Hoa Pham, Truong V Truong, Son Nguyen, Reynaldo Martorell, O. Yaw Addo, Usha RamakrishnanAbstract:Small-for-gestational age (SGA) is a global public health concern with important short- and long- term consequences. Identifying the timing of growth faltering is critical for the prevention of SGA. This study aims to examine patterns of fetal growth and the use of ultrasound measurements in predicting SGA at birth. We used ultrasound and birth data (n=1,412) that were collected in a randomized controlled trial evaluating pre-conception micronutrient supplements on maternal and child health outcomes in Vietnam (PRECONCEPT). Biparietal diameter (BPD), head (HC) and abdominal circumference (AC) and femur length (FL) were compared with the INTERGROWTH 21st fetal growth standards. SGA was defined as birthweight
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Effects of Pre-conceptual Micronutrient Supplementation on Maternal Depression in Vietnamese Women
The FASEB Journal, 2015Co-Authors: Usha Ramakrishnan, Ines Gonzalez-casanova, Phuong Nguyen, Hieu Nguyen, Hoa Pham, Truong V Truong, Son Nguyen, Ann M. Digirolamo, Reynaldo MartorellAbstract:Micronutrient malnutrition has been associated with maternal depressive symptoms (MDS), but little is known about the effects of pre-conceptual micronutrient supplementation. We examined the effects of pre-conceptual micronutrient supplementation on MDS during pregnancy and postpartum using data from a double-blind controlled trial (PRECONCEPT) in which 5011 Vietnamese women were randomized to receive weekly supplements containing either a) multiple micronutrients MM b) iron and folic acid IFA or c) folic acid FA until conception, followed by daily IFA supplements through delivery. Maternal depression was assessed using CES-D at baseline and 12 m post-partum and the EPDS during pregnancy and 3 m postpartum. The proportion of women ever experiencing elevated MDS during pregnancy (n=1616), postpartum (n= 1465) was 17.8% and 5.4%, respectively. No significant differences were seen by treatment. Among women at risk for depression at baseline (CES > 10; n=157), 29.1 and 30.1% experiencing elevated MDS during p...
Hoa Pham - One of the best experts on this subject based on the ideXlab platform.
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Impact of preconceptional micronutrient supplementation on maternal mental health during pregnancy and postpartum: results from a randomized controlled trial in Vietnam
BMC Women's Health, 2017Co-Authors: Phuong H. Nguyen, Ines Gonzalez-casanova, Hieu Nguyen, Hoa Pham, Truong V Truong, Son Nguyen, Ann M. Digirolamo, Kimberly B Harding, Wei Hao, Gregory A ReinhartAbstract:Background Micronutrient malnutrition has been associated with maternal depressive symptoms (MDS), but little is known about the effects of preconceptional micronutrient supplementation. This paper examined the effects of preconceptional micronutrient supplementation on MDS during pregnancy and postpartum. Methods We used data from a double-blind controlled trial (PRECONCEPT) in which 5011 Vietnamese women were randomized to receive weekly supplements containing either a) multiple micronutrients (MM) b) iron and folic acid (IFA) or c) folic acid (FA) until conception ( n = 1813). Maternal mental health was assessed using the Center for Epidemiologic Studies Depression Scale (CES-D) at baseline (preconception), and the Edinburgh Postnatal Depression Scale (EPDS) during pregnancy and 3 months postpartum. Elevated MDS was defined as EPDS score ≥ 4. All group comparisons were done using ANOVA or chi-square tests of proportions intention to treat and per protocol analyses (women consumed supplements ≥26 weeks before conception). We also conducted stratified analyses by preconception CES-D scores, underweight, or anemia status using generalized linear models. Results Baseline CES-D scores were similar across treatment groups. The proportion of women experiencing elevated MDS was 11.3, 8.1 and 4.9% at first, second and third trimesters of pregnancy, respectively, and 3.6% at 3 mo postpartum. Mean EPDS scores at first (1.5 ± 2.7), second (1.1 ± 2.4), and third trimester of pregnancy (0.7 ± 2.0) and early postpartum (0.6 ± 1.8) were low and did not differ by treatment group. However, among women in the highest tertile of CES-D scores at preconception, mean EPDS scores in the first and second trimesters of pregnancy were lower in the MM and IFA groups compared to FA only ( P
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Timing of Gestational Weight Gain on Fetal Growth and Infant Size at Birth in Vietnam.
