Prenatal Research Articles

How It Works 8: Uterine Physiological Changes – Pre and Post-Birth

During pregnancy a woman’s/birthing person’s uterus (womb) will go through various physiological changes to accommodate the growing fetus. The changes are to alter the uterus into a habitat of sustenance, safety and nourishment for the unborn child.1 This is the eighth and final article in the ‘How it Works’ series in which uterine changes in throughout childbearing, birth and postpartum are considered.

Spectrum of Heterotopic and Ectopic Splenic Conditions.

A spectrum of heterotopic and ectopic splenic conditions may be encountered in clinical practice as incidental asymptomatic detection or symptomatic diagnosis. The radiologist needs to be aware of these conditions and their imaging characteristics to provide a prompt correct diagnosis and avoid misdiagnosis as neoplasm or lymphadenopathy. Having a strong knowledge base of the embryologic development of the spleen improves understanding of the pathophysiologic basis of these conditions. Spleen-specific imaging techniques-such as technetium 99m (99mTc)-labeled denatured erythrocyte scintigraphy, 99mTc-sulfur colloid liver-spleen scintigraphy, and MRI with ferumoxytol intravenous contrast material-can also be used to confirm the presence or absence of splenic tissue. Heterotopic splenic conditions include splenules and splenogonadal fusion (discontinuous or continuous forms). These heterotopic conditions are caused by incomplete fusion of the splenic primordia (splenule) and abnormal fusion of the gonadal and splenic tissue (splenogonadal fusion). Ectopic splenic conditions arise in patients with a prior splenic injury (splenosis), laxity or maldevelopment of the splenic ligaments (wandering spleen), or heterotaxy syndromes (polysplenia and asplenia). Importantly, these heterotopic and ectopic splenic conditions can also manifest with complications, including vascular torsion and rupture. ©RSNA, 2024.

Ventral Root Boundary Cap Cells of Rat Spinal Cord Contain Connexin-43.

Boundary cap cells are a population of multipotent stem cells that have great potential for the use in the treatment of damaged nervous system. We studied the patterns of distribution of the gap junction protein connexin-43 (Cx43) in boundary cap cells of the ventral root of the spinal cord of rat embryos (E12-E20; n=40). It was found that Cx43 is expressed in ventral boundary cap cells at all stages of its existence during embryogenesis. At the early stages of prenatal development, the cytoplasmic distribution of Cx43 in the boundary cap cells predominates; at the later stages, Cx43-immunopositive punctate structures are identified. These puncta represent gap junction plaques between the cells. It can be assumed that during the early embryogenesis, Cx43 regulates the main histogenetic processes in boundary cap cells and only in the later stages of prenatal development, Cx43-mediated communications are formed between boundary cap cells.

Decoding the human prenatal immune system with single-cell multi-omics.

The human immune system is made up of a huge variety of cell types each with unique functions. Local networks of resident immune cells are poised to sense and protect against pathogen entry, whereas more widespread innate and adaptive immune networks provide first rapid, then long-lasting and targeted responses. However, how we develop such a diverse and complex system remains unknown. Studying human development directly has been challenging in the past, but recent advances in single-cell and spatial genomics, together with the co-ordinated efforts of the Human Cell Atlas and other initiatives, have led to new studies that map the development of the human immune system in unprecedented detail. In this Review, we consider the timings, transitions, cell types and tissue microenvironments that are crucial for building the human immune system. We also compare and contrast the human system with model species and in vitro systems, and discuss how an understanding of prenatal immune system development will improve our knowledge of human disease.

