Higher Birth Research Articles

Did the increase in birth grants result in higher births? Evidence from the Czech demographic and population policy change

PurposeThis research contributes to a better understanding of the effects of public demographic and population policy. The study investigates whether a considerable increase in birth grants in 2006 in the Czech Republic resulted in a higher number of births.Design/methodology/approachTo quantify the effects, we work with the administrative, statistical daily data (1993–2016) on the number of births and use time series analysis tools. In particular, we estimate a time series regression model via the ordinary least squares (OLS) technique with robust standard errors, testing placebo effects and the differences between the trend-forecasted values in the absence of the grant change.FindingsOur results, spread over several time windows covering up to a ten-year period after the intervention, show that the intervention significantly and positively affected the number of births in the post-intervention periods. The evidence obtained from the econometric analysis of the time series clearly shows that after the demographic and population policy change, there was an average increase of 17–19 births daily when the data was analysed up to 2016. Therefore, the conclusion is that the policy intervention led to expected and desired policy outcomes.Originality/valueThe study provides the stakeholders and policymakers with an experience of the public policy aiming to support fertility, which has reached its expectations.

Associations of Organophosphate Ester Flame Retardant Exposures during Pregnancy with Gestational Duration and Fetal Growth: The Environmental influences on Child Health Outcomes (ECHO) Program.

Widespread exposure to organophosphate ester (OPE) flame retardants with potential reproductive toxicity raises concern regarding the impacts of gestational exposure on birth outcomes. Previous studies of prenatal OPE exposure and birth outcomes had limited sample sizes, with inconclusive results. We conducted a collaborative analysis of associations between gestational OPE exposures and adverse birth outcomes and tested whether associations were modified by sex. We included 6,646 pregnant participants from 16 cohorts in the Environmental influences on Child Health Outcomes (ECHO) Program. Nine OPE biomarkers were quantified in maternal urine samples collected primarily during the second and third trimester and modeled as -transformed continuous, categorized (high/low/nondetect), or dichotomous (detect/nondetect) variables depending on detection frequency. We used covariate-adjusted linear, logistic, and multinomial regression with generalized estimating equations, accounting for cohort-level clustering, to estimate associations of OPE biomarkers with gestational length and birth weight outcomes. Secondarily, we assessed effect modification by sex. Three OPE biomarkers [diphenyl phosphate (DPHP), a composite of dibutyl phosphate and di-isobutyl phosphate (DBUP/DIBP), and bis(1,3-dichloro-2-propyl) phosphate] were detected in of participants. In adjusted models, DBUP/DIBP [odds ratio (OR) per ; 95% confidence interval (CI): 1.02, 1.12] and bis(butoxyethyl) phosphate (OR for high vs. ; 95% CI: 1.06, 1.46), but not other OPE biomarkers, were associated with higher odds of preterm birth. We observed effect modification by sex for associations of DPHP and high bis(2-chloroethyl) phosphate with completed gestational weeks and odds of preterm birth, with adverse associations among females. In addition, newborns of mothers with detectable bis(1-chloro-2-propyl) phosphate, bis(2-methylphenyl) phosphate, and dipropyl phosphate had higher birth weight-for-gestational-age -scores ( for detect vs. ); other chemicals showed null associations. In the largest study to date, we find gestational exposures to several OPEs are associated with earlier timing of birth, especially among female neonates, or with greater fetal growth. https://doi.org/10.1289/EHP13182.

Business research methods: A perspective of street traders in the informal economy

Many people, despites being educated or not, struggle to find decent jobs in the formal economy. Some end-up working in the informal economy as self-employed/own-account workers. Informal economy is the largest employer with more potentials, employing approximately 61 percent of the global labour force. Despite different forms of occupations, street trading is the most visible occupation in the informal economy. There is a research gap between formal and informal economy, with most research done in the formal economy. It is recommended that micro-level individuals must be included in research to broaden knowledge. The informal economic activities are not reported in government statistics. It is odd because the informal economy is the largest global employer and street trading is found in both developed and developing economies. Informal economic activities are however associated with lack of growth and social security, money laundering, and financing of terrorist activities. The study was conducted to determine work engagement of street traders using the Utrecht Work Engagement Scale (UWES). The UWES is validated and used for quantitative studies in the formal economy. The instrument was pretested and piloted for quality appraisal purposes for validation and use in the informal economy. The general lack of credible records of street trading activities, makes it difficult for researchers to conduct studies using different methodologies in the informal economy. The convenience sampling strategy, a nonprobability sampling startegy, was used in choosing participants, and was most valid for solving the problem of the study, choosing participants accidentally on availability. Most quantitative studies involving street traders are restricted to using nonprobabiliity sampling, which is a concern. The high birth and/or mortality rate of street trading businesses make the database inconsistent to use as some do not report when exiting or entering. The lack of credible records/database of street trading activities, and over reliance on nonprobability sampling strategy, restrict the holistic generation of knowledge. The street traders’ activities must be registered to develop from knowledge generated through research.

