Using a life history framework to understand the relationship between neighborhood structural deterioration and adverse birth outcomes.

2011 ◽  
Vol 5 (4) ◽  
pp. 260-274 ◽  
Author(s):  
Daniel J. Kruger ◽  
Melissa A. Munsell ◽  
Tonya French-Turner
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Thokozile R. Malaba ◽  
◽  
Annibale Cois ◽  
Hlengiwe P. Madlala ◽  
Mushi Matjila ◽  
...  

Abstract Background High blood pressure (BP) late in pregnancy is associated with preterm delivery (PTD); BP has also been associated with HIV and antiretroviral therapy (ART), but whether the relationship between BP assessed longitudinally over pregnancy and PTD and low birthweight (LBW) is modified by HIV/ART is unclear. We hypothesise the presence of distinctive BP trajectories and their association with adverse birth outcomes may be mediated by HIV/ART status. Methods We recruited pregnant women at a large primary care facility in Cape Town. BP was measured throughout pregnancy using automated monitors. Group-based trajectory modelling in women with ≥3 BP measurements identified distinct joint systolic and diastolic BP trajectory groups. Multinomial regression assessed BP trajectory group associations with HIV/ART status, and Poisson regression with robust error variance was used to assess risk of PTD and LBW. Results Of the 1583 women in this analysis, 37% were HIV-infected. Seven joint trajectory group combinations were identified, which were categorised as normal (50%), low normal (25%), high normal (20%), and abnormal (5%). A higher proportion of women in the low normal group were HIV-infected than HIV-uninfected (28% vs. 23%), however differences were not statistically significant (RR 1.27, 95% CI 0.98–1.63, reference category: normal). In multivariable analyses, low normal trajectory (aRR0.59, 0.41–0.85) was associated with decreased risk of PTD, while high normal (aRR1.48, 1.12–1.95) and abnormal trajectories (aRR3.18, 2.32–4.37) were associated with increased risk of PTD, and abnormal with increased risk of LBW (RR2.81, 1.90–4.15). Conclusions While HIV/ART did not appear to mediate the BP trajectories and adverse birth outcomes association, they did provide more detailed insights into the relationship between BP, PTD and LBW for HIV-infected and uninfected women.


BMJ Open ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. e047133
Author(s):  
Thokozile R Malaba ◽  
Landon Myer ◽  
Clive Gray ◽  
Marie-Louise Newell

PurposePrematurity Immunology in Mothers living with HIV and their infants Study (PIMS) is a prospective cohort study in South Africa investigating the association between antiretroviral therapy (ART) use, preterm delivery (PTD) and small-for-gestational age (SGA) live births. PIMS main hypotheses are that ART initiation in pregnancy and ART-induced hypertension are associated with PTD and SGA respectively and that reconstitution of cellular immune responses in women on ART from before pregnancy results in increases in PTD of GA infants.ParticipantsPregnant women (n=3972) aged ≥18 years regardless of HIV status recruited from 2015 to 2016 into the overall PIMS cohort (2517 HIV-negative, 1455 living with HIV). A nested cohort contained 551 women living with HIV who were ≤24 weeks’ GA on ultrasound: 261 initiated ART before pregnancy, 290 initiated during the pregnancy.Findings to dateWomen in the overall cohort were followed antenatally through to delivery using routine clinical records; further women in the nested cohort were actively followed up until 12 months post partum, with data collected on maternal health (HIV care and ART use, clinical care and intercurrent clinical history). Other procedures conducted on the nested cohort included physical examinations (anthropometry, blood pressure measurement), assessment of fetal growth (ultrasound), maternal and infant phlebotomy for storage of plasma, RNA and peripheral blood mononuclear cells, collection of delivery specimens (placenta and cord blood) and infant 12-month developmental assessment. Preliminary findings have contributed to our understanding of risk factors for adverse birth outcomes, and the relationship between pregnancy immunology, HIV/ART and adverse birth outcomes.Future plansUsing specimens collected from study participants living with HIV throughout pregnancy and first year of life, the PIMS provides a valuable platform for answering a variety of research questions focused on temporal changes of immunology markers in women whose immune status is altered by HIV infection, and how ART initiated during the pregnancy affects immune responses. The relationship between these immunological changes with adverse birth outcomes as well as possible longer-term impact of exposure to ART in fetal and early life will be explored. Additionally, further active and passive follow-up of mothers and their infants is planned at school-going age and beyond to chart growth, morbidity and development, as well as changes in family circumstances.


