Maternal Age Research Articles

Does Weathering Explain Low Birth Weight in Uttar Pradesh? Findings From NFHS-5

The present study uses concept of weathering by evaluating maternal age birth and birth-weight associations across caste and religious groups in Indian context under the presumption that that disadvantaged caste and religious groups experience more rapidly deteriorating birth-weight outcomes at older ages than others. Caste and religion stratified average marginal effects of maternal age at birth on low birth-weight are estimated using data from 2015-16 and 2019-21 NFHS Uttar Pradesh data-files. The average marginal effect suggests no evidence of weathering across caste and religious groups in birth-weight patterns by maternal age at birth in Uttar Pradesh.  

Frequency of Placenta Previa among Women with Previous Cesarean-Section

Placenta Previa was defined as when the placenta was attached to the lower uterine segment, poses significant risks, including antepartum hemorrhage and maternal mortality. The incidence was rising, attributed partly to increased cesarean sections and advanced maternal age. Objective: To determine the frequency of placenta Previa among women with previous cesarean-sections. Methods: This cross sectional study was carried out at a Teaching Hospital of Sialkot, from June to December 2021. The sample size was 147 pregnant females. These pregnant females have a history of cesarean section. The non-probability Consecutive sampling technique was used, and data were analyzed by using SPSS version 25.0. Results: Among those, 16.3% had placenta Previa, which increased significantly in women with >2 previous cesarean sections to 26.4% (p = 0.003). Regarding parity, the increase in the risk of placenta Previa was not significant: 12.8% for parity < 3 and 20.3% for parity ≥ 3 (p = 0.087). However, in the stratified analysis by BMI, this became significant: 11.0% for normal-weight, 18.6% for overweight, and 66.7% for obese women (p = 0.001). There was no significant difference concerning age groups, p = 0.177. Such findings of the significant associations of placenta Previa with such factors as BMI and number of cesarean sections indicate that great attention to monitoring should be paid. Conclusion: Hence concluded that previous cesarean sections strongly correlate with placenta previa in subsequent pregnancies. Such findings underscore the need for rigorous monitoring and proactive measures, especially in cases of multiple cesarean deliveries, in the management of associated complications.

A RETROSPECTIVE STUDY OF MATERNAL AND FETAL OUTCOMES IN PLACENTAL ABRUPTION

Introduction:Placental abruption (PA) is a critical obstetrical emergency characterized by the premature separation of a normally implanted placenta, leading to maternal and fetal complications. It is unpredictable, with a sudden onset, often associated with risk factors like advanced maternal age, multiparity, pre-eclampsia, and history of high-risk pregnancy (HRP). Clinically, PA presents with abdominal pain, vaginal bleeding, uterine tenderness, and fetal distress.Patho physiologically, PA occurs when maternal vessels tear away from the placenta, causing a hematoma that disrupts maternal-fetal circulation, leading to hemodynamic instability, coagulation abnormalities, and potential fetal demise. The severity of PA varies, classified from asymptomatic (Class 0) to severe (Class 3), based on clinical symptoms and the extent of placental separation. Management strategies depend on the severity and gestational age, ranging from conservative management in mild cases to urgent delivery in severe cases.PA is associated with significant maternal and fetal morbidity and mortality, including hemorrhage, fetal demise, and potential recurrence in future pregnancies. Prompt recognition and management are essential to improve outcomes. Aim:To study the maternal and perinatal outcomes associated with placental abruption Material and Methods:This retrospective study was conducted on 22 cases of placental abruption in the Department of Obstetrics and Gynecology at MRMC Kalaburagi, covering the period from January 2023 to December 2023. The study exclusively included women diagnosed with placental abruption. Cases involving placenta previa and other extraplacental causes of antepartum hemorrhage were excluded from the analysis. Results:In the retrospective study of 22 cases of placental abruption, the age distribution of patients varied: 2 were 19 years old, 17 were between 21 and 30 years old, and 3 were over 30 years old. Among the women, 45% were primigravida, and 54% were multigravida. Delivery methods were split, with 40.9% undergoing a lower segment caesarean section (LSCS) and 59% delivering vaginally 7 patients required induction. Blood transfusion was necessary for 16 cases, which accounts for 72% of the sample. Couvelaire uterus was observed in 3 cases (13.6%). The study reported one maternal mortality, representing 4.5% of the cases. Conclusion:This study highlights significant maternal and perinatal outcomes associated with placental abruption. The majority of the women were within the 21-30-year age group, with a notable percentage being multigravida. A substantial portion of deliveries required lower segment cesarean section, and many patients underwent blood transfusions, reflecting the severity of the condition. Couvelaire uterus was observed in a notable subset of cases, and maternal mortality was relatively low but significant. These findings underscore the critical need for vigilant management and monitoring of placental abruption cases to improve both maternal and fetal outcomes.

