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To test the utility of a preconception checklist tool in identifying preconception health needs of women in three countries; China, Lebanon and the Philippines. An academic medical center within each country participated in the development and testing of a preconception checklist tool, which was administered over a 6 month period to selected target groups in each country. The checklist provided valuable data on the preconception health of 6,530 women. Aggregated data identified common preconception health needs across all countries, including provision of modern contraceptives and adequate immunization coverage; HIV and STI screening; treatment for anemia; and counseling for maintenance of a healthy weight. A preconception checklist tool was found to be useful in distinct cultural settings. The study was a pilot. Future steps include validation and standardization of the checklist, data from which could be used to help shape preconception care policies and implementation strategies. Keywords Preconception health assessment * Preconception care * Global maternal and child health * Middle-income countries, Introduction In much of the world, women seek antenatal care once they recognize they are pregnant; a time at which prevention of certain outcomes may be too late. Without public [...]

There appears to be a relation between immunization with DPT (diphtheria-pertussis-tetanus) vaccine and anaphylaxis or protracted crying in children who receive the vaccine. The rubella vaccine seems to be associated with acute and chronic arthritis in women who receive it. The National Academy of Sciences' Institute of Medicine (IOM) reviewed all published reports of possible side effects of DPT and rubella vaccines and found the evidence was most strong for these. IOM estimates 0.1% to 6% of children receiving DPT vaccine experience inconsolable crying. The institute estimates the rate of anaphylaxis to be two cases per 100,000 DPT injections. Among women who receive rubella vaccine, 13% to 15% develop acute arthritis, according to the IOM. Complete data on these associations can be found in the IOM report, Adverse Effects of Pertussis and Rubella Vaccines.

Abstract Each year, more than 1 in 10 of the world’s babies are born preterm, resulting in 15 million babies born too soon. World Prematurity Day, November 17, is a global effort to raise awareness about prematurity. This past year, there has been increased awareness of the problem, through new data and evidence, global partnership and country champions. Actions to improve care would save hundreds of thousands of babies born too soon from death and disability. Accelerated prevention requires urgent research breakthroughs.

Betrayal of Trust: The Collapse of Global Public Health, by Laurie Garrett. New York: Hyperion, 2000, 754 pp. Laurie Garrett, author of The Coming Plague and winner of the Pulitzer […]

Urgent action is needed to address preterm birth given that the first country-level estimates show that globally 15 million babies are born too soon and rates are increasing in most countries with reliable time trend data. As the first in a supplement entitled “Born Too Soon”, this paper focuses on the global policy context. Preterm birth is critical for progress on Millennium Development Goal 4 (MDG) for child survival by 2015 and beyond, and gives added value to maternal health (MDG 5) investments also linking to non-communicable diseases. For preterm babies who survive, the additional burden of prematurity-related disability may affect families and health systems. Prematurity is an explicit priority in many high-income settings; however, more attention is needed especially in low- and middle income countries where the invisibility of preterm birth as well as its myths and misconceptions have slowed action on prevention and care. Recent global attention to preterm birth hit a tipping point in 2012, with the May 2 publication of Born Too Soon: The Global Action Report on Preterm Birth and with the 2nd annual World Prematurity Day on November 17 which mobilised the actions of partners in many countries to address preterm birth and newborn health. Interventions to strengthen preterm birth prevention and care span the continuum of care for reproductive, maternal, newborn and child health. Both prevention of preterm birth and implementation of care of premature babies require more research, as well as more policy attention and programmatic investment. [ABSTRACT FROM AUTHOR]

The association of beer drinking with cancer of the rectum was investigated in a case-control study of 130 male and 88 female rectal cancer cases and 336 male and 249 female controls. Information was obtained on consumption of beer, wine, and hard liquor throughout adulthood (quantity and duration), as well as on smoking and sociodemographic characteristics. Beer intake was not significantly associated with estimated risk of rectal cancer in females but was in males, with an increasing gradient in the odds ratio (OR) with increasing beer consumption. For drinkers of 32 or more ounces of beer per day, the OR was 3.5 (95% Cl 1.8–7.0). No association was seen with duration of beer drinking. Wine and hard liquor consumption showed no association with the development of rectal cancer. In multiple logistic regression analyses, the relative risk for beer drinking was reduced slightly when potential confounding variables were included in the model (RR adjusted for religion and education: 2.7, 95% Cl 1.3–5.7). The study results are discussed in the light of other epidemiological studies of rectal cancer and beer drinking. We conclude from the aggregate evidence that the association of beer drinking with rectal cancer is probably not causal and that the slightly elevated OR's observed for males in this study are most likely due to incomplete control for confounding variables. [ABSTRACT FROM PUBLISHER]

Sohni Dean and colleagues report their CHNRI exercise that developed health research priorities for effective pre-conception care in low- and middle-income countries. Please see later in the article for the Editors' Summary

Presents the foreword of the June 2, 2004 issue of the journal "Nutrition Reviews."

