Search

Background: Studies suggest biologic mechanisms for gestational exposure to radiation and impaired fetal development. We explored associations between gestational radon exposure and term low birthweight, for which evidence is limited. Methods: We examined data for 68,159 singleton full-term births in Connecticut, United States, 2016-2018. Using a radon spatiotemporal model, we estimated ZIP code-level basement and ground-level exposures during pregnancy and trimesters for each participant's address at birth or delivery. We used logistic regression models, including confounders, to estimate odds ratios (ORs) for term low birth weight in four exposure quartiles (Q1-Q4) with the lowest exposure group (Q1) as the reference. Results: Exposure levels to basement radon throughout pregnancy (0.27-3.02 pCi/L) were below the guideline level set by the US Environmental Protection Agency (4 pCi/L). The ORs for term low birth weight in the second-highest (Q3; 1.01-1.33 pCi/L) exposure group compared with the reference (<0.79 pCi/L) group for basement radon during the first trimester was 1.22 (95% confidence interval [CI] = 1.02, 1.45). The OR in the highest (Q4; 1.34-4.43 pCi/L) quartile group compared with the reference group during the first [ABSTRACT FROM AUTHOR]

Prenatal exposure to perfluoroalkyl and polyfluoroalkyl substances (PFASs) may cause adverse birth outcomes. Thyroid hormones may play a key role in mediating the effects of PFAS. We enrolled 374 mother-infant pairs from the Ezhou birth cohort study between 2019 and 2020. Eight PFASs and six thyroid hormones were measured in maternal serum during the first trimester of pregnancy. Neonatal growth metrics, including birth weight, length, head circumference, and gestational age, were acquired. Multivariate linear regression was performed to determine the associations between maternal serum PFAS and thyroid hormone levels and birth outcomes and a mediation analysis was also conducted. Except for perfluoroheptanoic acid (41.2%), the other seven PFAS detection rates were more than 85%, and the highest median concentration was observed for PFOSA with levels of 5.21 ng/mL. After controlling for typical confounders, we observed a decrease in birth length (cm) with increasing serum concentrations of perfluorononanoic acid (PFNA) (β = -0.54; 95% CI = -1.0, -0.08) and perfluorohexane sulfonate (PFHxS) (β = -0.64; 95% CI = -0.86, -0.42). Additionally, a decrease in birth head circumference was observed with increasing concentrations of perfluorooctanote (PFOA) (β = -0.73, 95% CI = -1.19, -0.27) and PFHxS (β = -0.30; 95% CI = -0.53, -0.07). Maternal free triiodothyronine (FT3) mediated 36.7% of the negative association between PFNA and birth length, and free thyroxine (FT4) mediated 30.8% of the effect of PFOA on head circumference. When performing stratified analysis by infant sex, the associations might differ between boys and girls. Our study suggested prenatal exposure to some PFASs was negatively associated with birth length and circumference, and FT3 and FT4 may partly mediate the association. [ABSTRACT FROM AUTHOR]

Abstract Prenatal exposure to perfluoroalkyl and polyfluoroalkyl substances (PFASs) may cause adverse birth outcomes. Thyroid hormones may play a key role in mediating the effects of PFAS. We enrolled 374 mother-infant pairs from the Ezhou birth cohort study between 2019 and 2020. Eight PFASs and six thyroid hormones were measured in maternal serum during the first trimester of pregnancy. Neonatal growth metrics, including birth weight, length, head circumference, and gestational age, were acquired. Multivariate linear regression was performed to determine the associations between maternal serum PFAS and thyroid hormone levels and birth outcomes and a mediation analysis was also conducted. Except for perfluoroheptanoic acid (41.2%), the other seven PFAS detection rates were more than 85%, and the highest median concentration was observed for PFOSA with levels of 5.21 ng/mL. After controlling for typical confounders, we observed a decrease in birth length (cm) with increasing serum concentrations of perfluorononanoic acid (PFNA) (β = -0.54; 95% CI = -1.0, -0.08) and perfluorohexane sulfonate (PFHxS) (β = -0.64; 95% CI = -0.86, -0.42). Additionally, a decrease in birth head circumference was observed with increasing concentrations of perfluorooctanote (PFOA) (β = -0.73, 95% CI = -1.19, -0.27) and PFHxS (β = -0.30; 95% CI = -0.53, -0.07). Maternal free triiodothyronine (FT3) mediated 36.7% of the negative association between PFNA and birth length, and free thyroxine (FT4) mediated 30.8% of the effect of PFOA on head circumference. When performing stratified analysis by infant sex, the associations might differ between boys and girls. Our study suggested prenatal exposure to some PFASs was negatively associated with birth length and circumference, and FT3 and FT4 may partly mediate the association.

Abstract Background To investigate the association between maternal sepsis during pregnancy and poor pregnancy outcome and to identify risk factors for poor birth outcomes and adverse perinatal events. Methods We linked the Taiwan Birth Cohort Study (TBCS) database and the Taiwanese National Health Insurance Database (NHID) to conduct this population-based study. We analysed the data of pregnant women who met the criteria for sepsis-3 during pregnancy between 2005 and 2017 as the maternal sepsis cases and selected pregnant women without infection as the non-sepsis comparison cohort. Sepsis during pregnancy and fulfilled the sepsis-3 definition proposed in 2016. The primary outcome included low birth weight (LBW,

Background: To investigate the association between maternal sepsis during pregnancy and poor pregnancy outcome and to identify risk factors for poor birth outcomes and adverse perinatal events. Methods: We linked the Taiwan Birth Cohort Study (TBCS) database and the Taiwanese National Health Insurance Database (NHID) to conduct this population-based study. We analysed the data of pregnant women who met the criteria for sepsis-3 during pregnancy between 2005 and 2017 as the maternal sepsis cases and selected pregnant women without infection as the non-sepsis comparison cohort. Sepsis during pregnancy and fulfilled the sepsis-3 definition proposed in 2016. The primary outcome included low birth weight (LBW, < 2500 g) and preterm birth (< 34 weeks), and the secondary outcome was the occurrence of adverse perinatal events. Results: We enrolled 2,732 women who met the criteria for sepsis-3 during pregnancy and 196,333 non-sepsis controls. We found that the development of maternal sepsis was highly associated with unfavourable pregnancy outcomes, including LBW (adjOR 9.51, 95% CI 8.73–10.36), preterm birth < 34 weeks (adjOR 11.69, 95%CI 10.64–12.84), and the adverse perinatal events (adjOR 3.09, 95% CI 2.83–3.36). We also identified that socio-economically disadvantaged status was slightly associated with an increased risk for low birth weight and preterm birth. Conclusion: We found that the development of maternal sepsis was highly associated with LBW, preterm birth and adverse perinatal events. Our findings highlight the prolonged impact of maternal sepsis on pregnancy outcomes and indicate the need for vigilance among pregnant women with sepsis. [ABSTRACT FROM AUTHOR]

The relationship between exposure to air pollutants and fetal growth outcomes has shown inconsistency, and only a limited number of studies have explored the impact of air pollution on gestational hypertension and birth outcomes. This study aimed to evaluate how maternal exposure to air pollutants and blood pressure could influence fetal birth outcomes. A total of 55 women with gestational hypertension and 131 healthy pregnant women were enrolled in this study. Data pertaining to personal characteristics, prenatal examinations, outdoor air pollutant exposure, and fetal birth outcomes were collected. The study revealed that fetal birth weight and abdominal circumference exhibited a significant reduction among women with gestational hypertension compared to healthy pregnant women, even after adjustments for body mass index, gestational age, and exposure to air pollutants had been made. Moreover, maternal exposure to outdoor air pollutants displayed a notable correlation with decreased birth length of fetuses. Consequently, the study concluded that maternal blood pressure and exposure to outdoor air pollutants during pregnancy potentially stand as pivotal factors influencing fetal birth outcomes. [ABSTRACT FROM AUTHOR]

