Importance Of Birth Research Articles

Influence of maternal age on birth and infant outcomes at 6 months: a cohort study with quantitative bias analysis.

Maternal age is increasingly recognized as a predictor of birth outcomes. Given the importance of birth and growth outcomes for children's development, wellbeing and survival, this study examined the effect of maternal age on infant birth and growth outcomes at 6 months and mortality. Additionally, we conducted quantitative bias analysis (QBA) to estimate the role of selection bias and unmeasured confounding on the effect of maternal age on infant mortality. We used data from randomized-controlled trials (RCTs) of 21 555 neonates in Burkina Faso conducted in 2019-2020. Newborns of mothers aged 13-19 years (adolescents) and 20-40 years (adults) were enrolled in the study 8-27 days after birth and followed for 6months. Measurements of child's anthropometric measures were collected at baseline and 6months. We used multivariable linear regression to compare child anthropometric measures at birth and 6 months, and logistic regression models to obtain the odds ratio (OR) of all-cause mortality. Using multidimensional deterministic analysis, we assessed scenarios in which the difference in selection probability of adolescent and adult mothers with infant mortality at 6 months increased from 0% to 5%, 10%, 15% and 20% if babies born to adolescent mothers more often died during the first week or were of lower weight and hence were not eligible to be included in the original RCT. Using probabilistic bias analysis, we assessed the role of unmeasured confounding by socio-economic status (SES). Babies born to adolescent mothers on average had lower weight at birth, lower anthropometric measures at baseline, similar growth outcomes from enrolment to 6months and higher odds of all-cause mortality by 6months (adjusted OR = 2.17, 95% CI 1.35 to 3.47) compared with those born to adult mothers. In QBA, we found that differential selection of adolescent and adult mothers could bias the observed effect (OR = 2.24, 95% CI 1.41 to 3.57) towards the null [bias-corrected OR range: 2.37 (95% CI 1.49 to 3.77) to 2.84 (95% CI 1.79 to 4.52)], whereas unmeasured confounding by SES could bias the observed effect away from the null (bias-corrected OR: 2.06, 95% CI 1.31 to 2.64). Our findings suggest that delaying the first birth from adolescence to adulthood may improve birth outcomes and reduce mortality of neonates. Babies born to younger mothers, who are smaller at birth, may experience catch-up growth, reducing some of the anthropometric disparities by 6 months of age.

Plasticity of intestinal gene expression profile signatures reflected by nutritional interventions in piglets

BackgroundImmediately after birth, the porcine intestine rapidly develops morphologically, functionally, and immunologically. The jejunum, the second part of the small intestine, is of importance for nutrient uptake and immune surveillance. To study the early postnatal development of the jejunum, a meta-analysis was performed on different transcriptomic datasets. These datasets were acquired from different experimental in-house studies or from experiments described in literature of porcine jejunum mucosa. Gene expression was measured under different experimental interventions, such as nutritional intervention, at various time-points (age).ResultsThe studies included in the meta-analysis provided gene expression data for various time-points (piglet ages) for piglets that had received a treatment versus control piglets. In separate studies, treatments were administered to the sow (i.e. amoxicillin), or nutritional supplementation directly to the piglets with medium chain fatty acids (MCFAs), and oral administration of fructooligosaccharides (FOS) or a high dose of zinc-oxide, respectively. In the meta-analysis, genes were grouped into 16 clusters according to their temporal gene expression profiles for control piglets, i.e. the changes of gene expression level over time. Functional analysis showed that these temporal profile clusters had different dominant processes, such as immune related processes or barrier function. Transcriptomics data of treatment piglets was subsequently superimposed over the control temporal profiles. In this way we could investigate which temporal profile clusters (and which biological processes) were modulated by the treatments. Interestingly, not all 16 temporal profiles were modulated.ConclusionsWe showed that it is possible to re-use (publicly available) transcriptomics data and produce temporal gene expression profiles for control piglets with overexpression of genes representing specific biological processes. Subsequently, by superimposing gene expression data from (nutritional) intervention studies we observed deviations from some of these reference profile(s) and thus the plasticity of the system. By employing this meta-analysis approach we highlighted the importance of birth and weaning and the underlying biological processes.

Birth and the Microbiome; What all Midwives Need to Know

Birth is an important event in many ways, but emerging research is demonstrating that the way we are born may have far-reaching consequences for our future health and wellbeing. This article looks briefly at what is known about the microbiome and health, the importance of birth, skin-to-skin and breastfeeding for ‘seeding and feeding’ the infant’s microbiome. The possible impact of caesarean section is discussed and suggestions made as to how midwives can maximise the chances of seeding and feeding happening as fully as possible. We are discovering the importance of our symbiotic relationship with the microbial communities that live on and inside us in such staggering numbers. There are around 30 trillion human cells in our bodies, which are host to over 100 trillion bacteria (Blaser 2014). The microbes live on our skin, in the nose and mouth, stomach, gut and, in women, the vagina. They co-exist with our bodies and the only time we become aware of them is when an imbalance or infection causes us to feel unwell or an obvious inflammatory response occurs. Most of the time we live together in relative peace.

