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Pregnancy-specific stress (PSS) arises from the numerous changes that women experience during pregnancy and from their concerns about childbirth and the health of their offspring. Prolonged or elevated maternal stress heightens risk for poor fetal, infant, and child outcomes. The Prenatal Distress Questionnaire (PDQ) and its expanded successor, the revised Prenatal Distress Questionnaire (NuPDQ), were developed to assess PSS, but their psychometric properties and findings are not well-documented. We reviewed research using the PDQ (n = 45) or NuPDQ (n = 37). Results establish that PSS as measured by these instruments is common in pregnancy; PSS is associated with sociodemographic and obstetric characteristics, perceptions of pregnancy, health behaviors, maternal health, and birth outcomes. The NuPDQ is an especially appropriate tool to assess PSS, with demonstrated reliability and convergent, concurrent, and predictive validity. The ability to assess PSS in a reliable and valid manner is critical to advance research and improve maternal and child health., Author(s): Sirena M. Ibrahim [sup.1] , Marci Lobel [sup.1] Author Affiliations: (1) grid.36425.36, 0000 0001 2216 9681, Department of Psychology, Stony Brook University, , 11794-2500, Stony Brook, NY, USA Introduction [...]

Background Few studies have evaluated the effect of maternal influenza vaccination on the development of allergic and autoimmune diseases in children beyond 6 months of age. We aimed to investigate the association between in utero exposure to seasonal inactivated influenza vaccine (IIV) and subsequent diagnosis of allergic and autoimmune diseases. Methods and findings This longitudinal, population-based linked cohort study included 124,760 singleton, live-born children from 106,206 mothers in Western Australia (WA) born between April 2012 and July 2016, with up to 5 years of follow-up from birth. In our study cohort, 64,169 (51.4%) were male, 6,566 (5.3%) were Aboriginal and/or Torres Strait Islander children, and the mean age at the end of follow-up was 3.0 (standard deviation, 1.3) years. The exposure was receipt of seasonal IIV during pregnancy. The outcomes were diagnosis of an allergic or autoimmune disease, including asthma and anaphylaxis, identified from hospital and/or emergency department (ED) records. Inverse probability of treatment weights (IPTWs) accounted for baseline probability of vaccination by maternal age, Aboriginal and/or Torres Strait Islander status, socioeconomic status, body mass index, parity, medical conditions, pregnancy complications, prenatal smoking, and prenatal care. The models additionally adjusted for the Aboriginal and/or Torres Strait Islander status of the child. There were 14,396 (11.5%) maternally vaccinated children; 913 (6.3%) maternally vaccinated and 7,655 (6.9%) maternally unvaccinated children had a diagnosis of allergic or autoimmune disease, respectively. Overall, maternal influenza vaccination was not associated with diagnosis of an allergic or autoimmune disease (adjusted hazard ratio [aHR], 1.02; 95% confidence interval [CI], 0.95 to 1.09). In trimester-specific analyses, we identified a negative association between third trimester influenza vaccination and the diagnosis of asthma (n = 40; aHR, 0.70; 95% CI, 0.50 to 0.97) and anaphylaxis (n = 36; aHR, 0.67; 95% CI, 0.47 to 0.95).We did not capture outcomes diagnosed in a primary care setting; therefore, our findings are only generalizable to more severe events requiring hospitalization or presentation to the ED. Due to small cell sizes (i.e., Conclusions In this study, we observed no association between in utero exposure to influenza vaccine and diagnosis of allergic or autoimmune diseases. Although we identified a negative association of asthma and anaphylaxis diagnosis when seasonal IIV was administered later in pregnancy, additional studies are needed to confirm this. Overall, our findings support the safety of seasonal inactivated influenza vaccine during pregnancy in relation to allergic and autoimmune diseases in early childhood and support the continuation of current global maternal vaccine programs and policies., Author(s): Damien Foo 1,2,*, Mohinder Sarna 1,2, Gavin Pereira 1,3,4, Hannah C. Moore 1,2, Annette K. Regan 1,2,5,6 Introduction Influenza is a major respiratory infection that is linked with serious [...]

