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that the LCPUFA n-3 supplementation affected the increase in birth weight. This
is based on a related article entitled Effect of fish oil supplementation in
pregnancy on bone, lean, and fat mass at six years: randomised clinical trial,
Supplementation with n-3 LCPUFA in the third trimester of pregnancy resulted
in a higher BMI in the children from age 1 to 6 years but no increase in the
number of obese children. Body composition assessed by dual energy x ray
absorptiometry scans confirmed that the higher BMI was not the result of a higher
fat percentage but reflected a proportional increase in lean mass, bone mass, and
fat mass, suggesting a general growth stimulating effect of the n-3 LCPUFA
supplementation. That trial is the first to show that n-3 LCPUFA supplementation
in the third trimester of pregnancy leads to a higher BMI in offspring through
childhood, whereas previous trials and systematic reviews showed no effect of n-3
LCPUFA supplementation during pregnancy and/or lactation on BMI or growth
development in childhood.7 8 9 21 22 . The dose of n-3 LCPUFA in that trial was 2.4
g per day, which is higher than in most previous studies, in which 900 mg or 1.5 g
was administered,7 9 25 26
. In line with that findings, one previous trial
supplementing mothers with 1.5 g n-3 LCPUFA (40% eicosapentaenoic acid)
during the first four months of lactation showed a significantly higher BMI and
increased waist circumference in the n-3 LCPUFA supplemented children at 2.5
years,29 but no differences were seen at 7 or 13 years of age.8 The n-3 LCPUFA
supplementation in pregnancy led to a 0.4 kg higher weight at age 6 years, but our
dual energy x ray absorptiometry data obtained at 3.5 and 6 years showed no
difference in bone mass, fat mass, or lean mass percentages. Instead, they
observed a proportional increase in all three compartments in the children from
the n-3 LCPUFA supplemented group. Furthermore, we did not find any
differences between the intervention groups with regard to IOTF grades or
children in the highest or lowest 10% of BMI at 6 years. This suggests that mainly
children with a BMI in the normal range were affected by the n-3 LCPUFA
intervention. Also, the effect of n-3 LCPUFA supplementation on bone mineral
content and bone mineral density might imply a positive health benefit in terms of
decreased risk of later fragile bones.31
The article explained that supplementation of n-3 LCPUFA in the third
trimester of pregnancy increases BMI rather than fat presentation in children aged
1-6 years. This is a factor that does not influence the addition of LCPUFA n-3
supplementation to an increased risk of obesity. This statement is supported by
previous studies with n-3 LCPUFA supplementation in mothers who breastfeed
during the first four months of breastfeeding affect BMI of children aged 2.5 years
and there is no difference in children aged 7 or 13 years. The increase also occurs
in bone mass in which there is also an increase in bone mineral content and bone
density. Thus it implies the health benefits of LCPUFA n-3 supplementation on
health in terms of reducing the risk of brittle bones in the future.
As proved in other studies [16, 18, 19], this study verified maternal
education as an important socioeconomic factor related to the neonatal birth
weight. A higher level of maternal education may be associated with higher family
income and better nutrition of children, which may lead to improvement in infant
birth weight. What is interesting in our study is that the maternal educational
level and the number of prenatal care visits have a synergetic protective
interaction on decreasing the neonatal LBW risk, which have not been previously
reported.
Powered by the article Does Maternal Education Really Improve Child
Health? which explains that the mother's higher education level affects the
provision of nutrition to her children. Data obtained by children with PEM
(protein energy malnutrition) and education qualifications from mothers, shows
that the higher the educational qualifications of mothers the better the level of
nutrition in the same environmental conditions.
In this study it was observed that as the educational status of the mother
improved there was a decrease in the percentage of children with severe grade of
protein energy malnutrition. Out of 449 children only one child had grade IV
PEM (TABLE-2). The percentage of distribution of normal children were more
(70.6%) in group 4 which included the mothers whose educational status was 11
standard and above. It was observed that the percentage of grade I and grade II
protein energy malnutrition was more in group 1 mothers 44.2% and 22.6%
respectively. Group 1 includes illiterate mothers. In Group 2 and Group 3
mothers the percentage of distribution of grade 1 malnutrition was almost the
same(FIGURE -1) .The percentage of distribution of grade 3 PEM was more in
Group- 1 mothers (70.6%). This results indicate that the higher the educational
qualification better the nutritional grade. In this study the environmental
condition were same for all the mothers. The observed results may be due to the
fact that maternal education has created awareness in the mothers regarding the
access to the health delivery system and nutrition during illness. This possibly
could be the reason for the improved health status observed in the children of
mothers with better education .
In a study done Sleath et al they have found that younger mothers with
lower literacy skills are more likely to report a barrier for giving medication to
the children and also found it difficult to access the health service[9].
In addition, another factor that is influenced by the level of maternal
education is the nutritional status of children by the importance of breastfeeding.