Birth Certificate Research Articles

Validation of gestational weight gain records on South Carolina birth certificate data

ObjectiveTo examine the accuracy of gestational weight gain (GWG) reported on birth certificates (BCs) in comparison with electronic medical records (EMRs), the gold standard.MethodsBC data and EMR data were from a random sample of pregnant women who enrolled in CenteringPregnancy program, a type of group-based prenatal care, at three obstetric clinics in South Carolina between 2015 and 2019 (n = 206). Retrospective review of EMR data on patients’ prepregnancy BMI and GWG according to 2009 Institute of Medicine guidelines was conducted. Analyses involved summarizing the variables by their mean and mean differences per data source, and then calculating percent-weighted agreement and kappa statistics.ResultsThe mean values of BMI, delivery weight and total weight gain were similar between BC and EMRs. Data correlation for variables was high for both data sources (height: r = 0.94, prepregnancy weight: r = 0.93, prepregnancy BMI: r = 0.92, delivery weight: r = 0.96, total weight gain: r = 0.60). The BCs slightly underestimated the proportion of women in the normal-weight BMI category but overestimated the proportion in the overweight BMI category. Additionally, BCs slightly overestimated women with inadequate GWG and underestimated those with excessive GWG. Overall, the BC and EMR data were in agreement regarding prepregnancy BMI (weighted-agreement = 90%, Kappa = 0.78) and GWG categories (weighted-agreement = 84%, Kappa = 0.63).ConclusionBC estimates of prepregnancy BMI and GWG categories were similar to those recorded in the EMRs. The South Carolina BC database is a valid database for gestational weight and can provide reasonable estimates for the state in the evaluation of the CenteringPregnancy program.

Pengaruh Media Motion Video Education Kelas Ibu Hamil terhadap Peningkatan Pengetahuan dan Sikap Ibu Hamil tentang Anemia

Background: Classes for pregnant women, are a means to learn together about health for pregnant women, in the form of face-to-face groups that aim to increase the knowledge and skills of mothers regarding pregnancy, pregnancy care, childbirth, postpartum care, newborn care, myths, infectious diseases and birth certificates. Pregnant women need interesting educational tools to increase their knowledge and attitudes about anemia. The use of Educational Motion Video Media aims to increase the knowledge and attitudes of Pregnant Women about anemia. Method: Article review is made using the literature review method. The articles used were obtained from relevant articles in the last 10 years. Results: From several studies that have been conducted, the results obtained. The use of Motion Video Education Media can increase the knowledge and attitudes of pregnant women about anemia. Conclusion: Media Motion Video Education is very useful for increasing the knowledge and attitudes of pregnant women about anemia.

Risk factors for stillbirth at term: an Italian area-based, prospective cohort study

Stillbirth at term has great emotional impact on both parents and professionals. In developed countries, efforts to identify risk factors are mandatory to plan area-specific prevention strategies. The aim of the study was to identify independent risk factors that contribute to stillbirth at 37 weeks' gestation or later. This was an area-based, prospective cohort study on pregnancy at term with enrolled from 2014 to 2021 in Emilia-Romagna, a north Italian region. Data were retrieved from both birth certificates and the Stillbirth Surveillance system database. To identify independent risk factors, a multivariate analysis using logistic regression was performed. A descriptive analysis of the causes of stillbirth is also reported. In the observation period, 246,437 babies born at term (including 260 stillbirths, giving a rate of 1.06/1000) were considered. The risk factors independently associated with stillbirth were small for gestational age babies (odds ratio, 2.58; 95% confidence interval, 1.88-3.53), pregnancy achieved though fertility treatments (odds ratio, 2.01; 95% confidence interval, 1.15-3.51), and delayed access to pregnancy services (odds ratio, 1.56; 95% confidence interval, 1.10-2.22). In multipara, the presence of a previous stillbirth (odds ratio, 3.91; 95% confidence interval, 1.98-7.72) was also associated with an increased risk for recurrence. Early- rather than late-term was an additional risk factor. The most frequent causes of death were placental and cord disorders (61/260 and 56/260, respectively). However, 28.1% of cases remain unexplained. The risks for stillbirth at term are known early in pregnancy or could be identified through tailored antenatal management, allowing effective preventive strategies to reduce preventable cases.

