Percentage Of Low Birth Weight Research Articles

Feto-Maternal Outcome in Patients with Placenta Previa at Aljala Maternity Hospital, Tripoli, Libya

To assess maternal and fetal morbidity associated with placenta previa. All patients with placenta previa who delivered in services hospital, Aljala Maternity hospital during the years 2020 to 2022 were involved. This study designed as descriptive retrospective cross-sectional study. Total number of 55 patients having placenta previa during the study period, 52.07% of patients were in age group 31-40 years while 15.5% of patients with placenta previa were less than 30 years (p<0.05). Regarding the gestational age, the current study showed that the mean gestational age for the patients who had PP was 37.19 weeks. The result was statistically insignificant with p value of 0.618. Most of the patients had H/O previous cesarean section (15 previous I C/S, 26 previous II C/S, 3 previous III C/S, 2 previous IV C/S, and 1 previous V C/S) which accounts 86.1% of the participated patients. Increased number of caesarean sections significantly associated with PP (p=0.0001). Around two third of women underwent urgent C/S (66%), and the rest of them (34%) had elective type. One third of the patients came with H/O vaginal bleeding. 21% of the patients had a complain of pain (most of them lower abdominal pain). 12.7% of the patients came shocked. Four percent of the participated women underwent hysterectomy, one of them had elective cesarean section. 15% of the patients had intrapartum bleeding, and 24% of the participated women had blood transfusion which reach 6 units in one case. With regard the birth weight, most of the neonates had average birth weight (80.4%). The percentage of low birth weight (LBW) was 9.4%. On the other hand, the percentage of macrosomia (birth weight is above 4.5kg) was 10.2% for the P value 0.737. 41.5% of the neonates had H/O admission to the neonatal intensive care unit. The most of the neonates were with mother (58.5%). There was one neonatal death during the admission in NICU. Placenta previa is danger to both the mother and the baby with high maternal morbidity and adverse perinatal outcome. Regular antenatal care with adequate arrangement of blood transfusion and multidisciplinary approach can reduce maternal morbidity and mortality.

ZERO-INFLATED NEGATIVE BINOMIAL MODELING IN INFANT DEATH CASE DUE TO PNEUMONIA IN EAST JAVA PROVINCE

Pneumonia is an acute infectious disease of the respiratory tract and an infection caused by a virus, bacteria or fungus that attacks the lung tissue. Several cases of pneumonia have resulted in deaths that occurred in toddlers aged 12-59 months. Based on official health in profile data, East Java's health in 2021 has a zero number of deaths under five aged 12-59 months due to pneumonia. Modeling data with many response variables is zero and there is overdispersion can be done using Zero Inflated Negative Binomial (ZINB) regression. This study aims to model the number of infant deaths aged 12-59 months due to pneumonia in East Java Province based on seven factors that are considered to influence the number of deaths in infants due to pneumonia. From this model, it can be seen that the factors that significantly influence the death of infants aged 12-59 months due to pneumonia in East Java Province using Zero Inflated Negative Binomial (ZINB) regression. The results of testing the parameters of the ZINB regression model show that the predictor variables that have a partial significant effect on the negative binomial model in East Java are the percentage of infants who received complete basic immunization, the percentage of coverage of under-five health services, the percentage of under-five children with malnutrition, the percentage of LBW (low birth weight babies). Selection of the best model is obtained by using the Bayesian Information Criterion (BIC) of 101,587.

Relationship between historical developments in the percentages of low birthweight and fetal mortality in Spain

ObjectiveTo document the differences in low birthweight in different population subgroups and to analyze its possible relationship with fetal mortality rates in Spain. MethodWe used the microdata on live births and stillbirths since 1975 to 2020 from the Spanish National Statistics Institute to examine differentials in delivering a low birthweight controlling for different sociodemographic variables and to determine the relationship between low birthweight and fetal mortality. No statistical analysis was necessary beyond the calculation of percentages and rates. ResultsThe data at our disposal for Spain confirm the historical increase in the incidence of low birthweight and allow us to link trends in low birthweight with a decrease in the fetal mortality rate. When fetal mortality is high, the incidence of low birthweight is low, given that a natural selection effect takes place. ConclusionsThe surprising historical increase in the incidence of low birthweight in Spain can be explained by the improvement in mortality rates. As more fetuses of lower gestational age are born alive, cases of low birthweight also increase.

