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Biomedical subjects

J A Kusin

Publications and source records attributed to J A Kusin.

At least 19 recordsLinked to original sources
PubMed1992

Energy supplementation during pregnancy and postnatal growth.

The effect of improving maternal nutrition during pregnancy on growth of the child has not been assessed, since previous studies supplemented the diets of children as well as mothers. In a controlled randomised trial in Madura, East Java, pregnant women received a high (HE) or low (LE) energy supplement that provided 1950 kJ (465 kcal) or 218 kJ (52 kcal), respectively, in the last trimester of pregnancy. The effect of this intervention on the children's growth was assessed longitudinally for the first 5 years of life. Only the children of mothers who had complied for at least 90 days were included. Infants entered the study at birth and their growth was measured at 4-week intervals until 12 months old; thereafter they were measured every 3 months. Growth curves were calculated from a mathematical model, based on the best fit of actual measurements and the age-related growth velocity. Up to the age of 24 months, HE children were significantly heavier than LE children (p less than 0.05). HE children were also taller throughout the first 5 years (p less than 0.005 from 15 to 48 months, p less than 0.05 at both 3-12 and 60 months). Weight-for-height by age was similar in both groups, but stunting (height-for-age) was less prevalent in HE children. In a community characterised by chronic energy deficiency among women of reproductive age, energy supplementation of women for the last 90 days of pregnancy was effective in the promotion of postnatal growth and reduction in malnutrition of preschool children.

Body Height↗
PubMed1992

Reproduction and maternal nutrition in Madura, Indonesia.

The prevalence and severity of chronic energy deficiency (CED) among women of reproductive age as well as its consequences on the newborn and the mother were assessed in a longitudinal study. More than 40% of the mothers had a Body Mass Index (BMI) less than 18.5 before pregnancy, a level below which CED is considered to exist. Weight gain during pregnancy was low, on average 6.6 kg. Taking the difference between 4 week postpartum weight and pre-pregnant weight as net weight gain during pregnancy, mothers with a BMI less than 18.5 before pregnancy gained weight while those with a higher BMI lost weight. This observation suggests that the partitioning of energy to the fetus and the mother depends on the energy reserves of the mother before pregnancy. The functional significance of BMI as an indicator of CED is illustrated by its relation with birth weight. Similarly, 4 week postpartum, weight and BMI were predictive for the weight changes in the mother in the first 12 months after delivery. The groups with the lowest values gained weight, while the heaviest mothers lost weight. In view of the negative effects of CED among women of reproductive age on the infant and the mother, maternal undernutrition should receive the same attention as malnutrition among preschool children.

Body Weight↗
PubMed1991

Nutritional transition during infancy in East Java, Indonesia: 1. A longitudinal study of feeding pattern, breast milk intake and the consumption of additional foods.

Infant feeding pattern was studied longitudinally from birth to 52 weeks among all infants born in the period September 1982-December 1984 in three villages in Madura, East Java (n = 687). Genuine demand breast-feeding was practised but it is the custom to force-feed infants from as early as the third day after birth until about 16 weeks. In a sub-sample the intake of breast milk and additional foods were measured, longitudinally in 76 infants and cross-sectionally in 77 infants. Breast milk intake ranged from 745 g per 24 h in the first month to 640 g per 24 h in the 12th month. Force-feeding did not have a negative influence on breast milk intake. The main constraint in infant feeding is the low intake of additional foods, which remained at 180 kcal and 3 g protein per day from the age of 16 weeks onwards.

Breast Feeding↗
PubMed1991

Nutritional transition during infancy in East Java, Indonesia: 2. A longitudinal study of growth in relation to the intake of breast milk and additional foods.

Weight and length of infants, born in two villages in Madura, East Java were measured longitudinally from birth to 12 months (n = 391). In a sub-sample (n = 76) the intake of breast milk and additional foods during 48 h were also measured. The shape of the weight curve of Madurese infants is comparable to that of healthy, exclusively breast-fed infants in the UK and US during the first 6 months of life, in spite of the custom to force-feed from as early as the first week. The use of a more 'appropriate' growth curve of exclusively breast-fed, healthy infants instead of the NCHS reference failed to define more accurately the age at which growth faltering starts. It is recommended to use weight increments as an indicator of the onset of growth faltering. Breast milk intake correlated significantly with attained weight. However, it explains only a small percentage of the variation in weight, viz. 12-24 per cent. There was no correlation between energy or protein intake from breast milk and additional foods and weight gain.

