Birth Prevalence Research Articles

Global birth prevalence of Robin sequence in live-born infants: a systematic review and meta-analysis.

Robin sequence (RS), a congenital disorder of jaw maldevelopment and glossoptosis, poses a substantial healthcare burden and has long-term health implications if airway obstruction is suboptimally treated. This study describes the global birth prevalence of RS and investigates whether prevalence estimates differ by geographical location, ethnicity or study data source (registry versus non-registry data). The protocol was prospectively registered with PROSPERO.Databases were searched using keywords and subject terms for "Robin sequence", "epidemiology", "incidence" and "birth prevalence". Meta-analysis was performed fitting random effects models with arcsine transformation.From 34 eligible studies (n=2722 RS cases), pooled birth prevalence was 9.5 per 100 000 live births (95% CI 7.1-12.1) with statistical heterogeneity. One third of studies provided a case definition for RS and numerous definitions were used. A total of 22 countries were represented, predominantly from European populations (53% of studies). There was a trend towards higher birth prevalence in European populations and lower prevalence from registry-based studies. Only two studies reported ethnicity.This study indicates that RS occurs globally. To investigate geographical differences in prevalence, additional studies from non-European populations and reporting of ethnicity are needed. Heterogeneity of estimates may be due to variable diagnostic criteria and ascertainment methods. Recently published consensus diagnostic criteria may reduce heterogeneity among future studies.

#322 : A Rare Case Report of Successfull Live Twin Birth in a Couple Who are Carriers of Mucopolysaccharidoses VII-Sly Syndrome

Introduction: Mucopolysaccharidoses VII or sly syndrome is an autosomal recessive condition discovered in 1972 by William Sly, occurs due to mutation in the beta glucoronidase encoding gene, it is an ultra-rare neurometabolic disorder caused by inherited deficiency of the lysosomal enzyme [Formula: see text]eta-glucuronidase. Precise data regarding its epidemiology is scarce, but birth prevalence is estimated to vary from 0.02 to 0.24/100,000 live births with 54 types of recorded mutations. The clinical course and disease progression are widely heterogeneous. So far 9 pregnancies have been recorded in patients with sly syndrome of which the majority showed some deformity. Here we present a case of a couple with two different variants of GUSB gene who delivered live twin birth with normal development. Background: A couple aged 29 & 31 who were anxious to conceive came to the clinic with a previous history of two abortions for pre conceptual counselling. Both pregnancies had features suggestive of non-anemic type nonimmune hydrops with increased nuchal fold thickness in USG. Both her pregnancies were terminated mid trimester with the autopsy results conclusive of the findings. Method & Results: Whole exome sequencing showed that both were carriers of GUSB gene of two different variants encoding for Sly syndrome. Based on the WES and karyotyping reports genetic counselling was given, and PGT-M was suggested. The patient underwent antagonist protocol and 12MII were retrieved. ICSI was done and the embryos were cultured to day 5 and subjected to PGT-A, PGT-M. The resultant 2 carrier blastocysts were transferred. Post transfer Beta Hcg was positive. The patient had an uneventful obstetric course and delivered normal twin girl babies on 27/01/23. The twins showed no physical abnormality and their genetic profiling showed they were carriers of GUSB gene. Conclusion: This case demonstrates that with appropriate pre-conceptual evaluation, genetic counselling, constant maternal and fetal surveillance, carriers of sly syndrome can be given multidisciplinary care leading to successful outcome.

The effect of antenatal isoniazid preventive therapy on birth outcomes in Western Kenya.

