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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]

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]

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]

We study the effect of exposure to immigrants on the educational outcomes of U.S.-born students, using a unique dataset combining population-level birth and school records from Florida. This research question is complicated by the substantial school selection of U.S.-born students, especially among White and comparatively affluent students, in response to the presence of immigrant students in the school. We propose a new identification strategy, comparing sibling outcomes with the inclusion of family fixed effects, to partial out the unobserved non-random selection of native-born families into schools. We find that the presence of immigrant students has a positive effect on the academic achievement of U.S.-born students, especially for students from disadvantaged backgrounds. Moreover, the presence of immigrants does not negatively affect the performance of affluent U.S.-born students, who typically show a higher academic achievement compared to immigrant students. We provide suggestive evidence on potential channels. [ABSTRACT FROM AUTHOR]

Individual abundances in the Milky Way disc record stellar birth properties [e.g. age, birth radius (R birth)], and capture the diversity of the star-forming environments over time. Assuming an analytical relationship between ([Fe/H], [α/Fe]), and R birth, we examine the distributions of individual abundances [X/Fe] of elements C, O, Mg, Si, Ca (α), Al (odd-z), Mn (iron-peak), Y, and Ba (neutron-capture) for stars in the Milky Way. We want to understand how these elements might differentiate environments across the disc. We assign tracks of R birth in the [α/Fe] versus [Fe/H] plane as informed by expectations from simulations for ∼59 000 GALAH stars in the solar neighborhood (R ∼ 7−9 kpc) which also have inferred ages. Our formalism for R birth shows that older stars (∼10 Gyrs) have an R birth distribution with smaller mean values (i.e. |$\bar{R}_{\mbox{birth}} \sim 5\pm 0.8$| kpc) compared to younger stars (∼6 Gyrs; |$\bar{R}_{\mbox{birth}} \sim 10\pm 1.5$| kpc), for a given [Fe/H], consistent with inside–out growth. The α-, odd-z, and iron-peak element abundances decrease as a function of R birth, whereas the neutron-capture abundances increase. The R birth–[Fe/H] gradient we measure is steeper compared to the present-day gradient (−0.066 dex kpc−1 versus −0.058 dex kpc−1), which we also find true for R birth–[X/Fe] gradients. These results (i) showcase the feasibility of relating the birth radius of stars to their element abundances, (ii) demonstrate that the Milky Way abundance gradients across R birth have evolved to be shallower over time, and (iii) offer an observational comparison to element abundance distributions in hydrodynamical simulations. [ABSTRACT FROM AUTHOR]

Objectives Very early-life conditions are recognized as critical for healthy brain development. This study assesses early-life risk factors for developing dementia. In the absence of historical medical birth records, we leverage an alternative full population approach using demographic characteristics obtained from administrative data to derive proxy indicators for birth complications and unfavorable birth outcomes. We use proxy variables to investigate the impact of early-life risk factors on dementia risk. Methods We use administrative individual-level data for full cohorts born 1932–1950 in Sweden with multigenerational linkages. Records on hospitalization and mortality are used to identify dementia cases. We derive 3 birth risk factors based on demographic characteristics: advanced maternal age, narrow sibling spacing, and twin births, and apply survival analysis to evaluate long-term effects on dementia risk. We control for confounding using multiple indicators for socio-economic status (SES), including parental surnames, and by implementing a sibling design. As comparison exposure, we add low education from the 1970 Census. Results The presence of at least 1 birth risk factor increases dementia risk (HR = 1.059; 95% CI: 1.034, 1.085). The occurrence of twin births poses a particularly heightened risk (HR = 1.166; 95% CI: 1.084, 1.255). Discussion Improvements to the very early-life environment hold significant potential to mitigate dementia risk. A comparison to the influence of low education on dementia (the largest known modifiable risk factor) suggests that demographic birth characteristics are of relevant effect sizes. Our findings underscore the relevance of providing assistance for births experiencing complications and adverse health outcomes to reduce dementia cases. [ABSTRACT FROM AUTHOR]

In Nigeria, most basic maternal and child health services in public primary health-care facilities should be either free of charge or subsidized. In practice, additional informal payments made in cash or in kind are common. We examined the nature, drivers and equity consequences of informal payments in primary health centres (PHC) in Enugu State. We used three interlinked qualitative methods: participant observation in six PHC facilities and two local government area (LGA) headquarters; in-depth interviews with frontline health workers (n  = 19), managers (n  = 4) and policy makers (n  = 10); and focus group discussions (n  = 2) with female service users. Data were analysed thematically using NVivo 12. Across all groups, informal payments were described as routine for immunization, deliveries, family planning consultations and birth certificate registration. Health workers, managers and policy makers identified limited supervision, insufficient financing of facilities, and lack of receipts for formal payments as enabling this practice. Informal payments were seen by managers and health workers as a mechanism to generate discretionary revenue to cover operational costs of the facility but, in practice, were frequently taken as extra income by health workers. Health workers rationalized informal payments as being of small value, and not a burden to users. However, informal payments were reported to be inequitable and exclusionary. Although they tended to be lower in rural PHCs than in wealthier urban facilities, participant observation revealed how, within a PHC, the lowest earners paid the same as others and were often left unattended if they failed to pay. Some female patients reported that extra payments excluded them from services, driving them to seek help from retail outlets or unlicensed health providers. As a result, informal payments reduced equity of access to essential services. Targeted policies are needed to improve financial risk protection for the poorest groups and address drivers of informal payments and unfairness in the health system. [ABSTRACT FROM AUTHOR]

Millions of women continue to die during and soon after childbirth, even where the knowledge and resources to avoid this are available. We posit that raising the share of women in parliament can trigger action. Leveraging the timing of gender quota legislation across developing countries, we identify sharp sustained reductions of 7%–12% in maternal mortality. Investigating mechanisms, we find that gender quotas lead to increases in percentage points of 5–8 in skilled birth attendance and 4–8 in prenatal care utilization, alongside a decline in fertility of 6%–7% and an increase in the schooling of young women of about 0.5 years. The results are robust to numerous robustness checks. They suggest a new policy tool for tackling maternal mortality. [ABSTRACT FROM AUTHOR]

Preterm birth occurs in 10% of all live births and creates challenges to neonatal life, which persist into adulthood. Significant previous work has been undertaken to characterize and understand the respiratory and cardiovascular sequelae of preterm birth, which are present in adulthood, i.e. "late" outcomes. However, many gaps in knowledge are still present and there are several challenges that will make filling these gaps difficult. In this perspective we discuss the obstacles of studying adults born preterm, including (1) the need for invasive (direct) measures of physiologic function; (2) the need for multistate, multinational, and diverse cohorts; (3) lack of socialized medicine in the United States; (4) need for detailed and better-organized birth records; and (5) transfer of neonatal and pediatric knowledge to adult care physicians. We conclude with a discussion on the "future" of studying preterm birth in regards to what may happen to these individuals as they approach middle and older age and how the improvements in perinatal and postnatal care may be changing the phenotypes observed in adults born preterm on or after the year 2000. [ABSTRACT FROM AUTHOR]

Introduction In December 2019, the minimum legal sales age (MLSA) for tobacco products in the United States was raised from 18 to 21 years as a measure of preventing smoking initiation. Smoking during pregnancy, which causes maternal, fetal, and infant morbidity and mortality, is a major public health concern. We first study the effects of purchase restrictions on smoking during different stages of pregnancy covering the entire United States and using the records of all live births during 2014–2018 by birthing people aged 18–21 years. Aims and Methods Our identification strategy utilizes the variation in the MLSA of tobacco products over time and across counties in the United States during 2014–2018 using a two-way fixed effects model, modified to accommodate a partially observable treatment indicator. Results The results show that 37.4% of potential smokers in our study population would have been prevented from smoking before pregnancy, 50.5% during the first trimester, 53.4% during the second trimester, and 14.8% during the third trimester if the law prevented selling tobacco products to them in the locality they live. A purchase restriction is estimated to cause the smoking intensity of those who smoke, the intensive margin, to drop by 5.4% before pregnancy, 10.4% during the first trimester, 14.8% during the second trimester, and 5.2% during the third trimester. Conclusions Our results show that purchase restrictions are highly effective in preventing smoking among birthing people in the 18–21 years age group. The effect on smoking prevalence during the first and second trimesters is more pronounced. Implications Many countries around the world have recently tightened age-based purchase restriction policies as a tobacco control measure. We first study the effects of purchase restrictions on smoking during different stages of pregnancy using the birth records of all pregnancies in the United States by birthing people aged 18–21 years during 2014–2018. The study utilizes the variation in the MLSA of tobacco products over time and across counties during that period. Our results show that purchase restrictions are highly effective in preventing smoking among birthing people in the 18–21 years age group. [ABSTRACT FROM AUTHOR]

