Incidence Of Low Birth Weight Research Articles

Environmental disaster, pollution and infant health: Evidence from the Deepwater Horizon oil spill

In 2010 the Gulf Coast experienced the largest oil spill affecting U.S. waters in history. Evaporating crude oil and dispersant chemicals can cause major health problems. This paper examines the impact of the Deepwater Horizon oil spill on air quality and infant health outcomes. Using U.S. Environmental Protection Agency (EPA) AirData, vital statistics data from National Center for Health Statistics (NCHS), and a difference-in-difference methodology, we find that the oil spill of 2010 increased concentrations of PM2.5, NO2, SO2, and CO in affected coastal counties, increased incidence of low birth weight (<2500 g) and premature born infants (<37 weeks of gestation). Heterogeneity effects reveal more pronounced adverse infant health outcomes for black, Hispanic, less educated, unmarried, and younger mothers. Results are robust to a wide range of controls and robustness checks.

Use of granulocyte colony-stimulating factor in ART treatment does not increase the risk of adverse perinatal outcomes.

Granulocyte colony-stimulating factor (G-CSF) acts on reproductive function at different stages, but its effects on the early stages of embryo development are unknown. The aim of this study was to assess the effect of G-CSF administration during treatment with assisted reproductive technologies (ART) and early pregnancy on newborns. Retrospective study in women undergoing egg donation, with a study group including 33 live-born children from a pregnancy in which G-CSF was administered, and a control group of 3798 children in which this medication was not ordered during pregnancy. The analysis was of perinatal outcomes resulting from G-CSF treatment administered off-label compared with a control group. No significant differences were found in maternal age (40.9±0.1 versus 38.9±1.8, P = 0.055), body mass index (23.2±0.2 versus 22.6±1.5, P = 0.503), infant birthweight (2952±200 versus 3145±270g, P = 0.184), gestational age (38±1 versus 37±1 weeks, P = 0.926) or length (50.2±1.5 versus 48.7±2.7cm, P = 0.678) (between the control group and women treated with G-CSF, respectively). The prematurity rates of births before week 36 (10.0% versus 9.5%, P = 0.783) or week 32 (2.2% versus 0.0%, P = 0.585) were similar in the control and study groups, respectively. The incidence of low birthweight (<2500g; 19.6% versus 11.8%, P = 0.570) or very low birthweight (1500g; 2.5% versus 0.0%, P = 0.454) was not significantly different between non-treated and G-CSF-treated women, respectively. Administration of G-CSF at embryo transfer and during early pregnancy in recurrent miscarriage patients with KIR-HLA-C mismatch undergoing egg donation ART treatment does not convey a higher risk of perinatal complications.

Binary logistic regression methods for modeling broncho-pneumonia status in infants from tertiary health institutions in north central Nigeria

Acute respiratory tract infections, predominantly bronchopneumonia, are one of the leading causes of infant deaths in developing countries and around the world. This work models the effects of the significant risk factors on infants’ bronchopneumonia status and also fits some reduced models and determines the best model with minimum number of parameters. The data for this study consist of a random sample of 433 births to women seen in the obstetrics clinic of two sampled tertiary health institutions in north-central Nigeria. These include University Teaching Hospital (UTH) Abuja, and Federal Medical Center (FMC) Keffi, Nasarawa State. Binary logistic regression was used to identify and model the effects of the various risk factors while stepwise regression technique was used to fit some reduced logistic regression models. Then the best fitting model with minimum number of parameters was identified using likelihood ratio statistic. It was observed that baby’s weight at birth, baby’s weight four weeks since birth, and mother’s occupation have significant effects on infant’s bronchopneumonia status. Additionally, among the four fitted reduced models, model4 is the best predictor of infants’ bronchopneumonia status, followed by model3 and then model2. Therefore, community service like home visiting for health education, supplementation of vitamin A, etc., would be an advantage if provided for teenaged pregnant women as it would, in turn, reduce incidence of low birth weight and thereby reduce bronchopneumonia infection among these children. Keywords: Bronchopneumonia, Multiple Logistic Regression Model, Fitness, likelihood ratio test

First trimester depression and/or anxiety disorders increase the risk of low birthweight in IVF offspring: a prospective cohort study.

