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The study aims to assess pregnancy-specific stress among pregnant women in Spain during the first lockdown of the COVID-19 pandemic. Two samples of pregnant women from the south of Spain (Andalusia) were assessed using the Prenatal Distress Questionnaire (PDQ) and a sociodemographic and obstetric questionnaire. Group 1 (N = 155) was recruited face-to-face, whereas Group 2 (N = 78) was recruited online. Pregnancy-specific stress levels were significantly different in both groups. The face-to-face group (Group 1) had higher pregnancy-specific stress levels than the online group (Group 2). The online sample over-represents young adult pregnant women with high education levels and a high number of previous miscarriages. The face-to-face study seems more accessible to racially and ethnically diverse groups. The main concern among both groups was the risk of having a sick neonate. Research during the COVID-19 pandemic can benefit from using online resources to collect data to screen and identify perinatal mental health problems in a crisis environment. Nevertheless, researchers should be aware of the potential limitations this strategy can have, for example, certain groups of people may have limited access to the internet.

Background: The collection and promotion of traditional knowledge is an international issue today. Thus, in this study we were interested in the local knowledge held by the Malinke of south-eastern Senegal on the plants used in gynecology. Methodology: The open semi-structured interviews technique, immersion, direct observations were used to collect local knowledge. The data are processed by descriptive statistical techniques for calculating ethnobotanical indices. Results: The Malinke use 30 plants, belonging to 24 genera, distributed in 15 families, the most representative of which are the Fabaceae with 5 species, the Rubiaceae comprising 4 species, the Apocynaceae, the Combretaceae and the Moraceae with 3 species each. Their traditional mode of use compared to the practice of modern medicine allows the plants used to be classified into 7 Groups: oxytocics, antispasmodics, uterine antispasmodics, antiemetics, diuretics, muscle relaxants and galactogens. The most used species are Erythrina senegalensis, Ficus umbellata, Raphionacme splendens and Indigofera leptoclada. Bark is mostly used (38%), followed by the leaves and roots (22% each), while the most common method of preparation is a decoction (60%). Conclusion: The study shows the importance of traditional medicine in rural areas of Kédougou region, south-eastern Senegal in the management of pregnancy, breastfeeding and maternal health. This is why a pharmacological characterization is underway to promote this local knowledge.

Background Assessing prenatal health-related quality of life (HRQoL) by parity using a comprehensive consistent instrument with the transient nature of pregnancy is still under investigation. Objective To assess HRQoL and specify its predictors among expectant women in Hungary through Patient Reported Outcomes Measurement Information System (PROMIS-43). Method s: 477 healthy pregnant women were asked to fill the Hungarian version of PROMIS-43 and further instruments in late pregnancy.The PROMIS-43 investigates seven parameters, including anxiety, ability to participate in social roles and activities, depression, fatigue, sleep disturbance, physical function, and pain interference. Results While physical function and fatigue subscales obtained the highest proportion in the mild and moderate range, respectively, other subscales were felled into the normal range in all participants. A comparison of parity showed that the mean T-score of subscale "Anxiety" was significantly higher in nulliparous than that of in multiparous women (p = 0.02). The assessments indicated that the predictors, including parity, anxiety, and depression were the most common predictors for the poor HRQoL domains in both the nulliparous and multiparous women. In nulliparous, social support was a significant predictor for better HRQoL in depression, fatigue, and pain intensity domains. In multiparous, the strongest predictors included social support for lower depression, wanted pregnancy for lower pain intensity, and previous emergency cesarean section for higher pain intensity subscale. Conclusion The results of PROMIS-43 support the fact that the screening and continuous assessment of physical function and psychological status at early and over pregnancy is still on demand to optimize the outcomes of maternity care.

Prenatal health behaviors can strongly influence risk of poor pregnancy birth outcomes. Although stress has been implicated in structuring the likelihood that individuals will engage in various prenatal health behavior patterns, no studies to date have examined life stress exposure occurring across the entire lifespan, and few have investigated how different types of stressors are comparatively associated with these outcomes. To address these issues, we interviewed 164 women at one of two large Midwestern, urban hospitals after delivering their first infant. We used the Stress and Adversity Inventory (STRAIN) to assess women's lifetime stress exposure severity and ordinary least squares regression models to examine associations between participants' life stress exposure and prenatal health behaviors. As hypothesized, greater lifetime stress exposure was associated with engaging in more negative prenatal health behaviors and fewer positive prenatal health behaviors while controlling for relevant sociodemographic factors and current perceived stress levels. These effects were stronger for negative versus positive health behaviors, and they differed substantially as a function of stressor type, exposure timing, and primary life domain. Stressors occurring over the life course thus have negative consequences for prenatal health behaviors, but these effects are not uniform across different types of life stress exposure.