The objective of this study was to compare three-breed rotational crossbred calves sired by Holstein, Jersey, Montbéliarde, Normande, Viking Red, and Limousin bulls with Holstein's calves fed a high milk allowance for growth, milk consumption, health scores, and profitability in an automated group feeding system. Breed groups were Holstein (n = 16), crossbreds of Montbéliarde, Viking Red, and Holstein (n = 24), crossbreds of Jersey, Normande, and Viking Red (n = 6), and Limousin crossbred beef × dairy (n = 45) calves. Calves were randomly assigned within the breed to one of two treatments from September 2019 to June 2020 at the University of Minnesota West Central Research and Outreach Center in Morris, MN. The five breed groups were balanced across the two treatment groups. Treatment groups were fed 8 L/d (8 L) or ad libitum (AL) milk allowance, and calves were introduced to the automated feeder at day 5 and were weaned at 56 d. Milk feeding behaviors (drinking speeds) were collected from the automatic feeding system and analyzed by feeding and breed groups. Body weights were recorded at birth and weekly through weaning. The health scores of calves were recorded twice per week. Variables included in the statistical model for analyses were fixed effects of birthweight, the season of birth, breed group, and treatment group. Calves fed AL had a greater weaning weight (P = 0.001; 106.4 kg vs. 91.4 kg) and greater (P = 0.001) average daily gain (ADG; 1.11 kg/d vs. 0.87 kg/d) than calves fed 8 L, respectively. The calves fed AL (1,064 mL/min) had a slower drinking speed (P = 0.01) than calves fed 8 L (1,467 mL/min). Most breed groups were not different for weaning weight or ADG across the 56 d. Daily milk consumption per calf was lower (P = 0.009) for Limousin crossbred calves compared with Holstein and crossbred dairy calves. As expected, AL calves had higher (P = 0.001) milk cost ($189.52) than the 8 L calves ($140.71). The average cost per kilogram of gain was similar for calves fed 8 L ($2.89/kg) compared to AL ($3.00/kg) calves. Overall, the Limousin crossbred calves had the least milk cost ($152.75) compared with Holstein ($175.67) calves and Montbéliarde, Viking Red, and Holstein crossbred calves ($177.13). The results from this study found that although feeding calves AL resulted in greater milk consumption and higher cost than 8 L calves, there may be an economic advantage with costs per kilogram of gain to feeding calves ad libitum if increased growth rates are realized. [ABSTRACT FROM AUTHOR]

The epidemiologic literature estimating the indirect or secondary effects of the coronavirus disease 2019 (COVID-19) pandemic on pregnant people and gestation continues to grow. Our assessment of this scholarship, however, leads us to suspect that the methods most commonly used may lead researchers to spurious inferences. This suspicion arises because the methods do not account for temporal patterning in perinatal outcomes when deriving counterfactuals, or estimates of the outcomes had the pandemic not occurred. We illustrate the problem in 2 ways. First, using monthly data from US birth certificates, we describe temporal patterning in 5 commonly used perinatal outcomes. Notably, for all but 1 outcome, temporal patterns appear more complex than much of the emerging literature assumes. Second, using data from France, we show that using counterfactuals that ignore this complexity produces spurious results. We recommend that subsequent investigations on COVID-19 and other perturbations use widely available time-series methods to derive counterfactuals that account for strong temporal patterning in perinatal outcomes. [ABSTRACT FROM AUTHOR]

"The Birth Certificate: An American History" by Susan J. Pearson is a comprehensive study of the birth certificate as a document that shapes our understanding of ourselves and our nation. Pearson explores how the birth certificate has been contested throughout its 400-year history, particularly in relation to issues of gender, race, and authority. The book draws on a wide range of primary sources and is divided into three sections: "Building Birth Registration," "Living with Birth Registration," and "Contesting Birth Registration." Pearson examines how birth registration has transformed family and community authority, and how it has been used as a tool for social control and discrimination. The book concludes by discussing the ongoing relevance of birth certificates in contemporary debates, such as the "bathroom bills" of the 21st century. Overall, "The Birth Certificate" provides valuable insights into the complex history and significance of this seemingly mundane document. [Extracted from the article]

Sudden unexpected infant death (SUID) disproportionately affects non-Hispanic Black (NHB) and American Indian/Alaskan Native infants, who have lower rates of breastfeeding than other groups. Using 13,077,880 live-birth certificates and 11,942 linked SUID death certificates from 2015 through 2018, we calculated odds ratios and adjusted risk differences of SUID in infants who were not breastfed across 5 racial/ethnic strata in the United States. We analyzed mediation by not breastfeeding in the race/ethnicity–SUID association. The overall SUID rate was 0.91 per 1,000 live births. NHB and American Indian/Alaskan Native infants had the highest disparity in SUID relative to non-Hispanic White infants. Overall, not breastfeeding was associated with SUID (adjusted odds ratio (aOR), 1.14; 95% confidence interval (CI): 1.10, 1.19), and the adjusted risk difference was 0.12 per 1,000 live births. The aOR of not breastfeeding for SUID was 1.07 (95% CI: 1.00, 1.14) in NHB infants and 1.29 (95% CI: 1.14, 1.46) in Hispanic infants. Breastfeeding minimally explained the higher SUID risk in NHB infants (2.3% mediated) and the lower risk in Hispanic infants (2.1% mediated) relative to non-Hispanic White infants. Competing risks likely explain the lower aOR seen in NHB infants of not breastfeeding on SUID, suggesting that social or structural determinants must be addressed to reduce racial disparities in SUID. [ABSTRACT FROM AUTHOR]

Crossbreeding is a common practice among commercial sheep producers to improve animal performance. However, genetic evaluation of U.S. sheep is performed within breed type (terminal sire, semi-prolific, and western range). While incorporating crossbred records may improve assessment of purebreds, it requires accounting for heterotic and breed effects in the evaluation. The objectives of this study were to: 1) describe the development of a paternal composite (PC) line, 2) determine the effect of direct and maternal heterosis on growth traits of crossbred lambs, 3) estimate (co)variance components for direct and maternal additive, and uncorrelated maternal environmental, effects, and 4) provide an interpretation of the estimates of random effects of genetic groups, and to use those solutions to compare the genetic merit of founding breed subpopulations. Data included purebred and crossbred records on birth weight (BN; n = 14,536), pre-weaning weight measured at 39 or 84 d (WN; n = 9,362) depending on year, weaning weight measured at 123 d (WW; n = 9,297), and post-weaning weight measured at 252 d (PW; n = 1,614). Mean (SD) body weights were 5.3 (1.1), 16.8 (3.9) and 28.0 (7.6), 39.1 (7.2), and 54.2 (8.7) kg for BN, WN (at the two ages), WW, and PW, respectively. In designed experiments, the Siremax, Suffolk, Texel, Polypay, Columbia, Rambouillet, and Targhee breeds were compared within the same environment. Estimates of heterotic effects and covariance components were obtained using a multiple trait animal model. Genetic effects based on founders' breeds were significant and included in the model. Percent estimates of direct heterosis were 2.89 ± 0.61, 2.60 ± 0.65, 4.24 ± 0.56, and 6.09 ± 0.86, and estimates of maternal heterosis were 1.92 ± 0.87, 4.64 ± 0.80, 3.95 ± 0.66, and 4.04 ± 0.91, for BN, WN, WW, and PW, respectively. Correspondingly, direct heritability estimates were 0.17 ± 0.02, 0.13 ± 0.02, 0.17 ± 0.02, and 0.46 ± 0.04 for BN, WN, WW, and PW. Additive maternal effects accounted for trivial variation in PW. For BN, WN, and WW, respectively, maternal heritability estimates were 0.16 ± 0.02, 0.10 ± 0.02, and 0.07 ± 0.01. Uncorrelated maternal environmental effects accounted for little variation in any trait. Direct and maternal heterosis had considerable impact on growth traits, emphasizing the value of crossbreeding and the need to account for heterosis, in addition to breed effects, if crossbred lamb information is included in genetic evaluation. [ABSTRACT FROM AUTHOR]

