Time Of Birth Research Articles

Arrhythmia burden in patients with congenital heart disease

Abstract Background The prevalence of congenital heart defects (CHD) is rising. Many patients experience arrhythmias either due to the defect itself or necessary intervention. Sudden onset of arrhythmia poses grave risks such as heart failure, stroke, or cardiac death. Research gaps exist regarding high-risk defects, age susceptibility, and prognostic implications of arrhythmia. Purpose Delineate the burden of arrhythmias in patients with CHD. Methods Patients born in the period 1970-2017 and diagnosed with CHD were identified in Swedish nationwide medical registries. Each patient was matched by birthyear and sex with ten controls from the general population. Cox proportional hazard regression model and Fine-Gray regression model with death as competing risk were used to compute risk (hazard ratio [HR]) and cumulative incidence of arrhythmias (supraventricular and ventricular arrhythmias). Estimates were compared with the matched controls. Follow-up started at time of birth. Results We included 63,559 patients and 583,205 matched controls with median follow-up of 12.8 years. Almost two-thirds of the total CHD population were born after year 2000 and 89% (n=56,564) had a simple lesion (defined as atrial or ventricular septal defect, coarctation of the aorta or malformation of the heart valves). During follow-up, 1,632 events of arrhythmia (90% of supraventricular origin) were registered in the population of patients with CHD, yielding an incidence rate of 16.4 per 10,000 person-years (versus 1.6 in the control population). The cumulative incidence of arrhythmias in the total CHD population was slightly increased during childhood compared with the control population, but rose significantly hereafter, illustrated in Figure 1, yielding an overall risk of 10.5 (CI 95%: 9.8-11.2). Stratified by lesion severity, the risk for arrhythmias was 8.7 (CI 95%: 7.6-8.7) and 30.4 (CI 95%: 26.2-35.2) in patients with simple and complex lesions, respectively. Patients with simple CHD lesions displayed a risk of 7.7 (95% CI: 7.1-8.4) for supraventricular arrhythmias and 11.5 (95% CI: 9.2-14.5) for ventricular arrhythmias. Correspondingly, patients with complex CHD lesions displayed risks of 66.7 (95% CI: 42.7-104.2) and 28.9 (95% CI: 24.8-33.6). Conclusion Arrhythmias, irrespective of origin, are common in patients with CHD and correlate with lesion severity. The overall burden of arrhythmias increased significantly after childhood. Meticulous follow-up is vital in order to prevent, detect and treat arrhythmias as it might trigger clinical deterioration and even sudden cardiac death in patients with CHD.

Adverse childhood experiences predict anxiety during postpartum and early childhood parenting

Perinatal anxiety disorders (PAD) affect one in five pregnant/postpartum people and are associated with adverse maternal and child health outcomes. Effective treatment and prevention rely on early identification and management of risk factors. Our study fills a gap in literature about how maternal adverse childhood experiences (ACEs) relate to PAD during and beyond the postpartum period. Using longitudinal data from a population-based sample of mothers in Colorado, USA (N = 1116), we evaluated whether maternal ACEs predicted self-reported anxiety symptoms, measured six times between 3 and 36 months postpartum. A mixed mean model of anxiety was fit with ACEs as the predictor and maternal age, race, ethnicity, education, marital status, and parity as covariates. Controlling for sociodemographic covariates, mothers reporting four or more ACEs had significantly higher levels of anxiety than those reporting less than four ACEs (b = 0.84, 95% CI (0.53, 1.15), p<.001) over the three-year period. Mothers of younger age at time of birth (25–34 years vs. <24 years: b=-0.54, 95% CI (-1.00, −0.08), p=.02) and non-Hispanic ethnicity (b = 0.47, 95% CI (0.09, 0.85), p=.01) were also found to have higher anxiety over this period. Our findings support screening for and addressing maternal ACEs early in obstetric care and well-child visits through trauma-informed, strengths-based approaches that promote maternal, child, and intergenerational well-being.

