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in
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a
[
1
]
–
[
4
]
.
T
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I
GF
s
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s
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co
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s
is
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s
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two
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lik
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f
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b
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d
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P).
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tem
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p
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b
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ab
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p
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life
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[
5
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Fetal
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[
6
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.
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ca
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th
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b
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p
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[
7
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–
[
9
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.
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11
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[
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tiv
e
s
o
d
iu
m
t
r
an
s
p
o
r
t
r
esp
o
n
s
es
in
ASDN
[
14
]
.
No
t
o
n
l
y
s
o
d
iu
m
,
b
u
t
zin
c
m
in
er
als
also
th
at
p
lay
a
r
o
le
i
n
th
e
m
etab
o
lic
ac
tiv
ity
o
f
m
o
r
e
th
an
2
0
0
e
n
zy
m
es
wh
ich
h
a
v
e
a
f
u
n
ctio
n
in
g
r
o
w
th
an
d
d
e
v
elo
p
m
e
n
t
m
a
y
b
e
r
el
ated
to
g
r
o
wth
h
o
r
m
o
n
e
[
15
]
.
Oth
er
s
tu
d
ies
f
o
u
n
d
a
p
o
s
itiv
e
r
elatio
n
s
h
ip
b
etwe
en
cir
cu
latin
g
I
GF
-
1
lev
els,
s
er
u
m
I
GFB
P3
,
an
d
s
er
u
m
ca
lci
u
m
[
16
]
.
T
h
e
b
o
d
y
f
lu
id
an
d
elec
tr
o
l
y
te
b
alan
ce
a
r
e
th
e
r
esu
lt
o
f
a
m
ec
h
an
is
m
th
at
is
s
en
s
itiv
e
to
ch
an
g
es
in
wate
r
an
d
elec
tr
o
ly
tes
in
th
e
b
o
d
y
[
17
]
.
T
h
e
r
o
le
o
f
en
d
o
cr
in
e
an
d
m
etab
o
lic
f
ac
to
r
s
in
f
etal
g
r
o
wth
ca
n
b
e
s
ee
n
in
late
p
r
eg
n
a
n
cy
,
wh
ich
d
ep
en
d
s
o
n
th
e
m
ater
n
a
l
en
v
ir
o
n
m
e
n
t
th
at
o
cc
u
r
s
d
u
r
i
n
g
th
e
p
er
i
o
d
o
f
c
o
n
ce
p
tio
n
[
18
]
,
[
19
]
.
B
o
d
y
f
lu
id
im
b
alan
ce
m
ay
af
f
ec
t
p
r
eg
n
a
n
cy
s
u
ch
as
th
e
im
b
alan
ce
o
f
am
n
io
tic
f
lu
id
,
im
b
alan
ce
o
f
s
er
u
m
s
o
d
iu
m
an
d
p
o
tass
iu
m
s
o
th
at
it
d
i
s
r
u
p
ts
o
x
y
g
en
p
u
m
p
to
th
e
h
ea
r
t,
ed
e
m
a
in
p
r
eg
n
an
t
wo
m
e
n
,
an
d
p
r
ee
clam
p
s
ia.
T
h
is
wil
l
im
p
ac
t th
e
p
r
e
g
n
an
c
y
o
u
t
p
u
t
[
20
]
,
[
21
]
.
I
n
p
r
ev
io
u
s
s
tu
d
ies,
p
r
eg
n
a
n
t
wo
m
en
with
s
er
u
m
zin
c
le
v
els
b
elo
w
7
2
-
3
3
3
μ
g
/L
r
es
u
lted
in
a
p
r
eg
n
a
n
cy
o
u
tp
u
t
o
f
lo
w
b
ir
th
weig
h
t
(
L
B
W
)
co
m
p
ar
ed
to
m
o
th
er
s
wh
o
h
a
d
n
o
r
m
al
s
er
u
m
zin
c
le
v
els
[
22
]
,
[
23
]
.
T
h
u
s
,
zin
c
s
tatu
s
ca
n
to
s
o
m
e
ex
ten
t
ex
p
lain
th
e
ab
n
o
r
m
alities
th
at
o
cc
u
r
in
p
r
e
g
n
an
t
wo
m
en
.
B
ased
o
n
th
e
ex
p
o
s
u
r
e,
n
o
t
m
an
y
s
tu
d
i
es
h
av
e
lo
o
k
ed
at
th
e
co
r
r
elat
io
n
o
f
I
GF
-
1
le
v
els
as
a
g
r
o
wth
in
d
icato
r
,
zin
c,
ca
lciu
m
,
an
d
s
o
d
i
u
m
with
p
r
e
g
n
an
cy
h
y
d
r
atio
n
s
tatu
s
.
T
h
is
allo
ws
f
o
r
a
n
ass
o
ciatio
n
with
h
y
d
r
atio
n
s
tatu
s
th
at
ca
n
af
f
ec
t
s
er
u
m
zin
c
lev
els,
s
er
u
m
ca
lciu
m
,
s
er
u
m
s
o
d
iu
m
,
an
d
I
GF
-
1
.
As
is
k
n
o
wn
,
h
y
d
r
atio
n
s
p
ec
if
ically
p
lay
s
a
r
o
le
in
tr
a
n
s
p
o
r
tin
g
n
u
tr
ien
ts
in
th
e
f
o
r
m
o
f
ca
r
b
o
h
y
d
r
ates,
v
itam
in
s
,
m
i
n
er
als
an
d
o
th
e
r
im
p
o
r
tan
t
n
u
tr
ien
ts
in
to
an
d
o
u
t
o
f
ce
lls
as
well
a
s
r
em
o
v
in
g
m
etab
o
lic
waste
p
r
o
d
u
cts
[
24
]
,
[
25
]
.
T
h
er
ef
o
r
e,
it
is
n
ec
ess
ar
y
to
s
tu
d
y
th
e
r
o
le
o
f
I
GF
-
1
in
m
ac
r
o
an
d
m
icr
o
m
in
er
als
in
th
e
ca
s
e
o
f
p
r
eg
n
an
cy
h
y
d
r
at
io
n
wh
ich
aim
s
to
d
eter
m
in
e
t
h
e
co
r
r
elatio
n
o
f
I
GF
-
1
lev
els,
zin
c,
ca
lciu
m
,
an
d
s
o
d
iu
m
with
h
y
d
r
atio
n
s
tatu
s
an
d
t
h
e
n
u
tr
ien
ts
im
p
ac
t
to
I
GF
-
1
lev
els
b
ased
o
n
h
y
d
r
atio
n
s
tatu
s
o
f
p
r
eg
n
an
t
wo
m
en
in
Keb
o
n
J
er
u
k
Hea
lth
C
en
ter
,
W
est
J
ak
ar
ta.
2.
M
E
T
H
O
D
2
.
1
.
Desig
n,
pla
ce
,
a
nd
t
i
m
e
T
h
is
s
tu
d
y
is
a
co
h
o
r
t
-
p
r
o
s
p
e
ctiv
e
s
tu
d
y
,
wh
ich
aim
s
to
s
t
u
d
y
th
e
in
ter
ac
tio
n
o
f
s
er
u
m
lev
els
o
f
I
GF
-
1
,
zin
c,
ca
lciu
m
,
s
o
d
iu
m
an
d
h
y
d
r
atio
n
s
tatu
s
.
