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Purpose: Under-5 mortality rates (U5MR) have declined drastically globally. However, it remains high in Nigeria, with variations across the Country's six geo-political zones. Understanding the factors associated with under-5 mortality (U5M) among lesser-explored subpopulations will inform strategies to curtail U5M. We investigated the factors associated with U5M in the south-south geopolitical zone (SSGZ) of Nigeria and population attributable risk percent (PAR%). Method: We analyzed population-based data from the Nigeria Demographic and Health Survey (NDHS) for 2013 and 2018. Logistic regression analysis was used in SPSS version 26.0 to calculate the Odds Ratios (OR) with 95% Confidence Intervals (CI) for U5M associated with various factors, while the PAR% was computed using Levine's formula. Results: The adjusted logistic regression analysis model showed maternal overweight (OR = 1.39, 95% CI 1.12–1.72, p < 0.05), primary education (OR = 2.18, 95%CI 1.18–4.04 p < 0.05) and secondary education (2.05, 95%CI 1.13–3.72, p < 0.05) levels, male gender (OR=1.22, 95%CI 1.01–1.47, p < 0.05), birth interval of less than two years (OR = 2.93, 95%CI 2.10–4.10, p < 0.001), and small birth size (OR = 2.54, 95% CI 1.94–3.31, P < 0.001) significantly increased U5M risk, while having seven or more household members (OR = 0.73, 95%CI 0.59–0.89, p < 0.05) and 2 under-five children in the household (OR = 0.66, 95% CI 0.52–0.83, p < 0.001) were protective factors, with PAR% for the factor significantly associated with U5M ranging from 4.5% to 47.1%. Conclusion: Increased interventions on maternal weight, maternal education, low birth size, and child spacing could reduce U5M in the SSGZ of Nigeria. [ABSTRACT FROM AUTHOR]

Background: Although Ethiopia has substantial improvements in various health indicators such as maternal and child mortality, the burden of neonatal mortality remains high. Between 2016 and 2019, neonatal mortality increased from 29 deaths per 1,000 live births to 33 deaths per 1,000 live births. This study aimed to explore the spatial patterns and factors contributing to neonatal mortality in Ethiopia. Methods: Data from the Ethiopian Demographic and Health Surveys (EDHS) for the years 2000, 2005, 2011, 2016, and 2019 were analyzed. The EDHS sampling design uses a two-stage cluster sampling technique, considering census enumeration areas as primary sampling units and households as secondary sampling units. We used the Spatial Scan analysis in SaTScan and Getis-Ord Gi* statistic in Geographic Information System (GIS), to analyse the spatiotemporal patterns of neonatal mortality. Maternal, newborn and health service-related factors contributing to neonatal mortality were also analyzed using a multilevel logistic regression model. Adjusted Odds Rios (AOR) with corresponding 95% CI were presented as a measure of association and a P-value of 0.05 was used to declare statistical significance. Results: During the initial three consecutive surveys, there was a consistent pattern of hot spot clusters in the Amhara and Benshangul Gumuz regions, along with certain parts of the Oromia region. However, in later surveys, these clusters shifted to the eastern parts of the country, notably including the Somali region. Early initiation of breast feeding was associated with reduced chances of neonatal death (Adjusted Odds Ratio [AOR]) = 0.27; 95% Confidence Interval [CI]: 0.23, 0.32). Neonates born at home (AOR = 1.46; 95% CI: 1.16, 1.82) and male babies had a higher likelihood of mortality during the neonatal period compared to their counterparts (AOR = 1.36; 95% CI: 1.24, 1.51). The odds of neonatal mortality increased with the number of children a mother had ever given birth to (AOR = 1.36; 95% CI: 1.24, 1.51). In contrast, longer birth intervals were associated with a reduced risk of neonatal mortality (AOR = 0.76; 95% CI: 0.68, 0.83). Conclusion: The central southern, central-western, north-western, and northern parts of Ethiopia had most of the neonatal death clusters in the first three rounds of DHS while eastern Ethiopia had the highest neonatal mortality clusters in the latest two surveys. Our results underscore the importance for policymakers and health administrators to reassess intervention approaches and reallocate resources to regions identified as hot spots for neonatal mortality. Enhancing the initiation of breastfeeding within the first hour of birth would improve newborn survival rates. Special attention and care need to be given to babies born of smaller sizes. [ABSTRACT FROM AUTHOR]

Background: Lack of credible sexual partner dialog and support regarding family planning (FP) and other sexual reproductive health issues is a major impediment to contraception service uptake and utilization. This study examined the feasibility and acceptability of attitudes toward using telehealth for remote education of couples through behavioral, motivational, and informational messaging on FP methods and its eventual impact on partner conversations around FP. Methods: The study was conducted in Kampala, Uganda, and involved recruiting 450 men from diverse settings. These men received regular SMS content on FP and sexual and reproductive health for a duration of 6 months. The content aimed to provide information and motivation while serving as a resource for discussions with their spouses. Following the main quantitative study, a qualitative follow-up study was conducted with a subset of 15 randomly selected men. In-depth interviews were conducted with these men to gain deeper insights into their experiences and perspectives. Results: The study revealed positive outcomes where men reported improved knowledge of FP methods such as child spacing, and types of contraception. The messaging prompted discussions with spouses on family size and spousal support. Couples reported a shift toward viewing FP as a joint responsibility, with some couples even taking concrete actions. The findings suggested that telehealth interventions can promote social and behavioral change and can improve couple communication and male involvement in FP decisions in Uganda. Conclusion: The study found that using telehealth messaging to educate men about FP in Uganda successfully improved communication between couples on the topic. [ABSTRACT FROM AUTHOR]

We examine population-level associations between birth spacing and child maltreatment using birth records and child welfare records for 1,099,230 second or higher parity children born in North Carolina between 1997 and 2013. Building upon previous research, administrative data linkages were used to address out-of-state migration and family-level heterogeneity in birth spacing and child maltreatment risk factors. Findings provide the strongest evidence to date that very short birth spacing of zero through 6 months from last birth to the index child's conception is a prenatal predictor of child maltreatment (indexed as child welfare involvement) throughout early childhood. Consequently, information about optimal family planning during the postpartum period should become a standard component of universal and targeted child maltreatment prevention programs. However, challenging previous empirical evidence, this study reports inconsistent results for benefits of additional spacing delay beyond 6 months with regard to child maltreatment risk reduction, especially for children of racial and ethnic minorities. These findings call for further inquiry about the mechanisms driving the connections between birth spacing and Child Protective Services assessments. [ABSTRACT FROM AUTHOR]

Purpose: Pakistan ranks third globally in terms of newborn deaths occuring within the first 24 hours of life. With a neonatal mortality rate of 42.0%, it carries the highest burden compared to neighboring countries such as Bangladesh (17%), India (22.7%) and Afghanistan (37%). While there has been a decline in neonatal mortality rates in Pakistan, the pace of this decline is slower than that of other countries in the region. Hence, it is crucial to conduct a comprehensive examination of the risk factors contributing to neonatal mortality in Pakistan over an extended period. This study aims to analyze the trends and determinants of neonatal mortality in Pakistan over three decades, providing valuable insights into this persistent issue. Design/methodology/approach: The study focused on neonatal mortality as the response variable, which is defined as the death of a live-born child within 28 days of birth. Neonates who passed away during this period were categorized as "cases," while those who survived beyond a specific timeframe were referred to as "noncases." To conduct a pooled analysis of neonatal mortality, birth records of 39,976 children born in the five years preceding the survey were extracted from four waves (1990–2018) of the Pakistan Demographic and Household Survey. The relationship between risk factors and the response variable was examined using the Cox Proportional Hazard Model. Neonatal mortality rates were calculated through the direct method using the "syncmrates" package in Stata 15. Findings: During the extended period in Pakistan, several critical protective factors against neonatal mortality were identified, including a large family size, improved toilet facilities, middle-aged and educated mothers, female children, singleton live births, large size at birth and longer birth intervals. These factors were found to reduce the risk of neonatal mortality significantly. Originality/value: This study makes the first attempt to analyze the trends and patterns of potential risk factors associated with neonatal mortality in Pakistan. By examining a large dataset spanning several years, the study provides valuable insights into the factors influencing neonatal mortality. Peer review: The peer review history for this article is available at: https://publons.com/publon/10.1108/IJSE-09-2022-0604 [ABSTRACT FROM AUTHOR]

Background: Birth spacing is crucial for ensuring the health of mothers and their children, as well as determining population growth. Short birth intervals represent a universal public health problem associated with adverse maternal, fetal, neonatal, and child outcomes. However, there is limited information in the study area regarding the determinants of suboptimal birth spacing. Thus, this study aimed to identify the determinants of suboptimal spacing among women of reproductive age in the Adama district, Ethiopia. Methods: A community-based unmatched case-control study was conducted among 568 randomly selected reproductive-age women using the multi-stage sampling technique. Data were collected using an interviewer-administered, structured questionnaire. The collected data were entered into Epi Info version 7.2 and analyzed using SPSS version 26. Binary logistic regression analysis was used to model the association between suboptimal birth spacing and independent variables. Adjusted odds ratios with their 95% confidence intervals were calculated to determine the strength of the association. A p-value < 0.05 was considered to declare statistical significance. Result: Educational status (no formal education) (AOR = 2.40; 95% CI: 1.23–1.75), inadequate knowledge of optimal birth space (AOR = 2.60; 95% CI; 1.80–3.90), non-use of modern contraceptives (AOR = 3.00; CI: 1.90–4.20), short breastfeeding duration (AOR = 2.30; 95% CI: 1.50–3.40), and having female index child (AOR = 1.60; 95% CI: 1.13–2.50) were independent determinants of suboptimal birth spacing practice. Conclusion: Encouraging women's education, contraceptive use, and breastfeeding is crucial for birth spacing. Community health initiatives should also focus on preventing sex-based birth intervals. [ABSTRACT FROM AUTHOR]