BACKGROUND: Pregnant women living with HIV (WLHIV) are at high risk for TB. There are limited data to inform whether TB preventive therapy is safe in pregnancy.METHODS: We completed a retrospective study of antenatal and birth records of mother-infant dyads at two health care facilities in Kisumu, Kenya. Among pregnant WLHIV, we assessed the relationship of antenatal isoniazid preventive therapy (IPT) with birth outcomes (preterm birth, low birth weight [LBW], congenital anomalies, and perinatal death).RESULTS: Of 576 mother-infant pairs, most women were on antiretroviral therapy (574, 99.7%) with viral suppression (518, 89.9%) and one-quarter had IPT exposure during pregnancy (152, 26.4%). The prevalence of preterm birth was lower among women with antenatal IPT exposure (21% vs. 30%; P = 0.03). LBW, congenital anomaly and perinatal death were not associated with antenatal IPT; however, we observed a trend toward fewer composite poor birth outcomes among women taking antenatal IPT (26% vs 33%; P = 0.08). Controlling for maternal age and viral load, IPT use during pregnancy was associated with lower odds of preterm birth (aOR 0.62, 95% CI 0.40-0.98; P = 0.04).CONCLUSION: In a programmatic setting in Western Kenya, IPT use was not associated with adverse birth outcomes.

Preterm Births and Associated Factors among Women who Delivered in a District Hospital in Eastern Province, Rwanda: A retrospective study

BackgroundPreterm birth is the primary cause of infant fatalities and is a global public health issue. In 2020, approximately 13.4 million babies were born preterm globally. Preterm birth was potentially associated with different socio-demographic factors as well as clinical and gynaeco-obstetrical factors. This study aimed at assessing the prevalence of preterm births and factors associated with them among women who delivered in Gahini District Hospital. MethodsThis study employed a cross-sectional retrospective study design and the sample size was 312 mothers. SPSS version 21 was used for data analysis. Univariate and bivariate analysis with Chi-square tests were performed. Multivariable logistic regression analysis was performed to figure out factors that were independently associated with preterm birth.Results This research revealed that the preterm birth prevalence in Gahini hospital was 9.6% and independently associated factors included mothers’ age >35 (AOR: 9.56; 95% CI: 1.38–66.33), being unmarried (AOR: 18.19, 95% CI: 2.96–111.59) and maternal BMI of 25–30 (AOR: 6.25, 95% CI: 1.34–29.12).ConclusionPreterm birth was found to be associated with different factors. Therefore, intervention strategies related to maternal and child health need to be developed and strengthened to address factors associated with preterm births. Rwanda J Med Health Sci 2023;6(3):269-279

Trends and Outcomes of Twin Births in Southwest Nigeria: A 14-Year Retrospective Cohort Study.

The study aimed to analyze the prevalence, trends, and outcomes of twin pregnancies in Ile-Ife, Nigeria, over two distinct periods. This research, based on a 14-year retrospective cohort study, scrutinized twin births occurring in two-time frames: recent years (2012-2018; Period II) and the recent past (2005-2011; Period I) at a University Teaching Hospital in Ile-Ife, Nigeria. The inclusion criteria were limited to twin births, excluding singleton and higher-order gestations. Outcomes were evaluated based on several parameters, including mode of delivery, birth weights, fetal gender combinations, APGAR scores, perinatal mortality, and maternal complications. Data analysis was conducted using the 26th version of Statistical Package for the Social Science, with a significance threshold of p < 0.05. The study documented a stable prevalence of twin gestations, registering at 20.7 per 1,000 births without a significant discrepancy between the two time periods (21.7‰ versus 19.7‰; p = 0.699). Individuals from the Yoruba tribe predominantly featured in both cohorts, showing no considerable variation between the two time periods [83 (95.4) vs. 120 (99.2); p-value = 0.116]). The data exhibited recurrent instances of caesarean delivery (65.6% vs. 50.2%, p = 0.119), vertex-vertex presentation (38.0% vs. 44.7%, p = 0.352), and differing sex combinations (33.3% vs. 38.0%, p = 0.722) across both time frames. Twin II neonates born through Caesarean section were more frequently admitted to neonatal intensive care units than Twin I (5.1% versus 4.6%; p = 0.001). The recent years witnessed a surge in preterm labor complications, notably higher than the earlier period (17.1% versus 7.8%; p = 0.008). The prevalence of twin births in Ile-Ife, Nigeria, demonstrates a fluctuating decline. To comprehensively understand the dynamics of twin births in the region, there is a pressing need for expansive, community-centric research in southwest Nigeria.