T
h
is
s
tu
d
y
was c
o
n
d
u
cted
in
s
ev
en
ar
ea
co
m
m
u
n
ity
h
ea
lt
h
ce
n
ter
s
in
Keb
o
n
J
er
u
k
s
u
b
-
d
i
s
tr
ict,
W
e
s
t
J
ak
ar
ta,
s
tar
t
in
g
f
r
o
m
Dec
em
b
er
2
0
1
6
to
J
an
u
a
r
y
2
0
1
8
.
T
h
e
s
tu
d
y
s
ite
ch
o
s
en
with
t
h
e
cr
iter
ia
o
f
b
ein
g
i
n
a
d
en
s
ely
p
o
p
u
lated
a
r
ea
,
lo
w
to
m
i
d
d
le
s
o
ci
o
-
ec
o
n
o
m
ic
co
n
d
itio
n
s
an
d
th
e
h
ig
h
est
n
u
m
b
e
r
o
f
p
r
eg
n
a
n
cy
s
er
v
ices.
T
h
is
s
tu
d
y
h
as
r
ec
eiv
ed
eth
ical
ap
p
r
o
v
al
f
r
o
m
t
h
e
Hea
lth
R
esear
c
h
E
th
ics
C
o
m
m
is
s
io
n
in
t
h
e
Facu
lty
o
f
Me
d
icin
e,
Un
i
v
er
s
ity
o
f
I
n
d
o
n
esia,
J
ak
ar
t
a
with
a
n
u
m
b
er
:
No
.
8
6
9
/UN2
.
F1
/ET
HI
C
S/2
0
1
6
d
ated
Octo
b
er
1
0
,
2
0
1
6
.
Su
b
jects
wer
e
s
ec
o
n
d
tr
im
ester
p
r
e
g
n
an
t
wo
m
en
(
1
6
-
1
8
w
ee
k
s
’
g
estatio
n
)
w
h
o
m
et
th
e
in
clu
s
io
n
cr
iter
ia:
i
)
d
o
in
g
p
r
e
g
n
an
c
y
ex
am
in
atio
n
at
a
h
ea
lth
ce
n
ter
in
th
e
s
tu
d
y
s
ite;
ii
)
b
ei
n
g
i
n
th
e
s
ec
o
n
d
tr
im
ester
o
f
p
r
eg
n
a
n
cy
(
>1
2
-
2
4
wee
k
s
)
;
i
ii
)
h
ea
lth
y
(
e.
g
.
,
n
o
s
ec
o
n
d
ar
y
in
f
ec
tio
n
s
)
,
b
ased
o
n
th
e
r
esu
lts
o
f
a
h
ea
lth
ex
am
in
atio
n
;
iv
)
h
a
v
e
n
o
h
is
to
r
y
o
f
b
a
b
ies
with
lo
w
-
b
ir
th
-
weig
h
t
o
r
s
tu
n
tin
g
(
<
4
8
cm
)
;
v
)
th
e
a
g
ed
b
etwe
en
>1
8
an
d
3
5
y
ea
r
s
;
vi
)
th
e
h
eig
h
t b
etwe
en
1
5
0
-
1
6
5
cm
;
v
ii
)
b
o
d
y
m
ass
in
d
ex
(
B
MI
)
(
1
8
.
5
-
2
5
.
0
)
;
v
iii
)
h
av
e
h
ad
a
h
is
to
r
y
o
f
u
r
in
ar
y
tr
ac
t
in
f
ec
t
io
n
s
;
ix
)
h
av
e
h
ad
a
h
is
to
r
y
o
f
d
iar
r
h
ea
,
n
a
u
s
ea
,
o
r
v
o
m
itin
g
i
n
ea
r
ly
p
r
eg
n
an
cy
;
x
)
h
a
v
in
g
p
lan
to
d
eliv
er
in
a
h
ea
lth
ce
n
ter
;
xi
)
f
ill
o
u
t
t
h
e
in
f
o
r
m
ed
co
n
s
en
t;
x
ii
)
c
o
m
p
ly
with
r
esear
ch
p
r
o
ce
d
u
r
es;
an
d
x
iii
)
n
e
v
er
h
a
d
a
ca
esar
ea
n
d
eliv
er
y
,
s
in
ce
t
h
er
e
is
a
p
o
s
s
ib
ilit
y
o
f
a
ce
s
ar
ea
n
d
eliv
er
y
in
th
e
n
ex
t
p
r
eg
n
an
cy
,
m
ea
n
wh
ile
th
is
r
esear
ch
f
o
cu
s
es
o
n
s
u
b
jects
with
m
id
d
le
to
lo
wer
s
o
cio
-
ec
o
n
o
m
ic
lev
els
an
d
th
er
e’
s
n
o
f
ac
ilit
y
ca
esar
ea
n
in
h
ea
lth
ce
n
ter
.
T
h
e
to
ta
l
s
u
b
ject
wh
o
willin
g
to
f
o
llo
w
th
is
s
tu
d
y
ar
e
6
6
p
r
eg
n
a
n
t
wo
m
en
in
th
e
s
ec
o
n
d
tr
im
este
r
.
T
h
e
r
ea
s
o
n
b
eh
in
d
th
is
is
th
at
s
am
p
lin
g
p
r
e
g
n
an
t
wo
m
e
n
>1
2
wee
k
s
o
r
th
e
s
ec
o
n
d
tr
im
ester
is
a
cy
cle
o
f
h
o
r
m
o
n
al
ch
an
g
es
an
d
a
p
h
a
s
e
o
f
r
ap
id
f
etal
g
r
o
wth
.
W
ith
u
s
ed
th
e
s
am
p
lin
g
p
r
o
p
o
r
tio
n
t
h
e
m
in
im
u
m
to
tal
s
am
p
lin
g
as 6
4
s
u
b
jects f
o
r
two
g
r
o
u
p
s
.
T
h
e
ex
p
lan
atio
n
in
t
h
e
F
ig
u
r
e
1
.
2
.
2
.
Da
t
a
c
o
llect
ing
T
h
is
s
tu
d
y
lo
o
k
ed
at
h
y
d
r
atio
n
s
tatu
s
o
n
3
2
-
3
7
wee
k
s
o
f
g
estatio
n
b
y
tak
in
g
b
lo
o
d
a
n
d
u
r
in
e
at
6
p
o
in
ts
;
3
p
o
in
ts
o
n
3
2
-
3
4
we
ek
s
o
f
g
estatio
n
an
d
3
p
o
i
n
ts
o
n
3
5
-
3
7
wee
k
s
o
f
g
estatio
n
.
Ob
s
er
v
atio
n
was
Evaluation Warning : The document was created with Spire.PDF for Python.
I
n
t J Pu
b
lic
Hea
lth
Sci
I
SS
N:
2252
-
8
8
0
6
Lo
w
z
in
c
s
eru
m
a
ffect
in
s
u
lin
-
like
g
r
o
w
th
fa
cto
r
-
1
leve
l in
d
eh
yd
r
a
ted
p
r
eg
n
a
n
t
…
(
E
r
r
y
Yu
d
h
ya
Mu
ly
a
n
i
)
177
co
n
tin
u
ed
u
n
til
th
e
p
ar
tu
r
itio
n
(
b
i
r
th
p
r
o
ce
s
s
)
to
d
r
aw
b
lo
o
d
in
th
e
u
m
b
ilical
v
ein
(
u
m
b
ilical
co
r
d
)
as
an
in
d
icato
r
o
f
I
GF
-
1
b
i
o
m
ar
k
e
r
s
.
