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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.

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: We aimed to develop an algorithm that accurately identifies children with Down syndrome (DS) using administrative data. Methods: We identified a cohort of children born between 2000 and 2017, enrolled in the Tennessee Medicaid Program (TennCare), who either had DS coded on their birth certificate or had a diagnosis listed using an International Classification of Diseases (ICD) code (suspected DS), and who received care at Vanderbilt University Medical Center, a comprehensive academic medical center, in the United States. Children with suspected DS were defined as having DS if they had (a) karyotype-confirmed DS indicated on their birth certificate; (b) karyotype-pending DS indicated on their birth certificate (or just DS if test type was not specified) and at least two healthcare encounters for DS during the first 6 years of life; or (c) at least three healthcare encounters for DS, with the first and last encounter separated by at least 30 days, during the first six years of life. The positive predictive value (PPV) of the algorithm and 95% confidence interval (CI) were reported. Results: Of the 411 children with suspected DS, 354 (86.1%) were defined as having DS by the algorithm. According to medical chart review, the algorithm correctly identified 347 children with DS (PPV = 98%, 95%CI: 96.0–99.0%). Of the 57 children the algorithm defined as not having DS, 50 (97.7%, 95%CI: 76.8–93.9%) were confirmed as not having DS by medical chart review. Conclusions: An algorithm that accurately identifies individuals with DS using birth certificate data and/or ICD codes provides a valuable tool to study DS using administrative data. [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 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: 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]

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]

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]

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]

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]

Many surveys ask participants to retrospectively record their location of birth. This paper examines the accuracy of such data in the UK Biobank using a sample of full siblings. Comparison of reported birth locations for siblings with different age gaps allows us to estimate the probabilities of household moves and of misreported birth locations. Our first contribution is to show that there are inaccuracies in retrospective birth location data, showing a sizeable probability of misreporting, with 28% of birth coordinates, 16% of local districts and 6% of counties of birth being incorrectly reported. Our second contribution is to show that such error can lead to substantial attenuation bias when investigating the impacts of location-based exposures, especially when there is little spatial correlation and limited time variation in the exposure variable. Sibling fixed effect models are shown to be particularly vulnerable to the attenuation bias. Our third contribution is to highlight possible solutions to the attenuation bias and sensitivity analyses to the reporting error. Many surveys ask participants to retrospectively record their location of birth. Here, the authors find misreporting in retrospective birth location data in UK Biobank using data from siblings, which can lead to bias in estimates of the impact of location-based exposures. [ABSTRACT FROM AUTHOR]

(1) Background: The incidence of congenital cholesteatoma (CC) has rarely been discussed, particularly from a demographic viewpoint. Therefore, we conducted an epidemiological study of CC using local medical characteristics. (2) Methods: The participants were 100 patients (101 ears) who underwent initial surgical treatment at university hospitals in two rural prefectures between 2006 and 2022. A total of 68% of the patients were males and 32% were females, with a median age of 5 years. We reviewed the medical records for the date of birth, date of surgery, stage of disease, and first symptoms of the disease. (3) Results: The total incidence of CC was calculated to be 26.44 per 100,000 births and tended to increase. No significant difference was found between the incidences in the two prefectures. The number of surgeries performed was higher in the second half of the study period. No difference in the stage of progress was observed based on age. (4) Conclusions: The incidence of CC was estimated to be 26.44 per 100,000 newborn births. The number of patients with CC tended to increase; however, this can be attributed to an increase in the detection rate rather than the incidence. [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.

Background: The prevalence of teenage pregnancy in Colombia is higher than the worldwide average. The identification of socio-geographical disparities might help to prioritize public health interventions. Aim: To describe variation in the probability of teenage maternity across geopolitical departments and socio-geographical intersectional strata in Colombia. Methods: A cross-sectional study based on live birth certificates in Colombia. Teenage maternity was defined as a woman giving birth aged 19 or younger. Multilevel analysis of individual heterogeneity and discriminatory accuracy (MAIHDA) was applied using multilevel Poisson and logistic regression. Two different approaches were used: (1) intersectional: using strata defined by the combination of health insurance, region, area of residency, and ethnicity as the second level (2) geographical: using geopolitical departments as the second level. Null, partial, and full models were obtained. General contextual effect (GCE) based on the variance partition coefficient (VPC) was considered as the measure of disparity. Proportional change in variance (PCV) was used to identify the contribution of each variable to the between-strata variation and to identify whether this variation, if any, was due to additive or interaction effects. Residuals were used to identify strata with potential higher-order interactions. Results: The prevalence of teenage mothers in Colombia was 18.30% (95% CI 18.20–18.40). The highest prevalence was observed in Vichada, 25.65% (95% CI: 23.71–27.78), and in the stratum containing mothers with Subsidized/Unaffiliated healthcare insurance, Mestizo, Rural area in the Caribbean region, 29.08% (95% CI 28.55–29.61). The VPC from the null model was 1.70% and 9.16% using the geographical and socio-geographical intersectional approaches, respectively. The higher PCV for the intersectional model was attributed to health insurance. Positive and negative interactions of effects were observed. Conclusion: Disparities were observed between intersectional socio-geographical strata but not between geo-political departments. Our results indicate that if resources for prevention are limited, using an intersectional socio-geographical approach would be more effective than focusing on geopolitical departments especially when focusing resources on those groups which show the highest prevalence. MAIHDA could potentially be applied to many other health outcomes where resource decisions must be made. [ABSTRACT FROM AUTHOR]