Factors Influencing Instrumental Assisted Births: A Retrospective Study

ABSTRACTObjectiveTo evaluate the rate of instrument‐assisted deliveries among parturient patients hospitalized for live, vaginal births across 5 years and test for factors influencing the use of this procedure.MethodsHospitalizations of pregnant people age 18 years or older presenting for a live vaginal birth between October 2017 and 2022 were included for gestational ages between 35.0 and 42.0 weeks. The outcome measured the presence of neonatal instrument‐assisted birth utilizing forceps or a vacuum. Independent variables tested as influencing the outcome included hospitalization year, maternal age, BMI, parity, gestational age, admission to birth time, labor induction, neonate weight, intrapartum analgesia, gestational diabetes and preeclampsia. Descriptive, bivariate and multivariate statistics were conducted in Excel to compare those with and without instrument‐assisted birth.ResultsThe descriptive analysis demonstrated that cases receiving an instrument‐assisted birth had significantly longer admission to birth time (17.8 h [SD = 11.0] vs. 14.1 h [SD = 14.5], p &lt; 0.001) and received intrapartum analgesics as follows: continuous labor epidural (92.1% vs. 80.6%, p &lt; 0.001), opioids (12.6% vs. 5.9%, p &lt; 0.001) and acetaminophen (20.3% vs. 11.1%, p &lt; 0.001). Multivariate logistic regression model demonstrated that intrapartum analgesics were significantly associated with instrument‐assisted births as follows: continuous labor epidural (OR 2.12, 95% CI 1.63−2.75), opioids (OR 1.37, 95% CI 1.10−1.72) and acetaminophen (OR 1.50, 95% CI 1.24−1.80). Conversely, multiparous status demonstrated decreased odds of having an instrument‐assisted birth (OR 0.32, 95% CI 0.27−0.37).ConclusionAmong pregnant patients, having a longer admission to birth time or receiving an intrapartum analgesic (continuous labor epidural, opioids and/or acetaminophen) was significantly associated with an instrument‐assisted birth, whereas multiparity reduced the odds of the procedure.

Birth Outcomes After Pertussis and Influenza Diagnosed in Pregnancy: A Retrospective, Population-Based Study.

Adverse birth outcomes and the maternal severity of influenza in pregnancy are well documented but information on pertussis is limited. Population-based linkage data were collected during 2001-2016. New South Wales, Australia. A total of 1 453 037 singleton births. Cox regression was used to estimate the associations between pertussis or influenza during pregnancy and birth outcomes with adjustment of covariates. Adverse birth outcomes (preterm birth and low birth weight). Among 1 453 037 singleton births over 16 years, we identified pertussis in 925 (49; 5.3% hospitalised) and influenza in 2850 (1092; 38.3% hospitalised) women during pregnancy. Cases of pertussis were similarly distributed by trimester (32% 3rd) whereas 46% of influenza cases were in the 3rd trimester. Younger age, previous birth, and being overseas-born were associated with both pertussis and influenza, whereas identifying as Aboriginal or Torres Strait Islander, hypertension or diabetes before and during pregnancy, and a number of other factors were only associated with influenza. Both pertussis and influenza in pregnancy were associated with increased risk of preterm birth (pertussis: aHR = 1.30, 95% CI 1.01-1.68; influenza: aHR = 1.56, 95% CI 1.36-1.79) and these increased risks were greater when infections in the period within 2 weeks of birth were considered (pertussis: aHR = 2.36, 95% CI 1.26-4.41; influenza: aHR = 2.29, 95% CI 1.78-2.96). Maternal pertussis and influenza infections close to the time of birth were associated with adverse birth outcomes. These findings highlight the benefits of vaccination during pregnancy.

Differences in time of birth between spontaneous and operative vaginal births.

Objective Previous studies have identified an association between obstetric interventions and time of day in which they are performed; however, they do not account for granular variations in temporality of delivery interventions, which is influenced by both healthcare provider and resource availability. We sought to assess differences in time of birth among spontaneous vaginal births (SVB) versus operative (forceps- and vacuum-assisted) vaginal births (OVB). Study Design This cross-sectional study used birth certificate data from the National Vital Statistics System from 2016-2021, which includes time of birth and delivery method for recorded U.S. births. The number of SVBs and OVBs at each minute was normalized relative to the total births within each delivery group to facilitate balanced comparisons between groups. Logistic regression analysis assessed the odds of OVB per time of day. Results A total of 15,412,129 subjects who underwent vaginal birth were included in this analysis, 690,905 (4.5%) of whom underwent OVB. Compared to births at other time intervals, those between 4:30-7:30 p.m. were more likely to be OVBs (odds ratio [OR] 1.13, 95% CI 1.12-1.14). Conversely, births between 3:00-6:00 a.m. were less likely to be OVBs (OR 0.87, 95% CI 0.86-0.88). After adjusting for adjusting for maternal age, gestational age, and induction of labor, births between 4:30-7:30 p.m. remained more likely to be OVBs (adjusted odds ratio [aOR] 1.09, 95% CI 1.08-1.10) and births between 3:00-6:00 a.m. remained less likely to be OVBs (aOR 0.91, 95% CI 0.90-0.92). Conclusions In this population-based study, we identified temporal differences between spontaneous and operative vaginal births with increased use of instrumentation during late afternoon and reduced use in the early morning. These findings prompt further investigation into the indications for OVBs and root causes of these temporal variations, which are likely multifactorial and involve provider and resource availability.

Predicting Admission to Neonatal Care Unit at Mid-Pregnancy and Delivery Using Data from a General Obstetric Population.

