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Introduction: MCH services are not utilized due to unawareness, poverty and lack of scientific knowledge regarding care during the issue. Though all the details are given in the MCPC to follow positive practices, utilization of the card is being done only for recording of the information. Objective: To assess the knowledge about the contents of mother and child protection card (MCPC) among the pregnant and lactating women of a rural area Methodology: This was a cross sectional study conducted on pregnant women and lactating mothers with child less than a year. Knowledge about the contents of MCPC was collected by interview method. Results: In our study, majority of the mothers had good knowledge about tetanus injection (92.5%), consumption of IFA tablets (72.6%), breastfeeding within an hour (92.5%), exclusive breastfeeding for 6 months (95.6%), cereals to be included in the complementary food (90.6%) and good perception about complete immunization of the baby (100%). Knowledge was found to be poor with respect to ANC checkups and examination, tracking weight of the baby and growth chart; assessing danger signs in newborn and emergency preparation. Conclusion: The study showed good knowledge about TT, IFA, nutrition, danger signs and immunization. There was poor knowledge about ANC checkups, baby growth, danger sings in newborn and emergency preparation.
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OBJECTIVE To provide reference for standardizing the labeling of medication information for pregnant women and lactating women in the instructions of antiarrhythmic drugs. METHODS The instructions of antiarrhythmic drugs were collected from the terms of “medication reference ”on official website of Yimaitong Technology Co. ，Ltd. The labeling of medication information of pregnant women and lactating women were sorted out ，counted and analyzed with reference to the Detailed Rules for Specifications of Instructions of Chemical Drugs and Therapeutic Biological Products issued by the State Food and Drug Administration. RESULTS A total of 111 instructions of antiarrhythmic drugs were collected in this study ，of which 102 instructions were marked with “medication for pregnant women ”（91.89％），of which the proportion of those with medication guidance and without medication guidance were 75.68％ and 16.22％ respectively. Eighty-eight drug instructions were marked with the item “medication for lactating women ”（79.28％），of which the proportion of those with medication guidance and without medication guidance were 70.27％ and 9.01％ respectively. Among different categories of antiarrhythmic drugs ，the best labeling of “medication for pregnant women ”was class Ⅰ antiarrhythmic drugs （100％），while class Ⅲ drugs（25.00％）were most missing ； class Ⅳ antiarrhythmic drugs （94.44％）were the best labeled for “medication for lactating women ”，while class Ⅰ（26.47％）were the most missing . There were differences in the labeling contents of “medication for pregnant women ”and“medication for lactating women ”in some drug instructions of the same variety from different manufacturers. Among the 99 drug instructions of domestic pharmaceutical enterprises ， 92 listed the items of “medication for pregnant women”and“medication for lactating women ”，and the proportions of them with medication guidance were 74.75％ and 69.70％ respectively；among the 12 drug instructions of foreign pharmaceutical enterprises ，10（83.33％）listed the items of “medication for pregnant women ”and“medication for lactating women ”，and the proportion with medication guidance was 83.33％ and 75.00％ respectively. CONCLUSIONS There are some problems in the labeling content of domestic antiarrhythmic drug instructions，such as the lack of information related to “medication for pregnant women ”and“medication for lactating women ”， the confusion of guidance expression ， the inconsistent content of drug instructions of the same variety from different manufacturers，the lag of modification and update ，and the poor standardization of drug instructions. Drug supervision and administration departments and drug manufacturers should pay attention to them and constantly strengthen the management and standardization of instructions.
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@#Introduction: Foods and nutrients are essential not only for human health, but also for the balance of gut microbiota. This research aimed to correlate the gut microbiota of lactating women with their food/ nutrient intakes, as well as with their infants’ gut microbiota. Methods: A cross-sectional study was conducted in 27 pairs of mothers and their exclusively breastfed infants. For lactating women, the dietary assessment was conducted by 24-hour recall, and food groups were assessed following the Food and Agriculture Organization’s guidelines, while nutrient intake was analysed using INMUNCAL V3 programme. Gut microbiota of mothers and infants were measured in stool samples using fluorescent in situ hybridisation technique. Results: It was found that energy intake of mothers was only 66% of the recommended Thai Dietary Reference Intakes (DRIs). Most micronutrient and dietary fibre intakes were below the Thai DRIs. Vitamin A (VA)-rich fruits and vegetables food group correlated positively with Lactobacillus species (spp). The association between gut microbiota and nutrient intake of lactating women showed that total protein, phosphorus, and VA were positively correlated with Bifidobacterium spp.; while β-carotene and vitamin C were also positively correlated with Lactobacillus spp. In contrast, consumption of eggs and calcium correlated negatively with Clostridium spp./ Enterobacter spp. Bifidobacterium spp. and Lactobacillus spp. of lactating women and breastfed infants showed strong correlations. Conclusion: Food and nutrient intakes of lactating women were correlated with their Clostridium spp./Enterobacter spp., Bifidobacterium spp. and Lactobacillus spp. Furthermore, Bifidobacterium spp. and Lactobacillus spp. of mothers and breastfed infants showed strong correlations.