Sickle Cell Disease Births and Social Vulnerability (2016-2020): A Report from the Sickle Cell Data Collection Program

Introduction Despite national implementation of universal newborn screening for sickle cell disease (SCD) since 2006, data on the prevalence of SCD births in the United States are scarce. Updated prevalence data by geographic location are needed to guide the allocation of resources and to connect newborns to comprehensive SCD care. The purposes of this study were to describe the 1) crude and race-adjusted SCD birth prevalence and 2) crude SCD birth prevalence by quartiles of the social vulnerability index (SVI, CDC, 2020) in 11 Sickle Cell Data Collection (SCDC) program states (Alabama, California, Colorado, Georgia, Indiana, Michigan, Minnesota, North Carolina, Tennessee, Virginia, and Wisconsin). Methods This retrospective cohort study used newborn screening (NBS) records from 2016 to 2020. Births were included if they were confirmed SCD births and the mother's county of residence at the time of birth was in an SCDC state. Mother's county and newborn's race, ethnicity, sex, date of birth, and genotype were extracted from NBS records or birth certificates, if available. Crude SCD birth prevalence per 10,000 was calculated by dividing the cumulative number of SCD births by the cumulative number of all live births from 2016 to 2020 and multiplying by 10,000. Race-adjusted SCD birth prevalence was calculated by dividing the cumulative number of Black SCD births by live non-Hispanic Black (NHB) births from 2016 to 2020 and multiplying by 10,000. Frequency of all births and NHB births were obtained from each state's health department. County characteristics were quantified by the SVI using the 2020 state-ranked CDC/ATSDR SVI datasets (CDC, 2020) and were matched to mother's county of residence at birth. SVI ranks counties on 16 social factors, including unemployment, minority status, and disability. Ranks were grouped into SVI quartiles: low (0 ≤ SVI ≤ 0.25), medium (0.25 &amp;lt; SVI ≤ 0.5), high (0.5 &amp;lt; SVI ≤ 0.75) and very high (0.75 &amp;lt; SVI ≤ 1.0) vulnerability. Crude SCD birth prevalence was calculated for each SVI quartile. Results From 2016 through 2020, there were 3,305 newborns with SCD across 11 SCDC states [ 49.6% male, 89.8% Black]. Georgia had the highest number of births (n=758) followed by North Carolina (n=435), California (n=419), and Alabama (n=386). The majority (57.0%) had Hb SS or Hb S Beta 0 thalassemia, 27.9% had Hb SC, and 9.6 % had Hb S Beta + thalassemia or other SCD type. The crude SCD birth prevalence ranged from 1.22 to 13.22 per 10,000 live births. The race-adjusted SCD birth prevalence for SCDC states was 28.55 per 10,000 or 1 in every 350 NHB births. Race-adjusted birth prevalence varied among states ranging from 19.53 to 34.11 per 10,000 NHB births (Table 1). Overall, the majority (67%) of mothers of newborns with SCD resided in high or very high social vulnerability counties (Figure 1). Except for Colorado, where the highest crude SCD birth prevalence was among mothers residing in medium social vulnerability counties, the remaining 10 SCDC states had the highest prevalence among mothers residing in high or very high social vulnerability counties. Limitations include using the mother's reported race for all births to calculate race-adjusted birth prevalence. Additionally, because of missing data on ethnicity for SCD births, we used all Black SCD births, rather than non-Hispanic Black SCD births, to calculate the race-adjusted SCD birth prevalence. Despite the limitations, the study provides crude and race-adjusted SCD birth prevalence data from 11 states in the South, Midwest, and Western United States, covering an estimated one third of the SCD population in the United States. Furthermore, providing the crude prevalence of SCD births by SVI quartile adds valuable information on county-level characteristics that might influence health outcomes for newborns with SCD. Conclusions The race-adjusted birth prevalence for SCD remains stable from previous estimates at 1 in every 350 BNH births. The finding that most mothers of newborns with SCD reside in high and very high social vulnerability counties at the time of birth underscores the importance of assessing social determinants of health (SDOH) that may impact health outcomes for newborns with SCD. Findings from this report can be used to guide state- and county-level programs that address SDOH for people with SCD and have implication for clinicians who must incorporate screening for SDOH in their practice and refer families to community resources as needed.