P-713 Preimplantation DNA methylation screening (PIMS) illustrates the outcome of assisted reproductive technology

Abstract Study question It is unknown whether using DNA methylation can improve the outcome of ART and can exclude the imprinted gene diseases. Summary answer Our study provides a criterion on selecting blastocyst according to DNA methylome, which can improve live birth rate and decrease birth defect rate. What is known already How to select the embryos is one key factor that can determine the successful rate of ART. As aneuploidy exists in 20-30% of blastocysts, preimplantation genetic screening (PGS) has been widely used, which increases the live birth rate. Unfortunately, the live birth rate remains around 50% even with the help of PGS. DNA methylation is known to play important function during embryogenesis. Previous study has shown that a large proportion of human embryos have abnormal DNA methylome. However, whether DNA methylation pattern can affect the clinical outcome of ART has not been investigated in clinics. Study design, size, duration To determine whether PIMS method can increase live birth rate during ART, the whole genome DNA methylation of 3-5 biopsied cells from trophectoderm were measured. The methylation level and chromosome copy number variation (CNV) were analyzed by using the methylome data. elective single embryo transfer (eSET) will be performed for embryos with euploid chromosome. The live birth rate, pregnant rate and abortion rate will be examined. 182 families including 800 blastocysts were enrolled in PIMT. Participants/materials, setting, methods Eligible couples include advanced maternal age, recurrent pregnancy loss with unknown reason, recurrent implantation failure with unknown reason, severe oligoteratozoospermia. Eligible couples must have two or more good-quality blastocysts. We call a blastocyst as good quality if the blastocyst is 4BC or better according to the Gardner morphologic criteria on day 5-6 of embryo culture. Main results and the role of chance No one has ever performed clinical trial to investigate the impact of DNA methylation of blastocyst on the outcome of artificial assisted reproductive (ART). Here, we performed PIMS using the biopsied trophectoderm of 800 blastocysts. Chromosome copy number variation and DNA methylation pattern were analyzed by using methylome data. 162 of euploid embryos were transferred. Our data show that significant variation of DNA methylation level of blastocysts can be observed in both younger women (£37 years old) and older women (>37 years). Blastocysts with global methylation level around 0.26 have the highest birth and pregnancy rate, but the lowest abortion rate. The higher the difference methylation value from 0.26 is, the lower the birth rate becomes. Furthermore, by using artificial intelligence method according to different methylated regions between the embryos succeeding in live-birth and those failing in live-birth, we can robustly predict the clinical outcome of blastocysts. PIMS method can find the abnormality of DNA methylation states in the imprinted control regions which can cause the imprinted diseases. Our study provides a criterion on selecting blastocyst according to DNA methylome during ART, which can potentially improve the live birth rate and decrease the birth defect rate. Limitations, reasons for caution Because of the low coverage of single cell DNA methylome, PIMS method cannot cover all imprinted control regions. Wider implications of the findings PIMS method can potentially find more human diseases which is caused by DNA methylation mutation. Trial registration number NCT03642574

Individual and community-level factors associated with caesarean section in Haiti: secondary analysis of data from the 2016–2017 Haitian Demographic and Health Survey

