Antenatal Vaccination Research Articles

Maternal and Neonatal Severe Acute Respiratory Syndrome Coronavirus 2 Omicron Variant Neutralization After Antenatal Messenger RNA Vaccination.

We evaluated the neutralization efficiency against SARS-CoV-2 Omicron variant in maternal and cord blood sera after antenatal BNT162b2 vaccination. Neutralizing antibodies against Omicron were lacking at the time of delivery after 2-dose vaccination. A third booster dose was essential in building neutralizing antibody capacity against Omicron among mothers and neonates.

Maternal influenza vaccination and child mortality: Longitudinal, population-based linked cohort study

Influenza vaccination is recommended to protect mothers and their infants from influenza. Few studies have evaluated the association between maternal influenza vaccination and child mortality. We aimed to evaluate the association between in utero exposure to seasonal inactivated influenza vaccine (IIV) and mortality among young children. This longitudinal, population-based cohort study included 191,247 maternal-child pairs in Western Australia between April 2012 and December 2017. Maternal vaccine information was obtained from a state-wide antenatal vaccination database. Mortality was defined as a record of a death registration. We used Cox proportional hazard models, weighted by the inverse-probability of treatment (vaccination), to estimate the hazard ratio of child mortality associated with in utero exposure to seasonal IIV. This study found no association between in utero exposure to seasonal IIV and mortality through age five years.

A causal model of the continuum of care for maternal, newborn, and child health in Myanmar: a structural equation modeling approach

Background: Incredible drop in global maternal mortality ratio (MMR) and neonatal mortality rate (NMR) is still far from sustainable development goals (SDGs) targets. Applying the continuum of care (CoC) concept reduces mother and newborn deaths. We determined the influencing factors of the continuity of maternal, newborn, and child health care (MNCH) services from pregnancy to child immunization with structural equation modeling (SEM) to continuously improve health outcomes and MNCH service utilization.Methods: We included 1,669 pair samples of mothers and their children under 24 months from (2015-2016) Myanmar demographic health survey (MDHS) data. We used STATA software (version 14) for all analyses. We evaluated the relationships between four latent independent constructs-characteristics of the individual, household, socio-economic, and child and four latent dependent constructs of CoC components- utilization of antenatal care (ANC), delivery, postnatal care (PNC), and vaccination programs using SEM approach.Results: Adequate utilization of ANC, delivery, PNC, and child immunization along the MNCH pathway were 19.7%, 44.8%, 21.8%, and 30.6%, respectively. SEM analysis shows that socio-economic status influences all CoC care components. Moreover, the receiving ANC favors the utilization of subsequent components of delivery, PNC, and vaccination. However, receiving delivery care favors only PNC utilization but not childhood vaccination. In addition, PNC utilization does not affect childhood vaccination.Conclusions: The quality and coverage of ANC is the most crucial factor in establishing the care continuum of MNCH services in Myanmar. The overall socio-economic development of the nation will alleviate the inequity in health access.

Health-care provision for displaced populations arriving from Ukraine

Health-care provision for displaced populations arriving from Ukraine

The impact of the COVID-19 pandemic on health service use in sub-Saharan Africa.

Six hospitals in four sub-Saharan African countries. To examine the indirect effects of COVID-19 on health service utilisation and to explore the risk of bias in studies on prediction models. Monthly data were analysed using interrupted time-series modelling. We used linear mixed-effect models for the analysis of antenatal care visits, institutional deliveries, vaccinations, outpatient visits and hospital admissions, and generalised linear mixed-effect models for hospital mortality. During 2018-2020, the six hospitals recorded a total of 57,075 antenatal care visits, 38,706 institutional deliveries, 312,961 vaccinations, 605,925 out-patient visits and 143,915 hospital admissions. The COVID-19 period was associated with decreases in vacci-nations (- 575 vaccinations, P < 0.0001), outpatient visits (- 700 visits, P < 0.0001) and hospital admission (- 102 admission, P = 0.001); however, no statistically significant effects were found for antenatal care visits (P = 0.71) or institutional deliveries (P = 0.14). Mortality rate increased by 2% per month in the pre-COVID-19 period; however, a decreasing trend (by 2% per month) was observed during the COVID-19 period (P = 0.004). Subgroup and sensitivity analyses broadly confirmed the main findings with only minor inconsistencies. A reduction in outpatient visits was also observed in hospitals from countries with a higher Stringency Index and in urban hospitals. The pandemic resulted in a reduction in health service utilisation. The decreases were less than anticipated from modelling studies.