Development and validation of risk prediction models at mid-pregnancy and delivery to predict admission to the neonatal care unit. We used data from all singleton deliveries at Cork University Maternity Hospital (CUMH), Ireland during 2019. Admission to the neonatal care unit was assumed if length of stay in the unit was > 24h. Multivariable logistic regression with backward stepwise selection was used to develop the models. Discrimination was assessed using the ROC curve C-statistic, and internal validation was assessed using bootstrapping techniques. We conducted temporal external validation using data from all singleton deliveries at CUMH during 2020. Out of 6,077 women, 5,809 (95.6%) with complete data were included in the analyses. A total of 612 infants (10.54%) were admitted to the neonatal care unit for > 24 hours. Six variables were informative at mid-pregnancy: male infants, maternal smoking, advancing maternal age, maternal overweight/obesity, nulliparity and history of gestational diabetes (C-statistic: 0.600, 95% CI: 0.567, 0.614). Seven variables were informative at delivery: male infants, nulliparity, public antenatal care, gestational age < 39 weeks', non-spontaneous vaginal delivery, premature rupture of membranes and time of birth between 17:01-07.59h (C-statistic: 0.738, 95% CI: 0.715, 0.760). Using these predictors, we developed nomograms to calculate individualised risk of neonatal care unit admission. Bootstrapping indicated good internal performance and external validation suggested good reproducibility. Our nomograms allow the user to quickly estimate individualised risk of neonatal care unit admission. Future research should aim to improve accuracy in early pregnancy to better assist counselling of parents.

Emergency Care Use During Pregnancy and Severe Maternal Morbidity

Pregnant individuals who repeatedly use emergency care during pregnancy represent a population who could be disproportionately vulnerable to harm, including severe maternal morbidity (SMM). To explore patterns of unscheduled care visits during pregnancy and ascertain its association with SMM at the time of birth. This cohort study used data from a statewide database that linked hospital records to births and fetal deaths occurring between October 1, 2002, and March 31, 2020, in Massachusetts. Pregnant individuals experiencing births or fetal deaths during the study period were included. Data analysis was conducted from June 2022 to September 2024. The exposure was 4 or more cases of emergency use, defined as either an emergency department visit or observational stay during pregnancy not resulting in hospital admission. Pregnancy episode was ascertained by subtracting the gestational age at birth from the date of birth. The outcome of interest was the odds ratio (OR) for SMM at the time of birth. The algorithm includes 20 conditions or procedures (excluding transfusion) identified through International Classification of Diseases, Ninth Revision and International Statistical Classification of Diseases and Related Health Problems, Tenth Revision codes across the study period. A total of 774 092 pregnant individuals (mean [SD] age, 31.2 [5.8] years; 16.8% Hispanic, 9.3% non-Hispanic Asian or Pacific Islander, 9.5% non-Hispanic Black, 63.1% non-Hispanic White) with emergency care visits during the pregnancy were included; 31.3% of these individuals had at least 1 visit. Overall, 18.1% had 1 visit and 3.3% had 4 or more visits. Four or more unscheduled visits were common among those younger than age 25 years (8.7%), with Hispanic (5.7%) or non-Hispanic Black (4.9%) race and ethnicity, with public insurance (6.5%), or with a comorbidity (19.0%) or an opioid use-related hospitalization (26.8%) in the year prior to pregnancy. Of those with 4 or more unscheduled visits, 43.8% visited more than 1 hospital during pregnancy. In a multivariable analysis of the likelihood of SMM, those with 4 or more unscheduled visits had an adjusted OR of 1.46 (95% CI, 1.29-1.66) compared with those with 0 visits. This cohort study found that high emergency care use during pregnancy was associated with an increased risk for SMM. With a significant proportion of those with frequent unscheduled visits also using multiple hospitals, solutions that are community-based and integrated across health systems may be most beneficial.