The early prediction of gestational diabetes mellitus by machine learning models

BackgroundWe aimed to determine the best-performing machine learning (ML)-based algorithm for predicting gestational diabetes mellitus (GDM) with sociodemographic and obstetrics features in the pre-conceptional period.MethodsWe collected the data of pregnant women who were admitted to the obstetric clinic in the first trimester. The maternal age, body mass index, gravida, parity, previous birth weight, smoking status, the first-visit venous plasma glucose level, the family history of diabetes mellitus, and the results of an oral glucose tolerance test of the patients were evaluated. The women were categorized into groups based on having and not having a GDM diagnosis and also as being nulliparous or primiparous. 7 common ML algorithms were employed to construct the predictive model.Results97 mothers were included in the study. 19 and 26 nulliparous were with and without GDM, respectively. 29 and 23 primiparous were with and without GDM, respectively. It was found that the greatest feature importance variables were the venous plasma glucose level, maternal BMI, and the family history of diabetes mellitus. The eXtreme Gradient Boosting (XGB) Classifier had the best predictive value for the two models with the accuracy of 66.7% and 72.7%, respectively.DiscussionThe XGB classifier model constructed with maternal sociodemographic findings and the obstetric history could be used as an early prediction model for GDM especially in low-income countries.

Risk Factors and Profile of Congenital Anomalies Abnormalities in Central Morocco

Background: In Morocco, there is no official data on the prevalence of congenital anomalies (CAs). Available data are mostly derived from hospital-based retrospective epidemiological analyses. Objectives: This study aims to describe the prevalence, distribution, and risk factors of CAs in the Beni Mellal-Khenifra region of central Morocco. Methods: Epidemiological data were obtained from delivery files of 163,842 births recorded by local medical services from January 2017 to December 2021. Additionally, a case-control study was conducted to analyze the risk factors. Results: The prevalence of CAs in this study area was 6.18 per thousand births. Musculoskeletal system anomalies were the most common (32.88%), followed by nervous system anomalies (22.20%). Genital organ abnormalities represented 7.37%, and cleft lip and palate accounted for 7.03%. Analysis by type of CA revealed that clubfeet were the most commonly reported anomalies in the study area, with a prevalence of 18%, followed by spina bifida (9%), anencephaly (7%), and cleft lips and palate (7.9%). The sex ratio (males/females) for all CAs was 1.24. Risk factors identified in this study included rural residency, maternal age over 35 years, parity, consanguinity, family history of CA, medication use before and during pregnancy, and infection episodes during pregnancy. Conclusions: The relatively high prevalence of congenital abnormalities in the Beni Mellal-Khenifra region highlights the need for prevention strategies through preconception care counseling and pregnancy monitoring, especially in rural areas. It is urgent to establish a teratovigilance registry in Morocco.

