Rb和P21基因在婴幼儿皮肤血管瘤中的表达及意义

目的探讨Rb和P21蛋白在婴幼儿血管瘤发生、发展及退化过程中的表达及与血管瘤退化有关的可能机制。方法采用免疫组织化学方法（SP法）检测Rb、P21WAF1/CIP1及增殖细胞核抗原在婴幼儿皮肤血管瘤标本增生期、退化期以及血管畸形标本中的表达情况,并用末端脱氧核苷酸基转移酶介导的脱氧尿苷三磷酸-生物素颈端标记法检测血管内皮细胞凋亡情况,结合CD34相关抗原的免疫组织化学染色,证实Rb和P21表达的细胞是血管内皮细胞。结果增生期血管瘤内皮细胞Rb和P21表达水平低于退化期,差异有统计学意义（P〈0．05）,退化期血管瘤Rb和P21表达水平与血管畸形组织相比,差异有显著统计学意义（P〈0．001）。结论Rb和P21可能通过抑制血管瘤内皮细胞增殖和促进血管内皮细胞凋亡,而在血管瘤的退化过程中起重要作用。     

血管内皮祖细胞在血管瘤中的表达和作用

目的探讨血管内皮祖细胞在血管形成和血管瘤的发病中的作用。方法应用RT—PCR荧光探针法定量检测CD133mRNA在28例血管瘤（包括增生期血管瘤13例,消退期血管瘤15例）、11例血管畸形、12例正常皮肤组织和10例胎盘绒毛膜标本中的表达。比较不同组织中CD133mRNA的阳性率及含量。应用免疫组化方法检测血管内皮祖细胞标志抗原CD133、成熟血管内皮细胞标志抗原CD31、端粒逆转录酶（TERT）和细胞增殖核抗原（Ki-67）在血管瘤、血管畸形及正常皮肤组织中的表达。观察血管内皮祖细胞在血管瘤血管形成中的形态学及组织学特征。结果13例增生期血管瘤中,9例有CD133 mRNA表达;10例胎盘绒毛膜组织中,7例有CD133mRNA表达,二者阳性率及表达量比较无统计学意义（P〉0．05）。消退期血管瘤、血管畸形和正常皮肤无CD133mRNA表达。8例增生期血管瘤CD133免疫组化染色阳性,而消退期血管瘤、血管畸形和正常皮肤CD133免疫组化染色均呈阴性。CD31在增生期血管瘤、消退期血管瘤、血管畸形和皮肤组织中均有表达,但增生期血管瘤中的表达阳性指数高于其它三组（P〈0．01）。增生期血管瘤TERT和Ki-67的表达均高于消退期血管瘤、血管畸形和正常皮肤（P〈0．01）。血管瘤中TERT和Ki-67存在直线正相关关系（r=0．983,P〈0．01）。结论增生期血管瘤中存在血管内皮祖细胞,而消退期血管瘤、血管畸形和正常皮肤组织中无血管内皮祖细胞。血管内皮祖细胞参与了血管瘤中内皮细胞的增殖和血管形成,是血管瘤血管内皮细胞活性异常的来源。     

婴幼儿血管瘤组织中bcl-2和bax与细胞凋亡的研究

目的　研究凋亡调控基因bcl- 2和bax与婴幼儿血管瘤细胞增生、凋亡的关系,探讨其在血管瘤增生、消退中的作用机制。方法　采用免疫组化SP法检测血管瘤及血管畸形组织中增殖细胞核抗原(PCNA)及凋亡调控基因bcl -2和bax的表达;用末端脱氧核苷酸转移酶(TdT)介导的d UTP生物素缺口末端标记技术 (TUNEL)检测凋亡细胞。结果　bcl 2阳性表达率在增生期和消退期分别是82.14%和46.67%,两者之间差异存在显著性意义(P<0.01),消退期与血管畸形表达差异无显著性意义(P>0.05)。Bax在血管瘤增生期和消退期均为 100%表达,与血管畸形中的表达差异有显著性意义(P<0.01)。bcl 2和bax在血管畸形组织中均不表达。婴幼儿血管瘤增生期和消退期凋亡指数(apop tosisindex,AI)为30.52±10.25和80.22±6.82;增殖指数 (proliferativeindex,PI)分别为11.40±8.90和4.79±3.63,两者之间差异均存在显著性意义(P<0.01)。AI与bcl 2的表达呈负相关 (r=-0.318,P<0.05),AI与bax的表达无明显相关性 (r=-0.077,P>0.05),AI与bcl 2/bax比值呈负相关 (r=-0.307,P<0.05)。结论　在血管瘤增生消退中存在着逐渐活跃的凋亡现象,细胞凋亡是血管瘤的典型生物学特征,是血管瘤的自然消退的关键因素。bcl -2和bax参与了血管瘤中细胞凋亡的调节。     