Prevalence of congenital anomalies according to maternal race and ethnicity, Texas, 1999-2018.

Few studies of congenital anomalies provide prevalence estimates stratified by maternal race/ethnicity. We sought to determine whether the prevalence of a broad spectrum of anomalies varies among offspring of women from different race/ethnic groups. We obtained information on cases with anomalies from the population-based Texas Birth Defects Registry, and denominator data on livebirths among Texas residents during 1999-2018 from the Texas Center for Health Statistics. We estimated the prevalence ratio (PR) and 95% confidence interval (CI) of N = 145 anomalies among offspring of Hispanic and non-Hispanic Black relative to non-Hispanic White women using Poisson regression, adjusting for maternal age, education, body mass index, and previous livebirths. We performed a two-stage analysis with a Bonferroni-adjusted p < 1.7 × 10-4 in the initial screening phase to identify anomalies with statistically significant variation. There were 7,698,768 livebirths and 1,187,385 anomalies diagnosed in 368,393 cases. The prevalence of any monitored congenital anomaly was similar among offspring of non-Hispanic White (referent), non-Hispanic Black (PR 0.98, CI 0.96-1.00), and Hispanic (PR 0.95, CI 0.93-0.96) women. We observed statistically significant racial/ethnic variation for 42 anomalies. Marked differences were observed when comparing offspring of non-Hispanic Black to non-Hispanic White women with respect to polydactyly (PR 4.38, CI 4.07-4.72), pyloric stenosis (PR 0.34, CI 0.29-0.40), and aortic valve atresia/stenosis (PR 0.51, CI 0.36-0.72). Birth prevalence of many major congenital anomalies varies by maternal race and ethnicity. While the reasons for these differences are likely multifactorial, a thorough understanding of racial and ethnic disparities is useful to stimulate etiologic research.

Risk factors associated with preterm birth among mothers delivered at Lira Regional Referral Hospital

BackgroundThe World Health Organization (WHO) defines Preterm Birth (PTB) as “a live birth taking place before the expected 37 weeks of gestation”. Annually, approximately 15 million infants are born prematurely, constituting significantly to infant mortality during the initial four weeks of life, responsible for 40% of deaths among children under the age of five. Evidently, preterm deliveries have contributed to 46% of admissions to the neonatal intensive care unit (NICU) at Lira Regional Referral Hospital (LRRH) over the past three years. Paradoxically, while the prevalence of preterm births remains high, there is a lack of documented information regarding the underlying risk factors. Consequently, the primary objective of this study was to assess the potential risk factors associated with preterm birth at LRRH.MethodsAn analytical cross-sectional research was undertaken at LRRH, employing a quantitative methodology. The study utilized secondary data obtained from a total of 590 comprehensive maternal medical records, of deliveries that occurred at the facility between April 2020 and July 2021. The collected data underwent analysis using STATA version 17 software. To identify predictors of preterm birth, a Logistic regression model was applied, yielding adjusted odds ratios (AOR) alongside 95% confidence intervals (CI). The significance level was set at p < 0.05 to establish statistical significance. Furthermore, assessments for multicollinearity and model fitness were conducted using the Variance Inflation Factor (VIF) and linktest, respectively.ResultsThe prevalence of preterm delivery among mothers who gave birth at LRRH stood at 35.8%. The outcomes of logistic regression analysis revealed that maternal employment status had a statistically significant association with preterm birth (AOR = 0.657, p = 0.037, 95%CI: 0.443–0.975); having a baby with low birth weight (AOR = 0.228, p < 0.001, 95% CI: 0.099–0.527) and experiencing preeclampsia (AOR = 0.142, p < 0.001, 95% CI: 0.088–0.229) were also identified as significant predictors of preterm birth in the study.Conclusions and recommendationsThe occurrence of preterm delivery is significantly higher (35.8%) among mothers who gave birth at LRRH when compared to the national average (13.6%). The prevalence of preterm birth among mothers was linked to factors such as employment status, delivery of low birth weight infants, and the presence of preeclampsia. Consequently, the research proposes a set of recommendations. Firstly, the Ministry of Health (MoH) should evaluate the present state of readiness within the healthcare system to effectively handle cases of preterm birth both within medical facilities and the community. Secondly, the Ministry of Gender, Labour, and Social Development should leverage Labor Officers to implement and uphold the regulations stipulated in the Employment Act and Labor Laws.

