Study on the Dose-Response Relationship between Magnesium and Type 2 Diabetes of Childbearing Women in the China Adult Chronic Disease and Nutrition Surveillance 2015.

Background: Magnesium (Mg) is an essential element and participates in many metabolic pathways. Many studies have found a certain negative correlation between magnesium and blood glucose parameters, but the dose-response relationship between them is still a relatively narrow research field. We aim to explore the dose-response relationship between plasma and dietary Mg and type 2 diabetes (T2DM) among childbearing women in a nationally representative sample. And we will also initially explore the threshold of dietary and plasma magnesium in the prevention of T2DM and their consistency. Methods: A total of 2912 18-44 year-old childbearing women were recruited from the China Adult Chronic Disease and Nutrition Surveillance (2015). Multivariate logistic regression was used to explore the dose-response relationship between plasma and dietary Mg and glucose parameters. The threshold effect between Mg and T2DM was explored by a restricted cubic spline regression. Results: It was found that when plasma Mg was increased by 0.041 mmol/L, the risk of T2DM, impaired fasting glucose (IFG), and HbA1c-hyperglycemia was reduced by 18%, 19%, and 18%, respectively. The possible threshold value for plasma Mg to prevent the risk of T2DM was 0.87 mmol/L. Through the quality control of the sample dietary survey data, 2469 cases were finally included for dietary analysis. And the possible threshold value for dietary Mg to prevent the risk of T2DM was 408 mg/d. Taking the recommended dietary Mg intake of 330 mg/d as the reference group, when the Mg intake reached 408 mg/d, the risk of T2DM was significantly reduced. And the average plasma Mg level of the people whose dietary intake reached 408 mg/d was 0.87 mmol/L. Conclusions: These results indicate that dietary Mg and plasma Mg have good consistency on the threshold effect of glucose parameters in women of childbearing age.

Contextual determinants of generational continuation of female genital mutilation among women of reproductive age in nigeria: analysis of the 2018 demographic and health survey.

BACKGROUND: Female genital mutilation (FGM) has negative health implications and has long been recognised as violating sexual rights. Despite the huge efforts expended on eradicating FGM, generational continuation of the practice, i.e. the act of mutilated women also mutilating their daughters, persists in Nigeria. This study investigated the individual, household, and community factors associated with generational continuation of FGM among women in Nigeria. METHODS: The study analysed data from the 2018 Nigeria Demographic and Health Survey (NDHS). A weighted sample of 3835 women with FGM history and who had given birth to female children was analysed. Models were estimated using mixed-effects multilevel logistic regression with Stata 16.0. RESULTS: The results showed that 40.0% of women continued FGM for their daughters. Regional prevalence of FGM continuation ranged from 14.9% in the South-South (the lowest) to 64.3% in the North-West (the highest). Women aged 15-24 years (uaOR = 0.40; 95% CI:0.28-0.57) and rich (uaOR = 0.44; 95% CI:0.35-0.56) had the least likelihood of generational continuation of FGM. In communities with low proportions of women unexposed to the media, the likelihood of FGM continuation was significantly higher (uaOR = 1.85; 95% CI:1.35-2.53). Generational continuation of FGM was significantly lower in communities with moderate proportions of uneducated mothers (aOR = 0.6; 95% CI:0.42-0.86). CONCLUSION: FGM continuation was high in Nigeria, and it was most common among older and poor mothers and in communities with large proportions of uneducated women and those unexposed to the media. Existing National Policy and Plan on FGM elimination should be strengthened to target these characteristics.

Fear of giving birth alone: Experiences of psychological distress, symptoms of anxiety and depression, and coping- strategies of childbearing women during COVID-19.