Health communication campaigns often suffer from the shortcomings of a limited budget and limited reach, resulting in a limited impact. This paper suggests a shift of these campaigns to audience-centered communication platforms—particularly, apps on mobile phones. By using a common platform, multiple interventions and campaigns can combine resources and increase user engagement, resulting in a larger impact on health behavior. Given the widespread use of mobile phones, mobile apps can be an effective and efficient tool to provide health interventions. One such platform is Father’s Playbook, a mobile app designed to encourage men to be more involved during their partner’s pregnancy. Health campaigns and interventions looking to reach expectant fathers can use Father’s Playbook as a vehicle for their messages.

Pregnant women and their infants are at increased risk for severe influenza-related complications. A decade has passed since influenza vaccination was first recommended for pregnant women in Germany in 2010, however, monitoring of vaccination coverage (VC) has not yet been implemented for this target group. Using nationwide outpatient claims data, we here provide results on influenza VC among pregnant women in Germany for seasons 2014/15 to 2019/20. For any given season, pregnant women were defined as women who had undergone prenatal health care in at least two consecutive quarters within a season. VC increased from 9.0% in season 2014/15 to 16.6% in 2019/20 (+84%), while most of the increase occurred from season 2016/17 (VC: 9.9%) onwards (+68%). Consistently across seasons, women in east Germany were 40 to 60% more likely to be vaccinated compared to women residing in west Germany. According to age, the highest VC was observed among women aged 35 to &lt, 40 years (2019/20: 18.2%). Despite noticeable increases in influenza VC during recent years, overall coverage remains low among pregnant women. Starting with this analysis, VC among pregnant women in Germany will be monitored on a yearly basis in order to detect trends and identify immunization gaps.

Background: The low incidence of exercise during pregnancy and the high rates of prenatal depression indicate more opportunities are needed for mothers to engage in exercise and obtain health-related support and education. MAPS (mental & physical support) was developed to support mothers’ psychological and physical health during pregnancy. MAPS consisted of physical activity classes 2×/week followed by either a speaker or group discussion regarding a parenting or health-related topic. The primary purpose of this study was to determine if the format was feasible prior to developing a main scale randomized trial. Methods: Program measurements included a pre/post survey, post-program focus group, attendance logs and scales for exercise, self-efficacy, and social support. Results: Findings indicated the program format is well-received by participants; however, issues in attendance warrant program format alterations. Further, larger scale studies and the addition of a control group are needed. Conclusion: This format offers practitioners an effective strategy for supporting pregnant women's physical and psychological health. Keywords: Mental and physical support, Moms, Prenatal health support program

For nearly 30 years, the rates of both wasting and stunting in the Philippines have been nearly flat. For 2019, the rate of stunting among children under five years of age (28.8 percent) was only slightly lower than in 2008 (32 percent)—the prevalence of underweight in 2019 was 19 percent and that of wasting was 6 percent. Based on the World Health Organization’s classification of undernutrition rates, the stunting prevalence of children in the Philippines is of “very high” public health significance. The Philippines’ 29 percent stunting rate places it fifth among countries in the East Asia and Pacific region, and among the top 10 countries globally. The Philippines’ high levels of childhood undernutrition can lead to a staggering loss of the country’s human and economic potential. The burden on the Philippines’ economy brought by childhood undernutrition was estimated at US$4.4 billion, or 1.5 percent of the country’s GDP, in 2015. Undernutrition robs Filipino children of their chance at a bright future. When viewed through the lens of the World Bank’s Human Capital Index (HCI), the country’s 2020 HCI score of 0.52 predicts that the future productivity of children born today will be 48 percent below what they might achieve if they were to enjoy complete education and full health. Undernutrition in the Philippines: Scale, Scope, and Opportunities for Nutrition Policy and Programming presents a comprehensive, analytical work on this topic. It provides evidence of why it is critical that the government of the Philippines prioritize tackling this persistent challenge. The report assesses the determinants and causes of childhood undernutrition and reviews current policies and programs directed at addressing this problem. Based on these analyses, the report provides recommendations of how national policies and programs can be strengthened to reduce the high rates of undernutrition in the country. It sets out to inform the debate on the causes and potential solutions of undernutrition while identifying high-priority policies and policy commitments for action.

