Regulation of inflammation during gestation and birth outcomes: Inflammatory cytokine balance predicts birth weight and length

Abstract Background A growing body of evidence is beginning to highlight how mass incarceration shapes inequalities in population health. Non-Hispanic blacks are disproportionately affected by incarceration and criminal law enforcement, an enduring legacy of a racially-biased criminal justice system with broad health implications for black families and communities. Louisiana has consistently maintained one of the highest rates of black incarceration in the nation. Concurrently, large racial disparities in population health persist. Methods We conducted a cross-sectional analysis of all births among non-Hispanic black women in Louisiana in 2014 to identify associations between parish-level (county equivalent) prevalence of jail incarceration within the black population and adverse birth outcomes (N = 23,954). We fit a log-Poisson model with generalized estimating equations to approximate the relative risk of preterm birth and low birth weight associated with an interquartile range increase in incarceration, controlling for confounders. In sensitivity analyses, we additionally adjusted for the parish-level index crime prevalence and analyzed regression models wherein white incarceration was used to predict the risk of adverse birth outcomes in order to quantify the degree to which mass incarceration may harm health above and beyond living in a high crime area. Results There was a significant 3% higher risk of preterm birth among black women associated with an interquartile range increase in the parish-level incarceration prevalence of black individuals, independent of other factors. Adjusting for the prevalence of index crimes did not substantively change the results of the models. Conclusion Due to the positive significant associations between the prevalence of black individuals incarcerated in Louisiana jails and estimated risk of preterm birth, mass incarceration may be an underlying cause of the persistent inequities in reproductive health outcomes experienced by black women in Louisiana. Not only are there economic and social impacts stemming from mass incarceration, but there may also be implications for population health and health inequities, including the persistence of racial disparities in preterm birth and low birth weight.

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Maternal exposure to airborne polychlorinated biphenyls (PCBs) and risk of adverse birth outcomes

European Journal of Epidemiology ◽

10.1007/s10654-021-00793-x ◽

2021 ◽

Author(s):

Ane Bungum Kofoed ◽

Laura Deen ◽

Karin Sørig Hougaard ◽

Kajsa Ugelvig Petersen ◽

Harald William Meyer ◽

...

Keyword(s):

Birth Weight ◽

Preterm Birth ◽

Sex Ratio ◽

Polychlorinated Biphenyls ◽

Birth Outcomes ◽

Gestational Age ◽

Small For Gestational Age ◽

Maternal Exposure ◽

Adverse Birth Outcomes ◽

Secondary Sex Ratio

AbstractHuman health effects of airborne lower-chlorinated polychlorinated biphenyls (LC-PCBs) are largely unexplored. Since PCBs may cross the placenta, maternal exposure could potentially have negative consequences for fetal development. We aimed to determine if exposure to airborne PCB during pregnancy was associated with adverse birth outcomes. In this cohort study, exposed women had lived in PCB contaminated apartments at least one year during the 3.6 years before conception or the entire first trimester of pregnancy. The women and their children were followed for birth outcomes in Danish health registers. Logistic regression was performed to estimate odds ratios (OR) for changes in secondary sex ratio, preterm birth, major congenital malformations, cryptorchidism, and being born small for gestational age. We performed linear regression to estimate difference in birth weight among children of exposed and unexposed mothers. All models were adjusted for maternal age, educational level, ethnicity, and calendar time. We identified 885 exposed pregnancies and 3327 unexposed pregnancies. Relative to unexposed women, exposed women had OR 0.97 (95% CI 0.82, 1.15) for secondary sex ratio, OR 1.13 (95% CI 0.76, 1.67) for preterm birth, OR 1.28 (95% CI 0.81, 2.01) for having a child with major malformations, OR 1.73 (95% CI 1.01, 2.95) for cryptorchidism and OR 1.23 (95% CI 0.88, 1.72) for giving birth to a child born small for gestational age. The difference in birth weight for children of exposed compared to unexposed women was − 32 g (95% CI—79, 14). We observed an increased risk of cryptorchidism among boys after maternal airborne LC-PCB exposure, but due to the proxy measure of exposure, inability to perform dose–response analyses, and the lack of comparable literature, larger cohort studies with direct measures of exposure are needed to investigate the safety of airborne LC-PCB exposure during pregnancy

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O-221 Stage and morphology of the competent blastocyst are associated with pregnancy and birth outcomes; a multicenter cohort study

Human Reproduction ◽

10.1093/humrep/deab128.045 ◽

2021 ◽

Vol 36 (Supplement_1) ◽

Author(s):

