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BackgroundSystematically recorded smoking data are not always available in vital statistics records, and even when available it can underestimate true smoking rates.ObjectiveTo develop a prediction model for maternal tobacco smoking in late pregnancy based on birth certificate information using a combination of self- or provider-reported smoking and biomarkers (smoking metabolites) in neonatal blood spots as the alloyed gold standard.MethodsWe designed a case-control study where childhood cancer cases were identified from the California Cancer Registry and controls were from the California birth rolls between 1983 and 2011 who were cancer-free by the age of six. In this analysis, we included 894 control participants and performed high-resolution metabolomics analyses in their neonatal dried blood spots, where we extracted cotinine [mass-to-charge ratio (m/z) = 177.1023] and hydroxycotinine (m/z = 193.0973). Potential predictors of smoking were selected from California birth certificates. Logistic regression with stepwise backward selection was used to build a prediction model. Model performance was evaluated in a training sample, a bootstrapped sample, and an external validation sample.ResultsOut of seven predictor variables entered into the logistic model, five were selected by the stepwise procedure: maternal race/ethnicity, maternal education, child's birth year, parity, and child's birth weight. We calculated an overall discrimination accuracy of 0.72 and an area under the receiver operating characteristic curve (AUC) of 0.81 (95% confidence interval [CI] 0.77, 0.84) in the training set. Similar accuracies were achieved in the internal (AUC 0.81, 95% CI 0.77, 0.84) and external (AUC 0.69, 95% CI 0.64, 0.74) validation sets.ConclusionsThis easy-to-apply model may benefit future birth registry-based studies when there is missing maternal smoking information; however, some smoking status misclassification remains a concern when only variables from the birth certificate are used to predict maternal smoking.

Summary: Background: Re‐exploration following caesarean birth and the associated maternal morbidity has not been investigated in the UK. Our aims were to determine the national incidence and identify the associated risk factors. Methods: We conducted a prospective observational case–control study across 194 UK consultant‐led maternity units in women whose caesarean birth was complicated by a re‐exploration. Independent factors for re‐exploration were analysed using multivariable multi‐level mixed effects logistic regression. Results: Over the study period (1 June 2021 and 31 May 2022) 238,423 caesarean births were recorded across the UK of which 187 women underwent re‐exploration, giving an incidence of one re‐exploration per 1282 caesarean births (95%CI 1:1099–1:1471). Haemorrhage (124/187, 66.3%) and sepsis (31/187, 16.6%) were the most common findings at re‐exploration. Median (IQR [range]) time interval to re‐exploration following the caesarean birth was 1 (0–4 [0–28]) day. Mechanical ventilation was required in 34 (18.6%) women, cardiac arrest was reported in 5 (2.7%) and 3 (1.6%) women died. Independent preceding factors associated with a re‐exploration included: receipt of blood transfusion (adjusted OR (95%CI) 8.25 (2.66–25.61)); use of a general anaesthetic (adjusted OR (95%CI) 3.33 (1.61–6.88)); pre‐eclampsia (adjusted OR (95%CI) 3.27 (1.55–6.91)); black ethnicity (adjusted OR (95%CI) 3.14 (1.39–7.11)); postpartum haemorrhage (adjusted OR (95%CI) 2.82 (1.81–4.37)); use of anticoagulants or antiplatelet drugs pre‐caesarean birth (adjusted OR (95%CI) 2.26 (1.35–3.81)); and emergency caesarean birth (adjusted OR (95%CI) 1.89 (1.01–3.57)). Conclusion: Re‐exploration following caesarean birth in the UK is uncommon but is associated with significant maternal morbidity and mortality. These study findings will help guide informed consent and encourage appropriate surveillance of high‐risk women postpartum. [ABSTRACT FROM AUTHOR]

ABSTRACT Background Methods Results Conclusion The increase in the number of people choosing community birth has raised interest in understanding the factors that influence birth setting choices. This study investigates how parity influences the association between maternal socioeconomic factors and choice of community versus hospital birth.We used 2009–2021 US birth certificate data to identify community births (planned home or birth center births), parity, and maternal characteristics, including Women, Infants, and Children (WIC) program participation, race, ethnicity, educational attainment, marital status, body mass index (BMI), and age. Parity was interacted with each covariate in a multivariable logistic regression model of birth setting.Among 26,526,010 eligible births, 58% were to multiparous mothers, with 1.9% occurring in a birth center or at home. For most maternal characteristics, associations with community birth were stronger in the multiparous group compared to the nulliparous group. For example, being married was associated with greater odds of community birth in both groups, but the strength of this association was greater within the multiparous group (odds ratio 4.00 vs. 1.94, interaction p < 0.001). The same pattern (stronger association with community birth in the multiparous group than in the primiparous group) was observed for race/ethnicity, educational attainment, and WIC participation, all of which were associated with lower odds of community birth.This study shows that parity significantly moderates associations between maternal socioeconomic characteristics and birth setting, implying studies of decision‐making in this context should purposively stratify samples and analyses by parity. [ABSTRACT FROM AUTHOR]

Objective: To compare maternal demographics based on occupation coding status and evaluate potential bias by excluding manually coded occupations. Methods: This case-control study assessed cases with clefts obtained from the Texas Birth Defects Registry. The NIOSH Industry and Occupation Computerized Coding Systemautomatically coded occupations, withmanual coding for unclassified cases. Maternal demographics were tabulated by occupation coding status (manual vs. automatic). Logistic regression examined associations between major occupation groups and clefts. Results: Automatic coding covered over 90% of all mothers. Building, grounds cleaning, and maintenance occupations, and office and administrative support occupations were significantly associated with cleft lip with or without cleft palate, even after excluding manually coded occupations. Conclusion: We found consistent associations before and after excluding manually coded data for most comparisons, suggesting that machine learning can facilitate occupation-related birth defects research. [ABSTRACT FROM AUTHOR]

Objective: To assess the impact of historical redlining on the risk of pregnancy complications and adverse birth outcomes in Massachusetts (MA) from 1995 to 2015. Methods: In total, 288,787 pregnant people from the MA Birth Registry had information on parental characteristics, pregnancy factors, and redlining data at parental residences at the time of delivery. Historic redlining data were based on MA Home Owners' Loan Corporation (HOLC) security maps, with grades assigned (A "best," B "still desirable," C "definitely declining," and D "hazardous"). We used covariate-adjusted binomial regression models to examine associations between HOLC grade and each chronic condition and pregnancy/birth outcome. Results: Living in HOLC grades B through D compared with A was associated with an increased risk of entering pregnancy with chronic conditions and adverse pregnancy/birth outcomes. The strongest associations were seen with pregestational diabetes (adjusted risk ratio [RR] Grade D: 1.7, 95% confidence interval [CI]: 1.3, 2.4) and chronic hypertension (adjusted RR Grade D: 1.5, 95% CI: 1.1, 1.9). Conclusions: Historical redlining policies from the 1930s were associated with adverse pregnancy outcomes and chronic conditions; associations were strongest for chronic conditions in pregnancy. [ABSTRACT FROM AUTHOR]

Introduction: Cesarean section at full dilatation has been associated with an increased risk of subsequent preterm birth. We hypothesized that there may be an increased risk of miscarriage in pregnancies that follow cesarean section at full dilatation. This study aimed to determine if a first‐term (≥37 weeks) cesarean section at full dilatation is associated with an increased risk of miscarriage in the next pregnancy. Material and Methods: A historical cohort study was conducted using routinely collected hospital data within the Aberdeen Maternity and Neonatal Databank (AMND). The population included were women who had a first‐term birth and who had a second birth recorded within the AMND. Logistic and multinomial regression was used to determine any association with miscarriage at any gestation and for early (<13 weeks gestation) and late (13–23 + 6 weeks gestation) miscarriage, with cesarean section at full dilatation defined as the exposure. Miscarriage in the second pregnancy (spontaneous loss of intrauterine pregnancy prior to 24 weeks gestation) was the primary outcome. Results: In total, 33 452 women were included. Women who had a first cesarean section at full dilatation were no more likely to have a miscarriage at any gestation than women with all other modes of first birth (including all vaginal births, planned CS, and the first stage of labor (<10 cm dilated CS)) [adjusted OR 0.84 (0.66–1.08); p = 0.18]. There was no association with early or late miscarriage after a CSfd, though the sample size for late miscarriage was small. Conclusions: This is the first observational study to investigate the risk of miscarriage following first‐term CSfd. We found no association between miscarriage at any gestation following a first‐term CSfd compared to all other modes of first birth. [ABSTRACT FROM AUTHOR]