Introduction: African countries facing conflict have higher levels of maternal mortality. Understanding the gaps in the utilization of high-quality maternal health care is essential to improving maternal survival in these states. Few studies have estimated the impact of conflict on the quality of health care. In this study, we estimated the impact of conflict on the quality of health care in Kenya, a country with multiple overlapping conflicts and significant disparities in maternal survival.Materials and Methods: We drew on data on the observed quality of 553 antenatal care (ANC) visits between January and April 2010. Process quality was measured as the percentage of elements of client–provider interactions performed in these visits. For structural quality, we measured the percentage of required components of equipment and infrastructure and the management and supervision in the facility on the day of the visit. We spatially linked the analytical sample to conflict events from January to April 2010. We modeled the quality of ANC as a function of exposure to conflict using spatial difference-in-difference models.Results: ANC visits that occurred in facilities within 10,000 m of any conflict event in a high-conflict month received 18–21 percentage points fewer components of process quality on average and had a mean management and supervision score that was 12.8–13.5 percentage points higher. There was no significant difference in the mean equipment and infrastructure score at the 5% level. The positive impact of conflict exposure on the quality of management and supervision was driven by rural facilities. The quality of management and supervision and equipment and infrastructure did not modify the impact of conflict on process quality.Discussion: Our study demonstrates the importance of designing maternal health policy based on the context-specific evidence on the mechanisms through which conflict affects health care. In Kenya, deterioration of equipment and infrastructure does not appear to be the main mechanism through which conflict has affected ANC quality. Further research should focus on better understanding the determinants of the gaps in process quality in conflict-affected settings, including provider motivation, competence, and incentives.

PURPOSE: Smoking during pregnancy may be linked to other problematic prenatal health behaviors in women. We examined interrelationships among prenatal smoking, prenatal health behaviors and mental health. The objective of this study was to examine factors that may contribute to variations in prenatal health practices among women who smoke during pregnancy. METHODS: Birth mothers from an adoption study (N = 912) were interviewed about prenatal smoking, health behaviors, and mental health symptoms at 5 months postpartum. RESULTS: One-quarter of participants (N = 222) reported smoking 6 or more cigarettes daily for at least 1 trimester. For mothers who smoked more than 6 cigarettes daily, higher levels of antisocial behaviors (β = −.14, p =.03) and depressive symptoms (β = −.17, p =.03) were associated with less frequent prenatal folate use; antisocial behaviors and depressive symptoms were not associated for prenatal folate use among women who did not smoke more than 6 cigarettes daily. For mothers who did not smoke more than 6 cigarettes daily, more depressive symptoms were associated with fewer prenatal care visits (β = .12, p =.01). Antisocial behaviors and anxiety symptoms were not associated with prenatal care visits in either group of mothers. CONCLUSIONS: Maternal antisocial behaviors and depressive symptoms during pregnancy may be markers for poorer adherence to recommendations for folate supplementation among women who smoke 6 or more cigarettes daily during pregnancy, independent of adequacy of prenatal care.

This study, which is focused on addressing the rising prevalence of gestational diabetes mellitus (GDM) in South Asians begins from the perspective that the development of diabetes has scope across public health and anthropology. The onset and progression are rooted within social determinants of health and cultural practices. Similarly, pregnancy—which is a crucial component of the life course—is a time where not only nutrients are shared between mother and child, but also when knowledge is exchanged, and cultural ways are imparted to the pregnant person from their friends and family. Within the South Asian community of Southern Ontario, recent public health evidence demonstrates a high rate of GDM where 1 in 3 South Asians will develop the condition. Babies born to GDM mothers are of higher birthweight and percent body fat than those of non-GDM mothers. Interventions to prevent GDM are important because GDM itself is a risk factor for postpartum obesity, diabetes, and atherosclerosis in the mother, and also because infants with more adipose tissue are more likely to become insulin resistant in adolescence and develop diabetes and cardiovascular disease as adults. Discussions to strengthen the public health response to this challenge can incorporate evidence-based counselling tools (e.g., easily scalable knowledge translation (KT) tools) that can be used by prenatal clinicians providing primary care. Given that diet and physical activity can be influenced not only by an individual locus of control, but also by familial interactions/networks and cultural/traditional foods and expectations, there is a need to better understand and weave in these experiences. I sought to better understand 1) the prenatal lifestyle counselling experiences of South Asians and their family doctors; and 2) the KT tools that have been designed and used in this population; then I used these learnings to develop and evaluate a conceptually-informed, evidence-based KT tool for pregnant South Asians and their family physicians. This dissertation begins with an introduction of patient and provider experiences with lifestyle change. I then present a systematic review and narrative synthesis of prenatal KT tools designed for South Asians. This is followed by a case report that outlines the process taken to develop a patient-facing and provider-facing KT tool (‘SMART START’). Next, I include the design and evaluation of a mixed methods pilot evaluation study of ‘SMART START.’ Finally, I culminate with an epilogue that ties in lessons learned and challenges that were overcome throughout the conduct of this work. The concluding chapter also includes a link to a video that captures the story behind this dissertation and the documentation of how all the aforementioned pieces are nested within and built upon one another. Dissertation Candidate in Philosophy