IntroductionFor several decades, the rate of caesarean section (CS) has been increasing in the world. In some countries, the CS rate is below the WHO recommended range (10–15%), while in other countries, it is significantly higher. The aim of this paper was to identify individual and community-level factors associated with CS in Haiti.MethodsSecondary data analysis was conducted on nationally representative cross-sectional survey data from the 2016–2017 Haitian Demographic and Health Survey (HDHS). The analysis was restricted to 6303 children born in 5 years prior the survey (of the interviewed women). The study population’ characteristics, and the prevalence of CS were analysed using descriptive analysis (univariate/bivariate). In addition, multilevel binary logistic regression analysis was performed to identify factors associated with CS. Both descriptive and multivariate analysis were conducted using STATA 16.0 software (Stata Corp, Tex, USA). Statistical significance was declared at p < 0.05.ResultsThe overall prevalence of CS delivery was estimated at 5.4% (95% CI 4.8–6.0) in Haiti. Results also revealed that mothers aged 35 and above (aOR = 1.38; 95% CI 1.00–1.96); who attended secondary (aOR = 1.95; 95% CI 1.39–2.76) and higher education level (aOR = 3.25; 95% CI 1.92–5.49); who were covered by health insurance (aOR = 2.57; 95% CI 1.57–4.19); with less than 3 children (aOR = 4.13; 95% CI 2.18–7.85) or 3–4 children (aOR = 2.07; 95% CI 1.09–3.94); who received 9 or more antenatal visits (aOR = 2.21; 95% CI 1.40–3.50) were significantly more likely to deliver by CS. Children in communities with high preponderance of private health facilities had greater odds to be delivered through CS (aOR = 1.90; 95% CI 1.25–2.85). Furthermore, children with an average birth weight (aOR = 0.66; 95% CI 0.48–0.91) were less likely to be delivered through CS than their counterparts with high birth weight.ConclusionsWhile the CS prevalence was low in Haiti, it masks significant geographic, social and economic disparities. To better develop and implement maternal and child health programs that address CS deliveries, the government authorities and NGOs operating in the field of women’s health in Haiti should take these disparities into account.

Promoting extinction or minimizing growth? The impact of treatment on trait trajectories in evolving populations.

When cancers or bacterial infections establish, small populations of cells have to free themselves from homoeostatic regulations that prevent their expansion. Trait evolution allows these populations to evade this regulation, escape stochastic extinction and climb up the fitness landscape. In this study, we analyse this complex process and investigate the fate of a cell population that underlies the basic processes of birth, death and mutation. We find that the shape of the fitness landscape dictates a circular adaptation trajectory in the trait space spanned by birth and death rates. We show that successful adaptation is less likely for parental populations with higher turnover (higher birth and death rates). Including density- or trait-affecting treatment we find that these treatment types change the adaptation dynamics in agreement with a geometrical analysis of fitness gradients. Treatment strategies that simultaneously target birth and death rates are most effective, but also increase evolvability. By mapping physiological adaptation pathways and molecular drug mechanisms to traits and treatments with clear eco-evolutionary consequences, we can achieve a much better understanding of the adaptation dynamics and the eco-evolutionary mechanisms at play in the dynamics of cancer and bacterial infections.

Anthelmintic usage on the Reproductive Parameters in Captive reared Agoutis (Dasyprocta leporina) in Trinidad and Tobago, West Indies.

The agouti (Dasyprocta leporina) is a rodent that is found in the Neo-tropical region. This animal is hunted for its meat but has recently been reared in captivity as a source of meat protein in rural communities. A 20-month experiment was carried out to evaluate the effect of an anthelmintic on the reproductive performance of the agouti (Dasyprocta leporina) reared in captivity. This experiment was conducted in the humid tropics of Trinidad and Tobago. Sixteen animals (15 females, 1 male) placed in each of the two treatment groups in a completely randomized study design. In treatment 1 (T1) animals were given subcutaneous injections of Endovet Ces® (Ivermectin/Praziquantel) at 0.2 mg/kg every three months. Treatment 2 (T2) was the negative control group where animals were not exposed to an anthelmintic. Reproductive data were collected at parturition which included birth weight, litter weight, litter size and gender of offspring. The results showed that there was no statistical difference (p > 0.05) between the treatment groups with respect to birth weight, litter weight, litter size and gender. However, agoutis that were dewormed had a higher birth weight (220.24 g vs 209.1 g) and litter weight (369.8 g vs 343 g). The same values were obtained for the litter size (1.7 vs 1.7) and animals that were dewormed had a higher female offspring to male offspring (2.41:1 vs 1.11:1). This experiment demonstrated that the use of an anthelmintic strategically in the management of captive reared agoutis had no statistical effect (p > 0.05) on the reproductive parameters. Therefore, these animals can be kept in captive conditions without being dewormed and produce efficiently with proper feeding and housing management.