12547 Spatiotemporal Analysis Of Steroidogenesis Pathway Genes Expression In Mouse Fetal Leydig Cells

Abstract Disclosure: K. Jiang: Other; Self; NIH ORIP P51OD011106&amp;S10OD028626. A. Kothandapani: None. Z. Fu: None. T.W. Kearse: None. J. Jorgensen: Grant Recipient; Self; NIH R01HD090660. Male mouse embryos experience a masculinization programming window (MPW, embryonic day, E13-16), during which a critical threshold of androgens is produced to ensure male-pattern development. Insufficient fetal androgens during the MPW leads to variations of masculinization, such as cryptorchidism and hypospadias. In rodents, fetal Leydig cells (FLC) are the primary source of androgens; however, our knowledge about their maturation and steroid synthesis regulation is limited. Hence, the objective for this research is to reveal spatiotemporal patterns of steroidogenic pathway genes in mouse fetal testes using high-resolution technologies. To understand the temporal aspect of steroidogenesis, we quantified transcript numbers of steroidogenic pathway genes via copy number qPCR from E11 to postnatal day 6 (P6). Results showed a gradual increase in transcripts as FLCs differentiate until E14, which then surge during the MPW until E16, followed by a rapid drop in expression to pre-FLC differentiation levels by the time of birth (P0). The profound changes persisted after data were normalized to FLC numbers, suggesting active stimulation and downregulation phases of transcription regulation. Next, to assess androgen output in relation to gene transcript levels, we collected testes at 24 hour intervals from E12 to P3 to measure progesterone, androstenedione, and testosterone via LC/MS/MS; results are pending. Guided by the temporal expression profile, we examined the spatial patterns of Star (steroidogenic acute regulatory protein) at the onset (E13), peak (E16), and end (P0) of steroidogenesis using single-molecule fluorescent in situ hybridization (smFISH). We were surprised to observe three different stages for Star transcription based on the subcellular localization of it: Stage I-only at gene loci in the nucleus, newly differentiated; Stage II-in both the nucleus and cytoplasm, peak activity; and Stage III-in cytoplasm only, repressed transcription. The proportion of Stage I FLC decreased over time (15% at E13, 2% at E16, and 0.4% at P0). Most (55%) FLCs at E16 were at Stage II, when testes exhibit maximum steroidogenic gene transcript numbers. Stage III FLCs dominated in P0 testes with 68% of the total FLC number, reflecting diminishing steroidogenesis. Of note, we also discovered that the global testis pattern for Star transcripts exhibited a unique pattern. At the onset of differentiation (E13), FLCs accumulated in the middle of the dorsal-ventral axis and at either pole of the anterior-posterior axis. By E16 and at P0, FLCs were evenly distributed throughout the testis. In conclusion, we observed that FLC steroidogenic pathway gene transcription is not synchronized but individual FLCs contribute to global testis androgen output as they differentiate in a coordinated pattern towards maximal output to coordinate masculinization. Presentation: 6/1/2024

12547 Spatiotemporal Analysis Of Steroidogenesis Pathway Genes Expression In Mouse Fetal Leydig Cells

Abstract Disclosure: K. Jiang: Other; Self; NIH ORIP P51OD011106&amp;S10OD028626. A. Kothandapani: None. Z. Fu: None. T.W. Kearse: None. J. Jorgensen: Grant Recipient; Self; NIH R01HD090660. Male mouse embryos experience a masculinization programming window (MPW, embryonic day, E13-16), during which a critical threshold of androgens is produced to ensure male-pattern development. Insufficient fetal androgens during the MPW leads to variations of masculinization, such as cryptorchidism and hypospadias. In rodents, fetal Leydig cells (FLC) are the primary source of androgens; however, our knowledge about their maturation and steroid synthesis regulation is limited. Hence, the objective for this research is to reveal spatiotemporal patterns of steroidogenic pathway genes in mouse fetal testes using high-resolution technologies. To understand the temporal aspect of steroidogenesis, we quantified transcript numbers of steroidogenic pathway genes via copy number qPCR from E11 to postnatal day 6 (P6). Results showed a gradual increase in transcripts as FLCs differentiate until E14, which then surge during the MPW until E16, followed by a rapid drop in expression to pre-FLC differentiation levels by the time of birth (P0). The profound changes persisted after data were normalized to FLC numbers, suggesting active stimulation and downregulation phases of transcription regulation. Next, to assess androgen output in relation to gene transcript levels, we collected testes at 24 hour intervals from E12 to P3 to measure progesterone, androstenedione, and testosterone via LC/MS/MS; results are pending. Guided by the temporal expression profile, we examined the spatial patterns of Star (steroidogenic acute regulatory protein) at the onset (E13), peak (E16), and end (P0) of steroidogenesis using single-molecule fluorescent in situ hybridization (smFISH). We were surprised to observe three different stages for Star transcription based on the subcellular localization of it: Stage I-only at gene loci in the nucleus, newly differentiated; Stage II-in both the nucleus and cytoplasm, peak activity; and Stage III-in cytoplasm only, repressed transcription. The proportion of Stage I FLC decreased over time (15% at E13, 2% at E16, and 0.4% at P0). Most (55%) FLCs at E16 were at Stage II, when testes exhibit maximum steroidogenic gene transcript numbers. Stage III FLCs dominated in P0 testes with 68% of the total FLC number, reflecting diminishing steroidogenesis. Of note, we also discovered that the global testis pattern for Star transcripts exhibited a unique pattern. At the onset of differentiation (E13), FLCs accumulated in the middle of the dorsal-ventral axis and at either pole of the anterior-posterior axis. By E16 and at P0, FLCs were evenly distributed throughout the testis. In conclusion, we observed that FLC steroidogenic pathway gene transcription is not synchronized but individual FLCs contribute to global testis androgen output as they differentiate in a coordinated pattern towards maximal output to coordinate masculinization. Presentation: 6/1/2024

