Birth Certificate Research Articles

Differences in health visiting contacts for children of mothers with and without a history of adversity-related hospital admissions in England (2018/19 to 2019/20): an analysis of novel linked community health and hospital data.

ObjectiveExplore differences in children’s contact with health visiting (HV) services by pre-birth exposure to maternal adversity. ApproachFor the first time, we linked the Community Services Dataset (CSDS), which records HV contacts for children in England from 1 April 2018 to 31 March 2020, to Hospital Episode Statistics (HES) which contains births and mothers’ hospital admissions in the preceding 3 years. We used admissions that included ICD-10 codes related to mental health, substance use and violence to identify children born to mothers with a history of adversity. We compared characteristics of children’s HV contacts (i.e. number, mode, location, duration) stratified by maternal adversity. ResultsOverall, 85.2% of 626,478 children in CSDS linked to a birth record in HES. Among children receiving HV contacts, 11.7% were exposed to maternal adversity: 11.1% mental health, 1.3% substance use, 0.4% violence. Children with maternal adversity had more HV contacts than other children (mean = 3.8 vs 2.7, p<0.001). There were no differences in contact mode (i.e. face-to-face or phone) for children with maternal adversity compared to others, but their contacts were longer (44.5% lasting >30 minutes vs 35.1%, p<0.001) and more likely to be at home (56.3% vs 47.8%, p<0.001). ConclusionsHV services respond in different ways to children with and without pre-birth exposure to serious maternal adversity, reflecting the “proportionate universalism” that underpins HV services in England. ImplicationsThe differential service response for vulnerable children may require additional resources (e.g. staff, training) which should be considered when designing and funding HV services.

Increasing Prevalence of Diagnosed Gestational Diabetes in South Carolina: 2015-2021.

Objective: To examine trends with a focus on racial and ethnic disparities in reported gestational diabetes mellitus (GDM) and related outcomes (macrosomia, large for gestational age infants) before and during the COVID-19 pandemic in South Carolina (SC). Methods: A retrospective cohort study of pregnancies resulting in livebirths from 2015 through 2021 was conducted in SC. Statewide maternal hospital and emergency department discharge codes were linked to birth certificate data. GDM was defined by ICD-9-CM (i.e., 648.01-648.02, 648.81-648.82) or ICD-10-CM codes (i.e., O24.4, O24.1, O24.9), or indication of GDM on the birth certificate without evidence of diabetes outside pregnancy (ICD-9-CM: 250.xx; ICD-10-CM: E10, E11, O24.0, O24.1, O24.3). Results: Our study included 194,777 non-Hispanic White (White), 108,165 non-Hispanic Black (Black), 25,556 Hispanic, and 16,344 other race-ethnic group pregnancies. The relative risk for GDM associated with a 1-year increase was 1.01 (95% confidence interval [CI]: 1.01-1.02) before the pandemic and 1.12 (1.09-1.14) during the pandemic. While there were race-ethnic differences in the prevalence of GDM, increasing trends were similar across all race-ethnic groups before and during the pandemic. From quarter 1, 2020, to quarter 4, 2021, the prevalence of reported GDM increased from 8.92% to 10.85% in White, from 8.04% to 9.78% in Black, from 11.2% to 13.65% in Hispanic, and from 13.3% to 16.16% in other race-ethnic women. Conclusion: An increasing prevalence of diagnosed GDM was reported during the COVID-19 pandemic. Future studies are needed to understand the mechanisms underlying increasing trends, to develop interventions, and to determine whether the increasing trend continues in subsequent years.