SCM-198 ameliorates the quality of postovulatory and maternally aged oocytes by reducing oxidative stress

Oocyte aging is a key constraint on oocyte quality, leading to fertilization failure and abnormal embryonic development. In addition, it is likely to generate unfavorable assisted reproductive technology (ART) outcomes. SCM-198, a synthetic form of leonurine, was found to rescue the rate of oocyte fragmentation caused by postovulatory aging. Therefore, the aim of this study was to conduct a more in-depth investigation of SCM-198 by exploring its relationship with aged oocytes after ovulation or maternal aging and clarifying whether it affects cell quality. The results indicate that, compared to the postovulatory aged group, the 50 µM SCM-198 group significantly improved sperm-egg binding and increased fertilization of aged oocytes, restoring the spindle apparatus/chromosome structure, cortical granule distribution, and ovastacin and Juno protein distribution. The 50 µM SCM-198 group showed significantly normal mitochondrial distribution, low levels of reactive oxygen species (ROS), and a small quantity of early oocyte apoptosis compared to the postovulatory aged group. Above all, in vivo supplementation with SCM-198 effectively eliminated excess ROS and reduced the spindle/chromosome structural defects in aged mouse oocytes. In summary, these findings indicate that SCM-198 inhibits excessive oxidative stress in oocytes and alters oocyte quality both in vitro and in vivo.Graphical

Hubungan ASI eksklusif dengan kejadian stunting pada balita 6-24 bulan pada tiga kecamatan kasus tertinggi stunting di Kabupaten Jeneponto, Sulawesi Selatan

Background: Stunting is a major issue with toddlers' eating habits, which are frequently linked to malnutrition during these crucial early years of development. The World Health Organization (WHO) defines stunting as a developmental failure characterized by a body length deficit about age, specifically a z-score of less than -2. A persistent problem with public health in some communities is the high rate of stunting. A few elements add to hindering, with selective breastfeeding being a basic determinant. Hindering, or weakened direct development, is a typical wholesome issue among babies that influences long-haul well-being, mental turn of events, and future efficiency. This study looks to evaluate whether selective breastfeeding is a gamble factor for hindering kids between the ages of 6 and two years in the Jeneponto region. Methods: An observational research design with a case-control approach was used. Children aged 6 to 24 months who were recorded in the posyandu (community health post) toddler register across three sub-districts—West Bangkala, Bontoramba, and Rumbia—were chosen for their high stunting rates. Findings: The review uncovered that 39.67% of kids were solely breastfed, while 60.33% were not. Bivariate examination demonstrated a remarkable connection between restrictive breastfeeding and hindering in this age bunch (p = 0.03; OR = 1.74), recommending that non-only breastfed youngsters had a 1.74 times higher gamble of hindering contrasted with the people who were solely breastfed. In any case, multivariate examination, which represented factors, for example, kid age, birth weight, mother's level, and breastfeeding status, uncovered that the connection between restrictive breastfeeding and hindering was as of now not huge (p = 0.49; OR = 1.23). This suggests that when these extra factors are thought of, the gamble of hindering non-solely breastfed youngsters was just 1.23 times higher than in only breastfed kids, a distinction not measurably huge. Conclusion: Although the initial data indicate that not exclusively breastfeeding increases the risk of stunting by 74%, this risk is reduced when other factors like maternal height, child age, birth weight, and overall breastfeeding status are taken into consideration. This demonstrates the complexity of stunting and the need for comprehensive interventions that address breastfeeding practices as well as broader factors affecting the health of mothers and children.

Socioeconomic position during pregnancy and pre-school exposome in children from eight European birth cohort studies