12674 Spatiotemporal Analysis Of Steroidogenesis Pathway Genes Expression In Mouse Fetal Leydig Cells

Abstract Disclosure: K. Jiang: Other; Self; NIH ORIP P51OD011106&amp;S10OD028626. A. Kothandapani: None. Z. Fu: None. T.W. Kearse: None. J. Jorgensen: Grant Recipient; Self; NIH R01HD090660. Male mouse embryos experience a masculinization programming window (MPW, embryonic day, E13-16), during which a critical threshold of androgens is produced to ensure male-pattern development. Insufficient fetal androgens during the MPW leads to variations of masculinization, such as cryptorchidism and hypospadias. In rodents, fetal Leydig cells (FLC) are the primary source of androgens; however, our knowledge about their maturation and steroid synthesis regulation is limited. Hence, the objective for this research is to reveal spatiotemporal patterns of steroidogenic pathway genes in mouse fetal testes using high-resolution technologies. To understand the temporal aspect of steroidogenesis, we quantified transcript numbers of steroidogenic pathway genes via copy number qPCR from E11 to postnatal day 6 (P6). Results showed a gradual increase in transcripts as FLCs differentiate until E14, which then surge during the MPW until E16, followed by a rapid drop in expression to pre-FLC differentiation levels by the time of birth (P0). The profound changes persisted after data were normalized to FLC numbers, suggesting active stimulation and downregulation phases of transcription regulation. Next, to assess androgen output in relation to gene transcript levels, we collected testes at 24 hour intervals from E12 to P3 to measure progesterone, androstenedione, and testosterone via LC/MS/MS; results are pending. Guided by the temporal expression profile, we examined the spatial patterns of Star (steroidogenic acute regulatory protein) at the onset (E13), peak (E16), and end (P0) of steroidogenesis using single-molecule fluorescent in situ hybridization (smFISH). We were surprised to observe three different stages for Star transcription based on the subcellular localization of it: Stage I-only at gene loci in the nucleus, newly differentiated; Stage II-in both the nucleus and cytoplasm, peak activity; and Stage III-in cytoplasm only, repressed transcription. The proportion of Stage I FLC decreased over time (15% at E13, 2% at E16, and 0.4% at P0). Most (55%) FLCs at E16 were at Stage II, when testes exhibit maximum steroidogenic gene transcript numbers. Stage III FLCs dominated in P0 testes with 68% of the total FLC number, reflecting diminishing steroidogenesis. Of note, we also discovered that the global testis pattern for Star transcripts exhibited a unique pattern. At the onset of differentiation (E13), FLCs accumulated in the middle of the dorsal-ventral axis and at either pole of the anterior-posterior axis. By E16 and at P0, FLCs were evenly distributed throughout the testis. In conclusion, we observed that FLC steroidogenic pathway gene transcription is not synchronized but individual FLCs contribute to global testis androgen output as they differentiate in a coordinated pattern towards maximal output to coordinate masculinization. Presentation: 6/1/2024

12674 Spatiotemporal Analysis Of Steroidogenesis Pathway Genes Expression In Mouse Fetal Leydig Cells

Abstract Disclosure: K. Jiang: Other; Self; NIH ORIP P51OD011106&amp;S10OD028626. A. Kothandapani: None. Z. Fu: None. T.W. Kearse: None. J. Jorgensen: Grant Recipient; Self; NIH R01HD090660. Male mouse embryos experience a masculinization programming window (MPW, embryonic day, E13-16), during which a critical threshold of androgens is produced to ensure male-pattern development. Insufficient fetal androgens during the MPW leads to variations of masculinization, such as cryptorchidism and hypospadias. In rodents, fetal Leydig cells (FLC) are the primary source of androgens; however, our knowledge about their maturation and steroid synthesis regulation is limited. Hence, the objective for this research is to reveal spatiotemporal patterns of steroidogenic pathway genes in mouse fetal testes using high-resolution technologies. To understand the temporal aspect of steroidogenesis, we quantified transcript numbers of steroidogenic pathway genes via copy number qPCR from E11 to postnatal day 6 (P6). Results showed a gradual increase in transcripts as FLCs differentiate until E14, which then surge during the MPW until E16, followed by a rapid drop in expression to pre-FLC differentiation levels by the time of birth (P0). The profound changes persisted after data were normalized to FLC numbers, suggesting active stimulation and downregulation phases of transcription regulation. Next, to assess androgen output in relation to gene transcript levels, we collected testes at 24 hour intervals from E12 to P3 to measure progesterone, androstenedione, and testosterone via LC/MS/MS; results are pending. Guided by the temporal expression profile, we examined the spatial patterns of Star (steroidogenic acute regulatory protein) at the onset (E13), peak (E16), and end (P0) of steroidogenesis using single-molecule fluorescent in situ hybridization (smFISH). We were surprised to observe three different stages for Star transcription based on the subcellular localization of it: Stage I-only at gene loci in the nucleus, newly differentiated; Stage II-in both the nucleus and cytoplasm, peak activity; and Stage III-in cytoplasm only, repressed transcription. The proportion of Stage I FLC decreased over time (15% at E13, 2% at E16, and 0.4% at P0). Most (55%) FLCs at E16 were at Stage II, when testes exhibit maximum steroidogenic gene transcript numbers. Stage III FLCs dominated in P0 testes with 68% of the total FLC number, reflecting diminishing steroidogenesis. Of note, we also discovered that the global testis pattern for Star transcripts exhibited a unique pattern. At the onset of differentiation (E13), FLCs accumulated in the middle of the dorsal-ventral axis and at either pole of the anterior-posterior axis. By E16 and at P0, FLCs were evenly distributed throughout the testis. In conclusion, we observed that FLC steroidogenic pathway gene transcription is not synchronized but individual FLCs contribute to global testis androgen output as they differentiate in a coordinated pattern towards maximal output to coordinate masculinization. Presentation: 6/1/2024

