Abortion Mortality Research Articles

Study of Immune Response in Infants of Non-Gestational Diabetic Mothers

Background Infants of diabetic mothers (IDMs) have significantly greater risk for spontaneous abortion, stillbirth, congenital malformations and perinatal mortality and morbidity but whether maternal DM affects the neonatal innate immune system is unknown. We aimed to assess the immune response of infants of diabetic mothers (IDMs) with non-gestational DM for Hepatitis B vaccine and to compare them with those of healthy mothers. Materials and Methods At a prospective case control study in Minia University Hospital for Children, 150 neonates were included in this study; divided into 2 groups, Group I included 75 infants of diabetic mothers (IDMs) and Group II: Included 75 apparently healthy infants of apparently healthy mothers. These neonates received Hepatitis B virus vaccine during the first 24 hours of age and at 1 and 6 months of age, Hepatitis B virus surface antibodies, Hepatitis B virus envelope antibody (HBe Abs), and Hepatitis B core antibody (HBc Abs) were measured at 9 and 12 months of age. Results Results showed that at 9 months of age, Hepatitis B surface antibodies (HBs Abs) titers were significantly higher in healthy neonates compared to IDMs group (p <0.001); while at 12 months of age they were comparable (p=0.118). Negative correlation between HBs antibodies levels at 9 months and Aspartate Aminotransferase (AST), Alanine Transferase (ALT), Glycated Hemoglobin (HbA1c) and the duration of maternal diabetes (p <0.001). Conclusion According to the results, delayed immune response for hepatitis B vaccine was present in infants of non-gestational diabetic mothers compared to healthy neonates reflecting the effect of diabetes on the immune response of IDMs. They became immune at 12 months of age while normal healthy neonates became immune at earlier age.

Risk Factors Associated with Mother-to-Child Transmission of HIV-1, Spontaneous Abortion and Infant Mortality in HIV-1 Infected Women in Burkina Faso: A Prospective Study

Background: Despite efforts to fight, HIV/AIDS mother-to-child transmission of HIV-1 (MTCT), as well as abortion and infant mortality, remains a problem in sub-Saharan Africa. Indeed, a low level of CD4 and a high viral load can be associated with these situations. The aim of this study was to determine the risk factors associated with the occurrence of MTCT, spontaneous abortion and infant mortality in HIV-1 infected women in Ouagadougou, Burkina Faso. This was a prospective study conducted from May 2014 to September 2017 and involved 423 HIV-1 infected women followed at Saint Camille Hospital in Ouagadougou, Burkina Faso. Sociodemographic data were collected through a questionnaire. The CD4 count and HIV-1 viral load were determined using respectively BD FACSCount and Abbott m2000rt instruments. Bivariate analysis and multinomial logistic regression were performed for associations with a significance threshold for p < 0.05. Results: The average age of women was 38.75 ± 7.98 years. Rates of MTCT, abortion and infant mortality were 16.31%, 30.49% and 34.75%, respectively. The number of pregnancies was associated with the number of infant deaths (p = 0.002). A correlation between the number of pregnancies and infant mortality was observed (p = 0.002) with a relatively high rate (28.6%) among women who had three pregnancies. In addition, marital status was associated with HIV-1 infection in infants (p = 0.042) and spontaneous abortion (p = 0.033). HIV-1 infected women with low CD4 counts (less than 350 cells/μL) and those with viral load more than 1000 copies/mL were about twice as likely to have an spontaneous abortion [OR (IC 95%): 2.50 (1.085 - 5.760); p = 0.03] and [OR (95% CI): 2.16 (1.043 - 4.505); p = 0.04]. Conclusions: The results of this study show the need to improve the treatment of HIV-1 infected women in order to restore CD4 levels and make viral load of HIV-1 undetectable.