Breast Feeding↗
PubMed1991

Patterns of variability in the nutrient intake of nutritionally vulnerable pregnant women.

Intra/inter-individual variance ratios for energy, protein, fat and retinol-equivalent intake during the third trimester of pregnancy were calculated. Data were collected on 743 pregnant women from rural Indonesia between 1982 and 1984. Food intake of these women was directly weighed for three consecutive days per month during months 6-9 of pregnancy, yielding 7139 observations for analysis. Ratios were calculated separately for a single month of pregnancy and for the last trimester of pregnancy. The intra/inter-individual variance ratio for kilocalorie and protein intake was less than 1.0 for a single month; it was greater than 1.0 for the trimester. This suggests that women varied their intake of kilocalories and protein more over the course of their pregnancy than they did during one month of their pregnancy. Both the monthly and trimester variance ratios for fat and retinol-equivalent intake were greater than 1.0. Our findings suggest that usual mean intake during the third trimester of pregnancy can be measured with relative precision with two replicates per individual. However, more measurements are needed for regression analyses: measurement error greatly attenuated the coefficients, even though data were collected by the direct weighing method. Thus the number of measurements per individual needed in a study of nutrition and pregnancy depends on the nutrient, the period of 'usual intake' that is of interest, as well as the analytical strategy.

Dietary Fats↗
PubMed1990

The effects on weight and attendance of a supplementary feeding programme operating in two under-5 clinics in Lesotho.

The routinely collected weight data of 2202 pre-school children who visited two under-5 clinics in Lesotho between 1978 and 1983 were used to calculate growth curves and to assess the effects of supplementary feeding. Up to the age of 5 months growth curves were above the NCHS reference. Growth started to decrease at the age of 3 months and stabilized at 11-13 months at the 10th percentile of the reference. The decrease of growth might have been due to environmental factors such as under-nutrition and disease. If this was the case, supplementary feeding might have had a positive impact on weight, but such an effect was not observed in this study. Supplementary feeding had, however, a positive effect on attendance rates and hence contributed to higher coverage of other under-5 clinic activities, such as immunization, health and nutrition education, and growth monitoring. Whether this positive effect warrants its extra cost remains open to question.

Ambulatory Care Facilities↗
PubMed1990

Energy supplementation in the last trimester of pregnancy in East Java, Indonesia: effect on maternal anthropometry.

The effect of prenatal energy supplementation on maternal anthropometry was assessed in a controlled, randomized trial in Madura, East Java. At 26-28 wk of gestation women were either given 465 kcal/d (HE group) or 52 kcal/d (LE group). Two hundred seventy-six women were enrolled in the HE group and 266 women, in the LE group. Supplement intake was variable. Testing of effect by treatment and compliance was thus done by subcategories (HE 1-3 and LE 1-3, corresponding to less than 45, 45-89, and greater than or equal to 90 packets of supplement consumed). Analysis of variance did not show significant differences among the six subcategories in third-trimester weight gain, sum of skinfold thicknesses, 4-wk postpartum weight, or body mass index. In this population energy supplementation for the short duration of the last 90-110 d of pregnancy was not sufficient to improve maternal nutrition as judged by anthropometry.

Analysis of Variance↗
PubMed1989

Energy supplementation in the last trimester of pregnancy in East Java, Indonesia: effect on breast-milk output.

Breast-milk output was measured in women who during the last trimester of pregnancy consumed a high- or low-energy supplement (53 and 55 women, respectively). Infant and mother pairs were enrolled at 2 or 6 wk postpartum. Test weighings were done four times at 8-wk intervals. Mean breast-milk output ranged from 682 to 744 g/d in the age period of 2 wk to 7 mo. There was no difference in milk output between the two experimental groups. In all cohorts, breast-feeding frequency influenced milk output positively. Only at age 18-22 wk did the mothers' prepregnancy or 4-wk postpartum body mass index play an additional role. The results confirm that breast-milk output of mildly undernourished women is comparable with that of well-nourished women. Short-term energy supplementation during pregnancy did not increase breast-milk output, probably because the sample studied was not at nutritional risk.

Adult↗
PubMed1989

Infant mortality in Madura, Indonesia. Implications for action.

Infant mortality by age at death and birth weight was assessed in a prospective, population-based study in Madura, East Java. Even after elimination of neonatal tetanus by vaccination during pregnancy as a major cause of death, the infant mortality rate was high, viz. 121 per 1000 live births. The majority of live born infants died in the first 6 months of life. Birth weight was the best practical indicator of survival. The implications for Primary Health Care are discussed.

