scholarly journals Factors associated with small- and large-for-gestational-age in socioeconomically vulnerable individuals in the 100 Million Brazilian Cohort

2021 ◽  
Author(s):  
Ila R Falcão ◽  
Rita de Cássia Ribeiro-Silva ◽  
Marcia Furquim de Almeida ◽  
Rosemeire L Fiaccone ◽  
Natanael J Silva ◽  
...  
Keyword(s):  
Gestational Age ◽  
Multinomial Logistic Regression ◽  
Mixed Race ◽  
Sociodemographic Factors ◽  
Reproductive Age ◽  
Large For Gestational Age ◽  
Maternal Characteristics ◽  
Factors Associated ◽  
Study Population ◽  
Brazilian Populations

ABSTRACT Background Evidence points to diverse risk factors associated with small- (SGA) and large-for-gestational-age (LGA) births. A more comprehensive understanding of these factors is imperative, especially in vulnerable populations. Objectives To estimate the occurrence of and sociodemographic factors associated with SGA and LGA births in poor and extremely poor populations of Brazil. Methods The study population consisted of women of reproductive age (14–49 y), whose last child was born between 2012 and 2015. INTERGROWTH 21st consortium criteria were used to classify weight for gestational age according to sex. Multinomial logistic regression modeling was performed to investigate associations of interest. Results Of 5,521,517 live births analyzed, SGA and LGA corresponded to 7.8% and 17.1%, respectively. Multivariate analysis revealed greater odds of SGA in children born to women who self-reported as black (OR: 1.21; 95% CI: 1.19, 1.22), mixed-race (parda) (OR: 1.08; 95% CI: 1.07, 1.09), or indigenous (OR: 1.11; 95% CI: 1.06, 1.15), were unmarried (OR: 1.08; 95% CI: 1.07, 1.08), illiterate (OR: 1.47; 95% CI: 1.42, 1.52), did not receive prenatal care (OR: 1.57; 95% CI: 1.53, 1.60), or were aged 14–20 y (OR: 1.21; 95% CI: 1.20, 1.22) or 35–49 y (OR: 1.12; 95% CI: 1.10, 1.13). Considering LGA children, higher odds were found in infants born to women living in households with ≥3 inadequate housing conditions (OR: 1.11; 95% CI: 1.10, 1.12), in indigenous women (OR: 1.22; 95% CI: 1.19, 1.25), those who had 1–3 y of schooling (OR: 1.18; 95% CI: 1.17, 1.19), 1–3 prenatal visits (OR: 1.16; CI 95%: 1.14, 1.17), or were older (OR: 1.26; 95% CI: 1.25, 1.27). Conclusions In poorer Brazilian populations, socioeconomic, racial, and maternal characteristics are consistently associated with the occurrence of SGA births, but remain less clearly linked to the occurrence of LGA births.

scholarly journals Exploring Attitudes About the Legality of Self-Managed Abortion in the US: Results from a Nationally Representative Survey

2021 ◽  
Author(s):  
Sarah Raifman ◽  
M. Antonia Biggs ◽  
Lauren Ralph ◽  
Katherine Ehrenreich ◽  
Daniel Grossman
Keyword(s):  
Multinomial Logistic Regression ◽  
Public Attitudes ◽  
The United States ◽  
Public Affairs ◽  
Policy Implications ◽  
Reproductive Age ◽  
Factors Associated ◽  
The Us ◽  
The Law ◽  
Nationally Representative