Background: Several studies have reported that climate change elevates heat exposure in pregnant women and high temperatures during pregnancy are associated with preterm births (PTBs). Although the association might be disproportionate, related evidence remains sparse. We evaluated the disproportionate risk of PTB associated with ambient temperature during pregnancy by individual and regional characteristics in South Korea. Methods: We collected data on birth certificates and daily mean temperatures during the period from 2011 to 2019. A time-stratified case-crossover design was used to investigate the association between temperature and PTB and stratified analyses were conducted to examine the effect modification of individual and regional characteristics. Results: A total of 160,067 singleton PTBs were recorded in Korea from 2011 to 2019. A 5℃ increase in the mean temperature during the last four weeks before delivery was associated with an increased risk of PTB with an odds ratio (OR) of 1.03 (95% confidence interval [CI]: 1.02, 1.05), and the association was more evident in mothers aged ≥35 years (OR: 1.06 [95% CI: 1.03, 1.10]) and with low education levels (OR: 1.04 [95% CI: 1.02, 1.05]). Additionally, the estimated risk was evident in districts with lower medical resources and more prominent disparities were shown by individual and regional characteristics in rural areas than in urban areas. Conclusions: This study provides evidence that the risk of PTB related to ambient temperature is disproportionate by individual and regional characteristics and suggests the need for public health policies to alleviate the disparities, especially in rural areas. [ABSTRACT FROM AUTHOR]

Maternity and neonatal services always have to operate 24 hours a day and 7 days a week, and require well preparedness to guarantee safe deliveries for both mothers and babies. However, the evidence of holiday effect from large-scale data is still insufficient from the obstetrics perspective. We analyzed data of over 21 million births in Japan from January 1, 1979, to December 31, 2018. We revealed that the number of births is lower on holidays, and especially among high-risk births such as low birthweight and preterm births. The frequency of high-risk birth has been increasing over the study period, and the variation by the day of week and between holiday and non-holiday have become more prevalent in recent years. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the performance of different approaches for identifying live births using Transformed Medicaid Statistical Information System Analytic Files (TAF). Data Sources: The primary data source for this study were TAF inpatient (IP), other services (OT), and demographic and eligibility files. These data contain administrative claims for Medicaid enrollees in all 50 states and the District of Columbia from January 1, 2018 to December 31, 2018. Study Design: We compared five approaches for identifying live birth counts obtained from the TAF IP and OT data with the Centers for Disease Control and Prevention (CDC) Natality data—the gold standard for birth counts at the state level. Data Collection/Extraction Methods: The five approaches used varying combinations of diagnosis and procedure, revenue, and place of service codes to identify live births. Approaches 1 and 2 follow guidance developed by the Centers for Medicare and Medicaid Services (CMS). Approaches 3 and 4 build on the approaches developed by CMS by including all inpatient hospital claims in the OT file and excluding codes related to delivery services for infants, respectively. Approach 5 applied Approach 4 to only the IP file. Principal Findings: Approach 4, which included all inpatient hospital claims in the OT file and excluded codes related to infants to identify deliveries, achieved the best match of birth counts relative to CDC birth record data, identifying 1,656,794 live births—a national overcount of 3.6%. Approaches 1 and 3 resulted in larger overcounts of births (20.5% and 4.5%), while Approaches 2 and 5 resulted in undercounts of births (−3.4% and −6.8%). Conclusions: Including claims from both the IP and OT files, and excluding codes unrelated to the delivery episode and those specific to services rendered to infants improves accuracy of live birth identification in the TAF data. [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]

This article provides a comprehensive overview of the problems associated with mixed school provision systems in Chile, specifically focusing on the private subsidized network. It examines the characteristics of schools within this network, including their attributes and selectivity practices. The study finds that traditional sources of status, such as fees, composition, and performance, play a significant role in determining the status of schools. It also highlights the importance of understanding how the private subsidized network is composed and how its attributes interact with the institutional characteristics of school provision. The article emphasizes the influence of various factors on educational provision and the responsiveness of schools to competition, including school choice and the preferences of families. It discusses the impact of selectivity practices on segregation and equity in education, based on data from private subsidized schools in the Santiago Metropolitan Area. The study finds that status attributes and access selectivity practices are strongly associated with each other but constitute separate factors. It also explores the correlation between status attributes and the replacement of family fees in school provision. The article concludes by discussing the challenges and failures of a school admission reform in Chile and the counter-reforming efforts that have taken place. It references various studies and reports that analyze the privatization of education, profit-making in schools, and the effects of student composition on school outcomes. Overall, this article provides valuable insights into the complexities and issues surrounding mixed school provision systems in Chile. [Extracted from the article]