M L Groendahl ◽

M. Buhl Borgstrøm ◽

U. Schiøler Kesmodel

Keyword(s):

Cohort Study ◽

Birth Weight ◽

Preterm Birth ◽

Birth Outcomes ◽

Gestational Age ◽

Blastocyst Transfer ◽

Singleton Pregnancy ◽

Child Weight ◽

Single Blastocyst Transfer ◽

Pregnancy And Birth

Abstract Study question Do stage and morphology of the competent blastocyst associate with initial hCG rise, gestational age, preterm birth, child birth weight, length, and child sex? Summary answer Higher stage, TE- and ICM-scores associated with higher hCG-rise; ICM- and TE-scores associated with length at birth, and higher stage and TE-score associated with boys. What is known already Many studies have focused on the developmental stage and morphology of the blastocysts in order to find biomarkers of competence to improve the efficacy of assisted reproduction technology treatment. In contrast, the associations between blastocyst assessment score parameters (individually or by combined score) and perinatal outcome have only been reported in few and smaller single center studies, and conflicting results have been presented. In the present study, we focused on the in vitro cultured blastocyst leading to a live birth and how the stage and morphology of these competent blastocysts relate to implantation and birth outcomes. Study design, size, duration Multicenter historical cohort study based on exposure (blastocyst stage (1-6) and morphology (trophectoderm (TE) and inner cell mass (ICM): A,B,C)) and outcome data (serum human chorionic gonadotrophin (hCG), gestational age, preterm birth, child weight, length, and sex) from women undergoing single blastocyst transfer resulting in singleton pregnancy and birth. Data from 16 private and university-based facilities for clinical services and research from 2014 to 2018 was included. Participants/materials, setting, methods 7246 women, who underwent ovarian stimulation or Frozen-thawed-Embryo-Transfer with single blastocyst transfer resulting in singleton pregnancy were identified. Linking to the Danish Medical Birth Registry resulted in a total of 4842 women with live birth being included. Initial serum hCG value (IU/L) (11 days after transfer), gestational age (days), preterm birth (%) child weight (grams), length (cm) and sex. The analyses were adjusted for female age, BMI, smoking, center, diagnosis, parity, gestational age and sex. Main results and the role of chance Higher mean initial hCG was consistently positively associated with higher developmental stage (p < 0.001), TE (p < 0.001) and ICM score (p = 0.02); for stage 6, TE (A) and ICM (A): 508.4, 436.5 and 428.5 IU/L, respectively. No differences between blastocyst morphology (stage, TE, ICM), gestational age (mean 276.6 days), preterm birth (8.3%) and birth weight (mean 3461.7 gram) were statistically significant. While stage showed no association with length at birth (mean 51.6 cm), length at birth between blastocysts with a TE score C and a TE score A were statistically significant (mean difference 0.5 cm (0.07;0.83)) as was the length at birth between blastocysts with an ICM score B and C compared to score A, mean differences respectively 0.2 cm (0.02;0.31) and 0.5 cm (0.03;0.87). Stage and TE, but not ICM were associated with the sex of the child. Blastocysts transferred with stage score 5 compared to blastocysts transferred with score 3 had a 33% increased probability of being a boy (OR 1.33 (1.08;1.64)). Further, TE score B blastocysts compared to TE score A blastocysts had a 28% reduced probability of being a boy (OR 0.72 (0.62;0.82)). Limitations, reasons for caution The assessment scores of the blastocystś stage and morphology were based on subjective evaluation, and information bias may have influenced the results. By adjusting for center, we took the potential variation in scoring between clinics into considerations. Wider implications of the findings Stage and morphology of the competent blastocyst was associated with initial hCG rise suggesting an effect on implantation, which may be used in routine, everyday information to women and couples on the day of blastocyst transfer. Trial registration number j.nr.: VD-2018-282

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Reduced birth weight caused by sextuple drug resistant Plasmodium falciparum infection in early 2nd trimester

The Journal of Infectious Diseases ◽

10.1093/infdis/jiab117 ◽

2021 ◽

Author(s):

Helle Hansson ◽

Daniel T R Minja ◽

Sofie L Moeller ◽

John P A Lusingu ◽

Ib C Bygbjerg ◽

...