Early and Forced Child Marriages in Rural Western Nepal

After reviewing the state of early and forced child marriage (ECM) globally and nationally within Nepal, this research assessed the determinants, consequences and preventive measures of ECM in rural municipalities in Nepal today. This mixed method surveyed 167 households taking 15 % sample from the clusters of three wards of Badhaiyatal Rural Municipality in Bardiya and Dullu Municipality in Dailekh of Western Nepal. Besides household survey, six Focus Group Discussions (FGDs), 16 Key Informant's Interviews (KIIs), and 12 In-depth-Interviews (IDIs) were also conducted. There was the prevalence of ECM in 94% of the total sampled households. Majority (64%) of the marriages had taken place at the age of 15-19 years. Besides, about 23% of the marriage had occurred at 10-14 years. Average age at marriage was 16.5 years. Lack of awareness, self-elopement, misuse of social media, and parents’ perception of daughters as burden were some contributing factors of ECM. Unsafe sexual behavior, unwanted pregnancy and its risk to unsafe abortion, maternal and child mortality, deprivation of education and self- dependence and violence were some effects of ECM. Recommendations to address ECM and curb its negative effects are presented.

Contraceptive preferences and unmet need for contraception in midlife women: where are the data?

This commentary discusses the limited availability of information on contraceptive preferences and unmet need for contraception among midlife women in both high and low income countries. Given that risk of pregnancy continues until women reach menopause and given the increased risk of pregnancy complications, elective abortion, and maternal mortality in women aged 45 to 54 years old, increased focus on gathering basic data on midlife women’s preferences and unmet need is warranted.

Caprine brucellosis: A historically neglected disease with significant impact on public health.

Caprine brucellosis is a chronic infectious disease caused by the gram-negative cocci-bacillus Brucella melitensis. Middle- to late-term abortion, stillbirths, and the delivery of weak offspring are the characteristic clinical signs of the disease that is associated with an extensive negative impact in a flock’s productivity. B. melitensis is also the most virulent Brucella species for humans, responsible for a severely debilitating and disabling illness that results in high morbidity with intermittent fever, chills, sweats, weakness, myalgia, abortion, osteoarticular complications, endocarditis, depression, anorexia, and low mortality. Historical observations indicate that goats have been the hosts of B. melitensis for centuries; but around 1905, the Greek physician Themistokles Zammit was able to build the epidemiological link between “Malta fever” and the consumption of goat milk. While the disease has been successfully managed in most industrialized countries, it remains a significant burden on goat and human health in the Mediterranean region, the Middle East, Central and Southeast Asia (including India and China), sub-Saharan Africa, and certain areas in Latin America, where approximately 3.5 billion people live at risk. In this review, we describe a historical evolution of the disease, highlight the current worldwide distribution, and estimate (by simple formula) the approximate costs of brucellosis outbreaks to meat- and milk-producing farms and the economic losses associated with the disease in humans. Successful control leading to eradication of caprine brucellosis in the developing world will require a coordinated Global One Health approach involving active involvement of human and animal health efforts to enhance public health and improve livestock productivity.

Neospora caninum and Bovine Neosporosis: Current Vaccine Research

Neospora caninum, a tissue cyst-forming parasite, is the causative agent of bovine neosporosis. It is considered to be one of the most important transmissible causes of reproductive failure in cattle; abortion and neonatal mortality result in significant economic losses within the cattle industry worldwide. The balance between acute (mediated by the tachyzoite stage) and persistent (mediated by the bradyzoite stage) phases of the infection is influenced by the immune status of the animal, and for pregnant cows (the intermediate host) immune status is critical for transplacental (i.e. vertical) transmission of the parasite and associated disease outcomes. The horizontal route of transmission from the definitive host, the dog, occurs via ingestion of oocysts containing sporozoites, and plays a minor but important role in transmission of the infection to cattle. Despite the importance of this disease, there is no vaccine or treatment available currently, and at the present the only control measure to reduce the impact of disease is informed management on the farm. The development of vaccines, targeting key biological processes such as invasion and persistent infection, is needed urgently for the control of this widespread parasite.