Study Question: In a country with supportive funding for medically assisted reproduction (MAR) technologies, what is the proportion of MAR births over-time?Summary Answer: In 2017, 6.7% of births were conceived by MAR (4.8% ART and 1.9% ovulation induction (OI)/IUI) with a 55% increase in ART births and a stable contribution from OI/IUI births over the past decade.What Is Known Already: There is considerable global variation in utilization rates of ART despite a similar infertility prevalence worldwide. While the overall contribution of ART to national births is known in many countries because of ART registries, very little is known about the contribution of OI/IUI treatment or the socio-demographic characteristics of the parents. Australia provides supportive public funding for all forms of MAR with no restrictions based on male or female age, and thus provides a unique setting to investigate the contribution of MAR to national births as well as the socio-demographic characteristics of parents across the different types of MAR births.Study Design, Size, Duration: This is a novel population-based birth cohort study of 898 084 births using linked ART registry data and administrative data including birth registrations, medical services, pharmaceuticals, hospital admissions and deaths. Birth (a live or still birth of at least one baby of ≥400 g birthweight or ≥20 weeks' gestation) was the unit of analysis in this study. Multiple births were considered as one birth in our analysis.Participants/materials, Setting, Methods: This study included a total of 898 084 births (606 488 mothers) in New South Wales and the Australian Capital Territory, Australia 2009-2017. We calculated the prevalence of all categories of MAR-conceived births over the study period. Generalized estimating equations were used to examine the association between parental characteristics (parent's age, parity, socio-economic status, maternal country of birth, remoteness of mother's dwelling, pre-existing medical conditions, smoking, etc.) and ART and OI/IUI births relative to naturally conceived births.Main Results and the Role Of Chance: The proportion of MAR births increased from 5.1% of all births in 2009 to 6.7% in 2017, representing a 30% increase over the decade. The proportion of OI/IUI births remained stable at around 2% of all births, representing 32% of all MAR births. Over the study period, ART births conceived by frozen embryo-transfer increased nearly 3-fold. OI/IUI births conceived using clomiphene citrate decreased by 39%, while OI/IUI births conceived using letrozole increased 56-fold. Overall, there was a 55% increase over the study period in the number of ART-conceived births, rising to 56% of births to mothers aged 40 years and older. In 2017, almost one in six births (17.6%) to mothers aged 40 years and over were conceived using ART treatment. Conversely, the proportion of OI/IUI births was similar across different mother's age groups and remained stable over the study period. ART children, but not OI/IUI children, were more likely to have parents who were socio-economically advantaged compared to naturally conceived children. For example, compared to naturally conceived births, ART births were 16% less likely to be born to mothers who live in the disadvantaged neighbourhoods after accounting for other covariates (adjusted relative risk (aRR): 0.84 [95% CI: 0.81-0.88]). ART- or OI/IUI-conceived children were 25% less likely to be born to immigrant mothers than births after natural conception (aRR: 0.75 [0.74-0.77]).Limitations, Reasons For Caution: The social inequalities that we observed between the parents of children born using ART and naturally conceived children may not directly reflect disparities in accessing fertility care for individuals seeking treatment.Wider Implications Of the Findings: With the ubiquitous decline in fertility rates around the world and the increasing trend to delay childbearing, this population-based study enhances our understanding of the contribution of different types of MARs to population profiles among births in high-income countries. The parental socio-demographic characteristics of MAR-conceived children differ significantly from naturally conceived children and this highlights the importance of accounting for such differences in studies investigating the health and development of MAR-conceived children.Study Funding/competing Interest(s): This study was funded through Australian National Health and Medical Research Council (NHMRC) grant: APP1127437. G.M.C. is an employee of The University of New South Wales (UNSW) and Director of the National Perinatal Epidemiology and Statistics Unit (NPESU), UNSW. The NPESU manages the Australian and New Zealand Assisted Reproduction Database with funding support from the Fertility Society of Australia and New Zealand. C.V. is an employee of The University of New South Wales (UNSW), Director of Clinical Research of IVFAustralia, Member of the Board of the Fertility Society of Australia and New Zealand, and Member of Research Committee of School of Women's and Children's Health, UNSW. C.V. reports grants from Australian National Health and Medical Research Council (NHMRC), and Merck KGaA. C.V. reports consulting fees, and payment or honoraria for lectures, presentations, speakers, bureaus, manuscript, writing or educational events or attending meeting or travel from Merck, Merck Sparpe & Dohme, Ferring, Gedon-Richter and Besins outside this submitted work. C.V. reported stock or stock options from Virtus Health Limited outside this submitted work. R.J.N. is an employee of The University of Adelaide, and Chair DSMC for natural therapies trial of The University of Hong Kong. R.J.N. reports grants from NHMRC. R.J.N. reports lecture fees and support for attending or travelling for lecture from Merck Serono which is outside this submitted work. L.R.J. is an employee of The UNSW and Foundation Director of the Centre for Big Data Research in Health at UNSW Sydney. L.R.J. reports grants from NHMRC. The other co-authors have no conflict of interest.Trial Registration Number: N/A. [ABSTRACT FROM AUTHOR]

Background: Beneficial effects of greenness on birth outcomes have been reported, but few studies have investigated the associations in both urban and non-urban settings. We aimed to evaluate and compare linear and nonlinear associations between greenness and birth outcomes in urban and non-urban settings.Methods: From October 2015 to December 2018, participants were recruited into the Maoming Birth Cohort Study. A total of 11 258 live birth records were obtained. Greenness exposure was assessed using the normalized difference vegetation index (NDVI) and enhanced vegetation index (EVI). Linear regression and nonlinear restricted cubic spline models were implemented to investigate the associations between greenness and birthweight, birth length, gestational age, preterm birth, low birthweight, small for gestational age and the potential for effect variation under urban or non-urban settings, after adjusting for covariates.Results: A 0.1-unit increase in NDVI-500m was significantly associated with an increase of 35.4 g in birthweight [95% confidence interval (CI): 13.2, 57.7], 0.15 cm in birth length (95% CI: 0.03, 0.26), 0.88 days in gestational age (95% CI: 0.05, 1.71) and lower odds of low birthweight [odds ratio (OR) = 0.69, 95% CI: 0.56, 0.85] and preterm birth (OR = 0.70, 95% CI: 0.58, 0.85). No association with head circumference was observed. For all outcomes, no significant linear associations were observed among non-urban dwellers. Inversed 'U-shaped' associations between greenness exposure and birth outcomes were observed in the total study population.Conclusions: Greenness exposure was associated with increased gestational age, birthweight and birth length in urban dwellers. Nonlinear associations assessed by restricted cubic splines suggested that health benefits could be larger when increasing greenness levels from low to medium compared with increasing greenness from medium to high levels. Further studies adopting nonlinear methods are warranted to verify our findings. [ABSTRACT FROM AUTHOR]