Distribution of environmental hazards and vulnerability to their effects vary across socioeconomic groups. Our objective was to analyse the relationship between child socioeconomic position (SEP) at birth and the external exposome at pre-school age (0–4 years).This study included more than 60,000 children from eight cohorts in eleven European cities (Oslo, Copenhagen, Bristol, Bradford, Rotterdam, Nancy, Poitiers, Gipuzkoa, Sabadell, Valencia and Turin). SEP was measured through maternal education and a standardised indicator of household income. Three child exposome domains were investigated: behavioral, diet and urban environment. We fitted separate logistic regression model for each exposome variable - dichotomised using the city-specific median - on SEP (medium/low vs high) adjusting for maternal age, country of birth and parity. Analyses were carried out separately in each study-area.Low-SEP children had, consistently across study-areas, lower Odds Ratios (ORs) of breastfeeding, consumption of eggs, fish, fruit, vegetables and higher ORs of TV screen time, pet ownership, exposure to second-hand smoke, consumption of dairy, potatoes, sweet beverages, savory biscuits and crisps, fats and carbohydrates. For example, maternal education-breastfeeding OR (95% Confidence Interval (CI)) ranged from 0.18 (0.14–0.24) in Bristol to 0.73 (0.58–0.90) in Oslo. SEP was also strongly associated with the urban environment with marked between-city heterogeneity. For example, income-PM2.5 OR (95%CI) ranged from 0.69 (0.47–1.02) in Sabadell to 2.44 (2.16–2.72) in Oslo.Already at pre-school age, children with lower SEP have consistently poorer diets and behaviours, which might influence their future health and wellbeing. SEP-urban environment relationships are strongly context-dependent.

The Risk Factors for Anemia in Women at Third Trimester of Pregnancy in the Primary Health Center of Tanjung Sekayam: A Case-Control Study

Background: The presence of anemia in pregnant women significantly affects the health of both mothers and their fetuses. Around 37% of pregnant women worldwide experience anemia. In the Community Health Center of Tanjung Sekayam, the prevalence of anemia in women at the third trimester of their pregnancy was notably high, at 50.4%. Objectives: This study aims to identify the risk factors for anemia in women at third trimester of pregnancy in the working area of the Community Health Center of Tanjung Sekayam Subdistrict, Sanggau Regency. Methods: This study was an observational research with a case-control design. The study population consisted of 153 women at third trimester of pregnancy, receiving antenatal care in the Community Health Center of Tanjung Sekayam. The samples included 62 respondents, selected through a simple random sampling, comprising of 31 cases and 31 controls. Data were collected using questionnaires and analyzed with the Chi-Square test to assess the factors associated with the occurrence of anemia. Results: There was a relation among maternal age (p=0.000; OR=22.9), interpregnancy interval (p=0.024; OR=6.9), parity (p=0.011; OR=2.2), nutritional status (chronic energy deficiency) (p=0.000; OR=11.3), compliance (p=0.021; OR=3.9), and knowledge (p=0.001; OR=8.2) and the prevalence of anemia in the third trimester. However, the family support did not show any significant relation. Conclusions: Maternal age, pregnancy interval, parity, nutritional status, compliance with iron tablet intake, and knowledge are related to the prevalence of anemia in third trimester of pregnancy. Family support did not show any significant relation with the incidence of anemia, possibly due to the limitations in measuring the family support itself and other factors, such as discomfort in consuming iron tablets and forgetfulness. More structured interventions and intensive education on the importance of iron and nutrition during the pregnancy are needed to reduce the risk of anemia.

Determinants of Risk Factors Associated with Low Birth Weight in Nigeria

Low birth weight (LBW) remains a significant public health challenge with profound implications for neonatal and child health, particularly in low-income countries. Defined by the World Health Organization as a birth weight of less than 2.5 kilograms, LBW contributes to increased neonatal mortality and long-term developmental issues. This study examines the prevalence and determinants of LBW in Nigeria, leveraging data from the 2018 Nigeria Demographic and Health Survey (NDHS). The study employs a cross-sectional design and a stratified two-stage sampling technique, analyzing 7,728 recorded birth weights. Key findings indicate that maternal age, education, and socio-economic status significantly influence birth weight. Optimal reproductive ages (25-34 years) and higher educational attainment are associated with healthier birth weights, whereas younger (below 20 years) and older mothers (above 40 years), and those with lower education levels, face higher LBW risks. Employment and wealth are positively correlated with better birth outcomes, underscoring the importance of financial stability. Environmental factors such as urban residence, access to improved water sources, and sanitation facilities also play crucial roles in determining birth weight. The study compares frequentist logistic regression and Bayesian structured additive logistic regression models to identify and predict LBW risk factors, highlighting regional disparities within Nigeria. The findings emphasize the need for targeted interventions addressing socio-demographic, socio-economic, and environmental determinants to reduce the prevalence of LBW and improve maternal and child health outcomes. Enhanced understanding of these factors through advanced statistical modeling can inform policy and health interventions, ultimately contributing to achieving global health targets and improving neonatal health in Nigeria.