Abstract Introduction Twenty-four states have at least one law in place that could be used to prosecute people for self-managed abortion (SMA), or the termination of a pregnancy outside of the formal healthcare system. We investigated factors associated with public attitudes about SMA legality and legal access to abortion more generally. Methods In August 2017, we surveyed a nationally representative sample of English- and Spanish-speaking women ages 18–49 years in the United States (US) using Ipsos Public Affairs’ KnowledgePanel. Unadjusted and adjusted multinomial logistic regression estimates identify characteristics associated with believing that SMA should not be against the law, compared to should be against the law, with weighting to account for sampling into the panel. Results Overall, 76% (95% CI: 74.3%-77.1%) and 59% (95% CI: 57.3%-60.4%) of participants (n = 7,022, completion rate 50%) reported that abortion and SMA, respectively, should not be against the law; 1% and 19% were unsure. Among those living in a state with at least one law that could be used to prosecute an individual for SMA, the majority (55%, 95% CI: 52.7%-57.9%) believed SMA should not be against the law. Factors associated with believing SMA should not be against the law, compared to should be against the law, included prior abortion experience and higher levels of education and income. Conclusion Most reproductive age women in the US believe that SMA should not be criminalized. There is more uncertainty about SMA legality than about the legality of abortion more generally. Policy Implications US laws that criminalize SMA are not supported by the majority of the people living in their jurisdictions.

scholarly journals Factors associated with the compliance of recommended first postnatal care services utilization among reproductive age women in Benin Republic: an analysis of 2011/2012 BDHS data

2017 ◽  
Vol 6 (4) ◽  
pp. 1161 ◽  
Author(s):  
Justin Dansou ◽  
Adeyemi O. Adekunle ◽  
Ayodele O. Arowojolu
Keyword(s):  
Postnatal Care ◽  
Multinomial Logistic Regression ◽  
Household Wealth ◽  
Reproductive Age ◽  
Special Focus ◽  
Wealth Status ◽  
Services Utilization ◽  
Factors Associated ◽  
To Receive ◽  
Benin Republic

Background: High maternal and neonatal mortality persist in Benin republic. Rates of decline are slow and factors influencing PNC services utilization are not well known. This study aims to assess factors associated with PNC services utilization among mothers and their newborns with special focus on the recommendation 2 of WHO guidelines on postnatal care of the mother and the newborn.Methods: This study analysed Benin’s 2011/2012 DHS data. A total of 16,599 women were interviewed where 8,275 eligible for the present study. Multinomial logistic regression was applied.Results: While 68.42% of mothers and their newborns received at least one PNC visit over postnatal period, the percent of newborns and their mothers with appropriate first PNC check-up was low, 19.95%. Factors explaining PNC uptake were place of residence, ethnic group, occupation, ANC attendance, place of delivery, baby birth size, household wealth status, mass media use, and to a lesser extent education attainment. Accessibility, number of living children followed by the birth order number, and desire for pregnancy appeared to be specific determinants to appropriate first PNC check-up. Mothers who attended more frequently ANC services were more likely to receive PNC check-ups. Mothers who delivered at private health facility were more likely to receive PNC check-ups.Conclusions: To increase the achievement of the recommended WHO PNC frequency, there is a need to: address unmet needs for Family Planning in Benin; to expend health education and counselling to encourage ANC attendance supervise by skilled personnel.

scholarly journals A first trimester prediction model for large for gestational age infants: a preliminary study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Francesca Monari ◽  
Daniela Menichini ◽  
Ludovica Spano’ Bascio ◽  
Giovanni Grandi ◽  
Federico Banchelli ◽  
...  
Keyword(s):  
Prediction Model ◽  
Gestational Age ◽  
Predictive Accuracy ◽  
First Trimester ◽  
University Hospital ◽  
Large For Gestational Age ◽  
Aneuploidy Screening ◽  
Maternal Characteristics ◽  
Targeted Interventions ◽  
Increased Risk