Neighborhood Child Opportunity and Preterm Birth Rates by Race and Ethnicity

In the US, infants born to non-Hispanic Black birthing parents are 50% more likely to be born preterm than those born to non-Hispanic White birthing parents, and individual-level factors do not fully account for this inequity. Neighborhood context, rooted in historic patterns of structural racism, may facilitate understanding patterns of inequity in preterm birth. To estimate the association between neighborhood opportunity level, measured by the Child Opportunity Index (COI), and preterm birth among infants in Massachusetts. In this cross-sectional, population-based study, Massachusetts birth certificates from 3 large metropolitan areas (Boston, Springfield, and Worcester) were linked to US Census tract-level data from the COI, and log binomial regression models and generalized estimating equations were fit to examine associations of different levels of opportunity with preterm birth. Singleton infants born in Massachusetts between February 1, 2011, and December 31, 2015, were included. Analyses were originally conducted in 2019 and updated in 2024. Level of child opportunity (measured by the COI) at the US Census tract level. Race and ethnicity were ascertained from the birth certificate, as reported by the birthing parent. Live birth before 37 completed weeks' gestation. The analytic dataset included 267 553 infants, of whom 18.9% were born to Hispanic, 10.1% to non-Hispanic Asian or Pacific Islander, 10.1% to non-Hispanic Black, and 61.0% to non-Hispanic White birthing parents. More than half of infants born to non-Hispanic Black and Hispanic birthing parents were born into very low opportunity neighborhoods, and in crude models, this was associated with greater prevalence of preterm birth relative to very high opportunity neighborhoods (prevalence ratio, 1.44; 95% CI, 1.37-1.52). After adjustment for covariates, infants born into very low opportunity neighborhoods still had a greater prevalence of preterm birth (prevalence ratio, 1.16; 95% CI, 1.10-1.23). In this cross-sectional study of neighborhood opportunity and preterm birth, elevated risk associated with exposure to a very low opportunity neighborhood, coupled with the disproportionate exposure by race and ethnicity, points to a modifiable factor that may contribute to racial and ethnic inequities in preterm birth. Future research should investigate interventions that seek to address neighborhood opportunity.

Split Genders: Medical versus Legal Understanding of Gender Identity (De Lege Lata and De Lege Ferenda)

Abstract For centuries, the law accepted the legal gender of an individual that was indicated at birth by the appearance of their genitalia and stated on their birth certificate. Nowadays, however, we have plenty of scientific, medical and psychological evidence (and thus reasons) to revise the adopted way of thinking about legal gender to associate it more with gender identity. Most people do not perceive a potential conflict between genital sex and gender identity, because their genital sex is consistent with their gender identity. Trans- and intersex comunnity needs recognition of their gender identity independent of their genital sex as a condition for a life of self-determination, personal freedom, respect and dignity; these are, aft er all, values that are extremely important for the law. The purpose of this analysis is to determine whether the concept of gender identity is perceived generally in the Polish language and the Polish legal system in a way that takes into account current medical knowledge and the legitimate needs of the individual. If not, then what de lege ferenda recommendations can be made to change this situation?

Examining rurality and social determinants of health among women with GDM: a 15-year comprehensive population analysis

BackgroundGestational diabetes mellitus (GDM) is a common pregnancy complication with long-term health consequences for mothers and their children. The escalating trends of GDM coupled with the growing prevalence of maternal obesity, a significant GDM risk factor projected to approach nearly 60% by 2030 in Kansas, has emerged as a pressing public health issue.MethodsThe aim of this study was to compare GDM and maternal obesity trends in rural and urban areas and investigate maternal demographic characteristics influencing the risk of GDM development over a 15-year period. Trend analyses and a binary logistic regression were employed utilizing 2005 to 2019 de-identified birth record vital statistics from the Kansas Department of Health and Environment (N = 589,605).ResultsOver the cumulative 15-year period, a higher prevalence of GDM was observed across age, race/ethnicity, education, and insurance source. Throughout this period, there was an increasing trend in both GDM and obese pre-pregnancy BMI age-adjusted prevalence, with noticeable rural-urban disparities. From 2005 to 2019, women, including Asians (OR: 2.73, 95% CI 2.58%-2.88%), American Indian or Alaskan Natives (OR: 1.58, 95%, CI 1.44-1.73%), Hispanics (OR: 1.42, 95% CI 1.37%-1.48%), women residing in rural areas (OR: 1.09, 95%, CI 1.06-1.12%), with advanced maternal age (35–39 years, OR: 4.83 95% CI 4.47%-5.22%; ≥40 years, OR: 6.36 95%, CI 5.80-6.98%), with lower educational status (less than high school, OR: 1.15, 95% CI 1.10%-1.20%; high school graduate, OR: 1.10, 95% CI 1.06%-1.13%), Medicaid users (OR: 1.10, 95% CI 1.06%-1.13%), or with an overweight (OR: 1.78, 95% CI 1.72%-1.84%) or obese (OR: 3.61, 95% CI 3.50%-3.72%) pre-pregnancy BMI were found to be at an increased risk of developing GDM.ConclusionsThere are persistent rural-urban and racial/ethnic disparities present from 2005 to 2019 among pregnant women in Kansas with or at-risk of GDM. There are several socioeconomic factors that contribute to these health disparities affecting GDM development. These findings, alongside with prominent rising maternal obesity trends, highlight the need to expand GDM services in a predominantly rural state, and implement culturally-responsive interventions for at-risk women.

