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Background: There are no national data on the prevalence of breastfeeding during pregnancy (BDP) in the world. Also, there is no consensus for the BDP. Aim: The purpose was to determine the prevale...

Short birth-to-pregnancy intervals have been associated with adverse perinatal outcomes. Racial disparities in short birth-to-pregnancy intervals and adverse perinatal outcomes are also well known. However, little is known about birth-to-pregnancy intervals among African-born black women in the US and risk factors that contribute to short birth-to-pregnancy intervals in this population.To investigate the risk and associated risk factors of short birth-to-pregnancy intervals among African-born black women in Washington State.A retrospective cohort study using data from linked birth certificate and hospital discharge records for 18,984 consecutive, singleton birth pairs (1992-2013) to African-born black (n = 3312), US-born white (n = 7839), and US-born black women (n = 7833) in Washington State. Logistic regression models were used to determine adjusted odds ratios (aOR) and 95% confidence intervals (CI).Women with short birth-to-pregnancy intervals (6 months) comprised 10.0% of African-born women, 4.3% of US-born white women, and 6.8% of US-born black women. African-born black women had 3-fold (aOR 3.44; 95%CI: 2.53-4.68) and 1.5-fold (aOR 1.49; 95%CI: 1.28-1.74) higher risk of short birth-to-pregnancy intervals compared with US-born white women and US-born black women, respectively. Among African-born black women, those born in East Africa (aOR 3.17; 95%CI: 1.92, 5.24) had higher odds of short birth-to-pregnancy intervals compared with those born in other regions of Africa. Maternal age ≥35 years old (aOR 0.59; 95%CI: 0.35, 0.98), multiparity (aOR 0.73; 95%CI: 0.54-0.98), 12 years education (aOR 0.52; 95%CI: 0.38-0.71), and cesarean delivery in prior births (aOR 0.61; 95%CI: 0.44-0.84) were associated with lower odds of short birth-to-pregnancy intervals among African-born black women.African-born black women have higher risk for short birth-to-pregnancy intervals compared with US-born white and black women. Several risk factors (age, parity, education, and prior delivery type) contribute to short birth-to-pregnancy intervals among African-born black women. Future studies may inform our understanding of factors affecting pregnancy spacing and family planning strategies among African-born black women.

Recent studies have reported an increased risk of autism among second-born children conceived 36 months after the birth of a sibling. Confirmation of this finding would point to inter-pregnancy interval (IPI) as a potentially modifiable risk factor for autism. This study evaluated the relationship between IPI and autism spectrum disorder (ASD) risk in a Wisconsin birth cohort of 31,467 second-born children, of whom 160 resided in the study area and were found to have ASD at age 8 years. In adjusted analyses, both short (84 month) IPIs were associated with a two-fold risk of ASD relative to IPIs of 24-47 months (p

We welcome Tvarozkova et al. 's1 investigation of their patient population's knowledge about postnatal contraception, and we agree that postnatal care currently represents a missed opportunity. However we would question the plan for a dedicated postnatal contraception service, in the absence of antenatal contraceptive counselling. The difficulty with a postpartum-only service is that discussing contraception …

Heller et al. 1 highlight the potential gap in providing contraception care postpartum. We also saw a missed opportunity to educate postnatal patients about contraception on our wards and to supply such care before discharge. We work in a busy culturally and ethnically diverse area of outer London, with 5300 deliveries annually. We carried out a short face-to-face survey of 50 women who had delivered during the previous week. Twenty-two of the women did not have English as their first language. Their median age was 30 (range 17–43) years, with 36 having a higher education qualification. Average parity following the index pregnancy was two, with 32 women …

Introduction Preconception care recognizes that many adolescent girls and young women will be thrust into motherhood without the knowledge, skills or support they need. Sixty million adolescents give birth each year worldwide, even though pregnancy in adolescence has mortality rates at least twice as high as pregnancy in women aged 20-29 years. Reproductive planning and contraceptive use can prevent unintended pregnancies, unsafe abortions and sexually-transmitted infections in adolescent girls and women. Smaller families also mean better nutrition and development opportunities, yet 222 million couples continue to lack access to modern contraception. Method A systematic review and meta-analysis of the evidence was conducted to ascertain the possible impact of preconception care for adolescents, women and couples of reproductive age on MNCH outcomes. A comprehensive strategy was used to search electronic reference libraries, and both observational and clinical controlled trials were included. Cross-referencing and a separate search strategy for each preconception risk and intervention ensured wider study capture. Results Comprehensive interventions can prevent first pregnancy in adolescence by 15% and repeat adolescent pregnancy by 37%. Such interventions should address underlying social and community factors, include sexual and reproductive health services, contraceptive provision; personal development programs and emphasizes completion of education. Appropriate birth spacing (18-24 months from birth to next pregnancy compared to short intervals

