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Monkeypox virus, which causes mpox, is the most medically concerning member of the genus Orthopoxvirus. Monkeypox virus is related to the variola virus, the etiologic agent of smallpox before its [...]

OBJECTIVE: Educational inequality in stillbirth has been documented in high-income countries and the province of Quebec, Canada, but temporal trends are poorly understood. Our objective was to determine time trends in inequality related to maternal education for all-cause and cause-specific stillbirth over the past three decades in Quebec. METHODS: We included 2,397,971 live births and 9,983 stillbirths from 1981 through 2009 using Quebec vital statistics. For each decade, we computed measures of inequality capturing relative (relative index of inequality, RII) and absolute (slope index of inequality, SII) differences between the least- and most-educated mothers for all-cause and cause-specific stillbirth, adjusting for maternal characteristics. RESULTS: Stillbirth rates decreased over time for all education levels. Absolute educational inequality (SII 2.5 per 1000 births, 95% CI 2.1-2.8; all periods combined) was stable over time, whereas relative inequality increased ([RII.sub.1981-1989] 1.8 vs. [RII.sub.2000-2009] 2.3). Absolute inequality decreased for stillbirths caused by placental abruption ([SII.sub.1981-1989] 0.6 vs. [SII.sub.2000-2009] 0.3), but increased for unspecified causes ([SII.sub.1981-1989] 0.2 vs. [SII.sub.2000-2009] 0.7). CONCLUSIONS: Absolute educational inequality in stillbirth persisted and relative inequality increased over the past three decades, despite an overall decrease in stillbirth rates. The decrease in absolute inequality for placental abruption was countered by an increase for unspecified causes. A better understanding of the underlying components of unspecified causes is needed to further address educational inequality in stillbirth. KEY WORDS: Cause of death; educational status; fetal death; socioeconomic factors; stillbirth; trend, temporal OBJECTIF: Des inegalites de scolarite maternelle pour les mortinaissances ont ete documentees dans plusieurs pays industrialises, mais leurs tendances temporelles sont moins connues. Notre objectif etait d'etudier les tendances temporelles des inegalites de scolarite pour les mortinaissances, toutes causes et par cause, pour les trois dernieres decennies au Quebec, Canada. METHODES: Nous avons inclus 2 397 971 naissances vivantes et 9 983 mortinaissances du Quebec de 1981 a 2009. Pour chaque decennie, nous avons obtenu un indice d'inegalite relatif (<< relative index of inequality >>, RII) et un indice d'inegalite absolu (<< slope index of inequality >>, SII) pour l'association entre la scolarite maternelle et les mortinaissances, toutes causes et par cause, en ajustant pour les caracteristiques maternelles. RESULTATS: Les taux de mortinaissance ont diminue pour tous les niveaux de scolarite. L'inegalite absolue de scolarite est demeuree stable (SII 2,5 pour 1 000 naissances, intervalle de confiance a 95 % 2,1-2,8; periodes combinees), tandis que l'inegalite relative a augmente (RII 1,8 a 2,3). L'inegalite absolue a diminue pour les mortinaissances causees par un decollement placentaire (SII 0,6 a 0,3), mais a augmente pour les causes non-specifiees (SII 0,2 a 0,7). CONCLUSIONS: L'inegalite absolue de scolarite pour les mortinaissances a persiste et l'inegalite relative a augmente au cours des trois dernieres decennies, malgre une diminution des taux de mortinaissance. Malgre une diminution de l'inegalite pour les decollements placentaires, on observe une augmentation pour les causes non-specifiees. Une meilleure comprehension des composantes contribuant a ces dernieres est necessaire pour mieux apprehender les inegalites de scolarite pour les mortinaissances. MOTS CLES: cause de deces; facteurs socioeconomiques; mort foetale; mortinaissance; scolarite; tendances temporelles, Stillbirth, an important contributor to perinatal mortality, (1) is unequally distributed across socio-economic groups. (2) Educational inequality in stillbirth has been documented in many high-income countries (2-4) and the province [...]

Objective: To describe the rate of and demographic factors associated with fetal postmortem investigation and to classify the cause of all fetal deaths that underwent postmortem investigation. To compare the proportion of deaths remaining unexplained after postmortem investigation with estimates derived from death certificates. Method: All fetal deaths in Western Australia (WA) from 1990 to 1999 were identified. These data were used to calculate postmortem rates and describe the characteristics of women consenting to postmortems. A multidisciplinary team classified the cause of all deaths that underwent postmortem investigation using the Perinatal Society of Australia and New Zealand Perinatal Death Classification System. The proportion of deaths that were unexplained was compared with estimates based on death certificates. Results: Of the 1,619 fetal deaths recorded for 1990 to 1999, 49% (n=789) underwent complete postmortem investigation, Based on investigations, 22% of the 789 fetal deaths were unexplained and a further 18% were identified as having fetal growth restriction. Based on death certificates, 42% were unexplained and 65% were later explained by postmortem investigation. Conclusion and Implications: Postmortem investigation rates are low. They reveal a cause of death for the majority of cases that are unexplained clinically. Epidemiological investigations of unexplained fetal death based on cases not subject to complete postmortem investigation may lead to inaccurate conclusions. A standardised definition for unexplained fetal deaths that distinguishes between cases with detailed investigation and those with limited or no investigation is needed. Key words: Fetal death; death certificate; cause of death; autopsy; epidemiology; classification.

* Objective.--To define the epidemiology, to determine factors associated with transmission, and to describe the clinical and laboratory features of congenital syphilis. Design.--Retrospective chart review and prospective analysis. Setting.--Kings County Hospital Center, Brooklyn, NY. Patients.--A total of 403 pregnancies during a 23-month period associated with positive syphilis serological findings. Results.--Seventy-three pregnancies (18%) resulted in congenital syphilis (35 live-born and 40 stillborn neonates). Pregnancies associated with congenital syphilis were significantly associated with lack of prenatal care, lack of maternal therapy for syphilis, and a higher rapid plasma reagin titer, but not with a reporter history of 'crack' or cocaine use, although detection of cocaine in urine samples was more likely with positive syphilis serology. Conclusion.--Most live-born infants with congenital syphilis (23 of 35) lacked rash, hepatosplenomegaly, or adenopathy but were identified by laboratory tests (roentgenograms, cerebrospinal fluid VDRL test, conjugated bilirubin determination, or aspartate aminotransferase levels in serum samples). Half of the infant with congenital syphilis were stillborn. (AJDC. 1993;147:727-731), Congenital syphilis (CS) is on the rise, contributing to an increase in infant death and illness. CS is syphilis in infants, transmitted by an infected mother during pregnancy. Among 403 pregnancies in which syphilis was involved, 363 infants were live-born and 47 were stillborn. There were 75 cases of CS, 35 among the live-born infants and 40 among the stillborn. The 35 live-born infants with CS were evaluated for physical characteristics of CS and were given laboratory tests. Common physical findings such as rash and enlarged liver and spleen were present in only 12 of these infants, and the rest were diagnosed by abnormal laboratory results. Mothers were more likely to transmit syphilis to their infants if they had no prenatal care, were not treated for their own syphilis, or had a strong positive reaction to a blood test for syphilis, which may indicate a recent infection.

Byline: Amar. Taksande, Krishna. Vilhekar, Pushpa. Chaturvedi, Manish. Jain Objective: To study the incidence of congenital anomalies and the associated risk factors in Department of Pediatrics at Mahatma Gandhi Institute [...]

More than 50% of newborn deaths and stillbirths related to syphilis could be prevented with low-cost screening and treatment during pregnancy, according to research published in The Lancet Infectious Diseases. [...]