MARRIAGE REGISTRATION AS A FORM OF MAṢLAḤAH MURSALAH

Registration of marriages can be categorized as a new phenomenon because in its history during the time of the Prophet there had never been registration and bookkeeping of marriages, divorces and reconciliation. Bookkeeping during the time of the Prophet was only a matter of bookkeeping in the Qur'an, whereas explicitly in the text there is an order to record and record books in the aspect of muamalah or selling buying and selling transactions. This article attempts to explore more deeply the issue of marriage registration within the framework of maslahah murlah. The author's findings are that marriage registration is in line with sharia provisions , namely creating benefits and preventing harm. The first dharuriy need is the benefit of maintaining religion. Marriage registration is seen as able to protect and maintain religious benefits. Second , benefit in protecting and guarding the soul. This can be seen from the psychological condition of the wife and children who are calmer, because without a marriage book a child cannot make a birth certificate. Third , benefit in maintaining reason. Marriage registration is very important for children's psychology, because with a marriage book, the child will feel calm because he is the legitimate child of both parents, so he will be confident in developing his mind to the maximum. Fourth , maintaining offspring. By registering a marriage, mixing between two people of different sexes is considered not adultery, so that children born from this relationship are considered valid and have clear identities and can be proven by law. Fifth, maintain property. By recording a marriage, the identity of the child born has clarity, so that when the parents die, the child will get his inheritance rights, so that the assets from the marriage can be maintained.

Health outcomes and provider choice under full practice authority for certified nurse-midwives

Full practice authority grants non-physician providers the ability to manage patient care without physician oversight or direct collaboration. In this study, we consider whether full practice authority for certified nurse-midwives (CNMs/CMs) leads to changes in health outcomes or CNM/CM use. Using U.S. birth certificate and death certificate records over 2008–2019, we show that CNM/CM full practice authority led to little change in obstetric outcomes, maternal mortality, or neonatal mortality. Instead, full practice authority increases (reported) CNM/CM-attended deliveries by one percentage point while decreasing (reported) physician-attended births. We then explore the mechanisms behind the increase in CNM/CM-attended deliveries, demonstrating that the rise in CNM/CM-attended deliveries represents higher use of existing CNM/CMs and is not fully explainable by improved reporting of CNM/CM deliveries or changes in CNM/CM labor supply.

Resuscitation, survival and morbidity of extremely preterm infants in California 2011–2019

ObjectiveTo describe changes over time in resuscitation, survival, and morbidity of extremely preterm infants in California.Study designThis population-based, retrospective cohort study includes infants born ≤28 weeks. Linked birth certificates and hospital discharge records were used to evaluate active resuscitation, survival, and morbidity across two epochs (2011–2014, 2015–2019).ResultsOf liveborn infants, 0.6% were born ≤28 weeks. Active resuscitation increased from 16.9% of 22-week infants to 98.1% of 25-week infants and increased over time in 22-, 23-, and 25-week infants (p-value ≤ 0.01). Among resuscitated infants, survival to discharge increased from 33.2% at 22 weeks to 96.1% at 28 weeks. Survival without major morbidity improved over time for 28-week infants (p-value < 0.01).ConclusionAmong infants ≤28 weeks, resuscitation and survival increased with gestational age and morbidity decreased. Over time, active resuscitation of periviable infants and morbidity-free survival of 28-week infants increased. These trends may inform counseling around extremely preterm birth.