Objective This study aimed to examine the temporal trends of severe maternal morbidity (SMM) in the U.S. population in relation to trends in maternal comorbidity. Study Design We performed a repeated cross-sectional analysis of data from individuals at 20 weeks' gestation or greater using U.S. birth certificate data from 2011 to 2021. Our primary outcome was SMM defined as the occurrence of intensive care unit admission, eclampsia, hysterectomy, uterine rupture, and blood product transfusion. We also examined the proportions of maternal comorbidity. Outcomes of the adjusted incidence rate ratio (IRR) with 99% confidence intervals (99% CIs) for 2021 m12 compared with 2011 m1 were calculated using negative binomial regression, controlling for predefined confounders. Results There were 42,504,125 births included in the analysis. From 2011 m1 to 2021 m12, there was a significant increase in the prevalence of advanced maternal age (35–39 [45%], 40–44 [29%], and ≥45 [43%] years), morbid obesity (body mass index 40–49.9 [66%], 50–59.9 [91%], and 60–69.9 [98%]), previous cesarean delivery (14%), chronic hypertension (104%), pregestational diabetes (64%), pregnancy-associated hypertension (240%), gestational diabetes (74%), and preterm delivery at 34 to 36 weeks (12%). There was a significant decrease in the incidence of multiple gestation (9%), preterm delivery at 22 to 27 weeks (9%), and preterm delivery at 20 to 21 weeks (22%). From 2011 m1 to 2021 m12, the incidence of SMM increased from 0.7 to 1.0% (crude IRR 1.60 [99% CI 1.54–1.66]). However, the trend was no longer statistically significant after controlling for confounders (adjusted IRR 1.01 [95% CI 0.81–1.27]). The main comorbidity that was associated with the increase in SMM was pregnancy-associated hypertension. Conclusion The rise in the prevalence of comorbidity in pregnancy seems to fuel the rise in SMM. Interventions to prevent SMM should include the management and prevention of pregnancy-associated hypertension. Key Points The rise in maternal mortality is related to morbidity. Pregnancy-associated hypertension increases morbidity. There were increasing trends in age, body mass index, and medical conditions. [ABSTRACT FROM AUTHOR]

Objective Our objective was to describe infant mortality within 1 year of life according to gestational age and birth weight percentile in infants delivered between 22 and 28 weeks of gestation. Study Design This study was a retrospective cohort study based on publicly available U.S. birth certificate data linked to infant death data between 2014 and 2020. Maternal–neonate pairs of singleton live births between 22 0/7 and 28 6/7 weeks' gestation (vaginal or cesarean) were evaluated. We excluded infants with major fetal anomalies, chromosomal disorders, and birth weight outliers. Our primary outcome was infant mortality within 1 year of life. Individuals were categorized into eight sex-specific birth weight percentiles categories: less than the 3rd, 3rd-less than the 10th, 10th-less than the 25th, 25th-to less than the 50th, 50th-less than the 75th, 75th-to less than the 90th, 90th-less than the 97th, and 97th or higher. Results Of 27,014,444 individuals with live births from January 2014 to December 2020, 151,677 individuals who gave birth at 22 to 28 weeks of gestation were included in the study population. The mortality rate ranged from 4.2% for the 50th-less than the 75th percentiles at 28 weeks to 80.3% for the 3rd-less than the 10th percentile at 22 weeks. Using the 50th-less than the 75th birth weight percentile at each gestational age as a reference group, birth weight less than the 50th percentile was associated with increased mortality at all gestational ages in a dose-dependent manner. From 22 to 25 weeks of gestation, higher birth weight percentiles were associated with lower mortality, while the 97th or higher birth weight percentile was associated with increased mortality compared with the 50th-less than the 75th birth weight percentile at 26 to 28 weeks of gestation. Conclusion The lower birth weight percentiles were associated with higher mortality across all gestational ages, but the association between higher birth weight percentiles and infant mortality exhibited an opposite pattern at 22 to 25 weeks as compared to later gestational age. Key Points Birth weight ≥97th percentile was associated with increased infant mortality at 26 to 28 weeks. Higher birth weight percentiles were associated with a lower risk of mortality at 22 to 25 weeks. Lower birth weight percentiles were associated with a higher risk of mortality at 22 to 28 weeks. [ABSTRACT FROM AUTHOR]

Previous literature suggested that promoting childhood health could have intergenerational benefits. While several studies have pointed to the life-cycle benefits of mass vaccinations and disease elimination, fewer studies have explored their long-run intergenerational aspects. This paper joins the ongoing literature by exploring the intergenerational health benefits of mothers' childhood exposure to the measles vaccination for their infants' birth outcomes. Our identification strategy takes advantage of cross-cohort exposure to the introduction of the measles vaccine in 1963 and cross-state variations in pre-vaccine measles rates. Using the universe of birth records in the US over the years 1970–2004, we show that mothers who were exposed to the measles vaccine reveal improved birth outcomes. For mothers in states with an average pre-vaccine measles rate, full exposure to the vaccine during childhood is associated with roughly 5.4 and 5.7 percent reduction in the incidence of low-birth-weight and preterm-birth newborns. A series of event study analyses suggest that these findings are not driven by preexisting trends in outcomes. Further analyses suggest that improvements in educational outcomes, increases in prenatal care utilization, reductions in smoking, and increases in several measures of socioeconomic status are potential mechanisms. [ABSTRACT FROM AUTHOR]

This document is a reply to a study on twinning in humans. The authors analyzed a large dataset of birth records from Northern and Central Europe to understand the relationship between twinning and fertility. They found a negative relationship between the probability of a mother having multiple offspring per birth and her total number of births, challenging the idea that mothers who are more fertile are more likely to have twins. The authors argue that the differences between their study and the previous study are due to the demographic transition and that both studies support the conclusion that the heterogeneity/maternal capacity hypothesis is not supported. They caution against removing specific births from the data and encourage further exploration of complex scenarios using their statistical framework. [Extracted from the article]

Background and Objectives Methods Results Discussion and Conclusions Scientific Significance Prenatal cannabis use prevalence in the United States has increased. Relaxation of state‐level cannabis policy may be contributing to the diminished risk perception of using cannabis. The main psychoactive constituent of cannabis, delta‐9‐tetrahydrocannabinol, crosses the placenta, interacting with functional cannabinoid receptors in the fetus. Here, we assess the association between prenatal cannabis exposure (PCE) and a set of birth outcomes.Using the Michigan Archive for Research on Child Health, a prospective pregnancy cohort, we linked prenatal survey data with neonatal data from state‐archived birth records. Recruitment occurred in 23 clinics across Michigan. Pregnant participants with live birth records between October 2017 and January 2022, after exclusion for missing data on cannabis use, birth outcomes, and covariates, were included in the final analytic sample (n = 584). Analyses involved generalized linear models.An estimated 15% (95% confidence interval [CI]: 12%, 18%) of participants reported using cannabis during pregnancy. Covariate‐adjusted models revealed an association between PCE and birth size (ß = −0.3; 95% CI: −0.5, −0.003).Findings suggest a relationship between PCE and smaller birth size. Clinicians should follow guidelines outlined by the American College of Obstetricians and Gynecologists when counseling pregnant patients on cannabis use.We detected a significant association between PCE and birth size. Most studies focus only on the extremes of birth size, however, use of z‐scores allow for assessment of the sex‐specific birth weight‐for‐gestational age distribution, increasing the accuracy of detecting an effect of cannabis exposure on birth size. [ABSTRACT FROM AUTHOR]

Background Astrovirus is a leading cause of acute gastroenteritis in children worldwide. However, few prospective studies have analyzed astrovirus in community-dwelling pediatric populations in low- and middle-income countries. Methods We assessed the incidence, risk factors, clinical characteristics, genotypes, viral coinfections, and time distribution of astrovirus gastroenteritis in 443 healthy Nicaraguan children born in 2017 to 2018 who were followed for 36 months. Children were recruited from hospitals and birth records in an economically diverse neighborhood of León city. Astrovirus-positive episodes and genotypes were identified from stool with reverse transcription quantitative polymerase chain reaction and Sanger sequencing. Results Of 1708 total specimens tested, 80 children (18%) experienced at least 1 astrovirus episode, and 9 experienced repeat episodes, mostly during the rainy season (May–October). Initial astrovirus episodes were not associated with a lowered risk against future episodes. In exploratory analyses, home toilets were associated with a lower risk of future astrovirus episodes (hazard ratio, 0.19; 95% CI,.04–.91). Human astrovirus 5 episodes, representing 15% of all typed episodes, were associated with longer diarrhea and more symptomatic rotavirus coinfections. Conclusions Astrovirus was a common cause of gastroenteritis in this cohort, and future studies should clarify the role of astrovirus genotype in clinical infection severity. [ABSTRACT FROM AUTHOR]

