Letson G.W.,2201 Westlake Avenue |
French J.,Center for Healthy Births |
Gujral I.,Boulder County Public Health |
Archer L.,Private Practice |
McGregor J.A.,Private Practice
Maternal and Child Health Journal | Year: 2016
Objectives We evaluated the ability of population attributable fraction (PAF) assessments to alter significant modifiable risks for low birthweight (LBW) and the impact of high altitude as a risk for LBW in Colorado. Methods Logistic regression analysis of birth certificate parameters in 1995–1997 identified risk factors for PAF assessment. PAF for birth at high altitude, multiple births, and LBW in singleton births were determined. Subsequent analysis of singleton LBW risks, using number needed to treat (NNT) analysis, estimated how elimination of major modifiable risk factors could reduce LBW in the study population. Public health interventions were initiated and PAF analysis conducted 12 years afterward to determine the effect of interventions. Results PAF in singleton births revealed low maternal weight gain in pregnancy and maternal smoking as the greatest modifiable attributable risk factors for LBW (12.7/12.5 %, respectively, in 1995–1997 and 12.9/7.1 % in 2007–2009). Significant interaction between these variables resulted in PAF of 34.4 % when the two occurred together in 1995–1997, decreasing to 19.4 % in 2007–2009. NNT analysis of singleton births in 1995–1997 revealed that eliminating low maternal weight gain, smoking, late prenatal care in all women and interpregnancy intervals <1 year in multiparous women reduced LBW by 46.5 %. The respective proportional reductions in PAF of 40.3 and 46.3 % for maternal smoking and weight gain/smoking interaction were associated with a 1.4 % LBW reduction in singleton births between the two study periods. Conclusions for Practice PAF and NNT analyses are valuable tools to predict intervention targets to lower LBW. © 2016 Springer Science+Business Media New York
Johns P.W.,Abbott Laboratories |
Parker M.E.,2201 Westlake Avenue |
Patel G.C.,Abbott Laboratories |
Lasekan J.B.,Abbott Laboratories |
And 5 more authors.
Food Analytical Methods | Year: 2014
A simple in vitro assay for the determination of soluble iron in fortified rice analogue/natural rice blends is described. The soluble iron, measured as an indicator of iron bioavailability, is quantified by FerroZine™ colorimetry of the supernatant obtained after simulated gastric (pepsin) and intestinal (pancreatin) digestions. Method suitability was defined by assessments of linearity (R 2 average=0.9999±0.0001, and low standard residual average=+0.6±0.9 %; n=17), precision (day-to-day RSD values [n=3 days] ranged from 5.3 % to 75 % for concentrations from 0.017 to 0.585 mg per 100 g of fortified rice analogue/natural rice blend), accuracy (spike recovery=97.5±0.4 %, n=4, spiking level=0.2 to 0.8 mg/l; and linear response of the digest plot [R 2=1.0000] vs. the standard solution plot [R 2=1.0000]), and selectivity (absence of interference from Ca, Mg, Mn, and Zn; reagent blank correction for minimal bias by Cu). The assay provides for a reliable quantification of the soluble iron in fortified rice analogue/natural rice blends. The assay is regarded not as a substitute for in vivo determination of iron absorption, but instead as a tool for identifying formulation, extrusion, and storage issues that are worthy of formal in vivo study. In this connection, application of the assay to fortified rice analogue/natural rice blends and to experimental rice flour preparations has identified potential agents of iron absorption enhancement (e.g., NaFeEDTA at only 2 % of total iron), and of iron absorption inhibition (zinc). © 2013 Springer Science+Business Media New York.