Are maternal depression and/or anxiety disorders (MDAD) before and during pregnancy associated with IVF outcomes? A total of 5661 women starting their first IVF cycle between 15 August 2014 and 31 December 2015 were pooled from a prospective cohort of IVF-conceived children. The self-rating depression scale (SDS) and self-rating anxiety scale (SAS) were used to determine MDAD. IVF outcomes were compared between MDAD+ and MDAD- groups. A total of 10.3% (572/5556) of women had MDAD before IVF (bMDAD). The fertilization rate was lower in the bMDAD+ group (59.41 ± 22.11% versus 61.72 ± 22.18%, Padjust < 0.05). No difference was found in the other IVF outcomes. Pregnancy and neonatal outcomes in women with singleton live births were similar between the two groups. A total of 17.4% (347) women with singleton live births had MDAD during the first trimester (pMDAD). Birthweight (3383 ± 556 g versus 3447 ± 518 g, Padjust < 0.05) was lower and incidence of low birthweight (LBW) (6.9% versus 3.3%, Padjust < 0.01) was higher in the pMDAD group. After adjustment for potential confounders (gestational age, maternal age, maternal pre-pregnancy body mass index, threatened abortion, hypertensive disorder complicating pregnancy and gestational diabetes mellitus), pMDAD remained significantly associated with LBW (odds ratio [OR] 2.50, 95% confidence interval [CI] 1.16-5.42, Padjust < 0.05). The preconception psychological state in the pMDAD group did not demonstrate any additional impact on neonatal outcomes. MDAD during the first trimester is associated with increased risk of LBW in offspring, whether preconception MDAD exists or not.

Associations between local government expenditures and low birth weight incidence: Evidence from national birth records.

Local governments play an integral role in providing public services to their residents, yet the population health benefits are frequently overlooked, especially when services are outside the traditional health domain. With data from the U.S. Census of Governments and national birth records (spanning from 1992 to 2014), we examined whether local government expenditures on parks and recreation services (PRS) and housing and community development (HCD) predicted county low birth weight outcomes (population incidence and black-white disparities). Hypotheses were tested using bias-corrected county-by-period fixed effects models in a sample of 956 U.S. counties with a total of 3619 observations (observations were defined as three-year pooled estimates), representing 24 million births. Adjusting for prior county low birth weight incidence, levels of total operational, health, and hospital expenditures, and time-varying county sociodemographics, an increase in per capita county PRS expenditures of $50 was associated with 1.25 fewer low birth weight cases per 1000. Change in county HCD expenditures was not associated with low birth weight incidence, and, contrary to hypotheses, neither expenditure type was linked to county black-white disparities. Further examination of the benefits to birth outcomes from increasing parks and recreation services is warranted.

Pregravid Oral Contraceptive Use and the Risk of Preterm Birth, Low Birth Weight, and Spontaneous Abortion: A Systematic Review and Meta-Analysis.

Background: Although oral contraceptives (OCs) have been widely used by women of childbearing age, their influence on pregnancy and birth outcomes, such as preterm birth (PB), low birth weight (LBW), and spontaneous abortion (SAB), is unclear. The aim of this systemic review was to assess these complications in women who had used OCs before pregnancy compared with those in a control group. Materials and Methods: The databases of PubMed, EMBASE, and Web of Science were searched up to December 2018. We included studies where the primary outcome was the risk of PB, LBW, and SAB in women with pregravid OCs use compared with the control group. Odds ratio (OR) value was calculated to assess the risk. Results: Eighteen studies were included in the systematic review, and a total of 148,406 subjects from 7 studies were pooled for the meta-analysis. Results showed that the risk of PB was slightly higher in the exposed group (OR = 1.17, 95% confidence interval [CI] = 1.07-1.27, p = 0.0005); however, there was a lower risk for SAB compared with the control group (OR = 0.63, 95% CI = 0.41-0.96, p = 0.03). No significant difference was found in the incidence of LBW (OR = 1.36, 95% CI = 0.92-2.02, p = 0.12). Conclusions: This systematic review and meta-analysis demonstrated a higher risk for PB and a lower risk for SAB in women with previous ORs use, whereas no association was found between ORs use and LBW risk.