“I was close to death!”: abortion and medical risk on American television, 2005–2016

ObjectivesTo examine the portrayal of complications and long-term health consequences associated with abortion on television, recognizing the impact that fictional stories can have on public beliefs about abortion's safety. Study designUsing a systematic online search, we identified all instances of abortion on US television from 2005 to 2016. We qualitatively coded these plotlines to identify any occurrences of complications, interventions or long-term health consequences associated with abortion care, with 95% intercoder reliability. We calculated the frequencies and rates of these occurrences in Microsoft Excel. ResultsOur search identified 80 abortion plot lines. A percentage of 37.5 of characters who obtained an abortion experienced complications, interventions and/or negative health consequences. This rate contrasts with the 2.1% of real patients who experience complications or require intervention as a result of their abortions. Most onscreen complications were major events (e.g., hemorrhage), as opposed to real women, whose complications are mostly minor. Major medical interventions (e.g., hysterectomy) were similarly overportrayed, while the most commonly used interventions for real patients (e.g., medication) were not depicted at all. Finally, 22.5% of characters faced a long-term adverse health consequence, including mental illness, infertility or death. The onscreen abortion mortality rate was 5%, about 7000 times the actual mortality rate. ConclusionsOverall, television dramatically exaggerates the risk associated with abortion procedures, overportraying medical complications — particularly major and life-threatening complications — and long-term adverse health consequences. This pattern of misrepresentation may be partially attributable to the occurrence of stories about illegal abortions or abortions taking place outside of modern medical contexts. ImplicationsOnscreen abortion portrayals may contribute to inaccurate beliefs about abortion's risk that are common among the public, broadly, and abortion patients, specifically. Abortion advocates and providers will be more equipped to respond misinformation if they understand how and to what extent our popular culture portrays abortion as unsafe.

Late-Term Abortion, Stillbirth, and Neonatal Foal Death in Kyrgyzstan: First Isolation of Equine Herpesvirus Type 1 in the Country

Late-term abortion, stillbirth, and neonatal foal mortality (commonly referred to as late fetal losses [LFLs]) of unknown etiology are a serious concern for horse farmers and breeders in Kyrgyzstan. Therefore, we investigated major infectious causes of LFL, with a focus on viral agents, for the first time in the horse population in the country. A total of 221 sera and 149 nasal swabs taken from mares in farms with a history of LFL within 1 year of testing as well as tissue samples collected from 17 LFL cases were investigated. Serologic studies revealed that equine herpesvirus type 1 (EHV-1) and type 4 (EHV-4) were prevalent in the population, although positivity rates were low with neutralizing antibody titers of 1:4 to 1:32 (median 1:8) against both pathogens. High antibody titers in the range from 1:32 to 1:512 (median 1:256) against equine arteritis virus (EAV) were detected in mares on a single farm, whereas three mares from different farms tested positive for Dourine. Virus isolation and PCR investigations of nasal swabs did not suggest ongoing active infection with EHV-1, EHV-4, or EAV in the examined mares. Bacteriologic and virological examination of tissue samples taken from LFL cases revealed the presence of Escherichia coli and/or Streptococcus equi (subsp. zooepidemicus) in 35% of neonatal foal death cases, and EHV-1 was isolated from a late-term abortion case representing the first isolation of this important pathogen of horses in the country and, to the best of our knowledge, in Central Asia.

Seroepidemiology of Toxoplasma gondii infection among pregnant women in public hospital in Khoy, Northwest of Iran, 2015–2017

Aims: Toxoplasma gondii is a protozoan parasite and congenital transmission, abortion, and prenatal mortality are major problems of this parasite. This study was carried out to determine the seroprevalence of Toxoplasma infection in the pregnant women, referring to Khoy Public Hospital, Iran, during 2015–2017. Materials and Methods: In this descriptive cross-sectional study, 3 ml of venous blood were taken from 1060 pregnant women and centrifuged; the collected sera were kept in a freezer at -20°C until testing. Then, samples were examined for the presence of IgG and IgM Toxoplasma antibodies using Autobio ELISA kit according to manufacturer's instructions. Data analysis was done using Chi-square test and SPSS-10 software. Results: Among 1060 serum samples of pregnant women, 38.2% were positive for anti-T. gondii antibodies. IgG and IgM titers of antibodies to T. gondii were positive in 36.6% and 1.2% of women, respectively. The incidence in women older than 30 years was 49.3%. The positive rate of IgG of pregnant women increased with age (P < 0.05). In women who were living in the village, the prevalence was 45.5% and in urban women, it was 21.5%; this difference was statistically significant (P < 0.05). Conclusion: The relatively high prevalence of T. gondii infection in this study showed that pregnant women infected with this parasite at an early age and it is important for pregnant women to prevent irreversible complications in neonates.