Remarriage Restriction for Woman of 300 Days in Türkiye: Review of the ECtHR’s Nurcan Bayraktar v. Türkiye Judgment

Abstract On 27 June 2023, the European Court of Human Rights unanimously declared that the complaint of Nurcan Bayraktar was admissible and held that there has been a violation of Article 8 and Article 14 in conjunction with Article 12 of the European Convention on Human Rights. The violation arose from the application of Article 132 of the Turkish Civil Code which imposes a 300-day waiting period on divorced women to remarry, unless they lodge an application to a Family Court to lift the waiting period by proving with a medical report that they are not pregnant. The Court concludes that obligation to produce medical evidence to prove that the applicant was not pregnant - which can only be obtained by means of medical examination - constituted an interference with the applicant’s exercise of her right to respect for her private life, considering that it was not necessary in a democratic society. Moreover, the Court found that the obligation imposed on divorced women, due to the possibility of pregnancy, to wait 300 days amounts to direct discrimination on grounds of sex, which cannot be justified by the aim of preventing uncertainty as to the parentage of an unborn child. This study aims to summarise and review this judgment, which was delivered in French, in English for a wider audience, by providing a background information on Article 132 of the Turkish Civil Code.

Delayed Prenatal Development of the Insula Lobe in SGA Fetuses at 2D Ultrasonography: A Perspective-Changing Retrospective Study

Delayed Prenatal Development of the Insula Lobe in SGA Fetuses at 2D Ultrasonography: A Perspective-Changing Retrospective Study

Extending Child Protection Law to the Unborn: Maternal Liability for Unborn Injury in Malaysia

The debate about the value of life is very important in discussions about abortion rights, with one side arguing that unborn children should be completely protected from harm. This view enhances with the widely held belief that pregnant women need strong legal protections to keep both of them and their unborn children safe. In Malaysia, the rights of unborn children are not clearly defined by law. The current laws try to protect pregnant women from harm caused by others but not from their own actions that could harm the unborn child. This lack of clarity leads to many legal, ethical, and social questions, especially concerning the rights of unborn children in cases of criminal acts. This article suggests a detailed legal approach that considers both scientific and medical perspectives. It argues that unborn children should be recognised as victims of crime, even when the crime is committed by their mothers.

Mechanical and bioprosthetic valves in young women: a systematic review and meta-analysis of cardiac, maternal, and fetal outcomes

Valve replacement for the heart in young women, particularly those who are pregnant, is challenging. It requires finding the right balance between valve durability, managing anticoagulation, and ensuring positive reproductive outcomes. This systematic review and meta-analysis compared mechanical prosthetic (MP) and bioprosthetic valves (BP) across cardiac, maternal, and fetal outcomes. Nine studies were included following a comprehensive literature search. The analysis revealed MACE involving MP and BP were not significantly different (OR: 1.31, 95% CI: 0.82–2.09, p = 0.26). Thromboembolic events were significantly more frequent in the MP group (OR: 6.59, 95% CI: 3.41–12.74, p < 0.001), while structural valve deterioration (SVD) occurred more often in BP recipients (OR: 0.01, 95% CI: 0.00–0.70, p = 0.03). Maternal outcomes showed a higher risk of pregnancy loss in MP recipients (OR: 4.62, 95% CI: 1.87–11.40, p < 0.001). Preterm delivery was more common went down in the MP group, but it wasn't enough to warrant statistical analysis (OR: 2.20, 95% CI: 0.86–5.58, p = 0.10). For reoperation or redo surgery, MP had lower risk and showed superior results than BP (OR: 0.06, 95% CI: 0.01–0.32, p = 0.001). These findings highlight the complexities involved in choosing between valve types. Although MP valves last longer, they increase the likelihood of thromboembolic events and miscarriage. While improving results for both the mother and the unborn child, BP valves, are prone to structural deterioration, necessitating reoperation. Individualized treatment decisions that consider patient preferences, clinical context, and reproductive plans are essential to optimizing outcomes for young women requiring valve replacement.

Adipose Tissue Macrophages of the Human Fetus.

