scholarly journals Prenatal PM2.5 Exposure in Relation to Maternal and Newborn Telomere Length at Delivery

Toxics ◽  
2022 ◽  
Vol 10 (1) ◽  
pp. 13
Author(s):  
Teresa Durham ◽  
Jia Guo ◽  
Whitney Cowell ◽  
Kylie W. Riley ◽  
Shuang Wang ◽  
...  
Keyword(s):  
Telomere Length ◽  
Statistical Significance ◽  
Negative Relationship ◽  
Newborn Health ◽  
Ambient Air ◽  
Air Pollutant ◽  
Ambient Air Pollution ◽  
Maternal And Newborn Health ◽  
Pm2.5 Exposure ◽  
Maternal And Newborn

Particulate matter with an aerodynamic diameter of 2.5 μm or less (PM2.5) is a ubiquitous air pollutant that is increasingly threatening the health of adults and children worldwide. One health impact of elevated PM2.5 exposure is alterations in telomere length (TL)—protective caps on chromosome ends that shorten with each cell division. Few analyses involve prenatal PM2.5 exposure, and paired maternal and cord TL measurements. Here, we analyzed the association between average and trimester-specific prenatal PM2.5 exposure, and maternal and newborn relative leukocyte TL measured at birth among 193 mothers and their newborns enrolled in a New-York-City-based birth cohort. Results indicated an overall negative relationship between prenatal PM2.5 and maternal TL at delivery, with a significant association observed in the second trimester (β = −0.039, 95% CI: −0.074, −0.003). PM2.5 exposure in trimester two was also inversely related to cord TL; however, this result did not reach statistical significance (β = −0.037, 95% CI: −0.114, 0.039), and no clear pattern emerged between PM2.5 and cord TL across the different exposure periods. Our analysis contributes to a limited body of research on ambient air pollution and human telomeres, and emphasizes the need for continued investigation into how PM2.5 exposure during pregnancy influences maternal and newborn health.

scholarly journals Continuity of care and its determinants of routine maternal and newborn health visits in Nepal: Evidence from a nationally representative household survey

2021 ◽  
Author(s):  
Resham Bahadur Khatri ◽  
Rajendra Karkee ◽  
Jo Durham ◽  
Yibeltal Assefa
Keyword(s):  
Continuity Of Care ◽  
Agricultural Sector ◽  
Multinomial Logistic Regression ◽  
Statistical Significance ◽  
Newborn Health ◽  
Outcome Variable ◽  
Maternal And Newborn Health ◽  
Health Management Information System ◽  
Neonatal Deaths ◽  
Maternal And Newborn

Abstract Background Maternal and newborn health (MNH) is a priority health issue in Nepal, has high maternal and neonatal deaths. Maternal and neonatal deaths can be prevented through uptake of essential antenatal, intrapartum, and postnatal interventions received during routine MNH visits. Not all women, however, receive all recommended routine visits across the MNH Continuum of Care (CoC) in Nepal. This study examined the patterns and determinants of (dis)continuity of care across the MNH continuum. Methods The study included 1,978 women aged 15–49 years who had a live birth in the two years preceding the survey. Data were derived from the Nepal Demographic and Health Survey (NDHS) 2016. The outcome variable was (dis)continuity of care at different stages of MNH visits (at least four antenatal care (4ANC) visits, institutional delivery, and postnatal care (PNC) visit). Several structural, intermediary and health system explanatory variables were included in the analysis. Multinomial logistic regression analysis was conducted, and the magnitude of (dis)continuity of care was reported as relative risk ratios (RR) with 95% confidence intervals (CIs). The statistical significance level was set p<0.05. Results More than two-in-five (41%) women in Nepal received all three MNH visits across the CoC. There was high risk of discontinuity of care during months or weeks prior to childbirth or around childbirth. Higher risk of discontinuation across the CoC was reported among women of disadvantaged ethnic groups, lower wealth status and illiterate. Similarly, women who speak Bhojpuri, provinces six and seven, who had higher birth order (≥4), who involved in agricultural sector, had unwanted last birth had higher risk of discontinuation of MNH visits. Women did not complete all MNH visits if they had poor awareness on health mother groups and if they perceived problem of not having female healthcare providers. Conclusions Women had poor completion of all routine MNH visits. High discontinuation was observed among disadvantaged groups across the COC. Regular monitoring using the composite indicator of continuity of care through routine health management information system is required. Program approaches should focus on disadvantaged women to improve the completion of routine MNH visits and uptake of essential interventions.