Outcome data from 15 years of cystic fibrosis newborn screening in a large UK region

BackgroundThe West Midlands Newborn Bloodspot Screening Laboratory is one of 16 in the UK and serves two tertiary paediatric cystic fibrosis (CF) centres (Staffordshire Children’s Hospital at Royal Stoke and...

X-linked adrenoleukodystrophy and primary adrenal insufficiency.

X-linked adrenoleukodystrophy (X-ALD; OMIM:300100) is a progressive neurodegenerative disorder caused by a congenital defect in the ATP-binding cassette transporters sub-family D member 1 gene (ABCD1) producing adrenoleukodystrophy protein (ALDP). According to population studies, X-ALD has an estimated birth prevalence of 1 in 17.000 subjects (considering both hemizygous males and heterozygous females), and there is no evidence that this prevalence varies among regions or ethnic groups. ALDP deficiency results in a defective peroxisomal β-oxidation of very long chain fatty acids (VLCFA). As a consequence of this metabolic abnormality, VLCFAs accumulate in nervous system (brain white matter and spinal cord), testis and adrenal cortex. All X-ALD affected patients carry a mutation on the ABCD1 gene. Nevertheless, patients with a defect on the ABCD1 gene can have a dramatic difference in the clinical presentation of the disease. In fact, X-ALD can vary from the most severe cerebral paediatric form (CerALD), to adult adrenomyeloneuropathy (AMN), Addison-only and asymptomatic forms. Primary adrenal insufficiency (PAI) is one of the main features of X-ALD, with a prevalence of 70% in ALD/AMN patients and 5% in female carriers. The pathogenesis of X-ALD related PAI is still unclear, even if a few published data suggests a defective adrenal response to ACTH, related to VLCFA accumulation with progressive disruption of adrenal cell membrane function and ACTH receptor activity. The reason why PAI develops only in a proportion of ALD/AMN patients remains incompletely understood. A growing consensus supports VLCFA assessment in all male children presenting with PAI, as early diagnosis and start of therapy may be essential for X-ALD patients. Children and adults with PAI require individualized glucocorticoid replacement therapy, while mineralocorticoid therapy is needed only in a few cases after consideration of hormonal and electrolytes status. Novel approaches, such as prolonged release glucocorticoids, offer potential benefit in optimizing hormonal replacement for X-ALD-related PAI. Although the association between PAI and X-ALD has been observed in clinical practice, the underlying mechanisms remain poorly understood. This paper aims to explore the multifaceted relationship between PAI and X-ALD, shedding light on shared pathophysiology, clinical manifestations, and potential therapeutic interventions.