Keyword(s):

Plasmodium Falciparum ◽

Birth Weight ◽

Birth Outcomes ◽

Birth Outcome ◽

Intermittent Preventive Treatment ◽

Preventive Treatment ◽

First Trimester ◽

Close Monitoring ◽

The Impact ◽

Mutant Haplotype

Abstract Mutations in the Plasmodium falciparum genes Pfdhfr and Pfdhps, particularly the sextuple mutant haplotype threatens the antimalarial effectiveness of sulfadoxine-pyrimethamine as intermittent preventive treatment during pregnancy (IPTp). To explore the impact of sextuple mutant haplotype infections on outcome measures after provision of IPTp-SP, we monitored birth outcomes in women followed from prior to conception or from the first trimester until delivery. Women infected with sextuple haplotypes in early 2 nd trimester specifically, delivered newborns with a lower birth weight (-267g, 95% CI -454; -59, p=0·01) compared to women who did not have malaria during pregnancy and women infected with less SP resistant haplotypes (-461g, 95% CI -877; -44, p=0·03). Thus, sextuple haplotype infections seems to impact the effectiveness of SP for IPTp and directly impact birth outcome by lowering birth weight. Close monitoring and targeted malaria control during early pregnancy is therefore crucial to improve birth outcomes.

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A similar pro/anti-inflammatory cytokine balance is present in the airways of competitive athletes and non-exercising asthmatics

Advances in Medical Sciences ◽

10.1016/j.advms.2017.07.004 ◽

2018 ◽

Vol 63 (1) ◽

pp. 79-86 ◽

Cited By ~ 1

Author(s):

Marcin Kurowski ◽

Janusz Jurczyk ◽

Agnieszka Olszewska-Ziąber ◽

Marzanna Jarzębska ◽

Hubert Krysztofiak ◽

...

Keyword(s):

Inflammatory Cytokine ◽

Cytokine Balance ◽

Competitive Athletes ◽

Anti Inflammatory ◽

Anti Inflammatory Cytokine

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Maternal Iodine Status and Associations with Birth Outcomes in Three Major Cities in the United Kingdom

Nutrients ◽

10.3390/nu11020441 ◽

2019 ◽

Vol 11 (2) ◽

pp. 441 ◽

Cited By ~ 9

Author(s):

Charles Snart ◽

Claire Keeble ◽

Elizabeth Taylor ◽

Janet Cade ◽

Paul Stewart ◽

...

Keyword(s):

Birth Weight ◽

Preterm Birth ◽

Pregnant Women ◽

Birth Outcomes ◽

Inductively Coupled Plasma ◽

Urinary Iodine ◽

World Health ◽

Spontaneous Preterm Birth ◽

Foetal Development ◽

Iodine Status

Severe iodine deficiency in mothers is known to impair foetal development. Pregnant women in the UK may be iodine insufficient, but recent assessments of iodine status are limited. This study assessed maternal urinary iodine concentrations (UIC) and birth outcomes in three UK cities. Spot urines were collected from 541 women in London, Manchester and Leeds from 2004–2008 as part of the Screening for Pregnancy End points (SCOPE) study. UIC at 15 and 20 weeks’ gestation was estimated using inductively coupled plasma-mass spectrometry (ICP-MS). Associations were estimated between iodine status (UIC and iodine-to-creatinine ratio) and birth weight, birth weight centile (primary outcome), small for gestational age (SGA) and spontaneous preterm birth. Median UIC was highest in Manchester (139 μg/L, 95% confidence intervals (CI): 126, 158) and London (130 μg/L, 95% CI: 114, 177) and lowest in Leeds (116 μg/L, 95% CI: 99, 135), but the proportion with UIC <50 µg/L was <20% in all three cities. No evidence of an association was observed between UIC and birth weight centile (−0.2% per 50 μg/L increase in UIC, 95% CI: −1.3, 0.8), nor with odds of spontaneous preterm birth (odds ratio = 1.00, 95% CI: 0.84, 1.20). Given the finding of iodine concentrations being insufficient according to World Health Organization (WHO) guidelines amongst pregnant women across all three cities, further studies may be needed to explore implications for maternal thyroid function and longer-term child health outcomes.