Background: An understanding of viral testing rates is crucial to accurately estimate the pathogen‐specific hospitalisation burden. We aimed to estimate the patterns of testing for respiratory syncytial virus (RSV), influenza virus, parainfluenza virus (PIV) and human metapneumovirus (hMPV) by geographical location, age and time in children <5 years old in Western Australia. Methods: We conducted a population‐based cohort study of children born between 1 January 2010 and 31 December 2021, utilising linked administrative data incorporating birth and death records, hospitalisations and respiratory viral surveillance testing records from state‐wide public pathology data. We examined within‐hospital testing rates using survival analysis techniques and identified independent predictors of testing using binary logistic regression. Results: Our dataset included 46,553 laboratory tests for RSV, influenza, PIV, or hMPV from 355,021 children (52.5% male). Testing rates declined in the metropolitan region over the study period (RSV testing in infants: from 242.11/1000 child‐years in 2012 to 155.47/1000 child‐years in 2018) and increased thereafter. Conversely, rates increased in non‐metropolitan areas (e.g., RSV in Goldfields: from 364.92 in 2012 to 504.37/1000 child‐years in 2021). The strongest predictors of testing were age <12 months (adjusted odds ratio [aOR] = 2.25, 95% CI 2.20–2.31), preterm birth (<32 weeks: aOR = 2.90, 95% CI 2.76–3.05) and remote residence (aOR = 0.77, 95% CI 0.73–0.81). Conclusion: These current testing rates highlight the potential underestimation of respiratory virus hospitalisations by routine surveillance and the need for estimation of the true burden of respiratory virus admissions. [ABSTRACT FROM AUTHOR]

BACKGROUND AND OBJECTIVES: Hypoxic-ischemic encephalopathy (HIE) is a leading cause of neonatal morbidity and mortality. Therapeutic hypothermia (TH), a proven treatment of moderate-severe HIE, was first used clinically after 2006. We describe trends in HIE diagnosis and use of TH over a 10-year period in California. METHODS: We identified 62 888 infants, ≥36 weeks gestation, who were cared for in California Perinatal Quality Care Collaborative-participating NICUs between 2010 and 2019, and linked them to birth certificate data. We evaluated trends in HIE diagnosis and use of TH. RESULTS: Over time, rates of HIE diagnosis increased from 0.6 to 1.7 per 1000 live births, and use of TH increased from 26.5 to 83.0 per 1000 infants. Rates of moderate HIE increased more than mild or severe, although use of TH for mild HIE increased more than for moderate. Of those with moderate-severe HIE, 25% remain untreated. Treatment varied by NICU level of care. CONCLUSIONS: The rates of HIE and TH increased steadily. Some infants with moderate-severe HIE remain untreated, suggesting a need for ongoing education. Further evaluation of systems of care is needed to assure all qualifying infants are treated. [ABSTRACT FROM AUTHOR]

STUDY QUESTION Is there an elevated risk of cyanotic congenital heart defects (CCHD) among livebirths following infertility treatments? SUMMARY ANSWER In this population-based study of single livebirths, infertility treatment (either ART or non-ART) was associated with a higher prevalence of CCHD among livebirths. WHAT IS KNOWN ALREADY The use of infertility treatment has been on the rise over the past few decades. However, there are limited studies assessing the risk of major cardiac defects following infertility treatments. STUDY DESIGN, SIZE, DURATION A retrospective cohort study of livebirth data from the National Vital Statistics System (NVSS) was conducted, comprising of 9.6 million singleton livebirths among first-time mothers aged 15–49 years from 2016 to 2022. PARTICIPANTS/MATERIALS, SETTING, METHODS Information on infertility treatment use and CCHD was obtained from the health and medical information section of birth certificates, which was completed by healthcare staff after reviewing medical records. Logistic regression models were used to estimate odds ratios (OR) and 95% CI. Entropy balancing weighting analysis and probabilistic bias analysis were also performed. MAIN RESULTS AND THE ROLE OF CHANCE The proportion of births following infertility treatment increased from 1.9% (27 116) to 3.1% (43 510) during the study period. Overall, there were 5287 cases of CCHD resulting in a prevalence of 0.6 per 1000 livebirths. The prevalence was 1.2 per 1000 live births among infertility treatment users (ART: 1.1 per 1000 livebirths; non-ART: 1.3 per 1000 livebirths) while that for naturally conceived births was 0.5 per 1000 livebirths. Compared to naturally conceived births, the use of any infertility treatment (OR: 2.06, 95% CI: 1.82–2.33), either ART (OR: 2.02, 95% CI: 1.73–2.36) or other infertility treatments (OR: 2.12, 95% CI: 1.74–2.33), was associated with higher odds of CCHD after adjusting for maternal and paternal age, race and ethnicity, and education, as well as maternal nativity, marital status, source of payment, smoking status, and pre-pregnancy measures of BMI, hypertension and diabetes. This association did not differ by the type of infertility treatment (ART versus other infertility treatments) (OR: 1.04, 95% CI: 0.82–1.33, P  = 0.712), and was robust to the presence of exposure and outcome misclassification bias and residual confounding. LIMITATIONS, REASONS FOR CAUTION The findings are only limited to livebirths. We did not have the capacity to examine termination data, but differential termination by mode of conception has not been supported by previous studies designed to consider it. Infertility treatment use was self-reported, leading to the potential for selection bias and misclassification for infertility treatment and CCHD. However, the association persisted when systematic bias as well as exposure and outcome misclassification bias were accounted for in the analyses. Information on the underlying etiology of infertility relating to either maternal, paternal, or both factors, data on specific types of ART and other infertility treatments, as well as information on subtypes of CCHD, were all not available. WIDER IMPLICATIONS OF THE FINDINGS In light of the increasing trend in the use of infertility treatment in the USA, and elsewhere, the finding of the current study holds significant importance for the clinical and public health of reproductive-aged individuals. The data show that the use of infertility treatment may expose offspring to elevated odds of severe congenital heart defects such as CCHD studied here. These findings cannot be interpreted causally. While our findings can assist in preconception counseling and prenatal care for pregnancies conceived by either ART or other infertility treatments, they also support some current recommendations that pregnancies resulting from infertility treatments undergo fetal echocardiography screening. STUDY FUNDING/COMPETING INTEREST(S) No funding was sought for the study. The authors declare that they have no conflict of interest. TRIAL REGISTRAION NUMBER N/A [ABSTRACT FROM AUTHOR]

Objectives: Evidence is limited on differences in cesarean rates for nulliparous, term, singleton, vertex (NTSV) births across racial and ethnic groups at the national and state level during the COVID-19 pandemic. We assessed changes in levels and trends of NTSV cesarean rates before and after stay-at-home orders (SAHOs) were implemented in the United States (1) overall, (2) by racial and ethnic groups, and (3) by 50 US states from January 2017 through December 2021. Methods: We used birth certificate data from 2017 through 2021, restricted to hospital births, to calculate monthly NTSV cesarean rates for the United States and for racial and ethnic groups and to calculate quarterly NTSV cesarean rates for the 50 states. We used interrupted time-series analysis to measure changes in NTSV cesarean rates before and after implementation of SAHOs (March 1 through May 31, 2020). Results: Of 6 022 552 NTSV hospital births, 1 579 645 (26.2%) were cesarean births. Before implementation of SAHOs, NTSV cesarean rates were declining in the United States overall; were declining among births to non-Hispanic Asian, non-Hispanic Black, Hispanic, and non-Hispanic White women; and were declining in 6 states. During the first month of implementation of SAHOs in May 2020, monthly NTSV rates increased in the United States by 0.55%. Monthly NTSV rates increased by 1.20% among non-Hispanic Black women, 0.90% among Hispanic women, and 0.28% among non-Hispanic White women; quarterly NTSV rates increased in 6 states. Conclusion: In addition to emergency preparedness planning, hospital monitoring, and reporting of NTSV cesarean rates to increase provider awareness, reallocation and prioritization of resources may help to identify potential strains on health care systems during public health emergencies such as the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Background: Despite many efforts to provide children with legal existence over the last decades, 1 in 4 children under the age of 5 (166 million) do not officially exist, with limited possibility to enjoy their human rights. In Latin America and the Caribbean, Haiti has one of the highest rates of undocumented births. This study aimed to analyze the prevalence and the determinant factors of undocumented childhood in Haiti. Methods: For analysis of undocumented childhood and related socioeconomic determinants, data from the 2016/17 Haiti demographic and health survey were used. The prevalence and the associated factors were analyzed using descriptive statistics and the binary logistic regression model. Results: The prevalence of undocumented childhood in Haiti was 23% (95% CI: 21.9–24.0) among children under-five. Among the drivers of undocumented births, mothers with no formal education (aOR = 3.88; 95% CI 2.21–6.81), children aged less than 1 year (aOR = 20.47; 95% CI 16.83–24.89), children adopted or in foster care (aOR = 2.66; 95% CI 1.67–4.24), children from the poorest regions like "Artibonite" (aOR = 2.19; 95% CI 1.63–2.94) or "Centre" (aOR = 1.51; 95% CI 1.09–2.10) or "Nord-Ouest" (aOR = 1.61; 95% CI 1.11–2.34), children from poorest households (aOR = 6.25; 95% CI 4.37–8.93), and children whose mothers were dead (aOR = 2.45; 95% CI 1.33–4.49) had higher odds to be undocumented. Conclusion: According to our findings, there is an institutional necessity to bring birth documentation to underprivileged households, particularly those in the poorest regions where socioeconomic development programs are also needed. Interventions should focus on uneducated mothers who are reknown for giving birth outside of medical facilities. Therefore, an awareness campaign should be implemented to influence the children late-registering behavior. [ABSTRACT FROM AUTHOR]