The Effect of Gestational Age at BNT162b2 mRNA Vaccination on Maternal and Neonatal Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Antibody Levels.

BackgroundCOVID-19 during pregnancy and early infancy can result in severe disease. Evaluating the effect of gestational age at the time of SARS-CoV-2 vaccination on maternal antibody levels and transplacental antibody transfer has important implications for maternal care and vaccination strategies.MethodsMaternal and cord blood sera were collected from mother/newborn dyads (n=402), following term delivery after antenatal two-dose SARS-CoV-2 BNT162b2 mRNA vaccination. SARS-CoV-2 spike protein (S) and receptor binding domain (RBD)-specific IgG levels were evaluated in the samples collected.ResultsMedian anti-S and anti-RBD-specific IgG levels in maternal sera at the time of delivery were lowest following 1 st trimester vaccination (n=90) (anti-S IgG: 76 AU/mL, anti-RBD-specific IgG: 478 AU/mL), intermediate in those vaccinated in the 2 nd trimester (n=124) (anti-S IgG: 126 AU/mL, anti-RBD-specific IgG: 1263 AU/mL), and highest after 3 rd trimester vaccination (n=188) (anti-S IgG: 240 AU/mL, anti-RBD-specific IgG: 5855 AU/mL). Antibody levels in neonatal sera followed a similar pattern and were lowest following antenatal vaccination in the 1 st trimester (anti-S IgG: 126 AU/mL, anti-RBD-specific IgG: 1140 AU/mL). In a subgroup of parturients vaccinated in the 1 st trimester (n=30), a third booster dose was associated with significantly higher maternal and neonatal antibody levels.ConclusionsThese results suggest a considerable antibody waning throughout pregnancy in those vaccinated at early gestation. The observed boosting effect of a third vaccine dose, hints to its potential benefit in those who completed the two-dose vaccine series at early pregnancy or prior to conception. The impact of antenatal immunization timing on SARS-CoV-2 transplacental antibody transfer may influence neonatal seroprotection.

Prevalence and determinants of antenatal tetanus vaccination in Sudan: a cross-sectional analysis of the Multiple Indicator Cluster Survey

BackgroundTetanus vaccination is an indispensable component of the antenatal care (ANC) and is considered one of the most effective and protective measures against tetanus deaths. However, data on antenatal tetanus vaccination in Sudan are scarce. We aimed to explore the level of antenatal tetanus vaccination and to identify the influencing factors in a nationally representative population sample.MethodsWe used the latest available data (2014) of the Sudan Multiple Indicator Cluster Survey (MICS), developed by the United Nations Children’s Fund (UNICEF). We assessed the level of antenatal tetanus vaccination among women of childbearing age who gave at least one birth preceding the survey and defined adequate antenatal tetanus vaccination according to the World Health Organization (WHO) recommendations. Data analysis was performed using descriptive statistics, bivariate analysis, and multivariate logistic regression analysis.ResultsThe total number of women of childbearing age involved in this analysis was 5433. Most of the participants (28.6%) were 25–29 years old, and vast majority of them (73.7%) live in rural areas. The prevalence of mothers who had adequate tetanus vaccination was 60.0%. Antenatal tetanus vaccination was significantly associated with higher level of mothers’ education (AOR = 1.70, 95% CI 1.25–2.32), higher household wealth index (AOR = 1.89, 95% CI 1.41–2.54), having four or more ANC visits (AOR = 1.49, 95% CI 1.30–1.71), and living in areas with low intensity of armed conflicts (AOR = 1.34, 95% CI 1.14–1.57).ConclusionsSocioeconomic status had a significant impact on adequate antenatal tetanus vaccination. The results indicate the existence of variable rates and unequal access to tetanus vaccination among women of childbearing age in Sudan.

