P–773 Infertility treatment and the risk of small for gestational age births: a population-based study in the United States

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
H Glatthorn ◽  
M Sauer ◽  
J Brandt ◽  
C Ananth
Keyword(s):  
United States ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
The United States ◽  
Infertility Treatment ◽  
Unmeasured Confounding ◽  
Live Births ◽  
The Us ◽  
Infertility Treatments ◽  
The Impact

Abstract Study question What is the association between infertility treatments and small for gestational age (SGA) births? Summary answer Women who conceived pregnancies with any infertility treatment had a decreased risk of SGA <10th, <5th and <3rd percentiles compared to naturally conceived pregnancies. What is known already Assisted reproductive technology (ART) and other infertility treatments have long been associated with an increased risk of SGA births, which confers a greater risk of perinatal morbidity and mortality compared to appropriate for gestational age births. Study design, size, duration This is a cross-sectional study of 16,836,228 births in the United States (US) between 2015–2019. The exposure group included women who underwent any infertility treatment, including ART and prescribed fertility enhancing medications. The comparison group included those who had naturally conceived pregnancies. The primary outcome was SGA birth, defined as sex-specific birthweight <10th percentile for gestational age. Secondary outcomes included SGA <5th and <3rd percentile births. Participants/materials, setting, methods Pregnant subjects (n = 16,836,228) in the US who delivered non-malformed, singleton live births between 24–44 weeks’ gestational age. We estimated risk of SGA births in relation to any infertility treatment from fitting log-linear Poisson regression models with robust variance. Risk ratios (RR) and 95% confidence intervals (CI) were estimated as the effect measure before and after adjusting for confounders. We also performed a sensitivity analysis to correct for potential non-differential exposure misclassification and unmeasured confounding biases. Main results and the role of chance During the study period, 1.4% (n = 231,177) of non-malformed singleton live births resulted from infertility treatments (0.8% ART and 0.6% fertility enhancing medications). Of these, 9.4% (n = 21,771) of pregnancies conceived with infertility treatment were complicated by SGA <10th percentile compared to 11.9% (n = 1,755,925) of naturally conceived pregnancies. For pregnancies conceived with infertility treatment versus naturally conceived pregnancies, the adjusted RR for SGA <10th percentile was 1.07 (95% CI 1.06, 1.08). However, after correction for misclassification bias and unmeasured confounding, infertility treatment was found to be protective for SGA and conferred a 27% reduced risk of SGA <10th percentile (bias-corrected RR 0.73, 95% CI 0.53, 0.85). These trends were similar for analyses stratified by exposure to ART and fertility enhancing medications and secondary SGA outcomes, including SGA <5th and <3rd percentile. Limitations, reasons for caution All information collected on infertility treatment relies on self-reporting by patients and recording by hospital staff at the time of delivery, which likely resulted in underreporting of infertility treatments. Additionally, we cannot determine the impact of interventions that were not recorded, such as intrauterine insemination (IUI). Wider implications of the findings: Compared to naturally conceived pregnancies, exposure to infertility treatment is associated with reduction in the risk of SGA births. These findings, which are contrary to some published reports, likely reflect changes in the modern practice of infertility care in the US, and importantly, robust analysis of the national data. Trial registration number Not applicable

The Impact of Monetary and Fiscal Policies on the Stock Market in the United States (U.S); Evidence from Linear ARDL Framework

2020 ◽  
Vol 11 (1) ◽  
pp. 132-132
Author(s):  
Aref Emamian
Keyword(s):  
United States ◽  
Stock Market ◽  
The United States ◽  
Real Effective Exchange Rate ◽  
Annual Data ◽  
Fiscal Policies ◽  
Long Run ◽  
The Us ◽  
Short Run ◽  
The Impact