This article discusses the issue of disparity in sanctions arising from the issuance of the Regulation of the Minister of Home Affairs of the Republic of Indonesia on Name Registration in Population Documents. A case in Tuban highlights a child who was unable to obtain a birth certificate because the name was too long to be entered into the Population and Civil Registration Office system. The regulation imposes restrictions on naming children, requiring a minimum of two words and no more than sixty characters. Non-compliance with this regulation can result in the non-issuance of a birth certificate, potentially rendering the child stateless. This situation contradicts UDHR Article 15, ICCPR Article 24, CRC Articles 7-8, and the 1945 Constitution Article 26 (1) on citizenship. The purpose of this study is to highlight the imbalance between regulatory rules and sanctions, demonstrating how lower-level regulations can violate higher-level rules. This research employs a qualitative, literaturebased, and normative-doctrinal approach. Secondary data sources include Permendagri No. 73/2022, the Population Administration Law, the 1945 Constitution, and international regulations related to population and citizenship. The findings indicate that birth certificates reflect the state’s responsibility to provide citizens with rights, including the right to identity. However, the sanction of not issuing a birth certificate due to regulatory non-compliance creates a disproportionate disparity in naming rights. Therefore, policy revision is necessary to optimize legal protection, making the system more equitable and in line with legal norms. [ABSTRACT FROM AUTHOR]

Objective To assess civil registration and vital statistics completeness for births in World Health Organization's Member States and identify data completeness gaps. Methods For the 194 Member States, we sourced birth registration data from the United Nations Children's Fund database of national surveys, and, where available, vital registration reports. We acquired publicly available vital statistics compiled by national authorities. We determined civil registration completeness as the percentage of living children younger than five years whose births have been reported as registered. We evaluated vital statistics completeness against the United Nations World Population Prospects' live birth estimates, and grouped countries into seven categories based on their civil registration and vital statistics completeness. Findings Globally, civil registration completeness for births was 77%, exceeding vital statistics completeness for births at 63%. Twenty countries had limited civil registration (25% to 74% completeness) and had nascent or no vital statistics data (completeness < 25%) for births. Five countries had nascent or no civil registration and vital statistics for births. Twenty countries had functional civil registration (75% to 94% completeness) but nascent or no available vital statistics. Approximately half (96) of the countries had complete civil registration and vital statistics for births, but contributed to only 22% of global births. Conclusion The gap in completeness between civil registration data and vital statistics for births is most pronounced in countries with lower civil registration completeness. Enhancing data transfer processes for birth registration, along with targeted investments to elevate registration rates, is crucial for yielding comprehensive fertility statistics for governmental planning. [ABSTRACT FROM AUTHOR]

Objective To assess the current state of the world's civil registration and vital statistics systems based on publicly available data and to propose strategic development pathways, including priority interventions, for countries at different levels of civil registration and vital statistics performance. Methods We applied a performance assessment framework to publicly available data, using a composite indicator highly correlated with civil registration and vital statistics performance which we then adjusted for data incomparability and missing values. Findings Globally, civil registration and vital statistics systems score on average 0.70 (0--1 scale), with substantial variations across countries and regions. Scores ranged from less than 0.50 in emerging systems to nearly 1.00 in the most developed systems. Approximately one fifth of the world's population live in the 43 countries with low system performance (< 0.477). Irrespective of system development, health sector indicators consistently scored lower than other determinants of civil registration and vital statistics performance. Conclusion From our assessment, we provide three main recommendations for how the health sector can contribute to improving civil registration and vital statistics systems: (i) enhanced health sector engagement in birth and death notification; (ii) a more systematic approach to training cause of death diagnostics; and (iii) leadership in the implementation of verbal autopsy methods. Four different civil registration and vital statistics improvement pathways for countries at different levels of system development are proposed, that can constitute a blueprint for regional civil registration and vital statistics strengthening activities that countries can adapt and refine to suit their capabilities, resources, and particular challenges. [ABSTRACT FROM AUTHOR]

Ever since its "birth certificate" on February 25, 1545, Commedia dell'arte's substantial resources of itineracy, improvisation, subversion, extraterritoriality, extemporaneity, laughter, and joy have unceasingly unveiled their essential mutability and ambiguity, prompting UNESCO's depiction of commedia as an "invisible and intangible cultural asset". The present study attempts to disclose the diasporic transgressions of Commedia dell'arte by considering four basic dimensions: the formal, the tropological, the topological, and the temporal, respectively. This approach further examines how and to what extent the diasporic transgressions of Commedia dell'arte can be elucidated by considering the afore-mentioned categories of explanation. Ultimately, the itinerant and improvisational character of Commedia dell'arte is explanatory for the mutations and developments within the four dimensions themselves. [ABSTRACT FROM AUTHOR]

Abstract Objectives: to analyze the temporal trend in maternal, care and newborns characteristics, in the city of Guarapuava, Paraná, Brazil in the period of 2010 to 2019. Methods: ecological temporal tendency study is based on Sistema de Informações sobre Nascidos Vivos (Live Birth Information System). To verify changes on the topics, the Prais-Winsten generalized linear regression was applied. Results: data from 28,919 live births were analyzed in 2019, 15.9% of the pregnancies were adolescents, 49.8% were cesarean deliveries and 9.2% were premature childbirths. A reduction in teenage pregnancy was observed, with annual percentage variation (APV) for mothers aged ten to 14 being -0.14% (p=0.005) and 15 to 19 years old -0.82% (p=0.004); there was an increase in mothers’ schooling, with an APV of 60.09% (p=0.026) for eight to 11 years of schooling and 11.27% (p