Measuring preparedness to infectious diseases among people exposed to climate disasters in Cabo Delgado, Mozambique: a cross-sectional study

IntroductionClimate change is contributing to increase the frequency and severity of climate disasters in Mozambique, leading, since 2019, to extensive damage to infrastructure and displacement 1.3 million people. Aim of this study is to evaluate baseline preparedness to vector-borne and water-borne infections among households and internally displaced people exposed to climate disasters in Mozambique.MethodsThis was a cross-sectional, community-based survey assessing the preparedness to infectious diseases outbreaks among people exposed to climate disasters in six districts in Mozambique. Structured form was delivered via face-to-face between October 15th and November 7th, 2022. Study outcome was defined as a seven-point score of preparedness to infectious disease outbreaks. Multivariable analysis of the score was conducted using Conway-Maxwell-Poisson regression.ResultsThis study included 2,140 households and 11,239 people, with IDPs accounting for 30% of them. Overall, 1,186 (55.4%) households were overcrowded. Median score of preparedness was 3 points (IQR 2–4). At multivariable analyses, districts with low preparedness were Montepuez and Mueda. Higher preparedness was associated with family planning (p < 0.0001), access to primary education for all children living in the household (p < 0.001) and possession of a birth certificate for all children aged < 5y (p < 0.0001), while preparedness was heterogeneous among the districts (p < 0.05). Households composed by IDPs were not associated with a lower preparedness score.ConclusionsIn climate-vulnerable communities in Mozambique, households practicing family planning, providing access to primary education and birth certificate for all children were less vulnerable to water-borne and vector-borne infectious disease outbreaks. Being family planning and childcare primarily performed by women, our findings can inform policymakers and practitioners on the importance of addressing women to mitigate the impact of climate disasters and reduce the risk of infectious disease outbreaks.

Legitimacy Status of Inheritance by Adopted Children

This study aims to analyze the legal strength of civil registration deeds as evidence of inheritance ownership. The first research, How is the legal force of civil registration deeds as the basis for controlling inheritance by children. As an official document that records a person's birth, a birth certificate plays an important role in legal proceedings related to property inheritance. In the context of inheritance law, the validity of the birth certificate is the main key in determining the right of an adopted child to inherit property from his adoptive parents. Along with a valid birth certificate, the adopted child has a strong legal basis to claim his inheritance rights. However, there are challenges and problems that may arise related to the validity of birth certificates in the context of inheritance control. Second, how can heirs report criminal acts against adopted children who have controlled the inheritance. Therefore, this study aims to analyze in depth the role of birth certificate power as a tool that allows adopted children to obtain inheritance rights, as well as to identify strategies that can be applied to ensure the effective protection of inheritance rights of adopted children. Through the approach of legal analysis and literature study, this study concludes that the strength of the birth certificate is a crucial foundation in proving the legal status of an adopted child in the process of controlling inheritance, but further efforts are needed to improve the legal protection of adopted children in the context of property inheritance.

Pelayanan pembuatan akta kelahiran menuju transformasi digital di kabupaten Bogor

Because it is impossible to reject the use of technology in public service procedures, the Bogor Regency Population and Civil Registration Service has implemented digital transformation in its operations, including the issuance of birth certificates. Knowing how digital transformation is implemented in the Bogor Regency Dukcapil Office is the aim of this research. This research applies Royyana's thesis (2021) which states that digital transformation is a shift for all institutions involving five indicators: technology adoption, process, structure, human resources and strategy. Bogor Regency Disdukcapil employees act as research informants in this qualitative descriptive research design. The findings of this research can show that the Bogor Regency Dukcapil Office has succeeded in implementing digital transformation.

Cardiovascular Events During Pregnancy: Implications for Adverse Pregnancy Outcomes in Individuals With Autoimmune and Rheumatic Diseases.