葡萄糖转运蛋白-1及血管内皮生长因子等在婴幼儿血管瘤相关疾病中的表达及意义

目的了解血管内皮生长因子（VEGF）、成纤维细胞生长因子-2（FCB-2）、金属蛋白酶组织抑制剂-1（TIMP-1）、胰岛素样生长因子-2（IGF-Ⅱ）及葡萄糖转运蛋白-1（GLUT1）在不同时期婴幼儿血管瘤（HOI）及迅速消退的先天性血管瘤（RICH）和血管畸形病变组织中的表达水平，探讨其临床意义。方法结合临床资料对74例血管病变标本进行病理复检。ElivisionTM免疫组织化学二步法检测GLUT1、VEGF、FGF-2、IGF-Ⅱ和TIMP-1的表达水平。结果3个时期HOI脉管的内皮层均有GLUT1表达，RICH和血管畸形病变组织未见表达。VEGF、FGF-2、IGF-Ⅱ和TIMP-1在增殖期HOI组的阳性表达率分别为90．0％、85．0％、95．0％和45．0％；在消退期HOI组的阳性表达率分别为80．0％、100％、27．0％和80．0％；在消退后期组的阳性表达率分别为11．0％、56．0％、11．0％和22．0％；在RICH组的阳性表达率分别为25．0％、100％、75．0％和25．0％；在血管畸形组的阳性表达率分别为12．0％、8．0％、0和8．0％。增殖期、消退期HOI组和血管畸形组VEGF的阳性表达率比较，差异有统计学意义（x^2=33．34，P〈0．01）；增殖期、消退期、消退后期HOI组和血管畸形组FGF-2的阳性表达率比较，差异有统计学意义（x^2=43．18，P〈0．01）；增殖期、消退期HOI组和血管畸形组IGF-Ⅱ的阳性表达率比较，差异有统计学意义（x^2=44．47，P〈0．01）；增殖期、消退期HOI组和血管畸形组TIMP-1的阳性表达率比较，差异有统计学意义（x^2=21．84，P〈0．01）。RICH组FGF-2和IGF-Ⅱ的阳性表达率同血管畸形组比较，差异有统计学意义。结论①HOI的生长和消退是一个多因素参与的连续性过程，IGF-Ⅱ可能在HOI的自然消退过程中起主要的调控作用；②GLUT1可作为HOI同其他血管病变相鉴别的特异性指标，VEGF、FGF-2、IGF-Ⅱ和TIMP-1也是HOI、血管畸形和RICH相互鉴别的良好指标。     

小儿皮肤血管瘤c-myc蛋白表达与其细胞增殖和凋亡的关系

目的　探讨小儿皮肤血管瘤中c myc蛋白表达水平与血管瘤增生消退、细胞增殖活性及凋亡程度的关系。方法　以5 8例小儿皮肤血管瘤组织为研究对象 ,用免疫组织化学SP法分别检测c myc蛋白和增殖细胞核抗原的表达 ,并用末端脱氧核苷酸转移酶介导的末端标记技术做原位细胞凋亡检测。结果　 5 8例血管瘤组织中c myc蛋白表达率消退期显著高于增生期 (P <0 .0 1)。随着c myc蛋白表达强度增加 ,其细胞增殖活性相应降低 ,凋亡相应增加 ,c myc蛋白 ( )组、( )组分别与 (-)组、( )组比较 ,增殖指数和凋亡指数的差异均有显著性 (P <0 .0 1)。结论　小儿血管瘤内皮细胞c myc蛋白表达强度的增加可诱导内皮细胞凋亡 ,同时使细胞增殖受到相对抑制 ,提示c myc基因在血管瘤发生、发展和退化中起重要作用。     