Summary: Background: In a population‐based birth cohort, we aimed to identify longitudinal trajectories of atopic dermatitis (AD) during childhood using data from different sources (validated questionnaires and healthcare records). We investigated the impact of different AD definitions on such trajectories and their relationships with various risk factors. Methods: Of the 1184 children born into the study, 1083 had information on current AD for at least three follow‐ups from birth to age 11 years and were included in the analysis for parentally reported AD (PRAD). Data were transcribed from healthcare records for 916 of 1184 children for the analysis of doctor‐diagnosed AD (DDAD). We also derived a composite definition of AD (CDAD) (at least two of the following: PRAD, DDAD, current use of AD treatment). Using latent class analysis (LCA), we determined longitudinal profiles of AD using the three definitions. Filaggrin (FLG) genotype data were available for 803 white participants. Results: For PRAD, LCA identified four AD classes ('no AD', 'persistent', 'early‐onset remitting' and 'late‐onset'). For DDAD and CDAD, the optimal number of phenotypes was three ('no AD', 'persistent' and 'early‐onset remitting'). Although AD classes at population level appeared similar in different models, a considerable proportion of children (n = 485, 45%) moved between classes. The association with FLG genotype, atopic diseases and early‐life risk factors was inconsistent across different definitions, but the association with oral food challenge‐confirmed peanut allergy was similar, with a nine‐ to 11‐fold increase among children in the persistent AD class. In a CDAD model, compared with the early‐onset remitting class, those with persistent AD were significantly more likely to have (at age 3 years) moderate/severe AD, polysensitization and current wheeze, and were less likely to have been breastfed. Conclusions: Standardized composite definitions of AD may help to define AD cases with more precision and identify more consistent long‐term trajectories. Whatis already known about this topic?Atopic dermatitis (AD) is heterogeneous, but there is no general consensus on what the different subtypes are.Techniques such as latent class analysis (LCA) have been used to disentangle the long‐term course of AD.AD phenotypes assigned the same name in different studies often differ in the age of onset, temporal trajectory, distributions within a population and associated risk factors, which makes comparisons difficult and clinical application uncertain. Whatdoes this study add?We report that the use of different data sources and definitions of AD has a major influence on the number and type of AD phenotypes identified by longitudinal LCA, in addition to the phenotype membership among individual children.Although AD latent classes, at a population level, appeared similar when different definitions were used, almost half of the children changed class allocation in different models.The association with oral food challenge‐confirmed peanut allergy across all models was similar, with a striking nine‐ to 11‐fold increase among children in the persistent AD class. Linked Comment: S-P. Sinikumpu and L. Huilaja. Br J Dermatol 2022; 186:208–209. Plain language summary available online [ABSTRACT FROM AUTHOR]

The importance of studying the health impacts of exposure mixtures is increasingly being recognized, but such research presents many methodological and interpretation difficulties. We used Bayesian g-computation to estimate effects of a simulated public health action on exposure mixtures and birth weights in Milwaukee, Wisconsin, in 2011–2013. We linked data from birth records with census-tract–level air toxics data from the Environmental Protection Agency's National Air Toxics Assessment model. We estimated the difference between observed and expected birth weights that theoretically would have followed a hypothetical intervention to reduce exposure to 6 airborne metals by decommissioning 3 coal-fired power plants in Milwaukee County prior to 2010. Using Bayesian g-computation, we estimated a 68-g (95% credible interval: 25, 135) increase in birth weight following this hypothetical intervention. This example demonstrates the utility of our approach for using observational data to evaluate and contrast possible public health actions. Additionally, Bayesian g-computation offers a flexible strategy for estimating the effects of highly correlated exposures, addressing statistical issues such as variance inflation, and addressing conceptual issues such as the lack of interpretability of independent effects. [ABSTRACT FROM AUTHOR]

Severe maternal morbidity (SMM) is a composite outcome measure that indicates serious, potentially life-threatening maternal health problems. There is great interest in defining SMM using administrative data for surveillance and research. In the United States, one common way of defining SMM at the population level is an index developed by the Centers for Disease Control and Prevention. Modifications to this index (e.g. exclusion of maternal blood transfusion) have been proposed; some research defines SMM using an index introduced by Bateman et al. (Obstet Gynecol. 2013;122(5):957–965). Birth certificate data are also increasingly being used to define SMM. We compared commonly used US definitions of SMM among all California births (2007–2012) using the kappa (κ) statistic and other measures. We also evaluated agreement between maternal morbidity fields on the birth certificate as compared with health insurance claims data. Concordance between the 7 definitions of SMM analyzed was generally low (i.e. κ < 0.41 for 13 of 21 two-way comparisons). Low concordance was particularly driven by the presence/absence of transfusion and claims data versus birth certificate definitions. Low agreement between administrative data–based definitions of SMM highlights that results can be expected to differ between them. Further research on validity of SMM definitions, using more fine-grained data sources, is needed. [ABSTRACT FROM AUTHOR]

The stability of genomic evaluations depends on the amount of data and population parameters. When the dataset is large enough to estimate the value of nearly all independent chromosome segments (~10K in American Angus cattle), the accuracy and persistency of breeding values will be high. The objective of this study was to investigate changes in estimated breeding values (EBV) and genomic EBV (GEBV) across monthly evaluations for 1 yr in a large genotyped population of beef cattle. The American Angus data used included 8.2 million records for birth weight, 8.9 for weaning weight, and 4.4 for postweaning gain. A total of 10.1 million animals born until December 2017 had pedigree information, and 484,074 were genotyped. A truncated dataset included animals born until December 2016. To mimic a scenario with monthly evaluations, 2017 data were added 1 mo at a time to estimate EBV using best linear unbiased prediction (BLUP) and GEBV using single-step genomic BLUP with the algorithm for proven and young (APY) with core group fixed for 1 yr or updated monthly. Predictions from monthly evaluations in 2017 were contrasted with the predictions of the evaluation in December 2016 or the previous month for all genotyped animals born until December 2016 with or without their own phenotypes or progeny phenotypes. Changes in EBV and GEBV were similar across traits, and only results for weaning weight are presented. Correlations between evaluations from December 2016 and the 12 consecutive evaluations were ≥0.97 for EBV and ≥0.99 for GEBV. Average absolute changes for EBV were about two times smaller than for GEBV, except for animals with new progeny phenotypes (≤0.12 and ≤0.11 additive genetic SD [ SDa ] for EBV and GEBV). The maximum absolute changes for EBV (≤2.95 SDa) were greater than for GEBV (≤1.59 SDa). The average(maximum) absolute GEBV changes for young animals from December 2016 to January and December 2017 ranged from 0.05(0.25) to 0.10(0.53) SDa. Corresponding ranges for animals with new progeny phenotypes were from 0.05(0.88) to 0.11(1.59) SDa for GEBV changes. The average absolute change in EBV(GEBV) from December 2016 to December 2017 for sires with ≤50 progeny phenotypes was 0.26(0.14) and for sires with >50 progeny phenotypes was 0.25(0.16) SDa. Updating the core group in APY without adding data created an average absolute change of 0.07 SDa in GEBV. Genomic evaluations in large genotyped populations are as stable and persistent as the traditional genetic evaluations, with less extreme changes. [ABSTRACT FROM AUTHOR]

What was long feared by legislators and courts has now become reality: trans men give birth to their own children and request to be designated as their 'fathers' for the purpose of birth registration. This article sheds light on the transformative potential of such procreative scenarios and the following legal claims for fatherhood. An argument is made that they invite essential reflections on what it means to be a father today and, in so doing, they prompt a (re)construction of legal fatherhood which includes care as a relevant, paternal parameter. By focusing on ongoing cases decided by English and German courts, however, this article shows that domestic courts' understanding of fatherhood has essentially preserved its conventionally heteronormative, biological, and mediated nature. Yet, the game is still open and an application pending before the European Court of Human Rights may breathe fresh air into the debate. [ABSTRACT FROM AUTHOR]

Background Coronavirus disease 2019 (COVID-19) has become a pandemic. Despite the growing number of patients with COVID-19 infection, data on the clinical characteristics of pregnant patients are still limited. Methods We retrospectively included childbearing-age female patients with laboratory-confirmed COVID-19 at Renmin Hospital of Wuhan University from January 15 to February 23, 2020. Demographic, clinical, radiological, laboratory, and treatment data were reviewed. Clinical characteristics of pregnant and nonpregnant patients were compared. Results One hundred eleven childbearing-age women with COVID-19 were included, including 16 patients (14.4%) with severe or critical disease. Compared with nonpregnant patients (n = 80), pregnant patients (n = 31) were less likely to have dyspnea (16.1% vs 37.5%), asthenia (3.2% vs 33.8%), and ≥3 symptoms (22.6% vs 45.0%); had a significantly higher neutrophil count (5.2 vs 2.5 ×109/L) and a higher percentage of CD3+ cells (76.7% vs 73.7%) and CD8+ cells (32.3% vs 28.4%); and had a dramatically lower percentage of lymphocytes (18.2% vs 31.8%), a lower CD4+/CD8+ ratio (1.2 vs 1.4), and a lower level of IgG (9.8 vs 11.9 g/L). Of note, pregnant patients had a significantly lower percentage of severe disease (3.2% vs 18.8%) and a substantially higher level of inflammation markers including neutrophil-to-lymphocyte ratio (4.4 vs 1.9) and systematic inflammatory index (812.8 vs 354.7) than nonpregnant patients. Seventeen live births were recorded, and all of these showed negative results of postnatal COVID-19 detection together with a normal Apgar score. Conclusions Pregnant patients with COVID-19 had a lower level of severity and an enhanced inflammatory response and cell immunity when compared with nonpregnant patients. [ABSTRACT FROM AUTHOR]