This study explored Aboriginal and Torres Strait Islander women&rsquo, s use of supports for their general health, for smoking cessation, and the health of babies or children, and analyzed the women&rsquo, s predictors for seeking types of support. Aboriginal and Torres Strait Islander women were recruited for a cross-sectional survey in two regions of NSW N = 132. The 19-item survey questioned the likelihood that the participant would use the various supports for their health, to quit smoking, and for a baby or child&rsquo, s health. Logistic regression analyses were performed on N = 98 with complete data. Older participants were less likely to use Facebook or the internet for their health, or the health of a child, but were more likely to consult with health professionals. Women who had quit smoking were less likely to use an app for their health compared to smokers. Women who had a child living in their household were less likely to use the internet for a child&rsquo, s health. This community-based study revealed age-related differences for access to health services and differences according to smoking status. Patterns of internet and app use warrant further consideration when planning strategies to improve Aboriginal and Torres Strait Islander women and children&rsquo, s health.

Objective: Prenatal behavior, including nutrition, exercise, drug use and smoking, affects health of a pregnant woman and her fetus. Psychometric evaluation of the Prenatal Health Behavior Scale (PHBS) is important for developing research on measurement of such this behavior during pregnancy.Methods: The present descriptive study was conducted in 2018. The original version was in English, and was then translated into Persian after obtaining permission from tool designer and using Backward-Forward translation.The final Persian version included 240 pregnant mothers who were selected using random cluster sampling from hospitals affiliated to Shahid Beheshti University of Medical Sciences in Tehran. The factor analysis methods (exploratory and confirmatory), Pearson correlation, and Cronbach's alpha coefficient by SPSSV19 and LISRELV8.80 were used to analyze research findings.Results: Content validity and face validity were assessed by survey of 10 experts and 20 pregnant mothers.In general, the CVI was 94%.The confirmatory factor analysis indicated that all factor loadings were appropriate and significant in the initial model. Furthermore, coefficient alpha was 0.932 for prenatal health promoting behavior and 0.935 for Health-impairing behaviors. The values were acceptable and indicated the high validity of tool in the Iranian sample.Conclusion: The research findings indicated that the Prenatal Health Behavior Scale (PHBS) had acceptable psychometric properties among Iranian pregnant women and could be used as a valid tool for assessing prenatal health behavior in Iran.