Introduction: Our study examines the relationship between newborn postnatal care and neonatal mortality stratified by maternal antenatal care attendance under a matched case-control framework. Methods: Data from the fifth round of the National Family Health Survey was used. A total of 172,079 recent births to eligible women (15–49 years) in five years preceding the survey were included in the study. We used the conditional logistic regression model, a commonly used regression model to fit matched case-control data to examine the effects of newborn postnatal care on neonatal mortality. The mother's age at birth of the newborn, previous birth intervals, birth order of the newborn, and birthsize of the newborn were included as the matching variables. Results: Newborns receiving postnatal care within two days or more than two days of birth are less likely to die during the neonatal period. Preferences for newborn postnatal care were also observed to increase with more maternal antenatal care visits. Our study also found a lower risk of neonatal mortality among those newborns whose umbilical cord was examined within two days of birth, regardless of the number of maternal antenatal care visits. Similarly, the risk of newborn deaths was lower among babies whose body temperature was measured within two days of birth. The tendency to breastfeed their newborns within an hour after delivery was considerably higher among those births that occurred to mothers who had a higher number of maternal antenatal care visits. The risk of newborn deaths was also observed to be lower among those born in public or private healthcare facilities. Conclusion: Considering the cohesive nature of the relationship between neonatal mortality and maternal and child healthcare utilisation, strategic planning and management of the existing policies and programmes related to accessibility, availability, and affordability of maternal and child healthcare services is needed to achieve goal 3.2 of the Sustainable Development Goals. Promoting cost-effective measures such as continuous monitoring of the baby's body temperature and umbilical cord care could also effectively help reduce neonatal mortality. [ABSTRACT FROM AUTHOR]

Studies in low-fertility settings have consistently found positive relationships between parents’ and children’s fertility timing and family sizes, and these persist after accounting for socio-demographic factors. We explore intergenerational transmission of fertility in Great Britain, where socio-economic inequalities are larger and could play a greater role in explaining intergenerational continuities than in other settings. Using the 1970 British Cohort Study, a long-running longitudinal data set, we estimate parity-specific discrete-time event-history models to investigate the role of mother’s family size and age at first birth in birth transitions. We find stronger evidence for transmission of birth timing and family size in transitions to first and third births than second births. Family size transmission affects daughters more than sons. Accounting for socio-economic and demographic characteristics does not explain these associations. Except for first births, transmission of fertility is equally likely across the socio-economic hierarchy, highlighting the importance of socialization and cultural preferences for fertility transmission, even in the relatively unequal British context. [ABSTRACT FROM AUTHOR]

Objectives: Undergoing women of pregnancy termination (PT) significantly faces the problem of physical and mental health. This study aims to assess the prevalence and socioeconomic disparity factors of PT in Bangladesh. This study analyzed data from the 2017–18 Bangladesh Demographic and Health Survey. Researchers employed chi-square tests to identify relationships between categorical variables and logistic regression to pinpoint factors associated with PT. To assess the socioeconomic variation of PT, the analysis utilized concentration curves, concentration indices, and decomposition techniques. Results: The study found that 21.0% of reproductive-aged women in Bangladesh had ever terminated a pregnancy. Our study revealed that women from Chittagong and Sylhet regions, with wealthier backgrounds, aged 30 or older, employed in business, taking short birth intervals, and whose husband/partner was 35 or older, were more likely to have had a pregnancy termination with statistical significance (p < 0.05). Besides, concentration curves showed a higher prevalence of PT among wealthier women (CCI = 0.029, p < 0.001). Decomposition of this inequality revealed that a woman's wealth status was the largest contributor (74.98%) to the observed disparities, followed by exposure to mass media (41.82%), place of residence (34.35%), occupation (24.81%), and preceding birth interval (6.53%). Our study recommended that, in mitigating the above disparities, we should foster open discussions about underlying factors contributing to PT in Bangladesh. [ABSTRACT FROM AUTHOR]

Introduction: According to the World Health Organization and Ethiopian Demographic and Health Survey on birth spacing, there should be at least a two-year gap between conception and the first of two children born in quick succession. In poor nations like Ethiopia, resource issues were complex, making it difficult to get statistics for the entire country. However, by examining Ethiopian mini demographic and health survey data, we were able to provide data at the national level. Method: The cross-sectional survey-based study was conducted in several of Ethiopia's administrative cities and nine regions. In the analysis, sampling weight was used to correct the survey's non-proportional sample distribution to strata and areas throughout the survey process and restore representative data. The study's household population was presented and described using descriptive statistics such as weighted frequencies and percentages. The statistically significant factors linked to frequent short birth intervals were found using a multivariable, multilevel logistic regression analysis. Result: Overall, 4306 weighted multigravida mothers nested within 305 enumeration areas were included in the analysis. The respondents' mean (standard deviation) of the birth interval was 42.027(26.69). Higher-educated women had 12% lower odds of having a shorter pregnancy (AOR = 0.88; 95% CI: 0.35, 0.98) than women without higher education. The odds of a short birth interval were 3.04 times greater among women in the age category of 40–49 years at first marriage (AOR = 3.04; 95% CI: 1.08, 8.46) than among women in the age category of 15–19 years. This indicates that older women were most likely to have short birth intervals. Conclusion: In the multilevel logistic regression model, maternal age, maternal educational status, the wealth quintile index, use of contraceptives, duration of breastfeeding, and contextual regions were significantly associated with short birth intervals in Ethiopia. [ABSTRACT FROM AUTHOR]

The global decline in insect biomass has far‐reaching implications for terrestrial and freshwater food webs, impacting species reliant on insects as a crucial component of their diet. This issue extends to species traditionally considered agricultural pests, such as the common cockchafer Melolontha melolontha. In the race to combat cockchafers through collection, insecticide use, and other control methods, the repercussions of their numerical fluctuations on predators, including species of high conservation importance like bats, have been largely overlooked. Drawing on 31‐years of monitoring data for a greater horseshoe bat Rhinolophus ferrumequinum population in the Aosta Valley (Western Italian Alps), we investigated whether annual fluctuations in bat counts are influenced by cockchafer availability and weather conditions. Despite an overall positive trend in bat abundance, we observed pronounced annual fluctuations, mostly driven by cockchafer availability rather than variations in temperature and precipitation. Furthermore, we found a significant association between cockchafer availability and the median date of birth and birth rate of bats. Births occurred approximately 5 days earlier in cockchafer flight years, with earlier births also linked to warmer spring temperatures and higher numbers of warm days in April. Moreover, the ratio pups/older bats was 0.56 in cockchafer flight years, compared to 0.47 in other years. Our results underscore the importance of considering predator–prey dynamics when examining the long‐term population trends of species of conservation concern. We recommend implementing restrictions on the use of chemicals and other potentially harmful practices that may diminish prey abundance or quality, including that of species considered as agricultural pests. In designing conservation strategies, a delicate balance should be struck between the current interests of farmers and the overarching goal of preserving biodiversity against potential future threats. [ABSTRACT FROM AUTHOR]

Background: Researchers over the years have underscored the role of birth spacing on maternal health, however, inadequate maternal repletion due to shorter birth intervals could also affect the health of the child. Even so, limited studies exist on the linkage between birth spacing and child nutrition. This study examines the association between birth spacing and child stunting and underweight using the 2014 Ghana Demographic and Health Survey. Methods: The study sourced data on 1, 904 children less than 59 months from the 2014 Ghana Demographic and Health Survey. The study employed bivariate analysis and logistic regressions to establish the association between birth spacing, and child stunting and underweight. Results: The analyses reveal that childbirth spacing between 24 and 35 months (OR = 0.62, 95% CI: 0.38–0.99; p < 0.05), 36 to 47 months (OR = 0.42, 95% CI: 0.25–0.70; p < 0 0.01), and beyond 47 months (OR = 0.47, 95% CI: 0.28–0.78; p < 0.01) have lower odds of child stunting than children with birth spacing less than 24 months. Children with birth spacing between 24 and 35 months (OR = 0.53, 95% CI: 0.29–0.98; p < 0.05), 36 to 47 months (OR = 0.44, 95% CI: 0.22–0.90; p < 0.01) and beyond 47 months (OR = 0.49, 95% CI: 0.26–0.94; P < 0.05) have lower odds of being underweight than those with birth spacing less than 24 months. Conclusion: The study reveals that mothers with a birth spacing of at least two to three years compared to their counterparts with less than two years of birth spacing have lower odds of having a stunted and underweight child under age five. The study recommends that Ghana Health Service and other healthcare providers should educate mothers on the gains of birth spacing of at least two years on their children. [ABSTRACT FROM AUTHOR]

