Articles

Association of Maternal Tobacco Use During Pregnancy With Preadolescent Brain Morphology Among Offspring

The objective of this study was to investigate the association between maternal smoking during pregnancy and offspring brain development in preadolescence as well as the mediating pathways. The findings of this cohort study suggest that continued maternal tobacco use during pregnancy was associated with lower brain volumes and suboptimal cortical traits of offspring in preadolescence, which seemed to be independent of shared family factors. Tobacco cessation before pregnancy, or as soon as pregnancy is known, should be recommended to women for optimal brain development of their offspring.

Delivery, maternal and neonatal outcomes in nulliparous women with gestational diabetes undergoing epidural labour analgesia: a propensity score-matched analysis

This study aimed to retrospectively analyse the influence of epidural labour analgesia (ELA) on delivery and maternal and neonatal outcomes in nulliparous women with gestational diabetes mellitus (GDM) using propensity score-matched analysis. Findings suggest that the use of ELA decreases the rate of caesarean section and improves maternal and neonatal outcomes in nulliparous women with GDM.

COVID-19 booster dose induces robust antibody response in pregnant, lactating, and nonpregnant women

The study sought to profile the humoral immune response to a COVID-19 mRNA booster dose in a cohort of pregnant, lactating, and age-matched nonpregnant women. These data suggest that receipt of a booster dose during pregnancy induces a robust Spike-specific humoral immune response, including against Omicron. If boosting occurs in the third trimester, higher Spike-specific cord IgG1 levels are achieved with greater time elapsed between receipt of the booster and delivery. Receipt of a booster dose has the potential to augment maternal and neonatal immunity.

Effect of an Intensive Nurse Home Visiting Program on Adverse Birth Outcomes in a Medicaid-Eligible Population: A Randomized Clinical Trial

The objective of this study was to determine the effect of an intensive nurse home visiting program on a composite outcome of preterm birth, low birth weight, small for gestational age, or perinatal mortality. In this South Carolina–based trial of Medicaid-eligible pregnant individuals, assignment to participate in an intensive nurse home visiting program did not significantly reduce the incidence of a composite of adverse birth outcomes. Evaluation of the overall effectiveness of this program is incomplete, pending assessment of early childhood and birth spacing outcomes.

Changes in cesarean section rates after introduction of a punitive financial policy in Georgia: A population-based registry study 2017-2019

The aim of this study was to assess the impact of this policy on cesarean section rates, subgroups of women, and selected perinatal outcomes. The cesarean section rate in Georgia decreased during the 2-year post-policy period. The reduction mainly took place among primiparous women. The policy had no impact on the neonatal intensive care unit transfer rate or the perinatal mortality rate. The impact of the national cesarean section reduction policy on other outcomes is not known.

Geographical accessibility of emergency neonatal care services in Ethiopia: analysis using the 2016 Ethiopian Emergency Obstetric and Neonatal Care Survey

The objective of this study was to analyse the physical accessibility of emergency neonatal care (EmNeC) services at the national and subnational levels in Ethiopia. Findings suggest that the physical access to EmNeC services in Ethiopia is well below the universal health coverage expectations stated by the United Nations. Increasing the availability of EmNeC to health facilities where routine delivery services currently are taking place would significantly increase physical access. Our results reinforce the need to revise service allocations across administrative regions and consider improving disadvantaged areas in future health service planning.

The association between asthma and perinatal mental illness: a population-based cohort study

The authors studied the association between asthma and perinatal mental illness and explored the modifying effects of social and medical complexities. Findings suggest that women with asthma predating pregnancy are at slightly increased risk of mental illness in pregnancy and post-partum. A multidisciplinary management strategy may be required to ensure timely identification and treatment.

Mendelian randomization study of maternal coffee consumption and its influence on birthweight, stillbirth, miscarriage, gestational age and pre-term birth

The authors investigated whether there is a causal relationship between coffee consumption and miscarriage, stillbirth, birthweight, gestational age and pre-term birth using Mendelian randomization (MR). Results suggest that coffee consumption during pregnancy might not itself contribute to adverse outcomes such as stillbirth, sporadic miscarriages and pre-term birth or lower gestational age or birthweight of the offspring.

