Biomedical subjects

Anna Maria Siega-Riz

Publications and source records attributed to Anna Maria Siega-Riz.

46 records · Page 3Linked to original sources

PubMed2003

The association between impaired glucose tolerance and birth weight among black and white women in central North Carolina.

OBJECTIVE: This study examines the relationship of glucose intolerance during pregnancy to birth weight among black and white participants of the Pregnancy, Infection, and Nutrition Study. RESEARCH DESIGN AND METHODS: This prospective cohort study recruited women from prenatal clinics in central North Carolina at 24-29 weeks' gestation. A 1-h 50-g glucose challenge test (GCT) and 100-g oral glucose tolerance test (OGTT) were conducted. Impaired glucose tolerance (IGT) was defined as one high value on the OGTT, gestational diabetes mellitus (GDM) as two or more high values, and normal glucose tolerance (NGT) was defined as a low or high value on the GCT screen but no high values on the OGTT. Women with known glucose status and birth outcome information were included in this analysis (n = 2055). RESULTS: Black women with IGT had higher rates of both macrosomia (38.5%) and large for gestational age (LGA) (53.9%) compared with white women (10.0% and 13.2%). Black infants' birth weights (3800 g) and prevalence of macrosomia and LGA were significantly higher among mothers with IGT compared with NGT women (birth weight, 3184 g; macrosomia, 7.0%; LGA, 11.6%). In contrast, among white infants, there was no significant increase in birth weight, macrosomia, or LGA associated with the mother's glucose tolerance status. In addition, there was no effect of GDM on birth weight in either group. CONCLUSIONS: This study suggests that, independent of maternal prepregnant weight, there may be significant increased risk of macrosomia among black IGT women but not among white IGT women. Further investigations into factors that may contribute to the observed results are needed.

Adult↗

PubMed2002

Who should be screened for postpartum anemia? An evaluation of current recommendations.

The authors evaluated the utility of selective screening criteria for postpartum anemia developed by the Centers for Disease Control and Prevention (CDC) versus criteria developed among low-income women using prevalence-based screening principles. Pregnant women in Raleigh, North Carolina, were followed up to the postpartum visit in 1997-1999 (n = 345). Prevalence of postpartum anemia was 19.1%. Independent risk markers, arrived at through multivariate logistic regression, were multiparity (odds ratio (OR) = 1.5, 95% confidence interval (CI): 0.8, 2.9), obesity (OR = 3.0, 95% CI: 1.6, 5.5), anemia at 24-29 weeks' gestation (OR = 2.3, 95% CI: 1.2, 4.4), anemia before delivery (OR = 3.4, 95% CI: 1.8, 6.7), and not exclusively breastfeeding (OR = 2.8, 95% CI: 1.0, 7.7). Risk scores were calculated by counting risk markers present. Likelihood ratios were determined for all possible risk scores of our algorithm and CDC's algorithm. Anemia screening decisions differed depending on clinic anemia prevalence. For example, if low test thresholds are assumed, when clinic prevalence is 10%, women with risk scores >3 on the authors' algorithm and >0 on CDC's algorithm should be screened. The authors' algorithm, in combination with prevalence information, can save clinics more money than CDC's current algorithm because a broader range of likelihood ratios was obtained, indicating a better ability to distinguish high- from low-risk women. However, if resources are available, universal screening should be considered in high-prevalence settings.

Adult↗

PubMed2002

Trends in food locations and sources among adolescents and young adults.

BACKGROUND: The aim of this study was to determine overall trends of total energy intake by food location and food type in diets of adolescents and young adults. METHODS: This study used a nationally representative sample of 16,810 individuals, ages 12-29 from the 1977 to 1978 Nationwide Food Consumption Survey and the 1989-1991 and 1994-1996 Continuing Surveys of Food Intake by Individuals. For each survey year, the percentage of total energy intake from meals and snacks was calculated for adolescents ages 12-18 and young adults ages 19-29. The percentage of energy intake by location and for specific food group was computed for both age groups, separately. RESULTS: Both adolescents and young adults are obtaining less of their energy intake at home and more at restaurants and fast food places. This is predominantly seen among calories from snacking occasions for adolescents and both meals and snacks among the older age group. Significant increases in consumption of pizza, cheeseburgers, and salty snacks and decreases in consumption of desserts and certain milk and meat products by both age groups are shown. CONCLUSIONS: To improve the diets of adolescents and young adults, healthy food choices outside the home need to be as readily available as the foods which have increased in popularity over the past 20 years.