Early neonatal mortality and determinants in Ethiopia: multilevel analysis of Ethiopian demographic and health survey, 2019

IntroductionDespite remarkable achievements in improving maternal and child health, early neonatal deaths still persist, with a sluggish decline in Ethiopia. As a pressing public health issue, it requires frequent and current studies to make appropriate interventions. Therefore, by using the most recent Ethiopian Mini Demographic Health Survey Data of 2019, we aimed to assess the magnitude and factors associated with early neonatal mortality in Ethiopia.MethodsSecondary data analysis was conducted based on the demographic and health survey data conducted in Ethiopia in 2019. A total weighted sample of 5,753 live births was included for this study. A multilevel logistic regression model was used to identify the determinants of early neonatal mortality. The adjusted odds ratio at 95% Cl was computed to assess the strength and significance of the association between explanatory and outcome variables. Factors with a p-value of < 0.05 are declared statistically significant.ResultsThe prevalence of early neonatal mortality in Ethiopia was 26.5 (95% Cl; 22.5–31.08) per 1000 live births. Maternal age 20–35 (AOR, 0.38; 95% Cl, 0.38–0.69), richer wealth index (AOR, 0.47; 95% Cl, 0.23–0.96), having no antenatal care visit (AOR, 1.86; 95% Cl, 1.05–3.30), first birth order (AOR, 3.41; 95% Cl, 1.54–7.56), multiple pregnancy (AOR, 18.5; 95% Cl 8.8–38.9), presence of less than two number of under-five children (AOR, 5.83; 95% Cl, 1.71–19.79) and Somali region (AOR, 3.49; 95% Cl, 1.70-12.52) were significantly associated with early neonatal mortality.ConclusionThis study showed that, in comparison to other developing nations, the nation had a higher rate of early newborn mortality. Thus, programmers and policymakers should adjust their designs and policies in accordance with the needs of newborns and children’s health. The Somali region, extreme maternal age, and ANC utilization among expectant moms should all be given special consideration.

KANET evaluation in patients with SARS-CoV-2.

To determine a possible correlation between SARS-CoV-2 infection during pregnancy and altered fetal behavior. Kurjak's antenatal neurodevelopmental test (KANET) was applied from 28 to 40weeks in 38 gestations (group A) diagnosed with COVID-19 infection during the first week and 43 non-COVID pregnant women (group B). No statistically significant differences considering maternal age (33±3.9 years for group A vs. 31±4.1 years for group B) and gestational age (33±1.6weeks for group A compared to 33±2.1weeks for group B) were observed. KANET scores were not different between the two groups. Fetal behavior differences are not altered in women diagnosed with SARS-CoV-2 infection during the third trimester of pregnancy.

Analysis of factors related to the incident of hypertension in pregnancy

Introduction: Pregnancy-related hypertension is defined as hypertension that develops during pregnancy, usually in the final month of the pregnancy or after 20 weeks of gestational age that was previously normal. Five to fifteen percent of pregnancy-related problems are caused by hypertension, which is also one of the leading causes of maternal death and morbidity. Objective: The purpose of this study is to determine how the risk of hypertension during pregnancy is related to maternal age, parity, pregnancy spacing, BMI, junk food consumption habits, and prenatal visits. Method: Case control research design was employed. Eighty control samples were acquired using a simple random technique, while forty samples from the case group were taken using the accidental technique. A questionnaire was used to collect data. The logistic regression test and the chi square test were used in the data analysis. This study was taken in Ardita's Clinic, Indonesia. This study's sample was taken using the total sampling technique involving 33 respondents. Result: The incidence of hypertension proved to be significantly correlated (p&lt;0.05) with maternal age, junk food consumption, and prenatal visits while parity, pregnancy interval, and BMI weren't associated with a significant correlation (p&gt;0.05). The most significant factor is the junk food consumption habit (OR=13.483). Conclusion: Women should plan their pregnancies at a peak age, avoid from junk food, and arrange many antenatal appointments in order to ensure a successful pregnancy.