Background The Text4baby (T4B) mobile health (mHealth) program is acclaimed to provide pregnant women with greater access to prenatal health care, resources, and information. However, little is known about whether urban African American and Afro-Caribbean immigrant pregnant women in the United States are receptive users of innovative health communication methods or of the cultural and systematic barriers that inhibit their behavioral intent to use T4B. Objective This study aimed to understand the lived experiences of urban African American and Afro-Caribbean immigrant pregnant women with accessing quality prenatal health care and health information; to assess usage of mHealth for seeking prenatal health information; and to measure changes in participants’ knowledge, perceptions, and behavioral intent to use the T4B mHealth educational intervention. Methods An exploratory sequential mixed methods study was conducted among pregnant women and clinical professionals for a phenomenological exploration with focus groups, key informants, interviews, and observations. Qualitative themes were aligned with behavioral and information technology communications theoretical constructs to develop a survey instrument used. repeated-measures pre- and post-test design to evaluate changes in participants’ knowledge, attitudes, and beliefs, of mHealth and T4B after a minimum of 4 weeks’ exposure to the text message–based intervention. Triangulation and mixing of both qualitative and quantitative data occurred primarily during the survey development and also during final analysis. Results A total of 9 women participated in phase 1, and 49 patients signed up for T4B and completed a 31-item survey at baseline and again during follow-up. Three themes were identified: (1) patient-provider engagement, (2) social support, and (3) acculturation. With time as a barrier to quality care, inadequate patient-provider engagement left participants feeling indifferent about the prenatal care and information they received in the clinical setting. Of 49 survey participants, 63% (31/49) strongly agreed that T4B would provide them with extra support during their pregnancy. On a Likert scale of 1 to 5, participants’ perception of the usefulness of T4B ranked at 4.26, and their perception of the compatibility and relative advantage of using T4B ranked at 4.41 and 4.15, respectively. At follow-up, there was a 14% increase in participants reporting their intent to use T4B and a 28% increase from pretest and posttest in pregnant women strongly agreeing to speak more with their doctor about the information learned through T4B. Conclusions Urban African American and Afro-Caribbean immigrant pregnant women in Brooklyn endure a number of social and ecological determinants like low health literacy, income, and language that serve as barriers to accessing quality prenatal health care and information, which negatively impacts prenatal health behaviors and outcomes. Our study indicates a number of systematic, political, and other microsystem-level factors that perpetuate health inequities in our study population.

Modern availability of rich geospatial datasets and analysis tools can provide insight germane to the design of field experiments. Design of field experiments, and in particular the choice of sampling strategy, requires careful consideration of its consequences on the external representativity and interference (SUTVA violations) of the experimental sample. This paper presents a methodology for a) modeling the geospatial and social interaction factors that drive interference in rural field experiments; and b) eliciting a set of nondominated sample options that approximate the Pareto-optimal tradeoff between interference and external representativity, as functions of sample choice. The study develops and tests the methodology in the context of a large-scale health experiment in rural Mexico, involving more than 3,000 pregnant women and 600 health clinics across 5 states. Relevant for the practitioner, the methodology is computationally tractable and can be implemented leveraging open sourced geo-spatial data and software tools.

Background Cell-free DNA (cfDNA) in blood, urine, and other biofluids provides a unique window into human health. A proportion of cfDNA is derived from bacteria and viruses, creating opportunities for the diagnosis of infection via metagenomic sequencing. The total biomass of microbial-derived cfDNA in clinical isolates is low, which makes metagenomic cfDNA sequencing susceptible to contamination and alignment noise. Results Here, we report low biomass background correction (LBBC), a bioinformatics noise filtering tool informed by the uniformity of the coverage of microbial genomes and the batch variation in the absolute abundance of microbial cfDNA. We demonstrate that LBBC leads to a dramatic reduction in false positive rate while minimally affecting the true positive rate for a cfDNA test to screen for urinary tract infection. We next performed high-throughput sequencing of cfDNA in amniotic fluid collected from term uncomplicated pregnancies or those complicated with clinical chorioamnionitis with and without intra-amniotic infection. Conclusions The data provide unique insight into the properties of fetal and maternal cfDNA in amniotic fluid, demonstrate the utility of cfDNA to screen for intra-amniotic infection, support the view that the amniotic fluid is sterile during normal pregnancy, and reveal cases of intra-amniotic inflammation without infection at term.

An estimated 40 percent of the world's garbage is burned in open-air fires, which are responsible for as much as half of the global emissions of some pollutants. However, there is little evidence on the health consequences of open-air waste burning. In this paper, we estimate the effect of in utero exposure to open-air waste burning on birth outcomes. We do so by examining the consequences of the Lebanese garbage crisis of 2015, which led to an abrupt, unanticipated increase in waste burning in residential neighborhoods in Beirut and Mount Lebanon. To identify effects, we exploit variation in exposure across neighborhoods before and after the crisis. Results indicate exposure had large impacts on birth outcomes; in utero exposure to at least one open-air waste burn increased premature births by 4 percentage points (50%) and low birth weight by 5 to 8 percentage points (80 - 120%). Given previous research documenting the long-run effects of prenatal shocks on adult health, human capital, and labor market outcomes, this suggests open-air waste burning imposes significant costs on populations worldwide.

No abstract available. published

1997년 IMF 이후 사회경제적 지위에 상관없이 여성들의 결혼과 출산 시기는 모두 늦어지기 시작하면서, 미숙아 및 저체중아 출산에 있어 여성들의 사회 경제적･행동적 및 심리적 특성보다는 이들의 연령과 생물학적 특성이 더 중요한 위험요인으로 주목받고 있다. 이에 본 연구는 한국 여성들의 미숙아 및 저체중아 출산에 대한 사회경제적 격차가...

