Free Content about the Zika Virus Now Available

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Just 8 days after the public health emergency was declared, this content regarding the Zika virus has been written, reviewed, edited, and released as a freely available resource.

On February 1st, the World Health Organization declared a Public Health Emergency of International Concern related to clusters of microephaly cases in some areas affected by the Zika virus. Like the Ebola virus, there had been very little funding and research on Zika until the recent emergency and associated media and scientific attention – there is therefore a dearth of information and there is neither a vaccine nor prophylactic pharmacotherapy available to prevent Zika virus infection.

In response to concern over the effects of Zika virus infection in pregnant women, the medical publishing team at Cambridge University Press commissioned a brief summary of current evidence and recommendations. Just 8 days after the public health emergency was declared, this content has been written, reviewed, edited and released as a freely available resource. The content has been provided by Professor Bernard Gonik, Fann S. Srere Chair of Perinatal Medicine, Wayne State University School of Medicine.

Released in advance as a freely accessible public resource, this content is part of High-Risk Pregnancy: Management Options – a forthcoming updateable online product from Cambridge University Press. Like all of the content in High-Risk Pregnancy: Management Options, the Zika section will be regularly updated as new information arises.

Read about the Zika Virus Here

 

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Pregnant women lack guidance on iodine intake levels


Pregnant women are not getting enough information about the need to include iodine in their diets, despite high awareness of general advice for pregnancy nutrition.

While 96% of pregnant women surveyed by researchers were aware of general nutritional recommendations for pregnant women, only 12% were aware of iodine-specific advice.

The study, published in the British Journal of Nutrition, estimated the median intake of iodine during pregnancy was 190 micrograms (ug) per day, with 74% consuming less than the World Health Organisation (WHO) recommended intake of 250ug daily.

Iodine is required for the production of thyroid hormones, which are crucial for fetal development with links between iodine deficiency and developmental impairments.

Dr Emilie Combet, who led the reserch at the University of Glasgow, said: “Women aren’t receiving the message about the importance of iodine in pregnancy, meaning they cannot make informed choices to ensure they get the amount they require.”

Iodine deficiency affects 1.9 billion people globally and is the most preventable cause of intellectual disability. The UK is ranked 8th in a list of iodine-deficient countries in the world.

The main sources of iodine-rich foods are seafood and dairy products, and in some countries iodine-fortified salt or bread. In the UK, the Reference Nutrient Intake (RNI) for adults is 140ug per day, with no proposed increment for pregnant and lactating women.

Unborn children and young infants are entirely reliant on their mother for iodine supply, making babies and pregnant or lactating mothers the most vulnerable groups of the population.

At present there is no recommendation for routine iodine supplementation in the UK unlike folic acid and Vitamin D, or routine testing in pregnancy that would reflect iodine levels, as there is with iron.

The study surveyed 1,026 women across the UK who were pregnant or mothers of children aged up to 36 months. Participants were asked about their awareness of nutritional guidelines and completed a food frequency questionnaire.

Knowledge of iodine-rich foods was low, with 56% unable to identify any iodine-rich food and the majority wrongfully believing dark green vegetables and table salt had high levels. Most, 84% were unaware that iodine from diet is important for the healthy development of the unborn baby, and only 11% had heard about iodine from a healthcare professional.

Dr Combet said: “Iodine is crucial during pregnancy and the first months of life, to ensure adequate brain development, but achieving over 200ug a day of iodine through diet requires regular consumption of iodine-rich foods such as milk and sea fish. Not everyone will have the knowledge, means or opportunity to achieve this.

“There is an ongoing debate as to whether there should be some form of fortification of food with iodine. Iodine-fortified salt is common in other countries, but using salt as the delivery method has raised concerns since it is perceived to clash with public health messaging around reducing salt intake to combat high blood pressure. However, other countries have demonstrated that both measures could be held simultaneously. We need to work toward a solution.

“The most important issue to come from this study, however, was the lack of awareness of the important role iodine plays in fetal development and how to consume adequate levels of this essential mineral. This is something that needs to be addressed. Our current Yorkhill Children Charity – funded project us developing tools and resources for health care professionals and women either pregnant or planning a pregnancy.”

This paper is freely available for 2 weeks

Related links

Dr Emilie Combet: researcher profile

Media enquiries: stuart.forsyth@glasgow.ac.uk / 0141 330 4831

Pregnant women are exceeding weight gain guidelines

Mums-to-be are advised to watch their “overall food intake and takeaway consumption” following the results of a new study on the health behaviours and psychological well-being of pregnant women in Ireland.

The findings published in the scientific journal Public Health Nutrition reveal that almost two-thirds (62.5%) of women in Ireland exceed the recommended levels* of weight gain during pregnancy.

According to the study, pregnant women who report eating “a little more food” during their pregnancy are 60% more likely to gain excessive weight over the course of their pregnancy than those women who report eating “about the same” as before they became pregnant. It also shows that women who report eating “a lot more food” during their pregnancy are twice as likely to exceed weight gain guidelines.

The study identifies “increased food intake and takeaway consumption” as two key drivers of weight gain during pregnancy. To conduct the study researchers at University College Dublin and the National Maternity Hospital examined four health behaviours of almost 800 pregnant women: food intake, physical activity, sleep and smoking. They also assessed additional dietary behaviours including the frequency of takeaway and fried food consumption and the number of snacks eaten per day.

The findings show that foreign nationals living in Ireland are almost twice as likely as women born in Ireland to gain excessive weight over the course of their pregnancy.

“Excessive weight gain during pregnancy has significant implications for infant growth and obesity, with potential implications for later adult health,” says Fionnuala McAuliffe, Professor of Obstetrics and Gynaecology at UCD School of Medicine & Medical Science, University College Dublin, and the National Maternity Hospital, Holles Street, Dublin, who co-authored the study.

“With these findings, public health campaigns can be better designed to target the types of dietary changes required to bring weight gain during pregnancy into line with the recommended guidelines.”

Women who were overweight before they became pregnant were also shown to be the most likely to gain excessive weight during their pregnancy. This matches findings from many other studies in this area. “To our knowledge, this is the first study to find an independent association between consumption of takeaway meals and weight gain during pregnancy,” says Dr Emily Heery of the UCD School of Public Health, Physiotherapy and Population Science, University College Dublin, the lead author of the study. 53% of the women who took part in the study were first time mums-to-be, 30% were foreign nationals, and almost half (47%) had obtained at least a degree qualification. Over half (55%) of the women had private health insurance.

The article is freely available until 27 February 2015.

– Dr Emily Heery

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