Domestic violence against pregnant women is a potential risk factor for low birthweight in full-term neonates: A population-based retrospective cohort study.

Domestic violence's most frequently reported outcomes are preterm delivery and low birthweight, both of which are the strongest correlates of mortality and morbidity. Several studies have shown that pregnant women with domestic violence during pregnancy were more likely to deliver low-birthweight and preterm neonates. However, there has been no consensus on associations between domestic violence and low-birthweight and preterm delivery. To examine the impact of domestic violence on birthweight stratified by preterm or full-term delivery, a population-based retrospective cohort study was conducted that linked four national databases in Taiwan. A total of 1,322 subjects associated with a report of domestic violence during pregnancy were compared with 485,981 subjects without any record of reported domestic violence. The percentage of low birthweight in the group exposed to domestic violence was significantly higher than in the unexposed group with full-term delivery (4.9% vs. 3.3%, p = 0.001). Multivariable logistic regression analysis showed that pregnant women exposed to domestic violence had an OR of 1.37 (95% CI 1.05, 1.79) for low birthweight in full-term delivery. However, domestic violence was not significantly associated with low birthweight in preterm delivery. Screening for intimate partner violence in the perinatal health care system should be seen as especially important for women who have had full-term low-birthweight neonates.

INVERSE GAUSSIAN REGRESSION MODELING AND ITS APPLICATION IN NEONATAL MORTALITY CASES IN INDONESIA

Inverse Gaussian Regression (IGR) is a suitable model for modeling positively skewed response data, which follows the inverse Gaussian distribution. The IGR model was formed from the Generalized Linear Models (GLM). This study aims to model the IGR with applied to model the factors influencing the infant mortality cases of provinces in Indonesia. Estimation of the IGR model parameters was employed by the Maximum Likelihood Estimation (MLE) and Fisher scoring methods. The Likelihood Ratio Test (LRT) and Wald test were used for hypothesis testing of significance parameters. The IGR model was applied to the infant mortality cases of provinces in Indonesia in 2020. The data for modeling infant mortality cases using IGR were obtained from the Ministry of Health of the Republic of Indonesia and the Central Bureau of Statistics. The result shows that the factors influencing the infant mortality cases of provinces in Indonesia based on the IGR model were: the percentage of pregnant women who received blood-boosting tablets, the percentage of low birth weight, the percentage of complete neonatal visits (KN3), the percentage of toddlers who received early initiation of breastfeeding, the percentage of toddlers who are exclusively breastfeeding, the percentage of toddlers who received complete primary immunization, the percentage of households with access to adequate drinking water, and the percentage of households with access to appropriate sanitation.

Elevated serum uric acid level is associated with adverse reproductive outcomes in women with polycystic ovary syndrome undergoing in vitro fertilization or intracytoplasmic sperm injection embryo transfer cycles: a retrospective cohort study

Serum uric acid levels are elevated in polycystic ovary syndrome, however, the relationship between serum uric acid level and reproductive outcomes in women with polycystic ovary syndrome remains unclear. This study aimed to investigate the association between serum uric acid level and the reproductive outcomes in women with polycystic ovary syndrome undergoing invitro fertilization or intracytoplasmic sperm injection embryo transfer cycles. This was a retrospective cohort study performed at a university-affiliated reproductive medicine center. A total of 1903 women with polycystic ovary syndrome undergoing their first invitro fertilization or intracytoplasmic sperm injection embryo transfer cycles between January 2010 and January 2021 were initially included. The trends for reproductive outcomes in polycystic ovary syndrome across quartiles of serum uric acid levels were assessed. A logistic regression analysis was performed to obtain the odds ratios for invitro fertilization outcomes based on the quartiles of serum uric acid with or without adjusting for potential confounding variables. Using generalized additive models, serum uric acid was further treated as its original continuous property to visualize its nonlinear relationship with invitro fertilization outcomes. The live birth rate was the main outcome. After exclusions, a total of 883 women with polycystic ovary syndrome with their first fresh-embryo transfer cycles were included. In quartiles of serum uric acid levels, there was a significant decreasing trend in the live birth rate from the lowest quartile (Q1: 61.8%) to the highest (Q4:45.9%) (Ptrend=.002). The percentage of low birthweight increased from Q1 (22.3%) to Q4 (31.7%) (Ptrend=.049). Compared with those in Q1, women in Q4 showed a significant lower probability of live birth and clinical pregnancy and a higher risk for low birthweight (all P<.05). Both the unadjusted and adjusted generalized additive models indicated that as the serum uric acid level increased, the probability of clinical pregnancy and the live birth rate exhibited an overall decreasing profile, and the risk for low birthweight showed an increasing profile. An elevated serum uric acid level is associated with decreased probabilities of live birth and clinical pregnancy and an increased risk for low birthweight in women with polycystic ovary syndrome. However, these associations may be confounded by other factors and more well-designed studies are needed to confirm these findings in the future.