Maternal autoimmune disease and offspring risk of haematological malignancies: a case–control study

Autoimmune diseases are known to be associated with an increased risk of cancer. Whether maternal immune dysregulation can have an impact on the development of haematological malignancies in offspring remains uncertain. Therefore, we explored the association between offspring risk of haematological malignancies and maternal autoimmune disease using a real-world nationwide population-based study. In this case-control study, we identified 2172 children with haematological malignancies between 2004 and 2019 from Taiwan's National Health Insurance program and compared them with population-based controls without haematologic malignancies, who were matched with each individual at a ratio of 1:4. The medical information of the autoimmune mothers were obtained from the Taiwan Maternal and Child Health Database. Conditional logistic regression was used to estimate the odds ratio for haematologic malignancy in offspring. Furthermore, subgroup and stratified analyses were conducted. Among the rheumatologic diseases in our study, Crohn's disease was the most common disease both in the haematological malignancy group (1.1%) and the control group (0.9%). In multivariable analysis, the odds ratio for haematological malignancy in offspring with maternal autoimmune diseases was 1.2 (95% confidence interval [CI] 0.91-1.58). The overall risk of haematologic malignancy was not significantly higher when adjusted for specific risk factors, including neonatal age, maternal age, family income, urbanization, maternal occupation, birth weight, or maternal comorbidity, except for prematurity. When comparing different autoimmune diseases among haematological malignancies and the control group, maternal psoriatic arthritis/psoriasis had the highest adjusted overall risk for haematological malignancies (adjusted OR 2.11, CI 0.89-5), followed by ankylosing spondylitis (adjusted OR 1.45, CI 0.7-3), autoimmune thyroiditis (OR 1.26, CI 0.57-2.81), systemic lupus erythematosus (OR 1.21, CI 0.48-3.02), Crohn's disease (OR 1.19, CI 0.75-1.9), and Sjogren's syndrome (OR 1.18, CI 0.65-2.15), but no significance was reached in these analyses. Multivariable analysis of risk factors associated with haematological malignancy subtypes was done. It showed no associations between maternal autoimmune disease and childhood haematological malignancies. We found no significant relationship between maternal autoimmune disease and childhood haematological malignancies. The influence of maternal immune dysregulation on the next generation with respect to haematological malignancies development may be limited. There was no funding source for this study.

Reexamining the causes of age patterns in Black-White birth weight disparities: Evidence from U.S. cohorts

Black-White disparities in low birth weight (LBW) rise with maternal age. Why? The “weathering hypothesis” holds that the increasing disparity is due to the accumulation of adverse exposures leading to accelerated aging among Black compared to White mothers. Using US birth certificate data covering millions of births to successive cohorts of US women, this paper finds two sets of results that complicate this theory. Descriptively, I find that Black-White LBW disparities increase with age for some cohorts but not others. More causally, analyses exploiting a plausibly exogenous policy shock show that the effects of reducing adverse exposures were larger for older compared to younger mothers. This evidence points toward an alternative or complementary hypothesis: that LBW risks are more responsive to adverse exposures at older maternal ages than at younger ages. Emphasizing this pathway -- what I call “responsiveness” -- as opposed to accumulation has important implications for both research and policy.

Prediction Models for HIV Infection in Infants: Analysis of Scoring Systems on Maternal, Infants, and Mode of Delivery Risk Factors.