皮肤血管瘤患儿肿瘤坏死因子相关凋亡诱导配体及死亡受体的表达与细胞凋亡的关系

目的探讨肿瘤坏死因子相关凋亡诱导配体(TRAIL)及其死亡受体4、5(DR4、DR5)在小儿皮肤血管瘤各阶段的表达及其与细胞凋亡的关系。方法采用免疫组织化学法检测增生期、消退期血管瘤和正常皮肤组织中TRAIL和DR4、DR5蛋白的表达,并采用末端脱氧核苷酸转移酶介导的末端标记技术(TUNEL法)检测各组织细胞凋亡情况。结果TRAIL、DR4、DR5蛋白的阳性表达率及细胞凋亡指数(AI)在血管瘤消退期明显高于血管瘤增生期和正常皮肤组织(P<0.05)。结论血管瘤的各个阶段均存在细胞凋亡现象,在由增生期转变为消退期的过程中出现细胞凋亡的上调,TRAIL及DR4、DR5参与细胞凋亡的调节,其与血管瘤的自行消退过程有关。     

血管瘤裸鼠移植模型生物学特性的动态观察

目的建立能客观、真实地反映人血管瘤的临床发展过程的稳定的血管瘤裸鼠移植模型，动态观察其生物学特性的变化。方法以裸小鼠为载体，选取1例2月龄婴儿增生期毛细血管瘤，将瘤体组织转种于裸小鼠皮下，动态观察瘤体生长情况及组织学变化，检测不同时期移植血管瘤糖皮质激素受体、血管内皮细胞生长因子、Ki-67的表达。结果血管瘤组织移植后3～4周内，瘤体基本上无明显变化，40d后，大多数瘤体开始生长，60d左右达到最大，90d时可见部分瘤体颜色变浅，质地较前变硬，90～120d时部分瘤体仅有少许残留组织。糖皮质激素受体、血管内皮细胞生长因子、Ki-67在增生期移植血管瘤中高表达，而在退化期移植血管瘤中表达极弱。糖皮质激素受体与Ki-67、血管内皮细胞生长因子的表达正相关，Ki-67与血管内皮细胞生长因子表达正相关。结论将人体血管瘤皮下部分移植于裸鼠所建立的人血管瘤动物模型，能较真实地反映人血管瘤的发展过程，是研究血管瘤的较理想的平台。糖皮质激素受体、血管内皮细胞生长因子与移植血管瘤的演变过程有着密切的关系。     

Caspase-8、Fas/FasL在小儿血管瘤中的表达

目的 观察Caspase-8、Fas/FasL在小儿血管瘤中的表达,探讨血管瘤内皮细胞的凋亡途径.方法 收集未经其他治疗、单纯行手术切除并经病理诊断为血管瘤的标本44例,结合Mulliken分类法与增殖细胞核抗原(PCNA)表达对血管瘤进行分期,采用免疫组织化学Evision二步法检测PCNA、Caspnse-8、Fas、FasL的表达.采集图像并分析,计算积分吸光度(IA),应用SPSS 13.0软件进行统计学分析.结果 结合Mulliken分类法与PCNA表达将44例血管瘤的标本分为增生期血管瘤25例,消退期血管瘤19例.25例增殖期血管瘤Caspase-8、Fns、FasL的IA分别为1186.42±863.86、99.08±54.80、538.65±344.41.19例消退期血管瘤Caspnse-8、Fas、FasL的IA分别为20 544.18±7 556.04、714.34±288.38、1 917.12±507.21.血管瘤增殖期Caspase-8、Fas、FasL的IA明显低于消退期,差异均有统计学意义(Pa<0.01).Fas与Caspase-8的表达呈正相关(r=0.644 P<0.01).结论 Caspase-8、Fas/FasL参与了小儿血管瘤内皮细胞凋亡的调节,在血管瘤内皮细胞的凋亡调控中起作用的可能是Fas/FasL介导的死亡受体通路.     