BackgroundPrenatal drug use may cause toxicity to bone health in newborns. We aimed to examine whether birth outcomes mediate the association between medication use and neonatal metabolic bone disease (MBD).MethodsA prospective cohort of 10,801 pregnant women (17–49 years) and their infants followed at a single center from 1 January 2012 to 31 December 2021 were included. Based on four single drugs, comprehensive medication use was determined and categorized into three groups using latent-class analysis: group 1 included antibiotics and furosemide or less than two drugs except for MgSO4; group 2 included MgSO4 without antibiotics or furosemide; and group 3 encompassed dexamethasone and antibiotics. Mediation analysis was conducted to assess the mediating effects of prematurity, low birth weight (LBW), and small for gestational age (SGA).ResultsThere were 138 (1.3%) infants with MBD; 2,701 (25%) were born preterm, 1717 (15.9%) had LBW, and 303 (2.8%) were SGA. Pregnant women in groups 2 and 3 were 2.52 to 14.66 times more likely to deliver an infant with MBD than those in group 1. Only LBW showed a significant mediating effect on the association between comprehensive medication use and MBD, with a mediation proportion of 51.8% (45.0–64.1%, p

Abstract Background Previous studies of maternal iron and birth outcomes have been limited to single indicators that do not reflect the comprehensive relationship with birth outcomes. We aimed to investigate the relationship between maternal iron metabolism and neonatal anthropometric indicators using comprehensive iron-related indicators. Methods A total of 914 Chinese mother-child dyads were enrolled in this prospective study. Subjects’ blood samples were collected at ≤ 14 weeks of gestation. Serum concentrations of iron-related indicators were measured by enzyme-linked immunosorbent assay (ELISA). Femur length was measured by B-ultrasound nearest delivery. Neonatal anthropometric indicators were collected from medical records. Results After adjustment for potential covariates, higher iron (per one standard deviation, SD increase) was detrimentally associated with − 0.22 mm lower femur length, whereas higher transferrin (per one SD increase) was associated with 0.20 mm higher femur length. Compared with normal subjects (10th-90th percentiles), subjects with extremely high (> 90th percentile) iron concentration were detrimentally associated with lower femur length, birth weight, and chest circumference, and a higher risk of low birth weight, LBW (HR: 3.92, 95%CI: 1.28, 12.0). Subjects with high concentration of soluble transferrin receptor, sTFR and transferrin (> 90th percentile) were associated with higher femur length. Subjects with low concentration of iron and ferritin concentrations (

Introduction: Lithium use during pregnancy reduces the risk of mood episodes in the perinatal period for women with bipolar disorder. Some previous studies found deleterious effects of intrauterine lithium exposure on birth outcomes, yet little is known about a dose response relationship. The current study investigated the influence of maternal lithium serum levels on birth outcomes. Methods: This retrospective observational cohort study included women with a bipolar spectrum disorder who were referred to a specialized psychiatric and obstetric outpatient clinic from 2003 to 2019 and used lithium during the entire pregnancy. For 101 pregnancies at least one lithium level during pregnancy was available. A weighted average lithium level was calculated for the entire pregnancy, as well as for each trimester. Detailed information on maternal, obstetric and neonatal outcomes were retrieved from the medical records. Linear and logistic regression models were used to investigate the association between weighted average lithium level and pregnancy duration, birth weight percentiles, preterm birth and large for gestational age births (LGA). In subsequent exploratory analyses, we studied the role of thyroid‐stimulating hormone (TSH) and thyroxine (T4) as a mediator in the found associations. Results: The weighted average lithium serum level during pregnancy was negatively associated with pregnancy duration and positively with preterm birth, but not with birth weight percentile or LGA. In exploratory analyses, TSH and T4 did not mediate the association between average lithium serum level and pregnancy duration. Conclusion: The results of this cohort study during pregnancy indicate a dose response relationship between maternal lithium serum levels and pregnancy duration. [ABSTRACT FROM AUTHOR]

Background: Previous studies of maternal iron and birth outcomes have been limited to single indicators that do not reflect the comprehensive relationship with birth outcomes. We aimed to investigate the relationship between maternal iron metabolism and neonatal anthropometric indicators using comprehensive iron-related indicators. Methods: A total of 914 Chinese mother-child dyads were enrolled in this prospective study. Subjects' blood samples were collected at ≤ 14 weeks of gestation. Serum concentrations of iron-related indicators were measured by enzyme-linked immunosorbent assay (ELISA). Femur length was measured by B-ultrasound nearest delivery. Neonatal anthropometric indicators were collected from medical records. Results: After adjustment for potential covariates, higher iron (per one standard deviation, SD increase) was detrimentally associated with − 0.22 mm lower femur length, whereas higher transferrin (per one SD increase) was associated with 0.20 mm higher femur length. Compared with normal subjects (10th-90th percentiles), subjects with extremely high (> 90th percentile) iron concentration were detrimentally associated with lower femur length, birth weight, and chest circumference, and a higher risk of low birth weight, LBW (HR: 3.92, 95%CI: 1.28, 12.0). Subjects with high concentration of soluble transferrin receptor, sTFR and transferrin (> 90th percentile) were associated with higher femur length. Subjects with low concentration of iron and ferritin concentrations (< 10th percentile) were associated with a higher risk of LBW (HR: 4.10, 95%CI: 1.17, 14.3) and macrosomia (HR: 2.79, 95%CI: 1.06, 7.35), respectively. Conclusions: Maternal iron overload in early pregnancy may be detrimentally associated with neonatal anthropometric indicators and adverse birth outcomes. [ABSTRACT FROM AUTHOR]

Abstract Objective Early onset of adiposity rebound (AR) is considered an early indicator of obesity risk. Our objective was to investigate the association of birth outcomes and early physical growth patterns with early AR in children. Methods Study subjects (n = 2705) were enrolled from the Ma’anshan birth cohort (MABC). The body mass index (BMI), head circumference, waist circumference, and body fat were collected. Rapid weight gain (RWG) was defined by the change in weight standard-deviation score in the first two years of life. Group-based trajectory modeling (GBTM) was used to determine children’s physical growth trajectories. The age of AR was fitted using fractional polynomial function models. Results Children with very high BMI trajectories (RR = 2.83; 95% CI 2.33 to 1.40), rising BMI trajectories (RR = 3.15; 95% CI 2.66 to 3.72), high waist circumference trajectories (RR = 4.17; 95% CI 3.43 to 5.06), and high body fat trajectories (RR = 3.01; 95% CI 2.62 to 3.46) before 72 months of age were at a greater risk of experiencing early AR. Low birth weight (LBW) (RR = 1.86; 95% CI 1.28 to 2.51), preterm birth (PTB) (RR = 1.50; 95% CI 1.17 to 1.93), and small for gestational age (SGA) (RR = 1.37; 95% CI 1.14 to 1.64) associated with increased risk of early AR. Moreover, infants experiencing RWG (RR = 1.59; 95% CI 1.40 to 1.83), low BMI trajectories (RR = 1.27; 95% CI 1.06 to 1.53) and rising BMI trajectories (RR = 1.50; 95% CI 1.22 to 1.84) in the first two years were at higher risk of developing early AR subsequently. Compared to the group with non-early AR, the BMI of children with early AR tended to be lower first (from birth to 6 months of age) and then higher (from 18 to 72 months of age). Conclusions Children with overall high BMI, high waist circumference, and high body fat before 72 months of age are more likely to experience early AR, but infants with low BMI trajectories, rising BMI trajectories and infants experiencing RWG in the first two years of life similarly increase the risk of early AR. These results can help to understand the early factors and processes that lead to metabolic risks.

