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Factors associated with ultrasound-aided detection of suboptimal fetal growth in a malaria-endemic area in Papua New Guinea.

ABSTRACT: Fetal growth restriction (FGR) is associated with increased infant mortality rates and ill-health in adulthood. Evaluation of fetal growth requires ultrasound. As a result, ultrasound-assisted evaluations of causes of FGR in malaria-endemic developing countries are rare. We aimed to determine factors associated with indicators of abnormal fetal growth in rural lowland Papua New Guinea (PNG).Weights and growth of 671 ultrasound-dated singleton pregnancies (<25 gestational weeks) were prospectively monitored using estimated fetal weights and birthweights. Maternal nutritional status and haemoglobin levels were assessed at enrolment, and participants were screened for malaria on several occasions. FGR was suspected upon detection of an estimated fetal weight or birthweight <10(th) centile (small-for-gestational age) and/or low fetal weight gain, defined as a change in weight z-score in the first quartile. Factors associated with fetal weight and fetal weight gain were additionally assessed by evaluating differences in weight z-scores and change in weight z-scores. Log-binomial and linear mixed effect models were used to determine factors associated with indicators of FGR.SGA and low weight gain were detected in 48.3% and 37.0% of pregnancies, respectively. Of participants, 13.8%, 21.2%, and 22.8% had a low mid-upper arm circumference (MUAC, <22 cms), short stature (<150 cms) and anaemia (haemoglobin <90 g/L) at first antenatal visit. 24.0% (161/671) of women had at least one malaria infection detected in peripheral blood. A low MUAC (adjusted risk ratio [aRR] 1.51, 95% CI 1.29, 1.76, P?

SUBMITTER: Unger HW

PROVIDER: S-EPMC4404558 | biostudies-literature | 2015 Apr

REPOSITORIES: biostudies-literature

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Factors associated with ultrasound-aided detection of suboptimal fetal growth in a malaria-endemic area in Papua New Guinea.

Unger Holger Werner HW Ome-Kaius Maria M Karl Stephan S Singirok Dupain D Siba Peter P Walker Jane J Wangnapi Regina Alice RA Mueller Ivo I Rogerson Stephen John SJ

BMC pregnancy and childbirth 20150403

<h4>Background</h4>Fetal growth restriction (FGR) is associated with increased infant mortality rates and ill-health in adulthood. Evaluation of fetal growth requires ultrasound. As a result, ultrasound-assisted evaluations of causes of FGR in malaria-endemic developing countries are rare. We aimed to determine factors associated with indicators of abnormal fetal growth in rural lowland Papua New Guinea (PNG).<h4>Methods</h4>Weights and growth of 671 ultrasound-dated singleton pregnancies (<25 g ...[more]

PMID: 25881316

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Project description:Live coral is harvested throughout the Indo-West Pacific to make lime, used in the consumption of the world's fourth-most consumed drug, betel nut. Coral harvesting is an environmental concern; however, because lime-making is one of the few sources of income in some areas of Papua New Guinea (PNG), the practice is unlikely to stop. To better manage coral harvest, we used standard fishery-yield methods to generate sustainable-harvest guidelines for corymbose Acropora species found on the reef flat and crest at Lababia, PNG. We constructed a yield curve (weight-specific net annual-dry-weight production) by: 1) describing the allometric relationship between colony size and dry weight, and using that relationship to estimate the dry weight of Acropora colonies in situ; 2) estimating annual growth of Acropora colonies by estimating in situ, and describing the relationship between, colony dry weight at the beginning and end of one year; and 3) conducting belt-transect surveys to describe weight-frequencies and ultimately to predict annual weight change per square meter for each weight class. Reef habitat covers a total 2,467,550 m2 at Lababia and produces an estimated 248,397 kg/y (dry weight) of corymbose Acropora, of which 203,897 kg is produced on the reef flat/crest. We conservatively estimate that 30,706.6 kg of whole, dry, corymbose, Acropora can be sustainably harvested from the reef flat/crest habitat each year provided each culled colony weighs at least 1805 g when dry (or is at least 46 cm along its major axis). Artisanal lime-makers convert 24.8% of whole-colony weight into marketable lime, thus we estimate 7615.2 g of lime can be sustainably produced annually from corymbose Acropora. This value incorporates several safety margins, and should lead to proper management of live coral harvest. Importantly, the guideline recognizes village rights to exploit its marine resources, is consistent with village needs for income, and balances an equally strong village desire to conserve its marine resources for future generations.

Dataset Information

Factors associated with ultrasound-aided detection of suboptimal fetal growth in a malaria-endemic area in Papua New Guinea.

Publications

Factors associated with ultrasound-aided detection of suboptimal fetal growth in a malaria-endemic area in Papua New Guinea.

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