Reproductive phenology is a critical element of how animals persist in their environment and affects survival of young, especially in seasonal environments. We investigated the correlation between fetal eye diameter and birth timing to determine if birthdates could be predicted by a prenatal metric. We used ultrasonography to measure eye diameters of fetuses and vaginal implant transmitters to determine birthdates of Rocky Mountain Bighorn Sheep (Ovis canadensis canadensis) in Wyoming, United States, from 2019 to 2023. Fetal eye diameter strongly predicted days until birth (β = −2.8; pseudo- R 2 = 0.88). Effective prediction of birthdates via ultrasonography can yield opportunities for logistical planning in neonatal studies, monitoring changes in reproductive phenology, and evaluating questions of resource allocation relative to reproductive processes. [ABSTRACT FROM AUTHOR]

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In Bauchi State, northern Nigeria, communities recognise short birth interval (kunika in the Hausa language) as harmful, but family planning is a sensitive topic. This paper describes the development of a culturally safe way to communicate about kunika in a conservative Muslim setting. The objective was to co-design culturally safe communication material, based on local knowledge about short birth interval, to share with women and men in households. Six community co-design groups of women and six of men (total 96 participants) reviewed summaries of their previously created maps of perceived local causes of kunika, categorised as frequent sex, family dynamics and non-use of contraception. They advised how these causes could be discussed effectively and acceptably with women and their husbands in households and suggested storylines for three short video docudramas about the prevention of kunika. The research team created the docudramas with a local producer and fieldworkers piloted their use in households. The design groups advised that communication materials should focus on child spacing rather than on limitation of family size. Even sensitive issues could be covered. People would not change their sexual behaviour but could be advised to use contraceptives to prevent kunika. The groups approved the final videos and six focus groups of visited women and men reported they were acceptable and helpful. Community co-design of communication about kunika was feasible and led to videos about a sensitive topic that were acceptable to ordinary men and women in communities in Bauchi. [ABSTRACT FROM AUTHOR]

Multiple births strain mothers' and families' resources in ways that should highlight preferences for family size, birth spacing, and parity-dependent stopping behavior. Couples with surviving twins reach their target family size sooner than other couples and should be more likely to practice family limitation. Twins are also a greater burden on the mother's time and health, which could lead to postponing the next birth, even among couples who want additional children. We examine these hypotheses by analyzing families with twins in the 1900 and 1910 U.S. Censuses. Using reconstructed birth histories for more than 7 million women in the IPUMS full-count 1900 and 1910 datasets and event-history methods (Kaplan–Meier curves, cure models), we find clear evidence of family limitation following a multiple birth. Couples who had twins or triplets were more likely to stop childbearing, and those who continued having children delayed their next birth. Responses to multiple births were larger in groups previously identified as leaders in the transition to smaller families, and roughly one third of couples stopped after one or two children. We find no evidence that some groups relied primarily on birth spacing to reduce family size while others relied primarily on stopping. [ABSTRACT FROM AUTHOR]

Despite a large literature on the importance of childhood neighbourhoods for life course transitions, there is a lack of fertility studies combining a life‐course perspective with detailed neighbourhood measures. Addressing this gap, we use longitudinal data in which the entire population of a Swedish town is geocoded at the address‐level, 1939–1967, and linked to national registers from 1968 to 2015. We study how social neighbourhoods in childhood influence fertility outcomes by constructing individual neighbourhoods at the address level to measure the social class of nearby childhood neighbours. We analyse the age at first and last birth, children ever born, birth spacing and childlessness. Growing up in higher‐status neighbourhoods is associated with delayed fertility for both men and women, but no association is found for the number of children ever born or for childlessness. Associations are stable over time, and later ages of neighbourhood exposure matter more, especially for men. Contrary to prior literature's focus on the lower classes, our results are driven by higher‐status individuals growing up in distinctly white‐collar neighbourhoods. [ABSTRACT FROM AUTHOR]

Background: A short birth interval adversely affects the health of mothers and children. This study aimed to measure the prevalence of short birth intervals and identify their associated factors in a semi-urban setting in Burkina Faso. Methods: We conducted a cross-sectional study in which data were collected in households between May and October 2022. The dependent variable was the short birth interval (SBI), defined by the World Health Organization as the time between two live births. We performed a multilevel mixed-effects Poisson regression with robust variance to determine the factors associated with the SBI by reporting adjusted prevalence ratios (aPR) with a 95% confidence interval (CI). Results: A total of 5544 birth intervals were recorded from 4067 women. A short birth interval was found in 1503 cases out of 5544, i.e., a frequency of 27.1%. The prevalence of short birth interval (time between two live births less than 33 months) was higher in never users of modern contraceptive users (aPR = 1.24; 95% CI [1.14–1.34] vs. previous users), in younger ages with aPR of 4.21 (95% CI [3.30–5.37]), 2.47 (95% CI [1.96–3.11]), and 1.45 (95% CI [1.16–1.81]), respectively for under 18, 18–24 years old, and 25–34 years old, compared to 35 and over. Childbirths occurring before the implementation of the maternal and infant free health care policy (aPR = 2.13; 95% CI [1.98–2.30]) and also before the free family planning policy (aPR = 1.53; 95% CI [1.28–1.81]) were more likely to have SBI. Women with low socio-economic positions were also more likely to have SBI. Conclusion: This study found a high SBI in Burkina Faso (more than one woman out of four). Our results have programmatic implications, as some factors, such as contraceptive practice and socioeconomic status, are modifiable. These factors need particular attention to lengthen birth intervals and, in turn, improve mother–child couple health by reducing short birth interval consequences. [ABSTRACT FROM AUTHOR]

Malnutrition is responsible for over one-third of deaths among children under the age of five in low-and middle-income countries, including Ethiopia, and is largely preventable. The objective of this study was to determine the prevalence of undernutrition and its contributing factors among children aged 6–59 months in the Gedio zone of Southern Ethiopia. A community-based cross-sectional study design was used, and data were collected from 403 children and their mothers selected through random sampling technique. Anthropometric measures were converted to Z-scores using WHO-Anthro version 3.2.2 software. The prevalence of underweight, wasting, and stunting were 19.7% (95% CI 16-24%), 10% (95% CI 7–13%), and 49% (95% CI 44–54%) respectively. Low birth weight (AOR = 2.8, 95% CI (1.585–4.895), feeding non-diversified diet (AOR = 1.9, 95% CI (1.036–3.497), and being unvaccinated (AOR: 2.0; 95%CI (1.013–4.197) were significantly associated with being underweight. Family size of ≥ 5 (AOR = 4.4, CI (1.274–5.059), meal frequency of < 3 times per a day (AOR = 2.3, CI (1.037–5.024), and index birth interval of < 24 months (AOR = 2.2, CI (1.015–4.843) were significantly associated with wasting. Similarly, children aged ≥ 24 months (AOR = 2.8, CI (1.769–4.474), feeding non-diversified diet (AOR = 1.8, CI (1.153–2.894), total duration of breast-feeding < 12 months (AOR = 4.0, CI (2.547–6.429), and mothers BMI below 18.5 (AOR = 2.2, CI (1.328–3.718) were identified as a predictors of stunting. The study revealed significant levels of undernutrition, including underweight, wasting, and stunting, among children in the study area. Factors such as birth weight, dietary diversity score, and vaccine status were found to be strongly linked to underweight. Additionally, living in a large family, meal frequency, and birth interval were significantly associated with wasting. The age of the child, duration of breastfeeding, dietary diversity score, and maternal BMI status were also significantly linked to stunting. To address this issue, the study recommends promoting healthier feeding practices, dietary diversification, optimal breastfeeding, complete vaccination, wider birth intervals, and improving maternal nutrition to reduce undernutrition among children aged 6–59 months in the area. Implementing these measures could significantly improve the health of children in the study area. [ABSTRACT FROM AUTHOR]

Simple Summary: Studies have shown that dietary arginine supplementation can promote placental growth and vascular development in pregnant sows, increase litter size and improve the reproductive performance of sows. However, there are few studies on the optimal arginine and arginine to lysine ratio in sows during pregnancy. In this study, we investigated the optimal standardized ileal digestible arginine to lysine (SID Arg: Lys) ratio on the reproductive performance, immune response, and biochemical parameters of sows during gestation, as well as the colostrum composition and performance of their offspring. Our results indicate that an appropriate dietary SID Arg: Lys ratio can increase the number of piglets born alive, reduce the birth interval, and promote milk fat synthesis. The aim of this study was to determine the optimal SID Arg: Lys ratio for maximizing the reproductive performance, immunity and biochemical parameters of sows during gestation, the colostrum composition, and the performance of their offspring. A total of 174 multiparous sows were randomly allocated to five treatment groups varying in dietary SID Arg: Lys ratios (0.91, 1.02, 1.14, 1.25 and 1.38) through modification of the levels of Arg or alanine supplementation (the total level of nitrogen was the same in all treatments). The results showed that increasing the dietary SID Arg: Lys ratio increased the number of piglets born alive (p < 0.05, linear and quadratic). The number of stillborn piglets, the birth weight variation of born alive piglets, the birth interval (p < 0.05, linear and quadratic) and the number of mummies (p < 0.05, quadratic) reduced with increasing the dietary SID Arg: Lys ratio. Broken-line regression analysis indicated that the optimal SID Arg: Lys ratio requirement for gestating sows to maximize the number of piglets born alive was 1.25. The content of non-fat solid, total solid, protein, and energy in colostrum increased linearly and quadratically (p < 0.05) with increasing dietary SID Arg: Lys ratio. Additionally, when increasing the dietary SID Arg: Lys ratio, the concentration of IgA (p < 0.05, quadratic) and IgM (p < 0.05, linear and quadratic) of plasma increased at day 90 of gestation; IgG (p < 0.05, linear and quadratic) concentration increased at day 110 of gestation of sows. The dietary SID Arg: Lys ratio had an increasing effect (p < 0.05, linear and quadratic) on plasma insulin levels at day 90 of gestation. Furthermore, there were increases in plasma concentrations of nitric oxide and ornithine at day 110 of gestation, Arg at day 90 and 110 of gestation (p < 0.05, linear and quadratic) and total protein at day 110 of gestation (p < 0.05, linear) with increasing dietary SID Arg: Lys ratio. The results of our study indicated that increases in the dietary SID Arg: Lys ratio during gestation resulted in an increase in the number of piglets born alive, a decrease in birth intervals, and an improvement in immunity and colostrum composition. The optimal SID Arg: Lys ratio for gestating sows to maximize the number of piglets born alive was 1.25. [ABSTRACT FROM AUTHOR]