The occurrence of five periparturient events and their effects on subsequent culling and fertility was recorded in eight herds in the UK. Combining data from all 2105 calvings, the proportion affected by assisted calving, dead calf, retained fetal membranes (RFM), milk fever or twins was 5.9, 8.2, 5.3, 5.0 or 3.3 per cent, respectively. Compared with unaffected herdmates, cows with an assisted calving or a dead calf had higher early (but not late) culling rates, (assisted calving: 8.8 per cent being culled before 100 days after calving compared with 5.7 per cent; P=0.05; dead calf: 12.2 per cent culled compared with 5.3 per cent; P=0.001). Compared with unaffected animals, cows with milk fever were four times more likely to be culled before 100 days after calving (16.2 per cent compared with 5.3 per cent; P=0.001), whereas those with RFM were twice as likely to be culled between 100 and 200 days (14.3 per cent compared with 7.6 per cent; P=0.003), and both groups were twice as likely to not be pregnant by 200 days. Cows with RFM or milk fever also had markedly reduced subsequent fertility: both conditions extended calving to pregnancy intervals (by 20 days; P=0.001, or by 13 days; P=0.03, respectively), lowered 100-day in-calf rates (by 24.5 per cent; P=0.001, or by 17.8 per cent; P=0.008, respectively) and lowered 200-day in-calf rates (by 20 per cent; P=0.001, or by 15 per cent; P=0.002, respectively). The birth of twins had no effect on subsequent culling or fertility.

Experiments in rodents indicate that during the post-embryonic period of prenatal development, the fetus is more sensitive than the adult to certain carcinogens, by several decimal orders of magnitude. Most such agents are direct-acting and independent of metabolism. To other substances, often those which require enzyme-mediated metabolic conversion to a chemically reactive derivative in order to effect carcinogenesis, the fetus may be less vulnerable than the adult. The neonate is also more susceptible than adults to some carcinogens, and may be more susceptible than the fetus to certain agents. Both rodent and primate studies indicate that gravid females are also at elevated risk for carcinogenesis, in part because of the presence in the placenta of trophoblastic tissue which may become malignant. The contributions of rapid growth rate, changing metabolic competence, and tissue differentiation to elevated perinatal susceptibility to carcinogens in rodents and primates are discussed, together with the implications of these findings for human beings subjected to industrial or environmental exposures to such chemicals. Images FIGURE 1. FIGURE 2.

Studies have revealed associations between preceding short and long birth-to-birth or birth-to-pregnancy intervals and poor pregnancy outcomes. Most of these studies, however, have examined the effect of intervals that began with live births. Using data from Bangladesh, we examined the effect of inter-outcome intervals (IOI) starting with a non-live birth or neonatal death, on outcomes in the next pregnancy. Pregnancy spacing behaviors in rural northeast Bangladesh have changed little since 2004. We analyzed pregnancy histories for married women aged 15-49 years who had outcomes between 2000 and 2006 in Sylhet, Bangladesh. We examined the effects of the preceding outcome and the IOI length on the risk of stillbirth, neonatal death and spontaneous abortion using multinomial logistic regression models. Data included 64,897 pregnancy outcomes from 33,495 mothers. Inter-outcome intervals of 27-50 months and live births were baseline comparators. Stillbirths followed by IOI’s

Variations in the time required for next conception by outcome ofthe preceding pregnancy, and the age of woman, are studied for Taiwanese women. Pregnancy interval, defined as the period between the end of one pregnancy and the beginning of the next, is taken as a measure of the time required for the next conception. The averages and variances of pregnancy intervals are estimated from reports of pregnancies occurring in a probability sample of 2,443 married women, aged 20-39, living in Taichung (Taiwan) in 1962. The effects of 'truncation bias' and 'memory bias' on the two moments of pregnancy intervals are estimated indirectly by cross-classifying women according to their ages at interview and their ages at the beginning (or end) of each pregnancy interval. The moments of post-partum amenorrhoea are, then, estimated indirectly from the moments of pregnancy intervals. The effects of truncation bias and memory bias are compensatory in this sample. In the absence of contraception, women, on an average, took longer to conceive following a live birth than following a foetal death. The time taken for next conception increases as women become older irrespective of the outcome of the preceding pregnancy.