The effect of birth order on length of hospitalization for pediatric traumatic brain injury: an analysis of the 1987 Finnish birth cohort

PurposeThis study examines the relationship between birth order and length of hospitalization due to pediatric traumatic brain injury (TBI).MethodsWe prospectively followed 59,469 Finnish newborns from 1987 until age 18 years. Data on first diagnosis of TBI was recorded within the 1987 Finnish Birth Cohort (FBC). Hospitalization period was divided into two categories: 2 days or less and more than 2 days. The latter was considered in this study as longer hospitalization.ResultsCompared with first born siblings, later born siblings had an increased risk of a longer hospitalization for TBI (12.7% of fourth or higher born birth children diagnosed with TBI were hospitalized for 2 or more days, 11.3% of first born, 10.4% of third born and 9.0% of second born). Fourth or higher born children were more likely to experience a repeat TBI; 13.4% of fourth or higher born children diagnosed with TBI had 2–3 TBIs during the study period compared to 9% of third born, 7.8% of second born and 8.8% of the first born. Injuries in the traffic environment and falls were the most common contributors to pediatric TBI and occurred most frequently in the fourth or higher birth category; 29.3% of TBIs among fourth or higher birth order were due to transport accidents and 21% were due to falls.ConclusionsThis study revealed a significant increase in risk for longer hospitalization due to TBI among later born children within the same sibling group. The study provides epidemiological evidence on birth order as it relates to TBI, and its potential to help to explain some of the statistical variability in pediatric TBI hospitalization over time in this population.

Dietary protein intake during pregnancy and birth weight among Chinese pregnant women with low intake of protein

BackgroundPrevious studies have yielded inconsistent results on the association between maternal dietary protein intake and birth weight. Moreover, little is known about the effects of dietary protein intake from different sources on fetal growth. This study aimed to investigate the associations of different dietary protein sources (total protein, animal protein, plant protein, and major dietary protein sources) during pregnancy with birth weight and the related adverse birth outcomes.Methods7310 women were recruited using a stratified multistage random sampling method at 0–12 months (median: 3; 10–90th percentile: 0–7) after delivery in Shaanxi, China. Maternal diets were gathered by a validated FFQ and other characteristics were collected by a standard questionnaire. Multilevel linear or logistic regression models were used to estimate birth weight changes or ORs (95% CIs) for adverse birth outcomes associated with different dietary protein sources during pregnancy.ResultsThe mean percentage of energy from total protein was 11.4% (SD 2.2), with only 27.4% of total protein derived from animal protein. Per 3% increase in energy from total protein, animal protein, and dairy protein was associated with birth weight increases of 19.4 g (95% CI 6.0–32.9), 20.6 g (4.8–36.5), and 18.2 g (4.7–31.7), respectively. Per 3% increase in energy from total protein, animal protein, and dairy protein was also associated with lower risks of low birth weight (LBW) (total protein: OR = 0.78, 95% CI 0.64–0.94; animal protein: 0.79, 0.65–0.96; dairy protein: 0.71, 0.56–0.91), small for gestational age (SGA) (total protein: 0.88, 0.79–0.98; animal protein: 0.87, 0.78–0.97; dairy protein: 0.81, 0.68–0.96), and intrauterine growth retardation (IUGR) (total protein: 0.84, 0.72–0.98; animal protein: 0.86, 0.75–0.98; dairy protein: 0.78, 0.66–0.92). We observed no associations of plant protein and other major dietary protein sources with birth weight and the above birth outcomes. The results did not change when maternal protein was substituted for fat or carbohydrate.ConclusionsAmong Chinese pregnant women with low intake of protein, higher intake of dietary protein, in particular animal protein and dairy protein, is associated with higher birth weight and lower risks of LBW, SGA, and IUGR.

Manifestações neuropsicológicas por Covid-19 em pacientes Hospitalizados: dados preliminares / Neuropsychological manifestations of Covid-19 in hospitalized patients: preliminary data

