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Background An efficacy evaluation of the AutoAnthro system to measure child (0–59 months) anthropometry in the United States found 3D imaging performed as well as gold-standard manual measurements for biological plausibility and precision. Objectives We conducted an effectiveness evaluation of the accuracy of the AutoAnthro system to measure 0- to 59-month-old children's anthropometry in population-based surveys and surveillance systems in households in Guatemala and Kenya and in hospitals in China. Methods The evaluation was done using health or nutrition surveillance system platforms among 600 children aged 0–59 months (Guatemala and Kenya) and 300 children aged 0–23 months (China). Field team anthropometrists and their assistants collected manual and scan anthropometric measurements, including length or height, midupper arm circumference (MUAC), and head circumference (HC; China only), from each child. An anthropometry expert and assistant later collected both manual and scan anthropometric measurements on the same child. The expert manual measurements were considered the standard compared to field team scans. Results Overall, in Guatemala, Kenya, and China, for interrater accuracy, the average biases for length or height were −0.3 cm, −1.9 cm, and −6.2 cm, respectively; for MUAC were 0.9 cm, 1.2 cm, and −0.8 cm, respectively; and for HC was 2.4 cm in China. The inter-technical errors of measurement (inter-TEMs) for length or height were 2.8 cm, 3.4 cm, 5.5 cm, respectively; for MUAC were 1.1 cm, 1.5 cm, and 1.0 cm, respectively; and for HC was 2.8 cm in China. For intrarater precision, the absolute mean difference and intra-TEM (interrater, intramethod TEM) were 0.1 cm for all countries for all manual measurements. For scans, overall, absolute mean differences for length or height were 0.4–0.6 cm; for MUAC were 0.1–0.1 cm; and for HC was 0.4 cm. For the intra-TEM, length or height was 0.5 cm in Guatemala and China and 0.7 cm in Kenya, and other measurements were ≤0.3 cm. Conclusions Understanding the factors that cause the many poor scan results and how to correct them will be needed prior to using this instrument in routine, population-based survey and surveillance systems. [ABSTRACT FROM AUTHOR]

Summary Background & aims Increasing evidence suggests that iron-containing multiple micronutrient may reduce the risk of pregnancy-induced hypertension including gestational hypertension or preeclampsia. We aimed to examine whether 30 mg iron plus folic acid or multiple micronutrients during pregnancy reduces the risk of pregnancy-induced hypertension. Methods We conducted a secondary data analysis by the dataset from a double-blind randomized controlled trial in China from 2006 to 2009 that was conducted to investigate the effects of multiple micronutrient supplements on adverse pregnancy outcomes when provided to pregnant women with no/mild anemia. We used logistic regression to estimate the adjusted odds ratio and 95% confidence interval and test for effect modification. Results The incidence of pregnancy-induced hypertension was 7.1% (423/5923), 6.3% (374/5933) and 6.3% (372/5914) among the pregnant women who took folic acid only, iron-folic acid and multiple micronutrient supplements, respectively. The adjusted odds ratios associated with iron-folic acid supplements and multiple micronutrient supplements for pregnancy-induced hypertension were both nearly 0.88 (95% confidence interval, 0.76–1.02), compared with folic acid supplements only. Among pregnant women aged 20–24 years, iron-folic acid (adjusted odds ratios: 0.81, 95% confidence interval: 0.67–0.96) or multiple micronutrient supplementation (adjusted odds ratios: 0.83, 95% confidence interval: 0.70–0.99) can significantly reduce the risk of pregnancy-induced hypertension compared to folic acid supplementation. Conclusions Overall, there were no significant differences in pregnancy-induced hypertension across supplement groups. However, among pregnant women aged 20–24 years, iron-containing multiple micronutrient supplementation was associated with a reduced risk of pregnancy-induced hypertension compared with folic acid supplements only. Trial registration ClinicalTrials.gov NCT00133744. [ABSTRACT FROM AUTHOR]