Legal sex status: the attitudes of non-binary people towards reform in England and Wales

AbstractThe merits and means of accommodating non-binary populations into UK law is becoming an increasingly important issue for policymakers, judges, scholars and legal professionals. Following Elan-Cane's Supreme Court challenge to binary passport sex markers in 2021, the UK Government face another challenge this year concerning non-binary recognition on birth certificates. While an additional third sex option is perhaps the most well-known reform option for the current binary system, other options have been suggested, including additional multiple sex options and/or removing sex from the birth certificate. While scholars and policymakers debate the merits of these, little is known about non-binary people's own preferences towards these options. This paper therefore presents original empirical data on non-binary attitudes towards these options, demonstrating the various perceived opportunities and drawbacks of each, and reflecting on the possible consequences of reform.

Political representation and perinatal outcomes to Black, White, and Hispanic people in Georgia: a cross-sectional study

PurposeOur goal was to estimate differences in perinatal outcomes by racial differences in political representation, a measure of structural racism. MethodsWe gathered data on the racial composition of county-level elected officials for all counties in Georgia (n = 159) in 2022. We subtracted the percent of non-White elected officials from the percent of non-White residents to calculate the “representation difference,” with greater positive values indicating a larger disparity. We linked this to data from 2020–2021 birth certificates (n = 238,795) on outcomes (preterm birth, <37 weeks, low birthweight birth <2500 g, birthweight, hypertensive disorders of pregnancy, cesarean delivery). We fit log binomial and linear models with generalized estimating equations, stratified by individual race/ethnicity and including individual and county covariates. ResultsMedian representation difference was 17.5% points (interquartile range: 17.2). A 25-percentile point increase in representation difference was associated with a greater risk of hypertensive disorders of pregnancy [White: adjusted risk ratio (RR): 1.12, 95% confidence interval (CI): (1.05, 1.2), Black: 1.06, 95% CI: (0.95, 1.17), other: 1.14, 95% CI: (1.0, 1.3), Hispanic: 1.19, 95% CI: (1.07, 1.32)] and lower mean birthweight for Black birthing people [adjusted beta −15.3, 95% CI: (−25.5, −7.4)]. ConclusionsParity in political representation may be associated with healthier environments.

National Trends in Preterm Infant Mortality in the United States by Race and Socioeconomic Status, 1995-2020

Inequalities in preterm infant mortality exist between population subgroups within the United States. To characterize trends in preterm infant mortality by maternal race and socioeconomic status to assess how inequalities in preterm mortality rates have changed over time. This was a retrospective longitudinal descriptive study using the US National Center for Health Statistics birth infant/death data set for 12 256 303 preterm infant births over 26 years, between 1995 and 2020. Data were analyzed from December 2022 to March 2023. Maternal characteristics including race, smoking status, educational attainment, antenatal care, and insurance status were used as reported on an infant's US birth certificate. Preterm infant mortality rate was calculated for each year from 1995 to 2020 for all subgroups, with a trend regression coefficient calculated to describe the rate of change in preterm mortality. The average US preterm infant mortality rate (IMR) decreased from 33.71 (95% CI, 33.71 to 34.04) per 1000 preterm births per year between 1995-1997, to 23.32 (95% CI, 23.05 to 23.58) between 2018-2020. Black non-Hispanic infants were more likely to die following preterm births than White non-Hispanic infants (IMR, 31.09; 95% CI, 30.44 to 31.74, vs 21.81; 95% CI, 21.43 to 22.18, in 2018-2020); however, once born, extremely prematurely Black and Hispanic infants had a narrow survival advantage (IMR rate ratio, 0.87; 95% CI, 0.84 to 0.91, in 2018-2020). The rate of decrease in preterm IMR was higher in Black infants (-0.015) than in White (-0.013) and Hispanic infants (-0.010); however, the relative risk of preterm IMR among Black infants compared with White infants remained the same between 1995-1997 vs 2018-2020 (relative risk, 1.40; 95% CI, 1.38 to 1.44, vs 1.43; 95% CI, 1.39 to 1.46). The rate of decrease in preterm IMR was higher in nonsmokers compared with smokers (-0.015 vs -0.010, respectively), in those with high levels of education compared with those with intermediate or low (-0.016 vs - 0.010 or -0.011, respectively), and in those who had received adequate antenatal care compared with those who did not (-0.014 vs -0.012 for intermediate and -0.013 for inadequate antenatal care). Over time, the relative risk of preterm mortality widened within each of these subgroups. This study found that between 1995 and 2020, US preterm infant mortality improved among all categories of prematurity. Inequalities in preterm infant mortality based on maternal race and ethnicity have remained constant while socioeconomic disparities have widened over time.