Prenatal adipose tissue development affects body composition and growth trajectory in early infancy, therefore it is a key determinant of adiposity in childhood. Childhood overweight and obesity increase the probability of being obese as an adult. After birth and in adulthood, adipose tissue macrophages (ATMs) are relevant constituents of the fat depots, and they are necessary for physiological adipose tissue development and fat metabolism. In obesity, however, ATMs may induce chronic inflammation leading to insulin resistance, pancreatic beta cell damage and self-immunity. Despite being relevant regulators of adipose tissue development and functioning, it is unknown whether ATMs are present in the fetal adipose tissue, therefore it is elusive whether they may affect the prenatal establishment of fat depots. Here we studied the distribution of ATMs in the human fetus between gestational weeks 17 and 38 and labeled ATMs in the early postnatal life. We found that CD45+/CD14+/CD68+ ATMs infiltrated the fetal adipose tissue from the 17th week of gestation and remained persistent throughout the second and third trimesters. ATMs were phagocytic in the neonate and expressed interleukin-6, along with other pro-inflammatory gene products. These findings show that ATMs colonize the adipose tissue early in gestation, raising the possibility that intrauterine ATM-adipocyte communication may exist, eventually allowing ATMs to affect prenatal adipose tissue development.

Ex situ spawning, larval development, and settlement in massive reef‐building corals (Porites) in Palau

AbstractReproduction, embryological development, and settlement of corals are critical for survival of coral reefs through larval propagation. Yet, for many species of corals, a basic understanding of the early life‐history stages is lacking. In this study, we report our observations for ex situ reproduction in the massive reef‐building coral Porites cf. P. lobata across 2 years. Spawning occurred in April and May, on the first day after the full moon with at least 2 h of darkness between sunset and moonrise, on a rising tide. Only a small proportion of corals observed had mature gametes or spawned (14–35%). Eggs were 185–311 μm in diameter, spherical, homogenous, and provisioned with 95–155 algal cells (family Symbiodiniaceae). Males spawned before females, and ex situ fertilization rates were high for the first 2 h after egg release. Larvae were elliptical, ~300 μm long, and symbiotic. Just 2 days after fertilization, many larvae swam near the bottom of culture dishes and were competent to settle. Settlers began calcification 2 days after metamorphosis, and tentacles were developed 10 days after attachment. Our observations contrast with previous studies by suggesting an abbreviated pelagic larval period in Porites cf. P. lobata, which could lead to the isolation of some populations. The high thermal tolerance and broad geographic range of Porites cf. P. lobata suggest that this species could locally adapt to a wide range of environmental conditions, especially if larvae are locally retained. The results of this study can inform future work on reproduction, larval biology, dispersal, and recruitment in Porites cf. P. lobata, which could have an ecological advantage over less resilient coral species under future climate change.

The future of screening and early detection in the Netherlands: a foresight study to support new screening policy strategies

Abstract The Dutch government provides several population screening programmes intended for early detection of diseases so that prompt treatment can be provided. These include population screenings for various forms of cancer and screenings for specific diseases in unborn and newborn children. The future provision of these screenings is influenced by various developments, including the ageing population, economic fluctuations and technological advancements. To understand these developments and their potential impacts on the future of screening and early detection, RIVM has conducted a foresight study based upon a systematic six-step approach. Important steps in this process are building a conceptual framework, identifying important developments via horizon scanning, selecting scenario logics and making scenarios in order to select important challenges and opportunities for the future. The final output of the foresight study consists of a broad horizon scan, two simple future scenarios and four societal perspectives on screening and early detection. In this foresight study, there was special attention for the role of different societal perspectives and the variation in desirable futures that these perspectives entail. These perspectives were presented to the Ministry and other important stakeholders in the future strategy planning, by playing a serious role game. The results of the foresight study and the experience of looking to the future through various perspectives forms the input for the Dutch Ministry of Health, Welfare and Sport in formulating a strategy for the future of screening and early detection and making informed decisions about potential actions. The presentation will focus on how the foresight process was done and how this has informed the Ministry of Health in order for them to follow the next steps in setting future goals and ambitions and planning for a future policy strategy.