BACKGROUND: Psychological distress during pregnancy is a well-documented risk factor for adverse maternal outcomes. Distress related to the COVID-19 pandemic may further increase the vulnerability of pregnant women to negative mental health outcomes. AIM: To explore the mental health experiences of pregnant women, focusing on mental health outcomes, challenges related to the pandemic, coping strategies, and factors buffering mental health factors during the restricted COVID-19 lockdown period. METHODS: A mixed-methods survey study was conducted, examining symptoms of anxiety, depression, and burnout among 21 pregnant women. Qualitative data were gathered through open-ended questions about participants' experiences of challenges, coping strategies and buffering factors amid the pandemic. Symptoms of anxiety, depression and burnout were calculated, and qualitative data was thematically analyzed. RESULTS: Approximately one-third (24 %) of the respondents reported clinically significant levels of depression, 19 % reported clinically significant levels of anxiety, and 43 % reported experiencing burnout. All participants reported distress and emotional burden, including fear, worry, stress and anxiety related to the pandemic. Specific concerns such as fear of giving birth alone, fear of the consequences due to lockdown restrictions, insufficient information, disruption of prenatal healthcare services, and fear of miscarriage were prevalent among the participants. Social support, financial stability, stable relationships, adherence to daily routines, reduced stress and social demands, a calmer daily life, physical activity, and less work-related stress including working from home, emerges as buffering factors that aided women in coping with pandemic-related distress. CONCLUSION: Healthcare providers should prioritize stability, predictability, and minimizing disruptions to prenatal care. Broad-based screening is crucial to identify women at risk of depression, anxiety, and burnout. Recommendations for clinical pathways aimed at pregnant women are discussed.

Perinatal Smoking and E-cigarette Use and Their Relationship with Breastfeeding: PRAMS 2015-2020.

Introduction: Electronic cigarette (e-cigarette) use poses concerns among women of child-bearing age. We examined prevalence of breastfeeding among the U.S. women and characteristics associated with exclusive use of cigarettes, e-cigarettes, or both products. Materials and Methods: Our study is based on pooled cross-sectional data from 2015-2020 Pregnancy Risk Assessment Monitoring System. Two outcomes were breastfeeding initiation and breastfeeding duration for over 6 months, as recommended by the American Academy of Pediatrics (AAP). Binary logistic regressions were used to examine associations between each outcome and type of tobacco products unadjusted and adjusted for potential confounders, with post hoc estimation of average adjusted predictions, marginal effects, and contrasts of margins in Stata. Results: Adjusted prevalence of breastfeeding initiation was significantly higher in women who used e-cigarettes (86.15%) than conventional cigarettes (72.16%) or both products (79.54%). Similarly, a significantly higher percentage of women who used e-cigarettes continued breastfeeding after 6 months (49.20%) than women who smoked conventional cigarettes (31.30%) or both products (29.83%). Among women who neither smoked nor used e-cigarettes, 85.29% initiated breastfeeding and 57.20% continued breastfeeding as recommended by the AAP. Conclusion: Likelihood of breastfeeding initiation and continuation in women using e-cigarettes was comparable to those who neither smoked nor used e-cigarettes. Future research needs to elucidate differences in breastfeeding by sociodemographic and health-related characteristics of women who smoke or use both products compared to those who use e-cigarettes. Understanding women's motivation behind use of a particular tobacco product is also important, so mothers who smoke e-cigarettes are not incorrectly perceived as safer users and excluded from tobacco cessation interventions.

Using Andersen's behavioral model of health care use for intermittent preventive treatment of malaria in pregnancy in Nigeria.