婴幼儿血管瘤及血管畸形组织中p16及TRAIL的表达及其意义

目的　检测婴幼儿血管瘤组织中抑癌基因 p1 6及肿瘤坏死因子相关凋亡诱导配体(TRAIL)的表达 ,并探讨它们在血管瘤增生、消退过程中的作用。方法　采用免疫组化SP法检测 32例增生期、2 0例消退期血管瘤及 1 4例血管畸形组织中p1 6和TRAIL的表达。结果　p1 6在增生期和消退期血管瘤组织中阳性表达率分别为 78.1 % (2 5/ 32 )、90 .0 % (1 8/ 2 0 ) ,血管畸形组织中全部为阴性。经秩和检验 :Hc=2 6 .6 ,三者之间差异存在显著性意义 (P <0 .0 1 ) ,两者之间差异有显著性意义(P <0 .0 5)。TRAIL在增生期和消退期血管瘤组织中阳性表达率分别为 2 1 .9% (7/ 32 )、80 .0 % (1 6/2 0 ) ,血管畸形中全部为阴性 ,卡方检验 :χ2 =2 7.8,三者之间差异存在显著性意义 (P <0 .0 1 ) ,两两之间比较经 χ2 分割 ,增生期与消退期之间有差异 (P <0 .0 5) ,消退期与血管畸形之间有差异 (P <0 .0 5) ,增生期与血管畸形之间无差异 (P >0 .0 5) ,血管瘤与血管畸形之间有差异。结论　p1 6和TRAIL的表达水平与血管瘤的增生、消退有关 ,p1 6可抑制内皮细胞的分裂增殖 ,TRAIL可通过诱导内皮细胞凋亡发挥作用 ,两者均可促进血管瘤消退     

婴幼儿血管瘤survivin基因启动子甲基化的研究

目的 采用亚硫酸氢盐修饰后测序法(BSP)检测不同病理阶段的婴幼儿血管瘤组织及正常皮肤组织中survivin基因启动子区域CpG岛的甲基化状态,探讨survivin基因启动子甲基化与婴幼儿血管瘤增生与退化的可能关系.方法 ①采用免疫组化S-P法检测增殖期婴幼儿血管瘤石蜡标本30例、消退期30例及正常包皮皮肤组织标本10例中survivin蛋白的表达;②提取石蜡包埋块组织基因组DNA并纯化后,采用亚硫酸氢盐修饰后测序法(BSP)分别检测增殖期血管瘤30例、消退期血管瘤30例及正常包皮组织10例中survivin基因启动子CpG岛甲基化情况.结果 ①survivin 蛋白在增殖期血管瘤、消退期血管瘤和正常包皮组织中阳性表达率分别为76.6％ (23/30)、33.3％(10/30)和20.0％(2/10);②10例正常包皮皮肤组织中1例(10.0％)survivin基因启动子CpG岛非甲基化,9例(90.0％)甲基化;30例消退期血管瘤标本中8例(26.6％)survivin基因启动子CpG岛非甲基化,22例(73.3％)甲基化;30例增殖期血管瘤标本中24例(80.0％) survivin基因启动子CpG岛非甲基化,6例(20.0％)甲基化;增殖期血管瘤survivin基因启动子CpG岛甲基化率明显低于消退期和正常包皮组织;③survivin蛋白表达阳性的血管瘤33例中31例survivin基因启动子CpG岛为非甲基化,survivin蛋白表达阴性的27例中26例survivin基因启动子CpG岛为甲基化状态.结论 ①增殖期血管瘤survivin蛋白表达明显高于消退期血管瘤;②survivin基因启动子CpG岛甲基化状态在增殖期血管瘤、消退期血管瘤中存在明显差异;血管瘤组织中survivin基因启动子的甲基化状态与survivin蛋白的表达具有相关性;survivin基因启动子区CpG岛异常甲基化在血管瘤的增殖与消退调控中可能起到了一定作用.     

Obesogenic home food availability,diet, and BMI in Pakistani and White toddlers

Individuals of South Asian ethnicity have an increased risk for obesity and related diseases. Foods available in the home during the first 1000 days (conception to 24 months old) are an important determinant of diet, yet no study has examined the association of early‐life home food availability (HFA) with later diet and obesity risk in South Asian households. We examined whether obesogenic HFA at 18 months of age is associated with dietary intake and body mass index (BMI) at 36 months of age in low‐income Pakistani and White households in the United Kingdom. In this prospective birth cohort study (Born in Bradford 1000), follow‐up assessments occurred at 18 (n = 1032) and 36 (n = 986) months of age. Variety and quantity of snack foods and sugar‐sweetened beverages (SSBs) in the home and consumed were measured using the HFA Inventory Checklist and food frequency questionnaires, respectively. BMI was calculated using measured length/height and weight. Multinomial logistic regression models examined associations between HFA and tertiles of dietary intake, and multivariable linear regression models assessed associations between HFA and BMI. Pakistani households had a greater variety and quantity of snack foods and SSBs available compared with White households. Variety and quantity of snack foods and SSBs in the home at 18 months were positively associated with children''s intake of these items at 36 months, but associations between HFA and BMI were null. Reducing obesogenic HFA during the first 1000 days may promote the development of more healthful diets, though this may not be associated with lower obesity risk during toddlerhood.     