Data
o
n
ch
ar
ac
ter
is
tics
o
f
p
r
eg
n
an
t
wo
m
en
,
m
e
d
ical
h
is
to
r
y
a
n
d
an
th
r
o
p
o
m
etr
y
s
u
ch
as
m
at
er
n
al
ag
e,
b
o
d
y
weig
h
t
d
u
r
in
g
p
r
e
g
n
an
c
y
,
b
l
o
o
d
p
r
ess
u
r
e,
p
u
ls
e,
th
y
r
o
id
g
la
n
d
,
leg
ed
em
a,
ey
e
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n
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n
ctiv
a,
e
y
e
s
cler
a,
an
d
f
etal
m
o
v
em
en
ts
o
v
e
r
f
iv
e
m
o
n
th
s
wer
e
o
b
tain
e
d
f
r
o
m
s
u
b
ject
in
ter
v
iews
co
n
d
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cte
d
b
y
t
r
ain
ed
en
u
m
er
ato
r
s
f
o
r
1
5
-
2
0
m
in
u
tes
at
wee
k
1
6
-
1
8
o
f
g
estatio
n
.
T
h
e
s
cr
ee
n
in
g
was
d
o
n
e
with
m
id
wiv
es
a
n
d
d
o
ct
o
r
s
th
r
o
u
g
h
r
ep
ea
ted
m
ea
s
u
r
em
en
ts
,
ch
ec
k
in
g
c
o
h
o
r
t
b
o
o
k
an
d
K
I
A
b
o
o
k
(
m
ater
n
al
an
d
ch
i
ld
h
ea
lth
)
.
Ur
in
e
co
lo
r
,
u
r
in
e
s
p
ec
if
ic
g
r
av
ity
,
s
er
u
m
s
o
d
iu
m
,
u
r
in
e
an
d
s
er
u
m
o
s
m
o
lality
ar
e
m
ea
s
u
r
ed
f
r
o
m
6
o
b
s
er
v
at
io
n
p
o
in
ts
to
s
ee
th
e
m
o
th
er
'
s
h
y
d
r
atio
n
s
tatu
s
,
th
e
n
m
icr
o
an
d
m
ac
r
o
m
in
er
als
(
Z
n
,
C
a,
Na)
lev
els,
an
d
I
GF
-
1
lev
els
as
in
d
icato
r
s
o
f
g
r
o
wth
f
r
o
m
m
o
th
er
to
f
e
t
u
s
.
B
io
m
ar
k
er
’
s
m
ea
s
u
r
em
en
t
o
f
h
y
d
r
atio
n
s
tatu
s
an
d
m
ac
r
o
-
m
i
cr
o
m
in
er
als
tak
en
th
r
o
u
g
h
s
am
p
le
o
f
b
l
o
o
d
(
2
0
m
l)
an
d
u
r
i
n
e
(
5
0
m
l
)
ar
e
ca
r
r
ied
o
u
t
b
y
a
tr
ai
n
ed
p
h
le
b
o
to
m
y
an
d
th
e
s
am
p
le
ex
am
in
atio
n
is
ca
r
r
ied
o
u
t
to
ac
cr
ed
ited
lab
o
r
ato
r
y
.
Ur
i
n
e
s
p
ec
if
ic
g
r
a
v
ity
was
test
ed
b
y
u
r
in
o
m
eter
m
eth
o
d
,
u
r
in
e
an
d
p
lasma
o
s
m
o
lality
wer
e
ch
ec
k
ed
b
y
o
s
m
o
m
eter
,
u
r
in
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co
lo
r
was
ch
ec
k
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b
y
c
h
ec
k
y
o
u
r
o
w
n
u
r
in
e
(
PUR
I
)
in
d
icato
r
,
an
d
s
er
u
m
s
o
d
iu
m
was
ex
am
in
e
d
b
y
I
o
n
s
e
lectiv
e
elec
tr
o
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e
(
I
SE
)
m
et
h
o
d
.
Deh
y
d
r
ate
d
g
r
o
u
p
was
d
ef
in
ed
b
y
o
s
m
o
lality
≥
5
0
0
m
Osm/k
g
,
s
er
u
m
o
s
m
o
lalit
y
>2
9
9
m
Osm/k
g
,
u
r
in
e
s
p
ec
if
ic
g
r
av
ity
>1
.
0
1
5
,
an
d
u
r
i
n
e
co
lo
r
s
co
r
e
>
4
.
0
.
B
io
m
ar
k
er
s
m
ea
s
u
r
i
n
g
Z
n
,
C
a
a
n
d
Na
s
er
u
m
lev
els
ar
e
tak
en
th
r
o
u
g
h
v
ei
n
s
in
th
e
3
rd
tr
im
ester
,
wh
ic
h
is
3
4
-
3
7
wee
k
s
o
f
g
estatio
n
.
Ser
u
m
Z
n
le
v
els
wer
e
m
ea
s
u
r
ed
u
s
in
g
th
e
in
d
u
ctiv
ely
c
o
u
p
le
p
lasma
-
m
ass
s
p
ec
tr
o
p
h
o
to
m
eter
(
I
C
P
-
MS)
m
eth
o
d
an
d
s
er
u
m
C
a
lev
els
wer
e
m
ea
s
u
r
ed
th
r
o
u
g
h
th
e
Ar
s
en
az
o
I
I
I
Dy
e
m
eth
o
d
.
I
GF
-
1
lev
els
ar
e
tak
en
th
r
o
u
g
h
u
m
b
ilical
v
ei
n
s
(
u
m
b
ilical
co
r
d
)
s
h
o
r
tly
af
te
r
b
ir
th
(
p
ar
t
u
r
itio
n
)
an
d
m
ea
s
u
r
e
d
b
y
th
e
en
z
y
m
e
-
l
in
k
ed
im
m
u
n
o
s
o
r
b
en
t a
s
s
ay
(
E
L
I
SA
)
m
eth
o
d
.
T
h
is
s
tu
d
y
u
s
ed
b
l
o
o
d
(
2
0
m
l)
an
d
u
r
i
n
e
(
5
0
m
l)
as
a
s
am
p
le.
T
h
e
b
lo
o
d
tak
en
f
r
o
m
in
tr
av
e
n
o
u
s
b
lo
o
d
.
Ur
in
e
tak
en
f
r
o
m
s
p
o
t
u
r
in
e
a
t
1
4
.
0
1
-
1
6
.
0
0
lo
ca
l
tim
e.
All
o
f
th
e
e
x
am
in
atio
n
o
f
h
y
d
r
ati
o
n
b
io
m
ar
k
e
r
s
was
ca
r
r
ied
o
u
t in
an
ac
c
r
ed
ited
la
b
o
r
ato
r
y
co
llab
o
r
atin
g
with
th
i
s
s
tu
d
y
[
2
6
]
.
E
q
u
ip
m
en
t
u
s
ed
in
th
e
s
tu
d
y
wer
e
C
am
r
y
d
ig
ital
s
ca
les,
C
o
m
b
u
r
1
0
M
(
R
o
ch
e
)
,
Osmo
m
at
3
0
0
0
Go
n
o
tec
Gm
B
H,
PUR
I
I
n
d
ica
to
r
,
ADVI
A
1
8
0
0
(
f
o
r
s
o
d
iu
m
ex
am
in
atio
n
)
with
ADVI
A
c
h
em
is
tr
y
is
e
b
u
f
f
er
(
s
iem
en
s
)
r
ea
g
en
ts
,
I
C
P
-
MS
Ag
ilen
t
7
7
0
0
x
,
an
d
Ar
ch
itect
C
-
8
0
0
0
.