Abstract Background Large for gestational age infants (LGA) have increased risk of adverse short-term perinatal outcomes. This study aims to develop a multivariable prediction model for the risk of giving birth to a LGA baby, by using biochemical, biophysical, anamnestic, and clinical maternal characteristics available at first trimester. Methods Prospective study that included all singleton pregnancies attending the first trimester aneuploidy screening at the Obstetric Unit of the University Hospital of Modena, in Northern Italy, between June 2018 and December 2019. Results A total of 503 consecutive women were included in the analysis. The final prediction model for LGA, included multiparity (OR = 2.8, 95% CI: 1.6–4.9, p = 0.001), pre-pregnancy BMI (OR = 1.08, 95% CI: 1.03–1.14, p = 0.002) and PAPP-A MoM (OR = 1.43, 95% CI: 1.08–1.90, p = 0.013). The area under the ROC curve was 70.5%, indicating a satisfactory predictive accuracy. The best predictive cut-off for this score was equal to − 1.378, which corresponds to a 20.1% probability of having a LGA infant. By using such a cut-off, the risk of LGA can be predicted in our sample with sensitivity of 55.2% and specificity of 79.0%. Conclusion At first trimester, a model including multiparity, pre-pregnancy BMI and PAPP-A satisfactorily predicted the risk of giving birth to a LGA infant. This promising tool, once applied early in pregnancy, would identify women deserving targeted interventions. Trial registration ClinicalTrials.gov NCT04838431, 09/04/2021.

scholarly journals A Model of Disparities: Risk Factors Associated with COVID-19 Infection

2020 ◽  
Author(s):  
Yelena Rozenfeld ◽  
Jennifer Beam ◽  
Haley Maier ◽  
Whitney Haggerson ◽  
Karen Boudreau ◽  
...  
Keyword(s):  
Risk Factors ◽  
English Language ◽  
Sociodemographic Factors ◽  
Black African ◽  
Factors Associated ◽  
Emerging Risk ◽  
Study Population ◽  
Structural Inequities ◽  
African American Race ◽  
The U.S

Abstract Background By mid-May 2020, there were over 1.5 million cases of (SARS-CoV-2) or COVID-19 across the U.S. with new confirmed cases continuing to rise following the re-opening of most states. Prior studies have focused mainly on clinical risk factors associated with serious illness and mortality of COVID-19. Emerging risk factors in the U.S., including clinical, sociodemographic, and environmental variables associated with contraction of COVID-19 have not been widely studied to assess disparities across populations. Methods A multivariable statistical model was used to identify predictors associated with COVID-19 contraction in the study population of 34,503 patients, comparing laboratory confirmed positive and negative COVID-19 cases in the Providence Health System (U.S.) between February 28 and April 27, 2020. Publicly available data were utilized as approximations for social determinants of health, and patient-level clinical and sociodemographic factors were extracted from the electronic medical record. Results Higher risk of contraction was associated with older age (OR 1.69; 95% CI 1.41-2.02, p<0.0001), male gender (OR 1.32; 95% CI 1.21-1.44, p<0.0001), Asian race (OR 1.43; 95% CI 1.18-1.72, p= 0.0002), Black/African American race (OR 1.51; 95% CI 1.25-1.83, p<0.0001), Latino ethnicity (OR 2.07; 95% CI 1.77-2.41, p<0.0001), non-English language (OR 2.09; 95% CI 1.7-2.57, p<0.0001), high school education or less (OR 1.02; 95% CI 1.01-1.14, p=0.04), residing in a neighborhood with financial insecurity (OR 1.10; 95% CI 1.01-1.25, p=0.04), low air quality (OR 1.01; 95% CI 1.0-1.04, p=0.05), housing insecurity (OR 1.32; 95% CI 1.16-1.5, p< 0.0001) or transportation insecurity (OR 1.11; 95% CI 1.02-1.23, p=0.03), and living in senior living communities (OR 1.69; 95% CI 1.23-2.32, p= 0.001). Conclusions Risks associated with COVID-19 contraction reflect disparities across age, race, ethnicity, language, socioeconomic status, and living conditions. Health promotion and disease prevention strategies should prioritize groups most vulnerable to contraction and address structural inequities that contribute to risk through social and economic policy.