Background: Both interpregnancy intervals (IPI) and environmental factors might contribute to low birth weight (LBW). However, the extent to which air pollution influences the effect of IPIs on LBW remains unclear. We aimed to investigate whether IPI and air pollution jointly affect LBW. Methods: A retrospective cohort study was designed in this study. The data of birth records was collected from the Jiangsu Maternal Child Information System, covering January 2020 to June 2021 in Nantong city, China. IPI was defined as the duration between the delivery date for last live birth and date of LMP for the subsequent birth. The maternal exposure to ambient air pollutants during pregnancy—including particulate matter (PM) with an aerodynamic diameter of ≤ 2.5 μm (PM2.5), PM10, ozone (O3), nitrogen dioxide (NO2), sulfur dioxide (SO2) and carbon monoxide (CO)—was estimated using a hybrid kriging-LUR-RF model. A novel air pollution score was proposed, assessing combined exposure to five pollutants (excluding CO) by summing their concentrations, weighted by LBW regression coefficients. Multivariate logistic regression models were used to estimate the effects of IPI, air pollution and their interactions on LBW. Relative excess risk due to interaction (RERI), attributable proportion of interaction (AP) and synergy index (S) were utilized to assess the additive interaction. Results: Among 10, 512 singleton live births, the LBW rate was 3.7%. The IPI-LBW risk curve exhibited an L-shaped pattern. The odds ratios (ORs) for LBW for each interquartile range increase in PM2.5, PM10, O3 and the air pollution score were 1.16 (95% CI: 1.01–1.32), 1.30 (1.06–1.59), 1.22 (1.06–1.41), and 1.32 (1.10–1.60) during the entire pregnancy, respectively. An additive interaction between IPI and PM2.5 was noted during the first trimester. Compared to records with normal IPI and low PM2.5 exposure, those with short IPI and high PM2.5 exposure had the highest risk of LBW (relative risk = 3.53, 95% CI: 1.85–6.49, first trimester). Conclusion: The study demonstrates a synergistic effect of interpregnancy interval and air pollution on LBW, indicating that rational birth spacing and air pollution control can jointly improve LBW outcomes. [ABSTRACT FROM AUTHOR]

Among those with a severe maternal morbidity (SMM) event and a subsequent birth, we examined how the risk of a second SMM event varied by patient characteristics and intrapartum hospital utilization. We used a Massachusetts population-based dataset that longitudinally linked in-state births, hospital discharge records, prior and subsequent births, and non–birth-related hospital utilizations for birthing individuals and their children from January 1, 1999, to December 31, 2018, representing 1,460,514 births by 907,530 birthing people. We restricted our study sample to 2,814 people who had their first SMM event associated with a singleton birth and gave birth a second time within the study period. Our outcome measure was recurrence of SMM in the second birth. We calculated the prevalence of SMM at second birth, compared SMM conditions between births, and estimated the adjusted risk ratios and 95% confidence intervals for having an SMM event at second birth among those who had an SMM at the first birth. We also examined overall hospital utilization including inpatient admissions, emergency room visits, and observational stays, and hospital utilization by interpregnancy intervals (IPIs) between the first and second birth. There were 2,814 birthing people with at least one birth after the first SMM singleton birth. Among those, 198 (7.0%) had a subsequent SMM. The percentage of people with a second SMM event varied by age, race/ethnicity, insurance, IPI, and history of hypertension at first case of SMM (all p <.05). Between births, people with a second SMM event had significantly higher proportions of inpatient admissions (60.1% vs. 33.2.0%; p <.001), emergency room visits (71.7% vs. 57.7%; p <.001), and observational stays (35.4% vs. 19.5%; p <.001) compared with those who did not experience a second SMM event. Hospital utilization after a birth with SMM might indicate an elevated risk of a second SMM event. Providers should counsel their patients about prevention and warning signs. [ABSTRACT FROM AUTHOR]

Background: Our study aimed to investigate the value of inflammatory indices in predicting the latency period until birth in patients with preterm premature rupture of membranes (PPROM). Methods: This retrospective study was conducted on PPROM cases between 24 and 34 weeks of gestation at Ankara Etlik City Hospital Perinatology Department from October 2023 to April 2024. A total of 146 participants were divided into two groups: Group 1 included 73 patients who gave birth within 72 hours (h) of PPROM diagnosis, and Group 2 included 73 patients who gave birth after 72 h. Results: This study evaluated the prognostic significance of various inflammatory markers neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), monocyte/lymphocyte ratio (MLR), systemic immune inflammation index (SII), systemic inflammatory response index (SIRI), pan-immune inflammation value (PIV), immature granulocytes (IG), multi-inflammatory index (MII)-1, MII-2, and MII-3 in predicting the latency period in patients with PPROM. Only MII-1, MII-2, and MII-3 reliably predicted labor within 72 h. The cut-off value for MII-1 was > 48.3, with a sensitivity of 57.7% and specificity of 57.3% (AUC: 0.598, 95% CI: 0.503–0.692, p = 0.042). For MII-2, the cut-off was > 1037.6, with a sensitivity of 57.7% and specificity of 57.3% (AUC: 0.611, 95% CI: 0.516–0.705, p = 0.021). MII-3 had a cut-off of > 10919.9, with a sensitivity of 53.5% and specificity of 52% (AUC: 0.595, 95% CI: 0.501–0.690, p = 0.046). Conclusion: Our findings show that, among NLR, PLR, MLR, SII, SIRI, PIV, IG, MII-1, MII-2, and MII-3, only MII-1, MII-2, and MII-3 levels are statistically significant in predicting birth timing. [ABSTRACT FROM AUTHOR]

Predators impose top‐down forces on prey populations, with the strength of those effects often varying over space and time and among demographic groups. In ungulates, predation risk is typically greatest for neonatal offspring, with some suggesting that predators can key in on adult activity to locate hidden neonates. However, few field studies to date have been able to directly assess the influence of maternal care on ungulate neonate survival. Using a population of white‐tailed deer under heavy coyote predation pressure, we tested the maternal dispersion hypothesis, which suggests the dispersion of maternal activity temporally and spatially attenuates risk of predation for ungulate neonates during this vulnerable altricial phase. We compared support for this hypothesis with more commonly tested hypotheses regarding the influence of habitat conditions and intrinsic factors on neonatal survival. Fawn survival to 16 weeks was 27.7%, with coyotes accounting for 59% of fawn mortalities. In support of our maternal temporal diffusion hypothesis, we found that neonatal survival decreased as more maternal visits (proportionally) occurred at night. The only other significant (p <.1) predictor of fawn survival was birth timing, with fawn survival decreasing as the season progressed. Given that fawn survival declined as the proportion of nighttime visits increased, and that wild pig presence and human disturbance can push doe and fawn activity toward nocturnal hours, additional research is needed to determine whether managing pig and human disturbance can decrease fawn mortality. More broadly, given the importance of recruitment in ungulate population dynamics, our finding opens a potentially important new line of inquiry on how maternal behaviors influence predation risk in large animal predator–prey ecology. [ABSTRACT FROM AUTHOR]

The collapse of communism led to highly skewed sex ratios in Albania, which had a long patriarchal tradition before the advent of communism. While the use of sex-selective abortions in the region is well-known, little is known about other forms taken by revealed son preference, such as differential stopping behaviour and birth spacing. Pooling data from the Demographic Health Surveys in 2008–2009 and 2017–2018, we find evidence of a higher proportion of boys being born at the last birth, indicating that parents practice differential stopping behaviour. Using a logit model, we also show that in sonless households parents shorten the birth intervals significantly, endangering mothers' and children's health. We conclude that differential stopping behaviour and short birth spacing are prevalent in all regions and across the socio-economic spectrum. [ABSTRACT FROM AUTHOR]