Summary: Distributed lag models have been used to identify critical pregnancy periods of exposure (i.e. critical exposure windows) to air pollution in studies of pregnancy outcomes. However, much of the previous work in this area has ignored the possibility of spatial variability in the lagged health effect parameters that may result from exposure characteristics and/or residual confounding. We develop a spatially varying Gaussian process model for critical windows called 'SpGPCW' and use it to investigate geographic variability in the association between term low birth weight and average weekly concentrations of ozone and PM2.5 during pregnancy by using birth records from North Carolina. SpGPCW is designed to accommodate areal level spatial correlation between lagged health effect parameters and temporal smoothness in risk estimation across pregnancy. Through simulation and a real data application, we show that the consequences of ignoring spatial variability in the lagged health effect parameters include less reliable inference for the parameters and diminished ability to identify true critical window sets, and we investigate the use of existing Bayesian model comparison techniques as tools for determining the presence of spatial variability. We find that exposure to PM2.5 is associated with elevated term low birth weight risk in selected weeks and counties and that ignoring spatial variability results in null associations during these periods. An R package (SpGPCW) has been developed to implement the new method. [ABSTRACT FROM AUTHOR]

We assessed whether early childhood and adulthood experiences of neighborhood privilege, measured by the Index of Concentration at the Extremes (ICE), were associated with preterm delivery and related racial/ethnic disparities using intergenerationally linked birth records of 379,794 California-born primiparous mothers (born 1982–1997) and their infants (born 1997–2011). ICE measures during early childhood and adulthood approximated racial/ethnic and economic dimensions of neighborhood privilege and disadvantage separately (ICE-income, ICE-race/ethnicity) and in combination (ICE–income + race/ethnicity). Results of our generalized estimating equation models with robust standard errors showed associations for ICE-income and ICE–income + race/ethnicity. For example, ICE–income + race/ethnicity was associated with preterm delivery in both early childhood (relative risk (RR) = 1.12, 95% confidence interval (CI): 1.08, 1.17) and adulthood (RR = 1.07, 95% CI: 1.03, 1.11). Non-Hispanic black and Hispanic women had higher risk of preterm delivery than white women (RR = 1.32, 95% CI: 1.28, 1.37; and RR = 1.11, 95% CI: 1.08, 1.14, respectively, adjusting for individual-level confounders). Adjustment for ICE–income + race/ethnicity at both time periods yielded the greatest declines in disparities (for non-Hispanic black women, RR = 1.23, 95% CI: 1.18, 1.28; for Hispanic women, RR = 1.05, 95% CI: 1.02, 1.09). Findings support independent effects of early childhood and adulthood neighborhood privilege on preterm delivery and related disparities. [ABSTRACT FROM AUTHOR]

Focusing on the United States, Field and Syrett argue that the supposed universality of chronological age masks the processes through which legislators and government officials relied upon age to reinforce inequalities rooted in coverture and chattel slavery. Two case studies reveal how bureaucratic and legislative age requirements functioned in tandem to deny equal citizenship to women and formerly enslaved people. During the Civil War, Congress passed legislation to grant age-based Civil War pensions for minor children that appeared neutral in law but came to be administered in ways that denied equal benefits to the families of black Civil War soldiers on the grounds that they lacked adequate proof of age. State governments, meanwhile, continued to pass laws that differentiated between men and women in the realm of legal majority, using chronological age as a means to shore up gender inequality even as women gained new rights and opportunities. Recent conflicts over voter identification laws and age determination for child migrants reveal that chronological age remains a contested category through which government officials can deny equal treatment under the law by defining the criteria for what counts as adequate proof of age. Cracks in the modern regime of government-issued birth certificates reveal that age remains what it has always been: not a neutral fact, but a vector of power through which government officials and ordinary people construct and contest the boundaries of citizenship. [ABSTRACT FROM AUTHOR]

Background and Objectives: Measuring head circumference (HC) of newborns is an important tool for evaluating intra-uterine brain development. HC reference charts currently in use in Nigeria are not representative of the local population. We thus present locally derived HC reference data for Nigerian infants at birth.Subjects and Methods: We reviewed birth records of all infants at the Jos University Teaching Hospital (JUTH) over a 10 year period from January 2006. JUTH is a tertiary care center offering obstetric services to a large population of women in Jos and its environs. All births with gestational age between 28 and 42 weeks were included in the study. STATA version 14 was used to calculate gestational age associated HC percentile measurements.Results: We included 18 282 babies to generate the reference values. The mean HC value was 34.4 ± 2.1 cm (M = 34.6 ± 2.16 cm, F = 34.1 ± 2.02 cm, p < 0.001). Our HC reference values significantly differ from the USA and INTERGROWTH-21 charts currently in use in our country. Mean HC was higher in male infants compared with female infants. This difference was uniformly so across all gestational age groups.Conclusions: The use of our locally derived HC reference values could be more appropriate in defining normal head growth in Nigerian infant populations thereby improving newborn care. [ABSTRACT FROM AUTHOR]

Infants and children are particularly vulnerable to in utero and early-life exposures. Thus, a mother's exposures before and during pregnancy could have important consequences for her child's health, including cancer development. We examined whether birth certificate–derived maternal anthropometric characteristics were associated with increased risk of subsequent childhood cancer development, accounting for established maternal and infant risk factors. Pennsylvania birth and cancer registry files were linked by the state Department of Health, yielding a virtual cohort of births and childhood cancers from 2003 through 2016. The analysis included 1,827,875 infants (13,785,309 person-years at risk), with 2,352 children diagnosed with any cancer and 747 with leukemia before age 14 years. Children born to mothers with a body mass index (weight (kg)/height (m)2) of ≥40 had a 57% (95% confidence interval: 12, 120) higher leukemia risk. Newborn size of ≥30% higher than expected was associated with 2.2-fold and 1.8-fold hazard ratios for total childhood cancer and leukemia, respectively, relative to those with expected size. Being <30% below expected size also increased the overall cancer risk (P for curvilinearity < 0.0001). Newborn size did not mediate the association between maternal obesity and childhood cancer. The results suggest a significant role of early-life exposure to maternal obesity- and fetal growth–related factors in childhood cancer development. [ABSTRACT FROM AUTHOR]

While prepregnancy obesity increases risk of stillbirth, few studies have evaluated the role of newly developed obesity independent of long-standing obesity. Additionally, researchers have relied almost exclusively on parametric models, which require correct specification of an unknown function for consistent estimation. We estimated the association between incident obesity and stillbirth in a cohort constructed from linked birth and death records in Pennsylvania (2003–2013). Incident obesity was defined as body mass index (weight (kg)/height (m)2) greater than or equal to 30. We used parametric G-computation, semiparametric inverse-probability weighting, and parametric/nonparametric targeted minimum loss-based estimation (TMLE) to estimate the association between incident prepregnancy obesity and stillbirth. Compared with pregnancies from women who stayed nonobese, women who became obese prior to their next pregnancy were estimated to have 2.0 (95% confidence interval (CI): 0.5, 3.5) more stillbirths per 1,000 pregnancies using parametric G-computation. However, despite well-behaved stabilized inverse probability weights, risk differences estimated from inverse-probability weighting, nonparametric TMLE, and parametric TMLE represented 6.9 (95% CI: 3.7, 10.0), 0.4 (95% CI: 0.1, 0.7), and 2.9 (95% CI: 1.5, 4.2) excess stillbirths per 1,000 pregnancies, respectively. These results, particularly those derived from nonparametric TMLE, were highly sensitive to covariates included in the propensity score models. Our results suggest that caution is warranted when using nonparametric estimators to quantify exposure effects. [ABSTRACT FROM AUTHOR]