Perinatal outcomes of singletons following vitrification versus slow-freezing of embryos: a multicenter cohort study using propensity score analysis.

Is embryo vitrification associated with a higher risk of adverse perinatal outcomes than slow-freezing? Embryo vitrification was not associated with increased risks of adverse perinatal outcomes of pre-term birth (PTB), low birthweight (LBW), small for gestational age (SGA), large for gestational age (LGA) and macrosomia, as compared to slow-freezing. Vitrification is becoming a widely adopted technology for embryo cryopreservation with higher embryo survival rate and live birth rate than the slow-freezing technique. However, limited data are currently available on risks of adverse perinatal outcomes following vitrification as compared to that of slow-freezing. The impact of vitrification on perinatal outcomes remains further to be elucidated. Six large reproductive medical centers in Guangdong province, Southeast of China, took part in this multicenter retrospective cohort study. Cohorts of 3199 live born singletons after Day 3 frozen-thawed embryo transfer (FET) cycles with either vitrification or slow-freezing between January 2011 and December 2015 were included in the study. Each patient only contributed one cycle per cohort and vanishing twins were excluded. Propensity score (PS) matching was used to control for potential confounding factors. All live-born singletons following either a vitrified or a slow-frozen cleavage FET cycle during the period from 2011 to 2015 were analyzed. Perinatal outcomes of PTB, LBW, macrosomia, SGA and LGA were compared. The vitrified and slow-frozen cohorts were matched by propensity scores with a 1:1 ratio accounting for potential confounding factors associated with perinatal outcomes. These variables included baseline demographics (maternal age, BMI, education level, parity, type of infertility and cause of infertility), as well as IVF characteristics (insemination method, endometrial preparation protocol and embryo cryopreservation duration). A total of 2858 cases from vitrified embryo transfer (ET) and 341 babies from the slow-freezing group were included. After PS matching, 297 pairs of newborns were generated for comparison. The median gestational age was 39weeks for both cohorts and the birthweights were comparable (3187.7 ± 502.1g in the vitrified group vs. 3224.6 ± 483.6 in the slow-freezing group, P>0.05). There were no significant differences between the two groups on the incidence of PTB (5.4% vs. 7.7%), LBW (6.7% vs. 5.7%), macrosomia (5.7% vs. 6.1%), SGA (12.5% vs. 8.4%) and LGA (6.4% vs. 8.1%). Parallel logistic regression analysis indicated that vitrification was non-inferior to slow-freezing method in terms of the occurrence of PTB (OR, 0.68 [95% CI, 0.35, 1.31]), LBW (OR, 1.19[0.61-2.32]), macrosomia (OR, 0.94 [0.48-1.86]), SGA (1.55[0.91-2.64]) and LGA (0.78[0.42-1.45]), P>0.05. Sex-stratified PS matching models with multivariable regression analysis further confirmed that vitrification did not increase the risks of above-mentioned adverse perinatal outcomes in either the male or female infant cohort. Although the analysis was adjusted for a number of important confounders, the hospital dataset did not contain other potential confounders such as the medical history and obstetrics outcomes of women during pregnancy to allow adjustment. In addition, the current findings are only applicable to cleavage stage FET, but not pronuclei stage or blastocyst stage ET. Vitrified ET, in comparison with slow-frozen ET, was not associated with increased risks of adverse neonatal outcomes. With its superiority on live birth rates and non-inferiority on safety perinatal outcomes, transition from slow-freezing to the use of vitrification for embryo cryopreservation is reassuring. Nonetheless, future research is needed for the long-term effects of vitrification method on offspring's health outcomes. The study was funded by the National Key Research and Development Program (2016YFC100205), Guangzhou Science and Technology Project (201804020087), Guangdong Province Science and Technology Project (2016A020218008) and Guangdong Provincial Key Laboratory of Reproductive Medicine (2012A061400003). The authors have no conflicts of interest to declare.