The present study investigated factors associated with the incidence of stillbirth in young hyper‐prolific sows within free farrowing systems in tropical environments. A total of 714 live‐born and 54 stillborn piglets from 57 Landrace × Yorkshire sows, with an average parity of 2.7 ± 1.0 (range: 1 – 4), were comprehensively investigated. Reproductive variables of the sows, including gestation length, farrowing duration, the total number of piglets born per litter, and the birth order and status of each piglet, were recorded. Differences in the physiological characteristics of live‐born and stillborn piglets, such as birth interval, cumulative birth interval, body weight at birth, crown‐rump length, body mass index (BMI), ponderal index (PI), meconium staining score, and the percentage of piglets with a broken umbilical cord, were analysed. Piglets were divided into four groups based on the quartiles of birth order (Q1–Q4). On average, the duration of farrowing was 173.3 ± 85.9 min, and the total number of piglets born and number of piglets born alive‐per litter were 14.1 ± 3.8 and 12.5 ± 3.5, respectively. The incidence of stillbirth was 6.7% (54/801 piglets). The higher percentages of stillbirths were detected in sows with large litter sizes (≥17 piglets, 10.9%) compared to those with small (≤13 piglets, 6.1%) and moderate (14 – 16 piglets, 2.8%) litter sizes (p <.001). The incidences of stillbirth in Q3 and Q4 of the litters were higher than in Q1 and Q2 (p <.001). Compared to live‐born piglets, stillborn piglets had higher cumulative birth interval (103.0 ± 3.71 vs. 142.4 ± 9.35 min, p <.001), BMI (17.1 ± 0.15 vs. 18.4 ± 0.39 kg/m2, p =.002), PI (63.7 ± 0.59 vs. 70.8 ± 1.59 kg/m3, p <.001), meconium staining scores (1.78 ± 0.04 vs. 2.04 ± 0.10, p =.021), and the percentage of piglets born with a ruptured umbilical cord (45.2% vs. 66.0%, p =.004). An increase in the incidence of stillbirth was detected at 60, 120, 150, 180, and ≥ 210 min after the first piglet was born, compared to those born within the first 30 min of farrowing (p <.05). In conclusion, the study found that stillbirths in young, hyper‐prolific sows were linked to several factors: large litter sizes (≥17 piglets per litter), prolonged cumulative birth intervals (142.4 min), elevated BMI of 18.4 kg/m2, high PI values of 70.8 kg/m3, increased meconium staining scores, and a higher occurrence of ruptured umbilical cords. To reduce the risk of stillbirth, particularly among piglets with high body indices born later in the birthing process, it is recommended to enhance farrowing supervision for young sows, starting at a cumulative birth interval of 60 min. [ABSTRACT FROM AUTHOR]

Background: Short inter-pregnancy or birth interval is associated with an increased risk of adverse perinatal outcomes. However, some emerging evidence questions this association and there are also inconsistencies among the existing findings. This study aimed to systematically review the evidence regarding the effect of short inter-pregnancy or birth intervals on adverse perinatal outcomes in the Asia-Pacific region. Methods: A comprehensive search of five databases was conducted targeting studies published between 2000 to 2023. Studies that reported on short inter-pregnancy or birth interval and examined adverse perinatal outcomes, such as low birthweight (LBW) preterm birth (PTB), small for gestational age (SGA), and neonatal mortality were included and appraised for methodological quality using the Joanna Briggs Institute critical appraisal tools. Three reviewers independently screened the studies and performed data extraction. Narrative synthesis and meta-analyses were conducted to summarise the key findings. Results: A total of 41 studies that fulfilled the inclusion criteria were included. A short-interpregnancy interval was associated with an increased risk of low birthweight (odds ratio [OR] = 1.65; 95%CI:1.39, 1.95), preterm birth (OR = 1.50; 95%CI: 1.35, 1.66), and small for gestational age (OR = 1.24; 95%CI:1.09, 1.41). We also found elevated odds of early neonatal mortality (OR = 1.91; 95%CI: 1.11, 3.29) and neonatal mortality (OR = 1.78; 95%CI: 1.25, 2.55) among women with short birth intervals. Conclusion: This review indicates that both short inter-pregnancy and birth interval increased the risk of adverse perinatal outcomes. This underscores the importance of advocating for and implementing strategies to promote optimal pregnancy and birth spacing to reduce the occurrence of adverse perinatal outcomes. Reproductive health policies and programs need to be further strengthened and promote access to comprehensive family planning services and increase awareness about the importance of optimal pregnancy and birth spacing. [ABSTRACT FROM AUTHOR]

Most studies on the impact of birth intentions on children's well‐being do not separate risks of infant mortality associated with pregnancy intention status from the risks that are associated with sociodemographic characteristics. There is a lack of studies taking a multicountry comparative perspective. We analyzed 60 Demographic and Health Surveys in Asia, the Americas, and Africa to examine the association between birth intentions and infant mortality using sibling fixed‐effects linear probability models accounting for confounding due to time‐invariant maternal characteristics. Compared to wanted births, the probability of infant mortality was higher after an unwanted or mistimed birth, or both, in 41 countries. Particularly in West Africa, mostly mistimed pregnancies were associated with infant mortality, whereas in the Americas unwanted pregnancies mattered more. These differences could be partly due to contextual variation in the concept of birth intentions and in the importance of birth spacing and limiting. We show that the risk of infant mortality after an unwanted/mistimed pregnancy was higher in countries with low human development index and high overall infant mortality rate, highlighting the importance of taking context into account rather than pooling data. To the best of our knowledge, this is the first large‐scale, cross‐regional, and cross‐country comparative study to analyze the association between birth intentions and infant mortality using a fixed‐effects approach. [ABSTRACT FROM AUTHOR]

Background: Short birth interval (SBI) has profound implications for the health of both mothers and children, yet there remains a notable dearth of studies addressing wealth-based inequality in SBI and its associated factors in India. This study aims to address this gap by investigating wealth-based disparities in SBI and identifying the underlying factors associated with SBI in India. Methods: We used information on 109,439 women of reproductive age (15–49 years) from the fifth round of the National Family Health Survey (2019-21). We assessed wealth-based inequality in SBI for India and its states using the Erreygers Normalised Concentration Index (ECI). Additionally, we used a multilevel binary logistic regression to assess the factors associated with SBI in India. Results: In India, the prevalence of SBI was 47.8% [95% CI: 47.4, 48.3] during 2019-21, with significant variation across states. Bihar reported the highest prevalence of SBI at 61.2%, while Sikkim the lowest at 18.1%. SBI prevalence was higher among poorer mothers compared to richer ones (Richest: 33.8% vs. Poorest: 52.9%). This wealth-based inequality was visible in the ECI as well (ECI= -0.13, p < 0.001). However, ECI varied considerably across the states. Gujarat, Punjab, and Manipur exhibited the highest levels of wealth-based inequality (ECI= -0.28, p < 0.001), whereas Kerala showed minimal wealth-based inequality (ECI= -0.01, p = 0.643). Multilevel logistic regression analysis identified several factors associated with SBI. Mothers aged 15–24 (OR: 12.01, p < 0.001) and 25–34 (2.92, < 0.001) were more likely to experience SBI. Women who married after age 25 (3.17, < 0.001) and those belonging to Scheduled Caste (1.18, < 0.001), Scheduled Tribes (1.14, < 0.001), and Other Backward Classes (1.12, < 0.001) also had higher odds of SBI. Additionally, the odds of SBI were higher among mothers in the poorest (1.97, < 0.001), poorer (1.73, < 0.001), middle (1.62, < 0.001), and richer (1.39, < 0.001) quintiles compared to the richest quintile. Women whose last child had passed away were also significantly more likely to have SBI (2.35, < 0.001). Furthermore, mothers from communities with lower average schooling levels (1.18, < 0.001) were more likely to have SBI. Geographically, mothers from eastern (0.67, < 0.001) and northeastern (0.44, < 0.001) regions of India were less likely to have SBI. Conclusion: The significant wealth-based inequality in SBI in India highlights the need for targeted interventions focusing on economically disadvantaged women, particularly in states with high SBI prevalence. Special attention should be given to younger mothers and those from socially disadvantaged groups to enhance maternal and child health outcomes across the country. [ABSTRACT FROM AUTHOR]

OBJECTIVE To determine the proportion of women suffering from antenatal depression and anxiety visiting a tertiary care hospital for routine antenatal visits to evaluate the psychosocial factors associated with their depression and anxiety. STUDY DESIGN A descriptive cross-sectional study PLACE AND DURATION Department of Gynaecology & Obstetrics Ward 9B, Jinnah Postgraduate Medical Center (JPMC), Karachi from January 2024 to May 2024. METHODS The study was conducted with 249 pregnant women via non-probability, consecutive sampling. The Urdu validated version of Hospital Anxiety and Depression scale was used to assess anxiety and depression. Psychosocial stressors were also recorded. The data was entered and analyzed using SPSS for Windows version 23.0. RESULTS The study showed that 20% of women in their 2nd and 3rd trimesters of pregnancies were anxious and 5% were depressed. Critical psychosocial factors included low education, marital stressors such as low social support from husband and/or in-laws, living separately from husband, and intimate partner violence, financial stressors such as husband unemployment and pregnancy-related factors such as unplanned pregnancy and narrow birth spacing. CONCLUSION The study provides a significant burden of antenatal mental health issues in our region and their specific associated psychosocial factors. The study emphasizes upon the need for Biopsychosocial support systems as well as interventional measures to mitigate any risk of developing antenatal depression and to optimize the maternal health, both mental and physical, during this crucial period. [ABSTRACT FROM AUTHOR]