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@#Introduction: The Janani Shishu Suraksha Karyakram (JSSK) is a government of India initiative for all pregnant women visiting public health facilities, with many free entitlements – free diet being one. After an in-depth study of existing dietary provisions in all community health centres, an elaborate cyclic-weekly nutritious menu was designed taking into consideration the latest recommendations (2019) by the Ministry of Family and Child Welfare, India to improve maternal health nutrition. Methods: The health functionaries from all ten community health centres of rural Vadodara were chosen for an in-depth estimation of the different meals served in the facilities. Standard measuring cups and spoons were used to measure the exact serving sizes for each person. Each meal served was supervised, checked and quantified in triplicate, while macro- and micronutrients were calculated using the Indian Food Composition Tables 2017 (Longvah et al. 2017). To bridge the gap in service delivery, two new models of cyclic-weekly menu were developed, keeping in mind the amount per mother per day as one hundred Indian rupees. Results: On average the foods served in the community health centres provided 69% of recommended energy intake, while mean recommended dietary allowance met for protein was 51%, calcium 18%, iron 50%, and fat 267%. Conclusion: The recommendations specified in this paper would improve the nutritional status of all pregnant and lactating women availing the services in rural health facilities, which would go a long way in ensuring safe and healthy motherhood.
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Nutritional status is considered as one of the key indicators of the overall wellbeing of a population. Lactating women and children are among the most vulnerable groups due to their higher nutritional needs and detrimental effects of poor nutrition on their health. Lactating women have increased nutritional needs and if not well met, breast milk quality and quantity are negatively affected, which leads to increased risk for child morbidity and mortality. Studies have been done in the different regions of Ethiopia to assess the nutritional status among lactating women and have reported various prevalence and different associated factors. Despite the different efforts to improve nutrition in Ethiopia, the prevalence of underweight is still high, with most regions having a higher prevalence than the documented 5-20% of African women.We aimed to review the prevalence and associated factors of underweight among lactating women in Ethiopia. We used literature searched from key databases such as Google Scholar, Web of Science, among others, to collect relevant information about the prevalence of underweight among pregnant women in Ethiopia The mini-review identified the highest prevalence at 50.6% in the Northern parts and the lowest at 17.4% in the Southern parts of Ethiopia. Several factors were identified to be associated with underweight among lactating women in Ethiopia including; dietary diversity score, household food security, family income, place of delivery,nutritional education programs and antenatal care attendance. This implies the need for targeted programs/policies to promote household food security and family income, community nutritional education, and nutritional counselling during antenatal care attendance. Besides, there is a need to conduct national and regional studies to inform policy further since there were more studies done in the Southern parts of the Country with less information from other regions
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Background:Dietary diversity score indicates that the intake of general nutritional adequacy. Low dietary diversity is a major problem among poor populations in the developing world due to consumption of monotonous staple diet consumption. Therefore, it has various consequences on the health and wellbeing of the family, communities, and nation at large. Overall, there are limited studies on this major issue and its contributing factors among lactatingmothers. Methods:Institution based cross-sectional study was employed among 419 participants who were selected by using a systematic sampling method. The data werecollected using a pretested structured questionnaire. The collected data were checked for completeness, cleaned, coded and entered into EPI info version 7 and exported into SPSS version 20.0 software for further analysis. The degree of association between dependent and independent variables were assessed by using odds ratio with a 95% of confidence interval and variableswith p≤0.05 were considered significant after fitting into logistic regression.Results:The average dietary diversity score±SD was 4.94±0.76. The magnitude of low dietary diversity score was 25% (95% CI: 22.1, 30.4). Women’s, being government employer and having meal 2 times per day were the factors associated with low dietary diversity score among lactating mothers.Conclusions:One-fourth of the lactating women were had poor dietary diversity and age of the women, meal frequency, and respondent occupation were the determinant factors. So, appropriate counseling during maternal care are very important to halt this problem.