BACKGROUND: Studies in Nigeria and elsewhere in sub-Saharan Africa (sSA) have explored factors influencing usage of intermittent preventive treatment of malaria in pregnancy (IPTp). Most studies, however, are not model or theory-based, which provides less satisfactory guidance to malaria control programming. This study fills the knowledge gap by adapting Andersen's behavioral model of health care use to IPTp usage in Nigeria. METHODS: This study adopted a cross-sectional design that utilized secondary data extracted from the 2018 Nigeria Demographic and Health Survey (NDHS). A weighted sample of 4,772 women who had given birth in the past year preceding the survey, was analyzed. Outcome variable was usage of IPTp, dichotomized into optimal or otherwise. Explanatory variables cut across individual and community levels and were divided into predisposing, enabling and need factors in line with the theoretical constructs of the Andersen model. Two multilevel mixed-effects logistic regression models were fitted to identify factors which influenced optimal usage of IPTp. Analyses were performed using STATA 14. Statistical significance was set at 5%. RESULTS: Realised level of optimal IPTp usage was 21.8%. Factors that either predispose or enable pregnant women to take optimal doses of IPTp were maternal education, being employed, being autonomous in their own healthcare, health insurance enrolment, partner education, receiving antenatal care in public health facilities, rural residence, being resident in northern geo-political zones, community literacy level and community perception of the consequences of malaria. Two significant need factors affecting optimal usage of IPTp were timing of the first antenatal care visit and sleeping under mosquito bed nets. CONCLUSION: Optimal usage of IPTp is low among pregnant women in Nigeria. There is a need to devise additional public health educational programs promoting IPTp usage through the formation of Advocacy, Communication and Social Mobilisation (ACSM) in every ward in all local government areas, particularly in the rural and northern parts of the country. In addition, health planners should adopt the Andersen model for assessing key determinants of IPTp usage among childbearing women in Nigeria.

Reference Range of Vitamin K Evaluating Indicators in Chinese Childbearing Women.

BACKGROUND: Vitamin K is an essential fat-soluble vitamin for the human body and its functions, such as promoting blood coagulation, bone health and preventing atherosclerosis, have attracted increasing attention. However, there is no recognized indicator and corresponding reference range for evaluating vitamin K status of different populations at present. The aim of this study is to establish a reference range for vitamin K evaluating indicators in healthy women of childbearing age in China. METHODS: The population sample in this study was from the Chinese Adult Chronic Disease and Nutrition Surveillance (CACDNS) 2015-2017. A total of 631 healthy women of childbearing age (18-49 years) were included using a series of strict inclusion and exclusion criteria. The concentrations of VK1, MK-4 and MK-7 in serum were detected by liquid chromatography-tandem mass spectrometry (LC-MS/MS). The other commonly-reported indicators evaluating vitamin K nutritional status, including undercarboxylated osteocalcin (ucOC), osteocalcin (OC), matrix Gla protein (MGP), desphosphorylated undercaboxylated MGP (dp-ucMGP) and protein induced by vitamin K absence II (PIVKA-II), were measured by enzyme-linked immunosorbent assay (ELISA). The reference range was obtained by calculating the 2.5% to 97.5% interval of the vitamin K evaluating indicators in the reference population. RESULTS: The reference ranges of VK1, MK-4 and MK-7 in serum were 0.21-3.07 ng/mL, 0.02-0.24 ng/mL and 0.12-3.54 ng/mL, respectively. The reference ranges of ucOC, %ucOC, dp-ucMGP and PIVKA-II were 1.09-2.51 ng/mL, 5.80-22.78%, 2.69-5.88 ng/mL and 3.98-8.40 ng/mL, respectively. The cut-off values that can be used to evaluate subclinical vitamin K deficiency were as follows: VK1 < 0.21 ng/mL, MK-7 < 0.12 ng/mL, ucOC > 2.51 ng/mL, %ucOC > 22.78%, dp-ucMGP > 5.88 ng/mL and PIVKA-II > 8.40 ng/mL. CONCLUSION: The reference range of VK1, MK-4, MK-7 and vitamin K-related indicators for healthy women of childbearing age established in this study could be used to assess the nutritional and health status of this population.

Assessing the relationship between knowledge and the actual use of contraceptives among childbearing women in South-South Nigeria: evidence from the 2018 Nigeria demographic and health survey.