Background: Every year, 1·1 million babies die from prematurity, and many survivors are disabled. Worldwide, 15 million babies are born preterm (<37 weeks' gestation), with two decades of increasing rates in almost all countries with reliable data. The understanding of drivers and potential benefit of preventive interventions for preterm births is poor. We examined trends and estimate the potential reduction in preterm births for countries with very high human development index (VHHDI) if present evidence-based interventions were widely implemented. This analysis is to inform a rate reduction target for Born Too Soon., Methods: Countries were assessed for inclusion based on availability and quality of preterm prevalence data (2000-10), and trend analyses with projections undertaken. We analysed drivers of rate increases in the USA, 1989-2004. For 39 countries with VHHDI with more than 10,000 births, we did country-by-country analyses based on target population, incremental coverage increase, and intervention efficacy. We estimated cost savings on the basis of reported costs for preterm care in the USA adjusted using World Bank purchasing power parity., Findings: From 2010, even if all countries with VHHDI achieved annual preterm birth rate reductions of the best performers for 1990-2010 (Estonia and Croatia), 2000-10 (Sweden and Netherlands), or 2005-10 (Lithuania, Estonia), rates would experience a relative reduction of less than 5% by 2015 on average across the 39 countries. Our analysis of preterm birth rise 1989-2004 in USA suggests half the change is unexplained, but important drivers include non-medically indicated labour induction and caesarean delivery and assisted reproductive technologies. For all 39 countries with VHHDI, five interventions modelling at high coverage predicted a 5% relative reduction of preterm birth rate from 9·59% to 9·07% of livebirths: smoking cessation (0·01 rate reduction), decreasing multiple embryo transfers during assisted reproductive technologies (0·06), cervical cerclage (0·15), progesterone supplementation (0·01), and reduction of non-medically indicated labour induction or caesarean delivery (0·29). These findings translate to roughly 58,000 preterm births averted and total annual economic cost savings of about US$3 billion., Interpretation: We recommend a conservative target of a relative reduction in preterm birth rates of 5% by 2015. Our findings highlight the urgent need for research into underlying mechanisms of preterm births, and development of innovative interventions. Furthermore, the highest preterm birth rates occur in low-income settings where the causes of prematurity might differ and have simpler solutions such as birth spacing and treatment of infections in pregnancy than in high-income countries. Urgent focus on these settings is also crucial to reduce preterm births worldwide., Funding: March of Dimes, USA, Eunice Kennedy Shriver National Institute of Child Health and Human Development, and National Institutes of Health, USA., (Copyright © 2013 Elsevier Ltd. All rights reserved.)

Preterm birth complication is the leading cause of neonatal death resulting in over one million deaths each year of the 15 million babies born preterm. To accelerate change, we provide an overview of the comprehensive strategy required, the tools available for context-specifi c health system implementation now, and the priorities for research and innovation. There is an urgent need for action on a dual track: (1) through strategic research to advance the prevention of preterm birth and (2) improved implementation and innovation for care of the premature neonate. We highlight evidence-based interventions along the continuum of care, noting gaps in coverage, quality, equity and implications for integration and scale up. Improved metrics are critical for both burden and tracking programmatic change. Linked to the United Nation’s Every Women Every Child strategy, a target was set for 50% reduction in preterm deaths by 2025. Three analyses informed this target: historical change in high income countries, recent progress in best performing countries, and modelling of mortality reduction with high coverage of existing interventions. If universal coverage of selected interventions were to be achieved, then 84% or more than 921,000 preterm neonatal deaths could be prevented annually, with antenatal corticosteroids and Kangaroo Mother Care having the highest impact. Everyone has a role to play in reaching this target including government leaders, professionals, private sector, and of course families who are aff ected the most and whose voices have been critical for change in many of the countries with the most progress.