The effect of China’s many-child policy on the number of births and the prevalence of serious teratogenic and disabling defects in Hunan Province

BackgroundTo research the effect of China’s many-child policy on the number of births and the prevalence of serious teratogenic and disabling defects (STDDs) in Hunan province.MethodsWe performed an observational study based on the Birth Defect (BD) Surveillance System of Hunan Province and chose STDD case cards. From 2012–2022, we defined the following 4 periods: the one-child policy (OCP) (2012.01–2013.12), partial two-child policy (PTCP) (2014.1–2015.12), universal two-child policy (UTCP) (2016.1–2020.12), and the early stage of the three-child policy (ETCP) (2021.1–2022.12). Crude odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to examine the association of policy changes with STDDs. Crame′rʹs V was calculated to estimate the effect sizes. Joinpoint regression analysis and annual percent change (APC) were used for each segment of the trend.ResultsA total of 1,652,079 births were included in this analysis. Joinpoint regression analysis showed that the number of perinatal births increased from 2012 to 2017, with APC = 9.52 (95% CI: 7.2 to 11.8), and decreased from 2017 to 2022, with an APC = -10.04 (95% CI: -11.9 to -8.1). The number of mothers over 30 years old gradually increased, from 25.54% during the OCP period to 54.05% during the ETCP period (Ptrend < 0.001).With policy changes, the total prevalence of STDDs increased from 28.10 per 10,000 births during the period of OCP into 46.77 per 10,000 births during the ETCP period by 66.44%. The live birth prevalence of STDDs increased only during the ETCP period (PTCP: OR = 1.27, 95% CI: 0.99–1.24, p = 0.057, UTCP: OR = 1.22, 95% CI: 0.99–1.52, p = 0.067, ETCP: OR = 1.75, 95% CI: 1.37–2.24, p < 0.001). Over the past ten years, there was a decrease in the gestational age at diagnosis (*F = 772.520, p < 0.001), from 24.49 ± 5.65 weeks in 2012 to 20.77 ± 5.17 weeks in 2022. From 2012 to 2022, the percentage of deaths within 7 days decreased with APC = -18.85 (95% CI: -26.4— -10.5, P > 0.05).ConclusionMany-child policies were associated with a moderate increase in fertility especially for women in urban areas and older women. However, they have lost the ability to control birth since 2017. The total prevalence of STDDs increased over the entire period, but the live birth prevalence increased only during the ETCP period. The gestational age at diagnosis decreased and the percentage of deaths within 7 days decreased.

A descriptive study on the risk factors of preterm birth with its maternal and fetal outcomes at a tertiary care hospital

Background: India contributes to greatest number of preterm births all over the world. The global annual prevalence of preterm birth ranges from 9-12%. It is the most common indication for antenatal hospitalization and is the leading cause for under-five mortality. Aims and objectives were to study the incidence, risk factors, clinical presentation, effectiveness of timely intervention and, maternal and fetal outcomes of preterm birth. Methods: A Prospective hospital based cross-sectional study was done from February 2021 to February 2022. Results: The incidence of preterm labour in the study was 24%. Majority of cases presented with symptoms of UTI (47%), vaginal discharge (43%) and leaking per vagina (13%). Infections were the most common aetiology, 40% of cases had positive urine and vaginal swab culture. The most common neonatal complications were respiratory distress syndrome (7%) and neonatal sepsis (7%), others included seizures (2%), birth asphyxia (1%), enterocolitis (1%), hypoxic ischemic encephalopathy (1%), intracranial hemorrhage (1%), meningitis (1%) and pulmonary hemorrhage (1%). 5% of neonatal deaths were noted. Conclusions: Urogenital infections were the commonest etiology for the onset of preterm labour, followed by gestational hypertensive disorders, previous history of preterm birth and anaemia in pregnancy. We conclude that in established preterm labour, aggressive management with antenatal corticosteroids, Magnesium sulphate for neuroprotection when indicated, antibiotic coverage and use of tocolytics with early in-utero transfer of mother to centres with equipped neonatal care units will improve the neonatal outcome.

Birth prevalence and risk factors of neural tube defects in Ethiopia: a systematic review and meta-analysis

ObjectiveThis study aims to estimate the prevalence of neural tube defects (NTDs) and to identify potential risk factors in the Ethiopian context.Study designSystematic review and meta-analysis.Study participantsA total of 611...