Background Nutritional status may play a role in infant immune development. To identify potential boosters of immunogenicity in low-income countries where oral vaccine efficacy is low, we tested the effect of prenatal nutritional supplementation on immune response to 3 doses of a live oral rotavirus vaccine. Methods and findings We nested a cluster randomized trial within a double-blind, placebo-controlled randomized efficacy trial to assess the effect of 3 prenatal nutritional supplements (lipid-based nutrient supplement [LNS], multiple micronutrient supplement [MMS], or iron-folic acid [IFA]) on infant immune response (n = 53 villages and 1,525 infants with valid serology results: 794 in the vaccine group and 731 in the placebo group). From September 2015 to February 2017, participating women received prenatal nutrient supplement during pregnancy. Eligible infants were then randomized to receive 3 doses of an oral rotavirus vaccine or placebo at 6-8 weeks of age (mean age: 6.3 weeks, 50% female). Infant sera (pre-Dose 1 and 28 days post-Dose 3) were analyzed for anti-rotavirus immunoglobulin A (IgA) using enzyme-linked immunosorbent assay (ELISA). The primary immunogenicity end point, seroconversion defined as [greater than or equal to]3-fold increase in IgA, was compared in vaccinated infants among the 3 supplement groups and between vaccine/placebo groups using mixed model analysis of variance procedures. Seroconversion did not differ by supplementation group (41.1% (94/229) with LNS vs. 39.1% (102/261) with multiple micronutrients (MMN) vs. 38.8% (118/304) with IFA, p = 0.91). Overall, 39.6% (n = 314/794) of infants who received vaccine seroconverted, compared to 29.0% (n = 212/731) of infants who received placebo (relative risk [RR]: 1.36; 95% confidence interval [CI]: 1.18, 1.57, p < 0.001). This study was conducted in a high rotavirus transmission setting. Study limitations include the absence of an immune correlate of protection for rotavirus vaccines, with the implications of using serum anti-rotavirus IgA for the assessment of immunogenicity and efficacy in low-income countries unclear. Conclusions This study showed no effect of the type of prenatal nutrient supplementation on immune response in this setting. Immune response varied depending on previous exposure to rotavirus, suggesting that alternative delivery modalities and schedules may be considered to improve vaccine performance in high transmission settings. Trial registration ClinicalTrials.gov NCT02145000., Author(s): Sheila Isanaka 1,2,*, Souna Garba 3, Brian Plikaytis 4, Monica Malone McNeal 5, Ousmane Guindo 3, Céline Langendorf 1, Eric Adehossi 6, Iza Ciglenecki 7, Rebecca F. Grais 1 [...]

Byline: Pravash. Mishra, Mayadhar. Barik, A. Mahapatra Background: Folic acid and multivitamin supplements ((FAMVS) and genetics involvement is one of the major roles in the development of neural tube defects [...]

Although recent research has examined discrimination in health care, no studies have investigated women's experiences during prenatal or obstetrical care. Analyses of data from the Oregon Pregnancy Risk Assessment Monitoring System showed that 18.53% of mothers reported discrimination by providers during prenatal care, labor, or delivery, most commonly be cause of age or insurance status. Perceived discrimination was associated with maternal characteristics such as age, marital status, and type of insurance, but not with number of subsequent well-baby visits.