T
h
e
q
u
esti
o
n
n
air
e
o
f
ch
ar
ac
ter
is
tic
o
f
s
u
b
ject,
m
ed
ical
h
is
to
r
y
,
a
n
d
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th
r
o
p
o
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etr
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a
d
o
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d
f
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m
t
h
e
B
asic
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lth
R
esear
ch
(
R
I
SKESDAS
)
2
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1
3
q
u
esti
o
n
n
ai
r
e.
Fig
u
r
e
1
.
Flo
wch
ar
t
s
am
p
lin
g
2
.
3
.
Da
t
a
a
na
ly
s
is
Data
is
p
r
o
ce
s
s
ed
an
d
an
aly
z
ed
with
Mic
r
o
s
o
f
t
Of
f
ice
E
x
ce
l
an
d
SP
SS
2
0
.
0
p
r
o
g
r
am
s
.
T
h
e
d
ata
co
llected
was
an
aly
ze
d
d
escr
ip
tiv
ely
an
d
p
r
esen
ted
in
th
e
f
o
r
m
o
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m
ea
n
,
m
ed
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d
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ar
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o
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o
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b
ased
o
n
5
b
io
m
ar
k
er
s
f
r
o
m
th
e
6
p
o
in
ts
wh
er
e:
if
m
o
r
e
th
an
o
r
2
o
f
th
e
in
d
icato
r
s
h
as
v
alu
e
ab
o
v
e
th
e
n
o
r
m
al
b
aselin
e,
it
will
b
e
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n
clu
d
ed
in
th
e
d
eh
y
d
r
ated
g
r
o
u
p
an
d
v
ice
v
er
s
a
.
Gen
er
ally
,
b
io
m
ar
k
er
s
u
s
ed
in
p
r
eg
n
an
cy
h
y
d
r
atio
n
s
tatu
s
ar
e
u
r
in
e
c
o
lo
r
,
u
r
in
e
o
s
m
o
lality
,
an
d
u
r
in
e
s
p
ec
if
ic
g
r
av
ity
[
27
]
–
[
30
]
.
B
ased
o
n
p
r
ev
io
u
s
s
tu
d
y
,
we
u
s
ed
2
in
d
ic
ato
r
s
as
th
e
cu
t
-
o
f
f
v
alu
e
h
y
d
r
atio
n
s
tatu
s
.
I
GF
-
1
b
io
m
ar
k
e
r
d
ata,
s
er
u
m
zin
c
l
ev
els,
s
er
u
m
ca
lci
u
m
a
n
d
s
er
u
m
s
o
d
i
u
m
lev
els
ar
e
p
r
esen
t
ed
with
m
ea
n
an
d
Evaluation Warning : The document was created with Spire.PDF for Python.
I
SS
N
:
2
2
5
2
-
8
8
0
6
I
n
t J Pu
b
lic
Hea
lth
Sci
,
Vo
l.
1
4
,
No
.
1
,
Ma
r
ch
20
2
5
:
1
75
-
1
82
178
s
tan
d
ar
d
d
e
v
iatio
n
s
v
alu
e
(
n
u
m
er
ical
d
ata)
.
T
h
e
b
iv
a
r
iate
an
aly
s
is
test
u
s
ed
in
d
ep
en
d
en
t
t
-
t
est
to
s
ee
d
if
f
er
en
ce
s
in
s
u
b
ject
ch
ar
ac
ter
is
tics
,
I
GF
-
1
lev
els,
m
ac
r
o
an
d
m
icr
o
m
in
er
als,
an
d
p
ea
r
s
o
n
c
o
r
r
elatio
n
to
s
ee
th
e
r
elatio
n
s
h
ip
o
f
m
ac
r
o
an
d
m
icr
o
m
in
er
al
in
ter
ac
tio
n
s
wit
h
h
y
d
r
atio
n
s
tatu
s
.
Data
wer
e
an
aly
ze
d
at
9
5
%
co
n
f
id
en
ce
in
ter
v
al
(
C
I
)
an
d
s
i
g
n
if
ican
ce
lev
el
p
<0
.
0
5
.
3.
RE
SU
L
T
S AN
D
D
I
SCU
SS
I
O
N
3
.
1
.
Cha
ra
c
t
er
is
t
ics dis
t
rib
u
t
io
n o
f
s
ub
j
ec
t
ba
s
ed
o
n hy
dra
t
io
n sta
t
us
Hy
d
r
atio
n
s
tatu
s
is
m
ea
s
u
r
ed
b
ased
o
n
an
av
er
ag
e
o
f
5
b
io
m
ar
k
er
s
f
r
o
m
th
e
6
p
o
i
n
ts
o
f
d
ata
co
llectio
n
:
u
r
in
e
co
lo
r
,
u
r
in
e
s
p
ec
if
ic
g
r
av
ity
,
s
er
u
m
s
o
d
iu
m
,
u
r
in
e,
a
n
d
s
er
u
m
o
s
m
o
lality
.
T
h
is
s
tu
d
y
d
iv
id
ed
th
e
s
u
b
jects
in
to
two
g
r
o
u
p
s
b
ased
o
n
h
y
d
r
atio
n
s
tatu
s
n
am
ely
d
eh
y
d
r
atio
n
(
5
1
.
5
%)
an
d
n
o
r
m
al
(
4
8
.
5
%).
B
ased
o
n
th
ese
d
ata
it
was
f
o
u
n
d
th
at
th
e
r
e
w
er
e
n
o
d
if
f
er
en
ce
s
in
s
u
b
ject
c
h
ar
ac
ter
is
tics
o
v
er
f
iv
e
m
o
n
th
s
b
etwe
en
th
e
two
g
r
o
u
p
s
(
p
0
.
0
5
)
.
Ph
y
s
io
lo
g
ical
r
eg
u
latio
n
o
f
s
o
d
iu
m
a
n
d
wate
r
in
tak
e
an
d
o
u
t
p
u
t w
as n
ee
d
ed
to
m
ai
n
tain
b
a
lan
ce
.
T
h
e
r
eg
u
latio
n
o
f
b
o
d
y
f
lu
id
an
d
s
o
d
iu
m
b
ala
n
ce
af
f
ec
ts
b
lo
o
d
p
r
ess
u
r
e,
wer
e
ex
ce
s
s
s
o
d
iu
m
in
b
lo
o
d
ca
u
s
es
h
y
p
er
ten
s
io
n
.
T
h
e
b
eh
a
v
io
r
al
an
d
n
eu
r
o
en
d
o
cr
in
e
m
ec
h
a
n
is
m
s
th
at
r
eg
u
late
f
l
u
id
a
n
d
s
alt
b
alan
ce
ar
e
in
ter
d
ep
en
d
en
t,
with
k
i
d
n
ey
o
u
tp
u
t
b
ein
g
o
f
f
s
et
b
y
c
h
an
g
es
in
th
ir
s
t
a
n
d
at
a
lo
wer
le
v
el,
ap
p
etite.
T
h
is
is
m
ain
tain
ed
in
t
h
e
th
ir
d
tr
im
ester
o
f
p
r
eg
n
an
cy
[
20
]
,
[
21
]
.