1187. Neurodevelopmental Outcomes of Children with Congenital Cytomegalovirus (cCMV) Infection: Does Antiviral Treatment Matter?

BackgroundcCMV infection is a major contributor to childhood neurologic and cognitive disabilities including sensorineural hearing loss (SNHL). Neonatal treatment with ganciclovir/valganciclovir improves hearing outcomes, but its impact on neurodevelopmental outcomes remains an important knowledge gap. We describe the neurodevelopmental outcomes of children with cCMV infection and evaluate the effect of neonatal antiviral therapy on outcomes. MethodsSince 2013, infants with cCMV infection referred to Nationwide Children’s Hospital’s NEO-ID Clinic have had a complete evaluation at diagnosis as well as follow-up neurodevelopmental assessments. Pertinent demographic, clinical, laboratory, radiographic, and follow-up data were obtained and managed using REDCap. Neurodevelopmental assessments were performed using Bayley Scales of Infant and Toddler Development (BSID) III/IV (cognitive, language, motor domains) at ~ 24 months of age. The Gross Motor Function Classification System was used to classify functional motor impairment. Neurodevelopmental outcomes were compared by receipt of antiviral therapy in early infancy. Results95 infants (mean ± SD; gestational age 35 ± 5 wk, birth weight 2121 ± 948 g; Table 1) with cCMV infection had follow-up neurodevelopmental assessments. 62% had central nervous system involvement, 37% had SNHL, 23% developed cerebral palsy (CP), and 6% were diagnosed with autism spectrum disorder. The majority had normal BSID scores (≥ 85) in cognitive and motor domains (65% and 54%, respectively) while 48% had normal scores in the language domain. 35% had severe impairment (< 70) in ≥ 1 domain (Table 2). 9 children had clinically inapparent cCMV infection; 2 (22%) had abnormalities on BSID testing (1, cognitive score: 80; 1, cognitive, language, and motor scores: 65, 68, 73, respectively). 11 (12%) children, including 6 who received antiviral therapy, had severe neurodevelopmental impairment, with CP and severe (< 70) BSID scores in both the cognitive and motor domains. Table 1. Demographic and Clinical Characteristics of 95 Children with Congenital CMV Infection by Receipt of Antiviral Treatment Table 2. Neurodevelopmental Outcomes Based on Testing with the Bayley Scales of Infant and Toddler Development (BSID) III/IV ConclusionA substantial proportion of children with cCMV infection had moderate (29%) or severe (33%) neurodevelopmental impairment, CP, or autism spectrum disorder, irrespective of antiviral treatment. Urgency exists for antenatal preventive strategies and vaccine development.Disclosures Asuncion Mejias, MD, PhD, MsCS, Janssen (Grant/Research Support, Advisor or Review Panel member)Merck (Grant/Research Support, Advisor or Review Panel member)Roche (Advisor or Review Panel member)Sanofi (Advisor or Review Panel member)

Improving uptake of vaccines in pregnancy: A service evaluation of an antenatal vaccination clinic at a tertiary hospital in the UK