scholarly journals Patterns and determinants of effective coverage of routine maternal and newborn health visits in Nepal: Analysis of the 2016 Demographic and Health Survey

2021 ◽  
Author(s):  
Resham Khatri ◽  
Jo Durham ◽  
Rajendra Karkee ◽  
Yibeltal Assefa
Keyword(s):  
Health Survey ◽  
Institutional Delivery ◽  
Statistical Significance ◽  
Newborn Health ◽  
Demographic And Health Survey ◽  
Maternal And Newborn Health ◽  
Effective Coverage ◽  
Significance Level ◽  
Remote Areas ◽  
Maternal And Newborn

Abstract Background Antenatal care (ANC) visits, institutional delivery, and postnatal care (PNC) visits are vital for improved health of mothers and newborns. Access of these routine maternal and newborn health (MNH) visits have increased in the last few decades in Nepal; however, little is known on the effective uptake (including timely, skilled, frequent, and adequate care) of essential MNH interventions during those visits. This study examined the patterns of effective coverage (EC) of routine MNH visits and their determinants in Nepal. Methods A secondary analysis was conducted taking data from the Nepal Demographic and Health Survey (NDHS) 2016. The study included 1,978 women aged 15–49 years who had a live birth in the two years preceding the survey. Three outcome variables were EC of i) at least 4ANC visits, ii) institutional delivery, and iii) first PNC visit for newborns and mothers within 48 hours of childbirth. The independent variables included several structural, intermediary and health system factors. Binomial logistic regression analysis was conducted, and the magnitude of EC was reported as odds ratio (OR) with 95% confidence intervals (CIs). The statistical significance level was set at p<0.05 (two-tailed).Results The effective coverage of 4ANC visits, institutional delivery, and PNC visit was 52%, 33% and 23%, respectively. Women with advantaged ethnicity were more likely and women living in province six, who speak the Maithili language, who had high birth order (≥4) were less likely to have good EC of MNH visits compared to their reference categories. Women who had access to a bank account, completed at least 4ANC visits or had caesarian-section delivery were more likely to have good EC of MNH visits. Women who perceived problem if not seen by female providers had poor EC of MNH visits compared to their reference counterpart. Conclusions Women with ethnic and social disadvantages and remote areas had poor EC of MNH visits. Continuous monitoring of EC of MNH visits is vital, especially among women with markers of disadvantages. Policies and programs should focus on increasing the uptake of essential MNH interventions, especially among women with social disadvantages and those living in remote areas.

scholarly journals Relationship between Air Pollutant Exposure and Gynecologic Cancer Risk

2021 ◽  
Vol 18 (10) ◽  
pp. 5353
Author(s):  
Qiwei Yu ◽  
Liqiang Zhang ◽  
Kun Hou ◽  
Jingwen Li ◽  
Suhong Liu ◽  
...  
Keyword(s):  
Air Pollution ◽  
Cancer Risk ◽  
Air Pollutants ◽  
Gynecological Cancer ◽  
Gynecologic Cancer ◽  
Ambient Air ◽  
Air Pollutant ◽  
Ambient Air Pollution ◽  
Short Term Exposure ◽  
Increased Risk