Objectives: Women experiencing homelessness have higher rates of unintended pregnancy than stably housed women and may benefit from reproductive interconception care. How reproductive interconception care differs between women who did and did not experience perinatal homelessness is not known. We estimated prevalence ratios of reproductive interconception behaviors among US women experiencing homelessness during the perinatal period. Methods: We used data from the 2016-2019 Pregnancy Risk Assessment Monitoring System to calculate the prevalence of 5 reproductive interconception care outcomes: attending a maternal postpartum checkup, participating in a conversation with a health care provider about birth intervals, receiving family planning counseling, obtaining a prescription for short-acting contraception, and having a long-acting reversible contraceptive inserted. We used complex survey weights, stratified by perinatal homelessness, and converted adjusted logistic regression odds ratios between housing status and outcome variables to adjusted prevalence ratios (aPRs) and 95% CIs. Results: Among participants, approximately 2.4% (weighted percentage; unweighted 2953 of 100 706) experienced homelessness sometime in the 12 months before their children were born; the majority were non-Hispanic (83.2%) and White (69.4%), were not married (82.2%), and had public health insurance (56.8%). Perinatal homelessness was significantly associated with a lower prevalence of attending a postpartum maternal visit (aPR = 0.90; 95% CI, 0.87-0.94) and a higher prevalence of having a conversation about birth intervals with their health care providers (aPR = 1.13; 95% CI, 1.03-1.21). Conclusions: Findings suggest that improving attendance at postpartum visits and evaluating birth interval conversations may strengthen interconception care practices while contextualizing social determinants such as housing stability. Improving uptake of postpartum visits may reduce unintended pregnancy, short birth intervals, and adverse birth outcomes in future pregnancies among women experiencing homelessness. [ABSTRACT FROM AUTHOR]

Child malnutrition remains a significant concern in the Asia‐Pacific region, with short birth intervals recognised as a potential risk factor. However, evidence of this association is inconclusive. This study aimed to systematically review the existing evidence and assess the summary effects of short birth interval on child malnutrition in the Asia‐Pacific region. Five electronic databases were searched in May 2023 to identify relevant studies reporting the association between short birth interval and child malnutrition, including stunting, wasting, underweight, anaemia and overall malnutrition, in Asia‐Pacific region between September 2000 and May 2023. Fixed‐effects or random‐effects meta‐analysis was performed to estimate the summary effects of short birth interval on child malnutrition. Out of 56 studies meeting the inclusion criteria, 48 were included in quantitative synthesis through meta‐analysis. We found a slightly higher likelihood of stunting (n = 25, odds ratio [OR] = 1.13; 95% confidence interval [CI]: 0.97–1.32) and overall malnutrition (n = 3, OR = 2.42; 95% CI: 0.88–6.65) among children born in short birth intervals compared to those with nonshort intervals, although the effect was not statistically significant. However, caution is warranted due to identified heterogeneity across studies. Subgroup analysis demonstrated significant effects of short birth intervals on child malnutrition in national‐level studies and studies with larger sample sizes. These findings underscore short birth intervals as a significant contributor to child malnutrition in the Asia‐Pacific region. Implementing effective policies and programs is vital to alleviate this burden, ultimately reducing child malnutrition and associated adverse outcomes, including child mortality. Key messages: Short interval pregnancies pose a persistent public health threat in the South Asian region.While a potential link with child malnutrition exists, reported associations often conflict.Our findings suggest that short interval births slightly increase the risk of child malnutrition.Addressing short interval pregnancies is crucial to mitigate the ongoing nutritional burden in South Asian countries. [ABSTRACT FROM AUTHOR]

Background: A healthy child can make way for a healthy adult. Some of the factors that can be used to determine the health of a young child are nutritional status of the child, the developmental milestones achieved, and frequency of illness. Objectives: The health status of children and associated factors are determined. Methods: This is a community-based cross-sectional study with 271 participants. The height and weight of the child were measured; questions were asked regarding developmental milestones achieved and frequent illnesses. An interview schedule was used to enquire about the determinants of health status. Descriptive statistics were done; Chi-square test and regression were used to determine association between the health status of children and determinants. Results: A total of 127 (46.86%) were found to have a good health status. Family type (Chi square value 9.568; P value = 0.002), birth spacing (Chi square 20.540; P value < 0.001), term or pre-term birth (Chi square 4.598; P value = 0.032), chronic medical problem in the child (Chi square 11.074; P value = 0.001), and immunization status of the child (Chi square 5.666; P value = 0.017) were found to have significant association with the health status of the child. By logistic regression, pre-term child birth and family type were found to have higher odds. Conclusion: For better health of the child, specific focus on birth spacing, term birth of baby, better care of the ill, and complete immunization play vital roles. [ABSTRACT FROM AUTHOR]

Background Anemia during pregnancy is a public health problem and is related to negative birth outcomes, especially in developing countries. The main aim of this study was to assess predictors of anemia among pregnant women attending antenatal clinics at Hiwot Fana Comprehensive Specialized University Hospital, Eastern Ethiopia. Methods Unmatched case-control study design was employed among 352 individuals. A face-to-face interview was used to gather data, and each pregnant woman's antenatal care follow-up record cards were reviewed in addition to the interview. EpiData version 3.1 and IBM SPSS version 26 was used for data entry and analysis, respectively. Bivariable and multivariable analyses were conducted to identify predictors of anemia, a p-value of <0.05 was considered a statistically significant association. Result The common determinants for anemia in pregnant mothers were: rural residency (AOR = 2.25, 95% CI: 1.14–4.8), no formal education (AOR = 4.4, 95% CI: 1.94–9.9), inter-pregnancy interval (AOR = 2.7, 95% CI: 1.24–5.8), and mid-upper arm circumference (AOR = 5.0, 95% CI: 2.0–12.7). Conclusion In this study, the identified determinant factors for anemia were: rural residency, maternal educational status, inter-pregnancy-interval, and mid-upper arm circumference. Therefore, providing health education and promotion for pregnant women regarding anemia by focusing on rural residents and counseling to lengthen their birth spacing is an important task. Moreover, counseling on taking iron supplementation as suggested and consuming a diet rich in iron during antenatal care will be recommended. [ABSTRACT FROM AUTHOR]

Background: Anemia in pregnancy is considered a significant public health problem. It has an essential role in disabled life and death of pregnant women and their future children, mainly in developing countries. Pregnant women in Yemen in internally displaced camps remain at most exposed to anemia. The aim of this study is to determine the prevalence and associated factors related to anemia among pregnant women in Marib, Yemen. Methods: A cross-sectional study was conducted among 402 pregnant women attending General hospitals from October 2023 to January 2024. The data were collected through structured pretested questionnaire, and via an interview. Laboratory investigations were done. Data Analysis: the data were statistically analyzed through SPSS program (version 21) using descriptive statistics, Chi square test for investigating the association between anemia and the independent factors. Results: The overall prevalence of anemia among study participants was 56.7%. The moderate anemia were the most prevalence among pregnant women (65.8%). Risk factors associated with anemia among pregnant women were displacement, level education, low family income, gestational age, space interval of birth, lack of iron supplementation during pregnancy, and one /zero consumption of monthly meat, liver and vegetables during pregnancy, habits such as taking tea immediately after meal and chewing of khat during pregnancy. Conclusion: prevalence of anemia in this study was public health problem. Several factors were found to be associated with anemia during pregnancy. Measures have to be taken to solve the problem by mass iron supplementation, family planning and health education towards risk factors that were associated with anemia to avoid them. [ABSTRACT FROM AUTHOR]

Sucrose reinforcement increases operant wheel running, but it is not certain that the increase is due to a reinforcement rather than a schedule-induction effect. To address this issue, eight female Long Evans rats were exposed to a fixed-interval (FI) 60-s schedule with wheel running as the operant. Across three conditions, water, sucrose, and water were delivered as outcomes. In addition, rats also ran freely for 20 min prior to, and subsequent to, exposure to the FI 60-s schedule. Results showed that operant wheel running on the FI 60-s schedule increased when sucrose was delivered. At the level of revolutions, over the reinforcement interval more rats showed increased revolutions in the sucrose condition in the latter half of the interval, consistent with a reinforcement effect, than an inverted U-shaped pattern in the initial half of the interval. Running during the pre- and postoperant running period was not substantially affected by the removal of sucrose reinforcement on the FI 60-s schedule. Sucrose reinforcement, but not water, increased running relative to the pre/post running periods. Results suggest that although both schedule-induction and reinforcement effects occur, the effect that dominates appears to be a function of the duration of the reinforcement interval with a reinforcement effect more prevalent with shorter intervals. [ABSTRACT FROM AUTHOR]