Introdução: o vírus Sars-CoV-2, responsável pela COVID-19, pode promover alterações neurológicas/neuropsicológicas no Sistema Nervoso Central e Periférico. Objetivo: investigar alterações neuropsicológicas em pacientes neurológicos com história de diagnóstico médico de COVID-19 durante a pandemia por COVID-19. Método: estudo transversal com 5 pacientes adultos internados em hospital geral empregando os instrumentos: anamnese, NEUROPSIC-R (considerando escore mínimo de 43 pontos para a identificação/suspeita de alterações neuropsicológicas e de 47 no caso de declínio cognitivo e demência, valores mínimos de 19 e máximo de 76 pontos), WASI - Escala Wechsler Abreviada de Inteligência e Mini Exame do Estado Mental (MEEM). Resultados e Discussão: os diagnósticos incluíram epilepsia, Acidente Vascular Cerebral, encefalite, demência, síndrome cerebelar e do neurônio motor. Dos pacientes, 4 utilizavam psicotrópicos/neurolépticos. A média etária foi de 59,6 anos (DP: 18,7) e a de escolaridade de 9,6 anos (DP: 4). O escore médio do NEUROPSIC-R foi de 54,4 (DP: 9,8), 4 sujeitos referiram prejuízo. No MEEM de 21 (DP: 1,76), 3 sujeitos mostraram déficit. Destes, 4 apresentaram QI total abaixo do esperado no momento, e 4 mostraram desempenho deficitário qualitativamente em memória verbal recente e tardia. Conclusão: na correlação de Spearman, destacam-se as díades memória tardia e recente, vocabulário e escolaridade, além de QI total e memória verbal tardia. Logo, constatou-se a relação entre a percepção da condição neuropsicológica e os achados cognitivos e comportamentais neste grupo.

Age heterogeneities in child growth and its associated socio-demographic factors: a cross-sectional study in India

BackgroundThe impacts of socio-demographic and environmental risk factors on child growth have been widely documented. However, it remains unclear whether the impacts of such risk factors on child growth have remained static or changed with child’s age. The present study aims to assess the underlying age heterogeneities in child growth and its potential determinants over age in under-five children.MethodsCross-sectional data on child height (measured as height-for-age z-score, i.e., HAZ) and weight (measured as weight-for-age z-score, i.e., WAZ) and potential confounding factors from India’s 2015–16 National Family Health Survey (NFHS) were used to construct anthropometric age-profiles by a number of bio-demographic and socioeconomic characteristics. Further, age-interacted multilevel regression analyses were performed to examine differential effects of such/those risk factors on child height and weight by age.ResultsFaltered height and weight growth during first two years of life was noticed in children of all socioeconomic groups studied, albeit with varying magnitude. In case of child’s height, factors such as short birth interval, higher birth order, maternal education, household wealth, district level mortality rate have shown strong interaction with child’s age during the first 23 months, signifying their age-varying role in different developmental stages of child growth. These factors explain the observed upward and downward shifts in height curve during first two years. Some of these variables (e.g., household wealth) have shown even stronger age interactions after the second birthday of children. For child’s weight, interactive effects of most socio-demographic risk factors attenuated parabolically with child’s age.ConclusionsThe impacts of several risk factors, measured at the child, mother, community, and district levels, on child growth indicators varied significantly with the child’s age. Nutritional interventions aimed at preventing poor linear growth in children in India should consider these underlying age heterogeneities for growth determinants into account.

P-422 A retrospective cohort study on the usefulness of Endometrial Receptivity Analysis (ERA) prior to a gestational carriers’ (GC) first euploid frozen embryo transfer (FET)

Abstract Study question Does determination of endometrial receptivity by ERA improve the outcome of FET for GC prior to their first FET using a euploid embryo? Summary answer GC with ERA prior to FET had 92.3% implantation and 84.6% live birth rate (LBR) compared to 81.5% implantation rate and 72.2% LBR without ERA. What is known already The endometrial window of implantation is approximately 24 hours wide with a complex interaction of autocrine, paracrine and endocrine factors. Successful embryo implantation involves a 3-step process of apposition, adhesion and invasion of an embryo into a receptive endometrium. The ERA was developed using the expression profile of 248 genes using Next Generation Sequencing to determine if the endometrium is receptive, early receptive, late receptive, pre-receptive or post-receptive to objectively determine the optimal timing of progesterone exposure prior to embryo transfer. Some studies have shown statistically significant improvements in live birth rates while other studies have shown no difference. Study design, size, duration A retrospective cohort study compared the implantation and live birth rates of 26 GC who chose to have a personalized embryo transfer using their ERA profile vs. 54 GC who used our standard FET protocol without an ERA prior to their first euploid FET. All GC having their first FET from January 2018 – December 2020 were included. Participants/materials, setting, methods A single private practice fertility clinic performed 80 euploid FET cycles on first-time GC from January 2018 – December 2020. All intended parents were offered the opportunity to complete an ERA for their GC prior to their first FET cycle. Implantation and live birth rates were calculated for all FET cycles using a GC for the first time with associated p – values. Main results and the role of chance GC were 22 – 38 years old with a mean age of 30 and a history of 2.4 previous spontaneous births prior to their first FET. GC who used a standard FET protocol with 5 days of progesterone (P + 5) exposure before FET had an implantation rate of 81.5% and a live birth rate of 72.2%, compared to an implantation rate of 92.3% and a live birth rate of 84.6% for GC who used a personalized embryo transfer protocol based on their ERA profile (p = 0.17). 19.2% of GC had a receptive endometrial profile using P + 5, 26.9% of GC were pre-receptive needing P + 5.5 and 53.8% needed P + 6. No GC were found to have a post-receptive endometrial profile (P + 4 or P + 4.5). Our retrospective cohort study was not powered to find a statistically significant difference, though our data trended towards an improvement in both implantation and live birth rates by over 10% if a GC were to complete an ERA prior to her first FET. Limitations, reasons for caution Implantation and live birth rates for the clinic during the study period were 75% and 68% respectively using euploid embryos. Our high baseline implantation and live birth rates, coupled with low numbers of patients included in this study, may make these results less generalizable to the IVF population at large. Wider implications of the findings It is controversial to recommend an ERA to a good prognosis patient such as a GC without a prior unsuccessful euploid FET. These results should prompt further study to confirm our findings with a larger prospective randomized controlled trial of gestational carriers using ERA profiles prior to their first FET. Trial registration number N/A