A large body of epidemiologic research has concentrated on the 1918 influenza pandemic, but more work is needed to understand spatial variation in pandemic mortality and its effects on natality. We collected and analyzed 35,151 death records from Arizona for 1915–1921 and 21,334 birth records from Maricopa county for 1915–1925. We estimated the number of excess deaths and births before, during, and after the pandemic period, and we found a significant decline in the number of births occurring 9–11 months after peak pandemic mortality. Moreover, excess mortality rates were highest in northern Arizona counties, where Native Americans were historically concentrated, suggesting a link between ethnic and/or sociodemographic factors and risk of pandemic-related death. The relationship between birth patterns and pandemic mortality risk should be further studied at different spatial scales and in different ethnic groups. [ABSTRACT FROM AUTHOR]

Background Negative effects of manual handling of burdens on pregnancy outcomes are not elucidated in Finland. This study examines the association between perinatal outcomes and occupational exposure to manual handling of burdens. Methods The study cohort was identified from the Finnish Medical Birth Register (MBR, 1997–2014) and information on exposure from the Finnish job-exposure matrix (FINJEM) 1997–2009. The cohort included all singleton births of mothers who were classified as 'service and care workers' representing the exposure group (n =74 286) and 'clerks' as the reference (n =13 873). Study outcomes were preterm birth (PTB) (<37 weeks), low birthweight (LBW) (<2500 g), small for gestational age (<2.5th percentile), perinatal death (stillbirth or early neonatal death within first seven days) and eclampsia. We used logistic regression analysis to calculate odds ratio (OR) and adjusted for maternal age, marital status, BMI, parity and smoking during pregnancy. Results The risks of PTB [OR 1.16, 95% confidence interval (CI) 1.06–1.27], LBW (OR 1.12, 95% CI 1.01–1.25) and perinatal death (OR 1.51, 95% CI 1.09–2.09) were significantly higher among the high exposure group than in the reference group. All adverse outcomes were statistically insignificant among primiparous women except perinatal death (OR=1.95, 95% CI 1.13–3.39). Conclusions The study indicates that the risk of adverse pregnancy outcomes might be more common among women that are highly exposed to occupational manual handling of burdens. The results should be interpreted with caution due to the use of occupational level exposure. Further studies with information on individual level exposure and start of maternity leave are recommended. [ABSTRACT FROM AUTHOR]

Few investigations have explored temperature and birth outcomes. In a retrospective cohort study, we examined apparent temperature, a combination of temperature and relative humidity, and term low birth weight (LBW) among 43,629 full-term LBW infants and 2,032,601 normal-weight infants in California (1999–2013). The California Department of Public Health provided birth certificate data, while meteorological data came from the California Irrigation Management Information System, US Environmental Protection Agency, and National Centers for Environmental Information. After considering several temperature metrics, we observed the best model fit for term LBW over the full gestation (per 10-degrees-Fahrenheit (°F) increase in apparent temperature, 13.0% change, 95% confidence interval: 4.1, 22.7) above 55°F, and the greatest association was for third-trimester exposure above 60°F (15.8%, 95% confidence interval: 5.0, 27.6). Apparent temperature during the first month of pregnancy exhibited no significant risk, while the first trimester had a significantly negative association, and second trimester, last month, and last 2 weeks had slightly increased risks. Mothers who were black or older, delivered male infants, or gave birth during the warm season had infants at the highest risks. This study provides further evidence for adverse birth outcomes from heat exposure for vulnerable subgroups of pregnant women. [ABSTRACT FROM AUTHOR]

Coal and oil power plant retirements reduce air pollution nearby, but few studies have leveraged these natural experiments for public health research. We used California Department of Public Health birth records and US Energy Information Administration data from 2001–2011 to evaluate the relationship between the retirements of 8 coal and oil power plants and nearby preterm (gestational age of <37 weeks) birth. We conducted a difference-in-differences analysis using adjusted linear mixed models that included 57,005 births—6.3% of which were preterm—to compare the probability of preterm birth before and after power plant retirement among mothers residing within 0–5 km and 5–10 km of the 8 power plants. We found that power plant retirements were associated with a decrease in the proportion of preterm birth within 5 km (−0.019, 95% CI: −0.031, −0.008) and 5–10 km (−0.015, 95% CI: −0.024, −0.007), controlling for secular trends with mothers living 10–20 km away. For the 0–5-km area, this corresponds to a reduction in preterm birth from 7.0% to 5.1%. Subgroup analyses indicated a potentially larger association among non-Hispanic black and Asian mothers than among non-Hispanic white and Hispanic mothers and no differences in educational attainment. Future coal and oil power plant retirements may reduce preterm birth among nearby populations. [ABSTRACT FROM AUTHOR]

Being born preterm and being raised in poverty are each linked with adverse cognitive outcomes. Using data from 5,250 singletons born in the United States in 2001 and enrolled in the Early Childhood Longitudinal Study, Birth Cohort, we examined whether household socioeconomic status (SES) modified the association between preterm birth (PTB) and children’s scores on cognitive assessments at age 2 years and reading and mathematics assessments at kindergarten age. Gestational age was measured from birth certificates and categorized as early preterm, moderate preterm, late preterm, early term, and term. SES was measured at age 9 months using a composite of parental education, occupation, and income. PTB was associated with 0.1- to 0.6-standard deviation-deficits in 2-year cognitive ability and kindergarten mathematics scores and with 0.1- to 0.4-standard-deviation deficits in kindergarten reading scores. Children living in the lowest (versus highest) SES quintile scored 0.6 standard deviations lower on 2-year cognitive ability, 1.1 standard deviations lower on kindergarten reading, and 0.9 standard deviations lower on kindergarten mathematics. The association between PTB and cognitive outcomes did not differ by postnatal SES. However, children who were both born preterm and lived in lower-SES households had the poorest performance on all 3 outcomes and therefore may represent a uniquely high-risk group. [ABSTRACT FROM AUTHOR]

The etiology of childhood cancers remains largely unknown, especially regarding environmental and behavioral risk factors. Unpacking the association between socioeconomic status (SES) and incidence may offer insight into such etiology. We tested associations between SES and childhood cancer incidence in a population-based case-cohort study (source cohort: Minnesota birth registry, 1989-2014). Cases, ages 0-14 years, were linked from the Minnesota Cancer Surveillance System to birth records through probabilistic record linkage. Controls were 4:1 frequency matched on birth year (2,947 cases and 11,907 controls). We tested associations of individual-level (maternal education) and neighborhood-level (census tract composite index) SES using logistic mixed models. In crude models, maternal education was positively associated with incidence of acute lymphoblastic leukemia (odds ratio (OR) = 1.10, 95% confidence interval (CI): 1.02, 1.19), central nervous system tumors (OR = 1.12, 95% CI: 1.04, 1.21), and neuroblastoma (OR = 1.15, 95% CI: 1.02,1.30). Adjustment for established risk factors--including race/ ethnicity, maternal age, and birth weight--substantially attenuated these positive associations. Similar patterns were observed for neighborhood-level SES. Conversely, higher maternal education was inversely associated with hepatoblastoma incidence (adjusted OR = 0.70, 95% CI: 0.51, 0.98). Overall, beyond the social patterning of established demographic and pregnancy-related exposures, SES is not strongly associated with childhood cancer incidence. [ABSTRACT FROM AUTHOR]

To explore a potential association between preeclampsia and selected birth defects, we examined the prevalence of certain birth defects among women with hypertensive disorders including preeclampsia. We analyzed data from 2,499,536 singleton live births in California from 2007 to 2011, includingmaternal and infant demographics from birth certificates as well as clinical details from delivery hospitalization records. We examined defect groups that were recognizable at birth (e.g., spina bifida and cleft lip). Hypertensive disorders included preexisting hypertension, gestational hypertension, mild preeclampsia, severe preeclampsia/eclampsia, and preeclampsia superimposed on preexisting hypertension. Relative risk values with 95% confidence intervals for each birth defect were calculated by hypertensive group, as well as independent and joint associations of hypertensive and diabetic disorders. Risks of each type of birth defect were higher among offspring of women with hypertensive disorders compared with those without. The risks of birth defects among offspring of women with only a hypertensive disorder were significantly higher than that among women with neither hypertensive nor diabetic disorders (relative risks ranged from 1.37 to 2.77). Risks of birth defects were highest among those born to women with both hypertensive and diabetic disorders compared with those with neither (relative risks ranged from 1.80 to 6.22). These findings support the existence of an association between preeclampsia and certain birth defects and suggest that diabetesmay be a contributing factor. [ABSTRACT FROM AUTHOR]

