BACKGROUND/OBJECTIVES: Little is known about the dietary patterns (DPs) of women during pregnancy. The present study aimed to identify the DPs of pregnant Malaysian women and their associations with socio-demographic, obstetric, and anthropometric characteristics. SUBJECTS AND METHODS: This prospective cohort study included 737 participants enrolled in Seremban Cohort Study between 2013 and 2015. Food consumption was assessed using a validated 126-food item semi-quantitative food frequency questionnaire (SFFQ) at four time-points, namely, pre-pregnancy and at each trimester (first, second, and third). Principal component analysis (PCA) was used to identify DPs. RESULTS: Three DPs were identified at each time point and designated DP 1–3 (pre-pregnancy), DP 4–6 (first trimester), DP 7–9 (second trimester) and DP 10–12 (third trimester). DP 1, 4, and 7 appeared to be more prudent diets, characterized by higher intakes of nuts, seeds & legumes, green leafy vegetables, other vegetables, eggs, fruits, and milk & dairy products. DP 2, 5, 8, and 11 had greater loadings of condiments & spices, sugar, spreads & creamer, though DP 2 had additional sweet foods, DP 5 and 8 had additional oils & fats, and DP 11 had additional tea & coffee, respectively. DP 3 and 6 were characterized by high protein (poultry, meat, processed, dairy, eggs, and fish), sugars (mainly as beverages and sweet foods), and energy (bread, cereal & cereal products, rice, noodles & pasta) intakes. DP 9 had additional fruits. However, DP 12 had greater loadings of energy foods (bread, cereal & cereal products, rice, noodles & pasta), sugars (mainly as beverages, and sweet foods), and good protein sources (eggs, nuts, seeds & legumes). Malays were more likely to have lower adherence (LA) for DP 1 and 10 than non-Malays. DP 2, 8, and 11 were more prevalent among Malays than non-Malays. Women with a higher education were more likely to have LA for DP 10, and women with a greater waist circumference at first prenatal visit were more likely to show LA for DP 11. CONCLUSIONS: DPs observed in the present study were substantially different from those reported in Western populations. Information concerning associations between ethnicity, waist circumference and education with specific DPs before and throughout pregnancy could facilitate efforts to promote healthy dietary behavior and the overall health and well-being of pregnant women.
Beverages ; Carbohydrates ; Coffee ; Cohort Studies ; Condiments ; Dairy Products ; Diet ; Edible Grain ; Education ; Eggs ; Fabaceae ; Fats ; Female ; Fruit ; Humans ; Meat ; Milk ; Nuts ; Oils ; Ovum ; Pregnancy ; Pregnant Women ; Principal Component Analysis ; Prospective Studies ; Spices ; Tea ; Vegetables ; Waist Circumference

BACKGROUND/OBJECTIVES: Low early pregnancy serum 25-hydroxy vitamin D (25[OH]D) levels can increase gestational diabetes mellitus (GDM) risk, although inconsistent findings related to that association have been reported. This study examined the association of serum vitamin D with GDM and the possible influencers on this association. SUBJECTS/METHODS: This study included 259 pregnant women within the Seremban Cohort Study (SECOST). Blood samples at < 14 weeks of gestation were drawn to determine serum 25(OH)D levels. GDM diagnosis was made at 24 to 32 weeks of gestation using a standard procedure. Association between serum vitamin D and GDM was tested using binary logistic regression. RESULTS: Nearly all women (90%) had mild (68.3%) or severe (32.2%) vitamin D deficiency (VDD). Non-GDM women with mild VDD had a significantly higher mean vitamin D intake than GDM women with mild VDD (t = 2.04, p < 0.05). Women with higher early pregnancy serum vitamin D levels had a greater risk of GDM. However, this significant association was only identified among those with a family history of type 2 diabetes mellitus (T2DM) and in women with a body mass index indicating overweight or obese status. CONCLUSIONS The high prevalence of VDD in this sample of pregnant women underscores the need for effective preventive public health strategies. Further investigation of this unexpected association between serum vitamin D level and GDM risk in predominantly VDD pregnant women and the potential effects of adiposity and family history of T2DM on that association is warranted.