AKIBAT HUKUM KEDUDUKAN ANAK DALAM PERNIKAHAN SIRI DITINJAU DARI HUKUM ISLAM DAN UNDANG-UNDANG PERKAWINAN

The goal to be achieved in this research is to find out the legal consequences of the position of children in unregistered marriages according to Islamic Law and the Marriage Law. To understand the concept of unregistered marriage according to Islamic Law and the Marriage Law. In this study the authors used the normative juridical writing method, namely legal research conducted using statutory regulations.According to Islamic law, an unregistered marriage is considered valid because a marriage that meets the pillars and conditions of marriage will be considered valid. Siri marriages are considered invalid according to the Marriage Law, because they refer to the provisions of Article 2 paragraph (2) of the Marriage Law regarding registration of marriages. From the provisions of this article, it can be seen that the Marriage Law focuses on the validity of marriage on two elements, namely; Marriage must be carried out in accordance with the conditions and procedures determined by law (state law) and religious law. This means that unregistered marriages that are carried out only by complying with religious law are not valid from the point of view of state law.For the legal status of children from unregistered marriages, according to Islamic law, they are considered legitimate children according to religion, because the child was born in or as a result of a legal marriage. According to the Marriage Law, the status of the child is the same as a child out of wedlock and cannot be said to be a child in a legal marriage, therefore the child does not have a birth certificate. As a result, legally the child has no right to claim support, inheritance or guardianship rights from his father. However, children from unregistered marriages can obtain their rights in accordance with Constitutional Court decision Number 46/PUU-VIII/2010 as long as they can prove it.

Analysis Of Innovation “Puber Anak Melania” In Acceleration Of Birth Certificate Ownership For Children 0-18 Years In The Dinas Kependudukan Dan Pencatatan Sipil Kota Payakumbuh Using Grounded Theory

“Puber Anak Melania” is a Program of the Payakumbuh City Government, in this case the Population and Civil Registration Office as a new innovation in providing convenience in obtaining family cards, birth certificates and baby identity cards for the people of Payakumbuh City. It is an acronym for "Pulang Bersalin Anak mendapat Akta Lahir dan Identitas Anak". This innovation program is a collaborative program with the Payakumbuh City Population and Civil Registration Office with RSKIA, Community Health Centers and independent practicing midwives throughout Payakumbuh City for mothers who give birth in health facilities in Payakumbuh City. The purpose of this study was to determine the effectiveness of Puber Anak Melania service innovation program in accelerating birth certificate ownership in Payakumbuh City, the inhibiting factors and to find out the efforts made by the Payakumbuh Population and Civil Registration Office using a grounded theory approach. Based on the research results, the authors concluded that the implementation of Puber Anak Melania Service innovation was quite effective. Even though there were obstacles such as the parents had not prepared the documents and requirements for issuing a birth certificate, the parents' data and documents had not been valid, and the baby's name had not been prepared by the parents so that the issuance of the birth certificate could not be processed. "Puber Anak Melania" is a Program of the Payakumbuh City Government, in this case the Population and Civil Registration Office as an innovation in providing convenience in obtaining family cards, birth certificates and baby identity cards for the people of Payakumbuh City. It is an acronym for " Pulang Bersalin Anak mendapat Akta Lahir dan Identitas Anak". This innovation program is a collaborative program with the Payakumbuh City Population and Civil Registration Office with RSKIA, Community Health Centers and independent practicing midwives throughout Payakumbuh City for mothers who give birth in health facilities in Payakumbuh City. The purpose of this study was to determine the supporting and inhibiting factors for Melania's Child Development service innovation program in accelerating birth certificate ownership in Payakumbuh City using a grounded theory approach. Based on the research results, the authors conclude that the implementation of the service innovation "Melania Childhood Puberty" has been going well but the results have not been optimal, namely there are obstacles such as documents and requirements for issuing birth certificates that have not been prepared by parents, data and documents of parents are not yet valid, and names the parents had not prepared the baby so that the issuance of the birth certificate could not be processed.