Assessing the impact of antenatal care utilization on low birthweight in India: Analysis of the 2015–2016 National Family Health Survey

Low birthweight (LBW) is a serious public health problem in lower-middle income countries. Despite several efforts have been made to improve the utilization of maternal health care, universalization of antenatal care (ANC) remains a major challenge in India. This paper aims to examine the association between the use of ANC services and LBW in India. A cross-sectional observational study was carried out using the data from the 2015 to 2016 National Family Health Survey (n = 147,762). We have carried out bivariate and multivariate analyses to fulfil the objective of this study. About 18% of the sample children were born with LBW. Only ¼th last birth women received full ANC services in 2015–2016. The results of binary logistic regression indicate that the likelihood of LBW was significantly lower among those children whose mother have adequate ANC services compared to those mother who did not receive those services even after accounting for important socioeconomic and demographic factors. The findings of this study suggest that providing affordable and quality ANC services could be an effective strategy to reduce the incidence of LBW. Furthermore, targeted invention is needed among socioeconomically vulnerable women to improve the utilization of ANC services, which could combat the incidence of LBW.

Pregnancy outcomes in Pregnant Women for the First Time after the Age of Thirty Five Years

Background: The elderly primigravida is defined as a woman who delivered fetus for the first time at the age of 35 years or older. Progressively, this has become more common in our contemporary society and traditionally such pregnancy is regarded as high risk. Objectives: The aim of this study was to compare the pregnancy outcomes in elderly primigravidae aged 35 years and above with young primigravidae aged < 35 years at time of delivery. Patients & Methods: This prospective observational study was carried out at Zagazig University, maternity Hospital between 1st January 2017 to 31st December 2017. The sample size was 250 women; they were 120 primigravida women aged 35years and above at time of delivery (Elderly porimigravidae group) and 130 young primigravidae (control group) aged < 35 years at time of delivery who delivered during the same period in the same hospital. Results: women aged 35 years and over had a higher prevalence of associated medical disorders as diabetes mellitus, hypertension. The indication for ceasarean section was preeclampsia, followed by malpresentation and fetal distress. The most frequent pregnancy complications were preeclampsia, gestational DM and preterm labor. The incidence of low birth weight was higher among neonate borne to older mother. NICU admission increase with elderly primigravida. Conclusions: Elderly Primigravida are at an increased risk of pregnancy-induced hypertension/Preeclampsia, gestational diabetes, malpresentaion, multiple pregnancy and ceasarean section than the younger primigravida, it suugested that the early booking and extra obstetric alterneess shall improve the pregnancy outcomes in this category .

Regression Analysis of Ordinal Logit and Probit Models to Predict the Factors Affecting Low Birth Weight

Low birth weight (LBW) has greater risk for experiencing problems. Based on Indonesian DHS data in 2012, the province with the highest infant mortality rate estimate was West Papua amounting to 75 per 1,000 live births. This study used logit and probit regression models to analyze the factors that caused low birth weight. It is thought that by comparing both logit and probit models, the best results could be obtained. The results of research showed that the independent variables that affected babies with LBW were the distance of pregnancy and maternal parity. If the distance of pregnancy was less than 2 years, it would increase the incidence of LBW by 2.7 times (p: 0,00: CI 1b: -4,05;CI ub: -1,50). Moreover, the distance of pregnancy which was less than 2 years would only improve LBW by 19.4 percent, compared with the distance of the pregnancy that was more than 2 years which would increase infant weight by 80.6 percent. As with maternal parity between 0 and more than 4, there was a chance of increasing the incidence of LBW by 1.94 times (p: 0,00; CI 1b: -2,66;CI ub: -1,21). On the other hand, maternal parity of 0 and parity &gt; 4 would improve LBW by 74.2 percent, and a parity of 1 to 4 would only see 25.8 percent improvement. The result of this study suggested that there should be improvement in health promotions, such as family planning cuonseling and consultation for eligible couples.