Exposure to air pollution has been suggested to be associated with an increased risk of women’s health disorders. However, it remains unknown to what extent changes in ambient air pollution affect gynecological cancer. In our case–control study, the logistic regression model was combined with the restricted cubic spline to examine the association of short-term exposure to air pollution with gynecological cancer events using the clinical data of 35,989 women in Beijing from December 2008 to December 2017. We assessed the women’s exposure to air pollutants using the monitor located nearest to each woman’s residence and working places, adjusting for age, occupation, ambient temperature, and ambient humidity. The adjusted odds ratios (ORs) were examined to evaluate gynecologic cancer risk in six time windows (Phase 1–Phase 6) of women’s exposure to air pollutants (PM2.5, CO, O3, and SO2) and the highest ORs were found in Phase 4 (240 days). Then, the higher adjusted ORs were found associated with the increased concentrations of each pollutant (PM2.5, CO, O3, and SO2) in Phase 4. For instance, the adjusted OR of gynecological cancer risk for a 1.0-mg m−3 increase in CO exposures was 1.010 (95% CI: 0.881–1.139) below 0.8 mg m−3, 1.032 (95% CI: 0.871–1.194) at 0.8–1.0 mg m−3, 1.059 (95% CI: 0.973–1.145) at 1.0–1.4 mg m−3, and 1.120 (95% CI: 0.993–1.246) above 1.4 mg m−3. The ORs calculated in different air pollution levels accessed us to identify the nonlinear association between women’s exposure to air pollutants (PM2.5, CO, O3, and SO2) and the gynecological cancer risk. This study supports that the gynecologic risks associated with air pollution should be considered in improved public health preventive measures and policymaking to minimize the dangerous effects of air pollution.

scholarly journals Maternal and newborn health risks of climate change: A call for awareness and global action

2021 ◽  
Author(s):  
Nathalie Roos ◽  
Sari Kovats ◽  
Shakoor Hajat ◽  
Veronique Filippi ◽  
Matthew Chersich ◽  
...  
Keyword(s):  
Climate Change ◽  
Health Risks ◽  
Newborn Health ◽  
Maternal And Newborn Health ◽  
Global Action ◽  
Maternal And Newborn

scholarly journals Intersectional (in) equities in contact coverage of maternal and newborn health services in Nepal: insights from a nationwide cross-sectional household survey

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Resham B. Khatri ◽  
Yibeltal Alemu ◽  
Melinda M. Protani ◽  
Rajendra Karkee ◽  
Jo Durham
Keyword(s):  
Institutional Delivery ◽  
Secondary Analysis ◽  
Newborn Health ◽  
Household Survey ◽  
Universal Coverage ◽  
Maternal And Newborn Health ◽  
Multiple Forms ◽  
Wealth Status ◽  
Cross Sectional ◽  
Maternal And Newborn

Abstract Background Persistent inequities in coverage of maternal and newborn health (MNH) services continue to pose a major challenge to the health-care system in Nepal. This paper uses a novel composite indicator of intersectional (dis) advantages to examine how different (in) equity markers intersect to create (in) equities in contact coverage of MNH services across the continuum of care (CoC) in Nepal. Methods A secondary analysis was conducted among 1978 women aged 15–49 years who had a live birth in the two years preceding the survey. Data were derived from the Nepal Demographic and Health Survey (NDHS) 2016. The three outcome variables included were 1) at least four antenatal care (4ANC) visits, 2) institutional delivery, and 3) postnatal care (PNC) consult for newborns and mothers within 48 h of childbirth. Independent variables were wealth status, education, ethnicity, languages, residence, and marginalisation status. Intersectional (dis) advantages were created using three socioeconomic variables (wealth status, level of education and ethnicity of women). Binomial logistic regression analysis was employed to identify the patterns of (in) equities in contact coverage of MNH services across the CoC. Results The contact coverage of 4ANC visits, institutional delivery, and PNC visit was 72, 64, and 51% respectively. Relative to women with triple disadvantage, the odds of contact coverage of 4ANC visits was more than five-fold higher (Adjusted Odds Ratio (aOR) = 5.51; 95% CI: 2.85, 10.64) among women with triple forms of advantages (literate and advantaged ethnicity and higher wealth status). Women with triple advantages were seven-fold more likely to give birth in a health institution (aOR = 7.32; 95% CI: 3.66, 14.63). They were also four times more likely (aOR = 4.18; 95% CI: 2.40, 7.28) to receive PNC visit compared to their triple disadvantaged counterparts. Conclusions The contact coverage of routine MNH visits was low among women with social disadvantages and lowest among women with multiple forms of socioeconomic disadvantages. Tracking health service coverage among women with multiple forms of (dis) advantage can provide crucial information for designing contextual and targeted approaches to actions towards universal coverage of MNH services and improving health equity.

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