This study examined maternal cardiovascular (CV) events relative to adverse pregnancy outcomes among individuals with autoimmune rheumatic diseases (ARDs), primary antiphospholipid syndrome (APS), and those with neither. Using a California population-based birth cohort (2005-2020), we identified those with CV events (CVEs), ARDs, and APS through International Classification of Diseases, 9th and 10th revisions, Clinical Modification codes in maternal discharge records. Selected adverse pregnancy outcomes identified from birth certificates were preterm birth (PTB; < 37 weeks' gestation), small-for-gestational-age infants (SGA; birth weight < 10th percentile for age and sex), and a composite of either outcome. Adjusted risk ratios (aRRs) for adverse outcomes and their 95% CIs were calculated. CVEs occurred more frequently in individuals with ARDs (265 of 19,340 [1.4%]) and primary APS (428 of 7758 [5.5%]) than those without (17,130 of 7,004,334 [0.3%]). The presence vs absence of CVEs was associated with a greater incidence of adverse outcomes in ARD (53.2% vs 26.6%), APS (30.6% vs 20.7%), and non-ARD/APS pregnancies (28.2% vs 15.2%). CVEs were associated with increased risks of SGA in all groups (aRRs 1.2-1.5) and PTB in ARD (aRR 1.6, 95% CI 1.3-2.0) and non-ARD/APS (aRR 1.7, 95% CI 1.7-1.8) pregnancies. CVEs were associated with modestly increased risks (20-70%) for PTB, SGA, or both across the groups. Notably, > 50% of ARD pregnancies with CVEs experienced adverse pregnancy outcomes. Given that ARD and APS pregnancies have higher (although still low) rates of CVEs and have higher baseline risks of adverse pregnancy outcomes than the general population, the additional burden conferred by CVEs is clinically important.

Births in the United States, 2023.

This report presents 2023 data on U.S. births compared with 2022 and 2021 for several key demographic and maternal and infant characteristics. Descriptive tabulations of data reported on the birth certificates of the 3.60 million births that occurred in 2023 are presented. Data are presented for the number of births, the general fertility rate, teenage birth rates, the distribution of births by trimester prenatal care began and the distribution of births by selected gestational age categories. Data for 2023 are compared with data for 2022 and 2021. A total of 3,596,017 births were registered in the United States in 2023, down 2% from 2022. The general fertility rate declined 3% in 2023 to 54.5 births per 1,000 females ages 15-44. Birth rates declined for females ages 15-19 (4%), 15-17 (2%), and 18-19 (5%), from 2022 to 2023. The percentage of mothers receiving prenatal care in the first trimester of pregnancy declined 1% to 76.1% in 2023 while the percentage of mothers with no prenatal care increased 5%. The preterm birth rate was essentially unchanged at 10.41% in 2023 but the rate of early term births rose 2%.

Uses of antiseizure medication among pregnant women with epilepsy and risk of adverse obstetric outcomes: A group-based trajectory analysis.

This study was undertaken to examine the association between different patterns of antiseizure medication (ASM) use during pregnancy and adverse obstetric outcomes (preterm birth, low birth weight [LBW], and small for gestational age [SGA]). This retrospective cohort study used the Birth Certificate Application and National Health Insurance data in Taiwan (January 1, 2004 through December 31, 2018). We retrieved weekly ASM among pregnant women with epilepsy who were prepregnancy chronic users and used group-based trajectory modeling to identify distinct patterns of use. Logistic regressions were adopted to examine the association between patterns of ASM use and risk of preterm birth, LBW, and SGA. In addition, we revealed postnatal ASM utilization pattern among these prepregnancy chronic users as an exploratory study. Of 2175 pregnant women with epilepsy, we identified four patterns of ASM use during pregnancy: frequent and continuous (64.87%), frequent but discontinuous (7.08%), intermittent (19.72%), and intermittent and discontinuous users (8.32%). Compared to frequent and continuous users, the adjusted odds ratios for preterm birth in frequent but discontinuous, intermittent, and intermittent and discontinuous users were .83 (95% confidence interval [CI] = .47-1.48), .71 (95% CI = .47-1.05), and .88 (95% CI = .52-1.49), respectively. Similar results were observed for LBW and SGA. In the exploratory study, we found that most of our study subjects maintained the same patterns before and after delivery. After considering duration and timing of exposure, our study did not find an association between four distinct patterns of ASM use and adverse obstetric outcomes among women with epilepsy. The findings suggested that optimal seizure control could be received for pregnant women with epilepsy after evaluating the risks and benefits.