Inflammatory and cardiovascular markers in placenta following SARS-CoV-2 infection during pregnancy: A Swedish prospective cohort study

IntroductionMaternal SARS-CoV-2 infection can affect pregnancy outcome, but the placental response to and the effect of timing of infection is not well studied. The aim of this study was to investigate the placental levels of inflammatory and cardiovascular markers in pregnancies complicated by SARS-CoV-2 infection compared to non-infected pregnancies, and to investigate whether there was an association between time point of infection during pregnancy and placental inflammatory and cardiovascular protein levels. MethodsPlacental samples from a prospectively recruited pregnancy cohort of SARS-CoV-2-infected (n = 53) and non-infected (n = 50) women were analysed for 177 inflammatory and cardiovascular proteins, using an antibody-based proximity extension assay. In the SARS-CoV-2-infected group, half of the women were infected before 20 weeks of gestation, and five women were hospitalised for severe SARS-CoV-2 infection. Single-protein analyses were performed with linear mixed effects models, followed by Benjamini-Hochberg correction for multiple testing. Multi-protein analyses were performed using principal component analysis and machine learning algorithms. ResultsThe perinatal outcomes and the placental levels of inflammatory or cardiovascular proteins in women with SARS-CoV-2 infection were similar to those in non-infected women. There were no differences in inflammatory or cardiovascular protein levels between early and late pregnancy SARS-CoV-2 infection, nor any linear correlations between protein levels and gestational age at time of infection. DiscussionWomen with SARS-CoV-2 infection during pregnancy without clinical signs of placental insufficiency have no changes in inflammatory or cardiovascular protein patterns in placenta at time of birth regardless of the timing of the infection.

Porutham - Creating varied Rhythmic Cadences with Chart Templates

Porutham is a Tamil word meaning ‘matching’. The word has varied meanings according to the context in which it is used in Tamil language. Porutham in Astrology means ‘match making between two astrological charts’ at the time of marriage. Porutham also means perfectly matched partners or friends. ‘Nalla Porutham’ is the phrase which means ‘Good Match’. It also means that it will be ideally suited for the particular object.Musically ‘Poruthams’ can be used as part of various cadential forms like Korvai, short ending items like Muktayi, theermanam, arudi etc. This can also be used in ‘Jati Pallavis’, in the Pallavi portion of Ragam, Tanam, Pallavi and in Kritis where neravals are sung. Porutham is generally done as a rhythmic exercise, where Jatis are employed when a percussion artiste uses Poruthams and Swaras are used when a Vocalist/instrumentalist uses them.This article also covers various examples covering porutham ideas for various kritis where neravals are popularly sung. Sample kritis have been taken from different Talas like Adi Tala, Rupaka Tala and Misra Chaapu Tala. Ragam-Tanam-Pallavis and Jati Pallavis have not been covered in this article, as we propose to cover them extensively in a separate article.

Fokker-Planck equation for the crystal-size probability density in progressive nucleation and growth with application to lognormal, Gaussian and gamma distributions

The Fokker Planck (FP) equation for the probability density function (PDF) of crystal size in phase transformations ruled by progressive nucleation and growth, has been derived. Crystals are grouped in sub-sets, we refer to as τ-crystals, where τ is the birth time of the set. It is shown that the size PDF is the superposition of the PDF of the crystal sub-sets (τ-PDFs), with weight given by the nucleation rate. The growth and diffusion coefficients entering the FP equations are estimated as a function of both τ-PDFs and nucleation rate. The functional form of these coefficients is studied for solutions of the FP equation for τ-crystals given by the lognormal, Gaussian and gamma distributions. For the first two distributions, the effect of fluctuations, nucleation rate and growth rate, on the shape of the distribution has been investigated. It is shown that for an exponential decay of the fluctuation term, the shape of the PDF is mainly governed by both the time constant for nucleation and the strength of the fluctuation. It is found that τ-PDFs given by the one-parameter gamma distributions are suitable to deal with KJMA (Kolmogorov Johnson Mehl Avrami) compliant phase transformations, where the fluctuation term is proportional to crystal size. The connection between the FP equation for the size PDF and the evolution equation for the density of crystal populations is also discussed.