ABSTRACT Introduction Methods Results Conclusion In the context of adverse in utero environments, the fetal brain might be preserved at the expense of other tissues. This trade‐off, brain sparing, has not been studied in the context of maternal infection. We investigated cases of maternal syphilis in the early 20th century and influenza during the 1918–1920 pandemic, in the Swiss city of Lausanne, a relatively high‐income setting. We tested the brain sparing hypothesis, that head circumference is protected at the expense of birth weight.A total of 8530 individual birth records from 1911 to 1922 from the University Maternity Hospital of Lausanne were used. We fitted generalized linear and additive linear models to explain how neonatal size varies under disease exposure.Influenza reduced head circumference and birth weight among livebirths similarly, by −0.11 and −0.14 standard deviation (SD) units respectively. Conversely, for syphilis‐exposed infants, head circumference was affected more than birth weight (−0.61 SD vs. −0.46 SD). Stillborn infants exposed to syphilis experienced a much greater reduction in head circumference (−1.92 SD) than liveborn infants. After adjustment for gestational age, these findings persisted in the case of influenza, but the effects of syphilis were reduced. Furthermore, half of syphilis‐exposed infants were born before term, suggesting that lower infant size was partly mediated by shorter gestation. Nevertheless, head circumference among stillbirths exposed to syphilis was still substantially reduced, even after adjustment for gestational age (−1.26 SD).Our findings do not support the brain sparing hypothesis. Moreover, the substantial reduction in head circumference among syphilis‐exposed fetuses might help explain why a quarter of them were stillborn. [ABSTRACT FROM AUTHOR]

Background Objective Search Strategy Selection Criteria Data Collection and Analysis Main Results Conclusion Around half of preterm births lack identifiable causes, indicating the need for further investigation to understand preterm birth risk factors. Existing studies on the intergenerational association of preterm birth showed inconsistency in effect size and direction.This systematic review and meta‐analysis aimed to review existing studies and provide comprehensive evidence on the intergenerational association of preterm births.We searched MEDLINE, Embase and Maternity and Infant Care databases, from the inception of each database to 04 April 2024.Eligibility criteria included studies that reported on women who had given birth and had recorded information about a family history of preterm birth in one or both of the child's biological parents.Data were extracted by two independent reviewers. A random‐effects model was used to compute pooled estimates using odds ratios.Sixteen eligible studies with a total of 2 271 612 mothers were included. The findings indicated a 1.44 (OR = 1.44, 95% CI: 1.34, 1.54) fold increase in odds of giving preterm births among women who were born preterm. Additionally, having a sibling born preterm (OR = 1.53, 95% CI: 1.24, 1.87) and having a partner born preterm (OR = 1.12, 95% CI: 1.01, 1.25) were associated with increased likelihood of giving preterm births among women.The study revealed that women with a family history of preterm birth face an increased risk of giving preterm births. Screening pregnant women for a family history of preterm birth is essential, with those having a positive family history requiring closer follow‐up. [ABSTRACT FROM AUTHOR]

The list of standard abbreviations for JDS is available at adsa.org/jds-abbreviations-24. Nonstandard abbreviations are available in the Notes. The main aim of the current study was to find biomarkers of health in calves transported at different ages. The selected blood parameters were total cholesterol, insulin, and IGF-1, and the longitudinal study investigated whether or not these concentrations were different between calves that were transported from the dairy farm to the veal farm at 14 or 28 d of age. Relationships between these blood variables and health characteristics of veal calves were investigated. In a 34-wk study period, a total of 683 calves originating from 13 Dutch dairy farms were transported at an age of 14 or 28 d to 8 Dutch veal farms. Calves were blood sampled the first week after birth (mean and SD: 4.4 ± 2.1 d), 1 d before transport (mean and SD: 25.8 ± 7.3 d), and in wk 2 post-transport (mean and SD: 36.7 ± 12.2 d). In these samples, insulin, IGF-1, and total cholesterol were determined and analyzed with a linear mixed model (LMM). Individual medical treatments were recorded from birth until the day of transport at the dairy farm, and from the moment of arrival at the veal farm until slaughter, and analyzed as a binary response variable (calf treated or not) with a generalized LMM. Fecal (calf with or without loose or liquid manure) and navel (calves with or without swollen and inflamed navel) scores measured during a single visit in wk 2 post-transport were also analyzed as binary response variables, whereas carcass weights at slaughter age were analyzed with a LMM. Cholesterol, insulin, and IGF-1 were included as covariates in the previous models to test their relationships with the likelihood of calves being medically treated, fecal and navel scores, and carcass weights. One day before transport 28-d-old calves had higher blood cholesterol (Δ = 0.40 mmol/L) and IGF-1 (Δ = 53.6 ng/mL) concentrations, and evidence of higher insulin (Δ = 12.2 µU/mL) compared with 14-d-old calves. In wk 2 post-transport, 28-d-old calves had higher blood IGF-1 (Δ = 21.1 ng/mL), with evidence of higher insulin (Δ = 12.2 µU/mL) concentrations compared with 14-d-old calves. Cholesterol concentration measured 1 d before transport and in wk 2 post-transport had a positive relationship with carcass weight at slaughter (regression coefficients [β] = 4.8 and 7.7 kg/mmol per liter, respectively). Blood cholesterol concentration in wk 2 post-transport was negatively associated with the fecal score measured at the same sampling moment (β = −0.55/mmol/L), with the likelihood of a calf of being treated with antibiotics (β = −0.36/mmol/L) and other medicines (β = −0.45/mmol/L) at the veal farm. Blood IGF-1 concentration in wk 2 post-transport was negatively associated with the likelihood of a calf of being treated with antibiotics and other medicines (both β = −0.01/ng/mL) at the veal farm, and with fecal score recorded in wk 2 post-transport (β = −0.004/ng/mL). When looking at the blood indicators, it appeared that calves transported at 28 d of age were more developed compared with 14-d-old calves, thus transport at an older age might be more beneficial for the animals. It can be concluded that both blood cholesterol and IGF-1 concentrations seemed to be valuable biomarkers of health and energy availability in veal calves. [ABSTRACT FROM AUTHOR]

Introduction: We investigated 2018 gestational diabetes mellitus (GDM) prevalence estimates in three surveillance systems (National Vital Statistics System, State Inpatient Database, and Pregnancy Risk Assessment Monitoring Survey). Methods: We calculated GDM prevalence for jurisdictions represented in each system; a subset of data was analyzed for people 18–39 years old in 22 jurisdictions present in all three systems to observe dataset-specific demographics and GDM prevalence using comparable categories. Results: GDM prevalence estimates varied widely by data system and within the data subset despite comparable demographics. Discussion: Understanding the differences between GDM surveillance data systems can help researchers better identify people and places at higher risk of GDM. Significance: What is Already Known on this Subject?: Gestational diabetes mellitus (GDM) prevalence varies by data system and population. Estimates of GDM prevalence are essential to inform prevention, identification, and management programs. What this Report Adds?: GDM prevalence estimates varied widely by data system (NVSS, SID, PRAMS) and participant demographics varied only slightly when a subset of comparable data were evaluated using jurisdictions available in all three systems (21 states and the District of Columbia). Understanding the differences between surveillance data systems can help researchers better identify people and places at higher risk of GDM. [ABSTRACT FROM AUTHOR]