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Objective To understand the effects of salt iodine content adjustment on iodine nutritional status of residents in Fujian Province.Methods In 2009 (before the adjustment) and 2014 (after the adjustment),cross-sectional research methods and stratified cluster sampling methods were adopted,17 and 19 survey sites (residential committees and villages) were selected,respectively.At each survey site,20 adults,30 pregnant women,30 lactating women and 50 children (8-10 years old) were selected in 2009;50 adults,50 pregnant women,50 lactating women and 100 children (8-10 years old) were selected in 2014.Random urine samples in one day were collected,and the urinary iodine content was measured by "the Arsenic and Cerium Catalyzed Spectrophotometric Method" (WS/T 107-2006).The results of before and after the adjustment were compared and iodine nutrition was evaluated.Results Before and after adjustment of salt iodine content,the urinary iodine median of children and adults was 208.7,202.8,163.0 and 157.6 μg/L,respectively,and after the adjustment,the iodine nutrition was at the appropriate level (100-199 μg/L).The urinary iodine median of lactating women was 128.9 and 107.4 μg/L before and after the adjustment,iodine nutrition was at an appropriate level (≥ 100 μg/L).The urinary iodine median of pregnant women was 149.2 and 124.0 μg/L before and after the adjustment,which were deficient (＜ 150 μg/L).Conclusion After down-regulating the iodized salt content,the iodine nutrition of the general residents in Fujian Province is basically at an appropriate level,and pregnant women have different levels of iodine deficiency.
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Objective To observe prolactin (PRL) and estradiol (E2) levels in lactating women in different iodine nutrition areas.Methods According to the recent national water-borne high iodine area survey and the monitoring results of iodine deficiency disorders,the following places were selected,including Nankang,Xinggang and Yingpan towns of Beihai City,Guangxi (water iodine ≤ 10 μg/L,low iodine areas),Yangcheng Township and Jiajiazhuang Township of Fenyang City,Shanxi (water iodine 50-100 μg/L,adaptive iodine areas),Pingyao County and Jicun Town of Fenyang City,Shanxi (water iodine ≥300 μg/L,high iodine areas),and urinary and blood samples were collected in lactating women (n =100,97,123) from the three regions.The urinary iodine concentration was tested by arsenic cerium catalytic spectrophotometry.Serum levels of PRL and E2 were determined by chemiluminescence immunoassay.Results The urinary iodine medians of lactating women were 51.42,283.62,842.31 μg/L,respectively,in the three regions,the difference between the regions was statistically significant (x2 =241.09,P ＜ 0.05);the iodine levels of lactating women in low iodine areas,adaptive iodine areas and high iodine areas were in the state of iodine deficiency (＜ 100 μg/L),sufficient or adequate (200-299 μg/L) and iodine excess status (≥ 300 μg/L),respectively.Serum PRL and E2 levels of lactating women in the three types of areas were 38.81,20.98,16.41 μg/L and 29.57,43.70,45.51 ng/L,respectively.The differences between the regions were statistically significant (x2 =41.54,24.03,P ＜ 0.05).Conclusion With the increase of iodine nutrition level,PRL in lactating women has presented a gradually decreasing trend,E2 is increased.