Growth among Twins: Use of Singleton versus Twin-Specific Growth Nomograms

2017 ◽  
Vol 35 (02) ◽  
pp. 184-191 ◽  
Author(s):  
Hector Mendez-Figueroa ◽  
Van Truong ◽  
Claudia Pedroza ◽  
Suneet Chauhan
Keyword(s):  
Neonatal Mortality ◽  
Gestational Age ◽  
Neonatal Morbidity ◽  
Large For Gestational Age ◽  
Maternal Fetal Medicine ◽  
Logistic Regression Models ◽  
Abnormal Growth ◽  
Birth Weight Percentile ◽  
Appropriate For Gestational Age ◽  
Study Population

Objective We hypothesized that utilization of a twin-specific nomograms, when compared with one based on singleton data, is less likely to classify twins as having abnormal growth and more likely to identify perinatal morbidity and mortality. Materials and Methods Data were culled from seven Maternal-Fetal Medicine Units (MFMU) studies, the included twin gestations in their study population. Each newborn twin's birth weight percentile was categorized using Alexander et al (singleton data) and Ananth et al (twin data) nomogram. Logistic regression models were adjusted for maternal race and body mass index, neonatal sex, study, and twin correlation. Results More twins were categorized as small for gestational age (SGA) when singleton nomogram was used (33%) compared with twin nomogram (4%). The use of singleton nomogram revealed a higher composite neonatal morbidity (CNM) and stillbirth rates among SGA twins but a similar neonatal mortality rate when compared with appropriate for gestational age. Correspondingly, when twin-specific nomogram was utilized, the CNM, odds of stillbirth, and neonatal mortality were higher among SGA twins. The rate of large for gestational age among twins was increased with the use of twin-specific nomograms. Conclusion Utilization of twin-specific nomogram is less likely to categorize twins as SGA and more likely to identify those at risk for stillbirth and neonatal mortality.

Maternal Characteristics and Migraine Pharmacotherapy During Pregnancy: Cross-Sectional Analysis of Data from a Large Cohort Study

Cephalalgia ◽  
2009 ◽  
Vol 29 (12) ◽  
pp. 1267-1276 ◽  
Author(s):  
K Nezvalová-Henriksen ◽  
O Spigset ◽  
H Nordeng
Keyword(s):  
Body Mass Index ◽  
Odds Ratio ◽  
Sociodemographic Factors ◽  
Population Based ◽  
Narcotic Analgesics ◽  
Cross Sectional ◽  
Maternal Characteristics ◽  
Factors Associated ◽  
Large Cohort Study ◽  
Sectional Analysis

Little is known about factors associated with migraine pharmacotherapy during pregnancy. Of 60 435 pregnant women in a population-based cohort, 3480 (5.8%) reported having migraine during the first 5 months of pregnancy. Of these, 2525 (72.6%) reported using migraine pharmacotherapy, mostly non-narcotic analgesics (54.1%) and triptans (25.4%). After adjustment for sociodemographic factors and comorbidities in logistic regression analysis, high pregestational body mass index [odds ratio (OR) 1.3, 95% confidence interval (CI) 1.2, 1.4], sleep < 5 h (OR 1.6, 95% CI 1.3, 1.9), being on sick-leave (OR 1.3, 95% CI 1.2, 1.5) and acute back/shoulder/neck pain (OR 0.6, 95% CI 0.6, 0.7) were associated with migraine pharmacotherapy during pregnancy. Many women need drug treatment for migraine during pregnancy, and the choice of pharmacotherapy during this period may be influenced by maternal sociodemographic factors and comorbidities.

scholarly journals Clinical characteristics and sociodemographic factors associated with COVID-19 infection in pregnant women in a maternal and children's public hospital