Adolescent↗

PubMed2002

Infant feeding practices and maternal dietary intake among Latino immigrants in California.

Mothers of 8-16-month-old infants were surveyed to examine infant feeding practices and maternal dietary intake associated with increased years of residency by Mexican immigrant families (n = 1093 mother-infant pairs). Mothers were recruited from San Diego and Contra Costa counties in California during 1992-93. Twenty-nine percent of Mexican mothers living in the United States for <6 years breastfed their infants exclusively for at least 16 weeks; only 20% of mothers living in the United States between 6 and 15 years and 17% of mothers residing in the United States for over 15 years engaged in exclusive breastfeeding. Neither breastfeeding duration nor the introduction of solids differed by years of residency. In contrast, maternal dietary intake varied markedly. Second generation mothers and those living in the United States the longest had significantly higher intakes of vegetables, low fat milk, salty snacks, animal protein, and cereals. Beyond early caregiving practices, the influence of years of residency on the diets of toddlers is less than that of the mothers.

Journal Article↗

PubMed2002

Trends in energy intake in U.S. between 1977 and 1996: similar shifts seen across age groups.

OBJECTIVE: To determine the trends in locations and food sources of Americans stratified by age group for both total energy and the meal and snack subcomponents. RESEARCH METHODS AND PROCEDURES: Nationally representative data was taken from the 1977 to 1978 Nationwide Food Consumption Survey and the 1989 to 1991 and 1994 to 1996 (and 1998 for children age 2 through 9) Continuing Surveys of Food Intake by Individuals. The sample consisted of 63,380 individuals, age 2 and up. For each survey year, the percentage of total energy intake from meals and snacks was calculated separately for 2- to 18-year-olds, 19- to 39-year-olds, 40- to 59-year-olds, and those 60 years and older. The percentage of energy intake by location (at-home consumption or preparation, vending, store eaten out, restaurant/fast-food, and school) and by specific food group was computed for all age groups separately. RESULTS: The trends in location and food sources were almost identical for all age groups. Key dietary behavior shifts included greater away-from-home consumption; large increases in total energy from salty snacks, soft drinks, and pizza; and large decreases in energy from low- and medium-fat milk and medium- and high-fat beef and pork. DISCUSSION: Total energy intake has increased over the past 20 years, with shifts away from meals to snacks and from at-home to away-from-home consumption. The similarity of changes across all age groups furthers the assertion that broad-based environmental changes are needed to improve the diets of Americans.

Adolescent↗

PubMed2002

What are pregnant women eating? Nutrient and food group differences by race.

OBJECTIVE: The purpose of this study was to identify foods that contributed most to nutrient and fiber intake in a sample of pregnant women in North Carolina. STUDY DESIGN: This was a prospective study of women in the Pregnancy, Infection, and Nutrition Study (n = 2247 women). Dietary information during the second trimester was collected with the use of a food frequency questionnaire. The contribution of each food item to the population's intake was calculated. RESULTS: Overall, low nutrient-dense foods were major contributors to energy, fat, and carbohydrates, whereas fortified foods were important sources of iron, folate, and vitamin C. The median energy intake for this population was 2478 kcal. The median dietary intakes of iron were below the recommended levels. Although black women consumed more calories on average, white women, after energy adjustment, consumed greater amounts of protein, iron, folate, and fiber. CONCLUSION: These data emphasize the importance of evaluating both the nutrient density in the diet and the frequency of consumption in the assessment of the diets of pregnant women.

Black or African American↗

PubMed2002

Comparison of pregnancy dating by last menstrual period, ultrasound scanning, and their combination.

OBJECTIVE: The purpose of this study was to evaluate the accuracy of algorithms for the assignment of gestational age with the use of the last menstrual period and early ultrasound information. STUDY DESIGN: Gestational age estimates that are based on last menstrual period, ultrasound scanning, or their combination were compared among women who attended prenatal care clinics in central North Carolina (n = 3655) by an evaluation of digit preference in the last menstrual period dates and a comparison of mean gestational age, preterm and postterm categories with the use of kappa statistics, difference between actual and expected delivery date, and birth weight among subgroups with discrepant assignments. RESULTS: Last menstrual period reports show digit preference, assign gestation 2.8 days longer on average than ultrasound scanning, yield substantially more postterm births (12.1% vs 3.4%), and predict delivery among term births less accurately. Misclassification of births as postterm was more common in younger women, those of nonoptimal prepregnancy body weight, cigarette smokers, and women who reported last menstrual period using preferred dates of the month. CONCLUSION: Last menstrual period estimates of the duration of gestation are subject to both random error and a systematic tendency to overstate the duration of gestation, most likely because of delayed ovulation.