Birth defects among offspring of California firefighters, 2007–2019

PurposeLimited research examines birth defects from maternal or paternal firefighting exposure. This study aims to assess if maternal or paternal occupational exposure to firefighting during periconception is associated with offspring birth defects. MethodsData from California birth certificates (2007–2019) were linked to maternal / offspring hospitalization records. Occupation during the periconceptional period was categorized from vital statistics as the following: paternal non-firefighting (n = 4,135,849), paternal firefighting (n = 22,732), maternal non-firefighting (n = 3,332,255) and maternal firefighting (n = 502). Birth defects were identified using ICD codes, grouped by anatomical regions. Adjusted odds ratios were estimated, and sensitivity analyses explored police officer reference groups and detailed birth defect categories. ResultsOffspring of paternal firefighters had lower odds of circulatory defects (aOR = 0.9, 95% CI 0.8, 1.0), oral clefts (aOR = 0.6, 95% CI 0.4, 0.8) and respiratory defects (0.7, 95% CI 0.6, 0.9) compared to paternal non-firefighters. Associations between maternal firefighting and offspring birth defects were imprecise. Substituting police officers as the reference group attenuated findings. ConclusionsOffspring of paternal firefighters may have similar or slightly lower birth defect odds compared to offspring of non-firefighters. Limited data was available for assessing maternal firefighting outcomes. Future studies should prioritize studies using occupational exposure matrices to limit misclassification of exposure.

Medication use patterns in pregnant women with psoriasis: A nationwide study in Taiwan.

Psoriasis, an autoimmune skin condition, affects 2%-4% of the global population, with significant prevalence among women of childbearing age. Pregnancy presents challenges in managing psoriasis due to hormonal changes and treatment safety concerns. Understanding treatment patterns in pregnant women is crucial, given limited real-world evidence. Explore the utilization patterns of medications among pregnant women diagnosed with psoriasis within a real-world data, utilizing data sourced from a nationwide database in Taiwan. This nationwide study utilized Taiwan's National Health Insurance (NHI) database and Birth Certificate Application. It included registered pregnant women diagnosed with psoriasis from 2005 to 2014. Medication usage was tracked three years before conception to three years after delivery. Medications were categorized based on Anatomical Therapeutic Chemical (ATC) codes, and statistical analyses were conducted using SAS software. A total of 30,267 pregnant women with psoriasis were studied. 11,651 (38.49%) mothers had received at least one prescription during follow-up (exposed group), and >60% had never received medication (unexposed group). Demographics and comorbidities were similar between these two groups. Topical corticosteroids were the most prescribed treatment, followed by phototherapy, with systemic drugs and biologics less common. During the study period, 11,096 women with psoriasis had used topical corticosteroids, 3,376 had used non-steroidal topical agents, 218 had used systemic agents or biologics, and 519 had received treatment with phototherapy. Medication usage declined during pregnancy, reaching its lowest in the third trimester but rebounded postpartum. Psoriasis medications, systemic, biological, or topical, were largely discontinued during pregnancy, sometimes up to 2 years before and extending postpartum. Research is needed to understand its impact on maternal and child health.

Perspectives on sperm donor anonymity: insights from donor-conceived adults in Belgium.