ObjectiveThis study aims to compare preterm birth (PTB) risk and maternal factors associated with PTB among non-Hispanic White, Black, and mixed-race Black/White women in the United States.MethodsIn this study, we used U.S. birth certificate data from the 2017 National Vital Statistics System. We included live singleton births to women who self-identified as non-Hispanic White, Black, or mixed-race Black/White. PTB was defined as less than 37 weeks of gestation. We used logistic regression models to estimate the PTB odds ratios for Black and Black/White relative to White women, adjusted for maternal factors. We used logistic regression to estimate associations between PTB and maternal factors in race-stratified models.ResultsThe sample included a total of 2,297,076 births in 2017 to White (n = 1,792,257), Black (n = 476,969), and Black/White (n = 27,850) women. The prevalence of PTB varied for Black (11.2%), Black/White (8.2%), and White (6.8%) women. The odds of PTB compared with White differed for Black (odds ratio, 1.51; 95% confidence interval, 1.49-1.53) and Black/White (odds ratio, 1.13; 95% confidence interval, 1.08-1.18) women after adjusting for maternal factors. The odds of PTB associated with maternal sociodemographic, prepregnancy, and gestational factors differed by maternal race.ConclusionsEvaluation of PTB risk among White, Black, and Black/White women revealed distinct associations between PTB and maternal factors for Black/White women. This study highlights the need for research assessing the relationships between social risk factors such as colorism and racism and the outcome of PTB, and it provides evidence that may inform more targeted PTB prevention among Black/White and Black women.

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]

Premise: There is mounting evidence that age matters in plant demography, but also indications that relationships between age and demographic rates may vary significantly among species. Age‐based plant demographic data, however, are time‐consuming to collect and still lacking for most species, and little is known about general patterns across species or what may drive differences. Methods: We used individual birth and death records for 12 Rhododendron species from botanic gardens and conducted Bayesian survival trajectory analyses to assess how mortality changed with age. We calculated the demographic measures of aging rate, life‐span equality, and life expectancy for each species, and assessed their relationships with the climatic conditions at species' sites of ancestral origin and with taxonomic group (subgenus). Results: We found substantial among‐species variation in survival trajectories, with mortality increasing, decreasing, or remaining constant with advancing age. Moreover, we found no relationships between demographic measures and ancestral climatic conditions but there were statistically significant differences among taxonomic groups in the rate of change in mortality with age (aging rate). Conclusions: We conclude that demographic consequences of aging can differ qualitatively, even among species in the same genus. In addition, taxonomic trends in aging rates indicate they may be genetically determined, though evolutionary drivers are still unclear. Furthermore, we suggest there is untapped potential in using botanic garden records in future studies on plant life history. [ABSTRACT FROM AUTHOR]

Newborn metabolite perturbations may identify potential biomarkers or mechanisms underlying adverse, smoking-related childhood health outcomes. We assessed associations between third-trimester smoking and newborn metabolite concentrations using the Tennessee Pregnancy Risk Assessment Monitoring System (PRAMS, 2009–2019) as the discovery cohort and INSPIRE (2012–2014) as the replication cohort. Children were linked to newborn screening metabolic data (33 metabolites). Third-trimester smoking was ascertained from birth certificates (PRAMS) and questionnaires (INSPIRE). Among 8600 and 1918 mother–child dyads in PRAMS and INSPIRE cohorts, 14% and 13% of women reported third-trimester smoking, respectively. Third-trimester smoking was associated with higher median concentrations of free carnitine (C0), glycine (GLY), and leucine (LEU) at birth (PRAMS: C0: adjusted fold change 1.11 [95% confidence interval (CI) 1.08, 1.14], GLY: 1.03 [95% CI 1.01, 1.04], LEU: 1.04 [95% CI 1.03, 1.06]; INSPIRE: C0: 1.08 [95% CI 1.02, 1.14], GLY: 1.05 [95% CI 1.01, 1.09], LEU: 1.05 [95% CI 1.01, 1.09]). Smoking cessation (vs. continued smoking) during pregnancy was associated with lower median metabolite concentrations, approaching levels observed in infants of non-smoking women. Findings suggest potential pathways underlying fetal metabolic programming due to in utero smoke exposure and a potential reversible relationship of cessation. [ABSTRACT FROM AUTHOR]