BackgroundVaccination against pertussis and seasonal influenza is recommended for all pregnant women in the UK. More recently COVID-19 vaccination has also been offered to women in pregnancy. ObjectivesTo evaluate the uptake of vaccines in pregnant women within a midwife-led immunisation clinic and to assess factors influencing pregnant women's decisions about accepting vaccination. MethodsUptake of vaccines amongst pregnant women referred to a single UK centre for antenatal care between 01/01/19 and 02/10/19 was assessed. Interviews with 20 pregnant women explored views of antenatal vaccination and experiences of the vaccination service. FindingsAmongst 4420 women, uptake was 90.6% for pertussis and 78.8% for influenza vaccines. Factors influencing vaccine-related decision-making amongst 20 interviewed women were: healthcare professional recommendation, perceived susceptibility and risk of infection, and previous experience of vaccination and vaccine-preventable disease. Conclusions and Implications for PracticeUptake of pertussis and influenza vaccines within a secondary care immunisation service was higher than the national or regional average. The model of vaccine delivery was associated with high levels of satisfaction. This model of vaccine delivery could be implemented elsewhere to increase vaccine uptake, and should be considered for delivery of COVID-19 vaccines in the future.

GAMBARAN ANTENATAL CARE (ANC) DAN VAKSINASI COVID-19 PADA IBU HAMIL

Purpose: to describe antenatal care and covid-19 vaccination for pregnant womenMethodology: a type of qualitative research with an exploratory approach. The type of data used is primary data by collecting 8 respondents from pregnant women, 8 husbands and 1 midwife. Data collection is done by sharing a google form linkResults: During the Covid-19 period, mothers carried out routine pregnancy checks according to their trimesters. Pregnant women study and apply MCH books in their daily lives. Participate in face-to-face classes for pregnant women by wearing a mask. P4K stickers have been filled in by pregnant women. The mother also did a pregnancy check by the doctor at the Puskesmas. Before the antenatal visit, the mother had made an appointment. Pregnant women have been vaccinated against COVID-19.Conclusion: antenatal care carried out by pregnant women has changed and mothers carry out covid-19 vaccinations to protect themselves and their fetuses.Keywords: antenatal care; vaccination; Journal of midwifery science.

Pertussis Disease and Antenatal Vaccine Effectiveness in Australian Children.

Population-level studies of severe pertussis extending beyond infancy are sparse, and none in the context of antenatal vaccination. We compared hospitalized pertussis cases from birth to 15 years of age before and after introduction of antenatal immunization. Active surveillance of laboratory-confirmed pertussis hospitalizations in a national network of pediatric hospitals in Australia January 2012 to June 2019. Impact of maternal vaccination was assessed by vaccine effectiveness (VE) in cases and test-negative controls with <2 months of age and by before-after comparison of age distribution of cases. Among cases eligible for one or more vaccine doses, we examined proportions age-appropriately immunized and with comorbidities by age group. Among 419 eligible cases, the proportion <2 months of age significantly decreased from 33.1% in 2012 to 2014 compared with 19.6% in 2016 to 2019 when mothers of only 4 of 17 (23.5%) cases <2 months of age had received antenatal vaccination. VE was estimated to be 84.3% (95% CI, 26.1-96.7). Across all years (2012-2019), of 55 cases 4-11 months of age, 21 (38%) had ≥2 vaccine doses, whereas among 155 cases ≥12 months of age, 122 (85.2%) had ≥3 vaccine doses. Prevalence of comorbidities (primarily cardiorespiratory) increased from 5 (2.1%) <6 months of age to 36 (24.2%) ≥12 months of age (P < 0.001), with 6/16 (38%) cases ≥12 months of age who required intensive care having comorbidities. Below the age of 12 months, prevention of severe pertussis will be maximized by high maternal antenatal vaccine uptake and timeliness of infant vaccine doses. Despite full immunization, we found children ≥12 months of age accounted for 27% of hospitalizations <15 years, with 24% having comorbities, suggesting new vaccine strategies, such as additional doses or more immunogenic vaccines, require evaluation.