This study examines the impact of monetary and fiscal policies on the stock market in the United States (US), were used. By employing the method of Autoregressive Distributed Lags (ARDL) developed by Pesaran et al. (2001). Annual data from the Federal Reserve, World Bank, and International Monetary Fund, from 1986 to 2017 pertaining to the American economy, the results show that both policies play a significant role in the stock market. We find a significant positive effect of real Gross Domestic Product and the interest rate on the US stock market in the long run and significant negative relationship effect of Consumer Price Index (CPI) and broad money on the US stock market both in the short run and long run. On the other hand, this study only could support the significant positive impact of tax revenue and significant negative impact of real effective exchange rate on the US stock market in the short run while in the long run are insignificant. Keywords: ARDL, monetary policy, fiscal policy, stock market, United States

scholarly journals The Convergence of Military Conduct and Policing in Israeli-Controlled Territories

2020 ◽  
Vol 35 (2) ◽  
pp. 1-8
Author(s):  
Nir Gazit ◽  
Keyword(s):  
United States ◽  
Police Officer ◽  
The United States ◽  
Police Brutality ◽  
Media Attention ◽  
Military Forces ◽  
The Us ◽  
The Military ◽  
The Impact

The murder of George Floyd by a police officer in the United States in May 2020 and the subsequent turmoil, as well as the violence against migrants on the US-Mexican border, have drawn major public and media attention to the phenomenon of police brutality (see, e.g., Levin 2020; Misra 2018; Taub 2020), which is often labeled as ‘militarization of police’. At the same time, in recent years military forces have been increasingly involved in policing missions in civilian environments, both domestically (see, e.g., Kanno-Youngs 2020; Schrader 2020; Shinkman 2020) and abroad. The convergence of military conduct and policing raises intriguing questions regarding the impact of these tendencies on the military and the police, as well as on their legitimacy.

scholarly journals Quebec’s Economic and Commercial Linkages with the United States, 1994–2017

2017 ◽  
Author(s):  
Earl H. Fry
Keyword(s):  
United States ◽  
Trade Agreement ◽  
The United States ◽  
The North ◽  
Nation States ◽  
Wide Range ◽  
The Us ◽  
Us Government ◽  
Big Picture ◽  
The Impact

This article examines the ebb and flow of the Quebec government’s economic and commercial relations with the United States in the period 1994–2017. The topic demonstrates the impact of three major forces on Quebec’s economic and commercial ties with the US: (1) the North American Free Trade Agreement (NAFTA) which became operational in 1994 and was fully implemented over a 15-year period; (2) the onerous security policies put in place by the US government in the decade following the horrific events of 11 September 2001; and (3) changing economic circumstances in the United States ranging from robust growth to the worst recession since the Great Depression of the 1930s. The article also indicates that the Quebec government continues to sponsor a wide range of activities in the United States, often more elaborate and extensive than comparable activities pursued by many nation-states with representation in the US. 1 1 Stéphane Paquin, ‘Quebec-U.S. Relations: The Big Picture’, American Review of Canadian Studies 46, no. 2 (2016): 149–61.

scholarly journals Warlords, the United States, and the state of anarchy in Afghanistan

2021 ◽  
Vol 6 (2) ◽  
Author(s):  
Ahmad Shah Azami
Keyword(s):  
United States ◽  
The United States ◽  
State Building ◽  
The State ◽  
Negative Consequences ◽  
Human Rights Abuses ◽  
Illegal Mining ◽  
The Us ◽  
The Government ◽  
The Impact