Regression Analysis of Ordinal Logit and Probit Models to Predict the Factors Affecting Low Birth Weight

Low birth weight (LBW) has greater risk for experiencing problems. Based on Indonesian DHS data in 2012, the province with the highest infant mortality rate estimate was West Papua amounting to 75 per 1,000 live births. This study used logit and probit regression models to analyze the factors that caused low birth weight. It is thought that by comparing both logit and probit models, the best results could be obtained. The results of research showed that the independent variables that affected babies with LBW were the distance of pregnancy and maternal parity. If the distance of pregnancy was less than 2 years, it would increase the incidence of LBW by 2.7 times (p: 0,00: CI 1b: -4,05;CI ub: -1,50). Moreover, the distance of pregnancy which was less than 2 years would only improve LBW by 19.4 percent, compared with the distance of the pregnancy that was more than 2 years which would increase infant weight by 80.6 percent. As with maternal parity between 0 and more than 4, there was a chance of increasing the incidence of LBW by 1.94 times (p: 0,00; CI 1b: -2,66;CI ub: -1,21). On the other hand, maternal parity of 0 and parity &gt; 4 would improve LBW by 74.2 percent, and a parity of 1 to 4 would only see 25.8 percent improvement. The result of this study suggested that there should be improvement in health promotions, such as family planning cuonseling and consultation for eligible couples.

Incidence and Risk Factors of Low Birth Weight Among Babies Delivered at Tertiary Level Teaching Hospital in Nepal

Introduction: Low birth weight is directly related to both immediate and long term development and wellbeing of a person. There are numerous maternal and foetal factors contributing to low birth weight. The mortality and morbidity of low birth weight can be reduced if the maternal risk factors are detected early and managed by simple techniques.&#x0D; Methods: 207 low birth weight live newborn babies regardless of gestational age born in a tertiary level teaching institute from September 2015 to September 2016 were enrolled as cases and same number of normal birth weight babies (i.e. 2.5 to 4 kgs) as control. Information was obtained directly from mothers using pretested structured questionnaire and was analysed using SPSS version 20.&#x0D; Results: The incidence of low birth weight was found to be 9.8%. Mean weight of low birth weight babies was 1.98 kg and mean gestational age was 37.34 weeks. Among low birth weight babies, 47.8% were preterm and 52.2% were term. Out of 119 small for gestational age babies, the frequency of symmetrical small for gestational age was 45.3% and asymmetrical small for gestational age was 54.6%. There was significant association of low birth weight with multiple maternal factors like maternal age, education, weight, height, weight gain during pregnancy, ANC visits, parity, antepartum haemorrhage, previous abortion/low birth weight, birth spacing, tobacco/alcohol intake and haemoglobin.&#x0D; Conclusions: Prevalence of low birth weight is likely to be far higher than figure in isolated rural settings of our country. Contribution of SGA is higher than Appropriate for Gestational Age which brings us to a larger burden of long term morbidity and mortality. Various maternal factors are responsible for birth of low birth weight babies.

Weight gain during pregnancy and low birth weight babies: a retrospective cohort study in Gianyar District, Bali

Background and purpose: Low birth weight (LBW) is a major causal factor for neonatal and perinatal mortality. The aim of this study is to determine the risk of LBW incidence in pregnant women with weight gain not in accordance with the Institute of Medicine (IOM) standards.Methods: This study used a retrospective cohort design with data obtained from three Public Health Centres (PHCs) in Gianyar District over the period of January-December 2017. Samples in this study were 186 pregnant women with the following criteria: complete data on the mother’s medical record, had an antenatal care visit in the first trimester and at the end of the third trimester, at term delivery, not giving birth to twins and no complications during pregnancy. The sample size was determined with 95% confidence level, 80% power, the proportion of LBW in the group of inadequate weight gain of 26%, the proportion of LBW in the group of adequate weight gain of 9% and a relative risk (RR) estimate of 3.0. Data extracted from medical record consisted of weight gain, pre-pregnancy weight, height, upper arm circumference, hemoglobin level, employment, age, parity and birth weight. The cumulative incidence of LBW was calculated to determine the RR. Multivariate analysis with binary logistic regression was conducted to determine the adjusted RR (ARR).Results: The incidence of LBW in the group whose weight gain during pregnancy not in accordance with IOM standards was 59%, while those in accordance with the standards were 8.2% with RR=7.22 (95%CI: 3.96–13.19). The ARR for those with weight gain during pregnancy not in accordance with IOM standards was 15.33 (95%CI: 5.82-40.38). The incidence of LBW in the anemia group was 49% and not anemia group was 10%. The RR and ARR values for LBW in the anemia group were 4.72 (95%CI: 2.66-8.36) and 6.66 (95%CI: 2.53-17.53) respectively.Conclusion: Mothers experiencing weight gain during pregnancy that was not in accordance with IOM standards and anemia were found to increase the risk of LBW. Monitoring of weight gain during pregnancy should be implemented using the IOM standards and anemia prevention among pregnant mothers should be enhanced.