Are donor-conceived adults in Belgium interested in obtaining donor information, and do these interests vary based on their family backgrounds? Donor-conceived adults express a significant interest in obtaining donor-related information, with the highest interest reported by offspring from heterosexual couples compared to those from lesbian couple-parented or single-parent families. In Belgium, sperm donation is mainly anonymous, but the rise of direct-to-consumer genetic testing challenges this anonymity. This was a cross-sectional study involving an online nationwide survey conducted from July 2022 to October 2023. Participants, aged 18years and older and being aware of their anonymous sperm donor-conceived status, were recruited through various channels. A total of 203 participants were included: 62.6% grew up in heterosexual families with infertile fathers, 26.1% with lesbian couples, 8.4% with single parents, and 3.0% in various or diverse family structures. The survey was available in both French and Dutch and consisted of 43 questions, including a mix of yes/no questions and multiple-choice items. The average age of disclosure was 16.5 years, with notably later disclosure in heterosexual couple-parented households. A substantial 82.8% of donor-conceived individuals expressed a keen interest in obtaining non-personally identifiable donor information, while 69% were curious about personally identifiable donor data. Furthermore, 61.6% conveyed a desire for personal contact with their donors, and 26.6% advocated for the inclusion of the donor's name on their birth certificates. Participants raised in lesbian two-parent families exhibited the lowest level of interest in donor-related information compared with those raised in other family structures. An overwhelming 90.1% wondered about the possibility of having half-siblings from the same sperm donor. Analysis of survey responses on DNA database registration revealed that 55.2% of donor-conceived offspring were already registered, with 68.8% discovering the same donor offspring and 30.4% successfully locating their donors. Compared to individuals from other family structures, those raised in heterosexual couple-parented households exhibit a less positive attitude toward their conception through anonymous sperm donation. About 61.6% of donor-conceived individuals reported experiencing distinct emotions compared to their peers, while 44.1% encountered psychological difficulties related to anonymous sperm donation, primarily attributed to late disclosure. The majority supported the idea of informing the donor about the number of children he facilitated to conceive. Lastly, the study highlighted that 21.2% of donor-conceived adults considered becoming donors themselves, and 31.3% expressed willingness to use an anonymous donor whenever faced with fertility challenges. Our sample size may not fully represent all adults conceived through anonymous sperm donation in Belgium. Participation bias may have influenced the results, especially due to the overrepresentation of participants from heterosexual couples. Additionally, an association exists between individuals raised by heterosexual couples and late disclosure, complicating the analysis by introducing a confounding factor. The findings of this study contribute to a better understanding of the needs and preferences of donor-conceived adults, with significant potential impact on patient education and healthcare policy. Study funding was not obtained for this research. There are no conflicts of interest to disclose. N/A.

Infertility treatments and cyanotic congenital heart defects among livebirths in the USA: findings from a contemporary cohort.

Is there an elevated risk of cyanotic congenital heart defects (CCHD) among livebirths following infertility treatments? In this population-based study of single livebirths, infertility treatment (either ART or non-ART) was associated with a higher prevalence of CCHD among livebirths. The use of infertility treatment has been on the rise over the past few decades. However, there are limited studies assessing the risk of major cardiac defects following infertility treatments. A retrospective cohort study of livebirth data from the National Vital Statistics System (NVSS) was conducted, comprising of 9.6 million singleton livebirths among first-time mothers aged 15-49 years from 2016 to 2022. Information on infertility treatment use and CCHD was obtained from the health and medical information section of birth certificates, which was completed by healthcare staff after reviewing medical records. Logistic regression models were used to estimate odds ratios (OR) and 95% CI. Entropy balancing weighting analysis and probabilistic bias analysis were also performed. The proportion of births following infertility treatment increased from 1.9% (27116) to 3.1% (43510) during the study period. Overall, there were 5287 cases of CCHD resulting in a prevalence of 0.6 per 1000 livebirths. The prevalence was 1.2 per 1000 live births among infertility treatment users (ART: 1.1 per 1000 livebirths; non-ART: 1.3 per 1000 livebirths) while that for naturally conceived births was 0.5 per 1000 livebirths. Compared to naturally conceived births, the use of any infertility treatment (OR: 2.06, 95% CI: 1.82-2.33), either ART (OR: 2.02, 95% CI: 1.73-2.36) or other infertility treatments (OR: 2.12, 95% CI: 1.74-2.33), was associated with higher odds of CCHD after adjusting for maternal and paternal age, race and ethnicity, and education, as well as maternal nativity, marital status, source of payment, smoking status, and pre-pregnancy measures of BMI, hypertension and diabetes. This association did not differ by the type of infertility treatment (ART versus other infertility treatments) (OR: 1.04, 95% CI: 0.82-1.33, P = 0.712), and was robust to the presence of exposure and outcome misclassification bias and residual confounding. The findings are only limited to livebirths. We did not have the capacity to examine termination data, but differential termination by mode of conception has not been supported by previous studies designed to consider it. Infertility treatment use was self-reported, leading to the potential for selection bias and misclassification for infertility treatment and CCHD. However, the association persisted when systematic bias as well as exposure and outcome misclassification bias were accounted for in the analyses. Information on the underlying etiology of infertility relating to either maternal, paternal, or both factors, data on specific types of ART and other infertility treatments, as well as information on subtypes of CCHD, were all not available. In light of the increasing trend in the use of infertility treatment in the USA, and elsewhere, the finding of the current study holds significant importance for the clinical and public health of reproductive-aged individuals. The data show that the use of infertility treatment may expose offspring to elevated odds of severe congenital heart defects such as CCHD studied here. These findings cannot be interpreted causally. While our findings can assist in preconception counseling and prenatal care for pregnancies conceived by either ART or other infertility treatments, they also support some current recommendations that pregnancies resulting from infertility treatments undergo fetal echocardiography screening. No funding was sought for the study. The authors declare that they have no conflict of interest. N/A.