Macro-level events such as elections can improve or harm population health across existing axes of stratification through policy changes and signals of inclusion or threat. This study investigates whether rates of, and disparities in, adverse birth outcomes between racialized and nativity groups changed after Donald Trump's November 2016 election, a period characterized by increases in xenophobic and racist messages, policies, and actions in the United States. Using data from 15,568,710 U.S. births between November 2012 and November 2018, we find that adverse birth outcomes increased after Trump's election among U.S.- and foreign-born mothers racialized as Black, Hispanic, and Asian and Pacific Islander (API), compared with the period encompassing the two Obama presidencies. Results for Whites suggest no change or a slight decrease in adverse outcomes following Trump's election, yet this finding was not robust to checks for seasonality. Black–White, Hispanic–White, and API–White disparities in adverse birth outcomes widened among both U.S.- and foreign-born mothers after Trump's election. Our findings suggest that Trump's election was a racist and xenophobic macro-level political event that undermined the health of infants born to non-White mothers in the United States. [ABSTRACT FROM AUTHOR]

This study aims to analyze the legal strength of civil registration deeds as evidence of inheritance ownership. The first research, How is the legal force of civil registration deeds as the basis for controlling inheritance by children. As an official document that records a person's birth, a birth certificate plays an important role in legal proceedings related to property inheritance. In the context of inheritance law, the validity of the birth certificate is the main key in determining the right of an adopted child to inherit property from his adoptive parents. Along with a valid birth certificate, the adopted child has a strong legal basis to claim his inheritance rights. However, there are challenges and problems that may arise related to the validity of birth certificates in the context of inheritance control. Second, how can heirs report criminal acts against adopted children who have controlled the inheritance. Therefore, this study aims to analyze in depth the role of birth certificate power as a tool that allows adopted children to obtain inheritance rights, as well as to identify strategies that can be applied to ensure the effective protection of inheritance rights of adopted children. Through the approach of legal analysis and literature study, this study concludes that the strength of the birth certificate is a crucial foundation in proving the legal status of an adopted child in the process of controlling inheritance, but further efforts are needed to improve the legal protection of adopted children in the context of property inheritance. [ABSTRACT FROM AUTHOR]

Background: Emerging evidence suggests newborn screening analytes may yield insights into the etiologies of birth defects, yet no effort has evaluated associations between a range of newborn screening analytes and birth defects. Methods: This population-based study pooled statewide data on birth defects, birth certificates, and newborn screening analytes from Texas occurring between January 1, 2007 and December 31, 2009. Associations between a panel of thirty-six newborn screening analytes, collected by the statewide Texas Newborn Screening Program, and the presence of a birth defect, defined as at least one of 39 birth defects diagnoses recorded by the Texas Birth Defects Registry, were assessed using regression analysis. Findings: Of the 27,643 births identified, 20,205 had at least one of the 39 birth defects of interest (cases) as identified by the Texas Birth Defects Registry, while 7,438 did not have a birth defect (controls). Among 1,404 analyte-birth defect associations evaluated, 377 were significant in replication analysis. Analytes most consistently associated with birth defects included the phenylalanine/tyrosine ratio (N = 29 birth defects), tyrosine (N = 28 birth defects), and thyroxine (N = 25 birth defects). Birth defects most frequently associated with a range of analytes included gastroschisis (N = 29 analytes), several cardiovascular defects (N = 26 analytes), and spina bifida (N = 23 analytes). Conclusions: Several significant and novel associations were observed between newborn screening analytes and birth defects. While some findings could be consequences of the defects themselves or to the care provided to infants with these defects, these findings could help to elucidate mechanisms underlying the etiology of some birth defects. [ABSTRACT FROM AUTHOR]

Background: An infant's presentation at delivery may be an early indicator of developmental differences. Non‐vertex presentation (malpresentation) complicates delivery and often leads to caesarean section, which has been associated with neurodevelopmental delays, including autism spectrum disorder (ASD). However, malpresentation could be an early sign of an existing developmental problem that is also an upstream factor from caesarean delivery. Little research has been done to investigate the association between malpresentation and ASD. Objectives: We examine the association between malpresentation at delivery and ASD and whether this association differs by gestational age. Methods: We used data from the Study to Explore Early Development (SEED), a multi‐site, case–control study of children with ASD compared to population controls. The foetal presentation was determined using medical records, birth records and maternal interviews. We defined malpresentation as a non‐vertex presentation at delivery, then further categorised into breech and other malpresentation. We used multivariable logistic regression to estimate the adjusted odds ratio (aOR) for the association between malpresentation and ASD. Results: We included 4047 SEED participants, 1873 children with ASD and 2174 controls. At delivery, most infants presented vertex (n = 3760, 92.9%). Malpresentation was associated with higher odds of ASD (aOR 1.31, 95% confidence interval [CI] 1.02, 1.68) after adjustment for maternal age, poverty level, hypertensive disorder and smoking. The association was similar for breech and other types of malpresentation (aOR 1.28, 95% CI 0.97, 1.70 and aOR 1.40, 95% CI 0.87, 2.26, respectively) and did not differ markedly by gestational age. Conclusions: Malpresentation at delivery was modestly associated with ASD. Early monitoring of the neurodevelopment of children born with malpresentation could identify children with ASD sooner and enhance opportunities to provide support to optimise developmental outcomes. [ABSTRACT FROM AUTHOR]

Objective Design Setting Population Methods Main Outcome Measures Results Conclusions To investigate the association between postpartum haemorrhage (PPH) and subsequent cardiovascular disease.Population‐based retrospective cohort study, using record linkage between Aberdeen Maternity and Neonatal Databank (AMND) and Scottish healthcare data sets.Grampian region, Scotland.A cohort of 70 904 women who gave birth after 24 weeks of gestation in the period 1986–2016.We used extended Cox regression models to investigate the association between having had one or more occurrences of PPH in any (first or subsequent) births (exposure) and subsequent cardiovascular disease, adjusted for sociodemographic, medical, and pregnancy and birth‐related factors.Cardiovascular disease identified from the prescription of selected cardiovascular medications, hospital discharge records or death from cardiovascular disease.In our cohort of 70 904 women (with 124 795 birth records), 25 177 women (36%) had at least one PPH. Compared with not having a PPH, having at least one PPH was associated with an increased risk of developing cardiovascular disease, as defined above, in the first year after birth (adjusted hazard ratio, aHR 1.96; 95% confidence interval, 95% CI 1.51–2.53; p < 0.001). The association was attenuated over time, but strong evidence of increased risk remained at 2–5 years (aHR 1.19, 95% CI 1.11–1.30, P < 0.001) and at 6–15 years after giving birth (aHR 1.17, 95% CI 1.05–1.30, p = 0.005).Compared with women who have never had a PPH, women who have had at least one episode of PPH are twice as likely to develop cardiovascular disease in the first year after birth, and some increased risk persists for up to 15 years. [ABSTRACT FROM AUTHOR]

Our study examined the acute and sustained impact of immigration policy changes announced in January 2017 on preterm birth (PTB) rates among Hispanic and non-Hispanic white women in Texas's border and nonborder regions. Using Texas birth certificate data for years 2008 through 2020, we used a multiple group interrupted time series approach to explore changes in PTB rates. In the nonborder region, the PTB rate among Hispanic women of any race was 8.64% in 2008 and was stable each year before 2017 but increased by.29% (95% CI [.12,.46]) annually between 2017 and 2020. This effect remained statistically significant even when compared with that of non-Hispanic white women (p =.014). In the border areas, the PTB rate among Hispanic women of any race was 11.67% in 2008 and remained stable each year before and after 2017. No significant changes were observed when compared with that of non-Hispanic white women (p =.897). In Texas as a whole, the PTB rate among Hispanic women of any race was 10.16% in 2008 and declined by.07% (95% CI [−.16, −.03]) per year before 2017, but increased by.16% (95% CI [.05,.27]) annually between 2017 and 2020. The observed increase was not statistically significant when compared with that of non-Hispanic white women (p =.326). The January 2017 immigration policies were associated with a sustained increase in PTB among Hispanic women in Texas's nonborder region, suggesting that geography plays an important role in perceptions of immigration enforcement. Future research should examine the impact of immigration policies on maternal and child health, considering geography and sociodemographic factors. [ABSTRACT FROM AUTHOR]