Effectiveness of traffic-related elements in tree bark and pollen abortion rates for assessing air pollution exposure on respiratory mortality rates

The majority of epidemiological studies correlate the cardiorespiratory effects of air pollution exposure by considering the concentrations of pollutants measured from conventional monitoring networks. The conventional air quality monitoring methods are expensive, and their data are insufficient for providing good spatial resolution. We hypothesized that bioassays using plants could effectively determine pollutant gradients, thus helping to assess the risks associated with air pollution exposure. The study regions were determined from different prevalent respiratory death distributions in the Sao Paulo municipality. Samples of tree flower buds were collected from twelve sites in four regional districts. The genotoxic effects caused by air pollution were tested through a pollen abortion bioassay. Elements derived from vehicular traffic that accumulated in tree barks were determined using energy-dispersive X-ray fluorescence spectrometry (EDXRF). Mortality data were collected from the mortality information program of Sao Paulo City. Principal component analysis (PCA) was applied to the concentrations of elements accumulated in tree barks. Pearson correlation and exponential regression were performed considering the elements, pollen abortion rates and mortality data. PCA identified five factors, of which four represented elements related to vehicular traffic. The elements Al, S, Fe, Mn, Cu, and Zn showed a strong correlation with mortality rates (R2>0.87) and pollen abortion rates (R2>0.82). These results demonstrate that tree barks and pollen abortion rates allow for correlations between vehicular traffic emissions and associated outcomes such as genotoxic effects and mortality data.

Development of a Conceptual Model and Survey Instrument to Measure Conscientious Objection to Abortion Provision.

Background and ObjectiveConscientious objection to abortion, clinicians’ refusal to perform legal abortions because of their religious or moral beliefs, has been the subject of increasing debate among bioethicists, policymakers, and public health advocates in recent years. Conscientious objection policies are intended to balance reproductive rights and clinicians’ beliefs. However, in practice, clinician objection can act as a barrier to abortion access–impinging on reproductive rights, and increasing unsafe abortion and related morbidity and mortality. There is little information about conscientious objection from a medical or public health perspective. A quantitative instrument is needed to assess prevalence of conscientious objection and to provide insight on its practice. This paper describes the development of a survey instrument to measure conscientious objection to abortion provision.MethodsA literature review, and in-depth formative interviews with stakeholders in Colombia were used to develop a conceptual model of conscientious objection. This model led to the development of a survey, which was piloted, and then administered, in Ghana.ResultsThe model posits three domains of conscientious objection that form the basis for the survey instrument: 1) beliefs about abortion and conscientious objection; 2) actions related to conscientious objection and abortion; and 3) self-identification as a conscientious objector.ConclusionsThe instrument is intended to be used to assess prevalence among clinicians trained to provide abortions, and to gain insight on how conscientious objection is practiced in a variety of settings. Its results can inform more effective and appropriate strategies to regulate conscientious objection.