Degendering Parents on Birth Certificates.

Birth certificates typically designate parents as "mothers" or "fathers," although some US states offer nongendered designations. The authors argue that gendered characterizations offer scant legal or moral value and that states should move to degender parental status on birth certificates but retain that information in registrations of birth. Registrations of birth identify the person giving birth to a child, when, and where, and they report demographic and health information useful for civic and public health purposes. Birth certificates typically report a child's name, sex, date and location of birth, and parentage so far as known. As documents establishing parents' standing in relation to children and vice versa, as well as age and presumptive citizenship, birth certificates add no legal or moral value by gendering parents. Gendering parents on birth certificates obliges the state to rely on exclusionary criteria of "mother" and "father." By contrast, degendering parental status withdraws the need for such criteria and confers benefits on people with transgender and nonbinary identities, as well as undercutting any problematic presumption that parents have responsibilities to their children qua mother or qua father.

The Birth Certificate: An American History

The Birth Certificate: An American History

Recurrence of pediatric intussusception: A nationwide population-based descriptive study in Taiwan.

Intussusception is frequently observed pediatric emergency that is often followed by recurrent intussusception after initial treatment. This study investigated the risk factors associated with recurrent intussusception in children aged ≤ 3 years. Between January 2007 and December 2015, a cohort study was conducted by linking the Taiwan Maternal and Child Health Database to the Birth Certificate Application database and the National Health Insurance Research Database in Taiwan. Patients aged ≤ 3 years with intussusception diagnosis and related treatment were included in our study. Multivariable logistic regression was used to analyze the risk factors associated with recurrent intussusception. In total, 5341 children with intussusception aged ≤ 3 years were enrolled in our cohort. The adjusted odds ratio (aOR) for recurrent intussusception in children aged 2 to 3 years was 0.62 (95% confidence interval [CI]: 0.47-0.82) compared with children aged < 1 year, and surgery decreased the risk of recurrent intussusception (aOR = 0.64, 95% CI: 0.46-0.88). Male patients had higher risk of recurrent intussusception than female patients had (aOR = 1.41, 95% CI: 1.13-1.75). Higher birth weight may increase the risk of recurrent intussusception, but this association was not statistically significant. Furthermore, gestational age did not seem to affect the risk of recurrent intussusception. Surgical treatment and delayed onset of intussusception are associated with a reduced risk of recurrent intussusception; males are associated with increased risk of recurrent intussusception. In addition, we suggest that in early infancy, patients who received non-surgical treatment as the initial treatment for intussusception should be closely followed up for potential recurrence of intussusception.