The Impact of COVID-19 on Pediatric Healthcare Utilization and Disease Dynamics: An Observational Study From Western Odisha.

IntroductionChildren were affected by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus during the first and second waves of the coronavirus disease 2019 (COVID-19 pandemic. Although the severity was less in children, the fear of contracting SARS-CoV-2 at the hospital might have led to a delayed health-seeking attitude. The objective of the study was tailored around emergency health care utilization affecting outcomes. The study was done to compare the trend concerning the utilization of pediatric healthcare and immunization services, changes in the profile of diseases, and the outcomes between the pre-COVID-19 period and the COVID-19 period in a tertiary care hospital.MethodsThis retrospective observational study was conducted in a tertiary care hospital in western Odisha. Data were collected retrospectively from different hospital registers (outpatient register, inpatient register, and immunization records) and analyzed between the pre-COVID-19 period (April 2019 to March 2020) and the COVID-19 period (April 2020 to March 2021) with appropriate statistical procedures.ResultsThere was a 60%, 49.8%, 51.1%, and 25.5% reduction in outpatient attendance, indoor pediatric admissions, nutritional rehabilitation centre admissions, and newborn admissions, respectively in COVID-19 period as compared to the pre-COVID-19 period. The pediatric bed occupancy rate was reduced by 54.5%. Unfavourable outcomes (death, left against medical advice, and referral) were significantly high in hospitalized children (24% vs. 18.1%, p < 0.001). The reduction in hospitalization due to common conditions like acute respiratory tract infections, bronchiolitis and asthma, and acute gastroenteritis during COVID-19 was 76.5%, 86.2%, and 39.5%, respectively. A higher percentage of low birth weight and preterm (<34 weeks) babies were admitted to special neonatal care unit (SNCU) during the pandemic (61.8% vs. 58%, p < 0.05; 18.9% vs. 15.8%; p < 0.05 respectively).ConclusionThe COVID-19 pandemic and the associated lockdown led to a significant decrease in pediatric and neonatal healthcare utilization. The impact of lower care-seeking and attendance resulting in poor patient-related outcomes (malnutrition, upsurge of vaccine-preventable diseases, disease-specific hospitalization, and mortality) post-pandemic is a real threat.

Predicting risks of low birth weight in Bangladesh with machine learning.

Background and objectiveLow birth weight is one of the primary causes of child mortality and several diseases of future life in developing countries, especially in Southern Asia. The main objective of this study is to determine the risk factors of low birth weight and predict low birth weight babies based on machine learning algorithms.Materials and methodsLow birth weight data has been taken from the Bangladesh Demographic and Health Survey, 2017–18, which had 2351 respondents. The risk factors associated with low birth weight were investigated using binary logistic regression. Two machine learning-based classifiers (logistic regression and decision tree) were adopted to characterize and predict low birth weight. The model performances were evaluated by accuracy, sensitivity, specificity, positive predictive value, negative predictive value, and area under the curve.ResultsThe average percentage of low birth weight in Bangladesh was 16.2%. The respondent’s region, education, wealth index, height, twin child, and alive child were statistically significant risk factors for low birth weight babies. The logistic regression-based classifier performed 87.6% accuracy and 0.59 area under the curve for holdout (90:10) cross-validation, whereas the decision tree performed 85.4% accuracy and 0.55 area under the curve.ConclusionsLogistic regression-based classifier provided the most accurate classification of low birth weight babies and has the highest accuracy. This study’s findings indicate the necessity for an efficient, cost-effective, and integrated complementary approach to reduce and correctly predict low birth weight babies in Bangladesh.