Influenza and Pertussis Vaccine Uptake during Pregnancy: Determinants Found through a Multi-Center Questionnaire Study of Pregnant Women and Healthcare Professionals

The objective of this article is to assess the adherence of pregnant women to the national recommendations for influenza and pertussis vaccination and the reasons behind their non-adherence. This was a retrospective observational study conducted in a well-defined puerperant population of adequate healthcare standards from December 2018 to December 2019. The study was carried out with 1006 puerperants and 66 health care practitioners. Data were collected, including demographic-obstetric features of pregnant women, whether they received antenatal vaccination, the reasons for having been vaccinated or not as well as health professional’s opinion regarding antenatal immunization. The uptake of influenza and pertussis vaccine during pregnancy was suboptimal with lack of recommendation of the vaccine by the healthcare providers being the main barrier. Factors positively associated with antenatal vaccination against influenza were higher level of maternal education and advanced maternal age while antenatal vaccination against pertussis was positively associated with higher level of maternal education. This large-scale retrospective study reveals the inadequacy of antenatal vaccination rates against pertussis and influenza in Crete, Greece. Results suggest that obstetricians’ confidence in vaccination is of outmost importance for implementing immunization in pregnancy and any doubts on vaccine effectiveness and safety should be resolved. Routine antenatal vaccination counseling and pregnancy immunization campaigns are essential to improve vaccine uptake during pregnancy.

An evaluation of an influenza vaccination campaign targeting pregnant women in 27 clinics in two provinces of South Africa, 2015 \u2013 2018

IntroductionDespite prioritization, routine antenatal influenza vaccine coverage is < 16% in South Africa. We aimed to describe maternal influenza vaccine coverage in 27 antenatal clinics (ANCs) in Gauteng and Western Cape (WC) Provinces, where in collaboration with the Department of Health (DoH), we augmented the annual influenza vaccination programme among pregnant women.MethodsFrom 2015 through 2018, 40,230 additional doses of influenza vaccine were added to the available stock and administered as part of routine antenatal care. Educational talks were given daily and data were collected on women attending ANCs. We compared characteristics of vaccinated and unvaccinated women using multivariable logistic regression.ResultsWe screened 62,979 pregnant women during the period when Southern Hemisphere influenza vaccines were available (27,068 in Gauteng and 35,911 in WC). Vaccine coverage at the targeted clinics was 78.7% (49,355/62682), although pregnant women in WC were more likely to be vaccinated compared to those in the Gauteng (Odds ratio (OR) =3.7 p < 0.001). Women aged 25—29 and > 35 years were less likely to be vaccinated than women aged 18—24 years (OR = 0.9 p = 0.053; OR = 0.9 p < 0.001). HIV positive status was not associated with vaccination (OR = 1.0 p = 0.266). Reasons for not vaccinating included: vaccine stock-outs where ANCs depleted available stock of vaccines and/or were awaiting delivery of vaccines (54.6%, 6949/12723), refusal/indecision (25.8%, 3285), and current illness that contraindicated vaccination (19.6%, 2489).ConclusionAntenatal vaccination uptake was likely improved by the increased vaccine supply and vaccine education offered during our campaign.

Codominant IgG and IgA expression with minimal vaccine mRNA in milk of BNT162b2 vaccinees

Lactating women can produce protective antibodies in their milk after vaccination, which has informed antenatal vaccination programs for diseases such as influenza and pertussis. However, whether SARS-CoV-2-specific antibodies are produced in human milk as a result of COVID-19 vaccination is still unclear. In this study, we show that lactating mothers who received the BNT162b2 vaccine secreted SARS-CoV-2-specific IgA and IgG antibodies into milk, with the most significant increase at 3–7 days post-dose 2. Virus-specific IgG titers were stable out to 4–6 weeks after dose 2. In contrast, SARS-CoV-2-specific IgA levels showed substantial decay. Vaccine mRNA was detected in few milk samples (maximum of 2 ng/ml), indicative of minimal transfer. Additionally, infants who consumed post-vaccination human milk had no reported adverse effects up to 28 days post-ingestion. Our results define the safety and efficacy profiles of the vaccine in this demographic and provide initial evidence for protective immunity conferred by milk-borne SARS-CoV-2-specific antibodies. Taken together, our study supports recommendations for uninterrupted breastfeeding subsequent to mRNA vaccination against COVID-19.