Trends in Gestational Weight Gain in Louisiana, March 2019 to March 2022

Average gestational weight gain (GWG) increased during the COVID-19 pandemic, but it is not known whether this trend has continued. To examine patterns of GWG during the COVID-19 pandemic by delivery and conception timing through the second year of the pandemic. This cohort study is a retrospective review of birth certificate and delivery records from 2019 to 2022. Electronic health records were from the largest delivery hospital in Louisiana. Participants included all individuals giving birth from March 2019 to March 2022. Data analysis was performed from October 2022 to July 2023. Delivery date (cross-sectionally) and conception before the pandemic (March 2019 to March 2020) and during the peak pandemic (March 2020 to March 2021) and late pandemic (March 2021 to March 2022). The primary outcome was GWG (total GWG and adherence to the 2009 Institute of Medicine recommendations) analyzed using linear and log-linear regression with control for covariates. Among 23 012 total deliveries (8763 Black individuals [38.1%]; 11 774 White individuals [51.2%]; mean [SD] maternal age, 28.9 [5.6] years), 3182 individuals (42.0%) exceeded the recommended weight gain in the year proceeding the pandemic, 3400 (45.4%) exceeded recommendations during the peak pandemic, and 3273 (44.0%) exceeded recommendations in the late pandemic. Compared with those who delivered before the pandemic (reference), participants had higher total GWG if they delivered peak or late pandemic (adjusted β [SE], 0.38 [0.12] kg vs 0.19 [0.12] kg; P = .007). When cohorts were defined by conception date, participants who conceived before the pandemic but delivered after the pandemic started had higher GWG compared with those whose entire pregnancy occurred before the pandemic (adjusted β [SE], 0.51 [0.16] kg). GWG was lower in the pregnancies conceived after the pandemic started and the late pandemic (adjusted β [SE], 0.29 [0.12] kg vs 0.003 [0.14] kg; P = .003) but these participants began pregnancy at a slightly higher weight. Examining mean GWG month by month suggested a small decrease for March 2020, followed by increased mean GWG for the following year. Individuals with 2 pregnancies (1289 individuals) were less likely to gain weight above the recommended guidelines compared with their prepandemic pregnancy, but this association was attenuated after adjustment. In this cohort, individuals with critical time points of their pregnancy during the COVID-19 pandemic gained more weight compared with the previous year. The increased GWG leveled off as the pandemic progressed but individuals were slightly heavier beginning pregnancy.

Hospital-level variation in racial disparities in low-risk nulliparous cesarean delivery rates

Nationally, rates of cesarean delivery are highest among Black patients compared with other racial/ethnic groups. These observed inequities are a relatively new phenomenon (in the 1980s, cesarean delivery rates among Black patients were lower than average), indicating an opportunity to narrow the gap. Cesarean delivery rates vary greatly among hospitals, masking racial disparities that are unseen when rates are reported in aggregate. This study aimed to explore reasons for the current large Black-White disparity in first-birth cesarean delivery rates by first examining the hospital-level variation in first-birth cesarean delivery rates among different racial/ethnic groups. We then identified hospitals that had low first-birth cesarean delivery rates among Black patients and compared them with hospitals with high rates. We sought to identify differences in facility or patient characteristics that could explain the racial disparity. A population cross-sectional study was performed on 1,267,493 California live births from 2018 through 2020 using birth certificate data linked with maternal patient discharge records. Annual nulliparous term singleton vertex cesarean delivery (first-birth) rates were calculated for the most common racial/ethnic groups statewide and for each hospital. Self-identified race/ethnicity categories as selected on the birth certificate were used. Relative risk and 95% confidence intervals for first-birth cesarean delivery comparing 2019 with 2015 were estimated using a log-binomial model for each racial/ethnic group. Patient and hospital characteristics were compared between hospitals with first-birth cesarean delivery rates <23.9% for Black patients and hospitals with rates ≥23.9% for Black patients. Hospitals with at least 30 nulliparous term singleton vertex Asian, Black, Hispanic, and White patients each were identified. Black patients had a very different distribution, with a significantly higher rate (28.4%) and wider standard deviation (7.1) and interquartile range (6.5) than other racial groups (P<.01). A total of 29 hospitals with a low first-birth cesarean delivery rate among Black patients were identified using the Healthy People 2020 target of 23.9% and compared with 106 hospitals with higher rates. The low-rate group had a cesarean delivery rate of 19.9%, as opposed to 30.7% in the higher-rate group. There were no significant differences between the groups in hospital characteristics (ownership, delivery volume, neonatal level of care, proportion of midwife deliveries) or patient characteristics (age, education, insurance, onset of prenatal care, body mass index, hypertension, diabetes mellitus). Among the 106 hospitals that did not meet the target for Black patients, 63 met it for White patients with a mean rate of 21.4%. In the same hospitals, the mean rate for Black patients was 29.5%. Among Black patients in the group that did not meet the 23.9% target, there were significantly higher rates of all cesarean delivery indications: labor dystocia, fetal concern (spontaneous labor), and no labor (eg, macrosomia), which are all indications with a high degree of subjectivity. The statewide cesarean delivery rate of Black patients is significantly higher and has substantially greater hospital variation compared with other racial or ethnic groups. The lack of difference in facility or patient characteristics between hospitals with low cesarean delivery rates among Black patients and those with high rates suggests that unconscious bias and structural racism potentially play important roles in creating these racial differences.