Fetomaternal Outcome in Females with Hepatitis Virus

Objective: This study was designed to see fetomaternal outcome in pregnant females with hepatitis virus infection. Methodology: This cross sectional study was designed at Lady Atchison hospital Lahore from March 2015 to September 2015. Using nonprobability purposive sampling, we enrolled 104 cases with hepatitis virus infection, in which 80(76.9%) cases had HCV and 24(23.1%) had Hepatitis B virus. Pregnant females 18-40 years old with gestational age &gt; 24 weeks (on dating scan), having any parity with positive diagnosis of HCV or HBV through Eliza were enrolled to see their fetomaternal outcome. The collected information was entered and analyzed in SPSS version 20. Results: The mean age of mothers was 27.35±4.339 years and mean gestational age at time of delivery was 36.1±3.51 weeks with minimum and maximum of 27 and 41 weeks. The mean birth weight was 2.792 ±1.41 kg whereas the mean APGAR score was 6.56±1.92 at 6 minutes. Intrauterine Deaths were observed in 10(9.6%) women. Preterm labour was seen in 24(23.1%) women. Fetal distress was found in 36 (34.6%) women. Emergency C section was done for 72 (30.8%) women. Postpartum haemorrhage was seen in 2 (1.9%) women. A total of 34 (32.7%) premature babies were born. Conslusion: Pregnant females with hepatitis infection had increased risk of intrauterine death, fetal distress and emergency caesarean delivery. Moreover, high percentage of low birth weight, pre-mature births and preterm labour was also observed. Keywords: Hepatitis Virus, C-section, low birth weight, premature births and preterm labour.

BIOCHEMICAL PROFILE, BACTERIAL PROFILE, AND ANTIBIOTIC SUSCEPTIBILITY PATTERN OF THE ISOLATES OF NEONATAL SEPTICEMIA IN TERTIARY CARE HOSPITAL, VISAKHAPATNAM

Objectives: The objective of the study was to determine sensitivity, specificity, and predictive values of C-reactive protein (CRP), leukocyte count, platelet count, and blood culture as indicators of neonatal sepsis. Methods: This prospective study was conducted in the Department of Paediatrics, GITAM Institute of Medical sciences and Research, Visakhapatnam during January 2019 to December 2019. The institutional ethics committee had approved the study. Eighty clinically suspected cases of neonatal sepsis constituted material of study. All neonates who were clinically suspected sepsis, categorized into 0–72 h (early onset) or late onset (&gt;3 days) sepsis based on day of presentation. Detailed history and clinical findings were recorded in the pro forma and screened with CRP and various hematological tests with predetermined cutoff values and at the same time blood culture was sent. Concerning a clinical scenario CSF, urine analysis, chest X-ray, and infective focus swabs were all taken. The length of treatment and time spent in the hospital were recorded. The death rate was calculated, and numerous risk variables were evaluated. Results: Intrapartum risk factors such as a prolonged rupture of membrane &gt;24 h, a long labor, several filthy vaginal examinations (&gt;3) before birth, and foul-smelling liquid were all linked to culture-proven newborn sepsis. Any of the two risk factors listed above was a good predictor of sepsis with a positive culture. Neonatal sepsis impacted a higher percentage of low birth weight and preterm babies. The sensitivity and negative predictive value of the I/T ratio and CRP were both high. The most prevalent isolates were Klebsiella species, followed by Staphylococcus aureus and Escherichia coli. While S. aureus was 80% sensitive to Cefotaxime and Amikacin, Klebsiella species and E. coli were only 20% sensitive. All were sensitive to Ofloxacin in range of 75-100%. Septicemia with multiorgan dysfunction was the most common mode of death with 100% risk of mortality. Conclusion: Intraparum risk factors are significantly with culture proven sepsis. All sepsis screening parameters used were statistically significantly associated with culture proven sepsis. I/T ratio and CRP were more sensitivity and had high negative predictive value. CRP can be used as an early and predictable screening test for diagnosing neonatal sepsis.

Assisted Reproductive Technology Surveillance - United States, 2018.