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Birth outcomes are superior after transfer of fresh versus frozen embryos for donor oocyte recipients

Human Reproduction ◽

10.1093/humrep/deaa245 ◽

2020 ◽

Vol 35 (12) ◽

pp. 2850-2859

Author(s):

Cassandra Roeca ◽

Rachel L Johnson ◽

Tracy Truong ◽

Nichole E Carlson ◽

Alex J Polotsky

Keyword(s):

Birth Weight ◽

Birth Outcomes ◽

Live Birth ◽

Risk Ratio ◽

Gestational Age ◽

Embryo Cryopreservation ◽

Adjusted Risk ◽

Donor Oocyte ◽

Adjusted Risk Ratio ◽

Frozen Embryos

Abstract STUDY QUESTION For donor oocyte recipients, are birth outcomes superior for fresh versus frozen embryos? SUMMARY ANSWER Among fresh donor oocyte recipients, fresh embryos are associated with better birth outcomes when compared with frozen embryos. WHAT IS KNOWN ALREADY Frozen embryo transfer (ET) with vitrification has been associated with improved pregnancy rates, but also increased rates of large for gestational age infants. Donor oocyte recipients represent an attractive biological model to attempt to isolate the impact of embryo cryopreservation on IVF outcomes, yet there is a paucity of studies in this population. STUDY DESIGN, SIZE, DURATION A retrospective cohort of the US national registry, the Society for Assisted Reproductive Technology Clinic Outcome Reporting System, of IVF cycles of women using fresh donor oocytes resulting in ET between 2013 and 2015. Thawed oocytes were excluded. PARTICIPANTS/MATERIALS, SETTINGS, METHODS Good obstetric outcome (GBO), defined as a singleton, term, live birth with appropriate for gestational age birth weight, was the primary outcome measure. Secondary outcomes included live birth, clinical pregnancy, spontaneous abortion, preterm birth, multiple births and gestational age-adjusted weight. Outcomes were modeled using the generalized estimating equation approach. MAIN RESULTS AND THE ROLE OF CHANCE Data are from 25 387 donor oocyte cycles, in which 14 289 were fresh and 11 098 were frozen ETs. A GBO was 27% more likely in fresh ETs (26.3%) compared to frozen (20.9%) (adjusted risk ratio 1.27; 95% confidence interval (CI) 1.21–1.35; P < 0.001). Overall, fresh transfer was more likely to result in a live birth (55.7% versus 39.5%; adjusted risk ratio 1.21; 95% CI 1.18–1.26; P < 0.001). Among singleton births, there was no difference in gestational age-adjusted birth weight between groups. LIMITATION, REASONS FOR CAUTION Our cohort findings contrast with data from autologous oocytes. Prospective studies with this population are warranted. WIDER IMPLICATIONS OF THE FINDINGS Among donor oocyte recipients, fresh ETs may be associated with better birth outcomes. Reassuringly, given its prevalent use, modern embryo cryopreservation does not appear to result in phenotypically larger infants. STUDY FUNDING/COMPETING INTEREST(S) None. TRIAL REGISTRATION NUMBER N/A.

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Regional Birth Outcomes after the 2011 Great East Japan Earthquake and Tsunami in Miyagi Prefecture

Prehospital and Disaster Medicine ◽

10.1017/s1049023x18000183 ◽

2018 ◽

Vol 33 (2) ◽

pp. 215-219 ◽

Cited By ~ 4

Author(s):

Junichi Sugawara ◽

Noriyuki Iwama ◽

Tetsuro Hoshiai ◽

Hideki Tokunaga ◽

Hidekazu Nishigori ◽

...

Keyword(s):

Birth Weight ◽

Preterm Birth ◽

Low Birth Weight ◽

Risk Analysis ◽

Birth Outcomes ◽

Birth Rate ◽

Great East Japan Earthquake ◽

Miyagi Prefecture ◽

Preterm Birth Rate ◽

Regional Risk Analysis

AbstractObjectivesThis study was aimed to analyze post-disaster birth outcomes in coastal and inland regions of Miyagi Prefecture, Japan.MethodsPrimary data sets were compiled from birth records of obstetric facilities and 12,808 patients were analyzed for baseline birth outcomes by region. Regional risk analysis of the low-birth-weight rate and premature birth rate were conducted using multi-level logistic regression analysis.ResultsFrom overall baseline birth outcomes, a preterm birth rate was 4.6% and low-birth-weight rate was 8.8%. Regional analysis revealed that a preterm birth rate was 3.2% (coastal) and 5.0% (inland), respectively, and the rate of low birth weight was 6.5% in the coastal and 8.5% in the inland region. In the risk analysis of low-birth-weight rate and preterm birth rate, the risk in the coastal region could not be considered any higher than in the inland region (adjusted odds ratio 0.91 [0.73-1.14] and 0.85 [0.46-1.59], respectively).ConclusionsThe incidence of preterm birth and low birth weight were not adversely affected by the disaster. Early transfer and intensive medical intervention may have led to those findings. Further survey will be necessary to determine the long-term effects in both mothers and children.SugawaraJ, IwamaN, HoshiaiT, TokunagaH, NishigoriH, MetokiH, OkamuraK, YaegashiN. Regional birth outcomes after the 2011 Great East Japan Earthquake and tsunami in Miyagi Prefecture. Prehosp Disaster Med. 2018;33(2):215–219.