Risk of central nervous system tumors in the offspring of individuals exposed to production radiation

Aim. To assess the risk of malignant central nervous system (CNS) tumors among the first-generation offspring of workers from the Mayak Production Association.Materials and Methods. A retrospective epidemiological analysis was conducted in a cohort of the offspring of workers from Russia's first nuclear power plant (n = 8890), born between 1949 and 1973. The comparison group consisted of 4345 offspring born during the same period to non-exposed parents. The observation period covered 72 years (1949−2020), with a total of 818,208 person-years of follow-up. The analysis focused on the frequency, dynamics, and structure of CNS malignancies. The relative risk of CNS tumors and the excess relative risk per unit dose of parental occupational radiation exposure were calculated with 95% confidence intervals.Results. Overall, the frequency of CNS tumors in both groups over the entire observation period did not differ significantly (3.4 per 1000 in the main group, 1.8 per 1000 in the comparison group). Analysis of CNS tumor incidence dynamics across calendar periods showed no significant differences, with the peak in the main group occurring during 2001−2010. No significant differences were found in the age of CNS tumor onset or the average age of parents at the time of offspring birth. Histological structure and localization of CNS tumors varied across groups. The relative risk assessment for CNS tumors showed a statistically insignificant increase in risk among the offspring in the main group when considering total observations and sex-specific analyses. Among the offspring of mothers with confirmed preconceptional and intrauterine occupational radiation exposure, the relative risk of CNS tumors was higher for males and both sexes combined (3.6 [1.06−12.28] and 2.74 [1.08−6.93]; 4.34 [1.27−14.77] and 3.3 [1.31−8.36], respectively). However, the analysis of excess relative risk did not indicate significant risk estimates for maternal radiation exposure, neither in general nor across different dose intervals.Conclusion. The study did not confirm the hypothesis that parental occupational radiation exposure influences the risk of CNS tumors in offspring. Given the relatively young age of the cohort and the low number of CNS tumor cases, issues related to maternal radiation exposure require further observation.

Hubungan Sosial Ekonomi dengan Penggunaan Alat Kontrasepsi Jangka Panjang (MKJP) di Puskesmas Labuhan Deli Kecamatan Labuhan Deli Kabupaten Deli Serdang Kecamatan Labuhan Deli Kabupaten Deli Serdang

The use of contraception is an action that helps individuals or married couples to achieve certain objectives, avoid unwanted births, get births that are truly desired, regulate the interval between pregnancies and control the time of birth in the husband and wife relationship. The aim of this research is to determine the socio-economic relationship with the use of long-term contraceptives (MKJP) at the Labuhan Deli Community Health Center. All acceptors who visited in May-June at the Labuhan Deli Community Health Center were 39 respondents. Data analysis using univariate, bivariate analysis. The results of this study show that there is a relationship between maternal knowledge about immunization and providing complete basic immunization to babies at the Penanggalan Community Health Center, Penanggalan District, Subulussalam City in 2023. It is hoped that there will be more questions from health workers or more use of existing facilities as input. to receive information about health, especially the use of MKJP

ANÁLISE DOS EFEITOS DA VIOLÊNCIA OBSTÉTRICA NO DESEJO DE UMA NOVA GESTAÇÃO

Objective: to analyze the psychological and reproductive interconnection, understand the epidemiological profile of patients, understand the level of influence of this crime on reproductive health in such a way as to analyze this reverberation within the family environment. Methodology: this is a cross-sectional and descriptive field research due to its quantitative bias. Results and Discussions: The study included the participation of 50 postpartum women, all of whom suffered obstetric violence, with the most described being the disregard of the woman's opinion at the time of birth, in view of this, there was also a predisposition of socioeconomic conditions, age , racial and school issues as the foundation of these experiences, such as the observation of the consequences for the human psyche arising from OV, as well as the interference in the desire for a new gestational cycle through trauma arising from this crime. Final considerations: More than a quarter of the participants would say that the experience of obstetric violence influenced the desire for a new pregnancy, the lack of prenatal guidance, the absence of a companion at the time of birth and economic and social factors are predisposing to the experience of obstetric violence.