2021 ◽  
Author(s):  
Hoda Fotovvat ◽  
Christopher T. Emrich

Abstract Background This study aims to explore the relationship between social vulnerability (SoVI)indicators (race/ethnicity, population structure, socioeconomic status, housing structure, and access/functional needs) with low birth weight (LBW) and preterm delivery (PTD) rates across the Southeastern United States. Methods Annual low birth weight and premature birth rates for all counties were collected between 2000 and 2015. LBW and PTD were recoded into two categories below (0) and above (1) the annual national average for each year. Multinomial logistic regression (MLR) was employed to conduct regression analysis to investigate the relationship. Results Twenty-six and twenty-four different social vulnerability indicators were influential in predicting low birth weight rates and preterm delivery across the SE United States from 2005–2015, respectively. Racial and ethnic variables were among the most frequent influential social vulnerability indicators of low birth weights. Like race and ethnicity, counties with low and medium house values have a higher likelihood of low LBW compared to counties with higher house values. Unlike LBW, race and ethnic characteristics influence PTD rates across the study area in different ways. Whereas LBW rates are driven up in counties with low/medium Hispanic populations compared to high percentage counties, PTD is more strongly associated with Black communities. Further, population structure and socioeconomic status indicators provide the most robust indication of counties more likely to have higher PTD than the national average. Conclusion Influential variables point toward a dire need to comprehensively understand the links between social vulnerability and LBW and PTD. Moving toward a comprehensive view of social vulnerability borne out of the hazards literature provides a more robust understanding of the drivers of adverse birth outcomes that has rarely been addressed in the literature.


2021 ◽  
Vol 31 (3) ◽  
pp. 196-200
Author(s):  
Abdulla Varoneckas ◽  
Kotryna Jasinskaitė ◽  
Asta Varašiūtė

Purpose: The aim of this review was to assess the relationship between adverse birth outcomes and early childhood caries. Methods: Two reviewers searched different databases from February 2020. Results: 1376 articles were shown after the initial electronic databases search. The authors identified 10 studies investigating the incidence of dental caries among children with primary dentition, covering 79284 children, with their age ranging from 0,5 to 6 years. The studies were published from 2010 to 2020 and included retrospective, cohort, case control and cross-sectional studies. Conclusion: The found scientific evidence demonstratedthat children with adverse birth outcomes are more likely to experience caries than healthy children.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sara K. Redd ◽  
Whitney S. Rice ◽  
Monica S. Aswani ◽  
Sarah Blake ◽  
Zoë Julian ◽  
...  

Abstract Background To examine racial/ethnic and educational inequities in the relationship between state-level restrictive abortion policies and adverse birth outcomes from 2005 to 2015 in the United States. Methods Using a state-level abortion restrictiveness index comprised of 18 restrictive abortion policies, we conducted a retrospective longitudinal analysis examining whether race/ethnicity and education level moderated the relationship between the restrictiveness index and individual-level probabilities of preterm birth (PTB) and low birthweight (LBW). Data were obtained from the 2005–2015 National Center for Health Statistics Period Linked Live Birth-Infant Death Files and analyzed with linear probability models adjusted for individual- and state-level characteristics and state and year fixed-effects. Results Among 2,250,000 live births, 269,253 (12.0%) were PTBs and 182,960 (8.1%) were LBW. On average, states had approximately seven restrictive abortion policies enacted from 2005 to 2015. Black individuals experienced increased probability of PTB with additional exposure to restrictive abortion policies compared to non-Black individuals. Similarly, those with less than a college degree experienced increased probability of LBW with additional exposure to restrictive abortion policies compared to college graduates. For all analyses, inequities worsened as state environments grew increasingly restrictive. Conclusion Findings demonstrate that Black individuals at all educational levels and those with fewer years of education disproportionately experienced adverse birth outcomes associated with restrictive abortion policies. Restrictive abortion policies may compound existing racial/ethnic, socioeconomic, and intersecting racial/ethnic and socioeconomic perinatal and infant health inequities.


2020 ◽  
Vol 34 (6) ◽  
pp. 713-723
Author(s):  
Angela M. Bengtson ◽  
Tamsin K. Phillips ◽  
Stanzi M. Roux ◽  
Kirsty Brittain ◽  
Allison Zerbe ◽  
...  

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