BACKGROUND: Nigeria has one of the world's highest fertility rates, which is detrimental to its public health and socioeconomic growth. Despite several efforts by the country and other development partners to reduce high fertility by increasing contraceptive use, the contraceptive prevalence rate among childbearing women remains low, particularly in the South-South compared to other Southern regions. This study, therefore, assessed the relationship between knowledge of and actual use of contraception among women in South-South Nigeria. METHODS: The study employed a cross-sectional analysis of a nationally representative weighted sub-sample of 4,553 South-South childbearing women extracted from the 2018 National Demographic and Health Survey dataset. The dataset was weighted and examined for missing values that were excluded during the analyses at univariate, bivariate, and multivariate levels. The analyses involved a baseline descriptive analysis, a chi-square test, and logistic regression models using Stata software. The results of the explanatory variables were presented as odds ratios (OR) and 95% confidence intervals (CI). RESULTS: Eighty-two per cent of the respondents knew at least one form of contraception, while approximately 82% never used any contraceptive method. The likelihood of using any contraceptive method increased among those who knew about contraceptives (aOR: 1.40; CI: 0.93-2.11). Also, contraceptive use was significantly higher among women and their partners who had post-primary education (aOR: 1.34; CI: 1.25-2.43 and aOR: 1.74; CI: 1.25-2.43, respectively). Furthermore, the prevalence of contraceptive use among women significantly increased with an increase in the household wealth index. Similar results were recorded among women who had five or more living children, who were residents of Rivers State, were married or lived with their partners, were aged 35 years or older, and were currently working. CONCLUSIONS: Contraceptive knowledge was high but did not translate into actual practice among childbearing women in South-South Nigeria. The use of any contraception was highly influenced by contraceptive knowledge, education, age, marital status, place of residence, and household wealth index, among others. Therefore, some policy issues relating to contraceptive knowledge and actual adoption must be addressed to improve the low rate of contraceptive use in Nigeria.

Intimate partner violence and its association with skilled birth attendance among women in Nigeria: evidence from the Nigeria Demographic and Health Surveys.

BACKGROUND: Intimate Partner Violence (IPV) has been identified as a violation of human rights and a major public health challenge. IPV against women has negative effects on women's mental well-being and leads to unfavourable health outcomes through poor maternal healthcare services utilisation, especially skilled birth attendance (SBA). This study examined the trends in IPV and SBA, as well as the different forms of IPV as predictors of SBA in Nigeria. METHODS: Data for the study were derived from a nationally representative weighted sample of 34,294 women selected and interviewed for the questions on the domestic violence module in the three consecutive Nigeria Demographic and Health Surveys conducted in 2008, 2013 and 2018. Descriptive and analytical analyses were carried out, including frequency distribution and binary logistic regression model at the multivariate level. The results of the explanatory variables were expressed as odds ratio (OR) and 95% confidence intervals (CI). RESULTS: The prevalence of emotional and physical IPV among the sampled women decreased in 2013 from 2008 but later increased in 2018. Sexual IPV increased from 4.1% in 2008 to 7.6% in 2018, while births delivered with the assistance of skilled providers increased from 37.7% in 2008 to 50.8% in 2018. The likelihood of using SBA significantly decreased among women who experienced emotional IPV in 2008 (aOR: 0.74; CI: 0.63-0.87) and sexual IPV in 2018 (aOR: 0.62; CI: 0.45-0.86). Women who experienced physical IPV were more likely to use SBA in 2008, 2013 and 2018 (aOR: 1.72; CI: 1.55-1.92; aOR: 1.40; CI: 1.26-1.56 and aOR: 1.33; CI: 1.15-1.54, respectively). The covariates have varying degrees of influence on SBA across the survey years. CONCLUSIONS: The showed that the prevalence of emotional and physical IPV increased in 2018 after a decrease in 2013, with an increase in sexual IPV and the use of SBA across the survey years. Also, emotional and sexual IPV, unlike physical IPV are associated with low chances of using SBA. There is a need for more pragmatic intervention programmes towards eliminating all forms of violence against all women, reducing maternal and child mortality and promoting the empowerment of women.

Birth plans: A systematic, integrative review into their purpose, process, and impact.