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OBJECTIVES: Use of dietary supplements containing vitamins and minerals is growing in Korean adults, especially in pregnant and lactating women. Vitamin and mineral supplements are available in different composition and in a wide range of contents. The purposes of the study were to examine nutrient composition and content of vitamin and mineral supplements for pregnant and lactating women and assess their appropriateness as dietary supplements. METHODS: Information on the name, manufacturer, nutrient composition, and usage of vitamin and mineral supplements for pregnant and lactating women were obtained from the homepage of the Food Safety Information Portal managed by the Ministry of Food and Drug Safety, and Korean Index of Medical Specialties. A total of 264 products were identified. RESULTS: Among 264 products, 26.1% were single nutrient products, and 73.9% were multinutrient products. The most commonly included nutrient was iron (70.1%), folic acid (66.3%), vitamin B12 (45.8%), vitamin C (38.6%), and vitamin B6 (38.6%). Although more than 50% of products contained nutrients less than 150% of Recommended Nutrient Intakes or Adequate Intakes for daily use, some products contained inappropriately high amounts of nutrients. When a maximum daily dose of supplements was taken as described on the label, iron in 73 products (39.5%), folic acid in 14 products (8.0%) were likely to be consumed in amounts greater than Tolerable Upper Intake Levels. Most products were assessed as inappropriate for pregnant women due to the possibility of excessive intake of vitamins or minerals when compared with Dietary Reference Intakes. CONCLUSIONS: Pregnant and lactating women need to carefully select dietary supplements containing adequate amounts of vitamins and minerals. Nutritionists should provide guidelines regarding selection of appropriate vitamin and mineral supplements for pregnant and lactating women.
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Adult , Female , Humans , Ascorbic Acid , Dietary Supplements , Folic Acid , Food Safety , Iron , Korea , Minerals , Miners , Nutritionists , Pregnant Women , Recommended Dietary Allowances , Vitamin B 12 , Vitamin B 6 , VitaminsABSTRACT
OBJECTIVES: Use of dietary supplements containing vitamins and minerals is growing in Korean adults, especially in pregnant and lactating women. Vitamin and mineral supplements are available in different composition and in a wide range of contents. The purposes of the study were to examine nutrient composition and content of vitamin and mineral supplements for pregnant and lactating women and assess their appropriateness as dietary supplements. METHODS: Information on the name, manufacturer, nutrient composition, and usage of vitamin and mineral supplements for pregnant and lactating women were obtained from the homepage of the Food Safety Information Portal managed by the Ministry of Food and Drug Safety, and Korean Index of Medical Specialties. A total of 264 products were identified. RESULTS: Among 264 products, 26.1% were single nutrient products, and 73.9% were multinutrient products. The most commonly included nutrient was iron (70.1%), folic acid (66.3%), vitamin B12 (45.8%), vitamin C (38.6%), and vitamin B6 (38.6%). Although more than 50% of products contained nutrients less than 150% of Recommended Nutrient Intakes or Adequate Intakes for daily use, some products contained inappropriately high amounts of nutrients. When a maximum daily dose of supplements was taken as described on the label, iron in 73 products (39.5%), folic acid in 14 products (8.0%) were likely to be consumed in amounts greater than Tolerable Upper Intake Levels. Most products were assessed as inappropriate for pregnant women due to the possibility of excessive intake of vitamins or minerals when compared with Dietary Reference Intakes. CONCLUSIONS: Pregnant and lactating women need to carefully select dietary supplements containing adequate amounts of vitamins and minerals. Nutritionists should provide guidelines regarding selection of appropriate vitamin and mineral supplements for pregnant and lactating women.
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Adult , Female , Humans , Ascorbic Acid , Dietary Supplements , Folic Acid , Food Safety , Iron , Korea , Minerals , Miners , Nutritionists , Pregnant Women , Recommended Dietary Allowances , Vitamin B 12 , Vitamin B 6 , VitaminsABSTRACT
Objective To assess iodine nutritional status of lactating women and infants (0-2 years old) in six ecological regions of Gansu Province,and to provide a scientific basis for iodine supplementation of target people.Methods According to different topography and climate conditions,Gansu Province was divided into six ecological regions:the desert region,the Gobi region of Hexi Corridor,the hills and valleys region of Loess Plateau,the Zhongshan Valley of Qinling Mountains,the grassland meadow area of Gannan plateau and the Loess Plateaugully region.Totally 5 counties were selected from each ecological region,and each county was divided into five geographic locations (east,south,west,north and center).In each location,one township was identified and ten samples of lactating women and infants (0-2 years old) were