Weight gain during pregnancy and low birth weight babies: a retrospective cohort study in Gianyar District, Bali

Background and purpose: Low birth weight (LBW) is a major causal factor for neonatal and perinatal mortality. The aim of this study is to determine the risk of LBW incidence in pregnant women with weight gain not in accordance with the Institute of Medicine (IOM) standards. Methods: This study used a retrospective cohort design with data obtained from three Public Health Centres (PHCs) in Gianyar District over the period of January-December 2017. Samples in this study were 186 pregnant women with the following criteria: complete data on the mother’s medical record, had an antenatal care visit in the first trimester and at the end of the third trimester, at term delivery, not giving birth to twins and no complications during pregnancy. The sample size was determined with 95% confidence level, 80% power, the proportion of LBW in the group of inadequate weight gain of 26%, the proportion of LBW in the group of adequate weight gain of 9% and a relative risk (RR) estimate of 3.0. Data extracted from medical record consisted of weight gain, pre-pregnancy weight, height, upper arm circumference, hemoglobin level, employment, age, parity and birth weight. The cumulative incidence of LBW was calculated to determine the RR. Multivariate analysis with binary logistic regression was conducted to determine the adjusted RR (ARR). Results: The incidence of LBW in the group whose weight gain during pregnancy not in accordance with IOM standards was 59%, while those in accordance with the standards were 8.2% with RR=7.22 (95%CI: 3.96–13.19). The ARR for those with weight gain during pregnancy not in accordance with IOM standards was 15.33 (95%CI: 5.82-40.38). The incidence of LBW in the anemia group was 49% and not anemia group was 10%. The RR and ARR values for LBW in the anemia group were 4.72 (95%CI: 2.66-8.36) and 6.66 (95%CI: 2.53-17.53) respectively. Conclusion: Mothers experiencing weight gain during pregnancy that was not in accordance with IOM standards and anemia were found to increase the risk of LBW. Monitoring of weight gain during pregnancy should be implemented using the IOM standards and anemia prevention among pregnant mothers should be enhanced.

The effects of amniotic fluid and foetal cord blood cotinine concentrations on pregnancy complications and the anthropometric measurements of newborns

Our objective was determining the effects of amniotic fluid (AF) and fetal cord blood (FCB) cotinine concentrations on pregnancy complications and the anthropometric measurements in the newborns whose mothers underwent amniocentesis. This study was conducted as a case-control study, in Turkey. A total of 250 pregnant women with amniocentesis indication were recruited into the study and the cotinine levels in the AF and FCB were determined. A smoking habit did not statistically affect the incidence of pregnancy complications (p>.05). The birth weights of the newborns were negatively correlated with the AF cotinine levels. The incidences of low birth weight, low Apgar scores and RDS were positively correlated with higher levels of cotinine in AF and FCB. It is important for healthcare staff to provide training and consultancy services for the health improvement of pregnant women and the prevention of smoking during pregnancy.Impact statementWhat is already known on this subject? The pre-pregnancy smoking habit usually continues during the pregnancy. A significant negative correlation was present between the foetal cord blood cotinine levels and the birth weight.What do the results of this study add? The anthropometric measurements of the newborns born from mothers with high AF cotinine levels were lower than newborns born from mothers with low amniotic fluid cotinine levels. Respiratory Distress syndrome is more often determined in newborns born from mothers with high AF cotinine levels.What are the implications of these findings for clinical practice and/or further research? Future studies should be performed to investigate the effects of cigarette smoking on the health problems, the growth characteristics and the neurological development of newborns and infants within the first year of life.