Spontaneous Perineal Trauma during Non-Operative Childbirth-Retrospective Analysis of Perineal Laceration Risk Factors.

Childbirth-related perineal trauma (CRPT) is defined as damage to the skin, muscles of the perineum, as well as to the anal sphincter complex and anal epithelium. The aim of the study was to analyze the risk factors for spontaneous injuries to the soft tissues of the birth canal during non-operative delivery. This was a single-center retrospective case-control study. The study included the analysis of two groups, the study group featured 7238 patients with spontaneous perineal laceration (any degree of perineal laceration) and the control group featured patients without perineal laceration with 7879 cases. The analysis of single-factor logistic regression showed that the factors related to perineal laceration during childbirth are the age of the patients giving birth (p = 0.000), the BMI before delivery (p = 0.000), the number of pregnancies (p = 0.000) and deliveries (p = 0.000), diagnosed gestational diabetes (p = 0.046), home birth (p = 0.000), vaginal birth after cesarean (VBAC) (p = 0.001), the use of oxytocin in the second stage of childbirth (p = 0.041), the duration of the second stage of childbirth (p = 0.000), body weight (p = 0.000), and the circumference of the newborn head (p = 0.000). Independent factors that increase the risk of perineal laceration during childbirth are an older age of the woman giving birth, a history of cesarean section, a higher birth weight of the newborn, and factors that reduce the risk of spontaneous perineal trauma are a higher number of deliveries and home birth.

The Effects of Precipitation and Temperature on Birth Weight: A Cross-Sectional Study from the Republic of Benin

Climate change, particularly changes in temperature and precipitation, prevents the improvement of maternal and neonatal health (MNH) in low-and middle-income countries (LMICs). Pregnant women and newborns in LMICs are considered the most vulnerable to adverse climate conditions, including extreme heat, floods, and droughts. This study examined the effects of precipitation and temperature on birth weight in the Republic of Benin, emphasizing climatic differences between the southern and northern regions. As a cross-sectional study, we pooled four rounds of Benin Demographic and Health Survey (BDHS) data, identifying 19 646 live births. We investigated the effects of precipitation and temperature on birth weight and the likelihood of low birth weight (LBW) newborns using multivariate multilevel linear and logistic regression models. We found that the average precipitation amount during the nine months before birth was positively correlated with higher birth weight in the south and was associated with a lower likelihood of LBW in the north. During the nine months before birth, a heat wave reduced birth weight by 57.0 g in the north. Furthermore, women and newborns in the north were more susceptible to precipitation and temperature, possibly due to food insecurity. Evaluating the MNH consequences of climate change is imperative for many developing countries facing severe climate change threats. Our findings provide an essential benchmark for future policies in Benin.

The Effect of Holistic Birth Support Strategies on Coping With Labor Pain, Birth Satisfaction, and Fear of Childbirth: A Randomized, Triple-Blind, Controlled Trial.