Health literacy in pregnant women facing prenatal screening: a short report from “SaperePer” project

Abstract Advancements in health promotion and prenatal medicine have made noninvasive prenatal testing (NIPT) a common practice during pregnancy, but understanding prenatal health information becomes crucial not only for the well-being of the mother but also for that of the unborn child. Analyze health-related information during pregnancy is fundamental, and this work fits perfectly with this topic, reporting preliminary results from the pilot study “SaperePer”. A health-related questionnaire was administered to 358 women in the first trimester of pregnancy, aiming to study different outcomes: 1.level of knowledge of NIPT; 2.number of screening tests undergone; 3.willingness to undergo a diagnostic test with a high outcome risk of screening test; 4.willingness to end the pregnancy following a diagnosis of pathology. The questionnaire was divided into 3 sections: personal characteristics and lifestyle habits, prenatal health behavior scale (PHBS), and knowledge of NIPT. Preliminary results showed that the level of knowledge of NIPT was higher in older, atheist, working, wealthy highly educated, and preliminary informed women, as well as the higher number of screening tests undergone and the propensity to undergo an invasive diagnostic test after a high-risk screening result (KS and MW tests p < 0.05). On the contrary, women with lower education, faithful and, even more, not preliminary and appropriately informed during prenatal counseling showed lower knowledge of NIPT, lower number of tests undergone, and meager chances to undergo an invasive diagnostic test or to end the pregnancy after a positive diagnosis of pathology (KS and MW tests p < 0.05). In conclusion, this study evaluated health-related information during the first but crucial stages of pregnancy, opening a new understanding of how health literacy and correct prenatal counseling could increase awareness and health promotion in pregnant women, particularly in those women with lower cultural tools. Key messages • Health literacy and correct prenatal counseling could increase awareness and health promotion in pregnant women. • Understanding prenatal health information becomes crucial both for maternal and prenatal well-being.

Influenza and COVID-19 vaccines in pregnancy: investigation on associated factors and HAPA theory

Abstract Background Infections caused by influenza and COVID-19 during pregnancy represent a current public health problem as there are multiple populations at risk of complications: pregnant women, fetus, and future unborn children. The anatomical and physiological remodulation characteristic of pregnancy is responsible for the high pathological burden related to respiratory infections. Co-administration of influenza and COVID-19 vaccines may be beneficial because these two respiratory viruses cocirculate during cold weather. The need to explore pregnant women’s attitudes toward co-administration of influenza and COVID-19 vaccines and to evaluate factors associated with vaccine decision-making led to the conduct of this study. Methods In Palermo, Italy, during the 2021-2022 influenza season, a cross-sectional study was conducted to evaluate pregnant women’s intention to adhere to co-administration of influenza and COVID-19 vaccines. The determinants of vaccination attitudes were investigated through the administration of a questionnaire. The Health Action Process Approach theory (HAPA) was adopted to explore the cognitive behavioral aspects. Results Overall, 120 pregnant women were enrolled; average age 32 years, 98.2% (n = 118) of Italian nationality and 25.2% (n = 30) with obstetric or pathological conditions of pregnancy at risk. Factors significantly associated with attitudes toward co-administration of influenza and COVID-19 vaccines among pregnant women were: high level of education (OR = 13.96; p < 0.001), expectations of a positive outcome (OR = 2.84; p < 0.001) and self-efficacy (OR = 3.1; p < 0.001). Conclusions Vaccines co-administration could represent an advantageous preventive practice to facilitate vaccination logistics and allow full adherence to vaccinations recommended to pregnant women. Effective strategies to promote co-administration of influenza and COVID-19 vaccines could be focused on counselling about the expectation of positive outcomes of vaccine co-administration. Key messages • The need to explore pregnant women’s attitudes toward co-administration of influenza and COVID-19 vaccines and to evaluate determinants of vaccine decision-making led to the conduct of this study. • Vaccines co-administration could represent an advantageous preventive practice to facilitate vaccination logistics and allow full adherence to vaccinations recommended to pregnant women.