Background: Regular evaluation of caesarean section (CS) is required due to their rising trend and outcomes. Many women recently opt for elective CS, even in resource-constrained settings. Data evaluating the outcomes of CS is however sparse. Hence, this study sought to determine the rate of fetal mortalities and their determinants following CS in the Tatale District Hospital of the Northern Region, Ghana. Methods: A retrospective cross-sectional study was employed to analyze the medical records of 275 women who underwent CS from 2019 to 2021. Data were collected from the hospital's record of CS cases from 2019 to 2021. Descriptive statistics were used to summarize the data and Pearson's chi-square/Fisher's exact test was used to examine the relationship between maternal and obstetric characteristics and fetal mortality. At a 95% confidence interval (95% CI), logistic regression was fitted to assess significant variables and reported the results using odds ratio. Results: Of 1667 deliveries, 16.5% of the mothers gave birth by CS. A fetal mortality rate of 76.4 per 1000 total births was recorded following CS. Babies born with low Appearance, Pulse, Grimace, Activity and Respiration (APGAR) scores (0–3) at fifth-minute had an increased risk of fetal mortality (AOR = 523.19, 95%CI: 49.24–5559.37, p = <0.001). Having a history of previous CS, cephalopelvic disproportion and delayed labour were the major indications for CS. Conclusion: Overall, this study found a high rate of CS based on the World Health Organization's recommended CS rate. Interventions such as reducing the waiting time for surgery and early diagnosis of the need for CS, and ensuring the availability of modern equipment to resuscitate infants with low APGAR scores can significantly improve fetal outcomes following CS. [ABSTRACT FROM AUTHOR]

Introduction: Anaemia in pregnant women is a major public health problem and is associated with adverse outcomes both in pregnant mothers and new-borns. According to NFHS-5, 45.7% of women in urban India were affected by anaemia during their pregnancy. The objectives of this study were to estimate the proportion of pregnant women who were anaemic and its effect on maternal and birth outcomes, and additionally, to assess the various socio-economic factors contributing to anaemia during pregnancy. Methodology: Data was collected by reviewing records between December 2018 and December 2021 of 302 pregnant women who had received antenatal care at a secondary level health facility in Krishnagiri, Tamil Nadu. The data included details of socio-economic parameters, parity, haemoglobin levels, mode of delivery, pregnancy related complications during the antenatal period and during delivery, including need for blood transfusions in mothers. Birth-related outcomes like miscarriages, intra-uterine death, low birth weight (LBW), need for NICU admission and congenital defects were also analysed. Variables in the study are described as frequencies and proportions. Appropriate tests were used to check for association and a P- value of less than 0.05 was considered as statistically significant. Results: The mean age of the women was 24 ± 3.72 years and the mean Haemoglobin level during the first trimester was 10.5 ± 1.12 gm/dl. The proportion of women with anaemia in the first trimester was 174 (57.6%). Among the anaemics, 15 (8.6%) required treatment in the form of injectable iron and 29 (16.7%) required blood transfusion. Gestational diabetes mellitus (GDM) (31.6%) (P < 0.05), preeclampsia (38.9%) (P < 0.02) less among anaemic. Hyperemesis (66.7%) (P = 0.58), risk of miscarriage (57.8%) (P = 0.94), postpartum haemorrhage (PPH) (80.0%) (P = 0.15) was higher in the anaemic group. Adverse Neonatal-related outcomes such as low birth weight babies (52.0%) (P = 0.54), meconium aspiration (72.7%) (P = 0.25) and need for NICU admission (75.0%) (P = 0.25) was higher in babies born to anaemic pregnant women. Conclusions: The proportion of anaemic women was 57.6%. There was no significant difference in maternal demographic characteristics or obstetric factors between anaemic and non-anaemic pregnant women. GDM, pre-eclampsia was less prevalent among anaemic women. Hyperemesis, risk of abortion, postpartum haemorrhage and low birth weight (LBW) infants was higher in anaemic pregnancies. The need for providing education regarding iron supplementation and early detection of anaemia during pregnancy should be emphasised to avoid complications. [ABSTRACT FROM AUTHOR]

Background: During the COVID-19 pandemic, hospitals' decision of not admitting pregnant women's partner or support person, and pregnant women's fear of contracting COVID-19 in hospitals may disrupt prenatal care. We aimed to examine whether prenatal care utilization in South Carolina varied before and during the COVID-19 pandemic, and whether the variation was different by race. Methods: We utilized 2018–2021 statewide birth certificate data using a pre-post design, including all women who delivered a live birth in South Carolina. The Kotelchuck Index - incorporating the timing of prenatal care initiation and the frequency of gestational age-adjusted visits - was employed to categorize prenatal care into inadequate versus adequate care. Self-reported race includes White, Black, and other race groups. Multiple logistic regression models were used to calculate adjusted odds ratio of inadequate prenatal care and prenatal care initiation after first trimester by maternal race before and during the pandemic. Results: A total of 118,925 women became pregnant before the pandemic (before March 2020) and 29,237 women during the COVID-19 pandemic (March 2020 – June 2021). Regarding race, 65.2% were White women, 32.0% were Black women and 2.8% were of other races. Lack of adequate prenatal care was more prevalent during the pandemic compared to pre-pandemic (24.1% vs. 21.6%, p < 0.001), so was the percentage of initiating prenatal care after the first trimester (27.2% vs. 25.0%, p < 0.001). The interaction of race and pandemic period on prenatal care adequacy and initiation was significant. The odds of not receiving adequate prenatal care were higher during the pandemic compared to before for Black women (OR 1.26, 95% CI 1.20–1.33) and White women (OR 1.10, 95% CI 1.06–1.15). The odds of initiating prenatal care after the first trimester were higher during the pandemic for Black women (OR 1.18, 95% CI 1.13–1.24) and White women (OR 1.09, 95% CI 1.04–1.13). Conclusions: Compared to pre-pandemic, the odds of not receiving adequate prenatal care in South Carolina was increased by 10% for White women and 26% for Black women during the pandemic, highlighting the needs to develop individual tailored interventions to reverse this trend. [ABSTRACT FROM AUTHOR]