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Paternal age and the risk of low birth weight and preterm delivery: a Finnish register-based study

Journal of Epidemiology & Community Health ◽

10.1136/jech-2017-210170 ◽

2018 ◽

Vol 72 (12) ◽

pp. 1104-1109 ◽

Cited By ~ 6

Author(s):

Alice Goisis ◽

Hanna Remes ◽

Kieron Barclay ◽

Pekka Martikainen ◽

Mikko Myrskylä

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Preterm Delivery ◽

Birth Outcomes ◽

Conclusive Evidence ◽

Paternal Age ◽

Adverse Birth Outcomes ◽

Maternal Characteristics ◽

Parental Characteristics ◽

Increased Risk

BackgroundBased on existing studies, there is no conclusive evidence as to whether and why paternal age matters for birth outcomes.MethodsWe used Finnish population registers on 106 652 children born 1987–2000. We first document the unadjusted association between paternal age and the risk of low birth weight (LBW; <2500 g) and preterm birth (<37 weeks’ gestation). Second, we investigate whether the unadjusted association is attenuated on adjustment for child’s, maternal and parental socioeconomic characteristics. Third, by adopting a within-family design which involves comparing children born to the same father at different ages, we additionally adjust for unobserved parental characteristics shared between siblings.ResultsThe unadjusted results show that being born to a father aged 40+, as opposed to a father aged 30–34, is associated with an increased risk of LBW of 0.96% (95% CI 0.5% to 1.3%) and to a younger father (<25) with a 1% (95% CI 0.6% to 1.3%) increased risk. The increased risk at younger paternal ages is halved on adjustment for the child’s characteristics and fully attenuated on adjustment for child/parental characteristics. The increased risk at paternal ages 40+ is partially attenuated on adjustment for maternal characteristics (β=0.62%; 95% CI 0.13% to 1.1%). Adjustment for unobserved parental characteristics shared by siblings further attenuates the 40+ coefficient (β=0.4%; 95% CI −0.5% to −1.2%). Results for preterm delivery are similar.ConclusionsThe results underscore the importance of considering paternal age as a potential risk factor for adverse birth outcomes and of expanding research on its role and the mechanisms linking it to birth outcomes.

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Association of US state policy orientation with adverse birth outcomes: a longitudinal analysis

Journal of Epidemiology & Community Health ◽

10.1136/jech-2020-214858 ◽

2021 ◽

pp. jech-2020-214858

Author(s):

Alicia R Riley ◽

Daniel Collin ◽

Jacob M Grumbach ◽

Jacqueline M Torres ◽

Rita Hamad

Keyword(s):

Birth Weight ◽

Preterm Birth ◽

Low Birth Weight ◽

Birth Outcomes ◽

State Policy ◽

Fixed Effects ◽

State Policies ◽

Adverse Birth Outcomes ◽

Lower Odds ◽

Policy Orientation

BackgroundThe current US context is marked by extreme right–left partisanship, which means that state policies tend to bundle together and are not experienced in isolation. While prior work has leveraged abrupt shifts in single policies to examine the effects of state policy on birth outcomes, we examined a holistic measure that captures political polarisation.MethodsData were drawn from national birth certificates for 2003–2017 (N=56 770 470). Outcomes included preterm birth, low birth weight, small-for-gestational age and other perinatal health measures. The primary exposure was a composite index of right–left state policy orientation, generated from historical data on 135 state policies. Multivariable regressions were used to estimate the association between state policy orientation and each outcome, adjusting for relevant covariates.ResultsCompared with infants born in states with right-leaning policy orientations, those born in left-leaning states had lower odds of adverse birth outcomes (eg, low birth weight: OR 0.95 (0.93, 0.97), preterm birth: OR 0.94 (0.92, 0.95)). Subgroup analyses revealed stronger associations for US-born and White mothers. With the inclusion of state fixed effects, left-leaning policy orientation was no longer associated with lower odds of adverse birth outcomes. Models were otherwise robust to alternative specifications.ConclusionWhile left-leaning state policy orientation has protective associations with a range of birth outcomes, the associations may be explained by stable characteristics of states, at least during the study period. Future studies should examine state policy orientation in association with other health outcomes and study periods.

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