Assisted Reproductive Technology Surveillance - United States, 2018.

Effects of the COVID-19 pandemic on perinatal outcomes: a retrospective cohort study from Turkey

BackgroundLockdowns, pregnant women’s fear from hospitalization in addition to uncertainties about appropriate birthing practices at the beginning of the pandemic may have affected the health outcomes of mother-infant couples. We aimed to explore whether pregnancy outcomes including the rates of cesarean delivery (CS), preterm, and low birth weight (LBW) births have changed during the pandemic period compared with the pre-pandemic period.MethodsWe applied a population-based retrospective cohort, before-after approach in 2020 vs. similar calendar months in 2019 for five periods [Jan-Feb (pre-pandemic); March–May (1st wave and lockdown); June–August; September–October; November–December (2nd wave and lockdown)]. The data was modelled through multiple logistic regressions using key outcomes; CS, preterm, and LBW births as the dependent variables, and adjustments were made for independent variables in SPSS software. We evaluated the modification of years by periods by adding interaction term (yearXperiod) to the model.ResultsThe rate of CS in hospital births increased from 57.7% in 2019 to 60.2% in 2020. CS rates were significantly increased during the 3rd and 4th periods. The overall preterm rate was 11%. When singleton pregnancies were considered, adjusted multivariable analyses showed a decrease in preterm proportions during all time periods with respect to the pre-pandemic period. The percentage of LBW was 7.7% during the pandemic period and was found to be significantly reduced compared to the pre-pandemic period. There was a significant reduction in LBW rates in all periods except the second lockdown period.ConclusionsOur findings suggested significant reductions in preterm and LBW births possibly due to the indirect effects of the pandemic. Moreover, strategies need to be considered to address the increased CS rates and shifting of maternity service utilization to private facilities.

Hubungan Preeklamsi Dengan Kejadian Berat Bayi Lahir Rendah (BBLR) Di RSUP Haji Adam Malik Medan

Maternal Mortality Rate (MMR) in developing countries in 2015 was 239 per 100,000 live births, is still very high compared to developed countries with an MMR of 12 per 100,000 live births. Indonesia is one of the developing countries with high MMR is still very high at 305 per 100,000 live births in 2015. Prevalence preeclampsia in developed countries 1.3-6%, while in developing countries 1.8-18%. Indonesia prevalence of preeclampsia 5.3% (Pusdatin Kemenkes RI, 2014). The results of Riskesdas in 2018 stated that the percentage of LBW in Indonesia is 6.2% and North Sumatra is 4.2%. Proportion of causes The highest neonatal mortality was asphyxia 35.3% and LBW 27.0% (Kemenkes RI, 2019).This research analytic correlation with cross sectional design, namely to determine the relationship preeclampsia with the incidence of LBW in H. Adam Malik Hospital. Data analysis results of statistical tests using the chi square test obtained p value of 0.001 &lt;0.05 and X2 = 24.38 means that there is a relationship between mothers who experience preeclampsia with the incidence of baby weight low birth, at the 95% CI level of 4.50-50.02, it means that mothers who experience preeclampsia 4-50 times the possibility of giving birth with Low Birth Weight (LBW) in RSUPH. Adam Malik Medan Starting in 2017-2019

Mapping of Community Empowerment in Prevention Stunting in Kabupaten Wonogiri Through “Sego Sak Ceting”

The prevalence of stunting in Kabupaten Wonogiri is still quite high. The factors that cause stunting include the lack of food availability in the household and the mother’s knowledge of good nutrition during pregnancy and child birth. One of the stunting prevention programs in Kabupaten Wonogiri is through community empowerment known as “Sego Sak Ceting”(Sesarengan Wargo Beraksi Cegah Stunting). This activity was initiated by Puskesmas Giriwoyo I, Kabupaten Wonogiri. Sego Sak Ceting program is focused on improving household food availability as well as increasing maternal knowledge about good nutrition during pregnancy and childbirth. The objectives of this study were (1) to determine the stages of community empowerment activities through Sego Sak Ceting and (2) to analyze the effectiveness of the program in the context of reducing stunting in KabupatenWonogiri. The data collection was conducted by doing observation, interviews, and literature study, and the data analysis was the qualitative descriptive analysis. The results showed that the stages of community empowerment activities through Sego Sak Ceting, namely socialization of the program to the target community; implementation of activities as well as monitoring and evaluation of the implementation of activities. Community empowerment throughSego Sak Cetinghas succeeded in: (1) reducing the percentage of pregnant women with Chronic Energy Deficiency (CED) from 9.5% to 5.42%; (2) reducing the percentage of Low Birth Weight (LBW) from 5.2% to 3%; (3) increasing the percentage of participation of pregnant women in the class of pregnant women from 82.48% to 85.10%; (4) increasing the percentage of attendance of mothers with toddlersto Posyandu/Integrated Healtcare Center from 82.48% to 85.10%. Sego Sak Ceting can improve the awareness and knowledge of society that handling and preventing the stunting is responsible of local government, corporation, and society.