The SARS-CoV-2 (COVID-19) pandemic impacted the health systems between and within countries, and in the course of the pandemic sexual and reproductive health services were the most disrupted. Findings from high-income settings have reported significant changes in preterm birth prevalence during the pandemic period. To understand the possible effects of the COVID-19 pandemic on preterm birth numbers at the Brazilian national level. We compare the number of preterm deliveries during the COVID-19 pandemic period (2020 and 2021) with previous years. We conducted a population-based cross-sectional study taking the period from January 2017 to December 2021 to account. We use individual-level live births data from the Brazilian Live Birth Information System (SINASC), and we estimate the odds ratio (OR) of preterm deliveries using propensity score weighting analysis in Brazil and its regions. During the study period (from 2017 to 2021), about 2.7 million live births were recorded per year, and the missing value for gestational age at delivery was less than 1.5%. The preterm birth prevalence slightly increased during the COVID-19 pandemic compared to the pre-pandemic period (11.32% in 2021 vs 11.09% in 2019, p-value < 0.0001). After adjusting for sociodemographic variables, the OR of preterm births in Brazil has significantly increased, 4% in 2020 (OR: 1.04 [1.03–1.05] 95% CI, p-value < 0.001), and 2% in 2021(OR: 1.02 [1.01–1.03] 95% CI, p-value < 0.001), compared to 2019. At the regional level, the preterm birth pattern in the South, Southeast and Northeast regions show a similar pattern. The highest odds ratio was observed in the South region (2020 vs 2019, OR: 1.07 [1.05–1.10] 95% CI; 2021 vs 2019, OR: 1.03 [1.01–1.06] 95% CI). However, we also observed a significant reduction in the ORs of preterm births in the northern region during the COVID-19 pandemic (2020 vs 2019, OR: 0.96 [0.94–0.98] 95% CI) and (2021 vs 2019, OR: 0.97 [0.95–0.99] 95% CI). Our analysis shows that the pandemic has increased regional variation in the number of preterm births in Brazil in 2020 and 2021 compared to the pre-pandemic years. [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]

The purpose of the current study was to establish the dynamics of weight development and growth capacities until weaning in lambs from the Karnobat Fine-fleece breed in both sexes and different types of birth. The subjects of the study were 15 female and 15 male lambs. The study was conducted in the flock owned by Institute of Agriculture – Karnobat, during the 2020 lambing season. Four groups were formed, equalized according to the method of analogues by type of birth (singles, twins), gender (male, female), age and live weight. Live weight was recorded at birth, at 10 days, at 30 days, at 70 days and at 90 days. It has been established that the Karnobat Fine-fleece sheep breed is characterized by a good intensity of offspring growth until weaning, with female lambs reaching an average of 29.233 kg, and male lambs, respectively, 30.835 kg at 90 days. The average daily gain of lambs from the Karnobat Fine-fleece breed ranged from 0.236 kg to 0.344 kg for females by periods and from 0.242 kg to 0.367 kg for male lambs. Lambs of both sexes achieved the highest growth in the period 30-70 days. The results of the study indicate good compensatory abilities in the weight development of lambs born as twins from the Karnobat Fine-fleece sheep breed. The total gain reached by twin lambs at 90 days was close in value to singles of both sexes, being 1.97% lower in female lambs and 4.77% lower in male offspring. The Karnobat Fine-fleece breed has a good genetic potential for meat production, which is an advantage for sustainable development against the background of competition from specialized meat-producing sheep breeds in Bulgaria. [ABSTRACT FROM AUTHOR]

Background: Common postpartum mental health (PMH) disorders such as depression and anxiety are preventable, but determining individual-level risk is difficult. Aims: To create and internally validate a clinical risk index for common PMH disorders. Method: Using population-based health administrative data in Ontario, Canada, comprising sociodemographic, clinical and health service variables easily collectible from hospital birth records, we developed and internally validated a predictive model for common PMH disorders and converted the final model into a risk index. We developed the model in 75% of the cohort (n = 152 362), validating it in the remaining 25% (n = 75 772). Results: The 1-year prevalence of common PMH disorders was 6.0%. Independently associated variables (forming the mnemonic PMH CAREPLAN) that made up the risk index were: (P) prenatal care provider; (M) mental health diagnosis history and medications during pregnancy; (H) psychiatric hospital admissions or emergency department visits; (C) conception type and complications; (A) apprehension of newborn by child services (newborn taken into care); (R) region of maternal origin; (E) extremes of gestational age at birth; (P) primary maternal language; (L) lactation intention; (A) maternal age; (N) number of prenatal visits. In the index (scored 0–39), 1-year common PMH disorder risk ranged from 1.5 to 40.5%. Discrimination (C-statistic) was 0.69 in development and validation samples; the 95% confidence interval of expected risk encompassed observed risk for all scores in development and validation samples, indicating adequate risk index calibration. Conclusions: Individual-level risk of developing a common postpartum mental health disorder can be estimated with data feasibly collectable from birth records. Next steps are external validation and evaluation of various cut-off scores for their utility in guiding postpartum individuals to interventions that reduce their risk of illness. [ABSTRACT FROM AUTHOR]

