See-Ling Loy

Maternal Serum and Breast Milk Vitamin D Levels: Findings from the Universiti Sains Malaysia Pregnancy Cohort Study

Background Vitamin D deficiency has become a global health issue in pregnant women. This study aimed to assess the adequacy of maternal vitamin D status by measuring maternal serum and breast milk 25-hydroxyvitamin D [25(OH)D] levels and to determine the association between maternal serum and milk 25(OH)D levels. Methods Data was obtained from the Universiti Sains Malaysia Pregnancy Cohort Study. This study was conducted from April 2010 to December 2012 in the state of Kelantan, Malaysia. Blood samples from pregnant women aged 19 to 40 years were drawn in the second and third trimesters of pregnancy, while breast milk samples at delivery, 2, 6 and 12 months postpartum were collected to analyze for 25(OH)D levels. A total of 102 pregnant women were included in the analysis. Results Vitamin D deficiency [25(OH)D <50 nmol/L] was detected in 60% and 37% of women in the second and third trimesters of pregnancy, respectively. There were 6% and 23% of women who reached normal level of vitamin D status in the second trimester and the third trimester, respectively. Multivitamin intakes during pregnancy were significantly associated with higher serum 25(OH)D levels in the second trimester (β = 9.16, p = 0.005) and the third trimester (β = 13.65, p = 0.003). 25(OH)D levels in breast milk during the first year of lactation ranged from 1.01 to 1.26 nmol/L. Higher maternal serum 25(OH)D level in the second trimester of pregnancy was associated with an elevated level of 25(OH)D in breast milk at delivery (β = 0.002, p = 0.026). Conclusions This study shows that high proportions of Malay pregnant women are at risk of vitamin D deficiency. Maternal vitamin D status in the second trimester of pregnancy was found to influence vitamin D level in breast milk at delivery.

Increase in maternal adiposity and poor lipid profile is associated with oxidative stress markers during pregnancy.

OBJECTIVE This study aimed to evaluate changes in maternal adiposity and lipid profile and to correlate these parameters with Deoxyribonucleic acid (DNA) damage and total antioxidant capacity (TAC) levels among pregnant women. METHOD This was a longitudinal study which took place in Kelantan state, Malaysia. Fasting blood samples of 159 healthy pregnant women were collected in second and third trimesters from April 2010 until October 2011. Maternal total body fat was assessed using bioimpedance analysis method. RESULTS When compared to data in second trimester, pregnant women in third trimester showed significantly higher levels of total body fat (p<0.001), total cholesterol (p<0.001), triglyceride (p<0.001), LDL-C (p=0.001), DNA damage (p<0.001) and TAC (p<0.001) but a lower level of HDL-C (p<0.001). Maternal adiposity and lipid profile were positively and consistently correlated with DNA damage in second and third trimesters. Significant and positive correlations of triglyceride with TAC levels were noted in both periods indicating compensatory action against increased oxidative stress. CONCLUSION Normal pregnancy is associated with marked changes in lipid metabolism, prooxidant and antioxidant status. Dyslipidemia-associated oxidative stress was demonstrated with advancing gestational age. Appropriate preventive and compensatory measures should be practiced to minimize the effect of oxidative stress throughout pregnancy.

Relative validity of dietary patterns during pregnancy assessed with a food frequency questionnaire

Abstract This study aimed to assess the relative validity of maternal dietary patterns derived from a semi-quantitative food frequency questionnaire (FFQ). A total of 162 pregnant women aged 19–40-years-old were enrolled from the Universiti Sains Malaysia (USM) Birth Cohort Study in year 2010 and 2011. The FFQ was compared with three 24-h dietary recalls (DRs). Two major dietary patterns were derived from the principle component analysis which are labeled as Healthy and Less-Healthy patterns. The Pearson correlation coefficients between FFQ and DRs for Healthy and Less-Healthy patterns were 0.59 and 0.63, respectively. At least 45% of the participants were correctly classified into the same third from the FFQ and DR for both dietary patterns. The weighted kappa showed moderate agreement for Healthy pattern while good agreement for Less-Healthy pattern between these two dietary assessment methods. Our results indicate reasonable validity of the dietary patterns identified from the FFQ in pregnant women.

Associations Between Prenatal Nicotine Exposure, Oxidative Stress, and Postpartum Visceral Fat

This study aimed to examine the associations among prenatal nicotine exposure, oxidative stress, and postpartum visceral fat among women exposed to secondhand smoke (SHS). The study was conducted in Kelantan, Malaysia, from April 2010 to December 2012. Blood samples were collected in the second and third trimesters from 135 healthy pregnant women who were followed-up at delivery, 2 months, 6 months and 12 months postpartum. Maternal hair nicotine and oxidative stress markers during pregnancy were measured. Visceral fat was assessed by bioelectrical impedance. Multiple linear regression analysis revealed that maternal hair nicotine concentration was associated with increased DNA damage (tail moment:β = 0.580, p = 0.001) and decreased glutathione peroxidase (β = –12.100; p = 0.009) in the second trimester of pregnancy. Increased DNA damage, protein oxidation and total antioxidant capacity in the second trimester were associated with 2, 6, and 12 months postpartum visceral fat. No direct association was found between prenatal hair nicotine level and postpartum visceral fat; however, these results suggest that any relation of SHS to visceral adiposity may be indirect, mediated via enhanced oxidative stress.