Human Resource Development in Birth Certificate Making Services at The Service of Population and Civil Registration of Kuningan District

Human Resource Development is any effort to improve the implementation of current and future work, by providing information, influencing attitudes, or adding skills, in other words, development is any activity intended to change behavior consisting of knowledge, skills, and attitudes. One of the objectives of human resource development according to Hasibuan is to improve services. The focus of the research conducted by the author is on the service of making birth certificates. The method used is a qualitative research method which is a method for exploring and understanding the meaning that a number of individuals or groups of people ascribe to problems. The informant retrieval technique uses Purposive Sampling which is a sampling technique with certain considerations. This technique includes people who are selected on the basis of certain criteria that are considered capable of providing information in accordance with the focus of the research. The results of this study are based on the dimensions of the research that in terms of knowledge it is still said to be not optimal due to formal education that does not meet the criteria and also lack of participation in non-formal education. For the skill dimension, it is also still not optimal because there is no special training on making birth certificates. However, the attitude and behavior dimensions are optimal. The factors that become obstacles are the rapid development of technology and the lack of discipline of employees. In addition, the efforts made are to carry out direction, supervision, and as well as sharing knowledge between fellow employees

Family size for women with primary ovarian insufficiency and their relatives.

How does the number of children in women with primary ovarian insufficiency (POI) compare to the number for control women across their reproductive lifespans? Approximately 14% fewer women with POI will have children, but for those able to have children the median number is 1 less than for age-matched controls. Women with POI are often identified when presenting for fertility treatment, but some women with POI already have children and there remains a low chance for pregnancy after the diagnosis. Further, POI is heritable, but it is not known whether relatives of women with POI have a smaller family size than relatives of controls. The study was a retrospective case-control study of women with POI diagnosed from 1995 to 2021 (n = 393) and age-matched controls (n = 393). Women with POI were identified using ICD9 and 10 codes in electronic medical records (1995-2021) from two major healthcare systems in Utah and reviewed for accuracy. Cases were linked to genealogy information in the Utah Population Database. All POI cases (n = 393) were required to have genealogy information available for at least three generations of ancestors. Two sets of female controls were identified: one matched for birthplace (Utah or elsewhere) and 5-year birth cohort, and a second also matched for fertility status (children present). The number of children born and maternal age at each birth were ascertained by birth certificates (available from 1915 to 2020) for probands, controls, and their relatives. The Mann-Whitney U test was used for comparisons. A subset analysis was performed on women with POI and controls who delivered at least one child and on women who reached 45 years to capture reproductive lifespan. Of the 393 women with POI and controls, 211 women with POI (53.7%), and 266 controls (67.7%) had at least one child. There were fewer children born to women with POI versus controls (median (interquartile range) 1 (0-2) versus 2 (0-3); P = 3.33 × 10-6). There were no children born to women with POI and primary amenorrhea or those <25 years old before their diagnosis. When analyzing women with at least one child, women with POI had fewer children compared to controls overall (2 (1-3) versus 2 (2-4); P = 0.017) and when analyzing women who reached 45 years old (2 (1-3) versus 3 (2-4); P = 0.0073). Excluding known donor oocyte pregnancies, 7.1% of women with POI had children born after their diagnosis. There were no differences in the number of children born to relatives of women with POI, including those with familial POI. The data are limited based on inability to determine whether women were trying for pregnancy throughout their reproductive lifespan or were using contraception. Unassisted births after the diagnosis of POI may be slightly over-estimated based on incomplete data regarding use of donor oocytes. The results may not be generalizable to countries or states with late first births or lower birth rates. Approximately half of women with POI will bear children before diagnosis. Although women with POI had fewer children than age matched controls, the difference in number of children is one child per woman. The data suggest that fertility may not be compromised leading up to the diagnosis of POI for women diagnosed at 25 years or later and with secondary amenorrhea. However, the rate of pregnancy after the diagnosis is low and we confirm a birth rate of <10%. The smaller number of children did not extend to relatives when examined as a group, suggesting that it may be difficult to predict POI based on family history. The work in this publication was supported by R56HD090159 and R01HD099487 (C.K.W.). We also acknowledge partial support for the Utah Population Database through grant P30 CA2014 from the National Cancer Institute. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The authors have no conflicts of interest. N/A.