Complications and Outcome of Pregnancy in Extremes of Reproductive Age Groups: Experience at Tertiary Care Center

Background: Pregnant women of extremes of reproductive age group at both ends ( 35 years age) comprise high risk groups. Pregnant women up to 35 years get many complications like diabetes, spontaneous abortion, hypertensive disorders, autosomal trisomies, increased newborn and maternal morbidity and mortality and cesarean sections. Pregnancies of 35 year age group and to compare both the groups. Methods: This retrospective study was done at department of obstetrics and gynaecology, Chatrapati Shahuji Maharaj Medical Uni- versity, Lucknow, from January 2010 to December 2010. Data were collected from institutional logbook and various complications and outcome were studied. Statistical analyses were carried out by using the statistical package for SPSS-15. Results: Present study showed that the definite increased risk of preeclampsia, eclampsia, obstetric cholestasis, twin gestation, anemia, preterm labor, premature rupture of membranes, intrauterine fetal growth restriction, and intrauterine fetal death in ado- lescent pregnancies and increased risk of eclampsia, diabetes, and cesarean sections in advanced age pregnancies. Conclusions: Both adolescent and advanced age groups are high risk pregnancy groups so for best reproductive outcome, preg- nancies at these ages should be very carefully supervised with both good maternal and fetal surveillance to achieve best maternal and fetal results.

Diabetes in Pregnancy: Maternal Profile and Neonatal Outcome

Background: Diabetes in pregnancy is associated with increased risk to the woman and to the developing fetus. Historically, infants born to mother with diabetes (IDM) have significantly greater risk for spontaneous abortion, stillbirth, congenital malformations and perinatal mortality and morbidity.Objective: To evaluate the complications associated with diabetes in pregnancy in the periconceptional, fetal, neonatal and postnatal period.Materials and method: This observational study was carried out in the department of Obstetrics &amp; Gynaecology of Bangladesh Institute of Research &amp; Rehabilitation in Diabetes, Endocrine &amp; Metabolic Disorders (BIRDEM), Dhaka, Bangladesh, from July 2013 to December 2013. Data of 100 patients with pregestational diabetes mellitus (PGDM) and gestational diabetes mellitus (GDM) delivering live baby after 37 completed weeks were evaluated during the period. They were divided into two groups: patients with PGDM in group-A and patients with GDM in group-B.Results: Majority of the PGDM patients were in 31-35 years age group whereas 50% of the GDM patients were from younger group (26-30). A major proportion of the patients of both the groups required Caesarean section with a higher rate in group-A. Diabetic mothers had more macrosomic babies than GDM mothers (14% vs 4%). Most commonly found neonatal complications were hyperbilirubinaemia followed by RDS and hypoglycaemia in both the groups with a higher proportion in PGDM group.Conclusion: Almost similar maternal and neonatal complications were observed in both PGDM and GDM group in our study despite of integrated antenatal, intranatal and perinatal care with a higher proportion in PGDM patients.Delta Med Col J. Jul 2016 4(2): 83-88

Survey of reproduction and calf rearing in Asian and African elephants in European zoos

Acyclicity, conception failure, abortion, stillbirth, dystocia, infanticide and neonatal mortality have all been reported as causes of reproductive failure in zoo elephants. These events are often reported as single case reports or in specific studies focused on a particular stage in the reproductive process. In North America wider surveys of reproduction in the zoo elephant population have been completed and repeated to provide data over a number of years. This study is the largest and most comprehensive study of reproduction in the European zoo elephant population to date. Two questionnaires collected data from throughout the reproductive process from assessing cyclicity to independence of the calf at 5 years old. Information was collected regarding 189 birth events. Many causative and contributing factors such as obesity, infectious disease, husbandry, facilities, stress, behaviour, herd size and social grouping have been proposed. The importance of these was assessed and where possible association identified using statistical analysis. In African elephants, this study found that age, obesity, reproductive pathology and dominance, identified as important risk factors for failure to conceive in the American zoo elephant population were of low importance. The most significant cause in Europe was lack of access to a compatible bull. In Asian elephants reproductive failure was much less common but when it did occur age and reproductive pathologies were significant factors as found in previous studies. Previous studies have found that age, obesity and infanticide were considered as the most important risk factors in the period from birth to rearing. In this survey it was found that herd stability and compatibility, allomothering or maternal experience and management at parturition can significantly influence reproductive success. Elephant Endotheliotropic Herpes virus was confirmed as the biggest cause of calf mortality. This work provides evidence to support changes to elephant management in European zoos in order to encourage development of social and affiliative herd behaviours and improve reproductive success.