Adolescent↗
PubMed1989

Birthweight distribution in a healthy urban population in Surabaya-Indonesia.

The birthweight distribution was assessed in an apparently healthy urban population in Surabaya, Indonesia. A total of 924 pregnant women of a middle income group were enrolled at 20-24 weeks of gestation of which 543 women delivered in the university hospital. In the latter group mean birthweight of liveborn singletons was 3047 g for males and 2900 g for females. The percentages of low birthweight by sex were 7.9% and 13.8% respectively. These values were lower than those reported for more affluent women in Indonesia and comparable with those of rural Madurese women studied in the same time period.

Adolescent↗
PubMed1988

Energy supplementation in the last trimester of pregnancy in East Java: I. Effect on birthweight.

The effect of two levels of energy supplementation in the last trimester of pregnancy on birthweight was tested in a controlled randomized trial in three villages in Madura, East Java. The high and low energy supplements provided 1.95 MJ (465 kcal) and 218 kJ (52 kcal) per day respectively. In the baseline period the home diet provided on average 6.28 MJ (1500 kcal) (SD 2.1 MJ (499 kcal] and 41 g (SD 13 g) of protein. The mean birthweight was 2835 g and the rate of low birthweight 12.2%. In the experimental period the home diet was better. The average intake ranged from 6.45 to 7.19 MJ (1541-1717 kcal) and 41.4-44.2 g per day, depending on the degree of compliance. Mean birthweight increased by 100 g and the rate of low birthweight dropped to 9.5%. There was no difference between the high and low energy supplemented group as a whole, probably due to the masking effect of the better home diet in the experimental period. It is likely that a positive effect of energy supplementation on birthweight was restricted to the group of pregnant women with the lowest home dietary intake and/or a low prepregnant weight. In this community targeting of supplementation to lean seasons and/or to women with a low prepregnant weight may be cost-effective.

Birth Weight↗
PubMed1986

Maternal nutrition and birthweight: selective review and some results of observations in Machakos, Kenya.

A selective review of maternal nutrition and birthweight is presented. Data from an observational, longitudinal study in Machakos, Kenya show that the habitual diet of pregnant women provided about 1600 kcal and 50 g of protein per day. Nevertheless the birthweight was acceptable, i.e., the mean value was 3058 g. This good reproductive performance was attributed to the fact that weight-for-height remained acceptable during pregnancy, in spite of low weight gain because of an acceptable pre-pregnant weight. However, the birthweight was found to be influenced by the mother's weight in the third month of pregnancy, her weight gain and her height.

Adult↗
PubMed1986

Early postnatal growth of Basotho infants in the Mantsonyane area, Lesotho.

The records of 814 infants born in a rural hospital in Lesotho were analysed. It was calculated that on average Basotho infants regained their birthweight between 3 and 4 days of age and the average weight loss amounted to 3%. Compared with Caucasian infants, Basotho infants regained their birthweight sooner. Of 289 infants in whom the gestational age was assessed, small-for-dates infants showed an increased mean growth rate compared with pre-term and appropriate-for-dates full-term infants.

Birth Weight↗
PubMed1986

Birthweight distribution in the Mantsonyane area: Lesotho.

A total of 832 maternal and newborn records in a rural hospital in Lesotho were analysed. The mean birthweight was 3.07 kg and the incidence of low birthweight rate 7.5%. This was compared with other countries in Africa. Increasing birth order was associated with higher birthweight irrespective of maternal age, except for the very young mothers. No seasonal variation in birthweight was observed. Of 313 newborns the gestational age was assessed. The overall anthropometric measurements of newborns in the Mantsonyane area were comparable to better off industrialized countries.

Adolescent↗
PubMed1985

Traditional infant feeding practices: right or wrong?

Infant feeding practices, breastmilk and food intake and post-natal growth in Madura, East Java, Indonesia and Machakos, Kenya are described. Breastfeeding is commonly practised. Additional foods are introduced the first week post-partum in Madura and at age 2-3 months in Machakos. Growth started to falter at 2-3 months in Madura but was acceptable during the first 6 months in Machakos. It was felt that apart from breastfeeding and morbidity, other factors pertaining to mother's perceptions about what infants should eat and her possibility to make suitable weaning foods, should be considered to understand the background of growth faltering.

Breast Feeding↗