Blurring the distinctions between on and off the job injuries: similarities and differences in circumstances.

OBJECTIVES: To compare the causes of non-fatal work and non-work injuries and the places or environments where they occur. It has been suggested that many injuries may have similar etiologies on and off the job and thus involve some common prevention strategies. However lack of comparable data on work relatedness has prevented testing this proposition. METHODS: The National Health Interview Survey (NHIS) now collects information on the cause, location, and work relatedness of all medically attended injuries. National US estimates of non-fatal work and non-work injuries were compared by cause and place/location for working age adults (18-64 years). RESULTS: Overall 28.6% of injuries to working age adults were work related (37.5% among employed people). The causes and locations of many work and non-work injuries were similar. Falls, overexertion, and struck/caught by were leading causes for work and non-work injuries. Motor vehicle injuries were less likely to be work related (3.4% at work v 19.5% non-work) and overexertion injuries more likely to be work related (27.1% v 13.8%). Assaults were less than 1% of work injuries and 1.8% of non-work injuries. Both work and non-work injuries occurred in every location examined-including the home where 3.5% of injuries were work related. CONCLUSIONS: Work and non-work injuries share many similarities suggesting opportunities to broaden injury prevention programs commonly restricted to one setting or the other. Comprehensive efforts to prevent both non-work and work injuries may result in considerable cost savings not only to society but also directly to employers, who incur much of the associated costs.     

Childhood Leukemia and Lymphoma: Long-Term Sequelae in Visual, Auditory and Vestibular Function

Twenty-six children in continuous complete remission from leukemia or lymphoma and no longer receiving chemotherapy were studied to determine the long-term sequelae in visual, auditory and vestibular function. Ophthalmologic examination revealed cataracts in five patients and an abnormality in the retina in one patient. These abnormalities were not associated with any disturbance of visual acuity. By otorhinolaryngologic examination, slight hearing loss was observed in five patients and an abnoormal righting reflex in one patient. The etiologies of these abnormal findings in visual, auditory and vestibular function were discussed.     

Preventing symptomatic vitamin D deficiency and rickets among Indigenous infants and children in Canada

Vitamin D deficiency (VitDD) rickets and other manifestations of severe VitDD, such as cardiomyopathy and hypocalcemic seizures, continue to be diagnosed in Canada. Breastfed Indigenous infants, particularly those living in northern communities, are disproportionately impacted, although formula-fed infants are not exempt in cases where the mother’s vitamin D status is critically low. This statement deals with the prevention of rickets and hypocalcemia due to VitDD for Indigenous children, and revises an earlier document from the Canadian Paediatric Society. An assessment of the risk for VitDD is recommended for each maternal-infant dyad because of the link between maternal and infant VitDD. Along with supports for enhanced adherence, additional VitD supplementation is recommended for prenatal women and infants deemed at high risk and, in certain situations, intermittent higher dose supplementation may be required. Food insecurity can also contribute to rickets, so advocacy is required to prevent VitDD rickets in Indigenous children.     

Remote provision of breastfeeding support and education: Systematic review and meta‐analysis

The Covid‐19 pandemic has led to a substantial increase in remotely provided maternity care services, including breastfeeding support. It is, therefore, important to understand whether breastfeeding support provided remotely is an effective method of support. To determine if breastfeeding support provided remotely is an effective method of support. A systematic review and meta‐analysis were conducted. Twenty‐nine studies were included in the review and 26 contributed data to the meta‐analysis. Remotely provided breastfeeding support significantly reduced the risk of women stopping exclusive breastfeeding at 3 months by 25% (risk ratio [RR]: 0.75, 95% confidence interval [CI]: 0.63, 0.90). There was no significant difference in the number of women stopping any breastfeeding at 4–8 weeks (RR: 1.10, 95% CI: 0.74, 1.64), 3 months (RR: 0.89, 95% CI: 0.71, 1.11), or 6 months (RR: 0.91, 95% CI: 0.81, 1.03) or the number of women stopping exclusive breastfeeding at 4–8 weeks (RR: 0.86, 95% CI: 0.70, 1.07) or 6 months (RR: 0.93, 95% CI: 0.85, 1.0). There was substantial heterogeneity of interventions in terms of mode of delivery, intensity, and providers. This demonstrates that remote interventions can be effective for improving exclusive breastfeeding at 3 months but the certainty of the evidence is low. Improvements in exclusive breastfeeding at 4–8 weeks and 6 months were only found when studies at high risk of bias were excluded. They are also less likely to be effective for improving any breastfeeding. Remote provision of breastfeeding support and education could be provided when it is not possible to provide face‐to‐face care.     