Background Use of tobacco, especially smokeless tobacco have characterised as highly prevalent among women, and also the mode of using smokeless tobacco varies based on geographic location, ingredient availability, cultural/societal norms, and personal preferences. Therefore, this study examines the prevalence and social determinants of use of smokeless tobacco among women in NE India. Further, it also identifies the cluster and district hotspots of smokeless tobacco prevalence. Methods We analysed a nationally representative data of NFHS-4, covering 93,409 eligible women aged 15–49 years from a survey of representative households from NE states, India. Descriptive statistics, chi-square, binary logistic and log-binomial regression were employed to analyse the data by using STATA software 13.1. Spatial clustering analysis and hotspot analysis were carried out using R-library. Findings The prevalence of SLT use among women in NE states, India is 23%. Mizoram (47.8 ± 1.2) shows the highest prevalence of SLT use, followed by Manipur (46.1 ± 0.7). It increases concomitantly with age among women. Social determinants like marital status (divorced/widowed), low educational level and residence (urban) were observed to be associated with smokeless tobacco use. Out of the 4032 clusters used in the analysis, 949 clusters were showed as hotspots. Conclusion The existing implementation of tobacco control programs and policies in the NE states needs to be evaluated. Owing to the geographical barriers and cultural differences, there is a need to explore the influences unique to these regions, which can further strengthen tobacco control measures. Targeted and tailored intervention within the identified hotspots can be beneficial.

Background The excess of manganese (Mn) causes severe deleterious effects in the central nervous system, and the developing brain is especially sensitive to Mn overload. However, results of prospective studies regarding Mn neurodevelopmental effects remain inconclusive. The present study aims at studying the association of prenatal Mn exposure and neurodevelopment at 4–5 years of age. Methods: Mn serum concentration was measured in 1465 pregnant women from the INMA (INfancia y MedioAmbiente, Environment and Childhood) Project. Neurodevelopment was assessed using a standardized version of the McCarthy Scales of Children's Abilities (MSCA). Multivariate regression models were used for data analysis. Results: No association was found between Mn levels in serum and any of the McCarthy scales. However, the stratification by sex showed a positive and beneficial association of prenatal Mn levels and the verbal, quantitative and general-cognitive scales in girls (β (95%CI): 4 (0.03, 7.96), 4.5 (0.43, 8.57) and 4.32 (0.6, 8.05), respectively). Conclusions: A beneficial association was found for the first time between prenatal Mn levels measured in serum and neurodevelopment of female offspring at 4 years of age, which could have implications on public health policies, specifically on the establishment of policies promoting prenatal health related to dietary deficits of micronutrients such as Mn.

Objective The rs10229583 polymorphism near paired box gene 4 ( PAX4) is associated with insulin resistance and type 2 diabetes. Mutations in the PAX4 gene may be associated with impaired differentiation/development of pancreatic islet beta cells during fetal development and, consequently, a compromised insulin response to high blood glucose. To ascertain whether this polymorphism plays a role in gestational diabetes mellitus (GDM), we investigated the genotypic and allele frequency differences between GDM and normal pregnancies. Methods A total of 310 GDM and 440 normal pregnancies were evaluated. Allele and genotype frequencies of rs10229583 were determined for all participants with Sanger sequencing and SNaPshot. Association of the allele and genotypes of the single nucleotide polymorphism with the disease was analyzed using Pearson’s χ2 test and OR (odds ratio). Results The G allele was more frequent in patients with GDM compared with controls (OR = 1.47, 95% confidence interval (CI): 1.12–1.939). The GG genotype frequency of rs10229583 was significantly different between subjects with GDM and normal controls (OR = 1.411, 95% CI: 1.032–1.928). The OR of the GA + GG genotype was 3.182 (95% CI: 1.294–7.826) for patients with GDM compared with controls. Conclusion The present study suggests that rs10229583 is associated with GDM.