As part of its “War on Terror”, the United States (US) provided immense sums of money and advanced equipment to Afghan warlords in order to defeat and dismantle the Taliban and al-Qaeda in Afghanistan. Nearly two decades after the 2001 US-led intervention in Afghanistan that toppled the Taliban regime, the US continues supporting the warlords in various ways. As the intervention was also aimed at establishing a functioning state and reconstruction of the war-torn country, the US needed the support of local warlords to achieve its goals. However, over time, warlords and warlordism became a major challenge to the postTaliban state-building project and in many ways undermined the overall security and the state monopoly on violence. These warlords, who had been mostly expelled and defeated by the Taliban regime, returned under the aegis of the B52 bombers, recaptured parts of the country and reestablished their fiefdoms with US support and resources. They not only resist giving up the power and prestige they have accumulated over the past few years, but also hamper the effort to improve governance and enact necessary reforms in the country. In addition, many of them run their private militias and have been accused of serious human rights abuses as well as drug trafficking, arms smuggling, illegal mining and extortion in the areas under their control or influence. In many ways, they challenge the government authority and have become a major hurdle to the country’s emerging from lawlessness and anarchy. This paper explores the emergence and reemergence of warlords in Afghanistan as well as the evolution of chaos and anarchy in the country, especially after the US-led intervention of late 2001. It also analyzes the impact of the post-9/11 US support to Afghan warlords and its negative consequences for the overall stability and the US-led state-building process in Afghanistan.

P–776 Singleton pregnancies conceived with infertility treatments and the risk of
neonatal and infant mortality

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
G Farley ◽  
M Sauer ◽  
J Brandt ◽  
C Ananth
Keyword(s):  
United States ◽  
Neonatal Mortality ◽  
Preterm Delivery ◽  
The United States ◽  
Infertility Treatment ◽  
Exposure Misclassification ◽  
Unmeasured Confounding ◽  
Adjusted Risk ◽  
Increased Risk ◽  
Singleton Live Birth

Abstract Study question Is maternal infertility treatment associated with an increased risk of neonatal and infant mortality when compared to natural conception? Summary answer Infertility treatment is associated with a 70% increased adjusted risk of neonatal mortality. This association is strongly mediated by preterm delivery. What is known already The number of assisted reproduction technology (ART) cycles performed in the United States (US) increased by 39% from 142,435 cycles in 2007 to 197,737 in 2016. Within this growing experience, several studies described an increased risk of preterm delivery, low birth weight, congenital malformations, neonatal intensive care unit admission, stillbirth, and perinatal mortality among singletons conceived through ART compared to those conceived naturally. Experts have called for ART patients to be advised of potential increased risk for adverse perinatal outcomes and for obstetricians to manage these pregnancies as high risk. Study design, size, duration This is a cross-sectional study of 11,289,466 pregnancies in the United States (US) from 2015–2017 that resulted in a non-malformed singleton live birth. The exposure group includes births resulting from any infertility treatment method, including ART and fertility-enhancing drugs. The control group includes births resulting from natural conceptions. The primary outcomes measured were neonatal (within 1 month), post-neonatal (1 month to a year), and infant (up to 1 year) mortality. Participants/materials, setting, methods Pregnancies (n = 11,289,466) resulting in a non-malformed singleton live birth in the US from 2015–2017. Associations were estimated from log-linear Poisson regression models with robust variance. Risk ratio (RR) and 95% confidence interval (CI) were derived as the effect measure with adjustments for confounders. The impact of exposure misclassification and unmeasured confounding biases were assessed. A causal mediation analysis of the infertility treatment-mortality association with preterm delivery (<37 weeks) was performed. Main results and the role of chance Any infertility treatment was documented in 1.3% (n = 142,215) of singleton live births during the study period. Any infertility treatment was associated with a 70% increased adjusted risk of neonatal mortality (RR 1.70, 95% CI 1.54–1.88), with an even higher risk for early neonatal (RR 1.82, 95% CI 1.63–2.05) than late neonatal (RR 1.37, 95% CI 1.11–1.69) mortality. These risks were similar among pregnancies conceived through ART and treatment with fertility-enhancing drugs. The mediation analysis showed that 68% (95% CI 59–81) of the total effect of infertility treatment on neonatal mortality was mediated through preterm delivery. In a sensitivity analysis, following corrections for exposure misclassification and unmeasured confounding biases, these risks were higher for early neonatal (bias-corrected RR [RRbc] 2.94 95% CIbc 2.16–4.01), but not for late neonatal (RRbc 1.04, 95% CIbc 0.68–1.59) mortality. Limitations, reasons for caution Limitations of the study include the potential underreporting of infertility treatment on birth certificates and potential confounding from sociodemographic characteristics that were not accounted for in this study. Wider implications of the findings: Pregnancies conceived with infertility treatment are associated with increased neonatal mortality and this association is mediated by the increased risk of preterm delivery. Knowledge of this risk should be shared with prospective couples consulting for fertility care in order to best provide adequate informed consent. Trial registration number Not applicable