Medwave ◽  
2021 ◽  
Vol 21 (07) ◽  
pp. e8442-e8442
Author(s):  
Yda Rodriguez Huaman ◽  
Pavel J Contreras ◽  
Michelle Lozada-Urbano
Keyword(s):  
Body Mass Index ◽  
Marital Status ◽  
Pregnant Women ◽  
Body Mass ◽  
Gestational Age ◽  
Lower Risk ◽  
Clinical Characteristics ◽  
Prevalence Ratio ◽  
Sociodemographic Factors ◽  
Factors Associated

Objective To describe the clinical characteristics and sociodemographic factors associated with COVID-19 among pregnant women in a maternal and children's hospital in Lima, Peru. Methods Quantitative observational study. The population under study consisted of pregnant women who attended an emergency room and had a COVID-19 test. These women were assessed for age, gestational age, place of origin, occupation, education, marital status, number of children, previous body mass index, gestational body mass index, tetanus vaccination, prenatal controls, and hemoglobin. After bivariate analysis, a generalized linear regression model was applied. Results We included 200 women aged between 18 and 34 years (84.5%) with a median gestational age of 36 weeks. More than half were from Lima (52.5%), most were housewives (79%), had high school education (71.9%), and had a cohabiting marital status (60%). The COVID-19 test positivity was 31.5% by rapid tests. Pregestational body mass index assessment showed that 36.7% of normal weight, 38,1% of overweight, and 30.3% of obese pregnant women had COVID-19 infection. 39.7% of patients with hemoglobin levels greater than or equal to 11 g/dL, 21.2% of patients with values between 10 and 10.9 g/dL, and 20% of patients with values between 7 and 9.9 g/dL had COVID-19 infection. The prevalence ratio (with a 95% confidence interval) found that cohabitation was associated with a lower risk of having COVID-19 infection in pregnant women (prevalence ratio: 0.41, p < 0.001). Conclusion Cohabiting pregnant women had a lower risk of COVID-19 infection compared with other marital statuses. Further research is needed to evaluate COVID-19 associated factors in pregnant women and possible sociodemographic or economic factors behind cohabiting marital status association among this population.

scholarly journals Study of foot length as an alternate measurement for assessment of gestational maturity in neonates

2019 ◽  
Vol 6 (2) ◽  
pp. 477 ◽  
Author(s):  
Ananya S. L. Tenali ◽  
Ravi Kumar Tenali
Keyword(s):  
Gestational Age ◽  
Healthcare Personnel ◽  
Large For Gestational Age ◽  
Growth Chart ◽  
Strongly Correlated ◽  
Simple Method ◽  
Medical College ◽  
Foot Length ◽  
Appropriate For Gestational Age ◽  
Study Population

Background: The aim was to study neonatal foot length as a simple method for quick gestational age assessment which can be done by basic healthcare personnel overcoming the technicality required by other assessment methods.Methods: Prospective descriptive study was done. Live born neonates at Saveetha Medical College, Kanchipuram from June 2016 to June2017 were enrolled. Gestational age was assessed by New Ballard’s Scoring and footlength was measured using the paddle blades of automated digital Vernier calipers within 24 hours while birth weight was taken within 72 hours of birth. Based on gestational age, babies were grouped into preterm, term and post term and were subclassified as small for gestational age (SGA), appropriate for gestational age (AGA) and large for gestational age (LGA) based on Lubchenco’s intrauterine growth chart. Correlation and regression analysis and Scattergram was done.Results: Out of 300 neonates, term, preterm and post-term were 70.3%,28.3% and1.3% while SGA, AGA, and LGA babies were 9%, 88% and 3%. Mean foot length was 7.728cm±0.59 with a range of 5-8.8cm. Foot length strongly correlated with gestational age in Preterm AGA, SGA and Term AGA babies (<0.001). Correlation coefficient of foot length with gestational age was higher in preterms (r=0.95). Gestational age in 54% of study population could be calculated with the derived regression equation derived.Conclusions: Foot length maybe useful for quick estimation of gestational age in preterm and term neonates for early referral of newborns requiring special care and can even be done by basic healthcare personnel.

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