Objectives: Underweight remains the primary public health concern among under-five-year-old children in Ethiopia, despite numerous government-implemented nutrition-specific and sensitive interventions. Therefore, this study aimed to assess underweight and associated factors among children in South Ethiopia. Methods: Between March and April 2021, 717 children in the South Ari district who were between the ages of 6 and 59 months participated in a cross-sectional study. To choose a sample of households containing a minimum of one child between the ages of 6 and 59 months, a multi-stage sampling procedure was used. Data were collected by interviewer-administered structured questionnaires from the mothers of the children. To determine the factors associated with being underweight, a binary logistic regression analysis was built. All variables with a p-value <0.25 in the bivariable analysis were entered into a multivariable logistic regression analysis. To assess the strength of the association, an adjusted odds ratio (AOR) with a 95% confidence interval was used. With a p-value below 0.05, statistical significance was declared. Results: The prevalence of underweight was determined to be 29.7% (95% CI: 26.5%, 33.2%). Child age 6–23 months [adjusted odds ratio (AOR) = 0.28; 95% confidence interval (CI): 0.18, 0.44], food insecurity (AOR = 1.48; 95% CI: 1.04, 2.10), sub-optimal child dietary diversity (AOR = 1.44; 95% CI: 1.01, 2.03), birth interval <24 months (AOR = 2.49; 95% CI: 1.75, 3.54), and common childhood illness (AOR = 2.21; 95% CI: 1.52, 3.21) were associated with being underweight. Conclusion: Underweight among children is predicted by household food insecurity, suboptimal dietary diversity, and common childhood illnesses, necessitating further efforts to improve food security and manage common illnesses. [ABSTRACT FROM AUTHOR]

Abstract Background This study aimed to explore the association of the second birth delivery mode and interval with maternal pelvic floor changes. Methods This prospective cohort study included women who had a first delivery and were in weeks 36–41 of a subsequent pregnancy at Panzhihua Central Hospital between July 2017 and June 2018. The primary outcomes of the study were the hiatus area at 6 months postpartum and bladder neck (mm) at rest and during a maximum Valsalva maneuver. Results There were 112 women with vaginal delivery and 182 with Cesarean section. The hiatus area and hiatus circumference decreased at all time points (all P

IntroductionShort interpregnancy interval (IPI) is a well-known risk factor for preterm births and low birth weights. However, research on the association between interpregnancy interval (IPI) and health outcomes in children under age 5 is limited in India. We examined the associations between IPI and five child health outcomes in India.MethodsWe used nationally representative cross-sectional data from three rounds of National Family Health Survey (NFHS) conducted in India during 2005-06, 2015-16 and 2019-21 to examine the associations between IPI [categorized as

Background: spousal violence against women (SVAW) is a common form of violence that occurs within the family context, with spouses being the main perpetrators. Afghanistan has one of the highest rates of SVAW in the world, and its impact on reproductive health and fertility is not well understood. This study aims to investigate the extent to which SVAW influences the total fertility rate (TFR) of Afghan women. Methods: In this study, a regression model of discrete-time survival models was used to calculate the total fertility rate (TFR), parity progression ratio (PPRs), and average closed birth intervals (CBI) between two children. The method used in this study has its roots in the works of Griffin Finney (1983) and was further developed by Redford et al. (2010). The study population utilized the 2015 Afghanistan Demographic and Health Survey, and sample weights were used to ensure accurate estimates for the population of Afghanistan as a whole. Results: The study found that women in Afghanistan who have experienced SV are more likely to progress to the next parity, start childbearing faster, and continue to do so. Women who have not experienced SV tend to progress to higher parities at a slower pace during their initial reproductive years. The study also suggests that women with spousal violence (SV) experience may have slightly higher fertility rates and shorter birth intervals for certain birth orders, although the differences between the two groups are generally small. Specifically, the total fertility rate (TFR) for women who experienced SV was 6.9, while the TFR for women who did not experience SV was 6.2. Conclusions: These results provide valuable information for policymakers and public health professionals in developing effective policies and programs to address SVAW and improve maternal and child health outcomes in Afghanistan. [ABSTRACT FROM AUTHOR]

Background: Postpartum contraception is essential to sexual and reproductive health (SRH) care because it encourages healthy spacing between births, helps women avoid unwanted pregnancies, and lessens the risks of health problems for mothers and babies. Sub-Saharan African immigrant and refugee populations are rapidly increasing in the United States, and they come from a wide range of cultural, linguistic, religious, and social origins, which may pose challenges in timely access to culturally acceptable SRH care, for preventing mistimed or unwanted childbearing. The objective of this scoping review is to assess the extent of the available literature on postpartum contraception among sub-Saharan African immigrant and refugee women living in the United States. Methods: We developed preliminary search terms with the help of an expert librarian, consisting of keywords including birth intervals, birth spacing, contraception, postpartum contraception or family planning, and USA or America, and sub-Saharan African immigrants, or emigrants. The study will include the following electronic databases: PubMed/MEDLINE, PsycINFO, CINAHL, EMBASE, and the Global Health Database. The sources will include studies on postpartum care and contraceptive access and utilization among sub-Saharan African immigrants living in the US. Citations, abstracts, and full texts will be independently screened by two reviewers. We will use narrative synthesis to analyze the data using quantitative and qualitative methods. Factors associated with postpartum contraception will be organized using the domains and constructs of the PEN-3 Model as a guiding framework. Conclusion: This scoping review will map the research on postpartum contraception among sub-Saharan African immigrant and refugee women living in the US. We expect to identify knowledge gaps, and barriers and facilitators of postpartum contraception in this population. Based on the findings of the review, recommendations will be made for advocacy and program and policy development toward optimizing interpregnancy intervals in sub-Saharan African immigrants living in the US. Trial registration: Review registration Open Science Framework: https://osf.io/s385j. [ABSTRACT FROM AUTHOR]

Existing literature documents connections between short birth spacing (birth‐to‐conception interval of under 18 months) and the risk of child maltreatment, but explanations for this relation are understudied. We hypothesise that short birth spacing predicts child maltreatment, and it mediates the association between maternal history of childhood maltreatment and their child's risk of abuse and neglect. We use data for second and higher parity children from the Prospective Study of Infant Development (n = 335) and fit logistic regression models with relevant covariates to examine the association between maternal history of childhood maltreatment, her offspring's short birth spacing and her offspring's child maltreatment (CM) as measured by Child Protective Services (CPS) assessments. Findings demonstrate that children of mothers who reported experiencing any abuse or neglect during childhood have a higher likelihood of being born shortly spaced and a higher likelihood of CM. Additionally, short birth spacing is associated with increased likelihood of CM. No evidence for mediation from maternal history of maltreatment to CM operating through short birth spacing was detected. We conclude that maternal history of childhood maltreatment and short birth spacing are independent, additive factors for CM risk. Key Practitioner Messages: Maternal history of childhood maltreatment is a strong predictor of her children's birth spacing and her children's abuse and neglect risk.Maternal history of childhood maltreatment and birth spacing between her children serve as independent predictors of her children's abuse and neglect risk.Child maltreatment risk assessment models should incorporate historical information about parental childhood trauma, as well as prenatal indicators of wellbeing such as birth spacing.Child maltreatment prevention programmes should address parental childhood trauma as well as family planning to minimise risk. [ABSTRACT FROM AUTHOR]

Background: Access to safe drinking water, sanitation, and hygiene (WASH) facilities is crucial for health and human rights, impacting nutrition and weight. Methods: Multiple Indicators Cluster Survey (MICS) 2017– 18 has been used in this study to examine the association between WASH and underweight, alongside other factors. Analysis included descriptive statistics, association tests, logistic regression, and population-attributable fractions (PAF). Results: According to results child were 1.8, 1.1 and 1.04 times less likely to be underweight if they had access to improved source of drinking water, improved sanitation and hygiene facilities respectively. The likelihood of child being underweight reduces by 1.4, 1.89, 2.01 and 2.55 times if the household wealth status increases from poorest to second, middle, fourth and richest wealth quintiles, respectively. As the mothers' education level increases from no schooling to primary, middle, secondary, and higher level, the possibility of child being underweight reduces by 1.22, 1.24, 1.60 and 2.01 times, respectively. Moreover, the likelihood of a child being underweight decreases as the education level of the household head improves. If maternal age is less than 20 or more than 35 years the likelihood of the child being underweight is increased by 1.074 and 1.121 times, respectively. A child is 1.1 times more likely to be underweight if birth spacing is less than 2 years. A child's risk of being underweight decreases by 1.1 times if they have not experienced diarrhea. A child who has never been breastfed has 1.3 times higher risk of being underweight. The results of Population Attributable Fraction (PAF) indicate that holding the other factors constant, approximately 36.46% burden of underweight was preventable by access to improved drinking water, sanitation, and hygiene practices. Conclusion: Comprehensive strategy is needed that focuses on improving access to safe drinking water, sanitation infrastructure, and hygiene behaviors. [ABSTRACT FROM AUTHOR]