selected randomly and 60 salt samples of residents were collected to determine iodine content.At the same time salt intake of 20 residents was surveyed in three townships as mentioned above.The water samples of all the centralized water supply projects were collected in each county,and one water sample of the decentralized water supply in ten townships with the largest population of each county from east,south,west,north and center locations was collected to determine iodine content.One soil sample was collected to determine iodine content in east,south,west,north and center townships of each county.The urinary iodine and water iodine levels were measured with the method for determination of iodine in urine by As3+-Ce4+ catalytic spectrophotometry (WS/T 107-2006).The direct titration method among thegeneric methods for iodide testing in salt production industry (GB/T 13025.7-2012) was used to determine the salt iodine level,and the arbitration method was adopted for quantitative determination in the case of Sichuan salt or other special salts and the salt intake was estimated based on three day weighed food record.The soil iodine was determined using the amplified colorimetric method.Results Totally 1 476 and 1 461 urine samples of lactating women and infants were collected,and the total urine iodine medians of lactating women and infants (0-2 years old) were 149.05 and 151.34 μg/L,respectively,the urine iodine median of lactating women and infants in each ecological region was at the 100-199 μg/L appropriate level.Not weaning infants urine iodine (155.32 μg/L) was higher than that of the weaning infants (146.30 μg/L),the difference was significant statistically (Z =-2.808,P ＜ 0.05).There was a correlation between urine iodine of not weaning infants aged 0-2 years old and breastfeeding women (r =0.133,P ＜ 0.01),and there was no correlation between weaning infants and breastfeeding women (r =0.045,P ＞ 0.05).About 9 008 salt samples were collected,and the rates of qualified iodized salt intake in the six ecological regions were all higher than 93％.The daily salt intake per person ranged from 4.5 g to 12.6 g,in which the Loess Plateaugully region was the highest with 12.6 g and the grassland meadow area of Gannan plateau was the lowest with 4.5 g.The water iodine median of 1 513 water samples was 3.3 μg/L.The water iodine medians of the rest 4 ecological regions were all less than 5 μg/L except for the desert region (42.4 μg/L) and the Loess Plateau-gully region (30.0 μg/L) of which the median of water iodine was higher than 20 μg/L.The soil iodine median of 155 soil samples was 127 μg/kg,in which the desert region was the lowest with 78 μg/kg and the grassland meadow area of Gannan plateau was the highest with 218 μg/kg.Conclusion Lactating women and infants are in good iodine nutritional status and the present iodized salt concentration can meet the demand of iodine nutrition of lactating women and infants well.
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Objective To set up the reference ranges of thyroid hormones for pregnant and lactating woman in Zhejiang.Methods A total of 338 pregnancy,322 lactating women and 139 non-pregnant women (as a control) were selected from 1 079 women in 13 survey sites of Zhejiang as survey subjects,through the questionnaire survey and thyroid B-ultrasound tests from June 2010 to September 2010.The level of urinary iodine was measured by spectrophotometer,and the thyroid hormone [free triiodothyronine (FT3),free (unbound) thyroxin (FT4),triiodothyronine (T3),tetraiodothyronine (T4),thyroid stimulating hormone (TSH)] was measured by automated chemiluminescence immunoassay.Analysis of thyroid hormone 95％ in pregnant women and lactating women.Results The median urinary iodine of all women investigated were in optimal urine levels (150-249 μg/L),which indicated they were in iodine sufficient status.The FT3 index of lactating women was higher than that of pregnant women and non pregnant women (Zlactating-pregnant =3.98,Zlactating-pregnant =2.46,all P ＜ 0.05);the FT4 index level of lactating women was higher than that of pregnant women and non pregnant women (Zlactating-pregnant =2.68,Zlactating-non-pregnant =2.25,all P ＜ 0.05);the T3 index level of lactating women was higher than that of pregnant women and non pregnant women (Zlactating-pregnant =3.51,Zlactating-non pregnant =2.41,all P ＜ 0.05);levels of T4 in lactating women was the highest (Zlactating-pregnant =2.30,Zlactating-pregnant =4.90,Zlactating-non pregnant =1.57,all P ＜ 0.05);TSH index of lactating women and non pregnant women were higher than that of pregnant women (Zlactating-pregnant =2.81,Zlactating-non pregnant =1.68,all P ＜ 0.05).And in pregnant,the 95％ medical reference interval of FT3 was 3.37-6.53 pmol/L,FT4 was 10.68-20.85 pmol/L,T3 was 1.40-2.79 nmol/L,T4 was 72.72-166.41 nmol/L,and TSH was 0.15-4.44 mU/L;in lactating woman,FT3 was 3.39-6.44 pmol/L,FT4 was 10.81-20.33 pmol/L,T3 was 1.44-2.77 nmol/L,T4 was 71.94-164.61 nmol/L,and TSH was 0.25-4.47 mU/L.Conclusion The thyroid hormone levels of pregnant and lactating women are different from those of non-pregnant women,therefore establishing reference data of thyroid hormones for pregnant and lactating women may be a very important step for clinical practice.