Changes of second-time mothers and their infants under the universal two-child policy in Changsha, China

BackgroundChina announced the implementation of the universal two-child policy in Oct, 2015; every couple was allowed to have two children. However, its influences on maternal well-being and infants’ outcomes are still to be discovered. ObjectivesTo detect influences of the universal two-child policy. To provide information for maternal health care under the new policy. Study designThis study enrolled 859 and 1230 women who delivered their second child (hereafter second-time mothers) before and after the policy's implementation, respectively, and the data included maternal demographic characteristics, gestational complications, delivery mode and infants’ outcomes. ResultsAfter the policy's implementation, the proportion of second-time mothers with advanced age increased significantly. The advanced gestational age is well acknowledged to correlate with higher risk during the pregnancy, both for pregnant women and their babies. However, in our study, the incidence of hypertensive disorders in pregnancy, placenta previa and postpartum haemorrhage decreased significantly after the introduction of the policy and no differences were noted in other gestational complications. Moreover, the hospitalization time was shortened, and caesarean delivery was chosen less frequently. As for the infants, foetal distress exhibited an alleviation and the incidence of premature labour and low birth weight decreased as well. ConclusionsEven though the age of second-time mothers increased after the introduction of the universal two-child policy, their general gestational health condition improved and their infants also exhibited a better outcome, which might be attributed to the improvement of China's maternal medical care system.

The association between assisted reproductive technologies and low birth weight.

To examine the existing literature in regards to the relationship between assisted reproductive technologies (ART) and low birth weight (LBW). In 2017, Martin et al. reported on the incidence of low birth weight in relation to the number of embryos transferred, and showed that incidence of low birth weight in singletons correlates with number of embryos transferred. Meanwhile, several studies have shown increased weight of singletons born after frozen embryo transfers compared with fresh embryo transfers. A recent study published by Sekhon et al., among others, disputes these findings, and claims that frozen and fresh embryo transfers result in comparable birth weights. It is also noteworthy that Mass et al., in 2016, analyzed how birth weight as a result of assisted reproductive technologies has evolved over the years, and concluded that birth weight has not changed significantly over a long period of time. Newborns conceived via assisted reproductive technologies are three times more likely to have low birth weight. Although multiple gestation and its associated prematurity are the main risk factors for low birth weight in ART-conceived pregnancies, some of the other processes specific to assisted reproduction also impact perinatal outcomes. Options, such as fresh or frozen embryo transfers, the number of embryos transferred, or endometrial preparation may all importantly affect birth weight and prematurity of ART-conceived newborns.

A rural-urban comparison of ownership and utilization of Long-Lasting Insecticide Treated Nets among pregnant women in Ogun State Nigeria

Background: The use of Long-Lasting Insecticide Treated Nets (LLINs) in Africa increased mean birth weight by 55g, reduced the incidence of low birth weight by 23% and decreased miscarriages/stillbirths by 33%. However, the benefit of the LLINs may be limited by the rate of ownership and utilization by pregnant women. Objective: To determine and compare the ownership and utilization of LLINs among pregnant women in urban and rural areas of Ogun State. Methods: A community-based comparative cross-sectional study on 72 and 74 pregnant women living in urban and rural areas, respectively of Ogun State was carried out. Using a multi-stage cluster sampling technique and a pretested semi-structured interviewer-administered questionnaire, information on LLINs ownership and use were obtained. Results: Ownership of LLINs was 81.1% in rural areas compared to 66.7% in urban areas. About 65% of participants in rural versus 44.4% in urban areas slept under LLINs. The predictor of ownership of LLIN was age group 15-24 years [AOR 0.10 (95%CI 0.01 - 0.56)]. The predictors of utilization of LLINs included urban residence [AOR 0.29 (95%CI 0.13 – 0.65)], age group 15-24 years [AOR 0.17 (95%CI 0.04 – 0.70)], registration of pregnancy for antenatal care [AOR 5.12 (95%CI 1.14 – 23.03)] and knowledge on prevention of malaria [AOR 4.94 (95%CI 1.51 – 16.17)]. Conclusion: Pregnant women should visit ANC clinics regularly, and health education on malaria should focus more on the prevention of malaria as well as encouraging the consistent use of the nets, particularly in the urban areas.