Oth
er
s
tu
d
ies
m
en
tio
n
th
at
p
r
eg
n
an
t
wo
m
en
o
v
er
3
5
y
ea
r
s
ar
e
at
h
ig
h
r
is
k
o
f
g
iv
in
g
b
ir
th
to
ch
ild
r
e
n
with
Do
wn
s
y
n
d
r
o
m
e,
m
is
ca
r
r
ia
g
e,
h
ig
h
b
lo
o
d
p
r
ess
u
r
e
an
d
p
r
eg
n
a
n
cy
co
m
p
licatio
n
s
[
31
]
,
[
32
]
.
B
ased
o
n
th
e
d
ata
as
s
h
o
wn
in
T
ab
le
1
,
it
was
f
o
u
n
d
th
at
th
er
e
wer
e
n
o
d
if
f
er
en
ce
s
in
s
u
b
ject
ch
ar
ac
ter
is
tics
;
m
ater
n
al
ag
e
,
g
estatio
n
al
weig
h
t
g
ain
,
b
lo
o
d
p
r
ess
u
r
e,
p
u
ls
e,
th
y
r
o
id
g
la
n
d
,
le
g
e
d
em
a,
ey
e
co
n
ju
n
ctiv
a,
e
y
e
s
cler
a
an
d
f
etal
m
o
v
em
en
ts
o
v
er
f
iv
e
m
o
n
t
h
s
b
etwe
en
th
e
two
g
r
o
u
p
s
(
p
0
.
0
5
)
.
I
n
th
is
s
tu
d
y
b
lo
o
d
p
r
ess
u
r
e
an
d
p
u
ls
e
wer
e
in
th
e
n
o
r
m
al
r
an
g
e.
L
eg
ed
em
a,
ey
e
co
n
ju
n
ctiv
a,
ey
e
s
cler
a
a
n
d
f
etal
m
o
v
e
m
en
ts
b
etwe
en
th
e
two
g
r
o
u
p
s
ar
e
in
n
o
r
m
al
co
n
d
itio
n
.
T
h
ese
s
y
m
p
to
m
s
ar
e
o
n
e
o
f
th
e
th
in
g
s
th
at
d
escr
ib
e
th
e
b
o
d
y
f
lu
id
s
b
alan
ce
o
f
s
o
d
iu
m
an
d
p
o
tass
iu
m
.
B
MI
b
ef
o
r
e
p
r
eg
n
a
n
cy
in
th
e
two
g
r
o
u
p
s
th
er
e
ar
e
d
if
f
er
en
ce
s
(
p
<0
.
0
5
)
an
d
ar
e
i
n
th
e
n
o
r
m
al
ca
te
g
o
r
y
(
1
8
.
5
-
2
4
.
0
k
g
)
.
No
r
m
al
g
estatio
n
al
weig
h
t
g
ain
was
r
an
g
e
d
f
r
o
m
1
1
.
5
-
1
6
.
0
k
g
[
33
]
.
Gestatio
n
al
weig
h
t
g
ain
is
as
s
o
ciate
d
with
a
h
ig
h
r
is
k
o
f
p
r
eg
n
an
c
y
p
r
o
b
lem
s
s
u
ch
as
h
ig
h
b
lo
o
d
p
r
ess
u
r
e,
lo
w
b
ir
th
weig
h
t,
a
n
d
m
is
ca
r
r
i
ag
e
[
3
3
].
T
ab
le
1
.
C
h
ar
ac
ter
is
tics
d
is
tr
ib
u
tio
n
o
f
s
u
b
ject
b
ased
o
n
h
y
d
r
atio
n
s
tatu
s
V
a
r
i
a
b
l
e
D
e
h
y
d
r
a
t
i
o
n
(
n
=
3
4
)
N
o
r
mal
(
n
=
3
2
)
p
-
v
a
l
u
e
A
g
e
(
y
e
a
r
)
2
5
.
5
4
.
7
2
6
.
8
4
.
9
0
.
2
8
B
M
I
(
k
g
/
m
2
)
2
3
.
8
3
.
5
2
1
.
4
3
.
6
0
.
0
0
G
e
st
a
t
i
o
n
a
l
w
e
i
g
h
t
g
a
i
n
(
k
g
)
1
2
.
4
4
.
2
1
1
.
5
3
.
8
0
.
3
4
B
l
o
o
d
P
r
e
ssu
r
e
:
S
y
st
o
l
e
(
mm
H
g
)
1
0
8
10
1
0
8
7
0
.
8
6
D
i
a
st
o
l
e
(
mm
H
g
)
67
6
69
6
0
.
3
2
P
u
l
s
e
(
mi
n
u
t
e
)
8
7
.
8
1
8
.
6
9
0
.
3
1
8
.
3
0
.
5
8
Th
y
r
o
i
d
g
l
a
n
d
:
0
.
1
8
N
o
t
p
a
l
p
a
b
l
e
(
0
)
3
4
(
1
0
0
.
0
)
2
9
(
9
0
.
6
)
P
a
l
p
a
b
l
e
b
u
t
n
o
t
v
i
s
i
b
l
e
(
I
a
)
0
(
0
.
0
)
2
(
6
.
3
)
V
i
si
b
l
e
i
n
n
o
r
mal
p
o
s
i
t
i
o
n
(
I
I
)
0
(
0
.
0
)
1
(
3
.
1
)
Le
g
e
d
e
m
a
:
N
o
t
p
r
e
s
e
n
t
3
4
(
1
0
0
.
0
)
3
2
(
1
0
0
.
0
)
Ey
e
c
o
n
j
u
n
c
t
i
v
a
:
1
.
0
0
0
P
r
e
sen
t
1
(
2
.
9
)
0
(
0
.
0
)
N
o
t
p
r
e
s
e
n
t
3
3
(
9
7
.
1
)
3
2
(
1
0
0
.
0
)
Ey
e
s
c
l
e
r
a
:
0
.
9
7
P
r
e
sen
t
0
(
0
.
0
)
1
(
3
.
1
)
N
o
t
p
r
e
s
e
n
t
2
4
(
1
0
0
.
0
)
3
1
(
9
6
.
9
)
F
e
t
a
l
m
o
v
e
me
n
t
s a
b
o
v
e
f
i
v
e
m
o
n
t
h
s
:
N
o
t
p
r
e
s
e
n
t
3
4
(
1
0
0
.
0
)
3
2
(
1
0
0
.
0
)
Th
e
d
a
t
a
a
r
e
n
o
r
mal
l
y
d
i
s
t
r
i
b
u
t
e
d
i
n
t
h
e
f
o
r
m
o
f
m
e
a
n
±
S
D
,
S
D
:
st
a
n
d
a
r
d
d
e
v
i
a
t
i
o
n
,
I
n
d
e
p
e
n
d
e
n
t
t
-
t
e
s
t
.
C
a
t
e
g
o
r
i
c
a
l
d
a
t
a
a
r
e
p
r
e
se
n
t
e
d
i
n
t
h
e
f
o
r
m
o
f
n
(
%),
C
hi
-
sq
u
a
r
e
t
e
s
t
3
.
2
.
I
G
F
-
1
,
Z
n,
Ca
,
a
nd
Na
l
ev
els a
nd
hy
dra
t
io
n sta
t
us
Z
n
,
C
a
an
d
Na
s
er
u
m
lev
els w
er
e
m
ea
s
u
r
ed
in
th
e
th
ir
d
tr
im
ester
o
f
p
r
eg
n
an
c
y
an
d
th
e
av
e
r
ag
e
v
alu
e
was
ca
lcu
lated
.