BackgroundResearch suggests that children's health and well-being are supported by core adaptive systems, including the autonomic nervous system (ANS). Despite evidence for the importance of adulthood ANS regulation in the development of disease, few studies have examined how early development may influence emerging ANS function. Therefore, we examined how infant adiposity gain during early infancy related to ANS regulation at 6 months.MethodsInfant weight and length were abstracted from birth records and measured during the 6-month assessment in a low-income, racially/ethnically diverse sample (N = 60). WHO-standardized weight-for-length-gain change was calculated across the first 6 months of life. ANS reactivity was measured as the combined sympathetic (i.e., pre-ejection period) and parasympathetic (i.e., respiratory sinus arrhythmia) nervous system responses during the developmentally challenging Still Face Paradigm (SFP). ANS "classic reactivity" response was characterized by paired sympathetic activation and parasympathetic withdrawal.ResultsLower weight-for-length gain in the first 6 months predicted classic reactivity during still face. However, greater weight-for-length gain predicted "classic reactivity" during the reunion, when infants were expected to recover, suggesting autonomic dysregulation.ConclusionsThese findings suggest an association between early life adiposity gain and the development of infant ANS regulation.ImpactAdiposity gain during early infancy was associated with autonomic nervous system regulation at 6 months. This study identifies early adiposity gain (greater than average infant weight-for-length gain) as a risk for ANS dysregulation. This research focuses on a critical developmental period of ANS plasticity. If confirmed, findings can be used to inform early intervention programs targeting obesity prevention and to promote self-regulation.

Background: Incidence rates of thyroid cancer in children and young adults (age 0-19 years) have nearly doubled over a recent 15-year period in the United States. Children with thyroid cancer may require long-term therapy and surveillance and are at greater risk for second primary malignancies. High-dose exposure to ionizing radiation is the only known nongenetic risk factor; the vast majority of cases have an unknown etiology. Methods: We conducted a population-based nested case-control study to evaluate the relationship between a range of birth characteristics and the risk of pediatric thyroid cancer. Using linked birth records and cancer registry data from California, we included 1012 cases who were diagnosed with first primary thyroid cancer at the age of 0-19 years from 1988 to 2015 and 50,600 birth-year matched controls (1:50 case to control ratio). We estimated adjusted odds ratios (OR) and 95% confidence intervals (CI) by using multivariable logistic regression models applied to the full population and stratified by thyroid cancer subtypes (papillary and follicular), race/ethnicity (white and Hispanic), and age at diagnosis (0-14 and 15-19 years). Results: Hispanic ethnicity (OR: 1.20 [CI 1.01-1.42]), higher birth weight (OR: 1.11 [CI 1.04-1.18] per 500g), and higher maternal education (13-15 years OR: 1.35 [CI 1.09-1.68], 16+ years OR: 1.35 [CI 1.07-1.71]) were associated with an increased risk of pediatric thyroid cancer, while male sex (OR: 0.21 [CI 0.18-0.25]) and higher birth order (third or higher OR: 0.81 [CI 0.68-0.98]) were associated with a decreased risk. Some heterogeneity was observed across subtype, most notably an elevated OR with higher birth order for follicular thyroid cancer, in contrast to the reduced risk for this category among papillary thyroid cancer cases (p-value for interaction = 0.01). Hispanic ethnicity was a risk factor for papillary, but not follicular thyroid cancer (p-value for interaction = 0.07). Conclusions: In this population-based study of birth characteristics and pediatric thyroid cancer, we identified several important risk factors for pediatric thyroid cancer, including female sex, Hispanic ethnicity, higher birth weight, higher maternal educational attainment, and lower birth order. Our data provide new areas for replication and investigation of biological mechanisms for this poorly understood malignancy.

(1) Background: Lower birth weight among newborns in higher altitudes has been well documented in previous literature. Several possible causes for this phenomenon have been investigated, including biophysiological adaptation, epigenetic or genetic mechanisms or lifestyle changes. This is the first study to show the effect modification of altitude and parity on the birth weight length ratio (BWLR) in women resident in moderate altitudes compared to a low sea level.; (2) Methods: This population-based study obtained data on altitude (0–300, 300–500, 500–700,700–900, >900 m), parity (1, 2, ..., 7, 8/9), birth weight and length on all births in Austria between 1984 and 2020 from birth certificates provided by Statistics Austria. The BWLR was calculated, and the effect of moderate altitude and parity was estimated using multivariable linear mixed models adjusting for predefined variables. Sub-group regression analyses were conducted by altitude group. (3) Results: Data on 2,057,702 newborns from 1,280,272 mothers were analyzed. The effect of parity on BWLR, as indicated by the difference of BWLR between the first- and second-born infants, ranged between 1.87 to 2.09 g per centimeter across all altitude groups. Our analyses found that the effect of parity on BWLR diminished from parity three onwards at altitude 0–300, whilst the effect of parity on BWLR continued to increase at higher than 300 m and was most notable in the highest altitude group >900 m. (4) Conclusions: Findings from our study indicated that the negative effect of increasing altitude on BWLR was deprived for newborns of higher parity. It shows that the residential altitude can modify the effect of parity on BWLR. [ABSTRACT FROM AUTHOR]