Child diet and mother–child interactions mediate intervention effects on child growth and development

This study examined whether child diet and mother–child interactions mediated the effects of a responsive stimulation and nutrition intervention delivered from 2009 to 2012 to 1324 children aged 0–24 months living in rural Pakistan. Results showed that the intervention improved children''s cognitive, language and motor development through child diet and mother–child interactions. Although the intervention did not improve child growth or socio‐emotional development, we observed positive indirect effects on child growth via child diet and on socio‐emotional development via both child diet and mother–child interactions. In addition, child diet emerged as a shared mechanism to improve both child growth and development, whereas mother–child interactions emerged as a distinct mechanism to improve child development. Nevertheless, our results suggest the two mechanisms were mutually reinforcing and that interventions leveraging both mechanisms are likely to be more effective at improving child outcomes than interventions leveraging only one of these mechanisms.     

Determinants of maternal low mid‐upper arm circumference and its association with child nutritional status among poor and very poor households in rural Bangladesh

Malnutrition among women is a long‐standing public health concern that has significant adverse consequences on the survival and healthy development of children. Maternal mid‐upper arm circumference (MUAC) could potentially represent a simpler alternative to traditional nutritional indicators. This study aimed to investigate the factors associated with low maternal MUAC (as an indicator of being underweight) and address the research question of whether maternal MUAC is significantly associated with children''s nutritional status among poor and very poor households in rural Bangladesh. Data on 5,069 households were extracted from the Suchana programme baseline survey, which was carried out in 80 randomly selected unions (the lowest administrative unit of Bangladesh) in Sylhet and Moulvibazar districts between November 2016 and February 2017. The outcome variables were three child nutritional status indicators: wasting, stunting and underweight. Mothers were classified as underweight if their MUAC was less than 23 cm. Separate multiple logistic regression analyses were used to determine the factors potentially associated with maternal underweight status and explore whether maternal underweight status is significantly associated with children''s nutritional status. The prevalence of maternal underweight status was 46.7%, and the prevalence of wasting, stunting and underweight among children under two were 10.5%, 44.4% and 31.9%, respectively. After controlling for various socio‐economic and demographic characteristics, maternal MUAC was significantly associated with children''s nutritional status in rural Bangladesh.     

Women's fasting habits and dietary diversity during Ramadan in rural Bangladesh

Little is known about fasting practices and dietary changes during Ramadan in low‐ and lower‐middle‐income countries. Although pregnant women are exempt from fasting, they may still fast. This is of interest as dietary habits during pregnancy may affect the development of the unborn child. In a community‐based sample of young women in rural Sylhet division, Bangladesh, we described fasting practices and beliefs (n = 852). We also examined reported food group consumption and minimally adequate dietary diversity for women (MDD‐W) by Ramadan occurrence (n = 1,895) and by fasting adherence (n = 558) using logistic regression with Hindu women as a seasonal control.During Ramadan in 2018, 78% of pregnant Muslim women fasted every day. Over 80% of Muslim women believe that they should fast during pregnancy and over 50% expect positive health effects on the mother and the unborn child. We found strong evidence that Muslim women have more diverse diets during Ramadan, with higher odds of MDD‐W (OR [95% CI]: 5.0 [3.6, 6.9]) and increased consumption of pulses, dairy, fruit, and large fish. Dietary diversity increased to a lesser extent on non‐fasting days during Ramadan. Ramadan appears to improve dietary quality in both fasting and non‐fasting Muslim women in a rural population in Bangladesh. These results help to interpret findings from studies on Ramadan during pregnancy on later‐life outcomes and thus contribute to a better understanding of intrauterine influences of maternal nutrition on healthy child development.