PloS one, 2017Co-Authors: Melissa F. Young, Phuong Nguyen, Hoa Pham, Son Nguyen, Reynaldo Martorell, O. Yaw Addo, Usha RamakrishnanAbstract:OBJECTIVE To examine the importance of timing of gestational weight gain during three time periods: 1: ≤ 20 weeks gestation), 2: 21-29 weeks) and 3: ≥ 30 weeks) on fetal growth and infant birth size. METHODS Study uses secondary data from the PRECONCEPT randomized controlled trial in Thai Nguyen province, Vietnam (n = 1436). Prospective data were collected on women starting pre-pregnancy through delivery. Maternal conditional weight gain (CWG) was defined as window-specific weight gains, uncorrelated with pre-pregnancy body mass index and all prior body weights. Fetal biometry, was assessed by ultrasound measurements of head and abdomen circumferences, biparietal diameter, and femoral length throughout pregnancy. Birth size outcomes included weight and length, and head, abdomen and mid upper arm circumferences as well as small for gestational age (SGA). Adjusted generalized linear and logistic models were used to examine associations. RESULTS Overall, three-quarters of women gained below the Institute of Medicine guidelines, and these women were 2.5 times more likely to give birth to a SGA infant. Maternal CWG in the first window (≤ 20 weeks), followed by 21-29 weeks, had the greatest association on all parameters of fetal growth (except abdomen circumference) and infant size at birth. For birth weight, a 1 SD increase CWG in the first 20 weeks had 3 times the influence compared to later CWG (≥ 30 weeks) (111 g vs. 39 g) and was associated with a 43% reduction in SGA risk (OR (95% CI): 0.57 (0.46-0.70). CONCLUSION There is a need to target women before or early in pregnancy to ensure adequate nutrition to maximize impact on fetal growth and birth size. TRIAL REGISTRATION ClinicalTrials.gov, NCT01665378.
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The relative influence of maternal nutritional status before and during pregnancy on birth outcomes in Vietnam.
European journal of obstetrics gynecology and reproductive biology, 2015Co-Authors: Melissa F. Young, Phuong Nguyen, Hieu Nguyen, Hoa Pham, Reynaldo Martorell, O. Yaw Addo, Wei Hao, Usha RamakrishnanAbstract:Abstract Objective This study aimed to: (1) examine the role of multiple measures of prepregnancy nutritional status (weight, height, body composition) on birth outcomes (low birth weight (LBW), small for gestational age (SGA), preterm, birth weight, birth length, infant head circumference and mid-upper arm circumference (MUAC)); (2) assess relative influence of maternal nutritional status before and during (gestational weight gain) pregnancy on birth outcomes. Study design We used prospective data on maternal body size and composition collected from women who participated in a randomized controlled trial evaluating the impact of preconceptional micronutrient supplements (PRECONCEPT) on birth outcomes in Thai Nguyen province, Vietnam (n = 1436). Anthropometric measurements were obtained before conception through delivery by trained health workers. The relationship between prepregnancy nutritional status indicators, gestational weight gain (GWG) and birth outcomes were examined using generalized linear models, adjusting for potential confounding factors. Results Maternal prepregnancy weight (PPW) was the strongest anthropometric indicator predicting infant birth size. A 1 standard deviation (SD) increase in PPW (5.4 kg) was associated with a 283 g (95%CI: 279–286) increase in birthweight. A similar and independent association was observed with birthweight for an increase of 1 SD in gestational weight gain (4 kg) (250 g; 95% CI: 245–255). Women with a PPW Conclusions These findings indicate that clinical care and programs aimed at improving birth outcomes will have the greatest impact if they address maternal nutrition both before and during pregnancy. Women with a PPW Trial registration NCT01665378 ( https://clinicaltrials.gov/show/NCT01665378 ).