The article discusses how state laws concerning transgender individuals birth certificates affect their ability to serve openly in the U.S. military. It examines the specific case of Missouri's birth certificate statute and its impact on transgender service members in the Missouri Army National Guard. It provides an overview of transgender terminology, discusses the historical context of transgender military service, analyzes the Department of Defense's policy on transgender service.

Identification and determination of age is imperative for diversity of reasons that include disputed birth records, premature delivery, legal issues etc. Assessment of growth and development of a child helps in orthodontic, tooth development, shedding analysis, surgical and orthopedic management in dentistry.Dental age is one of the few measures of physiologic development that is uniformly applicable from infancy to late adolescence.Several methods have been proposed for the assessment of a child's dental age. [ABSTRACT FROM AUTHOR]

The objective of this study is to evaluate if proximity to food sources, rather than density, is associated with gestational diabetes mellitus (GDM) risk. Rhode Island birth certificate data from 2015-2016 were utilized. A proximity analysis was used to determine the distance from each pregnant person's home address to the closest food source (fast food restaurant, supermarket, and farmers market/community garden). Multivariable logistic regression was used to examine the association between distance to food source and the risk of GDM. Of the 20,129 births meeting inclusion criteria, 7.2% (1,447) had GDM. Distance to food sources differed by insurance type, educational background, and race/ethnicity. There was no statistically significant association between distance to any of the food sources and GDM in the adjusted model. Other factors need to be examined to improve interventions, influence policy, and impact neonatal and maternal outcomes. [ABSTRACT FROM AUTHOR]

Background : Risk-appropriate care improves outcomes by ensuring birthing people and infants receive care at a facility prepared to meet their needs. Perinatal regionalization has particular importance in rural areas where pregnant people might not live in a community with a birthing facility or specialty care. Limited research focuses on operationalizing risk-appropriate care in rural and remote settings. Through the implementation of the Centers for Disease Control and Prevention (CDC) Levels of Care Assessment Tool (LOCATe), this study assessed the system of risk-appropriate perinatal care in Montana. Methods: Primary data was collected from Montana birthing facilities that participated in the CDC LOCATe version 9.2 (collected July 2021 – October 2021). Secondary data included 2021 Montana birth records. All birthing facilities in Montana received an invitation to complete LOCATe. LOCATe collects information on facility staffing, service delivery, drills, and facility-level statistics. We added additional questions on transport. Results: Nearly all (96%) birthing facilities in Montana completed LOCATe (N = 25). The CDC applied its LOCATe algorithm to assign each facility with a level of care that aligns directly with guidelines published by the American Academy of Pediatrics (AAP) and the American College of Obstetricians and Gynecologists (ACOG), and Society for Maternal-Fetal Medicine (SMFM). LOCATe-assessed levels for neonatal care ranged from Level I to Level III. Most (68%) facilities LOCATe-assessed at Level I or lower for maternal care. Close to half (40%) self-reported a higher-level of maternal care than their LOCATe-assessed level, indicating that many facilities believe they have greater capacity than outlined in their LOCATe-assessed level. The most common ACOG/SMFM requirements contributing to the maternal care discrepancies were the lack of obstetric ultrasound services and a physician anesthesiologist. Conclusions: The Montana LOCATe results can drive broader conversations on the staffing and service requirements necessary to provide high-quality obstetric care in low-volume rural hospitals. Montana hospitals often rely on Certified Registered Nurse Anesthetists (CRNA) for anesthesia services and telemedicine to access specialty providers. Integrating a rural health perspective into the national guidelines could enhance the utility of LOCATe to support state strategies to improve the provision of risk-appropriate care. [ABSTRACT FROM AUTHOR]

The Jewish community archive in Pisa owns a vast collection of documents and manuscripts that date back centuries. These documents contain valuable genealogical information, including birth, marriage, and death records. This paper aims to describe the preliminary results of the Archivio Storico della Comunita Ebraica di Pisa (ASCEPI) project, with a focus on the extraction of data from the Nati, Morti e Ballottati (NMB) Registry document in the archive. The NMB Registry contains about 1900 records of births, deaths, and balloted individuals within the Jewish community in Pisa. The study uses a semiautomatic pipeline of digitization, transcription, and Natural Language Processing (NLP) techniques to extract personal data such as names, surnames, birth and death dates, and parental names from each record. The extracted data are then used to build a knowledge base and a genealogical tree for a representative family, Supino. This study demonstrates the potential of using NLP and rule-based techniques to extract valuable information from historical documents and to construct genealogical trees. [ABSTRACT FROM AUTHOR]