Disparities in Abortion Experience and Access to Safe Abortion Services in Ghana: Evidence from a Retrospective Survey.

In Ghana, abortion mortality constitutes 11% of maternal mortality. Empirical studies on possible disparities in abortion experience and access to safe abortion services are however lacking. Based on a retrospective survey of 1,370 women aged 15-49 years in two districts in Ghana, this paper examines disparities in women's experiences of abortion and access to safe abortion care. Disparities in rates of abortion experience and access to safe abortion care were assessed using absolute (the difference in rates between groups), relative (the ratio of rates between selected and reference groups), and mean measures. Results suggest that 24% of women had at least one abortion in the five years preceding the survey. However, large gradients of socio-spatial disparities in abortion experience exist. The majority of abortions were also potentially unsafe: 53% of abortions occurred outside of any healthcare facility. Women themselves and medical doctors, respectively, performed 57% and 4% of all abortions. The majority of women also felt they could not get safe abortion even if they wanted one. Together, these results highlight the need for concerted multi-sectorial strategies, including legislative reform and provision of family planning services, to help transition from unsafe to safe abortions.

Experimental Infection of Calves by Two Genetically-Distinct Strains of Rift Valley Fever Virus

Recent outbreaks of Rift Valley fever in ruminant livestock, characterized by mass abortion and high mortality rates in neonates, have raised international interest in improving vaccine control strategies. Previously, we developed a reliable challenge model for sheep that improves the evaluation of existing and novel vaccines in sheep. This sheep model demonstrated differences in the pathogenesis of Rift Valley fever virus (RVFV) infection between two genetically-distinct wild-type strains of the virus, Saudi Arabia 2001 (SA01) and Kenya 2006 (Ken06). Here, we evaluated the pathogenicity of these two RVFV strains in mixed breed beef calves. There was a transient increase in rectal temperatures with both virus strains, but this clinical sign was less consistent than previously reported with sheep. Three of the five Ken06-infected animals had an early-onset viremia, one day post-infection (dpi), with viremia lasting at least three days. The same number of SA01-infected animals developed viremia at 2 dpi, but it only persisted through 3 dpi in one animal. The average virus titer for the SA01-infected calves was 1.6 logs less than for the Ken06-infected calves. Calves, inoculated with either strain, seroconverted by 5 dpi and showed time-dependent increases in their virus-neutralizing antibody titers. Consistent with the results obtained in the previous sheep study, elevated liver enzyme levels, more severe liver pathology and higher virus titers occurred with the Ken06 strain as compared to the SA01 strain. These results demonstrate the establishment of a virulent challenge model for vaccine evaluation in calves.

Reproductive justice & preventable deaths: State funding, family planning, abortion, and infant mortality, US 1980–2010

IntroductionLittle current research examines associations between infant mortality and US states’ funding for family planning services and for abortion, despite growing efforts to restrict reproductive rights and services and documented associations between unintended pregnancy and infant mortality. Material and methodsWe obtained publicly available data on state-only public funding for family planning and abortion services (years available: 1980, 1987, 1994, 2001, 2006, and 2010) and corresponding annual data on US county infant death rates. We modeled the funding as both fraction of state expenditures and per capita spending (per woman, age 15–44). State-level covariates comprised: Title X and Medicaid per capita funding, fertility rate, and percent of counties with no abortion services; county-level covariates were: median family income, and percent: black infants, adults without a high school education, urban, and female labor force participation. We used Possion log-linear models for: (1) repeat cross-sectional analyses, with random state and county effects; and (2) panel analysis, with fixed state effects. ResultsFour findings were robust to analytic approach. First, since 2000, the rate ratio for infant death comparing states in the top funding quartile vs. no funding for abortion services ranged (in models including all covariates) between 0.94 and 0.98 (95% confidence intervals excluding 1, except for the 2001 cross-sectional analysis, whose upper bound equaled 1), yielding an average 15% reduction in risk (range: 8–22%). Second, a similar risk reduction for state per capita funding for family planning services occurred in 1994. Third, the excess risk associated with lower county income increased over time, and fourth, remained persistently high for counties with a high percent of black infants. ConclusionsInsofar as reducing infant mortality is a government priority, our data underscore the need, despite heightened contention, for adequate public funding for abortion services and for redressing health inequities.