PSV-16 Evaluation of upper respiratory and fecal microbiomes in neonatal beef calves

Abstract There is a critical lack of information on the timing of colonization of bovine respiratory disease-related bacteria in the upper respiratory tract, potentially affecting calf health and disease onset. The objective of this study was to evaluate the upper respiratory tract and fecal microbiomes of neonatal beef calves during the first 24 h of life compared with their dams at the time of birth. Late-gestation commercial beef cows (n = 28) were assigned to individual, soil-surfaced pens (6.25 x 2.29 m) fitted with canvas tarps on shared fences to limit contact between unrelated pairs. Left nasal (LN), right nasal (RN), fecal, and vaginal swab samples were collected from cows at a single time point promptly after parturition. Swabs of the LN, RN, and rectum were collected from calves at birth (0 h), 6, 12, and 24 h post-parturition. Samples were flash-frozen and stored at -80°C until processing. DNA was extracted from swabs using Power Soil Pro kit. Extracted DNA was used to prepare DNA libraries for full-length 16S rRNA gene sequencing on a MinION Mk1C device. Sequenced reads were classified using Centrifuge and used in microbiome analyses conducted in R to estimate the changes in the microbiome according to animal type (cow versus calf), time of collection, and sample type (nasal, fecal, or vaginal). Upper respiratory microbiomes significantly differed (P &amp;lt; 0.005) between cows and their offspring at birth. In nasal microbiomes, animal type explained 12.6% (P = 0.002) and 18.5% (P = 0.001) of variance in beta diversity in left and right cavities, respectively. Animal type explained 42.1% of the beta diversity variance in fecal microbiomes (P = 0.001). Nasal microbiomes at birth were significantly more dispersed in dams compared with their calves in both the LN (P = 0.03) and RN (P = 0.03). Similarly, fecal microbiomes of dams were significantly more dispersed (P &amp;lt; 0.0001) than those of their offspring. There was a clear transition of the microbial communities associated with calf age in the upper respiratory and fecal niches. Calf age accounted for 2% (P = 0.02), 3.5% (P = 0.001), and 28% (P = 0.001) of the variance in the beta diversity of the LN, RN, and fecal microbiomes, respectively. After adjusting for calf age, the laterality of nasal microbiomes was not significantly (P = 0.682) associated with the composition of microbial communities. In conclusion, calf microbial communities were dissimilar to that of their dam at birth. Additionally, microbial community transition was evident with each subsequent sampling time point, potentially influenced by the presence of the dam.

The effect of birth timing manipulation around carnival on birth indicators in Brazil.

This paper studies the patterns and consequences of birth timing manipulation around the carnival holiday in Brazil. We document how births are displaced around carnival and estimate the effect of displacement on birth indicators. We show that there is extensive birth timing manipulation in the form of both anticipation and postponement that results in a net increase in gestational length and reductions in neonatal and early neonatal mortality, driven by postponed births that would otherwise happen through scheduled c-sections. We also find a reduction in birthweight for high-risk births at the bottom of the weight distribution, driven by anticipation. Therefore, restrictions on usual delivery procedures due to the carnival holiday can be both beneficial and detrimental, raising a double-sided issue to be addressed by policymakers.

Social Desirability Bias in a Randomized Controlled Trial That Included Breastfeeding Promotion in Western Kenya

BackgroundBreastfeeding promotion is associated with improved measures of breastfeeding practice; however, most studies rely on participant-reported outcomes. ObjectivesThis study aimed to evaluate the likelihood of bias in self-reported breastfeeding outcomes. MethodsWe used data from the WASH Benefits randomized controlled trial in Kenya (clinicaltrials.gov NCT01704105), which included intervention arms that received infant and young child feeding messages (nutrition group) and arms that did not (non-nutrition group) to examine recall bias in the assessment of early initiation of breastfeeding (EIBF) and exclusive breastfeeding (EBF) duration. Pregnant women were eligible for inclusion, but 40% of infants were born before the first visit by the health promoter. We used the random variability in the timing of the infant birth relative to the first contact with the health promoter to examine recall bias in EIBF. We used ≤5 rounds of repeated surveys to examine bias in recall of EBF duration. ResultsThere was a significant effect of the intervention group on EIBF [prevalence ratio: 1.50, 95% confidence interval (CI): 1.43, 1.57] and a significant difference in the duration of EBF [nutrition group: 6.0 mo; interquartile range (IQR): 3.0–6.0; nonnutrition group: 3.0 mo; IQR: 0.5–6.0; P < 0.001]. There was not a significant interaction with birth timing relative to the first contact with the health promoters (P = 0.915), suggesting that the observed main effect on EIBF was due to recall bias. We found that 75.9% of mothers who initially reported having ceased EBF before 6 mo in the nutrition group changed their response to 6 mo or later in subsequent surveys. Only 32.5% of mothers in the non-nutrition group followed this pattern. ConclusionsThese data provide strong evidence of bias in reporting of breastfeeding practices in this nonblinded intervention trial and should serve as a caution to researchers who rely on self-reported outcomes of behavior change interventions.This trial was registered at clinicaltrials.gov as NCT01704105.