BACKGROUND: The birth plan was introduced in the 1980s to facilitate communication between maternity care providers and women and increase agency for childbearing women in the face of medicalised birth. Forty years on, the birth plan is a heterogeneous document with uncertainty surrounding its purpose, process, and impact. The aim of this review was to synthesise the evidence and improve understanding of the purpose, process and impact of the birth plan on childbearing women's experiences and outcomes. METHODS: This systematic review followed the PRISMA guidelines. A comprehensive search strategy was designed and applied to electronic databases CINAHL, MEDLINE, PsychINFO, Cochrane Library, Scopus, and ClinicalTrials.gov. Articles were appraised using the Crowe Critical Appraisal Tool and a five-step integrative approach to analysis followed. FINDINGS: Eleven articles were identified, all quantitative in nature. It is clear that the general purpose of birth plans is communication, with decision making a key factor. Even though the processes of birth planning were varied, having a birth plan was associated with generally positive birth outcomes. CONCLUSIONS: Despite the heterogeneity of birth plans, birth plans were associated with positive outcomes for childbearing women when developed in collaboration with care providers. The act of collaboratively creating a birth plan may improve obstetric outcomes, aid realistic expectations, and improve satisfaction and the sense of control.

Magnesium Nutritional Status, Risk Factors, and the Associations with Glucose Parameters of Childbearing Women in the China Adult Chronic Disease and Nutrition Surveillance (2015).

Magnesium is an essential element and participates in many metabolic pathways. Inadequate magnesium levels may lead to various health problems such as type 2 diabetes (T2DM), hypertension, and cancer. But the role of Mg in childbearing women of China is still a relatively narrow researched field. We aimed to assess the Mg nutritional status, explore the risk factors of Mg deficiency, and the associations between Mg and glucose parameters among childbearing women in a nationally representative sample. A total of 1895 18-44 years childbearing women were recruited from the China Adult Chronic Disease and Nutrition Surveillance (2015). Multivariate logistic regression was used to explore the risk factors for Mg deficiency and estimate the odds ratios (ORs) and 95% confidence intervals (95% CIs) for the risk of hyperglycemia. The mean value of Mg was 0.87 mmol/L and the prevalence of deficiency was 4.69%. The risk factors of Mg deficiency (Mg < 0.75 mmol/L) was city-type of rural (p = 0.045), while calcium (p = 0.001), LDL-C (p = 0.024), age group of 26-35 years (p = 0.016), 36-44 years (p = 0.006), and CNNM2 rs3740393 genotypes of GC (p = 0.027) were protective factors. It was also found that magnesium deficiency induces an increase in plasma glucose (p = 0.001). Compared with the reference range, Mg < 0.75 mmol/L would have a 6.53 fold risk for T2DM, a 5.31 fold risk for glucose-hyperglycemia, and a 9.60 fold risk for HbA1c-hyperglycemia. Consistently, there was a negative association between plasma Mg and blood glucose parameters in the dose-response study. More attention should be paid to the nutritional status of magnesium and the impact of magnesium deficiency on human health.

Translation of the UK-Birth-Satisfaction-Scale-Revised (BSS-R) into Brazilian (Portuguese) and description of initial measurement properties.

RATIONALE: The concept of birth satisfaction embraces many factors, which include for example perceived quality of care provision, stress experienced, and personal coping strategies. A woman's birth experience has the power to affect her mental health, decisions surrounding future birth planning, and quality of relationships with her partner and family. The UK-Birth-Satisfaction-Scale-Revised (UK-BSS-R) is currently recommended as the tool of choice by the International Consortium for Health Outcome Measures (ICHOM) for measuring women's experiences of childbirth. It was therefore considered important to translate and validate this scale for use in a Brazilian context. OBJECTIVE: To translate and culturally adapt the UK-BSS-R into Brazilian (Portuguese) and validate its key measurement properties. METHODS: A repeated-measures survey was conducted for the purpose of examining factor structure, validity and reliability of the Brazilian (Portuguese)-BSS-R. PARTICIPANTS: Data was gathered from (n = 101) Brazilian Portuguese-speaking postnatal women. RESULTS: The initial measurement characteristics of the Brazilian (Portuguese)-BSS-R in terms of Intraclass Correlational Coefficient, Standard Error of Measurement and minimal detectable change were found to be excellent. CONCLUSION: The Brazilian (Portuguese)-BSS-R is now considered to be a valid and reliable multidimensional psychometric instrument for measuring birth satisfaction in a Brazilian Portuguese population of postnatal women. This translation was found to be conceptually consistent with the original English-language version (UK-BSS-R) and to have an excellent initial measurement characteristics profile. The direction of future research is indicated, specifically to undertake a thorough psychometric evaluation of the Brazilian (Portuguese)-BSS-R in a larger sample.