Seasonal immunisation against respiratory syncytial virus disease

Seasonal immunisation against respiratory syncytial virus disease

Birth‐year and current‐year influences on survival and recruitment rates of female Weddell seals

AbstractIn long‐lived species, juvenile survival typically is lower and more variable than adult survival, and modeling such variation is important for understanding population dynamics. Variability in juvenile survival can be related to birth‐ or current‐year influences, and the birth‐year influences can be transient, persistent, or intermediate in duration. We used multi‐state models and data collected from 5,459 known‐aged prebreeder female Weddell seals (Leptonychotes weddellii Lesson) tagged in Erebus Bay, Antarctica from 1980–2007 to evaluate the duration of potential birth‐year influences on survival rates and the importance of birth‐ and current‐year influences on survival and recruitment rates. Survival rates differed for each birth cohort and were positively related to current‐year winter sea‐ice conditions. The estimated duration of birth‐cohort effects on survival was intermediate (6 years) rather than transient (2 years) or permanent. Estimated survivorship from birth to 6 years of age varied among cohorts from 0.13 (SE = 0.04) to 0.42 (SE = 0.06), and averaged 0.25 (SE = 0.02). Recruitment rates (probability of transitioning from prebreeder to breeder state) varied annually but apparently were not related to birth‐year conditions. Our results provide evidence that birth‐ and current‐year conditions act in combination to influence survival. Although for many long‐lived species the influences of either birth‐ or current‐year conditions on survival are well‐studied, we suggest that modeling survival rates as a function of birth‐ and current‐year influences simultaneously could lead to better understanding of survival and improved stochastic models to project population dynamics.

Believing in birth – choosing VBAC: the childbirth expectations of a self‐selected cohort of Australian women

This study explored the childbirth expectations and knowledge of women who had experienced a caesarean and would prefer a vaginal birth in a subsequent pregnancy. Vaginal birth after caesarean is considered best practice. However, in most western world countries, despite the inherent risks of caesarean for both mother and baby, the number of women labouring after a previous caesarean is declining. Newspaper advertisements were used to recruit Western Australian women who had experienced a caesarean. Thematic analysis was used to analyse the interview data collected from women who attempted a vaginal birth (n=24), or stated they would choose this option, in a subsequent pregnancy (n=11). For this cohort of women, their caesarean experience reinforced their previously held expectations about birthing naturally. The women held strong views about the importance of working with their bodies to achieve a vaginal birth, which was considered an integral part of being a woman and mother. Positive support from family and friends and a reluctance to undergo another caesarean was also influential. Women articulated the risks of caesarean and considered vaginal birth enhanced the health and well-being of the mother and baby, promoted maternal infant connection and the eased the transition to motherhood. This study documents how the importance of birth, as a significant life event, remained the focus of these women's childbirth expectations influencing future decisions on birth mode and mediating against the 'pressure' of medical discourse promoting caesarean. Knowledge and appreciation of the multiple dimensions that contribute to women's decisions after a caesarean provides valuable information on which service providers and researchers can draw as they investigate interventions that enhance the uptake and success of women birthing vaginally after a caesarean.

Preterm birth in a French population: the importance of births by medical decision

This analysis describes the prevalence of preterm birth by medical decision among 50,307 live births from the district of Seine-Saint-Denis in France, using a classification that distinguishes between medically decided preterm births associated with premature rupture of membranes and those for other reasons. Thirty-seven percent of singleton and 28% of twin preterm births result from labour induction or a caesarean section in the absence of labour. One-quarter of singleton indicated preterm births are associated with premature rupture of membranes. Between 28 and 31 weeks of gestation, 40% of all singleton preterm births result from a medical decision not associated with premature rupture of membranes. The high levels of indicated preterm birth must be taken into account in evaluations of preterm birth rates and trends in developed countries.

Preterm birth in a French population: the importance of births by medical decision

This analysis describes the prevalence of preterm birth by medical decision among 50,307 live births from the district of Seine-Saint-Denis in France, using a classification that distinguishes between medically decided preterm births associated with premature rupture of membranes and those for other reasons. Thirty-seven percent of singleton and 28% of twin preterm births result from labour induction or a caesarean section in the absence of labour. One-quarter of singleton indicated preterm births are associated with premature rupture of membranes. Between 28 and 31 weeks of gestation, 40% of all singleton preterm births result from a medical decision not associated with premature rupture of membranes. The high levels of indicated preterm birth must be taken into account in evaluations of preterm birth rates and trends in developed countries.

ERRATUM

In the Subject Index (Pediatrics 68:919, 1981) an error has been noted on p 923. After "Mixoploidy ..." the next entry should be "Mortality, neonatal" which precedes the subentries (1) idealized death rate, 504 and (2) importance of birth weight/gestational age groups, 122.

Neonatal Mortality Risk for the Eighties: The Importance of Birth Weight/Gestational Age Groups

Since 1976 a computerized data base has been used to store information on babies admitted to two intensive care nurseries serving the Vermont/New Hampshire region. The data base now allows reporting "neonatal" mortality by birth weight/gestational age (BW/GA) groupings for 1976--1979. For all BW/GA groups, except the most immature infants, there has been marked improvement compared to data gathered in the sixties (ie, mortality has decreased). These data are probably applicable to most other centers providing neonatal intensive care. The use of BW/GA categories provides the most reliable way of objectively comparing statistics from one center to another. Differences between two centers were observed when birth weight specific rates were used, but were largely abolished by using BW/GA groups. Data gathered in this way will be increasingly important for comparisons between centers and across years and when evaluating the effectiveness of new therapeutic interventions.