The Impact of an Antenatal Balanced Plate Nutrition Education Intervention on Infant Birthweight: A Cluster Randomized Controlled Trial in Rural Bangladesh (OR25-01-19)

ObjectivesLow birthweight (LBW) is strongly associated with neonatal mortality. Evidence that nutrition education improves diet during pregnancy and reduces LBW is still weak. We investigated the effect of a nutrition education intervention for pregnant women in improving birthweight of infants. Our primary hypothesis was that women who receive the ‘balanced plate nutrition education’ during pregnancy would deliver babies 100 g heavier than those who receive standard nutrition education. MethodsWe conducted a parallel, two-arm, cluster-randomized controlled trial in Bangladesh, in which we randomly assigned 36 clusters in equal ratio to intervention or standard care. Participants in the intervention clusters received ‘balanced plate nutrition education’ with a practical demonstration from community health workers 4–7 times starting from the first trimester of pregnancy. The participants in the control clusters received standard nutrition education delivered by healthcare providers during antenatal care. Eligible participants were pregnant women of 12 weeks gestation or less. The primary outcome was mean birthweight and incidence of LBW (defined as birthweight less than 2500 gm). The trial is registered with number ACTRN12616000080426. ResultsWe included all assigned participants in the intervention (445) and comparison (448) groups in the analyses (Figure 1). Baseline characteristics were balanced between the treatment groups (Table 1). The mean birthweight increased by 125.3 g (95% confidence interval (CI) 5·7, 244·9; P = 0·04) and the risk of LBW was reduced by 54% (relative risk (RR) 0·46; 95% CI 0·28, 0·78; P = 0·004) in the intervention compared to the comparison group (Table 2). In post hoc analyses amongst adolescent mothers we observed a significant improvement in birthweight and reduction in LBW (mean difference 297·3 g; 95% CI 85·0, 509·6; P = 0·006 and RR 0·31; 95% CI 0·12, 0·77; P = 0·01). ConclusionsA community-based balanced plate nutrition education was effective in increasing birthweight and reducing the incidence of LBW in a rural population of Bangladesh.A community-based, balanced-plate nutrition education was effective in increasing birthweight and reducing the incidence of low birthweight in a rural population of Bangladesh. Funding SourcesJames P. Grant School of Public Health; Bangladesh, and Sydney Medical School; Australia. Supporting Tables, Images and/or Graphs▪▪▪

Gastroschisis Following Treatment with High-Dose Methimazole in Pregnancy: A Case Report.

Hyperthyroidism in pregnancy is associated with a increased incidence of low birth weight, preterm birth and admission to the neonatal intensive care unit. However, available treatment options are limited. In this report, we present a case of fetal gastroschisis with a history of intrauterine exposure to methimazole. A 37-year-old woman was diagnosed with Grave’s disease 3 years before her pregnancy. She had a poor response to propylthiouracil and required high-dose methimazole before her pregnancy. During the first trimester, she received methimazole 120 mg/day. After her 12th week of pregnancy, she received block-and-replace therapy (levothyroxine [LT4] 50 µg/day) because of the risk of hypothyroidism, and the dose of methimazole was downtitrated to 60 mg/day. Fetal ultrasonography showed fetal growth retardation and gastroschisis at gestational week 33. The relationship between the very high doses of methimazole in the first trimester of pregnancy and the incidence of gastroschisis in this patient was not fully understood because evidence of a relationship between the use of antithyroid drugs in the first trimester and congenital abnormalities in the fetus is lacking. Furthermore block-and-replace therapy is not recommended in pregnancy because it requires a higher dose of methimazole. We recommend preconception counseling and early screening of thyroid function. The counseling should include the best timeline for pregnancy and a discussion of the risks and benefits of hyperthyroidism treatment options.