Objectives: To explore the effects of maternal folic acid supplementation alone during pregnancy on the incidence of low birth weight (LBW) and small-for-gestational-age (SGA) infant status.Study Design: Data were derived from a large population-based cohort study performed in China to evaluate the prevention of neural tube defects with folic acid supplementation. The sample comprised 200 589 singleton live births registered in 2 southern Chinese provinces by mothers for whom detailed information on folic acid use was available. Gestational age was calculated from the first day of the last menstrual period. LBW was defined as a birth weight <2500 g. Infants were considered SGA when the age-adjusted birth weight was below the 10th percentile as defined by a national survey performed in 1998. Logistic regression was used to estimate the effects of folic acid after adjusting for the principal potential confounders.Results: The overall incidence of LBW and SGA status was 2.18% and 5.82%, respectively. The incidence of LBW and SGA status was 2.09% and 5.73% in women who took folic acid, and 2.27% and 5.90% in those who did not. The adjusted risk ratios associated with folic acid use were 0.85 (95% CI: 0.80-0.90) for LBW and 0.93 (95% CI: 0.89-0.96) for SGA status. Folic acid use during pregnancy appeared to be particularly important to prevent LBW and SGA status.Conclusions: A maternal daily intake of 400 µg folic acid alone significantly reduced the risks of infant LBW and SGA status. [ABSTRACT FROM AUTHOR]

To determine if exposure to methyl mercury (MeHg) in utero is associated with an elevated risk of neural tube defects (NTDs), we measured its concentration in the placentas of 36 anencephalic and 44 spina bifida cases, as well as in 50 healthy controls. The median MeHg concentration in NTD cases (0.49 ng/g) was higher than that in controls (0.33 ng/g). The crude and adjusted odds ratios (ORs) for a MeHg concentration above the median were 3.54 (95% confidence interval (CI), 1.68–7.49) and 3.64 (95% CI, 1.66–7.99), respectively. Both anencephaly and spina bifida subtypes had higher levels of MeHg than the controls. NTD risk increased for subjects in the second and third highest tertile of MeHg concentrations, with an OR of 2.24 (95% CI, 0.93–5.40) and 2.85 (95% CI, 1.17–6.94), respectively. In summary, higher placental levels of MeHg are associated with an elevated risk of NTDs. [ABSTRACT FROM AUTHOR]

Purpose: To examine the association between gestational weight gain (GWG) and cesarean delivery including cesarean delivery on maternal request (CDMR) among low-risk women.Methods: A total of 1,009,987 Chinese nulliparous women who delivered live term singletons during 1993-2010 were included. GWG, according to maternal pre-pregnancy body mass index-specified z-scores, was categorized into five groups: less than -1.2, -1.2 to less than -0.6, -0.6 to 0.6 (reference), more than 0.6 to 1.2, and more than 1.2. Multivariate log-binomial regression models were used to estimate the adjusted risk ratios and 95% confidence intervals (95% CIs).Results: GWG was positively associated with overall cesarean and CDMR after adjusting for various confounders. Adjusted risk ratios for cesarean were 0.75 (95% CI, 0.73-0.77), 0.84 (95% CI, 0.82-0.85), 1.00, 1.16 (95% CI, 1.14-1.19), and 1.32 (95% CI, 1.29-1.35) in five ascending GWG categories, and 0.70 (95% CI, 0.67-0.73), 0.80 (95% CI, 0.78-0.82), 1.00, 1.20 (95% CI, 1.18-1.23), and 1.43 (95% CI, 1.40-1.45) for CDMR. The graded positive associations were consistent across levels of maternal pre-pregnancy body mass index, and in strata defined by southern and/or northern provinces, urban and/or rural residence, maternal age at delivery, year of delivery, and level of delivering hospital.Conclusions: Even among low-risk women, higher GWG was monotonically associated with an increased risk of cesarean delivery, indicating that limiting GWG could benefit to curb the rate of both medically necessary and unnecessary cesareans. [ABSTRACT FROM AUTHOR]