Threshold for Relationship between Vitamin D and Parathyroid Hormone in Chinese Women of Childbearing Age.

Background: The aim of this study was to assess the relationship between serum 25-hydroxyvitamin D [25(OH)D] and serum intact parathyroid hormone (PTH) in Chinese childbearing women, and to estimate the optimum threshold of 25(OH)D that maximally inhibits the PTH, which is considered to be the optimal status for vitamin D sufficiency. Methods: Serum samples were selected from the biological samples' bank of the Chinese Chronic Diseases and Nutrition Survey (CCDNS) 2015. The serum 25(OH)D concentration was determined by liquid chromatography tandem mass spectrometry and the serum PTH was determined by electronic chemiluminescence. Simple linear and partial correlation analysis, locally weighted regression smooth scatterplot (LOESS), nonlinear least squares estimation (NLS), and segmented regression (SR) were utilized to estimate the relationship of 25(OH)D and PTH, and to determine the threshold of 25(OH)D. Results: A total of 1568 serum samples of 25(OH)D concentration and PTH concentration were analyzed. A significant inverse relationship between 25(OH)D and PTH concentration was observed below 15.25 (14.22-16.28) ng/mL, and PTH decreased slowly with the increase of 25(OH)D above 16.75 (15.43-18.06) ng/mL after adjusting by age, latitude, city type, season, corrected calcium, and phosphorus. A very short plateau of PTH was found at 15.25 ng/mL and 16.75 ng/mL in terms of 25(OH)D according to LOESS, NLS, and SR. Conclusions: The serum 25(OH)D was negatively correlated with the serum PTH. The threshold of VitD sufficiency was found in the range of 14.22-18.06 ng/mL in terms of serum 25(OH)D concentration for Chinese childbearing women aged 18-44 years old.

An Assessment of Health Outcomes and Methylmercury Exposure in Munduruku Indigenous Women of Childbearing Age and Their Children under 2 Years Old.

In line with the 1000-day initiative and the Sustainable Development Goals (SDG) 2 and 3, we present a cross-sectional analysis of maternal health, infant nutrition, and methylmercury exposure within hard-to-reach indigenous communities in the state of Pará, Brazilian Amazon. We collected data from all women of childbearing age (i.e., 12-49) and their infants under two years old in three Munduruku communities (Sawré Muybu, Sawré Aboy, and Poxo Muybu) along the Tapajos River. We explored health outcomes through interviews, vaccine coverage and clinical assessment, and determined baseline hair methylmercury (H-Hg) levels. Hemoglobin, infant growth (Anthropometric Z scores) and neurodevelopment tests results were collected. We found that 62% of women of childbearing age exceeded the reference limit of 6.0 µg/g H-Hg (median = 7.115, IQR = 4.678), with the worst affected community (Sawré Aboy) registering an average H-Hg concentration of 12.67 µg/g. Half of infants aged under 24 months presented with anemia. Three of 16 (18.8%) infants presented H-Hg levels above 6.0 µg/g (median: 3.88; IQR = 3.05). Four of the 16 infants were found to be stunted and 38% of women overweight, evidencing possible nutritional transition. No infant presented with appropriate vaccination coverage for their age. These communities presented with an estimated Infant Mortality Rate (IMR) of 86.7/1000 live births. The highest H-Hg level (19.6 µg/g) was recorded in an 11-month-old girl who was found to have gross motor delay and anemia. This already vulnerable indigenous Munduruku community presents with undernutrition and a high prevalence of chronic methylmercury exposure in women of childbearing age. This dual public health crisis in the context of wider health inequalities has the potential to compromise the development, health and survival of the developing fetus and infant in the first two critical years of life. We encourage culturally sensitive intervention and further research to focus efforts.

