Articles

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.

Association of SARS-CoV-2 Infection With Serious Maternal Morbidity and Mortality From Obstetric Complications

The objective of the study is to evaluate the association of SARS-CoV-2 infection with serious maternal morbidity or mortality from common obstetric complications. Findings suggets that among pregnant and postpartum individuals at 17 US hospitals, SARS-CoV-2 infection was associated with an increased risk for a composite outcome of maternal mortality or serious morbidity from obstetric complications.

Association of Discrimination and Health Care Experiences With Incomplete Infant Vaccination During COVID-19

This observational analysis explores how the COVID-19 pandemic contributed to a decrease in infant vaccinations.

Association of BNT162b2 COVID-19 Vaccination During Pregnancy With Neonatal and Early Infant Outcomes

The objective of this stuyd was to examine whether BNT162b2 mRNA vaccination during pregnancy is associated with adverse neonatal and early infant outcomes among the newborns. This large population-based study found no evident differences between newborns of women who received BNT162b2 mRNA vaccination during pregnancy, vs those of women who were not vaccinated, and contributes to current evidence in establishing the safety of prenatal vaccine exposure to the newborns. Interpretation of study findings is limited by the observational design.

Prenatal Exposure to Air Pollution and Autism Spectrum Disorder: Sensitive Windows of Exposure and Sex Differences

The study identified sensitive windows of exposure to regional air pollution and risk of autism spectrum disorder (ASD) and examined sex differences in a large birth cohort. Findings suggest that exposures to PM2.5 in the first two gestational trimesters were associated with increased ASD risk in children, with stronger associations observed for boys. The role of O3 exposure on ASD risk merits further investigation.

A prospective cohort study of COVID-19 vaccination, SARS-CoV-2 infection, and fertility

This study examined the associations of COVID-19 vaccination and SARS-CoV-2 infection with fertility among couples trying to conceive spontaneously using data from an internet-based preconception cohort study. Findings indicate that male SARS-CoV-2 infection may be associated with a short-term decline in fertility and that COVID-19 vaccination does not impair fertility in either partner.

Exploring association between place of delivery and newborn care with early-neonatal mortality in Bangladesh

The purpose of this study is to explore the association between place of delivery and newborn care with early neonatal mortality (ENNM), which represents more than 80% of total neonatal mortality in Bangladesh. Study findings highlight the importance of newborn and postnatal care in preventing early neonatal deaths. Further, findings suggest that increasing the proportion of women who give birth in a healthcare facility is not sufficient to reduce ENNM by itself; to realize the theoretical potential of facility delivery to avert neonatal deaths, we must also ensure quality of care during delivery, guarantee all components of ENC, and provide high-quality early PNC. Therefore, sustained efforts to expand access to high-quality ENC and PNC are needed in health facilities, particularly in facilities serving low-income populations.

Disparities in use of skilled birth attendants and neonatal mortality rate in Guinea over two decades

This study investigated the magnitude and trends in socioeconomic and geographic-related inequalities in Skilled Birth Attendance (SBA) in Guinea from 1999 to 2016 and neonatal mortality rate (NMR) between 1999 and 2012. Findings suggest that disproportionate inequalities in SBA and NMR exist among disadvantaged women such as the poor, uneducated, rural residents, and women from regions like Mamou region. Hence, empowering women through education and economic resources, as well as prioritizing SBA for these disadvantaged groups could be key steps toward ensuring equitable SBA, reduction of NMR and advancing the health equity agenda of "no one left behind."

Association of Birth During the COVID-19 Pandemic With Neurodevelopmental Status at 6 Months in Infants With and Without In Utero Exposure to Maternal SARS-CoV-2 Infection

The objective of this study was to examine the associations between maternal SARS-CoV-2 infection during pregnancy, being born during the COVID-19 pandemic regardless of maternal SARS-CoV-2 status, and neurodevelopment at age 6 months. In this study, birth during the pandemic, but not in utero exposure to maternal SARS-CoV-2 infection, was associated with differences in neurodevelopment at age 6 months. These early findings support the need for long-term monitoring of children born during the COVID-19 pandemic.

Receipt of COVID-19 Vaccine During Pregnancy and Preterm or Small-for-Gestational-Age at Birth - Eight Integrated Health Care Organizations, United States, December 15, 2020-July 22, 2021

To reduce the risk for severe COVID-19-associated illness, CDC recommends COVID-19 vaccination for women who are pregnant, recently pregnant (including those who are lactating), who are trying to become pregnant now, or who might become pregnant in the future.

Adverse pregnancy outcomes attributable to socioeconomic and ethnic inequalities in England: a national cohort study

The study aimed to quantify the magnitude of socioeconomic and ethnic inequalities at the population level in England. Results indicate that socioeconomic and ethnic inequalities were responsible for a substantial proportion of stillbirths, preterm births, and births with FGR in England. The largest inequalities were seen in Black and South Asian women in the most socioeconomically deprived quintile. Prevention should target the entire population as well as specific minority ethnic groups at high risk of adverse pregnancy outcomes, to address risk factors and wider determinants of health.