COVID-19 vaccination during pregnancy: coverage and safety

BackgroundConcerns have been raised regarding a potential surge of COVID-19 in pregnancy, secondary to the rising numbers of COVID-19 in the community, easing of societal restrictions, and vaccine hesitancy. Although COVID-19 vaccination is now offered to all pregnant women in the United Kingdom; limited data exist on its uptake and safety.ObjectiveThis study aimed to investigate the uptake and safety of COVID-19 vaccination among pregnant women.Study DesignThis was a cohort study of pregnant women who gave birth at St George’s University Hospitals National Health Service Foundation Trust, London, United Kingdom, between March 1, 2020, and July 4, 2021. The primary outcome was uptake of COVID-19 vaccination and its determinants. The secondary outcomes were perinatal safety outcomes. Data were collected on COVID-19 vaccination uptake, vaccination type, gestational age at vaccination, and maternal characteristics, including age, parity, ethnicity, index of multiple deprivation score, and comorbidities. Further data were collected on perinatal outcomes, including stillbirth (fetal death at ≥24 weeks’ gestation), preterm birth, fetal and congenital abnormalities, and intrapartum complications. Pregnancy and neonatal outcomes of women who received the vaccine were compared with that of a matched cohort of women with balanced propensity scores. Effect magnitudes of vaccination on perinatal outcomes were reported as mean differences or odds ratios with 95% confidence intervals. Factors associated with antenatal vaccination were assessed with logistic regression analysis.ResultsData were available for 1328 pregnant women of whom 140 received at least 1 dose of the COVID-19 vaccine before giving birth and 1188 women who did not; 85.7% of those vaccinated received their vaccine in the third trimester of pregnancy and 14.3% in the second trimester of pregnancy. Of those vaccinated, 127 (90.7%) received a messenger RNA vaccine and 13 (9.3%) a viral vector vaccine. There was evidence of reduced vaccine uptake in younger women (P=.001), women with high levels of deprivation (ie, fifth quintile of the index of multiple deprivation; P=.008), and women of Afro-Caribbean or Asian ethnicity compared with women of White ethnicity (P<.001). Women with prepregnancy diabetes mellitus had increased vaccine uptake (P=.008). In the multivariable model the fifth deprivation quintile (most deprived) (adjusted odds ratio, 0.10; 95% confidence interval, 0.02–0.10; P=.003) and Afro-Caribbean ethnicity (adjusted odds ratio, 0.27; 95% confidence interval, 0.06–0.85; P=.044) were significantly associated with lower antenatal vaccine uptake, whereas prepregnancy diabetes mellitus was significantly associated with higher antenatal vaccine uptake (adjusted odds ratio, 10.5; 95% confidence interval, 1.74–83.2; P=.014). In a propensity score–matched cohort, the rates of adverse pregnancy outcomes of 133 women who received at least 1 dose of the COVID-19 vaccine in pregnancy were similar to that of unvaccinated pregnant women (P>.05 for all): stillbirth (0.0% vs 0.2%), fetal abnormalities (2.2% vs 2.5%), postpartum hemorrhage (9.8% vs 9.0%), cesarean delivery (30.8% vs 34.1%), small for gestational age (12.0% vs 12.8%), maternal high-dependency unit or intensive care admission (6.0% vs 4.0%), or neonatal intensive care unit admission (5.3% vs 5.0%). Intrapartum pyrexia (3.7% vs 1.0%; P=.046) was significantly increased but the borderline statistical significance was lost after excluding women with antenatal COVID-19 infection (P=.079). Mixed-effects Cox regression showed that vaccination was not significantly associated with birth at <40 weeks’ gestation (hazard ratio, 0.93; 95% confidence interval, 0.71–1.23; P=.624).ConclusionOf pregnant women eligible for COVID-19 vaccination, less than one-third accepted COVID-19 vaccination during pregnancy, and they experienced similar pregnancy outcomes with unvaccinated pregnant women. There was lower uptake among younger women, non-White ethnicity, and lower socioeconomic background. This study has contributed to the body of evidence that having COVID-19 vaccination in pregnancy does not alter perinatal outcomes. Clear communication to improve awareness among pregnant women and healthcare professionals on vaccine safety is needed, alongside strategies to address vaccine hesitancy. These strategies include postvaccination surveillance to gather further data on pregnancy outcomes, particularly after first-trimester vaccination, and long-term infant follow-up.