Background While studies have demonstrated that certain COVID-19 vaccines administered during pregnancy did not affect neonatal or maternal outcomes significantly, the safety of inactivated SARS-CoV-2 vaccines in China, given during the first trimester, remains to be fully elucidated. Method A retrospective cohort study was conducted involving female participants who gave birth from January to October 2021. The study compared pregnancy, delivery, and neonatal outcomes between subjects who received one or two doses of the inactivated COVID-19 vaccines during their first trimester and unvaccinated control subjects. Results A total of 2658 pregnant women was recruited. Among them, 2358 (88.7%) reported ongoing pregnancies; 326 (13.8%) of these were vaccinated. Additionally, 277 (10.4%) experienced spontaneous miscarriages between 6 to 20 gestational weeks; 40 (14.4%) of these were vaccinated, yielding an odds ratio of 0.67–1.36 (95% confidence interval) for COVID-19 vaccination. The comparison of neonatal complications, including an Apgar score less than 7, preterm birth, low birth weight, and newborn respiratory complications, between unvaccinated and vaccinated participants revealed no statistical significance. Conclusion The administration of COVID-19 inactivated vaccines during the first trimester of pregnancy is not associated with adverse pregnancy or neonatal outcomes, providing a substantial ground for pertinent health education.

Background Many women diagnosed with cancer as adolescents and young adults (AYAs, age 15-39 years) want biological children after cancer but lack information on the potential impact of their cancer history on future reproductive outcomes. We investigated the risk of adverse birth outcomes among AYA cancer survivors. Methods We identified insured women diagnosed with AYA breast cancer, thyroid cancer, gynecologic cancers, lymphoma, or melanoma from 2003 to 2016 in the state of North Carolina or the Kaiser Permanente health care systems in northern and southern California. Post-diagnosis births to cancer survivors were each matched with up to 5 births to women without cancer. Risk ratios for preterm birth (<37 completed weeks), very preterm birth (<34 completed weeks), low birth weight (<2500 g), and small for gestational age (SGA, <10th percentile of weight for gestational age) were estimated using modified Poisson regression. Results Analyses included 1648 births to 1268 AYA cancer survivors and 7879 births to 6066 women without cancer. Overall, risk of preterm birth, very preterm birth, low birth weight, and SGA did not significantly differ between births to women with and without cancer. However, births to women with gynecologic cancers had a significantly increased risk of low birth weight (risk ratio = 1.82; 95% confidence interval: 1.03 to 3.21) and suggested increased risk of preterm birth (risk ratio = 1.59; 95% confidence interval: 0.99 to 2.54). Chemotherapy exposure was not associated with increased risk of adverse birth outcomes. Conclusions Women with gynecologic cancers, but not other cancers, had an increased risk of adverse birth outcomes compared to women without cancer. [ABSTRACT FROM AUTHOR]

Objective: Early onset of adiposity rebound (AR) is considered an early indicator of obesity risk. Our objective was to investigate the association of birth outcomes and early physical growth patterns with early AR in children. Methods: Study subjects (n = 2705) were enrolled from the Ma'anshan birth cohort (MABC). The body mass index (BMI), head circumference, waist circumference, and body fat were collected. Rapid weight gain (RWG) was defined by the change in weight standard-deviation score in the first two years of life. Group-based trajectory modeling (GBTM) was used to determine children's physical growth trajectories. The age of AR was fitted using fractional polynomial function models. Results: Children with very high BMI trajectories (RR = 2.83; 95% CI 2.33 to 1.40), rising BMI trajectories (RR = 3.15; 95% CI 2.66 to 3.72), high waist circumference trajectories (RR = 4.17; 95% CI 3.43 to 5.06), and high body fat trajectories (RR = 3.01; 95% CI 2.62 to 3.46) before 72 months of age were at a greater risk of experiencing early AR. Low birth weight (LBW) (RR = 1.86; 95% CI 1.28 to 2.51), preterm birth (PTB) (RR = 1.50; 95% CI 1.17 to 1.93), and small for gestational age (SGA) (RR = 1.37; 95% CI 1.14 to 1.64) associated with increased risk of early AR. Moreover, infants experiencing RWG (RR = 1.59; 95% CI 1.40 to 1.83), low BMI trajectories (RR = 1.27; 95% CI 1.06 to 1.53) and rising BMI trajectories (RR = 1.50; 95% CI 1.22 to 1.84) in the first two years were at higher risk of developing early AR subsequently. Compared to the group with non-early AR, the BMI of children with early AR tended to be lower first (from birth to 6 months of age) and then higher (from 18 to 72 months of age). Conclusions: Children with overall high BMI, high waist circumference, and high body fat before 72 months of age are more likely to experience early AR, but infants with low BMI trajectories, rising BMI trajectories and infants experiencing RWG in the first two years of life similarly increase the risk of early AR. These results can help to understand the early factors and processes that lead to metabolic risks. [ABSTRACT FROM AUTHOR]

Background: The physical environments in which women give birth can contribute positively to meeting both physiologic and psychosocial needs during labor. Most studies on the labor and delivery processes have focused on mitigating pain and providing psychological support. Fewer have explored the influence of the physical birth environment. In this study, we performed a scoping review to compile and examine qualitative and quantitative studies related to the characteristics of physical birth environments and their effects on labor outcomes. Methods: We searched the PubMed, CINHAL, Cochrane, Web of Science, and MEDLINE databases from inception to May 2022. A total of 13 studies met the criteria for inclusion in our review. Two reviewers screened the titles and full‐text articles and extracted data from the included studies. We used summary statistics and narrative summaries to describe the study characteristics, intervention implementation guidelines, intervention selection and tailoring rationale, and intervention effects. Results: In previous research, several elements of birth environments have been shown to provide physical and psychological support to birthing people and to improve outcomes related to the experience of care and pain management. We identified five main themes in the included studies: (1) "hominess;" (2) whether spaces are comfortable for activity; (3) demedicalization of the birth environment; (4) accommodations for birth partners; and (5) providing women with a sense of control over their birth environment. Conclusions: Birth environments should be designed to promote positive birthing experiences, both physiologically and psychologically. Facilities and those who manage them can improve the experiences and outcomes of service users by modifying or designing spaces that are "homey," comfortable for activity, demedicalized, and include natural elements. In addition, policies that allow the birthing person to control her own environment are key to promoting positive outcomes and satisfaction with the birth experience. [ABSTRACT FROM AUTHOR]

Copyright of African Journal of Reproductive Health is the property of Women's Health & Action Research Centre and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Problem: C‐reactive protein (CRP) is a marker for inflammation and its role as a possible biomarker for an early prediction of pre‐eclampsia (PE) is unclear. The present study investigates the levels of high‐sensitivity CRP (hs‐CRP) longitudinally across pregnancy in women with PE and compares them to women without PE (non‐PE). Method of Study: A total of 324 pregnant women [216 non‐PE and 108 PE women] were included in this study. Maternal blood was taken at four different intervals (V1 = 11–14 weeks, V2 = 18–22 weeks, V3 = 26–28 weeks, and V4 = at delivery). Results: Maternal serum hs‐CRP levels were higher at V1, V2, and V3 (p <.05 for all) in the PE group compared to the non‐PE group. The hs‐CRP levels were associated with maternal blood pressure throughout pregnancy. Maternal hs‐CRP levels did not differ among early and late onset PE. Higher maternal hs‐CRP levels were associated with the increased risk of PE in unadjusted model in early pregnancy. However, there was no significance after adjusting for confounding factors. Conclusions: Our findings suggest although the levels of hs‐CRP were higher in PE in early pregnancy, they are not associated with an increased risk of PE. [ABSTRACT FROM AUTHOR]

Objectives: In our study, we aim to determine: a) Transmission rate of SARS-COV-2 in neonates of SARS-COV-2 positive pregnant women. b) Transmission rate in different modes of delivery. Materials and methodology: A prospective hospital based study was conducted in Gauhati Medical College and Hospital, Guwahati for a period of six months. A total of 292 COVID -19 positive cases were delivered which includes antenatal patients and all postpartum patients within 14 days of delivery. The test undertaken was RT-PCR for identification of SARS COV-2. All data was analysed by SPSS version 21 and p-value of