Introduction: Nationally, cesarean birth is one of the most performed surgical procedures, yet cesarean births have been linked to an increased risk of delivery complications. Prenatal care (PNC) and education are possible strategies to reduce the number of cesarean births. However, there is scant research assessing the impact of these strategies on safely reducing primary cesarean births. This study evaluates the association between the adequacy of PNC utilization and primary cesarean birth. Methods: The analysis used 2018 birth certificate data, and the sample included nulliparous women with no reported pregnancy or delivery complications (N = 729,140). Logistic regression was used to model the association between the adequacy of PNC utilization and delivery method, as well as identify other factors associated with the delivery method. Results: Among women with a primary cesarean birth, 36.2% had received adequate plus PNC. After adjustment, there was no significant association between women receiving inadequate, intermediate, or adequate PNC and primary cesarean birth. However, women who received adequate plus PNC had an increased odds of having a primary cesarean birth compared to women with no PNC (OR, 1.23; 95% CI, 1.18–1.28). Discussion: Findings from this study highlight the need to further understand the role of PNC and its potential impact on the delivery method. Within the patient-provider relationship, healthcare providers have the unique opportunity to provide education and inform patients of the risks and benefits of all delivery options. Thus, there is an increased opportunity to safely reduce primary cesarean births. Significance: In the United States, cesarean births remain relatively high and are associated with potentially adverse effects. However, literature describing the potential impact of strategies to reduce cesarean births, such as prenatal care, and its association with the delivery method is lacking. Using 2018 birth certificate data, researchers were able to evaluate the adequacy of prenatal care utilization and primary cesarean birth association. This study found that women with a high utilization of prenatal care were more likely to have a primary cesarean birth; therefore, healthcare providers are essential in advising pregnant women about the risks and benefits of primary cesarean birth. [ABSTRACT FROM AUTHOR]

Background In the general population randomized controlled trial PreventADALL, frequent emollient bath additives from 2 weeks of age did not prevent atopic dermatitis, while the effect on skin barrier function throughout infancy is not established. Objectives The primary aim of this exploratory substudy was to assess the effect of mineral-based oil baths on transepidermal water loss (TEWL) and dry skin through infancy, and secondarily to explore if filaggrin (FLG) mutations modified the effect. Methods Overall, 2153 infants were included and randomized to either the 'Skin intervention' (SI) group (n = 995) (oil bath 4 times weekly from 2 weeks through 8 months) or 'No skin intervention' (NSI) group (n = 1158), with TEWL measurements at 3, 6 and/or 12 months of age. Information on FLG mutation status was available for 1683 of these infants. Effects of the skin intervention on TEWL and dry skin through infancy were assessed by mixed-effects regression modelling. Background characteristics and protocol adherence were collected from electronic questionnaires, birth records and weekly diaries. Results The TEWL (95% confidence interval) was on average 0.42 g m–2 h–1 (0.13–0.70, P = 0.004) higher in the SI group compared with the NSI group through the first year of life, with significantly higher levels at 3 months [8.6 (8.3–9.0) vs. 7.6 (7.3–7.9)], but similar at 6 and 12 months. Dry skin was observed significantly more often in the NSI group compared with the SI group at 3 months (59% vs. 51%) and at 6 months of age (63% vs. 53%), while at 12 months of age, the difference was no longer significant. At 3 months, the TEWL of FLG mutation carriers was similar to the TEWL in the SI group. No interaction between SI and FLG mutation was found in the first year of life. Conclusions Infants given frequent oil baths from 2 weeks of age had reduced skin barrier function through infancy compared with controls, largely attributed to higher TEWL at 3 months of age, while the skin at 3 and 6 months appeared less dry in infants subjected to the skin intervention. [ABSTRACT FROM AUTHOR]

I study the determinants of childhood lead screening using all Illinois birth records (2001–2014) matched to lead testing records and geocoded housing age data. Housing age measures lead risk, as older houses disproportionally have lead paint. Changes in geographic access to providers provide variation in nonmonetary costs of testing. Higher costs reduce screening among low- and high-risk households alike. Thus, self-selection based on screening costs does not appear to improve targeting, even though high-risk households are willing to pay $31–419 more than low-risk households for screening. Screening incentives would be cost-effective for reasonable values of lead poisoning externalities. [ABSTRACT FROM AUTHOR]

The so-called "Moldavian language", invented by the Soviets in the 1920s, was just another instrument for the Soviet effort trying to assimilate people and to erase national identities, in order to make room for the "Soviet identity". The Gulags, the massacres, the deportations and assassinations were not enough to "convince" people to embrace the new Soviet identity, the Soviet Communists needed pseudo-science as well. But the so-called "Moldavian language" was more than just another Soviet social engineering, it was an integrate part of a geopolitical strategy aimed at dismembering Romania and at conquering more of Central and South-Eastern Europe. This explicit anti-Romanian and geopolitical objective was written down by the Soviets in the very birth certificate of the "Moldavian language" in 1924, and it was copied by Serbian authorities after WW2, trying to invent a "Vlach language" for the Romanian minority in Serbia. Neither Russia, nor Serbia have yet abandoned these efforts. [ABSTRACT FROM AUTHOR]

Islamic Republic of Iran has provided a legal framework for embryo transfer so that fertility becomes possible with third party intervention. The use of this method of fertility as well as its effects and rules are subject to cultural, social and religious factors. The brief nature of the embryo donation law indicates the lack of adequate measures for the child's future. The present study aimed to review the embryo donation law in Iran and some challenges in determining the rights of the child. This study employed a library, descriptive and analytical method and is based on Shia jurisprudence and law books. By using the keywords of "Donation, Alimony, Custody, and Inheritance", various aspects of the embryo donation law have been investigated. Article 3 of the Embryo Donation Law considers the duties and responsibilities of the couples who donate the embryo and the born child in terms of maintenance, alimony and being mahram1, similar to the duties and responsibilities of children and parents. However, the important issues of lineage and inheritance are not considered. Neither it elaborates compliance with the principle of confidentiality and the non-identification of the genetic parents, the coercive guardianship of the father, and the prohibition of marriage (being mahram). There is neither enough clarity about the method of evaluating the recipient couple's moral competence, the limit of the number of gamete donations, alimony, or custody. It is necessary to explain the kinship and genetic inheritance, amend birth certificate registration law, specify the rejection of anonymity to prevent the phenomenon of mixing lineage based on Shia jurisprudence, or to add new materials to this law. [ABSTRACT FROM AUTHOR]

Purpose: Postneonatal mortality (PNM), which differs from infant and perinatal mortality, has been observed in the past 25 years with respect to the health outcomes of children. While infant and perinatal mortality have been well-evaluated regarding racial differentials, there are no substantial data on PNM in this perspective. The purpose of this study was to assess whether or not social determinants of health adversely affect racial/ethnic PNM differentials in the USA. Design/methodology/approach: A cross-sectional, nonexperimental epidemiologic study design was used to assess race as an exposure function of PNM using Cohort Linked Birth/Infant Death Data (2013). The outcome variable assessed PNM, while the main independent variables were race, social demographic variables (i.e. sex and age) and social determinants of health (i.e. marital status and maternal education). The chi-square statistic was used to assess the independence of variables by race, while the logistic regression model was used to assess the odds of PNM by race and other confounding variables. Findings: During 2013, there were 4,451 children with PNM experience. The cumulative incidence of PNM was 23.6% (n = 2,795) among white infants, 24.3% (n = 1,298) among Black/African-Americans (AA) and 39.5% (n = 88) were American-Indian infants (AI), while 21.3% (n = 270) were multiracial, χ2 (3) = 35.7, p < 0.001. Racial differentials in PNM were observed. Relative to White infants, PNM was two times as likely among AI, odds ratio (OR) 2.11 (95% confidence interval [CI] 1.61, 2.78). After controlling for the confounding variables, the burden of PNM persisted among AI, although slightly marginalized, adjusted odds ratio (aOR) 1.70, (99% CI 1.10, 2.65). Originality/value: In a representative sample of US children, there were racial disparities in PNM infants who are AI compared to their white counterparts, illustrating excess mortality. These findings suggest the need to allocate social and health resources in transforming health equity in this direction. [ABSTRACT FROM AUTHOR]

Background Methods Results Conclusions Previous research has linked prenatal maternal infections to later childhood developmental outcomes and socioemotional difficulties. However, existing studies have relied on retrospectively self‐reported survey data, or data on hospital‐recorded infections only, resulting in gaps in data collection.This study used a large linked administrative health dataset, bringing together data from birth records, hospital records, prescriptions and routine child health reviews for 55,856 children born in Greater Glasgow & Clyde, Scotland, 2011–2015, and their mothers. Logistic regression models examined associations between prenatal infections, measured as both hospital‐diagnosed prenatal infections and receipt of infection‐related prescription(s) during pregnancy, and childhood developmental concern(s) identified by health visitors during 6‐8 week or 27‐30 month health reviews. Secondary analyses examined whether results varied by (a) specific developmental outcome types (gross‐motor‐skills, hearing‐communication, vision‐social‐awareness, personal‐social, emotional‐behavioural‐attention and speech‐language‐communication) and (b) the trimester(s) in which infections occurred.After confounder/covariate adjustment, hospital‐diagnosed infections were associated with increased odds of having at least one developmental concern (OR: 1.30; 95% CI: 1.19–1.42). This was broadly consistent across all developmental outcome types and appeared to be specifically linked to infections occurring in pregnancy trimesters 2 (OR: 1.34; 95% CI: 1.07–1.67) and 3 (OR: 1.33; 95% CI: 1.21–1.47), that is the trimesters in which foetal brain myelination occurs. Infection‐related prescriptions were not associated with any clear increase in odds of having at least one developmental concern after confounder/covariate adjustment (OR: 1.03; 95% CI: 0.98–1.08), but were associated with slightly increased odds of concerns specifically related to personal‐social (OR: 1.12; 95% CI: 1.03–1.22) and emotional‐behavioural‐attention (OR: 1.15; 95% CI: 1.08–1.22) development.Prenatal infections, particularly those which are hospital‐diagnosed (and likely more severe), are associated with early childhood developmental outcomes. Prevention of prenatal infections, and monitoring of support needs of affected children, may improve childhood development, but causality remains to be established. [ABSTRACT FROM AUTHOR]