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OBJECTIVES: The purpose of the study was to develop a series of education materials as a card news format to provide nutrition information for pregnant and lactating women. METHODS: The materials were developed in seven steps. As a first step, the needs of pregnant and lactating women were assessed by reviewing scientific papers and existing education materials, and by interviewing a focus group. The second step was to construct main categories and the topics of information. In step 3, a draft of the contents in each topic was developed based on the scientific evidence. In step 4, a draft of card news was created by editors and designers by editing the text and embedding images in the card news. In step 5, the text, images and sequences were reviewed to improve readability by the members of the project team and nutrition experts. In step 6, parts of the text or images or the sequences of the card news were revised based on the reviews. In step 7, the card news were finalized and released online to the public. RESULTS: A series of 26 card news for pregnant and lactating women were developed. The series covered five categories such as nutrition management, healthy food choices, food safety, favorites to avoid, nutrition management in special conditions for pregnant and lactating women. The satisfaction of 7 topics of the card news was evaluated by 140 pregnant women, and more than 70% of the women were satisfied with the materials. CONCLUSIONS: The card news format materials developed in this study are innovative nutrition education tools, and can be downloaded on the homepage of the Ministry of Food and Drug Safety. Those materials can be easily shared in social media by nutrition educators or by pregnant and lactating women to use.
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Female , Humans , Comprehension , Education , Focus Groups , Food Safety , Pregnant Women , Social MediaABSTRACT
OBJECTIVE:To provide reference for drug use labeling for pregnant and lactating women. METHODS:The drug package inserts were collected from Linxi Hospital of Kailuan General Hospital during Jul. 2013-Dec. 2015. The information about drug use labeling for pregnant and lactating women was analyzed statistically. RESULTS:Among 762 drug package inserts,pack-age inserts which were not labeled with or labeled with indefinite drug use information for pregnant and lactating women accounted for 31.89% and 52.76% respectively. Among package inserts of 361 domestic chemical drugs and biological products,339 Chinese patent medicine and 62 imported drug,package inserts which were not labeled or labeled with indefinite drug use information for pregnant and lactating women accounted for 22.99% and 25.21%,44.54% and 88.50%,14.52% and 17.74%,respectively. CON-CLUSIONS:Except for poor drug use labeling for pregnant and lactating women in package inserts package,there still are other problems,such as items listed dispersedly,presentation content not consistent. Compared with imported drugs,the missing informa-tion for pregnant and lactating women are obvious in drug package inserts of domestic chemical drugs and biological products,and severe in those of Chinese patent medicine. It is recommended that drug manufacturers should strengthen drug tracing and monitor-ing after listed,and update and revise related content of package inserts timely;drug administration department should strengthen drug package inserts supervision,and unify and standardize labeled content management of drug use.
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The prevalence of HIV infection in Swaziland (26%) is among the highest in the world. We investigated nutritional knowledge, attitude, and practices (KAP) and the influence of sociodemographic factors on KAP among pregnant and lactating women living with HIV in the Manzini region of Swaziland. Interviews were conducted using a structured questionnaire to collect data from 324 subjects seeking healthcare from selected regional hospitals, health centres, and clinics in Manzini region. The results showed mean percentage scores of nutritional knowledge (67%), attitude (67%), and practices (51%) whereby educational level (p=0.002), employment status (p=0.009), income (p=0.008), religion (p=0.007), type of accommodation (p=0.006), type of transport used when going for shopping (p=0.001), and BMI (p=0.015) were significantly associated with nutritional practices. Significant positive correlations between nutritional KAP were observed: nutritional K and A (r=0.155, p=0.005), nutritional K and P (r=0.456, p=0.001), and nutritional A and P (r=0.230, p=0.001). Multiple linear regression analysis indicated that type of transport used when going for shopping (p=0.002), educational level (p=0.001), income (p=0.001), employment (p=0.038), knowledge of food proportion in a plate (p=0.000), a positive attitude towards high-fibre diet (p=0.004), and eating a variety of foods (p=0.006) were predictors of nutritional practices. Educational level was identified as a common predictor of nutritional knowledge, attitude, and practices, suggesting that both formal and informal education systems are potential factors influencing dietary practices among pregnant and lactating women living with HIV in Swaziland.