W
h
ile
I
GF
-
1
l
ev
els
ar
e
tak
en
in
v
en
o
u
s
u
m
b
ilical
s
h
o
r
tly
af
ter
th
e
m
o
th
er
g
iv
es
b
ir
th
.
T
ab
le
2
s
h
o
ws
n
o
d
if
f
er
en
ce
s
in
I
GF
-
1
,
Z
n
,
C
a,
an
d
Na
s
er
u
m
lev
els
with
h
y
d
r
atio
n
s
tatu
s
b
etw
ee
n
th
e
two
g
r
o
u
p
s
(p
0
.
0
5
)
.
Evaluation Warning : The document was created with Spire.PDF for Python.
I
n
t J Pu
b
lic
Hea
lth
Sci
I
SS
N:
2252
-
8
8
0
6
Lo
w
z
in
c
s
eru
m
a
ffect
in
s
u
lin
-
like
g
r
o
w
th
fa
cto
r
-
1
leve
l in
d
eh
yd
r
a
ted
p
r
eg
n
a
n
t
…
(
E
r
r
y
Yu
d
h
ya
Mu
ly
a
n
i
)
179
T
ab
le
2
.
Dif
f
e
r
en
ce
s
o
f
I
GF
-
1
,
Z
n
,
C
a,
an
d
Na
lev
els with
h
y
d
r
atio
n
s
tatu
s
V
a
r
i
a
b
l
e
D
e
h
y
d
r
a
t
i
o
n
(
n
=
3
4
)
N
o
r
mal
(
n
=
3
2
)
p
-
v
a
l
u
e
I
G
F
-
1
l
e
v
e
l
(
n
g
/
ml
)
4
4
.
4
1
0
.
8
4
6
.
9
1
3
.
3
0
.
4
0
Zn
l
e
v
e
l
(
µ
g
/
d
l
)
4
5
.
1
9
5
.
9
6
4
3
.
4
5
3
.
8
6
0
.
1
6
C
a
l
e
v
e
l
(
m
g
/
d
l
)
8
.
7
0
.
3
8
.
8
0
.
2
0
.
9
4
N
a
l
e
v
e
l
(
m
Eq
/
L)
1
3
7
.
5
1
.
0
1
3
7
.
7
1
.
2
0
.
3
1
D
a
t
a
p
r
e
s
e
n
t
e
d
i
n
f
o
r
m
o
f
m
e
a
n
S
D
;
S
D
:
st
a
n
d
a
r
d
d
e
v
i
a
t
i
o
n
,
i
n
d
e
p
e
n
d
e
n
t
t
-
t
e
st
.
T
h
is
s
tu
d
y
s
h
o
ws
th
at
th
e
le
v
els
o
f
C
a
an
d
Na
in
th
e
Deh
y
d
r
atio
n
a
n
d
n
o
r
m
al
g
r
o
u
p
s
ar
e
at
n
o
r
m
al
v
alu
es.
I
t
is
p
o
s
s
ib
le
th
at
in
th
e
th
ir
d
tr
im
ester
o
f
p
r
eg
n
an
c
y
th
e
m
o
th
er
ca
n
ad
ap
t
an
d
g
et
C
a
s
u
p
p
lem
en
ts
f
o
r
p
r
eg
n
a
n
t w
o
m
en
f
r
o
m
th
e
C
o
m
m
u
n
ity
Hea
lth
C
en
ter
wh
ich
o
n
e
o
f
th
e
g
o
v
er
n
m
e
n
t p
r
o
g
r
a
m
s
.
Na
lev
els in
th
e
two
g
r
o
u
p
s
wer
e
at
n
o
r
m
al
lev
els (
1
3
5
-
1
5
3
m
E
q
/L)
.
3
.
3
.
Co
rr
el
a
t
io
n o
f
Z
n,
Ca
,
a
nd
Na
a
nd
I
G
F
-
1
lev
els
T
ab
le
3
s
h
o
wed
th
at
t
h
er
e
is
n
o
r
elatio
n
s
h
ip
b
etwe
en
t
h
e
s
er
u
m
lev
el
o
f
C
a,
Na,
a
n
d
I
GF
-
1
(
p
≥
0
.
0
5
)
.
Alth
o
u
g
h
th
er
e
was
a
p
o
s
itiv
e
co
r
r
elatio
n
b
etwe
en
th
e
s
er
u
m
lev
el
o
f
Z
n
an
d
I
GF
-
1
(
0
<0
.
1
)
(
r
=0
.
2
1
)
.
T
o
d
eter
m
in
e
th
e
in
ter
ac
tio
n
o
f
th
ese
n
u
tr
ien
ts
o
n
h
y
d
r
atio
n
s
tatu
s
,
a
r
eg
r
ess
io
n
test
was
ca
r
r
ie
d
o
u
t
o
n
I
GF
-
1
.
T
h
e
r
esu
lts
s
h
o
w
th
er
e
is
a
ten
d
en
cy
f
o
r
a
p
o
s
itiv
e
co
r
r
elatio
n
b
etwe
en
Z
n
an
d
I
GF
-
1
lev
els,
th
en
Z
n
an
d
h
y
d
r
atio
n
s
tatu
s
co
n
tr
o
l o
f
I
GF
-
1
ar
e
s
h
o
wn
in
T
ab
le
4
.
A
r
elatio
n
s
h
ip
o
f
Z
n
with
I
GF
-
1
lev
els
wer
e
f
o
u
n
d
(
p
<0
.
0
5
)
.
T
ab
le
3
.
C
o
r
r
elatio
n
o
f
Z
n
,
C
a
,
an
d
Na
an
d
I
GF
-
1
le
v
els
V
a
r
i
a
b
l
e
I
G
F
-
1
l
e
v
e
l
(
n
g
/
ml
)
r
p
-
v
a
l
u
e
Zn
l
e
v
e
l
(
µ
g
/
d
l
)
0
.
2
1
0
.
0
7
*
C
a
l
e
v
e
l
(
m
g
/
d
l
)
-
0
.
1
1
0
.
3
7
N
a
l
e
v
e
l
(
m
Eq
/
L)
-
0
.
1
8
0
.
1
2
C
o
r
r
e
l
a
t
i
o
n
t
e
st
,
p
<
0
.
1
T
ab
le
4
.
R
eg
r
ess
io
n
m
o
d
el
o
f
Z
n
lev
el
an
d
h
y
d
r
atio
n
s
tatu
s
t
o
I
GF
-
1
V
a
r
i
a
b
l
e
(
S
E)
9
5
%
C
I
p
-
v
a
l
u
e
C
o
n
st
a
n
t
1
1
.
8
2
-
(
-
1
9
.
7
6
-
4
3
.
4
0
)
0
.
4
5
Zn
l
e
v
e
l
*)
0
.
7
2
0
.
3
0
(
0
.
0
2
-
1
.
4
1
)
0
.
0
4
H
y
d
r
a
t
i
o
n
s
t
a
t
u
s
2
6
.
0
7
1
.
0
8
(
-
3
1
.
4
4
-
8
3
.
5
9
)
0
.
3
6
I
n
t
e
r
a
c
t
i
o
n
o
f
Zn
l
e
v
e
l
a
n
d
h
y
d
r
a
t
i
o
n
st
a
t
u
s
-
0
.
5
1
-
0
.
