Objective: To test the hypothesis that maternal food fortification with omega-3 fatty acids and multiple micronutrients increases birth weight and gestation duration, as primary outcomes. Design: Non-blinded, randomised controlled study. Setting: Pregnant women received powdered milk during their health check-ups at 19 antenatal clinics and delivered at two maternity hospitals in Santiago, Chile. Subject: Pregnant women were assigned to receive regular powdered milk (n 5 477) or a milk product fortified with multiple micronutrients and omega-3 fatty acids (n 5 495). Results: Intention-to-treat analysis showed that mean birth weight was higher in the intervention group than in controls (65.4 g difference, 95% confidence interval (CI) 5-126 g; P 5 0.03) and the incidence of very preterm birth (,34 weeks) was lower (0.4% vs. 2.1%; P 5 0.03). On-treatment analysis showed a mean birth weight difference of 118 g (95% CI 47-190 g; P 5 0.001) and a relative fall in both the proportion of birth weight #3000 g (P 5 0.015) and the incidence of preeclampsia (P 5 0.015). Compliance with the experimental product was apparent from a haematological study of red-blood-cell folate at the end of pregnancy, which was performed in a sub-sample. In both types of analyses, positive differences were also present for mean gestation duration, birth length and head circumference. Nevertheless, the relatively small sample sizes allowed a statistical power of .0.80 just for mean birth weight and birth length in the on-treatment analysis; birth length in that analysis had a difference of 0.57 cm (95% CI 0.19-0.96 cm; P 5 0.003).
Conclusions:The new intervention resulted in increased mean birth weight. Associations with gestation duration and most secondary outcomes need a larger sample size for confirmation.
Presence of caregiver's depressive symptoms is associated with poor asthma control among children from an underserved community, but this association was no longer significant after accounting for ICS use.
Streptococcus grupo B (SGB) es el principal agente bacteriano en sepsis neonatal precoz. La infección generalmente es adquirida durante el trabajo de parto en hijos de madres colonizadas. La prevalencia de colonización reportada es variable (2 a 34%), encontrándose las cifras más altas cuando se utiliza muestra vaginal-perianal y medios de cultivo selectivos. Los objetivos del estudio fueron evaluar la prevalencia de SGB en el embarazo, y conocer el rendimiento del cultivo selectivo versus el cultivo en medio no selectivo. En 2192 embarazadas de 35-37 semanas de gestación ingresadas al estudio, la prevalencia encontrada utilizando medio selectivo fue de un 19,8%, porcentaje que baja a un 12,7% si se analizan los datos sólo a partir de medio no selectivo. La alta prevalencia de colonización en este grupo de pacientes, sugiere la necesidad de implementar el cultivo sistemático para SGB en todas las embarazadas en nuestro hospital, utilizando el medio selectivo, el cual mejora significativamente su recuperación.
At 38 weeks gestation, the ratio PRL/oestradiol identified all individual women according to the subsequent duration of their lactational amenorrhoea, suggesting that duration of lactational amenorrhoea is conditioned during pregnancy.
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