Objective: To describe utilization of prenatal care and outcomes of low birth weight and preterm birth among adolescent births in Mexico. Methods: We used birth certificate data and included live births to individuals 10–24 years, 2008–2019. Our outcomes were binary measures of adequate prenatal care, low birth weight, and preterm birth. We compared adolescents (10–14 years, 15–16, and 17–19) to those 20–24 years. We included individual‐, clinical‐, and municipality‐level variables, used multivariable logistic regression, and calculated adjusted predicted probabilities. We also tested whether receipt of prenatal care moderated the relationship of age with preterm birth and low birth weight. Results: We included a total of 12 106 710 births to women 10–24 years. The adjusted predicted probability of adequate prenatal care increased with age: 56.07% (95% CI 55.82–56.31%) adjusted probability among adolescents 10–14 years compared with 65.51% (95% CI 65.48%–65.55%) among individuals 20–24 years. Receipt of adequate prenatal care in part mitigated disparities in preterm birth and low birthweight across all age groups: 7.30% (95% CI 7.17%–7.43%) adjusted probability of delivering a preterm infant among those 10–14 years who received adequate prenatal care compared with 9.37% (95% CI 9.20%–9.53%) among those 10–14 years without adequate prenatal care. Conclusion: In Mexico, adolescent pregnancies are associated with inadequate prenatal care as well as higher odds of preterm delivery and low birth weight. Youngest adolescents (10–14 years) have the highest probability of adverse outcomes. Adequate prenatal care may help partially mitigate disparities in poor perinatal outcomes. Synopsis: In Mexico, adolescent pregnancies have higher odds of prematurity and low birthweight. Adequate prenatal care may partially mitigate these disparities. [ABSTRACT FROM AUTHOR]

Based on the background that has been presented, the researcher wants to evaluate the effectiveness of the birth certificate making process at the Population and Civil Registration Office of Kuningan Regency, especially in terms of service speed and community satisfaction. This research uses a qualitative approach by involving key informants such as the Head of Civil Registration Division, Reni Sriherliyani, SE, M.M., and the Head of Civil Registration Section, Teti Tresnawati, SE. The results of the interview show that the process of making a birth certificate at the Population and Civil Registration Office of Kuningan Regency has been carried out in accordance with applicable legal provisions, including Law Number 24 of 2013 concerning Amendments to Law Number 23 of 2006 concerning Population Administration, as well as Regional Regulation Number 1 of 2015 concerning Amendments to Kuningan Regency Regional Regulation Number 3 of 2010 concerning Population Administration Services. The author concludes that the service of making birth certificates at the Population and Civil Registration Office has been effective, with an emphasis on achieving concrete time and in accordance with applicable legal provisions. Nevertheless, there are still some obstacles in the process of making birth certificates at the Office. [ABSTRACT FROM AUTHOR]

Background: Poland has one of the highest cesarean birth (CB) rates in Europe. For this study, we used the Robson Ten‐Group Classification System (TGCS) to analyze trends in the induction and CB rates in one hospital in Poland over a period of 11 years. We compare these trends with changes in National Legislative and Medical Guidelines introduced during this time that were aimed at lowering rates of unnecessary medical interventions. Methods: We conducted a retrospective study including all births after 24 weeks' gestation between 2010 and 2020 from one tertiary hospital (n = 66,716 births). After the deletion of records with missing data, 66,678 births were included in the analysis. All births were classified according to the Robson TGCS. The size, CB rate, and contribution of each group for every year were calculated. Linear regression analyses were used to analyze trends over time. Results: The total CB rate varied from 29.6% to 33.0% during the study period, with a linear increase of 0.045 percentage points annually (R2 = 0.021; F(1) = 0.189; p = 0.674). This study was considerably lower than the total CB rate for Poland, which rose from 33.9% in 2010 to 45.1% in 2020, increasing at a rate of 1.13 percentage points per year (R2 = 0.93; F(1) = 61.88; p < 0.001). Induction rates among both nulliparous (R1 + R2) and multiparous (R3 + R4) women at term also increased. Study groups R5 (previous cesarean birth), R2 (nulliparous in induced or prelabor cesarean delivery), and R1 (nulliparous women at term with single cephalic pregnancy in spontaneous labor) were the highest contributors to the overall CB rate. The greatest decrease in the CB rate was detected in group R5b (more than one previous CB). None of the groups showed statistically significant increases in CB rates over the study period. Conclusions: The CB rate in the hospital where the study was conducted was considerably lower than the total CB rate in Poland. When compared with countries with similar CB rates, group R2b (women with nulliparous, prelabor cesarean birth) in our study was considerably larger. More comparisons across different hospital settings in Poland are needed. However, as hospitals are not encouraged to routinely collect the data needed to construct TGCS, such comparisons are very difficult to conduct. [ABSTRACT FROM AUTHOR]

Aim: Relatively few obese children and adolescents receive specialist treatment. Our aim was to assess associations between risk of receiving an obesity diagnosis in secondary/tertiary health services by socio-economic position and immigrant background in order ultimately to improve equity in health services. Methods: The study population comprised Norwegian-born children aged 2–18 years between 2008 and 2018 (N =1,414,623), identified via the Medical Birth Registry. Cox regressions were used to calculate hazard ratios (HR) of an obesity diagnosis from secondary/tertiary health services (Norwegian Patient Registry) by parental education and household income and by immigrant background. Results: Higher parental education and household income were associated with a lower hazard of obesity diagnosis regardless of Norwegian versus immigrant background. Compared to having a Norwegian background, having a Latin American (HR=4.12; 95% confidence interval (CI) 3.18–5.34), African (HR=1.54; 95% CI 1.34–1.76) and Asian (HR=1.60; 95% CI 1.48–1.74) background was associated with higher hazard of obesity diagnosis. Adjusted for parental education and household income, corresponding HRs were 3.28 (95% CI 2.95–3.65) for Latin America, 0.95 (95% CI 0.90–1.01) for Africa and 1.08 (95% CI 1.04–1.11) for Asia. Within Asia, those with a background from Pakistan, Turkey, Iraq and Iran had higher hazards than those with a Norwegian background, while those with a background from Vietnam had lower hazards, even after adjusting for parental education and household income. Conclusions: To ensure more equitable treatment, more knowledge is warranted about health-service access and referral patterns, and underlying population prevalence rates, for obese children and adolescents with different immigrant backgrounds. [ABSTRACT FROM AUTHOR]

The article focuses on the life and achievements of Giuseppe Biancheri, a notable figure in the Ventimiglia constituency and Knight of Saint Annunziata. Topics include his long tenure as president of the Subalpine and Italian Chambers, the unpublished telegrams and letters from state authorities preserved by the Biancheri Foundation, and significant moments such as his invitation to witness Prince Umberto's birth certificate registration and Queen Margaret's tribute after his passing.