9
3
(
-
1
.
8
1
-
0
.
7
8
)
0
.
4
3
Li
n
e
a
r
r
e
g
r
e
s
si
o
n
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p
<
0
.
0
5
.
H
y
d
r
a
t
i
o
n
st
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t
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s:
(
1
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n
o
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m
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l
,
(
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d
e
h
y
d
r
a
t
i
o
n
I
n
cr
ea
s
ed
Z
n
lev
el
o
f
p
r
e
g
n
an
t
wo
m
an
with
d
e
h
y
d
r
atio
n
ca
n
in
cr
ea
s
e
th
e
I
GF
-
1
lev
el.
I
n
cr
ea
s
ed
Z
n
p
er
1
m
g
in
d
eh
y
d
r
ated
m
o
th
er
s
will
in
cr
ea
s
e
0
.
7
2
I
GF
-
1
lev
els.
I
n
n
o
r
m
al
m
o
th
e
r
s
,
an
in
cr
ea
s
e
o
f
1
m
g
Z
n
in
cr
ea
s
es
I
GF
-
1
lev
els
b
y
2
6
.
2
8
.
T
h
u
s
,
in
p
eo
p
le
w
h
o
ar
e
d
e
h
y
d
r
ated
,
h
ig
h
co
n
s
u
m
p
tio
n
o
f
Z
n
ca
n
h
elp
i
n
cr
ea
s
e
I
GF
-
1
lev
els.
Du
r
in
g
n
o
r
m
al
p
r
eg
n
a
n
cy
,
t
h
e
d
ig
esti
v
e
tr
ac
t
an
d
it
i
s
s
u
p
p
o
r
tin
g
o
r
g
a
n
s
ch
an
g
ed
,
t
h
at
it
ca
u
s
es
ex
ce
s
s
iv
e
n
au
s
ea
an
d
v
o
m
itin
g
(
h
y
p
er
em
esis
g
r
av
id
a
r
u
m
)
in
th
e
ea
r
ly
t
r
im
ester
o
f
p
r
eg
n
an
cy
.
A
b
o
u
t
0
.
8
-
3
.
2
% o
f
p
r
eg
n
an
t w
o
m
e
n
,
r
esu
ltin
g
weig
h
t lo
s
s
,
d
eh
y
d
r
at
io
n
,
an
d
m
aln
u
tr
itio
n
[
3
4
]
,
[
3
5
]
.
W
h
ile
Z
n
lev
els b
etwe
en
th
e
two
g
r
o
u
p
s
wer
e
b
elo
w
n
o
r
m
al
v
alu
es (
7
0
-
2
5
0
µ
g
/d
l)
.
I
t is p
o
s
s
ib
le
th
at
at
th
e
b
eg
in
n
in
g
o
f
th
e
t
r
im
ester
th
e
m
o
th
e
r
ex
p
e
r
ien
ce
s
ex
ce
s
s
iv
e
n
au
s
ea
an
d
v
o
m
itin
g
b
u
t
ca
n
n
o
t
ca
tch
u
p
with
th
e
in
tak
e
o
f
zin
c
i
n
th
e
th
ir
d
tr
im
ester
.
T
h
is
s
tu
d
y
d
id
n
o
t
m
ea
s
u
r
e
Z
n
s
er
u
m
le
v
els
in
th
e
f
ir
s
t
tr
im
ester
.
T
h
er
ef
o
r
e,
we
d
id
n
'
t
p
r
ed
ict
wea
th
er
th
e
Z
n
s
er
u
m
lev
els
is
l
o
w
o
r
n
o
t
in
th
at
p
er
io
d
.
Z
n
is
a
m
icr
o
m
in
er
al
th
at
h
as
a
r
o
le
in
f
etal
g
r
o
wth
a
n
d
d
ev
elo
p
m
e
n
t.
Z
n
d
ef
icien
cy
ca
n
ca
u
s
e
s
tu
n
ted
f
etal
g
r
o
wt
h
,
m
is
ca
r
r
iag
e,
an
d
p
r
em
atu
r
e
[
14
]
,
[
3
6
]
.
Z
in
c
co
n
ce
n
tr
atio
n
in
s
er
u
m
af
f
ec
ts
T
3
,
T
4
an
d
s
er
u
m
T
SH
lev
els.
Z
in
c
tr
an
s
p
o
r
ter
s
(
Z
n
T
s
)
ar
e
p
r
esen
t
in
th
e
h
y
p
o
th
alam
u
s
,
p
itu
itar
y
,
an
d
th
y
r
o
id
,
alth
o
u
g
h
th
eir
f
u
n
ctio
n
is
u
n
k
n
o
wn
[3
7
]
.
I
n
a
d
d
itio
n
,
o
th
e
r
r
esear
c
h
s
tates
th
at
th
e
u
s
e
o
f
zin
c
a
n
d
Se
s
u
p
p
lem
e
n
ts
in
co
m
b
i
n
atio
n
with
a
l
o
w
-
ca
lo
r
ie
d
iet
ca
n
af
f
ec
t
r
esti
n
g
m
etab
o
lis
m
,
tim
ed
u
p
-
an
d
-
g
o
test
p
er
f
o
r
m
an
ce
an
d
s
elen
iu
m
lev
els
in
o
v
er
weig
h
t
p
eo
p
le
[3
8
]
.
T
h
u
s
in
cr
ea
s
in
g
lev
els
o
f
zin
c
an
d
s
elen
iu
m
in
tak
e
m
ay
b
e
b
en
e
f
icial
in
p
r
ev
en
tin
g
th
e
n
ew
o
n
s
et
o
f
h
y
p
o
th
y
r
o
id
is
m
in
o
v
er
weig
h
t a
d
u
lt wo
m
en
[
39
]
,
[
4
0
]
.
I
GF
-
1
is
two
p
ep
tid
e
h
o
r
m
o
n
e
s
th
at
s
h
ar
e
s
tr
u
ctu
r
al
h
o
m
o
lo
g
y
,
wh
ich
ac
ts
as
an
im
p
o
r
tan
t
r
eg
u
lato
r
in
f
etal
g
r
o
wth
an
d
d
ev
el
o
p
m
en
t
[
4
1
]
.
I
n
a
d
d
itio
n
,
I
GF
-
1
an
d
I
GFB
P3
p
lay
a
r
o
le
in
th
e
d
ev
elo
p
m
en
t
o
f
au
to
im
m
u
n
e
b
eta
ce
lls
[
4
2
]
.
Mo
r
e
th
an
7
0
.
0
%
I
GF
-
1
is
f
o
u
n
d
in
all
b
o
d
y
tis
s
u
es
an
d
s
y
n
th
esized
in
th
e
liv
er
Evaluation Warning : The document was created with Spire.PDF for Python.
I
SS
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2
2
5
2
-
8
8
0
6
I
n
t J Pu
b
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1
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Ma
r
ch
20
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75
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1
82
180
u
n
d
er
th
e
r
eg
u
latio
n
o
f
g
r
o
wt
h
h
o
r
m
o
n
e
(
GH)
,
t
h
u
s
s
er
u
m
I
GF
-
1
r
ep
r
esen
ted
t
h
e
en
d
o
g
en
o
u
s
s
ec
r
etio
n
o
f
g
r
o
wth
h
o
r
m
o
n
e
(
GH)
.