Introduction: To identify the growth patterns of young children during the first two years of life according to gestational age, birth weight, and growth status at 24 months of age. Methods: This was a retrospective cohort study of 4,570 young children in Selangor. Data were extracted from children’s health records in government health clinics. Growth data were analysed using the Anthro Plus software that utilises the World Health Organization growth standards. Results: Generally, wasting prevalence was the highest at birth and 24 months, but stunting was more predominant from 1 to 21 months. Weight-for-age z-scores (WAZ), lengthfor-age z-scores (LAZ), and weight-for-length z-scores (WLZ) from birth to 24 months were within -3.00 to 0.00 standard deviation (SD) for pre-term low birth weight children, –1.50 to 0.00 SD for pre-term normal birth weight children, and –2.50 to 0.50 SD for full-term low birth weight children. While WAZ, LAZ, and WLZ from birth to 24 months for underweight/stunted/wasted children were within –2.50 to 0.50 SD, the values for overweight/obese (OV/OB) children were within –1.00 to 2.00 SD. For normal children, WAZ, LAZ, and WLZ exhibited comparable trends, with values within –1.00 to 0.00 SD from birth to 24 months. Conclusion: While stunting and wasting persisted as the most common forms of malnutrition in this sample of young children, the prevalence of OV/OB increased by 24 months. Interventions to promote child growth should focus not only on the prevention of undernutrition, but also on OV/OB.

Introduction: Vitamin D deficiency (VDD) is associated with adverse health outcomes in pregnancy and newborns. This study aims to determine the Vitamin D status among pregnant Malaysian women and its associations with specific maternal & pregnancy characteristics. Methods: This study utilised cross-sectional data from a prospective cohort study of pregnant women in Seremban district in which 259 pregnant women had available vitamin D data. Blood samples were taken <14th week of gestation. Serum 25-hydroxy Vitamin D [25(OH)D] levels were analysed using chemiluminescent microparticle immunoassay (CMIA) technology on the ARCHITECT iSystem and categorised using the Institute of Medicine (IOM) 2011 cutoffs. A set of pre-tested interviewer-administered questionnaire was used to obtain information on socio-demographics, obstetrics, and anthropometry. Results: Mean serum 25(OH)D was 32.83±11.37nmol/L. The prevalence of severe and mild VDD was 23.2% (n=60) and 68.3% (n=177), respectively. About 8.5% (n=22) of pregnant women were vitamin D insufficient and none had sufficient serum 25(OH)D (>75nmol/L). Early pregnancy body mass index (AOR=2.95, 95% CI=1.03-8.47), working status (AOR=3.17, 95% CI=1.06–9.50) and gravidity (AOR=0.68, 95% CI=0.48–0.98) were significantly associated with VDD. Conclusion: The present study showed a high prevalence of VDD among pregnant women in Malaysia, especially among those who were overweight or obese, working in indoor environment and primigravida.

Introduction: This cohort aimed to determine glycemia distribution of pregnant women and maternal glycemia categories and its correlation with adverse pregnancy outcomes among Malaysian women. Methods: A retrospective cohort study of normal glycemia pregnant women. Binary logistic regression was used to examine the associations between maternal glycemia categories and adverse outcomes. Results: Women with elevated fasting plasma glucose (FPG) were at lower risk of having SGA infants (aORFPG 4= 0.64, 95% CI= 0.47 – 0.85; aORFPG 6= 0.68, 95% CI= 0.43–0.98; aORFPG 7= 0.64, 95% CI= 0.42–0.96) than those women in category 1. Women in the higher 2-hour plasma glucose (2hPG) category had a nearly two-fold risk of having LBW and LGA infants. Hyperglycemia less severe than gestational diabetes mellitus (GDM) was associated with LGA (aOR= 1.22, 95% CI= 1.07 – 1.88) and caesarean delivery (aOR= 1.80, 95% CI= 1.20 – 2.69), in the meanwhile GDM was associated with caesarean delivery (aOR= 1.33, 95% CI= 1.02 –1.79). Conclusion: Cut-off points for FPG and 2hPG that relate to adverse pregnancy outcomes started at 4.9 – 5.0 mmol/l and 7.5 – 7.7 mmol/l. These cut-off points were lower than the current recommended criteria of Clinical Practice Guideline (CPG) of Malaysia for GDM diagnosis. Large-scale studies are required to identify the optimal GDM cut-off.