Association of Adverse Outcomes with Abnormal Umbilical Artery Waveform in Intrauterine Growth Restricted Pregnancies

Background: Intrauterine growth restriction refers to a fetus with a fetal weight in the 10th percentile on ultrasonography who has not reached its biologically set growth potential due to a pathologic condition. Aim: To determine the association of adverse outcome with abnormal umbilical artery waveform groups in intrauterine growth restricted pregnancies. Methods: This Cohort Study was conducted from February 2019 to 12 February 2020 at Gynae &amp; Obs Department, Imran Idrees Teaching Hospital Sialkot, Sialkot Medical College, Sialkot 120 pregnant females, attending Department of Gynae &amp; Obs were recruited into the study after 28 weeks of gestation. The women were divided into two groups depending on their Doppler findings. One group (exposed) comprised of women with intrauterine growth restriction, with absent or reversed diastolic flow in the umbilical artery. The control (unexposed) group included women with small-for-date fetuses, with normal umbilical artery Doppler flow. Results: The mean age of females was 27.40 ± 4.77 years. The mean gestational age was 30.69 ± 2.19 weeks. The mean birth weight of neonates was 2.37 ± 0.90 kg. The mean AGPAR score of neonates was 6.60 ± 1.70. It was observed that there was significant association between groups and low birth weight with p-value = 0.002. Admissions to NICU were significantly lower in normal Doppler wave form group having p-value = 0.001. Conclusion: The percentage of NICU admission was 46.7% and the percentage of low birth weight was 46.7% in intrauterine growth restriction. The mean birth weight was significantly lower in exposed group and the mean APGAR score was also significantly lower in exposed group. Keywords: Apgar score, neonatal intensive care unit, Intrauterine Growth Restriction, Doppler ultrasound,

Trends in infants born at low birthweight and disparities by maternal race and education from 2003 to 2018 in the United States

BackgroundUnderstanding current levels, as well as past and future trends, of the percentage of infants born at low birthweight (LBW) in the United States is imperative to improving the health of our nation. The purpose of this study, therefore, was to examine recent trends in percentage of LBW, both overall and by maternal race and education subgroups. Studying disparities in percentage of LBW by these subgroups can help to further understand the health needs of the population and can inform policies that can close race and class disparities in poor birth outcomes.MethodsTrends of percentage of LBW in the U.S. from 2003 to 2018, both overall and by race/ethnicity, and from 2007 to 2018 by education and race by education subgroups were analyzed using CDC WONDER Natality data. Disparities were analyzed using between group variance methods.ResultsPercentage of LBW experienced a significant worsening in the most recent 5 years of data, negating nearly a decade of prior improvement. Stark differences were observed by race/ethnicity and by education, with all subgroups experiencing increasing rates in recent years. Disparities also worsened over the course of study. Most notably, all disparities increased significantly from 2014 to 2018, with annual changes near 2–5%.ConclusionsRecent reversals in progress in percentage of LBW, as well as increasing disparities particularly by race, are troubling. Future study is needed to continue monitoring these trends and analyzing these issues at additional levels. Targets must be set and solutions must be tailored to population subgroups to effectively make progress towards equitable birth outcomes and maternal health.