Background: With the rapid increase in the number of women in their later reproductive years (aged 35 and above) in the present decade, the concern surrounding their contraceptive considerations has reached a critical point of importance. This study aims to examine the trends and determinants of modern contraceptive uptake among later reproductive-aged women in Bangladesh. Methods: A total of 17,736 women aged 35 and above were included in the analysis, utilizing data from three consecutives Bangladesh Demographic and Health Surveys conducted in 2011, 2014, and 2017–18. The outcome variable was the uptake of modern contraceptive methods (yes or no). The explanatory variables encompassed survey years, individual characteristics of the women, as well as characteristics of their partners and the community. Multilevel logistic regression model was used to explore the association of the outcome variable with explanatory variables. Results: We found that approximately 54% of women aged 35 and more do not use modern contraceptive methods, and there have been no significant shifts in their usage observed over the survey years. Compared to women aged 35–39, women aged 40–45 (aOR = 0.53, 95% CI: 0.49–0.57) and 45–49 (aOR = 0.24, 0.22–0.26) reported lower likelihoods of modern contraceptive method uptake. Higher education correlated with increased uptake of modern contraceptive methods (112%-142%), while partner's education showed a negative association. Later reproductive-aged women in richer (aOR = 0.83, 95% CI: 0.74–0.94) and richest (aOR = 0.76, 95% CI: 0.66–0.88) quintiles reported lower uptake of modern contraceptive methods compared to their counterparts in the poorest quintile. Later reproductive-aged women in Dhaka (aOR = 1.22, 95% CI: 1.07–1.38) and Rajshahi (aOR = 1.37, 95% CI: 1.19–1.59) regions had higher uptake of modern contraception than those residing in the Barishal division. Modern contraceptive methods uptake was 1.22 times higher among women who reported exposure to mass media and 1.19 times higher among women who reported engagement in paid work compared to among women who reported no exposure to mass media and participation in no formal work, respectively. Modern contraceptive methods uptake was 43% higher (aOR = 1.43, 95% CI: 1.32–1.55) in women with more than 2 children compared to those with ≤2 children. Conclusion: The study highlights no significant change in modern contraception uptake among later reproductive-aged women in Bangladesh. This raises concerns about the elevated risk of unintended pregnancies and shorter birth intervals, emphasizing the need for targeted interventions to address the specific needs and preferences of this demographic. [ABSTRACT FROM AUTHOR]

Mothers with multiple-partner fertility have longer interbirth intervals (IBIs) than mothers with single-partner fertility, suggesting that partner change hinders achieving the preferred IBI. Previous studies have, however, overlooked possible differences in preferred IBI between these two groups. Using data from 724 Finnish mothers, we investigated how partner change between the first and second child moderated the association between actual and preferred IBI. Mothers with multiple-partner fertility had 54 months longer IBIs than mothers with single-partner fertility. The association between actual and preferred IBI was weaker in mothers with multiple-partner fertility. Our results further indicated that this difference could partly be explained by the mothers' deliberate actions, such as contraceptive use and abortions among mothers with multi-partner fertility. Family planning support could gain from mapping out the reasons among women with a partner change for postponing otherwise desired pregnancies and offering increased support in these areas. [ABSTRACT FROM AUTHOR]

It is commonly observed that poor access to food, especially during maternity and lactation, leads to under-nutrition and increases the probability of premature birth, anaemia amongst mothers and childhood stunting. This study investigates the correlation and aims to determine the relationship between childhood stunting and maternal underweight in specific rural and urban zones within the North 24 Parganas district of West Bengal. Primary data was collected through in-person interviews with checked and approved questionnaires during April- August 2023. A child aged one to fifty-nine months was selected randomly from each family to take part in the study. The Binary logistic regression model was used to investigate the impact of maternal body mass index (BMI) on rural-urban child stunting, long term nutritional deficit. A total of 860 children from both urban (430) and rural (430) backgrounds participated in the study. This study found a slight difference in the rate of stunting. The prevalence of stunting remains high at 9 percent in the urban zone and 11percent in the rural region. The study infers that addressing maternal malnutrition and educating and empowering women will improve access to family planning while reducing childhood stunting. Therefore, implementation of dietary, counselling, delivery transportation, and child spacing is essential. [ABSTRACT FROM AUTHOR]

An extensive literature has examined the relationship between birth spacing and subsequent health outcomes for parents, particularly for mothers. However, this research has drawn almost exclusively on observational research designs, and almost all studies have been limited to adjusting for observable factors that could confound the relationship between birth spacing and health outcomes. In this study, we use Norwegian register data to examine the relationship between birth spacing and the number of general practitioner consultations for mothers' and fathers' physical and mental health concerns immediately after childbirth (1–5 and 6–11 months after childbirth), in the medium term (5–6 years after childbearing), and in the long term (10–11 years after childbearing). To examine short-term health outcomes, we estimate individual fixed-effects models: we hold constant factors that could influence parents' birth spacing behavior and their health, comparing health outcomes after different births to the same parent. We apply sibling fixed effects in our analysis of medium- and long-term outcomes, holding constant mothers' and fathers' family backgrounds. The results from our analyses that do not apply individual or sibling fixed effects are consistent with much of the previous literature: shorter and longer birth intervals are associated with worse health outcomes than birth intervals of approximately 2–3 years. Estimates from individual fixed-effects models suggest that particularly short intervals have a modest negative effect on maternal mental health in the short term, with more ambiguous evidence that particularly short or long intervals might modestly influence short-, medium-, and long-term physical health outcomes. Overall, these results are consistent with small to negligible effects of birth spacing behavior on (non-pregnancy-related) parental health outcomes. [ABSTRACT FROM AUTHOR]

Reproductive interconception care provided at maternal postpartum visits may help reduce unintended pregnancies and elongate birth intervals for women experiencing homelessness. To improve interconception care uptake, this qualitative study aimed to identify barriers and facilitators to reproductive interconception care from the perspectives of women who were recently pregnant and homeless. A semi-structured interview guide and demographic survey were developed based on epidemiological findings, Information-Motivation-Behavioral Skill framework components, and a review by community health workers for content validity. After conducting 12 interviews with women recently pregnant and homeless in a local continuum of care in 2022, audio-recorded interviews were transcribed, iteratively coded using a priori and emerging codes, and thematically analyzed. Key themes were identified to determine implications and next steps to improving reproductive interconception care uptake. Interrelated themes focused on information (e.g., knowledge and misconceptions about pregnancy, birth intervals, contraception), motivation (e.g., attitudes about interconception care experiences, perinatal social influences), behavioral skills (e.g., objective ability to obtain interconception care and perceived self-efficacy related to attending maternal postpartum visits and increasing birth intervals), and macro-level factors (e.g., obtaining housing, contextualizing socioeconomic factors, navigating COVID-19). The findings suggest the need for flexible, streamlined, and personalized interconception care delivery that acknowledges pressing housing and relationship considerations and supports women's autonomy. Improvements to reproductive interconception care may reduce future unintended pregnancies, increase birth intervals, and improve birth outcomes among women experiencing homelessness. [ABSTRACT FROM AUTHOR]

Background: This study aimed to explore the association of the second birth delivery mode and interval with maternal pelvic floor changes. Methods: This prospective cohort study included women who had a first delivery and were in weeks 36–41 of a subsequent pregnancy at Panzhihua Central Hospital between July 2017 and June 2018. The primary outcomes of the study were the hiatus area at 6 months postpartum and bladder neck (mm) at rest and during a maximum Valsalva maneuver. Results: There were 112 women with vaginal delivery and 182 with Cesarean section. The hiatus area and hiatus circumference decreased at all time points (all P < 0.001). The women with Cesarean section had a smaller hiatus area and circumference (P < 0.001 and P < 0.001). The hiatus diameters decreased with time in both groups (all P < 0.001) and were smaller after Cesarean section (both P < 0.001). The bladder neck at maximum Valsalva increased with time (all P < 0.001) without significant differences between the two groups. Finally, the proportion of patients with POP-Q stage 0/I increased with time in both groups (all P < 0.001), with the proportions being higher in the Cesarean group (P = 0.002). The birth interval was negatively correlated with the hiatus area (B=-0.17, 95%CI: -0.25, -0.08, P < 0.001) and positively correlated with the bladder neck at rest (B = 0.22, 95%CI: 0.08, 0.35, P = 0.001) and at maximum Valsalva (B = 0.85, 95%CI: 0.65, 1.05, P < 0.001). Conclusions: In conclusion, the mode of delivery at the second birth could influence the hiatus area and circumference and bladder neck size. The birth interval was negatively correlated with the hiatus area and positively correlated with the bladder neck at rest and at maximum Valsalva. [ABSTRACT FROM AUTHOR]

Objective: Heart murmurs in childhood are the most common reason for pediatric cardiology consultations worldwide. The aim of this study is to investigate the frequency and etiology of congenital heart disease (CHD) in two different centers possessing significant differences in factors such as geography, climate, and sociocultural conditions. Methods: The study involves patients who’d been referred to the pediatric cardiology outpatient clinic due to heart murmurs between November 2022-October 2023. All patients were evaluated by echocardiograph to investigate the causes of the murmur. Results: The study includes 2,127 patients (1,452 from Şırnak and 675 from Giresun; median age = 1.95 years). The gender distributions were similar in both regions. Pathological heart murmurs were more prevalent in Şırnak (21.6%) compared to Giresun (7.7%), while Giresun had a higher percentage of innocent murmurs (92.3%). Cyanotic conditions were rare. Surgery was required for 3.7% of patients overall (4.5% in Şırnak; 1.9% in Giresun). Normal echocardiograms were found in 46% of the total population, with variations being 41% in Şırnak and 56% in Giresun. Pathological murmurs were more common in females. Patients with pathological murmurs were more likely to require surgery. Şırnak had more pathological echocardiography results and a higher need for surgery. Neonates were the age group most frequently requiring surgery in both centers. Conclusions: Educating society and fostering awareness are imperative steps for preventing consanguineous marriages and encouraging appropriate birth intervals. Swift public education is particularly crucial in developing nations marked by elevated consanguinity rates and limited financial resources, highlighting the potential detrimental consequences of inbreeding. [ABSTRACT FROM AUTHOR]