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Effects of Pre-conceptual Micronutrient Supplementation on Maternal Depression in Vietnamese Women
The FASEB Journal, 2015Co-Authors: Usha Ramakrishnan, Ines Gonzalez-casanova, Phuong Nguyen, Hieu Nguyen, Hoa Pham, Truong V Truong, Son Nguyen, Ann M. Digirolamo, Reynaldo MartorellAbstract:Micronutrient malnutrition has been associated with maternal depressive symptoms (MDS), but little is known about the effects of pre-conceptual micronutrient supplementation. We examined the effects of pre-conceptual micronutrient supplementation on MDS during pregnancy and postpartum using data from a double-blind controlled trial (PRECONCEPT) in which 5011 Vietnamese women were randomized to receive weekly supplements containing either a) multiple micronutrients MM b) iron and folic acid IFA or c) folic acid FA until conception, followed by daily IFA supplements through delivery. Maternal depression was assessed using CES-D at baseline and 12 m post-partum and the EPDS during pregnancy and 3 m postpartum. The proportion of women ever experiencing elevated MDS during pregnancy (n=1616), postpartum (n= 1465) was 17.8% and 5.4%, respectively. No significant differences were seen by treatment. Among women at risk for depression at baseline (CES > 10; n=157), 29.1 and 30.1% experiencing elevated MDS during p...
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Patterns of Fetal Growth based on Ultrasound Measurement and its Relationship to Small-for-Gestational Age at birth in Vietnam
The FASEB Journal, 2015Co-Authors: Phuong Nguyen, Ines Gonzalez-casanova, Hieu Nguyen, Hoa Pham, Truong V Truong, Son Nguyen, Reynaldo Martorell, O. Yaw Addo, Usha RamakrishnanAbstract:Small-for-gestational age (SGA) is a global public health concern with important short- and long- term consequences. Identifying the timing of growth faltering is critical for the prevention of SGA. This study aims to examine patterns of fetal growth and the use of ultrasound measurements in predicting SGA at birth. We used ultrasound and birth data (n=1,412) that were collected in a randomized controlled trial evaluating pre-conception micronutrient supplements on maternal and child health outcomes in Vietnam (PRECONCEPT). Biparietal diameter (BPD), head (HC) and abdominal circumference (AC) and femur length (FL) were compared with the INTERGROWTH 21st fetal growth standards. SGA was defined as birthweight
Phuong Nguyen - One of the best experts on this subject based on the ideXlab platform.
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Role of maternal preconception nutrition on offspring growth and risk of stunting across the first 1000 days in Vietnam: A prospective cohort study.
PloS one, 2018Co-Authors: Melissa F. Young, Phuong Nguyen, Son Nguyen, Reynaldo Martorell, Ines Gonzalez Casanova, O. Yaw Addo, Lan Mai Tran, Usha RamakrishnanAbstract:Growing evidence supports the role of preconception maternal nutritional status (PMNS) on birth outcomes; however, evidence of relationships with child growth are limited. We examined associations between PMNS (height, weight and body mass index- BMI) and offspring growth during the first 1000 days. We used prospective cohort data from a randomized-controlled trial of preconception micronutrient supplementation in Vietnam, PRECONCEPT (n = 1409). Poisson regression models were used to examine associations between PMNS and risk of offspring stunting (
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Timing of Gestational Weight Gain on Fetal Growth and Infant Size at Birth in Vietnam.
PloS one, 2017Co-Authors: Melissa F. Young, Phuong Nguyen, Hoa Pham, Son Nguyen, Reynaldo Martorell, O. Yaw Addo, Usha RamakrishnanAbstract:OBJECTIVE To examine the importance of timing of gestational weight gain during three time periods: 1: ≤ 20 weeks gestation), 2: 21-29 weeks) and 3: ≥ 30 weeks) on fetal growth and infant birth size. METHODS Study uses secondary data from the PRECONCEPT randomized controlled trial in Thai Nguyen province, Vietnam (n = 1436). Prospective data were collected on women starting pre-pregnancy through delivery. Maternal conditional weight gain (CWG) was defined as window-specific weight gains, uncorrelated with pre-pregnancy body mass index and all prior body weights. Fetal biometry, was assessed by ultrasound measurements of head and abdomen circumferences, biparietal diameter, and femoral length throughout pregnancy. Birth size outcomes included weight and length, and head, abdomen and mid upper arm circumferences as well as small for gestational age (SGA). Adjusted generalized linear and logistic models were used to examine associations. RESULTS Overall, three-quarters of women gained below the Institute of Medicine guidelines, and these women were 2.5 times more likely to give birth to a SGA infant. Maternal CWG in the first window (≤ 20 weeks), followed by 21-29 weeks, had the greatest association on all parameters of fetal growth (except abdomen circumference) and infant size at birth. For birth weight, a 1 SD increase CWG in the first 20 weeks had 3 times the influence compared to later CWG (≥ 30 weeks) (111 g vs. 39 g) and was associated with a 43% reduction in SGA risk (OR (95% CI): 0.57 (0.46-0.70). CONCLUSION There is a need to target women before or early in pregnancy to ensure adequate nutrition to maximize impact on fetal growth and birth size. TRIAL REGISTRATION ClinicalTrials.gov, NCT01665378.