Sex inequality in early initiation of breastfeeding in 24 sub-Saharan African countries: A multi-country analysis of Demographic and Health Surveys

Data from Demographic and Health Surveys conducted in 24 sub-Saharan African countries between January 2010 and December 2019 were pooled and analysed for sex inequality in early breastfeeding initiation in sub-Saharan Africa. The study found higher odds for early breastfeeding initiation of female children compared to male children in sub-Saharan Africa. To reduce breastfeeding initiation inequalities, programmes that educate and encourage early initiation of breastfeeding irrespective of the child sex should be promoted among mothers.

Knowledge, attitudes, and practices of pregnant women regarding COVID-19 vaccination in pregnancy in 7 low- and middle-income countries: An observational trial from the Global Network for Women and Ch

The objective of the study was to determine the knowledge, attitudes and practices of pregnant women regarding COVID-19 vaccination in pregnancy in seven low- and middle-income countries (LMIC). COVID-19 vaccine questionnaires were administered to pregnant women in the Global Network's Maternal Newborn Health Registry from February 2021 through November 2021 in face-to-face interviews.This COVID-19 vaccine survey in seven LMICs found that knowledge about the effectiveness and safety of the vaccine was generally low but varied. Concerns about vaccine safety and effectiveness among pregnant women is an important target for educational efforts to increase vaccination rates. 

School Age Children Health and Nutrition Survey (SCANS)-Sindh and Punjab, Pakistan

The Aga Khan Universitys' Institute for Global Health and Development, in collaboartion with the Health Department, Government of Sindh; Policy and Strategic Planning Unit, Government of Punjab; Trust for Vaccine and Immunisation (TVI); and Mother and Child Care Research (MccR) conducted a large scale survey in the provinces of Sndh and Punjab, to assess the health, nutrition, and lifestyle of school-aged children 5 to 9.9 years of age. The study also assessed the association of health and nutritional status with sociodemographic factors (wealth, food insecurity, maternal education and gender), setting (rural vs. urban), in-school vs. out-of-school, and child health (anemia, nutrition status and dietary intake). This survey highlights the burden of malnutrition, dietary and meal patterns, sanitation and hygiene practices, schooling in children living in urban and rural areas of the two provinces in Pakistan. It suggests implementation of large integrated programs to improve health and nutrition outcomes among children, especially who live in the rural areas of Sindh and Punjab. It also suggests need of interventions to improve school attendance and quality education and the development of a comprehensive school health and nutrition program focusing on multitude of issues and including life skills development, health and nutrition education and optimum lifestyle and education behaviors

Association of COVID-19 Vaccination in Pregnancy With Adverse Peripartum Outcomes

The objective of this study was to evaluate peripartum outcomes following COVID-19 vaccination during pregnancy. In this population-based cohort study in Ontario, Canada, COVID-19 vaccination during pregnancy, compared with vaccination after pregnancy and with no vaccination, was not significantly associated with increased risk of adverse peripartum outcomes. Study interpretation should consider that the vaccinations received during pregnancy were primarily mRNA vaccines administered in the second and third trimester.

The relationship between obstetrical interventions and the increase in U.S. preterm births, 2014-2019

This observational study analyzed 2014-2019 US birth data to assess changes in preterm birth, cesarean delivery, induction of labor, and associated risks. Findings suggest that a renewed effort to understand the trends in preterm interventions is needed to ensure that obstetrical interventions are evidence-based and are limited to those cases where they optimize outcomes for both mothers and babies.

Association of SARS-CoV-2 Vaccination During Pregnancy With Pregnancy Outcomes

The objective of this stuyd was to examine the risk of adverse pregnancy outcomes after vaccination against SARS-CoV-2 during pregnancy. Findings suggets that in this population-based study conducted in Sweden and Norway, vaccination against SARS-CoV-2 during pregnancy, compared with no SARS-CoV-2 vaccination during pregnancy, was not significantly associated with an increased risk of adverse pregnancy outcomes. The majority of the vaccinations were with mRNA vaccines during the second and third trimesters of pregnancy, which should be considered in interpreting the findings.