Ser
u
m
I
GF
-
1
is
in
f
lu
en
ce
d
b
y
a
g
e,
b
o
d
y
m
ass
in
d
ex
,
an
d
g
eo
g
r
ap
h
ical
ar
ea
[
4
2
]
.
Sev
er
al
s
tu
d
ies
f
o
u
n
d
th
e
r
elat
io
n
s
h
ip
o
f
s
er
u
m
Z
n
a
n
d
I
GF
-
1
an
d
I
GFB
P3
s
er
u
m
r
esp
ec
ti
v
ely
.
T
h
is
ass
u
m
es
th
at
th
er
e
was
s
t
im
u
latin
g
ef
f
ec
t
o
f
Z
n
lev
els
m
ed
iated
b
y
ch
a
n
g
es
in
I
GF
-
1
l
ev
els
an
d
is
clo
s
ely
r
elate
d
to
g
r
o
wth
h
o
r
m
o
n
e
(
G
H)
[
4
3
]
,
[
4
4
]
.
Gr
o
wth
h
o
r
m
o
n
e
is
p
r
o
d
u
ce
d
b
y
th
e
an
ter
io
r
p
itu
itar
y
g
lan
d
,
wh
ic
h
h
av
e
f
u
n
ctio
n
s
as
th
e
m
ain
r
e
g
u
lato
r
o
f
f
o
r
m
atio
n
a
n
d
g
r
o
w
th
.
T
h
is
h
o
r
m
o
n
e
also
p
r
o
m
o
t
es
lin
ea
r
g
r
o
wth
b
y
s
tim
u
latin
g
th
e
d
iv
is
io
n
o
f
p
r
ec
h
o
n
d
r
o
cy
tes
in
t
h
e
ep
o
p
h
y
s
ea
l
p
late.
T
h
er
e
f
o
r
e,
it
is
u
s
ed
as
a
m
ar
k
er
o
f
th
e
g
r
o
wth
h
o
r
m
o
n
e
GH
-
I
GF1
-
i
n
s
u
lin
-
lik
e
g
r
o
wth
f
ac
to
r
-
1
t
h
at
d
iv
id
es
g
r
o
wth
s
tatu
s
,
g
r
o
wth
p
o
ten
t
ial
an
d
r
esp
o
n
s
e
to
p
r
ev
e
n
tiv
e
a
n
d
th
e
r
ap
eu
tic
in
ter
v
en
tio
n
s
[4
4
]
.
I
GF
-
1
lev
els,
u
n
lik
e
GH,
a
r
e
m
o
r
e
s
tab
le
in
h
ea
lth
y
in
d
iv
id
u
als.
T
h
is
is
p
r
o
v
e
n
b
y
I
GF1
d
ir
ec
tly
s
tim
u
latin
g
g
r
o
wth
with
o
u
t d
ep
en
d
in
g
o
n
GH
s
tim
u
latio
n
.
I
n
f
ac
t
,
s
tu
d
ies o
n
m
ice
s
h
o
w
th
at
in
ter
v
en
tio
n
s
f
o
r
g
r
o
wth
f
ailu
r
e
d
u
e
to
lack
o
f
Z
n
lev
els ar
e
ca
u
s
ed
n
o
t o
n
ly
b
y
lo
w
I
GF
-
1
lev
els,
b
u
t
b
y
in
h
i
b
itin
g
th
e
an
ab
o
lic
I
GF
-
1
ac
tio
n
[
14
]
.
Oth
er
s
tu
d
ies
h
av
e
f
o
u
n
d
th
at
o
r
al
ad
m
in
is
tr
atio
n
o
f
Z
n
s
u
p
p
lem
e
n
ts
ef
f
ec
tiv
ely
i
n
cr
ea
s
es
Z
n
s
tatu
s
f
o
r
ch
ild
r
en
lack
in
g
zin
c,
I
GF
-
1
an
d
I
GFB
P3
s
ec
r
eto
r
y
lev
els,
GH
p
o
ten
tiality
,
an
d
h
eig
h
t
[
4
5
]
.
T
h
u
s
,
zin
c
lev
els in
p
r
eg
n
a
n
t w
o
m
en
in
f
lu
en
ce
h
ig
h
lev
el
s
o
f
I
GF
-
1.
4.
CO
NCLU
SI
O
N
T
h
is
s
tu
d
y
f
o
u
n
d
t
h
er
e
wer
e
n
o
d
if
f
er
en
ce
s
in
s
u
b
ject
ch
ar
ac
te
r
is
tics
;
m
ater
n
al
ag
e,
weig
h
t
g
ain
d
u
r
in
g
p
r
eg
n
a
n
cy
,
b
lo
o
d
p
r
ess
u
r
e,
p
u
ls
e,
th
y
r
o
id
g
la
n
d
,
leg
ed
em
a,
ey
e
co
n
ju
n
ctiv
a,
ey
e
s
cler
a
a
n
d
f
etal
m
o
v
e
m
en
ts
o
v
er
f
iv
e
m
o
n
th
s
b
etwe
en
th
e
t
wo
g
r
o
u
p
s
.
N
o
d
if
f
er
en
ce
s
i
n
I
GF
-
1
,
Z
n
,
C
a,
an
d
Na
s
er
u
m
le
v
els
with
h
y
d
r
atio
n
s
tatu
s
b
etwe
en
th
e
t
wo
g
r
o
u
p
s
.
T
h
er
e
is
n
o
r
elatio
n
s
h
ip
b
etwe
en
Z
n
,
C
a,
Na
s
er
u
m
lev
els
wit
h
I
GF
-
1
.
Ho
wev
er
,
th
er
e
is
a
p
o
s
itiv
e
co
r
r
elatio
n
b
etwe
en
Z
n
an
d
I
GF
-
1
le
v
els.
I
t
is
r
ec
o
m
m
en
d
e
d
to
c
o
n
s
u
m
e
zin
c
-
r
ich
f
o
o
d
s
o
u
r
ce
s
in
b
o
th
g
r
o
u
p
s
o
f
d
eh
y
d
r
ated
an
d
n
o
r
m
al
p
r
eg
n
a
n
t
wo
m
en
to
in
cr
ea
s
e
I
GF
-
1
lev
els.
I
t
s
h
o
u
ld
b
e
n
o
t
ed
th
at
th
is
r
esear
ch
is
o
n
ly
lim
ited
to
p
r
eg
n
a
n
t
wo
m
en
f
r
o
m
lo
we
r
m
id
d
le
-
in
co
m
e
an
d
th
e
s
am
p
le
is
lim
ited
.
T
h
er
ef
o
r
e
,
m
o
r
e
s
am
p
les
an
d
h
eter
o
g
en
e
o
u
s
s
o
cio
-
ec
o
n
o
m
ic
clu
s
ter
in
g
ar
e
n
ee
d
e
d
.
O
n
th
e
o
th
e
r
h
an
d
,
th
is
s
tu
d
y
is
n
ee
d
ed
to
s
ee
th
e
ef
f
ec
tiv
en
ess
o
f
zin
c
ad
m
in
is
tr
atio
n
in
p
r
eg
n
a
n
t w
o
m
en
to
in
cr
ea
s
e
I
GF
-
1
,
esp
ec
i
ally
in
ca
s
es o
f
p
r
e
g
n
an
c
y
h
y
d
r
atio
n
.
ACK
NO
WL
E
DG
E
M
E
NT
S
T
h
is
s
tu
d
y
was
f
u
lly
f
u
n
d
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Evaluation Warning : The document was created with Spire.PDF for Python.