Articles

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.

Depression in the Postpartum Year and Life Course Economic Trajectories

This study aims to assess the relationship between perinatal depression and long-term economic outcomes. Findings suggest that supporting perinatal mental health is crucial for strengthening the economic well-being of childbearing individuals and reducing the impact of maternal depression on intergenerational transmission of adversity.

Changes in neonatal admissions, care processes and outcomes in England and Wales during the COVID-19 pandemic: a whole population cohort study

The COVID-19 pandemic instigated multiple societal and healthcare interventions with potential to affect perinatal practice. The evaluated population-level changes in preterm and full-term admissions to neonatal units, care processes and outcomes. Findings indicate substantial changes occurred in care pathways and clinical thresholds, with disproportionate effects on black ethnic groups, during the immediate COVID-19 period, and raise the intriguing possibility that non-healthcare interventions may reduce extremely preterm births.

Perinatal and postpartum care during the COVID-19 pandemic: A nationwide cohort study

This study aimed to analyze perinatal outcomes and adverse events during the COVID-19 pandemic's first wave to help direct decision making in future waves. Findings suggest that perinatal and postpartum care during the first wave of the COVID-19 pandemic differed significantly from that provided before. Increased rates of adverse events underline the need to ensure access to high-quality obstetric care to prevent collateral damage.

Association between newborn separation, maternal consent and health outcomes: findings from a longitudinal survey in Kenya

Disrespectful and poor treatment of newborns such as unnecessary separation from parents or failure to obtain parental consent for medical procedures occurs at health facilities across contexts, but little research has investigated the prevalence, risk factors or associated outcomes. This study examined these experiences and associations with healthcare satisfaction, use and breast feeding. Newborns, mothers and families have a right to high-quality, respectful care, including the ability to stay together, be informed and properly consent for care. The implications of these experiences on health outcomes a month or more after discharge illustrate the importance of a positive experience of postnatal care.

Associations Between Maternal Depression, Antidepressant Use During Pregnancy, and Adverse Pregnancy Outcomes: An Individual Participant Data Meta-analysis

The objective of the study is to evaluate the associations of depressive symptoms and antidepressant use during pregnancy with the risks of preterm birth, low birth weight, small for gestational age (SGA), and low Apgar scores. Findings suggest that the depressive symptoms or a clinical diagnosis of depression during pregnancy are associated with preterm birth and low Apgar scores, even without exposure to antidepressants. However, SSRIs may be independently associated with preterm birth and low Apgar scores.

Hospital Quality of Care and Racial and Ethnic Disparities in Unexpected Newborn Complications

The objective was to investigate racial and ethnic differences in unexpected, term newborn morbidity and the influence of hospital quality on disparities. Findings suggest that Black and Hispanic women were more likely to deliver in hospitals with high complication rates than were white or Asian American women. Findings implicate hospital quality in contributing to preventable newborn health disparities among low-risk, term births. Quality improvement targeting routine obstetric and neonatal care is critical for equity in perinatal outcomes. 

Birth outcomes across the spectrum of maternal age: dissecting aging effect versus confounding by social and medical determinants

Given the trend of increasing maternal age and associated adverse reproductive outcomes in the US, this study aimed to assess whether this association is due to an independent aging or confounded by sociodemographic, biomedical, or behavioral determinants in a predominantly Black US population.  In this high-risk minority population, findings demonstrated that the association between increasing maternal age and adverse pregnancy outcomes was due to an independent aging effect and the presence of confounding by sociodemographic, biomedical, and behavioral factors. Some modifiable risk factors to counteract aging effect, include optimizing BMI and consistent intake of multivitamin supplement. A fundamental change in how care is provided to women, particularly low income Black women, is needed with emphasis on the protective role of optimal nutritional status.