Background: A small number of studies have used a natural experiment approach to examine the health impacts of increased economic resources stemming from Native American-owned casinos. We build on this work by examining whether casinos are associated with obesity-related health in utero.Methods: We examined whether casino openings or expansion (as proxy for increased economic resources) are associated with a decreased likelihood of infants being born large-for-gestational-age (LGA), an important risk factor for childhood overweight/obesity. We used repeated cross-sectional data from California birth records (1987-2011) to assess the prevalence of LGA births among Native Americans (n = 21 011). Using zip code fixed-effect regression models, we compared how prevalence of LGA births changed in association with casino openings or expansions, while controlling for secular trends through the inclusion of a comparison group of Native American newborns in zip codes that were eligible to open or expand casinos, but did not do so. In sensitivity analyses, we evaluated whether there was any change in small-for-gestational-age births (SGA).Results: Average prevalence of LGA births over the period was 11%. Every one slot machine per capita increase was associated with a 0.13 percentage point decrease (95% confidence interval: -0.25, -0.01) in the prevalence of LGA births but was not associated with SGA prevalence.Conclusions: Casino expansion in California is associated with a lower prevalence of LGA births. Interpreted in combination with previous work showing that California casino expansions were associated with a lower body mass index (BMI) among schoolchildren, these results suggest that casinos are associated with improvement in a surrogate marker of excess adiposity. Further studies are needed to elucidate the mechanisms by which casinos might be associated with obesity-related health outcomes among Native Americans. [ABSTRACT FROM AUTHOR]

Background: Growing evidence indicates that immigration policy and enforcement adversely affect the well-being of Latino immigrants, but fewer studies examine 'spillover effects' on USA-born Latinos. Immigration enforcement is often diffuse, covert and difficult to measure. By contrast, the federal immigration raid in Postville, Iowa, in 2008 was, at the time, the largest single-site federal immigration raid in US history.Methods: We employed a quasi-experimental design, examining ethnicity-specific patterns in birth outcomes before and after the Postville raid. We analysed Iowa birth-certificate data to compare risk of term and preterm low birthweight (LBW), by ethnicity and nativity, in the 37 weeks following the raid to the same 37-week period the previous year ( n  =   52 344). We model risk of adverse birth outcomes using modified Poisson regression and model distribution of birthweight using quantile regression.Results: Infants born to Latina mothers had a 24% greater risk of LBW after the raid when compared with the same period 1 year earlier [risk ratio (95% confidence interval) = 1.24 (0.98, 1.57)]. No such change was observed among infants born to non-Latina White mothers. Increased risk of LBW was observed for USA-born and immigrant Latina mothers. The association between raid timing and LBW was stronger among term than preterm births. Changes in birthweight after the raid primarily reflected decreased birthweight below the 5th percentile of the distribution, not a shift in mean birthweight.Conclusions: Our findings highlight the implications of racialized stressors not only for the health of Latino immigrants, but also for USA-born co-ethnics. [ABSTRACT FROM AUTHOR]

Hypogonadism is common in men with male factor infertility and hormone therapies may improve semen parameters and pregnancy rates in affected men. However, compared to paternal factors such as advanced age, male infertility or obesity, it is uncertain whether hypogonadism itself impacts perinatal birth outcomes and complications. This study evaluates the association between male hypogonadism and perinatal birth complications in the United States. We performed a retrospective analysis of the IBM MarketScan™ Commercial Claims and Encounters database between 2011-2017. We identified birth records using birth or pregnancy-related major diagnostic categories associated with persons age 0. Fathers were considered to be adult (> 18) male individuals with the same family identifier as the neonates listed as either the primary insurance beneficiary or spouse. Birth records were excluded if there was no family identifier or the father was unable to be linked. For each birth, we recorded whether they were preterm, diagnosed as low birth weight, or diagnosed with birth defects. For the fathers linked with each birth record, we determined paternal age, hypogonadism status, geographic region, and other associated comorbidities. Births were stratified based on whether the father had hypogonadism or not and we performed univariate tests for variation. Additionally, we conducted a multivariate logistic model of birth complication (preterm, low weight, or growth defect) against father's age, hypogonadism status, and paternal comorbidities. Between 2011 and 2017, paternal hypogonadism was found in 3.97% of fathers among 468,546 birth records. In contrast, no paternal hypogonadism was found in 96.03% of fathers among 468,546 birth records. Overall, our study reveals that paternal hypogonadism is positively associated with perinatal birth complications (odds ratio (OR) 1.10; 95% CI: 1.06, 1.13). Additionally, low birth weight was found in 46, 96% of birth among 196,607 birth records with paternal hypogonadism, follow by preterm birth with 7.64% of birth among 26,886 birth records with paternal hypogonadism. Male hypogonadism was associated with a statistically significant increase in perinatal birth complications. However, these results should be interpreted with caution because patients with male hypogonadism are also likely to have male infertility. For hypogonadism to be considered as a separate risk factor for perinatal birth complications further investigation will be needed. No [ABSTRACT FROM AUTHOR]

Prebreeding anestrus (failure to express estrus) affects 10-30% of gilts. Two main types of anestrus are delayed puberty (prepubertal anestrus; PPA) and ovulation without behavioral estrus (behavioral anestrus; BA). We hypothesized that growth of cyclic gilts during development is greater than PPA and BA gilts. The objectives of this study were to determine if birth weight and growth differed between cyclic and anestrus gilts and the relationship of age at puberty (AP) with growth. Individual body weights were recorded at birth (BTW), and at 4, 8, and 20 weeks of age for cyclic (n=4,982), PPA (n=578), and BA (n=428) gilts. Because anestrus gilts lack puberty records, genomic best linear unbiased prediction was used to predict genomic estimated breeding values for AP (GEBV-AP) for PPA and BA gilts using AP of cyclic gilts. A mixed model was fit using phenotypic group, sire line, and dam parity (1-4) as fixed effects and contemporary group as a random effect. The PPA gilts had a greater GEBV-AP (P< 0.05) compared with cyclic and BA gilts and were heavier at birth than cyclic gilts (P< 0.05). The BA gilts had a greater lifetime growth rate (LGR; ADG from birth to 20 weeks) than cyclic and PPA gilts (P< 0.05). The LGR and GEBV-AP did not differ between dam parities. Relationship of AP and growth was evaluated using GEBV for cyclic and anestrus gilts in a mixed model regression. A positive relationship between GEBV-AP and GEBV-BTW and a negative relationship between GEBV-AP and GEBVLGR was observed. Results suggest that earlier attainment of puberty could be improved by avoiding the heaviest gilts at birth and selecting for faster growing gilts during grow-finish. However, the latter could increase the risk for more BA gilts due to possible antagonistic effects of growth on behavioral estrus. The USDA is an equal opportunity provider and employer. [ABSTRACT FROM AUTHOR]

Background Concern about increasing transfusion rates, adverse effects and increased costs have led to international efforts to reduce transfusion rates. Australian patient blood management guidelines were first introduced for critical bleeding in 2011, followed by obstetric guidelines in 2015. This study examines obstetric transfusion rates before and after the introduction of the critical bleeding and obstetric guidelines, accounting for pregnancy characteristics and prior trajectories. Methods Data were obtained from linked birth and hospital records from NSW between January 2002 and December 2017. Changes in raw and risk adjusted transfusion rates over time were investigated using interrupted time series analysis to assess changes in the trend in rate of transfusion among pregnant women with the introduction of each set of guidelines. Sensitivity analysis was performed to identify patterns in the data independently from the interventions. Results Data for 1,477,001 births in NSW from 2002 to 2017 were available for analysis. Preliminary analysis suggests the increasing rate of transfusion from 2002 was flattened after the introduction of the 2011 guidelines, with a significantly decreasing trend observed after the 2015 obstetric guidelines were introduced. Conclusions Patient blood management guidelines were associated with a reduction in the rate of obstetric transfusion in NSW. Key messages A focus on patient blood management was associated with an approximately 30% reduction in the transfusion rate, compared to the predicted rate, by the end of the study period. Future work will investigate whether this change in transfusion rates is associated with a change in rates of adverse outcomes. [ABSTRACT FROM AUTHOR]

