infant outcomes
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2022 ◽  
Vol 19 (1) ◽  
Author(s):  
Caitlin Shannon ◽  
Chris Hurt ◽  
Seyi Soremekun ◽  
Karen Edmond ◽  
Sam Newton ◽  
...  

Abstract Background Globally adopted health and development milestones have not only encouraged improvements in the health and wellbeing of women and infants worldwide, but also a better understanding of the epidemiology of key outcomes and the development of effective interventions in these vulnerable groups. Monitoring of maternal and child health outcomes for milestone tracking requires the collection of good quality data over the long term, which can be particularly challenging in poorly-resourced settings. Despite the wealth of general advice on conducting field trials, there is a lack of specific guidance on designing and implementing studies on mothers and infants. Additional considerations are required when establishing surveillance systems to capture real-time information at scale on pregnancies, pregnancy outcomes, and maternal and infant health outcomes. Main body Based on two decades of collaborative research experience between the Kintampo Health Research Centre in Ghana and the London School of Hygiene and Tropical Medicine, we propose a checklist of key items to consider when designing and implementing systems for pregnancy surveillance and the identification and classification of maternal and infant outcomes in research studies. These are summarised under four key headings: understanding your population; planning data collection cycles; enhancing routine surveillance with additional data collection methods; and designing data collection and management systems that are adaptable in real-time. Conclusion High-quality population-based research studies in low resource communities are essential to ensure continued improvement in health metrics and a reduction in inequalities in maternal and infant outcomes. We hope that the lessons learnt described in this paper will help researchers when planning and implementing their studies.


HIV Medicine ◽  
2021 ◽  
Author(s):  
Monique Lettow ◽  
Beth A. Tippett Barr ◽  
Joep J. Oosterhout ◽  
Erik Schouten ◽  
Andreas Jahn ◽  
...  

2021 ◽  
Author(s):  
Anne Driscoll ◽  
Elizabeth Gregory

This report presents data on distributions in prepregnancy body mass index, including the three classes of obesity, by maternal race and Hispanic origin for women who gave birth in 2020.


2021 ◽  
Author(s):  
Kathryn Sarullo ◽  
Deanna Barch ◽  
Christopher Smyser ◽  
Cynthia Rogers ◽  
Barbara Warner ◽  
...  

Race is commonly used as a proxy for multiple features including socioeconomic status. It is critical to dissociate these factors, identify mechanisms that impact infant outcomes, such as birthweight, and direct appropriate interventions and shape public policy. Demographic, socioeconomic, and clinical variables were used to model infant birthweight. Non-linear neural networks better model infant birthweight than linear models (R^2=0.172 vs. R^2=0.145, p-value=0.005). In contrast to linear models, non-linear models ranked income, neighborhood disadvantage, and experiences of discrimination higher in importance while modeling birthweight than race. Consistent with extant social science literature, findings suggest race is a linear proxy for non-linear factors. The ability to disentangle and identify the source of effects for socioeconomic status and other social factors that often correlate with race is critical for the ability to appropriately target interventions and public policies designed to improve infant outcomes as well as point out the disparities in these outcomes.


2021 ◽  
Author(s):  
Pingying Jiang ◽  
Yongzhu Huang ◽  
Kaiyi Mao ◽  
Yongxu Lin ◽  
Dan Li ◽  
...  

Abstract Background The effect of hepatitis B virus (HBV) replication during pregnancy on the outcomes of singleton pregnancies is not fully understood. In this study, we investigated the association between HBV replication and poor maternal and infant outcomes. Methods We retrospectively analyzed the clinical data of 836 pregnant inpatients with hepatitis B surface antigen positivity who delivered at two provincial tertiary grade A hospitals in Fujian Province from June 2016 to October 2020. The patients were divided into the HBV replication (n = 283) and non-HBV replication groups (n = 553). Chi-squared test of adverse maternal and infant outcomes was performed using SPSS 26.0 software, and univariate analysis of variance of basic clinical indexes of pregnant women and newborns was performed. P<0.05 was considered statistically significant. Results The incidences of perinatal outcomes of intrahepatic cholestasis of pregnancy, hypertensive syndrome complicating pregnancy, gestational diabetes mellitus, preterm birth, macrosomia, growth restriction, and vaginal infection in the HBV and non-HBV replication groups were not significantly different (P>0.05); however, there were significant differences between the two groups in the rate of cesarean section (53.8% vs. 45.0%; P=0.017) and neonatal jaundice (15.5% vs. 7.2%; P=0.000). After using propensity score analysis and multivariable modeling to adjust for glutamic pyruvic transaminase and glutamic oxaloacetic transaminase levels in the two groups, the replication group was found to have an increased risk for cesarean section (54.3% vs. 33.5%; P=0.000) and vaginal infection (3% vs. 0.4%; P=0.038), and their infants had a higher rate of newborn jaundice (16% vs.1.5%; P=0.000). Conclusion The findings provide further understanding of the association between maternal HBV replication status and perinatal outcomes. Pregnant women with viral replication have an increased risk of vaginal infection and cesarean section, and their infants appear to be at a higher risk for neonatal jaundice.