Diagnosis for HIV in infants is hard to determine, particularly in limited- resource areas. A delay in the diagnosis of HIV-infected infants will lead to high morbidity and mortality. The purpose of this project is to construct a model of an HIV-positive infant and develop a useful and practical scoring system to estimate the likelihood of mother-to-child transmission that can be applied in the field. A cross-sectional study on 100 subjects through medical records of infants born to HIV-infected mothers was conducted at four hospitals and one community health center. Several models of risk prediction scores of HIV-infected infants were then made. Furthermore, the performed validation was performed on 20 subjects of infants born to mothers with HIV in three hospitals by comparing the scoring system and the result of the PCR RNA examination performed at the age of 6 weeks old. The risk of HIV-infected infants was higher in mothers who did not receive ARV through PMTCT programs (OR 33.6; 95% CI 4.0 to 282.2), pulmonary TB infection (OR 5.1; IK95% 1.6 to 16.0) and vaginal delivery (OR 9.2; IK95 2.2 to 38.0%). Two models can predict the occurrence of infected HIV infants effectively. Model 1 consists of maternal age, maternal ARVs, lung TB infection, gestational age, mode of delivery, and sex of the infants with sensitivity and specificity of 78.9% and 70.8% (AUC=0.817 [95% CI 0.709 to 0.926]) and likelihood ratio score of 4. Model 2 consists of ARVs to the mother, pulmonary TB infection, and mode of delivery with sensitivity and specificity of 73.7% and 86.1%; AUC value of 0.812 (95% CI 0.687 to 0.938) and likelihood ratio of 5. External Validation gave similar results to the Model 2 scoring system with PCR RNA. The prediction score of HIV-infected infants in Model 2 can be used in newborns of HIV-positive mothers as an effective and practical risk screening tool for HIV-infected infants before the gold standard examination by PCR.

Perinatal outcomes of antenatally diagnosed omphalocele and gastroschisis: a survey from a university hospital.

To evaluate the clinical features and perinatal outcomes of antenatally diagnosed fetuses with omphalocele and gastroschisis. This was a retrospective, single-center, cohort study of prenatally diagnosed fetuses with omphalocele and gastroschisis followed-up and delivered at a university hospital. Demographic, pregnancy, birth and perinatal outcomes were compared between gastroschisis and omphalocele. A total of 75 fetuses with omphalocele and 21 cases with gastroschisis were evaluated. The mean maternal age of women carrying a fetus with omphalocele was significantly higher than the women with gastroschisis (p=0.001). Associated structural anomalies were found in 53.3% and 4.7% of fetuses with omphalocele and gastroschisis, respectively (p<0.001). The rate of chromosomal anomaly was 8.3% in pregnancies with omphalocele. In liveborn pregnancies, the mean gestational age at delivery and birth weight did not differ between the study groups. Time to postoperative oral intake, duration of parenteral nutrition and length of hospital stay were significantly longer in babies with gastroschisis than omphalocele (p<0.01). Rates of termination, intrauterine, neonatal and infant death of fetuses with omphalocele were 25.3%, 6.7%, 10.7% and 2.7% respectively. Time to postoperative oral intake, duration of parenteral nutrition and duration of hospitalization were significantly longer in babies with complex compared to simple gastroschisis (p<0.01). Survival rates were 95.2%, 82.9% and 20% in fetuses with gastroschisis, isolated and non-isolated omphalocele, respectively. Associated structural and chromosomal anomalies were significantly more common in fetuses with omphalocele compared to those with gastroschisis. Prognosis of fetuses with omphalocele depended on the associated structural and chromosomal anomalies, whereas bowel compromise was the main determining factor in gastroschisis.

Maternal knowledge on nutritional-focused nurturing care and associated factors among women with stunted children aged 6-23 months in Yogyakarta, Indonesia: A cross-sectional study.