Pesticides are widely used globally. Due to their widespread use, exposure to pesticides is of concern. In addition to occupational exposure, residential exposure during pesticide application is a concern for those living in or near agricultural areas. The objective of this study was to analyze the association between residential proximity to agricultural pesticide use and birth outcomes. The association between residential proximity to agricultural land use as pesticide exposure and birth outcomes was explored in a birth cohort including 283 pregnant women from a medical center in Hualien during 2013–2016. In the third trimester, we collected demographic information and the residential addresses of pregnant women via structured questionnaires. After delivery, newborn birth weight, gestational age, and head circumference were collected from medical records. Maternal residential address during pregnancy was collected for geospatial mapping. The percentages of farmland area within circular buffers of different sizes were applied to estimate pesticide exposure. Associations between residential proximity to agricultural land use as pesticide exposure and birth outcomes were analyzed by multiple linear regression analyses. A significantly smaller head circumference was associated with agricultural farmland located within 400 m (β = − 0.51 [95% CI, − 0.99, − 0.03], P = 0.037) and 500 m (β = − 0.67 [95% CI, − 1.14, − 0.19], P = 0.006) radii of residences in the tertile 2 group. A significantly smaller head circumference was also associated with dry farming area within 400 m (β = − 0.70 [95% CI, − 1.17, − 0.24], P = 0.003) and 500 m (β = − 0.81 [95% CI, − 1.27, − 0.34], P = 0.001) radii of residences in the tertile 2 group. The multivariate linear regression analyses did not show any significant association between residential farmland area and birth weight or gestational age. In conclusion, residential proximity to agricultural land use as pesticide exposure was associated with negative infant birth outcomes, especially a small head circumference. In the future, agricultural land use information could be combined with biological samples to more accurately assess exposure in pregnant women. [ABSTRACT FROM AUTHOR]

Objective The aim was to investigate birth outcome and birth experience in relation to women’s emotional health. An additional aim was to explore the relationship between emotional health, continuity with a known midwife, and the birth experience. Methods A prospective longitudinal cohort study of 243 women enrolled in a continuity of care project in a rural area in Sweden. Profiles were constructed from instruments measuring depressive symptoms, worries, fear of birth, and sense of coherence. Antenatal and birth records and questionnaires were used to collect data. Result Women were categorized into two cluster profiles: “emotionally healthy” vs. “emotionally unhealthy”. Women in the “emotionally unhealthy” cluster had a less positive birth experience (p = 0.006). The total score of the Childbirth Experience Questionnaire was highest in women who had had a known midwife assisting at birth. Babies born to women in the “emotionally unhealthy” cluster were more likely to have a severe neonatal diagnosis. Conclusion There were few differences in birth outcome between the clusters, while there were explicit differences in the childbirth experience. Having a known midwife is important to warrant women a more positive childbirth experience. Screening with validated instruments during antenatal care could be a first step to further investigate women’s emotional well-being and provide targeted psychosocial support.

According to the World Health Organization, midwife-led care is the most appropriate and cost-effective type of perinatal care. As the Covid-19 pandemic with its drastic changes and challenges for the health systems and the medical staff made large adjustments to the healthcare delivery system, midwife-led care became an even more important supportive tool in maintaining unnecessary interventions. This retrospective cohort study aims to compare the outcomes of midwife-led care and team-led care in low-risk births between the Covid-19 pandemic and non-Covid-19 pandemic period. The total studied population was 1,185 singleton births and consisted of 727 births during the non-Covid-19 period and 458 births from the Covid-19 period. The study revealed the safety of low-risk birth care during the first wave of the Covid-19 pandemic in both groups. The maternal and perinatal outcomes remained stable without an increased rate of unsuccessful vaginal births and newborn asphyxia; moreover, birth care of low-risk women provided by midwives preserved autonomy, integrity, and resistance to responding to a disaster. The aforementioned results exhibit that high-quality, safe supervision by midwives in low-risk births can be provided even in high-stress circumstances. [ABSTRACT FROM AUTHOR]

While studies have demonstrated that certain COVID-19 vaccines administered during pregnancy did not affect neonatal or maternal outcomes significantly, the safety of inactivated SARS-CoV-2 vaccines in China, given during the first trimester, remains to be fully elucidated. A retrospective cohort study was conducted involving female participants who gave birth from January to October 2021. The study compared pregnancy, delivery, and neonatal outcomes between subjects who received one or two doses of the inactivated COVID-19 vaccines during their first trimester and unvaccinated control subjects. A total of 2658 pregnant women was recruited. Among them, 2358 (88.7%) reported ongoing pregnancies; 326 (13.8%) of these were vaccinated. Additionally, 277 (10.4%) experienced spontaneous miscarriages between 6 to 20 gestational weeks; 40 (14.4%) of these were vaccinated, yielding an odds ratio of 0.67–1.36 (95% confidence interval) for COVID-19 vaccination. The comparison of neonatal complications, including an Apgar score less than 7, preterm birth, low birth weight, and newborn respiratory complications, between unvaccinated and vaccinated participants revealed no statistical significance. The administration of COVID-19 inactivated vaccines during the first trimester of pregnancy is not associated with adverse pregnancy or neonatal outcomes, providing a substantial ground for pertinent health education. [ABSTRACT FROM AUTHOR]

BACKGROUND: Induction of labor is defined as the process of artificially stimulating the uterus to start labor. Despite the unquestionable reputation of labor induction for ending pregnancies, there is a risk to the mother and/or the fetus. Studies from developed and developing countries report increased labor induction rates with additional cases of cesarean section (CS) and fetal distress. OBJECTIVE: The main aim of this study is to assess predictors of induction of labor and the success rate among mothers giving birth at Jimma University Medical Centre Southwest Ethiopia. METHODS: A facility based unmatched case control quantitative study design was done among 694 (cases = 347 plus controls is 347) mothers. A systematic random sampling technique was used to select both cases and controls from the registration delivery log book. A standard document review checklist was used to collect data. Multivariate binary logistic regression analysis was done to identify predictors of the outcome of the variable. RESULTS: The study findings revealed that the success rate of induction of labor in this study was 73.8%. Mothers with stillbirth history were three times more likely to be induced compared with mothers without stillbirth history. Mothers with abortion history were seven times more likely to be induced than mothers without an abortion history. Mothers with a gestational age of ≥42 weeks were 17 times more likely to be induced than mothers with a gestational age of 38–41 weeks. Mothers who had no antenatal care follow-up were seven times more likely to be induced than mothers who had antenatal care follow-up. CONCLUSION: Maternal age, gestational age, history of abortion, and history of stillbirth were significant predictors of induction of labor which was claimed to increase the rate of uterine rupture, CS and admission to a neonatal intensive care unit (NICU). [ABSTRACT FROM AUTHOR]

It has been well-investigating that individual phthalates (PAEs) or polycyclic aromatic hydrocarbons (PAHs) affect public health. However, there is still a gap that the mixture of PAEs and PAHs impacts birth outcomes. Through innovative methods for mixtures in epidemiology, we used a metabolome Exposome-Wide Association Study (mExWAS) to evaluate and explain the association between exposure to PAEs and PAHs mixtures and birth outcomes. Exposure to a higher level of PAEs and PAHs mixture was associated with lower birth weight (maximum cumulative effect: 143.5 g) rather than gestational age. Mono(2-ethlyhexyl) phthalate (MEHP) (posterior inclusion probability, PIP = 0.51), 9-hydroxyphenanthrene (9-OHPHE) (PIP = 0.53), and 1-hydroxypyrene (1-OHPYR) (PIP = 0.28) were identified as the most important compounds in the mixture. In mExWAS, we successfully annotated four overlapping metabolites associated with both MEHP/9-OHPHE/1-OHPYR and birth weight, including arginine, stearamide, Arg-Gln, and valine. Moreover, several lipid-related metabolism pathways, including fatty acid biosynthesis and degradation, alpha-linolenic acid, and linoleic acid metabolism, were disturbed. In summary, these findings may provide new insights into the underlying mechanisms by which PAE and PAHs affect fetal growth. [Display omitted] • The urinary PAHs and PAEs metabolite mixtures were associated with lower birth weight. • MEHP, 9-OHPHE and 1-OHPYR are the most important components. • Metabolic changes associated with PAE/PAH and birth weight were identified by MWAS. • Fatty acid, alpha linolenic acid and linoleic acid metabolism were disrupted. • Serum arginine, stearamide, Arg-Gln, and valine are potential intermediate biomarkers. [ABSTRACT FROM AUTHOR]