Suggested Reference Ranges of Blood Mg and Ca Level in Childbearing Women of China: Analysis of China Adult Chronic Disease and Nutrition Surveillance (2015).

BACKGROUND: Magnesium and calcium play a variety of biological roles in body functions. Reference values of these elements have not yet been systematically determined in China, especially in childbearing women. We proposed to establish the reference range of Mg, Ca, and Ca/Mg ratio in plasma and whole blood for 18-44 years healthy childbearing women in China. METHOD: A total of 1921 women of childbearing age (18-44 years) were randomly selected from the 2015 China National Nutrition and Health Survey by taking into account the regional types and monitoring points. Among them, 182 healthy women were screened out with a series strict inclusion criteria to study the reference ranges of elements. Fundamental indicators (weight, height, waist, blood pressure, total cholesterol, triglyceride, high-density lipoprotein cholesterol, low-density lipoprotein, fast glucose, HbA1c, blood pressure, uric acid) and elements concentrations in plasma and whole blood were collected. The 2.5th to 97.5th was used to represent the reference range of Mg, Ca, and Ca/Mg ratio. RESULTS: The reference range of Mg, Ca, and Ca/Mg ratio in plasma were 0.75-1.13 mmol/L, 2.27-3.43 mmol/L, and 2.41-3.44, respectively. Additionally, the reference range of Mg, Ca, and Ca/Mg ratio in whole blood were 1.28-1.83 mmol/L, 1.39-2.26 mmol/L, and 0.90-1.66, respectively. According to the established reference range, the prevalence of magnesium deficiency was 4.79% in 1921 childbearing women, 21.05% in type 2 diabetes, and 5.63% in prediabetes. CONCLUSION: The reference values of Mg, Ca and Ca/Mg proportion in plasma and entire blood of healthy childbearing women can be utilized as a pointer to assess the status of component lack and over-burden. The lower limit of plasma Mg is in good agreement with the recommended criteria for the determination of hypomagnesemia.

[Relationship between rs7041 polymorphism of GC gene and serum vitamin D status in Chinese women of childbearing age].

OBJECTIVE: To investigate the association of rs7041 polymorphism of GC gene that encodes the vitamin D-binding protein with serum vitamin D status in Chinese women of childbearing age. METHODS: A total of 1812 plasma samples of women childbearing aged 18-44 years old were selected by stratified random sampling technology from the established biological samples bank of Chinese Chronic Diseases and Nutrition Survey(CCDNS, 2015-2018). The serum 25(OH)D status was detected by enzyme-linked immunosorbent assay. The genotypes of rs7041 in the GC gene were analyzed by improved multiple ligase detection reaction method. RESULTS: A total of 1812 childbearing women aged 18-49 years were included in this study. The frequency of rs7041 genotypes in the study were distributed according to the Hardy-Weinberg equilibrium, indicating sufficient representativeness of our sample. The median serum 25(OH)D status was 16. 69(12. 04, 21. 69)ng/mL. The higher 25(OH)D levels was detected in the overall sample, southern women or women with normal vitamin D status with the CC genotype than the AA genotype(P<0. 05). Before and after correction, the risk of vitamin D insufficiency in the women carrying the CC genotype was decreased significantly compared with the women carrying the AA genotype(OR=0. 571, 95%CI 0. 373-0. 873). And the CC genotype of rs7041 was associated with a significant decrease in risk of 25(OH)D deficiency(in the subgroup of southern childbearing women, OR=0. 284, 95%CI 0. 144-0. 560 and in the subgroup of northern childbearing women, OR=0. 109, 95%CI 0. 015-0. 798). CONCLUSION: The GC rs7041 with A/C polymorphism are significantly correlated with 25(OH)D status in Chinese childbearing women, mutant CC genotype is a protective factor for vitamin D non-normal status risks.

Biological changes in the pregnancy-postpartum period and subsequent cardiometabolic risk-UPSIDE MOMS: A research protocol.

