Search

Objective Health behaviors before, during and after pregnancy can have lasting effects on maternal and infant health outcomes. Although a digital health intervention (DHI) has potential as a pertinent avenue to deliver mechanisms for a healthy behavior change, its success is reliant on addressing the user needs, without creating apprehension that may lead to attrition. Accordingly, the current study aimed to understand DHI needs and expectations of women before, during and after pregnancy to inform and optimize future DHI developments, specifically ‘the do’s and the don’ts’ for sustainable engagement and efficient intervention. Methods Forty-four women (13 pre-, 16 during and 15 post-pregnancy; age range = 21–40 years) completed a 60-minute, semi-structured, qualitative interview exploring participant’s experience in their current phase, experience with, and attitude towards digital health tools, and their needs and expectations of DHIs. Interviews were audio-recorded, transcribed verbatim and thematically analyzed. Results From the interviews, two core concepts emerged – personalized journey and embedding within the local ecosystem. Between both concepts, five themes and 12 sub-themes were identified. Themes and sub-themes within personalization cover ideas of two-way interactivity, journey organization based on phases and circumstances, and privacy trade-off. Themes and sub-themes within localization cover ideas of access to local health-related resources and information, and connecting to local communities through anecdotal stories. Conclusion The findings captured - through understanding user needs and expectations - the key elements for the development and optimization of a successful DHI for women before, during and after pregnancy. To potentially empower downstream DHI implementation and adoption, these insights can serve as a foundation in the initial innovation process for DHI developers and be further built upon through a continued co-design process.

Dysregulated transplacental lipid transfer and fetal-placental lipid metabolism affect birthweight, as does maternal hyperglycemia. As the mechanisms are unclear, we aimed to identify the lipids in umbilical cord plasma that were most associated with birthweight. Seventy-five Chinese women with singleton pregnancies recruited into the GUSTO mother-offspring cohort were selected from across the glycemic range based on a mid-gestation 75g oral glucose tolerance test, excluding pre-existing diabetes. Cord plasma were analysed using targeted liquid-chromatography tandem mass-spectrometry to determine relative concentrations of 404 lipid species across 17 lipid classes. Birthweights were standardized for sex and gestational age by local references, and regression analyses adjusted for maternal age, BMI, parity, mode of delivery, insulin treatment, and fasting/2h glucose, with false discovery-corrected p

Background: Carotenoids and vitamin E play beneficial roles against insulin resistance and β-cell dysfunction. Objective: To examine the associations of perinatal plasma carotenoids and E vitamers concentrations with glycemia, insulin resistance, gestational and type-2 diabetes mellitus at mid-pregnancy and post-pregnancy in women of the Growing Up in Singapore Towards healthy Outcomes (GUSTO) cohort. Methods: Plasma concentrations of carotenoids and E vitamers were measured at delivery, and principal component analysis derived patterns of their concentrations. Fasting and 2-hour plasma glucose, and fasting plasma insulin were measured at 26-28 weeks’ gestation and 4-6 years’ post-pregnancy, with derivation of homeostatic model assessment for insulin resistance (HOMA-IR). Associations were examined using linear or logistic regressions adjusting for key confounders. Results: In 678 women, two patterns of carotenoids (CP1: α-, β-carotene, lutein; CP2: zeaxanthin, lycopene, β-cryptoxanthin) and one pattern of E vitamers (VE: γ-, δ-, α-tocopherols) were derived. A higher CP1 score (1-SD) was associated with lower gestational fasting glucose [β (95%CI): -0.06 (-0.10, -0.02) mmol/L], and lower gestational and post-pregnancy HOMA-IR [gestational: -0.17 (-0.82, 0.01), P=0.065; post-pregnancy: -0.11 (-0.15, -0.08) mmol/L]. In contrast, a higher VE score (1-SD) was associated with higher gestational and post-pregnancy fasting and 2-hour glucose [gestational: 0.05 (0.01, 0.08) and 0.08 (0.01, 0.16); post-pregnancy: 0.19 (0.07, 0.31) and 0.24 (0.06, 0.42) mmol/L], but there were no associations with HOMA-IR. Conclusions: Higher α-, β-carotene and lutein may lower gestational fasting glycemia, and gestational and post-pregnancy insulin resistance; but higher vitamin E may increase gestational and post-pregnancy glycemia. Further investigation in cohorts with prospective longitudinal measurements of these vitamins are needed.

The infant gut microbiome contains a portion of bacteria that originate from the maternal gut. In the infant gut these bacteria encounter a new metabolic environment that differs from the adult gut, consequently requiring adjustments in their activities. We utilized community RNA sequencing data (metatranscriptomes) from ten mother-infant dyads participating in the NiPPeR Study to characterize bacterial gene expression shifts following mother-to-infant transmission. Maternally derived bacterial strains adapted by large scale gene expression shifts following the transmission to the infant gut, with 12,564 activated and 14,844 deactivated gene families, including 1,007 transferases and 85 bacteriophage genes. The implicated genes were most numerous and the magnitude shifts greatest in Bacteroides spp. This study demonstrates environment-dependent, strain-specific shifts in gut bacteria function and underscores the importance of metatranscriptomic analysis in microbiome studies.

Bioelectrical impedance techniques are easy to use and portable tools for assessing body composition. While measurements vary according to standing vs supine position in adults, and fasting and bladder voiding have been proposed as additional important influences, these have not been assessed in young children. Therefore, the influence of position, fasting, and voiding on bioimpedance measurements was examined in children. Bioimpedance measurements (ImpediMed SFB7) were made in 50 children (3.5 years). Measurements were made when supine and twice when standing (immediately on standing and after four minutes). Impedance and body composition were compared between positions, and the effect of fasting and voiding was assessed. Impedance varied between positions, but body composition parameters other than fat mass (total body water, intra- and extra-cellular water, fat-free mass) differed by less than 5%. There were no differences according to time of last meal or void. Equations were developed to allow standing measurements of fat mass to be combined with supine measurements. In early childhood, it can be difficult to meet requirements for fasting, voiding, and lying supine prior to measurement. This study provides evidence to enable standing and supine bioimpedance measurements to be combined in cohorts of young children.