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Introduction: Syphilis has represented a major challenge to public health in Brazil for its prevalence and serious perinatal sequel. Objectives: To know the prevalence of syphilis infection and the occurrence of abortion in pregnant women, by age and spatial distribution in the state of Sergipe. Methodology: This is a cross sectional descriptive study, retrospective in which were analyzed 39.807 entries of users of the Program for the Protection of Pregnant women (PPP) in 73 municipalities of the state of Sergipe in a period of approximately two years. Results: We screened 39.807 pregnant women, these 7.538 (18,9%) said they have aborted, 544 (1,37%) had syphilis positive and 192 (0,48%) pregnant women had syphilis positive and abortion declared. The proportion rose from 25,7% in the number of women who aborted and had any type of change to 35,3% in women who aborted and confirmed positive syphilis, an increase of 1,37 in the number of cases. The municipality of Carmopolis had the highest percentage of cases 2,19%, followed by Malhador 1,30%, Malhada dos Bois 1,16%, Estância 1,15%, Barra dos Coqueiros 1,14%, Santa Luzia do Itanhy 1,04% e Pedrinhas 1%. Conclusion: It was found that was high the registration of abortions in pregnant women in the most part of the municipalities. The rates of prevalence and incidence of syphilis were higher than those accepted by OMS. Through the PPP can be verified that syphilis may be an associated factor to the occurrence of high incidence of abortion and perinatal morbidity and mortality in the state of Sergipe in Brazil.

Abortion and Infant Mortality on the First Day of Life

Background: Fetal imaging for congenital anomalies increases pregnancy terminations late in gestation. Objectives: We assessed whether late-pregnancy terminations can accidentally result in live births, and how these births impact infant mortality rates over time. Methods: We carried out a population-level analysis of 12,141 infant deaths in Quebec, Canada from 1986 to 2012. We calculated the proportion of infants born alive who died following pregnancy termination. The exposure was pregnancy termination with or without congenital anomaly recorded on death certificates. The main outcome was mortality on the first day of life by the hour. Results: Pregnancy termination was the cause of 19.4 infant deaths per 100,000 in 2000-2012, compared with 1.0 per 100,000 in 1986-1999. Most deaths after termination occurred in the first 3 h of life among infants with anomalies who weighed <500 g. In 2000-2012, infants who died following pregnancy termination led to an excess of 0.2 deaths per 1,000 on the first day of life, i.e. an 8.6% increase in the infant mortality rate (p value = 0.002). Conclusions: Pregnancy termination in mid-gestation carries the risk of accidental live birth. These neonates increasingly affect infant mortality rates. Better recording is needed, including data on the prevention and management of accidental live births after pregnancy termination.

Development of a sheep challenge model for Rift Valley fever

Rift Valley fever (RVF) is a zoonotic disease that causes severe epizootics in ruminants, characterized by mass abortion and high mortality rates in younger animals. The development of a reliable challenge model is an important prerequisite for evaluation of existing and novel vaccines. A study aimed at comparing the pathogenesis of RVF virus infection in US sheep using two genetically different wild type strains of the virus (SA01-1322 and Kenya-128B-15) was performed. A group of sheep was inoculated with both strains and all infected sheep manifested early-onset viremia accompanied by a transient increase in temperatures. The Kenya-128B-15 strain manifested higher virulence compared to SA01-1322 by inducing more severe liver damage, and longer and higher viremia. Genome sequence analysis revealed sequence variations between the two isolates, which potentially could account for the observed phenotypic differences. We conclude that Kenya-128B-15 sheep infection represents a good and virulent challenge model for RVF.