The current study was aimed to evaluate the effects of interventions conducted in line with the coping with labor pain algorithm (holistic birth support strategies) on women's coping with labor pain, birth satisfaction, and fear of childbirth. The study is a single-center, parallel-group randomized, three-blind, controlled trial. The study was completed with 33 women in the experimental group and 31 in the control group. The mean score of the women in the experimental group from the Birth Satisfaction Scale (128.57 ± 5.83) was statistically significantly higher than that of the women in the control group (81.80 ± 7.73). The mean score of the women in the experimental group (61.96 ± 9.78) from the Wijma Birth Expectation/Experience Scale, Version B scale was statistically significantly lower than that of the women in the control group (148.64 ± 14.62). It was found that the women in the experimental group were able to better cope with labor pain, had higher birth satisfaction, and had less fear of childbirth.

“The Fate of the Nation”: Population Politics in a Changing Soviet Union (1964–1991)

AbstractThis article shows how the Soviet government perceived higher birth rates in Central Asia as a threat to national identity and the stability of the USSR. The issue of demographic change was complex, and concerns about differential fertility between republics were not informed solely by prejudice. Rather, prejudice and racism mingled with practical concerns about labor surpluses and shortages. The Central Asian Republics had low labor mobility because people were unwilling to leave their cultural community, had a low level of Russian, and tended to not to be trained in the kind of heavy industries that required workers elsewhere in the Soviet Union. I argue that rather than aiming to change these factors, the government misdiagnosed economic problems as demographic ones. They placed primary emphasis on changing patterns of reproduction to remedy the situation by changing the population itself, portraying Slavs and Central Asians as distinct groups who had a predetermined role and place in life. In doing so, Moscow elites failed to address the structural and operational issues of Soviet socialism and inflamed tensions with local leaders who saw demographic campaigns as an attack on their culture.

343-OR: Maternal Diabetes Is Associated with Hypothalamic Gliosis in Offspring

In utero exposure to gestational diabetes (GDM) or hypertension (HYP) is associated with child obesity. These maternal conditions alter the in utero milieu and may predispose offspring to obesity via an effect on the brain. Cellular inflammation (gliosis) in the mediobasal hypothalamus (MBH) has been associated with child and adult obesity and type 2 diabetes in adults. We evaluated the brain MRIs of offspring exposed to GDM or HYP during gestation for evidence of MBH gliosis. This case-control study included a subsample of 3child participants (9-11y) in the NIH ABCD study. Baseline T2-weighted MRI scans were analyzed for evidence of MBH gliosis (high MBH T2 signal) based on the mean bilateral MBH/Amygdala (AMY) T2 signal ratio. Putamen (PUT) /AMY and MBH/PUT were negative and positive control ratios, respectively. Findings from 49 children exposed to GDM and 53 exposed to HYP (by pregnancy survey) were contrasted to 2age- and sex-matched controls (healthy pregnancy) . Baseline, 1y and 2y follow-up anthropometrics were available. At baseline, groups did not differ on age, sex, race, and socioeconomic status. GDM group had more Hispanic children and higher birth weight than controls and HYP. Offspring exposed to GDM or HYP had higher BMI z-score, % of BMI 95th percentile, and waist/height ratio than controls at all time points (all P&amp;lt;0.01) . Overall, there were significant group differences in MBH/AMY signal ratio (F (2,294) :355, P=0.03, adjusted for site, age, sex and ethnicity) . Specifically, compared to controls, GDM-exposed offspring, but not HYP, had higher MBH/AMY signal ratio (GDM β:0.05, P=0.02; HYP β:0.03, P=0.11) . The results persisted when further adjusted for baseline BMI z-score (GDM β:0.04, P=0.03) . Results were replicated with the positive control ratio, but not the negative control ratio. GDM-exposed offspring have greater evidence of MBH gliosis, independent of body adiposity. This could represent one pathway by which the in utero environment may impact offspring’s future metabolic health. Disclosure L.E.Sewaybricker: None. K.Olerich: None. S.L.Kee: None. S.J.Melhorn: None. S.Chandrasekaran: None. E.Schur: None. Funding National Institutes of Health (R01DK117623)

1062-P: Outcomes in Pregnancies with Preexisting Type 1 Diabetes vs. Healthy Controls over a 14-Year Period