The reader will come to appreciate that: • Race-based disparities in pulse oximetry have been reported in large retrospective database studies involving adults and recently in pediatric populations. • Pulse oximeters overestimate oxygen saturation in Black compared to other races, particularly in hypoxic states. • Role of skin pigmentation and other dermatological factors that may vary between racial groups has not been evaluated. • Defining mechanisms of this inaccuracy is critical to addressing this disparity in pulse oximeter performance. Race-based and skin pigmentation-related inaccuracies in pulse oximetry have recently been highlighted in several large electronic health record-based retrospective cohort studies across diverse patient populations and healthcare settings. Overestimation of oxygen saturation by pulse oximeters, particularly in hypoxic states, is disparately higher in Black compared to other racial groups. Compared to adult literature, pediatric studies are relatively few and mostly reliant on birth certificates or maternal race-based classification of comparison groups. Neonates, infants, and young children are particularly susceptible to the adverse life-long consequences of hypoxia and hyperoxia. Successful neonatal resuscitation, precise monitoring of preterm and term neonates with predominantly lung pathology, screening for congenital heart defects, and critical decisions on home oxygen, ventilator support and medication therapies, are only a few examples of situations that are highly reliant on the accuracy of pulse oximetry. Undetected hypoxia, especially if systematically different in certain racial groups may delay appropriate therapies and may further perpetuate health care disparities. The role of biological factors that may differ between racial groups, particularly skin pigmentation that may contribute to biased pulse oximeter readings needs further evaluation. Developmental and maturational changes in skin physiology and pigmentation, and its interaction with the operating principles of pulse oximetry need further study. Importantly, clinicians should recognize the limitations of pulse oximetry and use additional objective measures of oxygenation (like co-oximetry measured arterial oxygen saturation) where hypoxia is a concern. [ABSTRACT FROM AUTHOR]

The issuance of birth certificates for the child population in Banten Province has reached the specified target, where out of 2,923,089 child population who have birth certificates as many as 2,905,894 residents or equivalent to 99.41%. However, this is not matched by the issuance of Child Identity Cards, the percentage of coverage is still very low, only reaches 29.78% of the entire child population who already has a birth certificate. The purpose of the research is to find out, analyze, and explain the implementation of the child identity card, and the determinant factors that determine and construct an effective Child Identity Card policy implementation model in Serang Regency, Banten Province. This research uses the theory of policy implementation put forward by Hamdi (2014) with the dimensions of productivity, linearity, and efficiency. Determinant factors that influence policy implementation are policy substance, implementing officer behavior, network interaction, target group participation, and resources. The research method used is qualitative research with a descriptive approach. Data collection techniques were carried out through interviews, observation, and documentation. The results showed that the implementation of the Child Identity Card policy in Serang Regency was not optimal. This is evidenced by the realization of the Child Identity Card in Serang Regency of 41.58%. Determinant factors affecting the implementation of the Child Identity Card policy in Serang Regency: the consistency of the derivation of content/specifications are in line with national policy, the learning ability of the need for support from the central, provincial and district/city governments in implementing the policy, cooperation between implementers of the Child Identity Card policy implementation has not gone well, and the participation of target groups is not optimal and even tends to conflict with government policy. To improve policy implementation, the ZEMI Model (Zoning, Efficiency, Modernization, and Innovation) of Child Identity Card Policy Implementation in Serang Regency, Banten Province is constructed. [ABSTRACT FROM AUTHOR]

This article discusses a case study involving a same-sex female couple who used a sperm donor to conceive a child. Under UK law, both partners were able to be registered as the child's legal parents on her birth certificate. However, when the couple later broke up, the law allowed the mother to have the second legal parent's name removed from the birth certificate and replaced with that of the sperm donor. This decision was based on the fact that the child's conception method (artificial insemination or sexual intercourse) could not be definitively proven. The article raises concerns about the impact of this decision on children's identities and suggests that the law should consider recognizing more than two legal parents in certain cases. [Extracted from the article]

Background: Contemporary estimates of diabetes mellitus (DM) rates in pregnancy are lacking in Canada. Accordingly, this study examined trends in the rates of type 1 (T1DM), type 2 (T2DM) and gestational (GDM) DM in Canada over a 15-year period, and selected adverse pregnancy outcomes. Methods: This study used repeated cross-sectional data from the Canadian Institute of Health Information (CIHI) hospitalization discharge abstract database (DAD). Maternal delivery records were linked to their respective birth records from 2006 to 2019. The prevalence of T1DM, T2DM and GDM were calculated, including relative changes over time, assessed by a Cochrane-Armitage test. Also assessed were differences between provinces and territories in the prevalence of DM. Results: Over the 15-year study period, comprising 4,320,778 hospital deliveries in Canada, there was a statistically significant increase in the prevalence of GDM and T1DM and T2DM. Compared to pregnancies without DM, all pregnancies with any form of DM had higher rates of hypertension and Caesarian delivery, and also adverse infant outcomes, including major congenital anomalies, preterm birth and large-for-gestational age birthweight. Conclusion: Among 4.3 million pregnancies in Canada, there has been a rise in the prevalence of DM. T2DM and GDM are expected to increase further as more overweight women conceive in Canada. [ABSTRACT FROM AUTHOR]

Objective: To assess the prevalence of adverse perinatal outcomes in antenatal women with low amniotic fluid index at term. Study Design: Observational Cross-sectional Analysis. Setting: Department of Gynaecology and Obstetrics Hayatabad Medical Complex, Peshawar. Period: 2nd February 2020, to 5th February 2021. Methods: The study involved a total of 165 patients, in 37 to 40-weeks of gestation period, the research included antenatal women with a low amniotic fluid index, with any parity, gravidity, and 18-35 years of age. While Excluded patients with any medical disorders during pregnancy (e.g., PIH, anemia, cardiac disease etc.), and those with gestational period <37 weeks from the study. Thorough history, clinical examination and ultrasound were carried out of all the women included in the study from OPD and emergency department, to confirm a low amniotic fluid index. Patient follow-up was extended to their arrival in the Obstetric suite during established labor, APGAR scores were calculated and recorded at birth, and at the 5-minute of birth for the neonate. Adverse Perinatal Outcome was considered positive if the APGAR Score was <7/10 at five minutes of life of neonate. Data analysis was performed using SPSS 23. Results: Out of 165 patients 57% of the patients were induced while 43% spontaneously delivered, similarly 66.7% were delivered vaginally while 33.3% were delivered via C Section. Low neonatal APGAR score was recorded in 67.9% patients which is a significant percentage, hence our study results showed positive correlation of low AFI with adverse perinatal outcome. We also observed that probability of satisfactory values of AFI is 1.5 times more in spontaneous deliveries (p=0.04, OR=1.5), however no such relation exists for period of gestation or number of parity. Similarly, there is a significant relation of mode of delivery with satisfactory values of AFI (p=0.00), however no such relation exists for period of gestation or number of parity. However, the probability of vaginal deliveries is 1.6 times more with an increased in number of para (p=0.02, OR=1.6). Conclusion: Reduced amniotic fluid index is linked with significant Unfavorable Perinatal Outcomes proved by low APGAR score (<7/10 at five minutes). [ABSTRACT FROM AUTHOR]

The preweaning period for a dairy calf is characterized by high morbidity and mortality rates, leading to financial losses for producers. Identifying strategies to improve the health and welfare of calves while reducing antimicrobial use continues to be crucial to the success of the dairy industry. The objective of this study was to determine the effects of feeding colostrum replacer (CR) to dairy heifer calves beyond d 1 of life on growth, serum IgG, the incidence of diarrhea and bovine respiratory disease (BRD), and the risk of mortality in the preweaning period. At birth, Holstein heifer calves (n = 200; 50/treatment) weighing 40.7 ± 0.35 kg (mean ± SE) were fed 3.2 L of CR (205 g IgG/feeding) at 0 h and 12 h of life. Calves were then randomly assigned to 1 of 4 treatments: 450 g of milk replacer (MR) from d 2 to 14 (control, CON), 380 g of CR + 225 g of MR from d 2 to 3, then 450 g of MR from d 4 to 14 (transition, TRAN), 45 g of CR + 450 g of MR from d 2 to 14 (extended, EXT); or 380 g of CR + 225 g of MR from d 2 to 3, then 45 g of CR + 450 g of MR from d 4 to 14 (transition + extended, TRAN+EXT). Each treatment was reconstituted to 3 L and fed twice daily. All CR treatments were fed using bovine-derived CR containing 27% IgG. From d 15 to 41, all calves were fed 600 g of MR reconstituted to 4 L twice daily. Body weight was recorded at birth and every 7 d until study completion on d 49. Blood samples were taken daily until d 7 to evaluate serum IgG and then every 7 d until d 49. A health assessment was performed daily to evaluate calves for BRD and diarrhea. Data were analyzed using mixed linear regression, mixed logistic regression, and survival analysis models in SAS 9.4. Serum IgG concentrations were not affected by treatment for the study period. The EXT and TRAN+EXT groups had greater average daily gain (ADG) from d 7 to 14 (0.14 kg/d) and the TRAN group had greater ADG from d 14 to 21 (0.11 kg/d), compared with CON. There was no association of treatment with the odds or the duration of a diarrhea bout. However, provision of CR to the TRAN and EXT calves was associated with a reduced hazard of diarrhea compared with CON calves. Furthermore, TRAN and EXT calves have a lower hazard of mortality compared with CON calves, with TRAN and EXT calves had a 2.8- and 3.8-times lower hazard of mortality, respectively. Our findings suggest that the supplementation of CR to dairy calves positively affects ADG, and reduces the hazard of diarrhea and mortality during the preweaning period. Future research should look to further refine the supplementation strategy of CR to calves and explore the mechanism of action. [ABSTRACT FROM AUTHOR]