Adolescent↗

PubMed2002

Sociodemographic determinants of added sugar intake in preschoolers 2 to 5 years old.

OBJECTIVES: To determine sociodemographic predictors of added sugar intake from a national representative sample of 2- to 5-year-old children. STUDY DESIGN: Cross-sectional study that used dietary intake data of the US Department of Agriculture Continuing Survey of Food Intake in Individuals 1994 to 1996 and 1998 (n = 5652). Amount of added sugar intake in teaspoons per day, teaspoons per 100 kcal, and percent of total energy was calculated by selected sociodemographic variables, accounting for sample design and weighted to permit inferences applicable to the total population. Multivariate linear regression analysis was used to predict added sugar intake. RESULTS: Average added sugar consumption was 15.4 tsp/d (15.7% of total energy). Significant differences were observed by several socio-demographic characteristics. Multivariate models predicting energy-adjusted intake indicated strong associations with age, ethnicity, income, day care/school attendance, Supplemental Program for Women, Infants, and Children (WIC) participation, region of residence, and female head of household's educational level. CONCLUSIONS: The identified sociodemographic predictors of high added sugar intake might help target public health messages to improve children's diet quality and prevent future chronic diseases to population groups at highest risk.

Child, Preschool↗

PubMed2002

A Diet Quality Index for Pregnancy detects variation in diet and differences by sociodemographic factors.

OBJECTIVE: Methods currently used to assess nutritional status during pregnancy have limitations if one wishes to examine the overall quality of the diet. A Diet Quality Index for Pregnancy (DQI-P) was developed to reflect current nutritional recommendations for pregnancy and national dietary guidelines. DESIGN: Dietary intake was assessed during the second trimester using a food-frequency questionnaire. The DQI-P includes eight components: % recommended servings of grains, vegetables and fruits, % recommendations for folate, iron and calcium, % energy from fat, and meal/snack patterning score. Scores can range from 0 to 80; each component contributed 10 points. SETTING: Two public prenatal clinics in central North Carolina. SUBJECTS: N = 2063 pregnant women who participated in the Pregnancy, Infection, and Nutrition (PIN) Study. RESULTS: The DQI-P quantitatively differentiated diets. The mean score for the population was 56.0 (standard deviation 12.0). Women who were >30 years old, >350% of poverty, nulliparous and high school graduates had significantly higher overall DQI-P scores. Higher percentages of recommended vegetable servings were consumed by higher-income, older and better-educated women. Greater percentages of recommended intakes of folate and iron were seen among black, low-income and nulliparous women. Higher iron intakes were also seen among women who graduated high school and were less than 30 years old. Other differences were observed for intake of fat and meal/snack pattern. Because this index was based on national recommendations, the DQI-P may be a useful tool for research and public health settings to evaluating overall diet quality of pregnant women.

Adult↗

PubMed2002

Vigorous leisure activity and pregnancy outcome.

BACKGROUND: Preterm birth is the leading cause of perinatal mortality in North America and Europe and a major predictor of neonatal and infant morbidity. Postterm birth is associated with increased infant mortality and morbidity, as well as increased frequency of surgical or induced labor. Because vigorous leisure activity may affect timing of delivery, this study examined association between vigorous leisure activity and birth outcomes. METHODS: Women (N = 1,699) with a singleton pregnancy were recruited at 24-29 weeks' gestation from prenatal clinics in central North Carolina between 1995 and 1998. The type and duration of any regular vigorous leisure activity was assessed in a telephone interview covering the 3-month period before pregnancy and during the first and second trimesters of pregnancy. RESULTS: The prevalence of vigorous leisure activity was 22% before pregnancy, 14% during the first trimester, and 8% during the second trimester. Vigorous leisure activity before pregnancy was unrelated to preterm (<37 weeks) as compared with term delivery (37 to <42 weeks). The risk of preterm birth was somewhat reduced with vigorous leisure activity during the first trimester (odds ratio = 0.80; 95% confidence interval = 0.48-1.35) and more so during the second trimester (odds ratio = 0.52; 95% confidence interval = 0.24-1.11). Vigorous leisure activity before pregnancy or during the first or second trimester was not associated with postterm delivery (>/=42 weeks). CONCLUSIONS: Vigorous leisure activity during the first trimester, and even more so in the second trimester, was associated with a reduced risk of preterm birth. There was no association with postterm birth. To address the etiologic role of activity on pregnancy outcome and to overcome self-selection, a randomized clinical trial would be needed.

Female↗