IMPLEMENTATION OF THE CHILD IDENTITY CARD POLICY IN SERANG DISTRICT, BANTEN PROVINCE

The issuance of birth certificates for the child population in Banten Province has reached the specified target, where out of 2,923,089 child population who have birth certificates as many as 2,905,894 residents or equivalent to 99.41%. However, this is not matched by the issuance of Child Identity Cards, the percentage of coverage is still very low, which only reaches 29.78% of the entire child population who already has a birth certificate. The purpose of the research is to find out, analyze and explain the implementation of the child identity card, the determinant factors that determine and construct an effective Child Identity Card policy implementation model in Serang Regency, Banten Province. This research uses the theory of policy implementation put forward by Hamdi (2014) with the dimensions of productivity, linearity and efficiency. Determinant factors that influence policy implementation are policy substance, implementing officer behavior, network interaction, target group participation and resources. The research method used is qualitative research with a descriptive approach. Data collection techniques were carried out by interview, observation and documentation. The results showed that the implementation of the Child Identity Card policy in Serang Regency was not optimal.

Concomitant use of antidepressants and benzodiazepines during pregnancy and associated risk of congenital malformations: a population-based cohort study in Taiwan

Despite the frequent co-administration of antidepressants and benzodiazepines, the association between such concomitant use during pregnancy and the risk of congenital malformations remains inadequately explored. This study aims to examine the association between concomitant use of antidepressants and benzodiazepines during the first trimester and organ-specific congenital malformations. We conducted a population-based cohort study using Taiwan's National Birth Certificate Application database, the Maternal and Child Health database, and Taiwan's National Health Insurance database. Pregnant people aged 15-50 years with singleton births between Jan 1, 2004, and Dec 31, 2018, were included. Use of antidepressants and benzodiazepines was defined as at least one prescription during the first trimester, and concomitant use was defined as the overlapping prescription of both drugs with an overlapping prescription period. The primary outcomes were overall congenital malformations and eight organ-specific malformations, consisting of the nervous system, heart, respiratory system, oral cleft, digestive system, urinary system, genital system, and limb malformations. Logistic regression models with propensity score fine stratification weighting approach were used to control for measured confounders. Analyses controlling for confounding by indication and sibling comparison analyses were done to address unmeasured confounders. No individuals with lived experience participated in the research or writing process. The cohort included 2 634 021 singleton pregnancies, and 8599 (0·3%) individuals were concomitant users of antidepressants and benzodiazepines during the first trimester (mean age at delivery was 31·8 years [SD 5·2] for pregnancies with exposure to antidepressants and benzodiazepines vs 30·7 years [SD 4·9] for pregnancies without exposure). All study participants were female, and information about ethnicity was not available. Absolute risk of overall malformations was 3·81 per 100 pregnancies with exposure, compared with 2·87 per 100 pregnancies without exposure. The propensity score-weighted odds ratios (weighted ORs) did not suggest an increased risk for overall malformations (weighted OR 1·10, 95% CI 0·94-1·28), heart defects (1·01, 0·83-1·23), or any of the other organ-specific malformations, except for digestive system malformations, for which the weighted OR remained statistically significant after adjustment (1·63, 1·06-2·51). The absence of an increased risk for overall congenital malformations associated with concomitant use of antidepressants and benzodiazepines was supported by the analyses controlling for confounding by indication and sibling-matched comparisons. The findings of this study suggest that the concomitant use of antidepressants and benzodiazepines during the first trimester is not associated with a substantial increase in risk for most malformation subtypes. However, considering other potential adverse effects of using both medications concomitantly, a thorough assessment of the risks and benefits is crucial for clinical decision making. National Science and Technology Council.