The Legacies of the Second Slavery

2019 ◽  
pp. 11-46
Author(s):  
Rafael Marquese
Keyword(s):  
United States ◽  
The United States ◽  
National State ◽  
American Capitalism ◽  
The Us ◽  
The Impact ◽  
Cotton Plantations

Chapter 1 by Rafael Marquese compares the impact of the demise of slavery in the US and Brazil and the transformation of the coffee economies and cotton economies. Marquese connects American Reconstruction with larger global processes to explore the reorganization of the national state and American capitalism that took place in the Era of Globalization (1870–1914). He shows how “Second Slavery,” a concept articulated by Dale Tomich, provides a model for understanding both the integrated trajectory of slavery in Brazil and the United States and the ways the coffee plantationa and economies and the cotton plantations and economies of these nations interacted after emancipation.

Western Europe and the collapse of Bretton Woods

2019 ◽  
Vol 74 (2) ◽  
pp. 282-300
Author(s):  
Michael De Groot
Keyword(s):  
United States ◽  
Western Europe ◽  
Domestic Politics ◽  
The United States ◽  
Rate System ◽  
Bretton Woods ◽  
The Us ◽  
Exchange Rate System ◽  
The 1960S ◽  
The Impact

This article contends that Western Europe played a crucial and overlooked role in the collapse of Bretton Woods. Most scholars highlight the role of the United States, focusing on the impact of US balance of payments deficits, Washington’s inability to manage inflation, the weakness of the US dollar, and American domestic politics. Drawing on archival research in Britain, Germany, the Netherlands, and the United States, this article argues that Western European decisions to float their currencies at various points from 1969 to 1973 undermined the fixed exchange rate system. The British, Dutch, and West Germans opted to float their currencies as a means of protecting against imported inflation or protecting their reserve assets, but each float reinforced speculators’ expectations that governments would break from their fixed parities. The acceleration of financial globalization and the expansion of the Euromarkets in the 1960s made Bretton Woods increasingly difficult to defend.

scholarly journals Museums Connect: Teaching Public History through Transnational Museum Partnerships

2015 ◽  
Vol 22 ◽  
pp. 56-68
Author(s):  
Richard J. W. Harker
Keyword(s):  
United States ◽  
Public History ◽  
The United States ◽  
Collaborative Partnership ◽  
Holocaust Education ◽  
Department Of State ◽  
Significant Power ◽  
Power Differentials ◽  
The Us ◽  
The Impact

Museums Connect is a program funded by the US Department of State and administered by the American Alliance of Museums that sponsors transnational museum partnerships. This program provides one model for teaching public history in a transnational context, and this article analyzes the experiences of two university-museums—the Museum of History and Holocaust Education (MHHE) in the United States and the Ben M’sik Community Museum (BMCM) in Morocco—during two grants between 2009 and 2012. In exploring the impact of the program on the staff, faculty, and students involved and by analyzing the experiences and reflections of participants, I argue that this program can generate positive pedagogical experiences. However, in addition to the successes of the MHHE and BMCM during their two grants, the participants encountered significant power differentials that manifested themselves in both the processes and products of the grants. It is the conclusion of this article that both partners in a public history project need to address and confront potential power issues at the outset in order to achieve a more balanced, collaborative partnership.

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