Exposure to oil pollution and maternal outcomes: The Niger Delta prospective cohort study

This study was designed to determine the effect of maternal exposure to oil pollution on maternal outcomes in the Niger Delta region of Nigeria. Findings suggest that women in high exposure areas are at a higher risk of PROM and PPH. This calls for policies and intervention toward reducing maternal exposure to oil pollution in the Niger Delta region of Nigeria.

Maternity Care Practices and Breastfeeding Intentions at One Month Among Low-Income Women

Maternity care practices have been linked with higher chances of meeting breastfeeding intentions, but this relationship has not been examined using national data on US low-income women enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). Using data from the WIC Infant and Toddler Feeding Practices Study-2 on 1080 women who intended to breastfeed, we estimated risk ratios for associations between (1) each of 6 maternity care practices supportive of breastfeeding (breastfeeding within 1 hour of birth, showing mothers how to breastfeed, giving only breast milk, rooming-in, breastfeeding on demand, no pacifiers), (2) each practice adjusted for all other practices, and (3) total number of practices experienced with whether women met their intention to feed only breast milk at 1 month old. Models were adjusted for demographics. Findings suggest that women who experienced maternity care practices supportive of breastfeeding were more likely to meet their prenatal breastfeeding intentions, underscoring the importance of breastfeeding support during the birth hospitalization in enabling mothers to achieve their breastfeeding goals.

Understanding ethnic inequalities in stillbirth rates: a UK population-based cohort study

The objective of this study was to investigate inequalities in stillbirth rates by ethnicity to facilitate development of initiatives to target those at highest risk. Findings suggest that stillbirth rates declined in the UK, but substantial excess risk of stillbirth persists among babies of black and Asian ethnicities. The combined disadvantage for black, Pakistani and Bangladeshi ethnicities who are more likely to live in most deprived areas is associated with considerably higher rates. Key causes of death were congenital anomalies and placental causes. Improved strategies for investigation of stillbirth causes are needed to reduce unexplained deaths so that interventions can be targeted to reduce stillbirths.

Effectiveness of Maternal Vaccination with mRNA COVID-19 Vaccine During Pregnancy Against COVID-19-Associated Hospitalization in Infants Aged <6 Months - 17 States, July 2021-January 2022

COVID-19 vaccination is recommended for persons who are pregnant, breastfeeding, trying to get pregnant now, or who might become pregnant in the future, to protect them from COVID-19. Completion of a 2-dose mRNA COVID-19 vaccination series during pregnancy might help prevent COVID-19 hospitalization among infants aged <6 months.

Interventions to prevent spontaneous preterm birth in women with singleton pregnancy who are at high risk: systematic review and network meta-analysis

The objective of this review was to compare the efficacy of bed rest, cervical cerclage (McDonald, Shirodkar, or unspecified type of cerclage), cervical pessary, fish oils or omega fatty acids, nutritional supplements (zinc), progesterone (intramuscular, oral, or vaginal), prophylactic antibiotics, prophylactic tocolytics, combinations of interventions, placebo or no treatment (control) to prevent spontaneous preterm birth in women with a singleton pregnancy and a history of spontaneous preterm birth or short cervical length. Findings suggest that vaginal progesterone should be considered the preventative treatment of choice for women with singleton pregnancy identified to be at risk of spontaneous preterm birth because of a history of spontaneous preterm birth or short cervical length. Future randomised controlled trials should use vaginal progesterone as a comparator to identify better treatments or combination treatments.

Child Protection Intervention and the Sexual and Reproductive Health of Female Adolescents Ages 13 to 17 Years

The objective of this study was to assess whether different forms of Child Protection Services (CPS) intervention are associated with sexual and reproductive health outcomes among female adolescents investigated by CPS for suspected exposure to maltreatment during childhood. This cohort study found that maltreated girls face increased risks of adverse sexual health outcomes in adolescence, but CPS interventions were associated with limited influence. More effective interventions are needed to help maltreated girls avoid teen pregnancy, sexually transmitted infections, and risky sexual behaviors in adolescence.