Hypospadias prevalence by severity and associated risk factors: A population-based active surveillance analysis

Hypospadias is one of the most common congenital anomalies. Trends of hypospadias prevalence by severity are not well reported. Most prevalence studies consist of pooled data from different countries or states suffer from low data quality due to inconsistent methodologies, limited variables, and lack of categorization of hypospadias severity. The objective of this study is to examine the prevalence of hypospadias by degrees of severity and associated risk factors using combined data sources from a stable and well-defined population. The study population includes infants born with hypospadias to mothers residing in Arkansas from 1997 to 2016. Cases were identified from an active population-based surveillance program of birth defects. Identified hypospadias cases from surveillance data were linked to birth certificate and to a clinical database. These two data sources provide more details on the location of the defect and maternal and infant characteristics. The prevalence and 95% confidence intervals were calculated using total male live births as denominator. Chi-square test was used to assess the association of nominal variables. Logistic regression was used to calculate adjusted odds ratio. A total 3230 hypospadias cases were identified from 1997 to 2016. The overall prevalence is 83.0 per 10,000 male births. A majority of cases (56.7%) were classified as first degree with the others having second degree (22.8%), third degree (4.7%) or not otherwise specified (15.6%). The highest prevalence of hypospadias was observed among Non-Hispanic whites. Higher prevalence also was observed among mothers in the older age group with no prenatal care in the first trimester and with gestational hypertension or diabetes. Premature or small for gestational age infants tend to have higher prevalence across all levels of severity. The number of hypospadias cases increased over time. After maternal age, race and education were adjusted, higher risk persisted for infants of restricted fetal growth, mothers with gestational hypertension or diabetes and the cohort of 2013-2016. There is an increase of hypospadias cases in Arkansas. Several maternal and infant characteristics associated with higher prevalence for all levels of severity are worth further investigation.

Prevalence, Characteristics, and Treatment of Hemorrhoids During Pregnancy: A Nationwide Population-Based Cohort Study in Taiwan.

Background: Hemorrhoids, a gastrointestinal tract disorder, are common during pregnancy. However, large-scale epidemiological studies on hemorrhoids during pregnancy are limited. Therefore, this study used analyzed data from a nationwide population-based database to investigate the prevalence, characteristics, and treatment of hemorrhoids in Taiwan. Materials and Methods: This retrospective population-based study used data from the National Health Insurance Research Database and Taiwan Birth Certificate Application to collect the medical records of women who were pregnant at any time during 2009-2018. Hemorrhoids was defined by International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) (455. X) and International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) (K64.X, O22.4X) with related treatment. Results: We enrolled 1,608,804 deliveries in 1,070,708 women. The proportion of hemorrhoids increased with age in both primipara and multipara women. Of the pregnant women, 31% received oral medication, and 93.2% used the topical ointment to treat their hemorrhoids. Few patients (1.8%) required procedure or surgery during pregnancy, and 41.4% of those patients underwent procedure or surgery in their first trimester. The cumulative incidence of hemorrhoids during pregnancy was significantly higher in women with a history of hemorrhoids and those with multifetal pregnancies. No significant difference in the incidence of hemorrhoids was observed between multiparous and primiparous women. Conclusion: Women with a history of hemorrhoids or those carrying multiple fetuses had an increased risk of hemorrhoids during pregnancy. The most commonly used treatment for hemorrhoids during pregnancy was topical ointments, with only a small proportion (1.8%) of patients requiring procedure or surgery.