Summary: Background: The practice of antenatal care does not address the preconception health of future parents and should not be viewed as an isolated activity rather as a continuum of care. There is a need to develop a promotion and prevention strategy to promote optimal maternal health and future generation. Pre-conception care is a promising new preventive strategy for improving maternal and fetal health through a primary prevention approach. Although there are many ways to conduct interventions for a healthy pregnancy, pre-conception care is rarely used in Ethiopia. The aim of the proposed study is to identify the effect of pre-conceptual picture-based health education and counseling on adherence to iron-folic acid supplementation and the effect of iron-folic acid supplementation on birth outcomes. Methods: A two-arm, parallel randomized controlled community trial will be conducted among 244 women with spontaneous abortion and women planning to pregnant in Dire Dawa City Administration. Both arms receive iron-folic acid supplementation for three months, while only the intervention arm receives a treatment which is a preconception picture-based health education and counseling. Using multivariable logistic regression analyzes, the independent effect of picture-based health education and counseling on the outcome variables will be determined using both intention-to-treatment and per-protocol analyzes. Both arms will evaluate the result after one year. The primary outcome of the study is adherence to iron folic acid supplementation.This study will assess the effectiveness of preconception care counseling with iron-folic acid supplementation to increase adherence of IFAS and to avert the risk of neonates developing a neural tube defect and other adverse pregnancy and birth outcome among planned mothers to pregnant in eastern Ethiopia.This trail was registered under Clinical Trials.gov with identifier number PACTR202104543567379. The trail was registered before starting enrolment of the first case.

BackgroundWomen's death due to complications of pregnancy and childbirth is still high. Maternity waiting homes are one of the strategies to reduce it. However, there is limited evidence on the effect of using maternity waiting homes on birth outcomes, particularly in this study area. Therefore, this study was aimed to estimate the effect of staying in maternity waiting homes use on maternal and perinatal birth outcomes and its challenges in the Amhara region, Northwest Ethiopia 2018.MethodsInstitutional-based comparative cross-sectional study using both quantitative and qualitative approaches was conducted. Data were collected using structured questionnaire interviews, in-depth interview and chart reviews. Propensity score matching analysis was used to estimate the effect of maternity waiting homes use on birth outcomes. Propensity score matching analysis was used to match potential differences in background characteristics that affect pregnancy outcomes between comparison groups. We used thematic analysis for qualitative data.ResultA total of 548 pregnant mothers (274 stayed in maternity waiting homes 274 did not stay) took part in this study. The proportion of adverse birth outcomes of mothers who stayed in maternity waiting homes were 15(5.5%) which is lower than those who didn't stay 35 (12.8%). After matching with baseline covariates, mean difference of adverse maternal birth outcomes, the difference between didn't use maternity waiting home and used was 10.4%, at (t = 3.78) at 5% level of significance. Similarly, the mean adverse perinatal birth outcomes difference between mothers who didn't use MWHs and used was 11% (t = 4.33).ConclusionsMaternity waiting home showed a significant positive effect on birth outcomes. Mothers who stayed in the maternity waiting homes had low adverse maternal and perinatal birth outcomes compared to non-users. Accommodations and quality health care services were the challenges mothers faced during their stay in the maternity waiting homes. Therefore, all concerned bodies should give attention accordingly to maternity waiting home services to reduce adverse birth outcomes through the strengthening of the quality of health care provided.

OBJECTIVE:To investigate the relationship between depressive symptoms and preterm birth (PTB) while adjusting for social support, both general and from the father of the baby. DESIGN:Retrospective study design. SETTING:Participants of the Life-course Influences of Fetal Environments (LIFE) study were recruited from a suburban hospital in Metropolitan Detroit, Michigan. PARTICIPANTS:The LIFE data consisted of 1,410 self-identified Black women age 18 to 45 years; 1,207 women were included in this analysis. METHODS:Women were interviewed using a structured questionnaire administered 24 to 48 hours after birth during their postpartum hospitalization. Data on the newborns and their mothers' health were collected through medical record abstraction. The Center for Epidemiologic Studies Depression Scale (CES-D) was used to measure symptoms of depression. The CES-D scores ≥23 were considered severe symptoms of depression. Modified Poisson regression models were built using a stepwise approach to assess association between symptoms of depression and PTB. RESULTS:Approximately, 17% of women had a PTB and 20% of women in the sample had a CES-D scores ≥23. Women who had CES-D score ≥23 were about 70% more likely to have a PTB compared with women with CES-D scores

As phthalate metabolites might cross the placenta, it is possible to find them in the amniotic fluid. This cross-sectional study aims to investigate the levels of phthalate metabolites in the amniotic fluid of a sample of Iranian women and its association with neonatal anthropometric measures. The other objective was to study the potential sources of maternal exposure to phthalates. This study was conducted from June 2019 to June 2021 in Isfahan, Iran. Pregnant women were recruited from their first trimester of pregnancy and followed up until their delivery. Amniotic fluid samples were collected from those who were assigned to have delivery by cesarean section. Overall, 158 samples of amniotic fluid were collected, of which 139 samples had sufficient volume and were free of blood. Data from 142 newborns were included in this study. Four phthalate metabolites were measured using gas chromatography–mass spectrometry (GC–MS). After extraction of phthalate metabolites, 4 phthalate metabolites including mono-butyl phthalate (MBP; normal: 0.08 ± 0.79; overweight: 0.20 ± 1.11; obese: 0.07 ± 1.07; p-value: 0.405), mono-benzyl phthalate (MBzP; normal: 7.54 ± 6.69; overweight: 7.48 ± 7.16; obese: 8.67 ± 12.75; p-value: 0.729), mono(2-ethyl-5-oxohexyl) phthalate (MEOHP; normal: 4.27 ± 6.36; overweight: 3.03 ± 8.44; obese: 3.53 ± 7.04; p-value: 0.245), and mono(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP; normal: 246.18 ± 189.80; overweight: 238.48 ± 200.23; obese: 287.65 ± 206.70; p-value: 0.723) were simultaneously detected in samples of maternal amniotic fluid. Our findings suggest that maternal exposure to phthalate metabolites is positively associated with in utero exposure of the developing fetus. The geometric means and medians of MBP, MBzP, MEOHP, and MEHHP of detected samples were 10.17 (9.52), 6.24 (3.47), 5.03 (11.72), and 174.79 (229.94) (μg/L), respectively. The median anthropometric measures of newborns were as follows: weight 3171.8 g, height 49.6 cm, head circumferences 34.9 cm, chest 33.3 cm, hip 31.5 cm, and arm circumferences 10.8 cm. There was no statistically significant association between phthalate metabolites concentration and newborn's anthropometric measures (p > 0.05). Future studies should focus on the collection of amniotic fluid at different trimesters and the corresponding maternal samples to better characterize the association and health impacts of these endocrine-disrupting chemicals during fetal development. [ABSTRACT FROM AUTHOR]