Recent research in environmental epidemiology has attempted to estimate the effects of exposure to nature, often operationalized as vegetation, on health. Although many analyses have focused on vegetation or greenness with regard to physical activity and weight status, an incipient area of interest concerns maternal health and birth outcomes. This paper reviews 14 studies that examined the association between greenness and maternal or infant health. Most studies were cross-sectional and conducted in birth cohorts. Several studies found evidence for positive associations between greenness and birth weight and maternal peripartum depression. Few studies found evidence for an association between greenness and gestational age or other birth outcomes, or between greenness and preeclampsia or gestational diabetes. Several assessed effect modification by individual or area-level socioeconomic status and found that effects were stronger among those of lower socioeconomic status. Few studies conducted mediation analyses of any kind. Future research should include more diverse birth outcomes and focus on maternal health (especially mental health) and capitalize on richer exposure information during pregnancy rather than cross-sectional assessment at birth.

Children in immigrant families are twice as likely to be uninsured as their counterparts, and states may influence these inequities by facilitating or restricting immigrant families’ access to coverage. Our objective was to measure differences in insurance by mother’s documentation status among a nationally representative sample of US-born children in immigrant families and to examine the role of state-level immigrant health care policy—namely, state-level immigrant access to prenatal coverage. Compared with US-born children in immigrant families with citizen mothers, children with undocumented immigrant mothers had a 17.0 percentage point ( P < .001) higher uninsurance rate (8.8 percentage points higher in adjusted models, P < .05). However, in states with nonrestrictive prenatal coverage for immigrants, there were no differences in children’s insurance by mother’s documentation status, while large inequities were observed within states with restrictive policies. Our findings demonstrate the potential for state-level immigrant health care policy to mitigate or exacerbate inequities in children’s insurance.

Early life, including prenatal development and childhood, is a period of sensitivity, with potential for developmental programming under conditions of adversity. The intergenerational effects of early adversity have received attention, most often studied in relation to fetal development according to maternal exposures. Less often considered but critically important is the effect of early adversity on future prenatal risk (e.g., risk for preeclampsia, preterm birth), which threatens the health of mother and infant. The body's ability to turn collections of genes "on" or "off" across a range of tissues via receptor-driven transcription factors and epigenetic mechanisms (i.e., chemical modifications to the genome) in response to the perceived environment may help to explain such associations. This review aims to summarize discoveries surrounding the effects of early adversity on gene expression, emphasizing prenatal populations. First, we review findings from gene expression studies examining the effects of early adversity on various tissues known to contribute to prenatal health in adulthood. Next, we review several gene regulatory mechanisms thought to underlie differences in gene expression. Finally, we discuss potential implications for prenatal risk among early adversity-exposed mothers according to our current understanding of the biology that contributes to the development of prenatal syndromes.

Objectives Use the Consolidated Framework for Implementation Research to describe the context in which a gestational weight gain (GWG) intervention, embedded within Parents as Teachers (PAT), will be implemented at PAT sites nationwide. Methods Ten site leaders and six parent educators from ten PAT sites in eight states participated in semi-structured interviews and a survey. Audio-recordings and systematic notes were used in a deductive analysis. Scales were descriptively analyzed. Results Surveys demonstrated positive perspectives of PAT+GWG. In interviews, participants described PAT+GWG filling a need for prenatal health education and confidence delivering this content, valued integration of PAT+GWG within the PAT curriculum, and recommended materials to meet their clients' needs. Conclusions Contextual information can help maximize PAT+GWG's impact.

Recent epidemiological studies suggest that prenatal exposure to acetaminophen (APAP) is associated with increased risk of Autism Spectrum Disorder (ASD), a neurodevelopmental disorder affecting 1 in 59 children in the US. Maternal and prenatal exposure to pesticides from food and environmental sources have also been implicated to affect fetal neurodevelopment. However, the underlying mechanisms for ASD are so far unknown, likely with complex and multifactorial etiology. The aim of this study was to explore the potential effects of APAP and pesticide exposure on development with regards to the etiology of ASD by highlighting common genes and biological pathways. Genes associated with APAP, pesticides, and ASD through human research were retrieved from molecular and biomedical literature databases. The interaction network of overlapping genetic associations was subjected to network topology analysis and functional annotation of the resulting clusters. These genes were over-represented in pathways and biological processes (FDR p < 0.05) related to apoptosis, metabolism of reactive oxygen species (ROS), and carbohydrate metabolism. Since these three biological processes are frequently implicated in ASD, our findings support the hypothesis that cell death processes and specific metabolic pathways, both of which appear to be targeted by APAP and pesticide exposure, may be involved in the etiology of ASD. This novel exposures-gene-disease database mining might inspire future work on understanding the biological underpinnings of various ASD risk factors.