Obstetric Theatres: Building the Confidence to Make a Difference

Nearly half of all births in England in the first three months of 2023 occurred in an obstetric theatre. Besides the elective and emergency caesarean sections, 10% were instrumental births, with the majority of these likely to have taken place in an operating theatre.1 Given the prevalence of operative births and postpartum surgical procedures, midwives need the knowledge and skills to advocate for women and parents and ease their transition through what can be a very challenging experience.

Efficacy and Safety of Nifedipine as a Tocolytic Drug for the Treatment of Preterm Labour: Comparison with Levosalbutamol

Background: The rising prevalence of preterm birth is a significant public health concern. This study aimed to assess the efficacy and safety of the calcium channel blocker Nifedipine compared to the β2 agonist Levosalbutamol for inhibiting uterine contractions in early preterm labor, with a focus on maternal side effects and perinatal outcomes. Methods: A randomized clinical trial was conducted at Rajshahi Medical College Hospital over one year, involving pregnant women experiencing early preterm labor (24-36 weeks gestation, regular uterine contractions, cervical dilation 1-3 cm). a total N=66 patients were randomly assigned to receive either Nifedipine (Experimental group) or Levosalbutamol (Control group). Primary maternal outcomes included tocolysis, time to tocolysis, prolongation of pregnancy by ≥2 days, and delivery at term. Secondary perinatal outcomes included birth asphyxia, perinatal mortality, and the need for emergency NICU admission. Secondary maternal outcomes included side effects such as headache, hypotension, nausea/vomiting, and tachycardia. Results: Over 90% of patients in the Nifedipine group achieved tocolysis compared to 72.7% in the Levosalbutamol group (p = 0.054). Nifedipine achieved significantly faster tocolysis (8.7 hours vs. 29.3 hours, p &lt; 0.001). The Experimental group showed higher rates of arresting preterm labor for ≥2 days and lower rates of preterm delivery. Maternal side effects were lower for headache but higher for hypotension and nausea/vomiting in the Nifedipine group. Tachycardia occurred in the Control group but not the Experimental group. Both groups had low rates of birth asphyxia. Perinatal mortality was lower in the Experimental group, and NICU admission was less frequent. Conclusion: Nifedipine demonstrated superior efficacy over Levosalbutamol in terms of tocolysis, time to tocolysis, prolongation of pregnancy, delivery at term, with fewer maternal side effects and improved perinatal outcomes in pregnant women .....

Prevalence of neural tube defects in England prior to the mandatory fortification of non-wholemeal wheat flour with folic acid: a population-based cohort study

ObjectivesTo determine the baseline trends in the total birth prevalence of neural tube defects (NTDs) in England (2000–2019) to enable the impact of folic acid fortification of non-wholemeal wheat flour...

Distribution of Preterm Births in Nigeria

Nigeria holds a concerning position globally concerning preterm births, with statistics indicating an alarmingly high rate of premature births and subsequent neonatal mortalities. This research aims to delve into the prevalence of preterm births across five regions of Nigeria, contextualizing the issue within the nation's healthcare infrastructure and contrasting it with developed nations like the USA and Russia. Observational and comparative analyses were employed from extensive secondary data sources, including the WHO, UNICEF, and more. Findings from various states within the five regions showed a varied prevalence, from 16.9% in Enugu, Southeast Nigeria, to as high as 46.4% in State, South-South Nigeria. The difference in the definition of preterm birth based on gestational age between Nigeria and developed nations underscores the need for improved neonatal healthcare facilities in the country.

Antiviral Treatment of Maternal and Congenital Cytomegalovirus (CMV) Infections.