Birth certificates of bridges – reference condition of new bridges

Information on changes in the structure and deviations from normal behavior is important for the predictive maintenance of engineering structures. Changes can be detected by using monitoring and structure inspection. The determination of changes, requires that these changes be compared with a reference condition. The determination of the reference condition currently takes place when changes and damage to the structure are already present. This is where the idea of the birth certificate begins. The birth certificate of a bridge describes the zero measurement of the bridge, which determines the reference condition and the load-bearing behavior of a bridge after its completion on the basis of suitable parameters. Measurements can be repeated at appropriate intervals to detect changes. The concept of birth certificate does not require continuous measurements over the entire life cycle. Relevant parameters are: - Physical: Determination is carried out by equipping the bridge with sensors and performing measurements possibly supported by test loads with the aim of mapping the static and dynamic behavior of the bridge. - Geometric: Creation of a three-dimensional, geo-referenced model of the actually built structure in sufficient detail. - Chemical: Detection of changes that lead to a reduction in durability via investigations of building materials technology. The main objective is to identify a reference condition for detecting and evaluating changes in the behavior and condition of the bridge. In the paper, the background to the creation of the birth certificate, the objectives and the approach in other countries or disciplines are presented. Furthermore, the importance of the reference measurement for the monitoring application in new construction and ideas of a concept for the implementation of birth certificates via the derivation of indicators, are described.

A Review on Dental Age Estimation in Children and Adolescents

Abstract Children are seen as beings who exist from birth through puberty, while teenagers are regarded as existing from puberty until around the age of 20 years. For a number of legal processes, including child labor, employment, the age of majority, rape, adoption, marriage eligibility, and situations where the birth certificate is unavailable, age estimation in children and adolescents is crucial. Despite the wide range of methods available, dental age estimation techniques that take into account tooth maturation are thought to be the most reliable predictors of chronological age in subadults. This is because genetic factors predominate and environmental factors, particularly between birth and age ten, tend to have little impact on tooth maturation. The eruption of teeth holds greater significance in the deciduous dentition, where genetic factors predominantly govern the process, compared to the permanent dentition. Conversely, tooth calcification serves as a viable indicator for estimating dental age in both primary and permanent dentitions. Current dental age estimation methods are based on age-related changes in teeth, such as tooth growth and development, changes that occur after teeth form, and biochemical changes. Therefore, in this review article, we will explore the several methodologies used for dental age assessment in children and adolescents.

Application of The Healthy Migrant Theory to Maternal Morbidity and Mortality Data in Ohio

BACKGROUND: The Healthy Migrant Theory is a phenomenon describing a protective effect regarding specific health outcomes when a person of color is born outside of the U.S. Previous literature has focused on the application of this theory to infant outcomes, leaving its application to maternal outcomes mostly unstudied. The objective of this research is to determine whether the Healthy Migrant Theory holds true to maternal morbidity in the Ohio population. METHODS: Birth record data from the Ohio Department of Health was analyzed from 2015-2020 that included mothers identifying as White or Black and data where country of birth was available (n=717,300). Mothers were grouped by race and nationality. Maternal morbidity and socioeconomic status (SES) were analyzed. One-way ANOVA was used to examine associations between SES and number of maternal morbidity events. Binary logistic regression models were developed to examine the relationships among race, nationality, and occurrence of maternal morbidity events. Interaction between race and nationality was also evaluated. RESULTS: Among black mothers, nationality was significantly associated with the likelihood of any maternal morbidity event occurring (OR= 1.659; 95% CI= 1.534, 1.795; p&lt; 0.001), with foreign-born mothers having about 1.66 times greater odds of having a maternal morbidity event. This relationship persisted after adjusting for SES. No statistical difference in low SES indicators was found between foreign-born Black mothers and US-born Black mothers (p= 0.349, 95% CI= -0.007, 0.030). DISCUSSION: Our findings appear to contradict the Healthy Migrant Theory. More research regarding treatment and outcomes of foreign-born Black mothers must be implemented to better understand the nuances of the application of this theory to maternal outcomes. Caution should be taken when comparing infant and maternal outcomes and interventions since they may not be as closely connected as previously thought. Limitations of this project include inaccuracies in data collection from birth certificates, limited morbidity variables, and lack of stratification based on country of origin.