Persistent Levoatriocardinal Vein in Association with Complete Duplication of SVC and IVC

AbstractPersistent levoatriocardinal vein (LACV) is a rare pulmonary venous anomaly characterized by persistence of embryonic pulmonary to systemic communication. It is commonly associated with obstructive lesions of the left heart, such as hypoplastic left heart syndrome and mitral atresia. Complete duplication of the superior vena cava (SVC) and inferior vena cava (IVC) is rare, and occurs due to aberrations in the multistep development of the cardinal venous system. Coexistence of double SVC and IVC has been reported in the literature; however, their occurrence with persistent levoatriocardinal vein is hitherto unreported. The current case describes a rare coexistence of these complex pulmonary and systemic venous anomalies: persistent levoatriocardinal vein in a child with double SVC and IVC. The embryological development and possible aberrations leading to these anomalies are also detailed.

Antenatal Care Services Uptake and Associated Factors in Somaliland: Further Analysis of the 2020 Somaliland Demographic Health Survey

Purpose Antenatal care (ANC) is vital to maintain the health of pregnant women and their unborn babies. It was linked to a positive pregnancy experience. However, ANC uptake remained low in Somaliland, and no study has been conducted to assess possible predictors. Hence, the current study aimed to determine the level of ANC utilization and to identify its associated factors in Somaliland. Materials and Methods Somaliland Demographic Health Survey (SLDHS) Data 2020 were used. A weighted sample of 3,192 women aged 15-49 years participated in the study. The survey used a two-stage cluster design for sample selection. Descriptive statistics in the form of frequency and percentage and multilevel multinomial logistic regression analysis were carried out to determine associated factors and statistical significance was declared by p< 0.05. Results The findings showed that 62.4% (95% CI: 60.7-64.1) of the women did not utilize ANC services, while 23.4% (95% CI: 21.9, 24.9) partially utilized and 14.2% (95% CI: 13.0, 15.4) adequately utilized ANC services. The odds of adequately utilizing ANC service decreased by a factor of 0.88 for women aged 35 and above compared to 15 - 24 year old women (AOR= 0.88, 95% CI: 0.61, 1.26). Women with higher educational levels had significantly higher odds (AOR=4.31, 95% CI: 1.54, 12.02) of adequately utilizing ANC compared to those with no formal education. The employment status, marital status, household wealth index, residence and region were also found to be associated with the utilization of Antenatal care. Conclusion The study showed low adequate utilization of ANC services in Somaliland. The variables, including age, education, wealth index, marital status, employment status, residence and region, were significantly associated with ANC utilization. Governmental and non-governmental organizations should enact a strategy with targeted intervention focusing on women from nomadic and rural communities, those from poor households, and low educational levels.

Vaccinations in pulmonary diseases - part 2: herpes zoste, RSV, pneumococcal infection and pertussis

RSV is a common cause of respiratory tract infections, posing a risk of severe disease, particularly for newborns and infants, as well as in older individuals with pre-existing conditions. Two safe and effective RSV vaccines were approved in 2023. These vaccines elicit protective antibodies and offer robust protection with no additional benefit from annual boosters. Both vaccines have been approved for individuals aged 60 years and older, while one of the vaccines has also been approved in pregnant women to elicit maternal immunity for passive protection of the unborn child. In Germany, RSV vaccination is currently recommended for all individuals aged 75 years and older, as well as people aged 60-74 years of age with severe underlying conditions. PNEUMOCOCCAL INFECTION: Streptococcus pneumoniae is a primary cause of community-acquired pneumonia (CAP). Since early 2022, a 20-valent conjugate vaccine (PCV20) is approved and recommended for people over 60 years of age and individuals over 18 years of age with risk factors. PCV20 replaces the 23-valent polysaccharide vaccine (PPV23) previously recommended for those over 60 years of age. Although viewed primarily as a childhood disease, the majority of infections affect adults. Patients with chronic respiratory diseases are at a higher risk for severe clinical course of pertussis infection. It has therefore been recommended that all adults should get a pertussis booster with their next scheduled tetanus vaccination, given as a combination vaccine (Tdap). For risk groups (healthcare personnel, community facilities) a booster vaccination every 10 years is recommended. Herpes Zoster (shingles) is caused by the varicella-zoster virus, and reactivations can lead to painful skin lesions and potential complications such as herpes zoster oticus, meningitis, or postherpetic neuralgia. People with chronic lung diseases such as COPD or asthma are at increased risk of herpes zoster-related complications. A recombinant adjuvanted inactivated vaccine was approved in 2018 and offers robust protection against herpes zoster and its complications. The vaccine is recommended for all people over 60 years of age and for certain risk groups over 50 years of age.