Childhood stunting poses serious long-term risks to cognitive development, education, and adult productivity. While research has explored stunting's causes and effects, there is a lack of focus on maternal knowledge of nutrition-focused nurturing care for stunted children. This gap limits the ability to design effective interventions that target improved caregiving practices. This study aimed to assess maternal knowledge of nutrition-focused nurturing care and explore associated factors, including child gender, maternal age, education, income, and prior exposure to nurturing care information, among mothers of stunted children aged 6-23 months in Indonesia. A cross-sectional study was conducted with 73 mothers in Kulon Progo, Yogyakarta. Data were collected from February to March 2024 using a validated self-assessment questionnaire covering four domains: responsive caregiving, early learning opportunities, safety and security, and supportive caregiver well-being. Statistical analyses, including t-tests and one-way ANOVA, were performed. Overall maternal knowledge of nurturing care was high, with a mean score of 25.15 (SD = 4.72). Factors significantly associated with higher knowledge included having male children (p = 0.017), being aged 30-34 years (p = 0.035), possessing higher education levels (p = 0.002), and prior exposure to nurturing care information (p <0.001). Family income significantly influenced knowledge in the domain of early learning opportunities (p = 0.006), though not in other areas. Maternal knowledge of nutrition-focused nurturing care was influenced by child gender, maternal age, education, income, and prior exposure to nurturing care information. These findings emphasize the importance of focused educational interventions in nursing practice to enhance maternal knowledge. Addressing these factors can help align nursing strategies better to support the healthy growth and development of children.

Maternal and Neonatal Predictors of Asphyxia: A Case-Control Study at Salatiga Regional General Hospital

Neonatal asphyxia remains a significant contributor to neonatal mortality and morbidity globally. Identifying maternal and neonatal predictors of asphyxia is crucial for developing targeted interventions to improve neonatal outcomes. This study aimed to investigate the association between various maternal and neonatal factors and the occurrence of asphyxia in newborns at Salatiga Regional General Hospital. A case-control study was conducted at Salatiga Regional General Hospital from January 1st to December 31st, 2023. Cases were newborns diagnosed with asphyxia based on an Apgar score ≤ 6 at 5 minutes. Controls were newborns without asphyxia. Data on maternal factors (premature rupture of membranes, mode of delivery, maternal age, parity, and gravidity) and neonatal factors (birth weight and gestational age) were collected from medical records. Bivariate and multivariate analyses were performed to assess the associations between these factors and asphyxia. The study included 234 newborns (117 cases and 117 controls). Bivariate analysis revealed significant associations between asphyxia and premature rupture of membranes (p = 0.027), mode of delivery (p = 0.000), birth weight (p = 0.000), and gestational age (p = 0.000). Multivariate logistic regression analysis identified the mode of delivery (OR = 83.468, 95% CI: 18.624-374.079) and birth weight (OR = 69.576, 95% CI: 8.781-551.277) as independent predictors of asphyxia. Cesarean section and low birth weight are significant predictors of neonatal asphyxia. These findings highlight the importance of careful consideration of delivery mode and close monitoring of newborns with low birth weight to prevent and manage asphyxia effectively.

Modifiable and Non-Modifiable Factors That Affect Human Milk Oligosaccharides Composition.

Human milk, the gold standard in infant nutrition, is a unique fluid that provides essential nutrients such as lactose, lipids, proteins, and free oligosaccharides. While its primary role is nutritional, it also protects against pathogens. This protection mainly comes from immunoglobulins, with human milk oligosaccharides (HMOs) providing additional support by inhibiting pathogen binding to host cell ligands. The prebiotic and immune-modulatory activity of HMOs strongly depends on their structure. Over 200 individual structures have been identified so far, with the composition varying significantly among women. The structure and composition of HMOs are influenced by factors such as the Lewis blood group, secretor status, and the duration of nursing. HMO profiles are heavily influenced by maternal phenotypes, which are defined based on the expression of two specific fucosyltransferases. However, recent data have shown that HMO content can be modified by various factors, both changeable and unchangeable, including diet, maternal age, gestational age, mode of delivery, breastfeeding frequency, and race. The first part of this overview presents the historical background of these sugars and the efforts by scientists to extract them using the latest chromatography methods. The second part is divided into subchapters that examine modifiable and non-modifiable factors, reviewing the most recent articles on HMO composition variations due to specific reasons and summarizing potential future challenges in conducting these types of studies.