Objective: To describe antiretroviral therapy (ART) regimens during pregnancy among women living with HIV (WLWH) in Denmark and to examine the association between ART use in pregnancy and adverse birth outcomes. Methods: A population‐based cohort study including all pregnancies among WLWH in Denmark between 2000 and 2019. Data were collected through national registries. Temporal trends of ART use in pregnancy were evaluated. Logistic regression models were used to examine the association of ART use in pregnancy and other risk factors with adverse birth outcomes. Results: In total, 589 pregnancies were included. Combination treatment with a nucleoside reverse transcriptase inhibitor (NRTI) and a protease inhibitor (PI) was the most common ART regimen (96%). ART regimen, PI use in pregnancy and timing of ART initiation were not significantly associated with increased odds of preterm birth, small for gestational age or low birth weight. First‐trimester initiation of ART was significantly associated with increased odds of intrauterine growth restriction in the multivariate analysis [adjusted odds ratio (aOR) = 3.78, 95% confidence interval (CI): 1.23–11.59], while first trimester PI use was associated with increased odds of IUGR in the univariate analysis only [OR = 3.24, 95% CI: 1.13–9.30]. Smoking, comorbidity, and maternal HIV RNA ≥ 50 copies/mL were independently associated with increased odds of adverse birth outcomes. Conclusions: Pregnant WLWH living in Denmark are generally well treated with HIV RNA < 50 copies/mL at delivery and NRTI + PI as the most common ART regimen used in pregnancy. Initiation of ART in the first trimester may be associated with poor fetal growth. The association between ART use in pregnancy and adverse birth outcomes may partly be explained by maternal risk factors. [ABSTRACT FROM AUTHOR]

Objective: The aim was to investigate birth outcome and birth experience in relation to women's emotional health. An additional aim was to explore the relationship between emotional health, continuity with a known midwife, and the birth experience.Methods: A prospective longitudinal cohort study of 243 women enrolled in a continuity of care project in a rural area in Sweden. Profiles were constructed from instruments measuring depressive symptoms, worries, fear of birth, and sense of coherence. Antenatal and birth records and questionnaires were used to collect data.Result: Women were categorized into two cluster profiles: "emotionally healthy" vs. "emotionally unhealthy". Women in the "emotionally unhealthy" cluster had a less positive birth experience (p = 0.006). The total score of the Childbirth Experience Questionnaire was highest in women who had had a known midwife assisting at birth. Babies born to women in the "emotionally unhealthy" cluster were more likely to have a severe neonatal diagnosis.Conclusion: There were few differences in birth outcome between the clusters, while there were explicit differences in the childbirth experience. Having a known midwife is important to warrant women a more positive childbirth experience. Screening with validated instruments during antenatal care could be a first step to further investigate women's emotional well-being and provide targeted psychosocial support. [ABSTRACT FROM AUTHOR]

Background: This review aimed at synthesizing evidence on the effectiveness of nutritional interventions that were carried out before and/or during early pregnancy versus the control groups on reducing the risk of low weight at birth in sub-Saharan Africa. Methods: We have searched on MEDLINE, SCOPUS, CINAHL, HINARI, and Cochrane Library of systematic review databases for published articles in English language from 2010 to 2021 years. For unpublished studies, we searched on Google scholar. Randomized controlled trial studies of nutritional interventions carried out before/or during early pregnancy in sub-Saharan Africa to improve low birth weight were considered. The data were extracted and pooled using the Joanna Briggs Institute software. The effect size was calculated using fixed-effect models. Mantel-Haenszel method was used to calculate the relative risk with their respective 95% CI. Heterogeneity was assessed using the standard chi-square and I 2 tests. Results: Seven studies were included in the review with a total of 5934 participants. Three types of nutritional interventions were identified: iron supplementations, lipid-based supplementations, and nutritional education and counseling. We have identified only one intervention started during preconception. The meta-analysis showed that none of the identified nutrition interventions had a statistically significant effect on low birth weight. Conclusions: Based on the review evidence, nutritional interventions before and/or during early pregnancy in sub-Saharan Africa had no significant effect on low birth weight. However, since our evidence was derived from a small number of trials and participants, a large-scale randomized controlled trials review might be required to elucidate the finding. [ABSTRACT FROM AUTHOR]

Background: Prenatal drug use may cause toxicity to bone health in newborns. We aimed to examine whether birth outcomes mediate the association between medication use and neonatal metabolic bone disease (MBD)., Methods: A prospective cohort of 10,801 pregnant women (17-49 years) and their infants followed at a single center from 1 January 2012 to 31 December 2021 were included. Based on four single drugs, comprehensive medication use was determined and categorized into three groups using latent-class analysis: group 1 included antibiotics and furosemide or less than two drugs except for MgSO 4 ; group 2 included MgSO 4 without antibiotics or furosemide; and group 3 encompassed dexamethasone and antibiotics. Mediation analysis was conducted to assess the mediating effects of prematurity, low birth weight (LBW), and small for gestational age (SGA)., Results: There were 138 (1.3%) infants with MBD; 2,701 (25%) were born preterm, 1717 (15.9%) had LBW, and 303 (2.8%) were SGA. Pregnant women in groups 2 and 3 were 2.52 to 14.66 times more likely to deliver an infant with MBD than those in group 1. Only LBW showed a significant mediating effect on the association between comprehensive medication use and MBD, with a mediation proportion of 51.8% (45.0-64.1%, p  < 0.001)., Conclusion: Comprehensive medication use during pregnancy was associated with an increased risk of neonatal MBD, largely mediated by LBW. Early antepartum monitoring and prevention targeting adverse birth outcomes are necessary to mitigate the risk of MBD., Competing Interests: HL and JY were employed by the company Aigora technology PTE. LTD, TRIVEX. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Jiang, Guo, Li, Li, Du, Canavese, Xie, Li, Yang, Ying and Hua.)

Assisted reproductive technologies (ARTs) such as in vitro fertilisation (IVF) and intracytoplasmic sperm injection (ICSI) are still discussed critically, as there is no consensus on whether these treatments could be the cause of risk factors for obstetric problems such as breech presentation. The aim of this study was to test the association between ART and breech presentation among 11920 singleton term births taking place in Vienna from 2010 to 2020. In this single-centre medical record-based study, data concerning the conception mode (spontaneous versus IVF or ICSI), child presentation, birth mode, newborn sex and size as well as age, height, weight, and reproductive history of the mother were included. Three hundred twenty-six newborns (2.7%) were conceived by IVF or ICSI, and 527 newborns (4.4%) were delivered in breech presentation. Breech presentation occurred in 7.6% of IVF/ICSI children but only in 4.3% of spontaneously conceived children ( P = 0.019). ART increased the crude risk of breech presentation significantly (OR = 1.67; 95% CI 1.71 - 2.38). After adjusting for maternal age, height, number of previous births, smoking, and newborn sex, however, ART had no longer a significant impact on the risk of breech presentation. In contrast, breech presentation was significantly associated with higher maternal age as well as a lower number of previous births, but not with ART. This study shows that the adverse outcomes of IVF and ICSI pregnancies may not be due to the ART treatment alone but might also be due to the mostly higher age and lower parity of the mothers using ART.

Studies have shown that prenatal ozone exposure is associated with an increased risk of adverse pregnancy outcomes, among which abnormal birth weight is a detrimental factor for diseases in adulthood, but the association between birth weight and ozone is inconclusive. Herein, we conducted this study by enrolling 407 couples of pregnant women and collected their demographical materials, their exposure to ambient ozone was assessed according to the place of their residence. The hourly monitored ozone was first averaged to the daily level, then monthly and whole-gestationally levels. After adjusting confounders, we processed a multivariate generalized addictive analysis to predict the association between prenatal ozone exposure and birth weight. We also divided the cohort into two categories according to whether the infant met the standard of macrosomia, and the occurrence of macrosomia was studied via univariate and multivariate logistic regression analyses as extreme conditions of the effects of ozone exposure on birth weight. We found that the ground-level ozone in Jinan changed with temperature periodically, higher in summer and lower in winter. Over the past 8 years from 2014, the ambient ozone increased by 1.74 μg/m3 per year. Of the 407 singleton-pregnant women, 21 infants were diagnosed with macrosomia. After adjusting confounders, we found that each unit increase in prenatal ozone exposure caused 8.80% [ORozone90%CI: 0.912 (0.850, 0.978)] decreased risk of macrosomia, but the splined ambient ozone exposure data was not statistically associated with birth weight, which is probably due to the limited sample size. In conclusion, prenatal ozone exposure is associated with decreased risk of macrosomia but is weakly linked to birth weight.