Assessment of Obesity Among Pregnant Women in the Volta Region of Ghana

Background: Obesity remains a rising challenge in both developed and developing countries, and maternal obesity has become one of the most occurring risk factors, which can lead to gestational diabetes, pre-eclampsia and prematurity in obstetric practice for both the mother and the child. Pregnancy is a timeline where obesity cannot be effectively worked on as the mother is more likely to live unhealthy lifestyle such as unhealthy diet, binge eating and less physical activity, which would most likely affect foetal health. This is an issue as most pregnant women in Volta Region are either overweight or obese. This research assessed the prevalence of obesity among pregnant women in the Volta Region of Ghana. Material and Method: A full structured questionnaire was administered to 220 participants based on their knowledge of obesity and its effect on pregnancy, food choices, mealtimes and portion sizes, as well as physical activity during pregnancy. Body weight and height were measured using standardized procedures and body mass index (BMI) was calculated. Overweight and obesity were defined based on WHO criteria. Data analysis was performed using SPSS version 20.0. Results: Based on excessive gestational weight gain, prevalence of obesity among the pregnant women was 54% (119). Majority of respondents had poor knowledge of obesity and its effect on the mother and the foetus, which represented a significant correlation (p< 0.0001) between their caloric intake and high gestational weight gain. Physical activity showed no significant effect (p = 0.2) on gestational weight gain. However, pre-pregnancy BMI of the expectant mothers was directly linked to high gestational weight gain with age being the significant risk factor (p<0.02) for obesity before pregnancy. Conclusion: This research found limited awareness of excessive gestational weight gain and its health consequences among pregnant women and the unborn baby. Therefore, monitoring gestational weight gain using diverse approaches to integrate and manage the condition in routine antenatal care needs consideration.

Aberrant Number of Vessels in the Umbilical Cord: What Do We Know?

The umbilical cord, comprising three vital blood vessels, serves as the lifeline between mother and fetus. Prenatal care emphasizes detailed ultrasound examinations of the umbilical cord and postnatal inspections of the placenta and cord to preemptively address potential complications. Studies have consistently shown a significant link between a single umbilical artery and unfavorable perinatal consequences, such as mortality and congenital abnormalities. Conversely, the impact of additional vessels remains uncertain. This review is dedicated to enhancing our understanding and refining diagnostic and therapeutic approaches in prenatal healthcare. The objective is to identify knowledge gaps and propose evidence-based solutions to improve care for pregnant women and their unborn babies. The presence of a single umbilical artery in prenatal diagnosis may signify potential risks for fetal anomalies and adverse pregnancy outcomes such as hemodynamic instability, ischemia, and an increased likelihood of intrauterine growth restriction. Additionally, even the presence of supernumerary vessels may be associated with fetal malformations. Serial fetal evaluations are recommended for detecting anomalies and monitoring fetal growth throughout pregnancy. Despite the generally benign nature of isolated SUA and supernumerary vessels, close monitoring and comprehensive prenatal care are essential to ensuring optimal outcomes for both mother and baby.