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OBJECTIVE: To investigate the instruction for drug use for pregnant and lactating women and to provide reference for standardizing drug package inserts. METHODS: Four hundred and ninty drug instructions sampled from the pharmacy in our hospital were investigated and analyzed on the part for pregnant and lactating women medication by Provisions for Drug Insert Sheets and Labels, Regulatory Guidelines for the chemicals non-prescription drug, Regulatory Guidelines for chemicals and living creature product and other references. RESULTS: In prescription medicines, The rate of pregnant and lactating women to use the medicine circumstance marked was 53.91%, and that of "not yet clear" or "still have no data" was 13.28%, and the other 32.81% have never carried on to mark. In non-prescription medicines, The rate of pregnant and lactating women to use the medicine circumstance marked was 46.23%, 53.77% have never carried on to mark. CONCLUSION: The contents of pregnant and lactating women medication are far from perfect, Which should draw attention to better management.
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Objective To observe the implementation of national food safety standard for “Iodine Concentration in Edible Salt”(GB 26878-2011) and its effectiveness on iodine nutritional status of key populations. Methods Information of iodine concentration in edible iodized salt of various provinces (autonomous regions and municipalities, including Xinjiang Production and Construction Corps) was collected using Baidu Searching Engine through the establishment of key words. Sal t samples were collected in Tianjin City and Aksu Region of Xinjiang , and the salt iodine concentration in both places was 30 mg/kg. In Tianjin, Hongqiao, Tanggu and Hangu, Beichen were selected as representatives of the downtown areas, the coastal areas and the suburbs, respectively and counties of Baodi and Ji were iodine deficiency areas in history. Sampling work was carried out from August 2012 to March 2013 in Tianjin. In Aksu, Yatuoer Township and Charqi Town in Baicheng County, Aotebeixi and Aketuohai Townships in Wushen County were chosen as iodine deficiency areas, and the survey was carried out from January to September 2013 . Random urine samples of school-age children ( 8 - 10 years old ) , pregnant women and lactating women were collected; urinary iodine was measured following the Method for Determination of Iodine in Urine by As3+-Ce4+ Catalytic Spectrophotometry(WS/T 107-2006) and iodine in edible iodized salt was measured following the General Test Method in Salt Industry Determination of Iodideion ( GB/T 13025 . 7-1999 ) . Results Fourteen of the provinces(autonomous regions and municipalities, including the Corps of Xinjiang) chose 25 mg/kg as their iodine concentration in edible iodized salt and 13 provinces chose 30 mg/kg. Besides, there were another 5 provinces providing 30 mg/kg particularly for pregnant women and lactating women while 25 mg/kg for other populations. In Tianjin, the medians of iodine concentration in edible iodized salt were ranged from 24.4 - 32.1 mg/kg in retail stores and 26.4 mg/kg at households. The household coverage rate of iodized salt and the proportion of households using adequately iodized salt were 78.5%(168/214) and 62.6%(134/214), respectively. The median ranges of urinary iodine were 178.2 - 183.9 μg/L in school children, 124.3 - 130.9 μg/L in pregnant women and 72.7 - 109.5 μg/L in lactating women. In Aksu, the medians of iodine concentration in edible iodized salt were 27.1 and 26.5 mg/kg in retail stores and households, respectively. The household coverage rate of iodized salt and the proportion of households using adequately iodized salt were 100.0% (363/363) and 98.9%(359/363), respectively. The median ranges of urinary iodine were 174.8 - 293.0, 154.9 - 230.0 and 135.8 - 239.3 μg/L among school children, pregnant women and lactating women, respectively. The median of iodine concentration in a special edible iodized salt sample reached 49.1 mg/kg, and qualified rate was 0(0/11) in Aksu. Conclusions All provinces , municipalities and autonomous regions ( including the Corps of Xingjiang ) in China have adjusted the iodine content in edible iodized salt in accordance with GB 26878-2011. However, in Tianjin the household iodine concentration in edible salt is lower than the local standards; the household coverage rate of iodized salt and the proportion of households using adequately iodized salt are lower than the national standards; pregnant women and lactating women are at risk of mild iodine deficiency.