Determinants of Risk Factors Associated to Pregnancy and Delivery in Maasai Community in Kiteto District, Tanzania

The objective of this study was to determine risk factors associated to pregnancy and delivery. The purpose was to find out whether danger signs during pregnancy and delivery motivate the respondents to attend and seek for maternal health services. The study employed cross-sectional research design in four villages in Kiteto District namely Partimbo, Kimana, Engusero and Ngipa to find out the determinants of risk factors associated to pregnancy and delivery. The study employed a three stage sampling technique. A simple random sampling technique was used to identify wards in the first stage. In second stage, four villages were purposively selected from two different wards. In third stage, households as a unit of analysis were obtained through random sampling, since the population was homogenous. However, in order to get population sample within each village, probability proportional to size (PPS) was applied. Cross tabulation and Chi-square were tested to determine the association of the variables and factors influencing maternal health utilization. The findings showed that 53 percent of the respondents were aware of danger signs associated with pregnancy and delivery. About 87 percent delivered at home due to various reasons mentioned like distance and transport costs. Also from the findings majority of the respondents by 64.6 percent suffered from anemia during the first pregnancy. However, the level of antenatal clinic visits was not significantly correlated with any other socio-demographic variables, but place of delivery and assistance during delivery showed a significant association with socio- demographic variables (p &lt; 0.005). Indeed, a lot could be gained by simple prevention, in particular regular antenatal visits, vaccinations, and quick referral in case of complications. Also TBAs should be taken as part of RCH in these pastoralist communities because of their cultural believes. Regular training and seminars should be conducted so as to help mothers in those remote areas.

Why Do Women Support Wife-Beating More Than Men in India? Evidence From the National Family Health Survey (2015–2016)

The motivation of this article comes from the observation that in India, more women than men justify violence. This study seeks to analyze this issue through an interplay of familial relationships along with micro-level factors in explaining attitudes. Also, this article aims to associate women’s perception of subjugation level with her lower sense of entitlement toward medical care and child vaccination. We use the National Family Health Survey 2015–2016 data of India of 47,514 married couples to analyze the above issues. Logistic odds ratios predict the factors of violence justification, and a bivariate probit model is used to analyze the joint probability of seeking antenatal care (ANC) and complete child vaccination. We find that (a) there is a significant variation within couples in their responses to the justification variables; even when both spouses disapproved of violence, around 18% of women reported facing the same. This number is 40% when both justified, (b) the higher the number of marital controls women face, the odds of justifying violence increases by three times, (c) also, the joint probability of utilizing both full ANC and Vaccination decreases by 11 percentage points with women living in the most restrictive marital environment. When international conventions and countrywide efforts are geared toward eliminating domestic violence, it is surprising that women themselves justify getting beaten by their husbands over domestic issues. Therefore, policies need to break the vicious chain of normalizing social norms that promote violence.

A Survey to Assess Knowledge of Antenatal Care among Rural Women of Gujrat, Pakistan