Human Cytomegalovirus (HCMV) is a ubiquitous member of the Herpesviridae family, responsible for the most common congenital viral infection-congenital Cytomegalovirus (cCMV) infection. While a majority of HCMV infections in children and adults are asymptomatic, HCMV is well known to cause severe infections in the immunocompromised individual and maternal infections with variable long-term sequelae after maternal-fetal transmission with primary or nonprimary infections. HCMV seroprevalence and cCMV incidence vary by geographic area and demographic characteristics like race and socioeconomic status. While cCMV birth prevalence ranges from 0.2% to 6% in different parts of the world, it is influenced by regional HCMV seroprevalence rates. HCMV screening during pregnancy is not routinely offered due to lack of awareness, hurdles to accurate diagnosis, and lack of well-established effective treatment options during pregnancy. This review will focus on antiviral treatment options currently available for use during pregnancy and in the newborn period for the treatment of maternal and congenital HCMV infections.

Why do women still give birth at home; perceptions of Pakistani women and decision-makers from marginalized communities.

In low- and middle-income countries (LMICs), maternal and newborn mortality is high due to the high prevalence of home births. Understanding the reasons behind this behavior is essential for improving maternal and newborn outcomes. Therefore, a qualitative exploratory study was conducted in a peri-urban community in Karachi, Pakistan to understand the perceptions of pregnant women who delivered at home despite receiving antenatal care and the perceptions of their decision-makers regarding this behavior. In-depth interviews were conducted with 15 randomly sampled women who chose to deliver at home after receiving antenatal care at a health facility, as well as 15 family members who were purposively identified as decision-makers by the women themselves. Thematic analysis was performed to explore the perceptions, myths, and cultural beliefs about homebirths as well as women's decision-making power related to childbirth. The three main themes identified showed that traditional beliefs and practices, poverty and gender inequality, and poor healthcare systems significantly influence the preference for childbirth. Traditional beliefs and practices, including religious and cultural beliefs, played a role in perceiving childbirth as a natural process best managed at home. The presence of traditional birth attendants who provide personalized care and emotional support further reinforced this preference. Gender inequalities, including limited access to mobile phones and women's caregiving roles, were identified as barriers to seeking formal healthcare at the time of delivery. Additionally, poor experiences with the formal healthcare system, such as the poor attitude of formal healthcare workers and fear of medical interventions, also contributed to the decision to deliver at home. The study highlighted the complex interplay between traditional/religious beliefs, gender inequalities, and healthcare experiences in shaping the decision to deliver at home despite receiving ANC services in marginalized settings. Addressing these factors is necessary for promoting facility-based delivery and improving maternal and neonatal outcomes in LMICs.

Characteristics of childbirth in highly productive sows

The purpose of this work was to analyze the prevalence of normal and pathological births in highly productive sows and the impact of their course on further reproductive function. The research was carried out in an industrial complex on 260 highly productive Yorkshire Landrace sows of Danish breeding. It was found that in highly productive sows in 32.69% of cases, pathological labor is recorded, including weak contractions and attempts - in 20.0% and manual labor – in 12.69%. With the clinical manifestation of weak labor activity in women in labor and with the provision of manual labor, 16.32% and 15.20% more piglets were received from them than during normal childbirth. At the same time, there is an increase in the duration of labor by 31.09% (p&lt;0.001) and by 43.15% (p&lt; 0.001), respectively. In pathological childbirth, women in labor are observed to breed more stillborn and mummified piglets than in normal childbirth. Providing obstetric care during childbirth increases the risk of developing inflammatory diseases of the uterus and breast in animals in the early postpartum period. The most common postpartum pathology with primary weakness of labor and manual labor is inflammation of the uterine mucosa, and with manual labor it is supplemented by an increase in the number of sick animals with postpartum dysgalactia. In the next reproductive cycle, the sows, in which the physiological course of the birth process and weak contractions and attempts were recorded, had identical reproduction indicators. However, in animals that had a history of primary weakness of labor activity during the last birth, an increase in the unproductive period was recorded. In sows, after manual care, there is a violation and delay in the restoration of sexual cyclicity, a decrease in fertilization.