Longitudinal biomonitoring of mycotoxin exposure during pregnancy in the Yale Pregnancy Outcome Prediction Study

Mycotoxins are fungal toxins that may trigger adverse health effects in pregnant women and their unborn children. Yet, data is scarce on the dynamic exposure patterns of mycotoxins in pregnant women, especially in the United States. This study assessed mycotoxin exposure profiles in women (n = 50) from the Yale Pregnancy Outcome Prediction Study (YPOPS) cohort at four distinct time points. Multi-analyte human biomonitoring assays based on liquid chromatography tandem mass spectrometry (LC-MS/MS), were developed for human serum and plasma matrices. The serum method was applied, together with an established urine method, to quantify mycotoxin levels in longitudinally collected matched serum (n = 200) and spot urine (n = 200) samples throughout pregnancy. The serum samples were mostly contaminated by the potential carcinogen ochratoxin A (detection rate: 46 %; median: 0.09 ng/mL), the hepato- and nephrotoxic citrinin (detection rate: 32 %; median: 0.02 ng/mL) and two enniatins (EnnB; detection rate: 97 %; median: 0.01 ng/mL and EnnB1; detection rate: 12 %; median: 0.003 ng/mL) which may act as immunotoxins. The most prevalent mycotoxins quantified in urine included deoxynivalenol (detection rate: 99 %; median: 23 ng/mL), alternariol monomethyl ether (detection rate: 69 %; median: 0.04 ng/mL), and zearalenone (detection rate: 63 %; median: 0.16 ng/mL). Seven other biomarkers of exposure including the highly estrogenic α-zearalenol and genotoxic Alternaria toxins, were also determined. Carcinogenic aflatoxins were not detected in any of the samples. Exposure assessment was based on the urinary data and performed by calculating probable daily intakes and comparing the human biomonitoring guidance value (HBM-GV) for deoxynivalenol. The results showed that the individuals exceeded the tolerable daily intake for deoxynivalenol and zearalenone on average at 28 % and 2 % over the different time points. Using the HBM-GV approach, the average exceedances for deoxynivalenol increased to 48 % indicating high exposure. For all the samples in which ochratoxin A was quantified, the estimated margin of exposure for neoplastic effects was below 10,000, indicating possible health concerns. Overall, this study showed that pregnant women were exposed to several regulated and emerging mycotoxins and that exposome-scale assessment should be a future priority in susceptible populations to better characterize xenobiotic exposure.

Association between Birth Weight of the Babies and Mode of Delivery: A Cross-Sectional Study

Background: Birth weight has significant short and long-term effects on health and survival and is a useful predictor of prenatal and postnatal development. Birth weight is likely to play a key role for the infant’s survival because it is one of the strongest predictors of infant mortality risk. The aim of the study was to find out the association between birth weight and mode of delivery. Methods: This was a cross-sectional study conducted at Combined Military Hospital, Ghatail from 15 March 2019 to 30 June 2019. Secondary data were used, which were collected from hospital register during the period of 01 January 2018 to 31 December 2018. The study population was all the newborn babies delivered in CMH, Ghatail during that period and mothers of the newborn babies were respondents of the study. Results: Out of 526 respondents majority (64.83%) were in the age group of 23-32 years with mean age 25.14(range: 18-40) years. Of the newborn babies around half (48.3%) were male. The mean birth weight was 2.92 kg with minimum weight 1.2 kg and maximum 4.2 kg. The data showed that the prevalence of Low Birth Weight (LBW) 13.1%. Majority (84.6%) of the mothers didn’t have any comorbidity, few (15.4%) suffered from comorbidity. 53.8% babies were born by caesarean section (CS) and 46.2% were delivered by normal vaginal delivery. Among the low birth weight babies 65.2% were born by CS. Statistically significant association was found between birth weight of the babies and mode of delivery (p<0.05). Conclusion: Caesarean section cannot be routinely recommended, unless there are other obstetric indications. Bangladesh Armed Forces Med J Vol 57 No (1) June 2024, pp 8-13