Introduction:Antenatal care is the daily health management of healthy pregnant women with few symptoms, orderly diagnosis of diseases or difficulties connected to obstetrics, and contributing to lifestyle, pregnancy, antenatal care, and safe delivery of child.&#x0D; Objective:To assess the knowledgeof antenatal Care among Pregnant women of Rural Population&#x0D; Material and Methods:The study was conducted at rural areas of Gujrat city for the periodof 6 months, fromJanuary 2021 to June 2021. The data was collected through Questionnaire which was piloted tested and validated by Cronbach. A sample of 100 was taken following inclusion criteria of pregnant women to assess knowledge from rural under developed areas of Gujrat, Pakistan.&#x0D; Results:A total of 100 participants were included in which common agegroups were 26-32 having 37%. The Profession and literacy status was evaluated and found 73% Housewives and 59% Illiterate. Results also shows the Responses about their knowledge clearly showing that 59% pregnant women do not visit and unaware of number of visits in Maternity Clinics. 40 % of the women were unaware about Blood Pressure maintenance in Antenatal care.52% women did not know about blood and urine tests performed during pregnancy. Pregnant women who was unaware of vaccination during antenatal care was 54% and 59% do not acknowledge about using of Multi vitamins during this period of pregnancy.&#x0D; Conclusion:In conclusion rural population had little of Antenatal care, maternal issues, nutritional supplements, investigation tests, and vaccinations practices. The primary reason for this was lack of awareness about proper health care services in rural areas. The secondary reason was family/husband restraints and impediments for not seeking antenatal care.

Evaluation of SARS-CoV-2 Spike Protein Antibody Titers in Cord Blood after COVID-19 Vaccination during Pregnancy in Polish Healthcare Workers: Preliminary Results.

Background: The coronavirus disease 2019 (COVID-19) pandemic has given rise to the need to develop a vaccine as quickly as possible. As pregnant women are at increased risk of contracting severe COVID-19, with higher mortality, it is essential to assess the safety of the vaccines administered during pregnancy. Methods: The aim of this study was to determine the titer of specific maternal and cord antibodies against severe acute respiratory syndrome coronavirus 2 S protein after antenatal vaccination. The secondary objective was to evaluate the ratio of the umbilical cord to the maternal antibody titers. Patients included in the study were enrolled after undergoing voluntary vaccination against COVID-19 during pregnancy at different weeks of gestation. All patients analyzed in our initial study were vaccinated with the BNT162b2 mRNA COVID-19 vaccine. Results: The results of the current study document high anti-S total IgG antibody titers in cord serum at birth in all mother–infant pairs analyzed. The mean umbilical cord blood sample IgG antibody titer anti-S protein was 1026.51 U/mL (±SD 769.25). The mean cord-to-maternal anti–S IgG antibody ratio was 1.28 (±SD 0.798). A significant positive correlation was observed between the week of gestation at which the first dose was administered and the week of gestation at which the second dose was administered, and the respective cord-to-maternal ratio (r = 0.48; p = 0.0029) for the first dose and (r = 0.39; p = 0.0102) for the second dose. Conclusions: To date, despite the prevalence of COVID-19 vaccination, there is a lack of conclusive evidence supporting the safety and efficacy of vaccination of pregnant women. Therefore, the results we present are complementary. Our study suggests that maternal immunization may provide neonatal protection through the transplacental transfer of antibodies. Of particular importance is the demonstration that antibody transfer is correlated with the time from vaccination to delivery, which may allow future determination of the optimal timing of COVID-19 vaccination in pregnant women.

Knowledge, perception and maternal immunisation practices of obstetricians in Singapore for the Tdap and influenza vaccines.

Obstetricians' knowledge and perception of evidence-based recommendations may influence the uptake of antenatal tetanus, diphtheria and pertussis (Tdap) and influenza vaccination. Our survey aimed to assess the knowledge, perception and practices of local obstetricians regarding delivery of antenatal Tdap and influenza vaccines, and perceived barriers to maternal immunisation. There was generally adequate knowledge that Tdap and influenza vaccination in pregnancy was safe, effective and beneficial. However, knowledge regarding recommendations in local guidelines was poorer for Tdap compared to influenza vaccination. Lack of time for patient education was the top perceived barrier for both Tdap and influenza vaccination. A significant proportion of obstetricians cited uncertainty regarding recommendations as a reason for not routinely offering maternal immunisation. These findings demonstrate an urgent need to raise awareness of evidence-based recommendations regarding maternal immunisation, and to promote Tdap and influenza vaccination during antenatal visits so as to improve maternal immunisation rates in Singapore.