Multiple physiological changes occur in pregnancy as a woman's body adapts to support the growing fetus. These pregnancy-induced changes are essential for fetal growth, but the extent to which they reverse after pregnancy remains in question. For some women, physiological changes persist after pregnancy and may increase long-term cardiometabolic disease risk. The National Institutes of Health-funded study described in this protocol addresses a scientific gap by characterizing weight and biological changes during pregnancy and an extended postpartum period in relation to cardiometabolic risk. We use a longitudinal repeated measures design to prospectively examine maternal health from early pregnancy until 3 years postpartum. The aims are: (1) identify maternal weight profiles in the pregnancy-postpartum period that predict adverse cardiometabolic risk profiles three years postpartum; (2) describe immune, endocrine, and metabolic biomarker profiles in the pregnancy-postpartum period, and determine their associations with cardiometabolic risk; and (3) determine how modifiable postpartum health behaviors (diet, physical activity, breastfeeding, sleep, stress) (a) predict weight and cardiometabolic risk in the postpartum period; and (b) moderate associations between postpartum weight retention and downstream cardiometabolic risk. The proposed sample is 250 women. This study of mothers is conducted in conjunction with the Understanding Pregnancy Signals and Infant Development study, which examines child health outcomes. Biological and behavioral data are collected in each trimester and at 6, 12, 24, and 36 months postpartum. Findings will inform targeted health strategies that promote health and reduce cardiometabolic risk in childbearing women.

Study on Reference Range of Zinc, Copper and Copper/Zinc Ratio in Childbearing Women of China.

Background: Copper and zinc are both essential elements in humans, that play various biological roles in body functions. Population-based reference values have not yet been established in China especially in childbearing women. The aim of this study is to establish a reference value of Zn, Cu and Cu/Zn ratios in childbearing women aged 18-44 from a representative population in China. Method: A total of 191 healthy childbearing women aged 18-44 years old were enrolled from the China Adult Chronic Disease and Nutrition Surveillance (2015) in this study with a series strict inclusion criteria. Basic biological indicators (weight, height, waist, blood pressure, high-density lipoprotein cholesterol, low-density lipoprotein, total cholesterol, triglyceride, fast glycose, HbA1c, blood pressure, uric acid) and elements levels in plasma and whole blood were collected. The 2.5th to 97.5th was used to represent the reference range of Cu, Zn and Cu/Zn ratio. Results: The reference range of Zn, Cu and Cu/Zn ratio in plasma were 70.46-177.53 µg/dL, 74.30-170.68 µg/dL and 0.54-1.68, respectively. The reference range of Zn, Cu and Cu/Zn ratios in whole blood were 402.49-738.05, 74.63-124.52 and 0.13-0.25 µg/dL, respectively. Conclusion: The reference range of Zn, Cu and Cu/Zn ratios in plasma and whole blood of healthy Chinese childbearing women could be used as an indicator to evaluate the status of element deficiency and overload.

Factors associated with institutional delivery among women in Bule Hora Town, Southern Ethiopia.

INTRODUCTION: Globally, approximately 303,000 women died during pregnancy and childbirth in 2015, and 830 women died each day from preventable causes related to pregnancy and childbirth. Although institutional delivery is crucial to save the lives of mothers and infants, many women in Ethiopia give birth at home. Identification of factors that prevent them from giving birth at health facilities is needed to resolve this issue. This study aimed to assess the use of institutional delivery services and associated factors among women of childbearing age in Bule Hora Town, Ethiopia. MATERIALS AND METHODS: A community-based quantitative cross-sectional study was undertaken from 1 February to 30 March 2018. Three hundred and sixty childbearing mothers were involved in the study using a systematic sampling method. The instrument was pre-tested on 5% of the sample in Gerba Town. Data were analysed using bivariate and multi-variate binary logistic regression. RESULTS: The prevalence of institutional delivery in Bule Hora Town was 72%. Age at first pregnancy, maternal education, paternal education, use of antenatal care services, parity, spousal communication regarding place of delivery, and paternal occupation were significantly associated with institutional delivery. CONCLUSIONS: The prevalence of institutional delivery in Bule Hora Town is higher than the national average, but lower than the national target. Policy makers and healthcare institutions should strengthen and create awareness on the importance of institutional delivery.