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Vitamin A status in a sample of pregnant and lactating women living in several representative regions of Congo was assessed and compared between August and September 2004. This survey was conducted using a randomized two-stage cluster-sampling method with stratification on 90 clusters, each consisting of at least 15 women. Vitamin A status was determined in a total of 1,054 individuals, using the impression cytology with transfer (ICT) test, the modified relative dose response test (MRDR test) on dried blood spots (DBS), and clinical examination to detect signs of xerophthalmia. The clinical criterion defining vitamin A deficiency was the presence of active xerophthalmia (Bitot’s spots [X1B]), active corneal disease), and/ or night blindness (XN stage). The prevalence of clinical signs of stage XN and X1B xerophthalmia in the Republic of Congo was found to be 16% and 19% respectively. The prevalence of clinical signs (X1B) was greater in the rural north than in urban areas, with a gradient running from urban (5%) to rural area (33%); 27% of all the ICT tests showed that the subjects were suffering from vitamin A deficiency. The deficiency rates were significantly higher (p<0.001) in urban surroundings (Brazzaville) than in the rural northern regions. The biochemical MRDR test showed the presence of vitamin A deficiency (≥0.06) in 26% of the mothers in Brazzaville compared to 6% in the town of Kouilou; 44% of the women had retinol levels of <10 μg/dL in the rural north whereas these percentages were significantly lower in the urban areas surveyed (chi-square=62.30, p<0.001). A significant correlation was found to exist (p<0.001) between the ICT test and the MRDR test on DBS. In the population as a whole, 30% of the mothers suffering from malarial attack had abnormally low MRDR levels (≥0.06) compared to no malaria. The results of the present study confirm that vitamin A deficiency is a serious public-health issue in pregnant and lactating mothers in the Republic of Congo.
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Objective To find out the iodine nutritional status and thyroid function of pregnant and lactating women in the urban areas of Wuwei City of Gansu Province,and to provide a scientific basis for iodine supplementation.Methods Blood and urine samples of pregnant (52 persons) and lactating women (59 persons) were collected in 2009.Urinary iodine content was measured with arsenic cerium catalytic spectrophotometric.Serum free three triiodothyronine(FT3),free thyroid hormone(FT4),triiodo thyronine(TT3),serum total thyroxine (TT4) and thyroid-stimulating hormone (TSH) were detected with direct chemiluminescence immunoassay.Results The medians urinary iodine of pregnant and lactating women were 274.68,217.88 μg/L.The rates of low urinary iodine (pregnant women below 150 μg/L,lactating women lower than 100 μg/L) were 9.62％ (5/52) and 6.78％ (4/59).Serum TT3,TT4 levels in pregnant women[(2.48 ± 0.59),(132.18 ± 33.36)nmoL/L] were higher than that in the lactating women[(2.16 ± 0.49),(108.79 ± 28.36)nmol/L,t =-3.123,-3.971,all P ＜ 0.05].Thyroid dysfunction incidence rates of pregnant and lactating women were 17.31％ (9/52) and 8.47％ (5/59).Thyroid dysfunction was mostly subclinical hypothyroidism.Conclusions Overall iodine nutrition of pregnant and lactating women is in good condition,some individuals have the trend of hypothyroidism.It is necessary to carry out routine monitoring of urinary iodine and thyroid function.
ABSTRACT
The use of psychotropic medications in lactating women is controversial. Despite widely accepted advantages of human milk, patients and professionals hesitate to use medications during breastfeeding. Package inserts written by manufacturers routinely discourage breastfeeding to prevent law suits. Here we conducted a review to help professionals to decide medication for lactating women on an evidence-based risk-benefit analysis. First, we reviewed lactational pharmacology. The relative infant dose (RID) was defined to give an objective measure for infant exposure to medication, and drugs with RID lesser than 10% were considered quite safe. Subsequently, we reviewed each category of psychotropic medications which were commonly used in mental illness. We provided information for each drug such as Dr. Hale's lactation risk category, RID, half-life, and time to peak plasma level as references for the risk analysis. There was no contraindicated psychotropic medication during breastfeeding, but for lithium, close monitoring of infant serum levels is warranted. In conclusion, most of medications used to treat mental illness in lactating women were usually safe. Nevertheless, medication use in lactating women should always be considered on an individualized risk-benefit analysis, and untoward adverse effects on the infant should be monitored.