Background: We studied maternal and neonatal outcomes in pregnancies with preexisting T1D and matched controls (age, gravida, BMI) to address limited data in this field in the US. Methods: Pregnancies (n=165) in preexisting T1D and matched healthy controls (n=165) were retrospectively studied (01/01/20to 12/1/2020) at a single center. Conditional logistic regression, Wilcoxon signed rank and Wilcoxon rank sum tests were used for analyses. Results: Pregnancies with T1D had significant hypertension [32% (19% pre-existing) vs. 10% (2% pre-existing) , p&amp;lt;0.01], preeclampsia (28% vs. 7%, p&amp;lt;0.01) , thyroid dysfunction (24% vs. 7%, p&amp;lt;0.01) and were affected by polyhydramnios (14% vs. 4%, p&amp;lt;0.01) , macrosomia affecting labor (16% vs. 2%, p&amp;lt;0.01) , increased C-section’s rate (16% vs. 7%, p=0.02) and complicated C- sections (6% vs. 1%, p=0.04) . In T1D, four neonates had cardiac complications and 14 (8.5%) were large for gestational age compared to 2 (1%) controls. More neonates in T1D were preterm (34.5% vs. 14.5%, p&amp;lt;0.01) , with fetal anomalies (15.8% vs. 4%, p&amp;lt;0.01) , Respiratory Distress Syndrome (25.5% vs. 7%, p&amp;lt;0.01) , apnea (14% vs 5.5%, p=0.01) , other pulmonary complications (13% vs. 5%, p&amp;lt;0.01) and respiratory failure (11% vs. 3%, p=0.01) . Significant hypoglycemia (16% vs. 7%) , sepsis (7% vs. 1%) , jaundice (70% vs. 36%) and upper GI complications (39% vs. 16%) were observed in neonates born to mothers with T1D. T1D neonates had higher birth weight (p =0.01) and were born early (37.2 vs. 39 wks, p&amp;lt;0.01) . HbA1c &amp;gt;7% was associated with above neonatal complications compared to those who with HbA1c &amp;lt;6.7%. Conclusion: Pregnancies with type 1 diabetes continue to be associated with high maternal and neonatal morbidity and need urgent development of interventions to improve outcomes. Disclosure R.Kaur: None. S.Rizvi: None. D.Desjardins: None. I.Zaniletti: None. C.Reid: None. S.K.Mccrady-spitzer: None. M.Trinidad: None. Y.C.Kudva: Advisory Panel; Novo Nordisk, Research Support; Dexcom, Inc., Hemsley Charitable Trust, JDRF, National Institutes of Health, Roche Diabetes Care, Tandem Diabetes Care, Inc.

Factors Associated with Development of Ventral Hernias and Healthcare Seeking Behaviors in a Cohort of Pakistani Women

Background: Anterior abdominal wall hernias constitute one of the most common surgical presentations. According to the World Bank data Pakistan has one of the highest birth rates per woman in the region at 3.6 births per woman. In Pakistan there has also been a large increase in C-section rates with nearly 20% of all pregnancies being delivered via C-section, nearly 1 out of every 5 births. Multi-parity is a risk factor for developing paraumbilical hernias and C-sections lead to incisional hernia developments. Methodology: The study conducted was a cross-sectional study at a tertiary care hospital in the department of surgery from 1st June 2021 till 1st September 2021. Any woman presenting with a ventral hernia to the clinic was asked to fill out a questionnaire. 60 women presented over the study period and were enrolled. Results: Fifty five percent paraumbilical hernias and 41.7% incisional hernias were reported. The mean number of pregnancies was 4.10 S.D 1.531 with a range from 0-8. C-sections were 2 times more common than SVDs. Increasing number of pregnancies associated with younger age of onset. Higher number of vaginal deliveries and C-sections were each associated with the development of a ventral hernia. Conclusion: The high fertility rate and C-section rate in Pakistan incurs a huge risk to women developing ventral hernias and poses a burden to the public healthcare system. Keywords: Paraumbilical hernia; parity; Pakistan

A Mathematical Model of Solid Waste Accumulation and Treatment with a Varying Human Population Size

Solid waste management has continued to be an increasing challenge worldwide and the situation has become worse in urban areas of developing countries. The rapid urban population growth, mainly due to high immigration and birth rates, has led to large amounts of solid waste, making it difficult for authorities to effectively manage the accumulated waste. Existing mathematical models of solid waste accumulation consider solid waste management by an external effort and do not address the contribution of the population in the management process. In this study, a mathematical model of solid waste accumulation is developed and analysed incorporating parameters for human immigration and solid waste recycling by particular population age groups. The solid waste is considered to be of two categories: biodegradable and non-biodegradable. Existence of equilibrium points is established and their stability analysed. Numerical simulations are done using MATLAB and Maple. Results show that solid waste increases with increasing human population and thus a solid waste free environment cannot be achieved. Sensitivity analysis suggests that improving the biodegradability of solid waste coupled with aiding solid waste decay and recycling reduces the final size of solid waste.