ANALISIS FAKTOR-FAKTOR YANG MEMPENGARUHI STUNTING PADA BALITA DI KOTA GORONTALO MENGGUNAKAN REGRESI BINOMIAL NEGATIF

This study aims to model stunting cases in children under five in Gorontalo city in 2018. In this model, it can be seen that the significant factors that affect stunting cases in children under five in Gorontalo city in 2018. This study uses data on stunting cases in 9 (nine) districts in the city of Gorontalo and the factors that influence it. The research data were obtained from the Public Health in Gorontalo city. This study used one response variable, namely the number of cases of stunting and four predictor variables, namely number of toddlers who received exclusive breastfeeding, the percentage of low birth weight (LBW), the percentage toddlers who received complete basic immunization, and number of proper sanitation. The results obtained were the variables of number of toddlers who received exclusive breastfeeding and the percentage toddlers who received complete basic immunization which had a significant effect on stunting cases in children under five in the city of Gorontalo in 2018. This was indicated by the P-value of the variable for number of toddlers who received exclusive breastfeeding of 0.00283 and P-value of variable the percentage toddlers who get complete basic immunization is 0.06564.

The Impact of Down-Regulation on Obstetrics and Perinatal Outcomes in Singleton Pregnancies After In Vitro Fertilization.

Backgrounddown-regulation has been widely used in IVF treatment; however, it lacks reports on the impact of down-regulation on obstetrics and perinatal outcomes. The purpose of this study was to compare the obstetrics and perinatal outcomes among different down-regulation conditions.Methodsthis is a retrospective cohort study on 3578 patients achieving cumulative singleton clinical pregnancy after their first oocytes retrieval cycle. Patients were grouped according to the serum estradiol after down-regulation (E2D) into three groups: <30, 30-55, >55 pg/ml. The obstetrics and perinatal outcomes, and live-birth rate per clinical pregnancy were main outcome measures. In the subgroup analysis, patients were further divided according to the mode of transfer. ANOVA, chi-square test, multivariate logistic regression, and multivariate general linear model were performed for statistical analysis.Resultsthe patients with E2D <30, 30-55, >55 pg/ml had similar live-birth rates. The patients with E2D <30 pg/ml had a lower risk of hypertension disorders than those with E2D 30-55 pg/ml. No difference was found in the risks of placenta previa, placenta abruption, premature rupture of membrane, hemorrhage, gestational diabetes mellitus, or intrauterine growth restriction. The newborns in the group with E2D <30 pg/ml had a lower risk of PICU admission than those in the group with E2D >55 pg/ml. There was no difference in the risks of congenital anomalies or mortality among the three groups. No differences were found in the gestational week, percentages of preterm birth and very preterm birth, birth weight, percentages of low birth weight and very low birth weight, delivery mode, or sex of newborn. Subgroup analysis showed that E2D 30-55 pg/ml was associated with a higher risk of low birth weight in patients with one fresh transfer + frozen transfer(s).ConclusionDown-regulation has no effect on the live-birth rate per clinical pregnancy. Patients with E2D <30 pg/ml may have advantages regarding lower risks of both maternal hypertension and newborn PICU admission. E2D 30-55 pg/ml may be associated with low birth weight in patients with relatively low quality embryos.

Poisson Regression Modeling of Diarrhea Events in Pasuruan Regency with Maximum Likelihood Estimates and Generalized Method Moment.

Context:Diarrhea characterized by a frequency increased of defecation more than 3 times/ day accompanied by changes in consistency (becoming liquid). The causes of diarrhea can be divided into 2 parts, which are direct causes and indirect causes that can facilitate or accelerate the occurrence of diarrhea, including bacteria, nutritional conditions, hygiene and sanitation, social culture such as population density, economic status, low birth weight, and immunization.Aims:The purpose of this study to examine the factors that influence the incidence of diarrhea.Methods:This research used secondary data, the prevalence of diarrhea and risk factors in Pasuruan Regency Health Center. Poisson regression approach with maximum likelihood estimator (MLE) estimation and Generalized Method Moment (GMM) used in this study.Results:The results showed that GMM estimation method in the Poisson regression model gave better performance in terms of significance parameters compared to the MLE method.Conclusions:Factors affecting the increase of diarrhea occurrences in area with an estimated MLE Percentage of non-exclusive breastfeeding and Percentage of normal nutritional status. Whereas the GMM estimation is the percentage of non-exclusive breastfeeding, the percentage of low birth weight, the percentage of population density, the percentage of smokers among family members in the house, the percentage of incomplete immunizations, the percentage of under-five years old children less than 2, the percentage of normal nutritional status, and the percentage of middle class socioeconomic status.