Objective: To assess the potential impact of a national iron supplementation programme in rural Vietnam. Methods: The study included questionnaires, focus group discussions of pregnant women and key informant interviews, together with measurements of haemoglobin (Hb) and a stool examination for soil-transmitted helminths. Results: Iron supplementation significantly increased Hb concentration among participants in the second and third trimesters by 0.4 and 0.7 g/dl, respectively (P=0.017 and P Conclusions: The results of this study show that an iron supplementation programme is beneficial as a part of a comprehensive anaemia programme for pregnant women in these communities. These results will be useful for developing improved iron-deficiency anaemia control programs for pregnant women. doi:10.1038/sj.ejcn.1602812; published online 23 May 2007 Keywords: iron-deficiency anaemia; community health; pregnancy; compliance; Vietnam; parasite infestation, Introduction Iron-deficiency anaemia (IDA) is the most frequently observed nutritional deficiency in pregnant women in developing countries (Preziosi et al., 1997). According to the World Health Organization (WHO), many pregnant [...]

: Introduction: Safer conception care encompasses HIV care, treatment and prevention for persons living with HIV and their partners who desire children. In 2012, South Africa endorsed a progressive safer conception policy supporting HIV‐affected persons to safely meet reproductive goals. However, aside from select research‐supported clinics, widespread implementation has not occurred. Using South Africa as a case study, we identify key obstacles to policy implementation and offer recommendations to catalyse expansion of these services throughout South Africa and further afield. Discussion: Four key implementation barriers were identified by combining authors’ safer conception service delivery experiences with available literature. First, strategic implementation frameworks stipulating where, and by whom, safer conception services should be provided are needed. Integrating safer conception services into universal test‐and‐treat (UTT) and elimination‐of‐mother‐to‐child‐transmission (eMTCT) priority programmes would support HIV testing, ART initiation and management, viral suppression and early antenatal/eMTCT care engagement goals, reducing horizontal and vertical transmissions. Embedding measurable safer conception targets into these priority programmes would ensure accountability for implementation progress. Second, facing an organizational clinic culture that often undermines clients’ reproductive rights, healthcare providers’ (HCP) positive experiences with eMTCT and enthusiasm for UTT provide opportunities to shift facility‐level and individual attitudes in favour of safer conception provision. Third, safer conception guidelines have not been incorporated into HCP training. Combining safer conception with “test‐and‐treat” training would efficiently ensure that providers are better equipped to discuss clients’ reproductive goals and support safer conception practices. Lastly, HIV‐affected couples remain largely unaware of safer conception strategies. HIV‐affected populations need to be mobilized to engage with safer conception options alongside other HIV‐related healthcare services. Conclusion: Key barriers to widespread safer conception service provision in South Africa include poor translation of policy into practical and measurable implementation plans, inadequate training and limited community engagement. South Africa should leverage the momentum and accountability associated with high priority UTT and eMTCT programmes to reinvigorate implementation efforts by incorporating safer conception into implementation and monitoring frameworks and associated HCP training and community engagement activities. South Africa's experiences should be used to inform policy development and implementation processes in other HIV high‐burden countries., Introduction Safer conception care encompasses HIV care, treatment and prevention for individuals and couples desiring a child, in which one or both partners are living with HIV [1]. Safer conception [...]

The impact of the introduction of routine opt-out HIV testing in antenatal care in Botswana is examined. The results have shown that routine HIV testing is more accepted than voluntary testing and it has led to substantial increases in the uptake of testing and prevention of mother-to-child transmission (PMTCT) interventions without adverse consequences.

The Cameroon Bapist Convention Health Board implemented to prevent mother-to-child transmission of HIV-1 into routine antenatal care, achieved high uptake of rapid HIV testing and posttest counseling on the same day, implemented routine uses on peripartum single-dose NVP for HIV-positive mothers and their infants in collaboration with the National AIDS Program is described. Consistent training and programmatic support contributed to rapid upscaling and high uptake counseling rates.

Developments in obstetric medicine during the past ten to twenty years have transformed the clinical status of the fetus. [2] Traditionally physicians have been trained to assess fetal condition by [...]

In the United States, pro-life advocacy groups, notably Americans United for Life, based in Washington DC, have been making headway in their mission (1) to limit women's access to abortions [...]