2021 ◽  
Author(s):  
Chad Lance Hemady ◽  
Lydia Gabriela Speyer ◽  
Janell Kwok ◽  
Franziska Meinck ◽  
G.J. Melendez-Torres ◽  
...  

Objective: The effects of maternal exposure to adverse childhood experiences (ACEs) may be transmitted to subsequent generations through various biopsychosocial mechanisms. However, studies tend to focus on exploring one or two focal pathways with less attention paid to links between different pathways. Using a network approach, this paper explores a range of core prenatal risk factors that may link maternal ACEs to infant preterm birth (PTB) and low birthweight (LBW). Methods: We used data from the Avon Longitudinal Study of Parents and Children (ALSPAC) (n = 8 379) to estimate two mixed graphical network models: Model 1 was constructed using adverse infant outcomes, biopsychosocial and environmental risk factors, forms of ACEs, and sociodemographic factors. In Model 2, ACEs were combined to represent a threshold ACEs score (≥ 4). Network indices were estimated to determine the shortest pathway from ACEs to infant outcomes, and to identify the risk factors that are most vital in bridging these variables. Results: In both models, childhood and prenatal risk factors were highly interrelated. Childhood physical abuse, but not threshold ACEs, was directly linked to LBW. Further, exposure to second-hand smoke, developing gestational hypertension, prenatal smoking, first time pregnancy, not being White, and older age were directly linked to LBW, while developing gestational diabetes, having previous pregnanc(ies), and lower educational attainment were associated with PTB. Only pre-eclampsia was directly linked to both outcomes. Network indices and shortest pathways plots indicate that sexual abuse played a central role in bridging ACEs to other risks and poor infant outcomes. Overall, prenatal smoking was determined as the most influential bridge node. Conclusions: As child physical abuse was directly linked to low birthweight, and child sexual abuse and prenatal smoking were the most influential bridge nodes, they can be considered priority candidate targets for interventions to disrupt intergenerational risk transmission. Further, our study demonstrates the promise of network analysis as an approach for illuminating the intergenerational transmission of adversity in its full complexity.


Children ◽  
2021 ◽  
Vol 8 (12) ◽  
pp. 1169
Author(s):  
Brendan Mulcahy ◽  
Daniel L. Rolnik ◽  
Alexia Matheson ◽  
Yizhen Liu ◽  
Kirsten R. Palmer ◽  
...  

Background Community lockdowns during the coronavirus disease 2019 (COVID-19) pandemic may influence preterm birth rates, but mechanisms are unclear. Methods We compared neonatal outcomes of preterm infants born to mothers exposed to community lockdowns in 2020 (exposed group) to those born in 2019 (control group). Main outcome studied was composite of significant neonatal morbidity or death. Results Median gestational age was 35 + 4 weeks (295 infants, exposed group) vs. 35 + 0 weeks (347 infants, control group) (p = 0.108). The main outcome occurred in 36/295 (12.2%) infants in exposed group vs. 46/347 (13.3%) in control group (p = 0.69). Continuous positive airway pressure (CPAP) use, jaundice requiring phototherapy, hypoglycaemia requiring treatment, early neonatal white cell and neutrophil counts were significantly reduced in the exposed group. Conclusions COVID-19 community lockdowns did not alter composite neonatal outcomes in preterm infants, but reduced rates of some common outcomes as well as early neonatal inflammatory markers.


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