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A Qualitative Study of Factors Influencing Initiation and Adherence to Micronutrient Supplementation Among Women of Reproductive Age in Vietnam.
Food and nutrition bulletin, 2016Co-Authors: Meredith Nechitilo, Ines Gonzalez-casanova, Phuong Nguyen, Reynaldo Martorell, Aimee Webb-girard, Ann M. Digirolamo, Usha RamakrishnanAbstract:Background and objectives:Initiation and adherence are both critical challenges for micronutrient supplementation programs, especially during the preconceptional period. This study examines factors influencing initiation of supplement use and continued adherence among women participating in PRECONCEPT, a double-blind randomized controlled trial of preconception micronutrient supplementation.Methods:In-depth interviews were conducted with 39 participants during different periods (prepregnancy [n = 15], pregnancy [n = 8], postpartum [n = 8], and dropouts [n = 8]). We examined participants’ knowledge about nutritional needs and micronutrient deficiencies, individual experience with nutritional supplements, and perceived benefits and side effects of supplements. Four focus groups were conducted with 24 village health workers (VHWs) to collect information on VHWs’ perceptions of factors influencing participants’ adherence and logistics of supplement distribution. Influences on initiation and adherence were exa...
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The relative influence of maternal nutritional status before and during pregnancy on birth outcomes in Vietnam.
European journal of obstetrics gynecology and reproductive biology, 2015Co-Authors: Melissa F. Young, Phuong Nguyen, Hieu Nguyen, Hoa Pham, Reynaldo Martorell, O. Yaw Addo, Wei Hao, Usha RamakrishnanAbstract:Abstract Objective This study aimed to: (1) examine the role of multiple measures of prepregnancy nutritional status (weight, height, body composition) on birth outcomes (low birth weight (LBW), small for gestational age (SGA), preterm, birth weight, birth length, infant head circumference and mid-upper arm circumference (MUAC)); (2) assess relative influence of maternal nutritional status before and during (gestational weight gain) pregnancy on birth outcomes. Study design We used prospective data on maternal body size and composition collected from women who participated in a randomized controlled trial evaluating the impact of preconceptional micronutrient supplements (PRECONCEPT) on birth outcomes in Thai Nguyen province, Vietnam (n = 1436). Anthropometric measurements were obtained before conception through delivery by trained health workers. The relationship between prepregnancy nutritional status indicators, gestational weight gain (GWG) and birth outcomes were examined using generalized linear models, adjusting for potential confounding factors. Results Maternal prepregnancy weight (PPW) was the strongest anthropometric indicator predicting infant birth size. A 1 standard deviation (SD) increase in PPW (5.4 kg) was associated with a 283 g (95%CI: 279–286) increase in birthweight. A similar and independent association was observed with birthweight for an increase of 1 SD in gestational weight gain (4 kg) (250 g; 95% CI: 245–255). Women with a PPW Conclusions These findings indicate that clinical care and programs aimed at improving birth outcomes will have the greatest impact if they address maternal nutrition both before and during pregnancy. Women with a PPW Trial registration NCT01665378 ( https://clinicaltrials.gov/show/NCT01665378 ).
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Maternal Glycemia and Preterm Birth in the PRECONCEPT Cohort in Vietnam
The FASEB Journal, 2015Co-Authors: Nicole D. Ford, Phuong Nguyen, Usha Ramakrishnan, Reynaldo MartorellAbstract:Objective: Studies on gestational glycemia have focused primarily on developed country and predominantly overweight populations. Despite low prevalence of traditional risk factors, Vietnamese women...