BackgroundPreeclampsia is associated with an increased risk of adverse maternal and perinatal outcomes. This study aimed to assess preeclampsia prevalence in a Malaysian referral maternity hospital and the association between preeclampsia and maternal characteristics and outcomes.MethodsA cross-sectional study was conducted between January 2010 and December 2020 using secondary data from a single tertiary healthcare center in Greater Kuala Lumpur, Malaysia. A total of 40,212 deliveries were included for analysis to investigate the association between conditions (maternal characteristics and adverse birth outcomes) and preeclampsia. Multivariable logistic regression was conducted to assess the association between multiple independent variables and the outcome variable (preeclampsia).ResultsThe reported prevalence of preeclampsia was 1.6%. Pregnant women with preeclampsia had a higher risk of preterm delivery (67.7%), instrumental and cesarean delivery (74.7%), neonatal low birth weight (48.5%), neonatal 5-min Apgar score

Vitamin D deficiency during pregnancy is common across the world. The effects of maternal vitamin D supplementation on offspring health were contradict from previous studies. This study was conducted to update the effects of vitamin D supplementation during pregnancy on offspring health with new evidence. A systematic search of Medline, Embase, the Cochrane Database of Systematic Reviews, ClinicalTrials.gov and ChiCTR.org.cn through July 2021 were conducted. Studies were included if they reported randomized clinical trials comparing vitamin D supplementation with placebo, no supplementation (400 IU/day or less) during pregnancy, and included birth outcomes. Pooled analyses were performed using random-effects models. Forty-two RCTs recruiting 11,082 participants were included. Vitamin D supplementation during pregnancy was associated with a lower risk of intrauterine or neonatal death (RR, 0.69; 95% CI, 0.48–0.99) in 13 RCTs with 6238 participants. We also found prenatal vitamin D supplementation was associated with an increased offspring length at birth (MD, 0.27 cm; 95% CI, 0.02–0.51), increased neonatal vitamin D concentration (MD, 27.72 nmol/L; 95% CI, 20.51–34.92), and reduced risk of vitamin D insufficiency (RR of 0.51; 95% CI, 0.38–0.67), but not associated with birth weight (MD, 37.07 g; 95% CI, −9.67 to 83.80), head circumference (MD, 0.15 cm; 95% CI, −0.02 to 0.32), preterm birth (RR, 0.93; 95% CI, 0.79–1.09), or low birth weight (RR, 0.90; 95% CI, 0.66–1.24). Supplementation initiated before the 20th week of gestation was associated with a decreased risk of small for gestational age (RR, 0.46; 95% CI, 0.24–0.90). Vitamin D supplementation during pregnancy was associated with improved offspring vitamin D sufficiency status, improved fetal linear growth, and reduced fetal or neonatal mortality. No effect was demonstrated for vitamin D supplementation on birth weight, risk of low birth weight, and risk of preterm birth. [ABSTRACT FROM AUTHOR]

ObjectiveThis study aimed to evaluate maternal serum levels of folate, vitamin B12, and their ratio on admission for labor and determine whether an imbalance between folate and vitamin B12, represented by a higher or lower serum folate to vitamin B12 ratio (SFVB12R), was associated with adverse pregnancy outcomes.MethodsA retrospective cohort study of 11,549 pregnant women attending a district specialized hospital and who had serum folate (SF) and serum vitamin B12 (SVB12) levels measured at delivery was performed. The levels of SF, SVB12, and SFVB12R were defined as high (>95th percentile), normal (5–95th percentile), and low (

PurposeThis study aimed to systematically review current evidence and quantitatively evaluate the associations between milk or dairy consumption during pregnancy and birth outcomes.MethodsThis systematic review had been reported in accordance with the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. A supplementary literature search in PubMed, Web of Science, Cochrane Library, and Embase was conducted on 30 March 2021. Studies that assessed the association of maternal consumption of milk or dairy with birth-related outcomes were identified. The dose-response meta-analyses of continuous data and categorical data were applied. One-stage approach and two-stage approach were used where appropriate.ResultsIn total, 42 studies were eligible for the present systematic review, and 18 of them were included in the outcome-specific meta-analyses. The dose-response meta-analysis [Number of studies (N) = 9] predicted a maximum mean change in birthweight of 63.38 g [95% Confidence Interval (CI) = 0.08, 126.67] at 5.00 servings per day. Intake of dairy products had the greatest protective effect on small for gestational age at a maximum of 7.2 servings per day [Relative risk (RR) = 0.69, 95% CI = 0.56, 0.85] (N = 7). The risk of large for gestational age was predicted to be maximum at 7.20 servings per day of dairy consumption, with the RR and 95% CI of 1.30 (1.15, 1.46; N = 4). In addition, the relationship between dairy consumption and low birth weight (RR = 0.70, 95% CI = 0.33, 1.50; N = 5) and pre-mature birth (RR = 1.13, 95% CI = 0.87, 1.47; N = 5) was not significant, respectively.ConclusionsMaternal consumption of dairy during pregnancy has a potential effect on fetal growth. Further well-designed studies are warranted to clarify the specific roles of individual dairy products.Systematic Review Registrationidentifier: PROSPERO 2020 CRD42020150608

At present, safety of letrozole administration as an ovulation-inducing drug still remains controversial. Investigation of the safety of letrozole use for the induction of ovulation in the Chinese population is scant. The present study aimed to fill this gap. Data concerning mothers using letrozole and birth outcomes of their singleton offspring were collected as the letrozole group (n=194), equivalent data from mothers using non-letrozole drugs and their singleton offspring were included as the non-letrozole group (control, n=154). Birth outcomes, congenital anomalies and neonatal complications were compared and analyzed between the two groups. Univariate analysis, Spearman's rank correlation analysis and the logistic regression model were utilized. For birth outcomes, the percentage of caesarean section deliveries in the letrozole group was lower than the non-letrozole group (43.8 vs. 56.4%, P=0.019). For congenital anomalies, no significant difference was found between the two groups (all P>0.05). The statistical P-value for the correlation between the maternal use of letrozole and neonatal complications was marginal (P=0.051). Results from the logistic regression analysis confirmed that maternal use of letrozole was not a significant contributor for neonatal complications, independent of statistical adjustment [crude odds ratio (OR), 1.436; 95% confidence interval (CI), 0.803-2.569; P=0.223 vs. adjusted OR, 1.406; 95% CI, 0.748-2.643; P=0.290). The results of the present study suggested that maternal use of letrozole for ovulation induction does not associate with poorer birth outcomes or increased risk of congenital anomalies and neonatal complications. [ABSTRACT FROM AUTHOR]

Rare earth elements (REEs) are emerging contaminants that are increasingly used in high technology products. However, limited information is available regarding exposure to REEs and associated health effects in neonates. This study aimed to investigate the association between REE concentrations and thyroid hormone levels, as well as birth outcomes in 109 newborns in Beijing, China. We measured the concentrations of 16 REEs and thyroid hormones in umbilical cord serum. To assess the impact of exposure to individual REEs and REE mixtures on thyroid hormone levels and birth outcomes, we employed univariate linear regression, least absolute shrinkage and selection operator (LASSO), and weighted quantile sum (WQS) models. We detected 14 REEs at high rates (92.6%–100%), with yttrium exhibiting the highest median (interquartile range) concentration [43.94 (0.33–172.55) ng/mL], followed by scandium [3.64 (0.46–11.15) ng/mL]. Univariate analyses showed that per logarithmic (ln)-unit change of neodymium (Nd) and samarium (Sm) was associated with 0.039 [95% confidence interval (CI): 0.001, 0.007] and 0.031 (95% CI: 0.003, 0.060) increases in free thyroxine (FT4) levels, respectively. Moreover, 14 REEs exhibited significant associations with triiodothyronine (T3) levels, resulting in increases ranging from 0.066 to 0.307. Elevated concentrations of terbium (Tb) [per ln-unit change: −0.021 (95% CI: −0.041, −0.01)] and lutetium (Lu) [-0.023 (95% CI: −0.043, −0.002)] were inversely correlated with birth length in newborns. A further multiple exposure analysis employing the LASSO model identified Sm, Nd, Y, Sc, and Lu as critical factors influencing FT4 and T3 levels. Additionally, WQS analyses showed positive associations between exposure to a mixture of 14 REEs and FT4 (P = 0.046), T3 (P < 0.001), and birth length (P = 0.049). These findings suggest that in utero exposure to REEs might disrupt thyroid hormone homeostasis and impact intrauterine growth. Further studies are warranted to validate these findings and elucidate the underlying mechanisms. [Display omitted] • Fourteen REEs have high detection rates in umbilical cord serum. • The element Y exhibited the highest median concentration, followed by Sc. • Multiple REEs showed positive effects on FT4 and T3 levels. • Tb and Lu displayed an inverse association with the increment of birth length. • The mixture of 14 REEs exhibited combined effects on FT4, T3 and birth length. [ABSTRACT FROM AUTHOR]