Introduction Identity information is often used to link records within or among information systems in public health and clinical settings. The quality and stability of birth certificate identifiers impacts both the success of linkage efforts and the value of birth certificate registries for identity resolution. Objective Our objectives were to describe: (1) the frequency and cause of changes to birth certificate identifiers as children age, and (2) the frequency of events (ie, adoptions, paternities, amendments) that may trigger changes and their impact on names. Methods We obtained two de-identified datasets from the Utah birth certificate registry: (1) change history from 2000 to 2012, and (2) occurrences for adoptions, paternities, and amendments among births in 1987 and 2000. We conducted cohort analyses for births in 1987 and 2000, examining the number, reason, and extent of changes over time. We conducted cross-sectional analyses to assess the patterns of changes between 2000 and 2012. Results In a cohort of 48 350 individuals born in 2000 in Utah, 3164 (6.5%) experienced a change in identifiers prior to their 13th birthday, with most changes occurring before 2 years of age. Cross-sectional analysis showed that identifiers are stable for individuals over 5 years of age, but patterns of changes fluctuate considerably over time, potentially due to policy and social factors. Conclusions Identities represented in birth certificates change over time. Specific events that cause changes to birth certificates also fluctuate over time. Understanding these changes can help in the development of automated strategies to improve identity resolution. [ABSTRACT FROM AUTHOR]

The article discusses the relationship between birth certificates and child labor laws in the U.S. from the 1870s through the 1930s, including efforts of labor reformers to have employers use age to regulate youth employment. An overview of parents' perspectives on their children's ages, including in regard to their lack of documentation of their children's birth dates, is provided. The role that the U.S. census played in maintaining records on age and birth dates is discussed.

Prenatal exposure to ambient air pollutants might cause adverse birth outcomes; however, there have been few studies in which the association between air pollution and preterm birth was examined after stratifying by pregnancy complications. We conducted a population-based case-control study of 1,510,064 singleton births from the Taiwanese birth registry during 2001–2007. Of the total of 1,510,064 births, we designated all 86,224 preterm births as the case group and then randomly selected an additional 344,896 from the remaining births (equivalent to 4 full-term births for every 1 preterm birth) as the control sample. We used an inverse distance weighting approach to calculate an average exposure parameter for air pollutants. The adjusted odds ratio for preterm birth per 10-ppb increase in ozone was 1.12 (95% confidence interval: 1.01, 1.23) for women with gestational diabetes mellitus who were exposed in the third trimester and 1.02 (95% confidence interval: 1.01, 1.03) for women without gestational diabetes (P for interaction <0.001). These findings suggest that exposure to ozone in pregnancy is associated with an increased risk of preterm birth, particularly for women who have gestational diabetes mellitus. [ABSTRACT FROM PUBLISHER]

In the early decades of the twentieth century, as the British government expanded its social programs, and private charities and co-operative associations began to offer more benefits, birth certificates became essential to the bureaucratic process of establishing both age and identity. But every time a birth certificate was produced, it made the private circumstances of an individual’s birth public knowledge. For those born out of wedlock, handing over these certificates was often stigmatizing at a time when illegitimacy remained for many a shameful family secret. When the government finally introduced an abbreviated birth certificate in 1947, which documented name, sex, and birth date without reference to parentage, they were responding to long-standing concerns both within and beyond the state bureaucracy about the tension inherent in keeping public records about people’s private lives. The emergence of the short form birth certificate is thus part of a much larger human story that can help us to map significant shifts in the relationship between the individual citizen and the modern state in the information age. [ABSTRACT FROM PUBLISHER]

The article offers the author's insights on considerations regarding the use of documents. Topics discussed include the use of documents as constituents of actions and its impact on the action it applied, the influence of information recorded in document on the action, and the need for teleological structure when action was applied to document. Also mentioned are informational gaps, the use of documents to get married, and types of documents such as birth certificates.

Birth characteristics predict a range of major physical and mental disorders, but findings regarding eating disorders are inconsistent and inconclusive. This total-population Swedish cohort study identified 2,015,862 individuals born in 1975–1998 and followed them for anorexia nervosa, bulimia nervosa, and eating disorder not otherwise specified until the end of 2010. We examined associations with multiple family and birth characteristics and conducted within-family analyses to test for maternal-level confounding. In total, 1,019 males and 15,395 females received an eating disorder diagnosis. Anorexia nervosa was independently predicted by multiple birth (adjusted hazard ratio = 1.33, 95% confidence interval: 1.15, 1.53) for twins or triplets vs. singletons) and lower gestational age (adjusted hazard ratio = 0.96, 95% confidence interval: 0.95, 0.98) per extra week of gestation, with a clear dose-response pattern. Within-family analyses provided no evidence of residual maternal-level confounding. Higher birth weight for gestational age showed a strong, positive dose-response association with bulimia nervosa (adjusted hazard ratio = 1.15, 95% confidence interval: 1.09, 1.22, per each standard-deviation increase), again with no evidence of residual maternal-level confounding. We conclude that some perinatal characteristics may play causal, disease-specific roles in the development of eating disorders, including via perinatal variation within the normal range. Further research into the underlying mechanisms is warranted. Finally, several large population-based studies of anorexia nervosa have been conducted in twins; it is possible that these studies considerably overestimate prevalence. [ABSTRACT FROM AUTHOR]

Several studies have examined associations between particulate matter with aerodynamic diameter of 2.5 µm or less (PM2.5) and preterm birth, but it is uncertain whether results were affected by individual predispositions (e.g., genetic factors, social conditions) that might vary considerably between women. We tested the hypothesis that a woman is at greater risk of preterm delivery when she has had elevated exposure to ambient PM2.5 during a pregnancy than when she has not by comparing pregnancies in the same woman. From 271,204 births, we selected 29,175 women who had vaginal singleton livebirths at least twice in Connecticut in 2000–2006 (n = 61,688 births). Analyses matched pregnancies to the same woman. Adjusted odds ratios per interquartile range (2.33-µg/m3) increase in PM2.5 in the first trimester, second trimester, third trimester, and whole pregnancy were 1.07 (95% confidence interval (CI): 1.00, 1.15), 0.96 (95% CI: 0.90, 1.03), 1.03 (95% CI: 0.97, 1.08), and 1.13 (95% CI: 1.01, 1.28), respectively. Among Hispanic women, the odds ratio per interquartile range increase in whole-pregnancy exposure was 1.31 (95% CI: 1.00, 1.73). Pregnancies with elevated PM2.5 exposure were more likely to result in preterm birth than were other pregnancies to the same woman at lower exposure. Associations were most pronounced in the first trimester and among Hispanic women. [ABSTRACT FROM PUBLISHER]

Preeclampsia encompasses multiple conditions of varying severity. We examined the recurrence and familial aggregation of preeclampsia by timing of onset, which is a marker for severity. We ascertained personal and family histories of preeclampsia for women who delivered live singletons in Denmark in 1978–2008 (almost 1.4 million pregnancies). Using log-linear binomial regression, we estimated risk ratios for the associations between personal and family histories of preeclampsia and the risk of early-onset (before 34 weeks of gestation, which is typically the most severe), intermediate-onset (at 34–36 weeks of gestation), and late-onset (after 36 weeks of gestation) preeclampsia. Previous early-, intermediate-, or late-onset preeclampsia increased the risk of recurrent preeclampsia with the same timing of onset 25.2 times (95% confidence interval (CI): 21.8, 29.1), 19.7 times (95% CI: 17.0, 22.8), and 10.3 times (95% CI: 9.85, 10.9), respectively, compared with having no such history. Preeclampsia in a woman's family was associated with a 24%–163% increase in preeclampsia risk, with the strongest associations for early- and intermediate-onset preeclampsia in female relatives. Preeclampsia in the man's family did not affect a woman's risk of early-onset preeclampsia and was only weakly associated with her risks of intermediate- and late-onset preeclampsia. Early-onset preeclampsia appears to have the largest genetic component, whereas environmental factors likely contribute most to late-onset preeclampsia. The role of paternal genes in the etiology of preeclampsia appears to be limited. [ABSTRACT FROM PUBLISHER]