Assisted Reproductive Technology Surveillance - United States, 2017.

Problem/condition Since the first U.S. infant conceived with assisted reproductive technology (ART) was born in 1981, both the use of ART and the number of fertility clinics providing ART services have increased steadily in the United States. ART includes fertility treatments in which eggs or embryos are handled in the laboratory (i.e., in vitro fertilization [IVF] and related procedures). Although the majority of infants conceived through ART are singletons, women who undergo ART procedures are more likely than women who conceive naturally to have multiple-birth infants because multiple embryos may be transferred. Multiple births can pose substantial risks for both mothers and infants, including obstetric complications, preterm birth ( Period covered 2017. Description of system In 1995, CDC began collecting data on ART procedures performed in fertility clinics in the United States as mandated by the Fertility Clinic Success Rate and Certification Act of 1992 (Public Law 102-493 [October 24, 1992]). Data are collected through the National ART Surveillance System (NASS), a web-based data collection system developed by CDC. This report includes data from the 50 states, the District of Columbia, and Puerto Rico. Results In 2017, a total of 196,454 ART procedures (range: 162 in Alaska to 24,179 in California) with at least one embryo transferred were performed in 448 U.S. fertility clinics and reported to CDC. These procedures resulted in 68,908 live-birth deliveries (range: 67 in Puerto Rico to 8,852 in California) and 78,052 infants born (range: 85 in Puerto Rico to 9,926 in California). Nationally, the number of ART procedures performed per 1 million women of reproductive age (15-44 years) was 3,040. ART use rates exceeded the national rate in 14 states (Connecticut, Delaware, District of Columbia, Hawaii, Illinois, Maryland, Massachusetts, New Hampshire, New Jersey, New York, Rhode Island, Utah, Vermont, and Virginia). ART use exceeded 1.5 times the national rate in seven states (Connecticut, the District of Columbia, Illinois, Maryland, Massachusetts, New Jersey, and New York). Nationally, among all ART transfer procedures, the average number of embryos transferred increased slightly with increasing age (1.3 among women aged 37 years). This year, single-embryo transfer (SET) rates among all embryo-transfer procedures are presented instead of elective single-embryo transfer procedures previously reported. Nationally, SET rates were 67.3% (range: 38.9% in South Dakota to 90.4% in Delaware), 65.0% (range: 23.6% in Puerto Rico to 89.4% in Delaware), and 60.0% (range: 28.6% in Puerto Rico to 83.1% in Delaware) among women aged 37 years, respectively. In 2017, ART contributed to 1.9% of all infants born in the United States (range: 0.4% in Puerto Rico to 5.0% in Massachusetts). Approximately 73.6% of ART-conceived infants were singleton infants. Overall, ART contributed to 14.7% of all multiple births, including 14.7% of all twin infants and 17.3% of all triplets and higher-order infants. ART-conceived twins accounted for approximately 96.5% (18,890 of 19,570) of all ART-conceived infants born in multiple deliveries. The percentage of multiple births was higher among infants conceived with ART (26.4%) than among all infants born in the total birth population (3.4%). Approximately 25.5% of ART-conceived infants were twins, and 0.9% were triplets and higher-order infants. Nationally, infants conceived with ART contributed to 4.5% of all low birthweight ( Interpretation Although singleton infants accounted for the majority of ART-conceived infants, multiple births from ART still contributed to a substantial proportion of all twins, triplets, and higher-order infants born in the United States. Variations in SET rates among states and territories were noted, reflecting variations in embryo-transfer practices among fertility clinics, which might in part account for higher multiple birth from ART observed in some states and territories. Public health action Reducing the number of embryos transferred and increasing use of SET, when clinically appropriate, can help reduce multiple births and related adverse health consequences for both mothers and infants. Because infants from multiple births are at increased risk for numerous adverse sequelae that cannot be ascertained from the data collected through NASS alone, long-term follow-up for ART infants through integration of existing maternal and infant health surveillance systems and registries with data available from NASS might be useful for monitoring adverse outcomes on a population basis.