Polycystic ovary syndrome (PCOS) is a common endocrine disorder in women and a high risk factor for adverse pregnancy complications. Therefore, we aimed to analyse the relationship between PCOS and pregnancy complications in a large sample from China. Additionally, since obesity and assisted reproductive technology (ART) are common in women with PCOS, we also aimed to determine whether both of these factors increased the complication incidence for women with PCOS. A retrospective cohort study that included 1357 pregnant women with PCOS and 6940 without PCOS was performed. Our results indicated women with PCOS had higher incidence of gestational diabetes mellitus (GDM), hypertension, postpartum haemorrhage, preterm birth, macrosomia and cervical incompetence. Additionally, obesity was associated with an increased incidence of hypertension and GDM in women with PCOS generally. ART did not result in an increase in the obstetric complication rate in women with PCOS. In conclusion, PCOS appeared to result in an increased risk of adverse pregnancy complications. Obesity may further increase the risks of hypertension and GDM among women with PCOS. However, ART did not increase the risk of pregnancy complications, which suggests that ART is a relatively safe and effective method to address infertility problems in women with PCOS. What is already known on this subject? There are several studies evaluating the associations of PCOS with the risk of pregnancy complications. However, reports about the risk of pregnancy complications between PCOS women with and without obesity or ART are limited. What do the results of this study add? PCOS appeared to increase the risk of adverse pregnancy complications, including GDM, pregnancy-induced hypertension, postpartum haemorrhage, preterm birth, macrosomia and cervical incompetence. Obesity further increased the risks of hypertension and GDM in women with PCOS, but it did not increase the incidence of macrosomia and postpartum haemorrhage. Additionally, ART did not increase the risk of adverse pregnancy complications among women with PCOS, except for postpartum haemorrhage. What are the implications of these findings for clinical practice and/or further research? This study contributes to the literature because it showed that PCOS independently increased the risk of adverse pregnancy complications in a large sample of patients. Second, obesity is a high risk factor for adverse complications in pregnant women with PCOS. Third, ART is a relatively safe and effective method for addressing infertility problems for women with PCOS. [ABSTRACT FROM AUTHOR]

Although preconception care is a key element of motherhood health care services, the package is ignored in developing countries including Ethiopia and has not been generally adopted and applied since its aim and purposes are not broadly unstated and incorporated. Therefore, the objective of the current study was to determine the level of preconception care use and its determinants among women in Debre Tabor Town Northwest Ethiopia. From November 1 to 30, 2020, a Community-based cross-sectional study was undertaken in Debre Tabor Town. Overall, 79 (15.8%) with 95% CI [12.6, 19] of women had a good level of practice on preconception care utilization. Age (35–49; AOR = 5.12, 95% CI [2.14, 9.98]), ante natal care (AOR = 8.78, 95% CI [2.66, 28.97]), history of adverse birth outcome (AOR = 4.89, 95% CI [3.09, 17.00]), presence of chronic disease (AOR = 7.51, 95% CI [2.33, 12.13]), and knowledge on preconception care (AOR = 3.55, 95% CI [1.57, 8.02]) were significantly associated with utilization of preconception care. Hence, the government and respective stakeholders must give establish on preconception care strategies and plan that covers all aspects of preconception care. Incorporation of the service with other maternal and child health service will be crucial when developing actual employment policies to scale up acceptance of preconception care. [ABSTRACT FROM AUTHOR]

The potential for positive transformation through giving birth is under-acknowledged and poorly understood. By drawing on theories of new feminist materialism to open up ways of thinking about childbirth and maternity care, we discuss how aspects of the process of matrescence, a woman's 'mother-becoming', pertain to women's opportunities in childbirth. We introduce the term, 'parturescence', as a moniker for the opportunity for 'becoming', and therefore transformation, offered in birth giving. Using Davies' interpretation of Bergson's lines of descent and ascent we suggest the conditions of a woman's parturescence (whether birth giving will result in a positive or negative transformation) is enabled by 'with woman' midwifery care. The intra-action between this care, and the materiality of birth – the pain and exhaustion women experience in labour and birth, results in a rematerialisation of who and what women are and the opportunity for women's transformation. The development of this theory of parturescence unifies disparate aspects of maternity care and birth literature, provides insight into the potential mechanisms and conditions that impact women's parturescence, and suggests that birth, including the challenging and destabilising parts, is not just for the production of a baby, but also a site of women's 'becoming'. [ABSTRACT FROM AUTHOR]

Abstract Background Many maternal factors are known to be associated with adverse birth outcomes, but studies about paternal factors yielded inconsistent conclusions. The study was to assess whether paternal factors are associated with low birth weight (LBW), preterm birth (PTB), and small for gestational age (SGA). Methods A birth cohort study was conducted in 2010–2012 at the Gansu Provincial Maternity and Child Care Hospital, the largest maternity and childcare hospital in Lanzhou, China. Paternal age, ethnicity, educational level, height, weight, smoking, and drinking were collected. Birth outcomes and pregnancy complications were extracted from the medical records. Results During the study period, 10,121 participants were included; the overall prevalence of LBW, PTB, and SGA was 7.2, 9.9, and 7.8%, respectively. Paternal higher height (OR = 0.64 95%CI: 0.49, 0.83), higher weight (P for trend 23.9 kg/m2 (P for trend

BackgroundA large body of emerging evidence suggests that per- and polyfluoroalkyl substances (PFAS) affect birth outcomes in various pathways, but the evidence is inconsistent. Therefore, this study aimed to systematically review the epidemiological evidence on PFAS exposure and birth outcomes.MethodsThree electronic databases were searched for epidemiological studies through February 13, 2021. We used random-effects meta-analysis for eight birth outcome indicators to calculate summary effect estimates for various exposure types. The risk of bias and the overall quality and level of evidence for each exposure-outcome pair were assessed.ResultsThe initial search identified 58 potentially eligible studies, of which 46 were ultimately included. Many PFAS were found to have previously unrecognized statistically significant associations with birth outcomes. Specifically, birth weight (BW) was associated with PFAS, with effect sizes ranging from −181.209 g (95% confidence interval (CI) = −360.620 to −1.798) per 1 ng/ml increase in perfluoroheptanesulfonate (PFHpS) to −24.252 g (95% CI = −38.574 to −9.930) per 1 ln (ng/ml) increase in perfluorodecaoic acid (PFDA). Similar patterns were observed between other PFAS and birth outcomes: perfluorooctanoic acid (PFOA) and perfluorooctane sulfonate (PFOS) with birth length (BL) and ponderal index (PI), PFOS and perfluorododecanoic acid (PFDoDA) with head circumference (HC), PFHpS with gestational age (GA), and perfluorononanoic acid (PFNA) and PFHpS with preterm birth (PTB). Additionally, PFDA showed a statistically significant association with small for gestational age (SGA). The level of the combined evidence for each exposure-outcome pair was considered to be “moderate”.ConclusionThis study showed that PFAS exposure was significantly associated with increased risks of various adverse birth outcomes and that different birth outcome indicators had different degrees of sensitivity to PFAS. Further studies are needed to confirm our results by expanding the sample size, clarifying the effects of different types or doses of PFAS and the time of blood collection on birth outcomes, and fully considering the possible confounders.