Proportion Of Low Birth Weight Research Articles

Implementation of preconception care for preventing adverse pregnancy outcomes in rural and tribal areas of Nashik District, India

IntroductionThe World Health Organization has suggested preconception care to improve pregnancy outcomes. Hence, the study aimed to compare the effect of preconception care on pregnancy outcomes, particularly prematurity and low birth weight. MethodsWe carried out interventions in one tribal and one non-tribal block. For comparison, one adjacent tribal block and one non-tribal block were included in Nashik district, India. The total study period was from April 2018 to July 2021. All reproductive age group women desiring pregnancy within one year in selected four blocks participated in the study. The services included clinical examination, laboratory investigations, treatment, six-monthly deworming, anemia management, folic acid supplementation, family planning services, and behavioral change communication using different media. The existing healthcare workers provided services to the women until they became pregnant or until the end of the follow-up period (27 months). We monitored pregnancy outcomes, including abortion, stillbirth, and live birth; among live births, low birth weight, preterm birth, congenital physical anomaly, and neonatal death. ResultsThe study enrolled 7,875 women, and 3,601 had outcomes. The proportion of preterm births in the intervention and comparison block was 11.18 % and 14.99 %, respectively (p = 0.001), and the proportion of low-birth-weight babies was 9.23 % and 11.25 %, respectively (p = 0.01). The adjusted prevalence ratio showed that the risk of preterm births in the absence of intervention was 1.3 (CI: 1.1–1.6). Preterm birth was a mediator between preconception care and low birth weight. ConclusionReduction in proportion of low birth weight and preterm babies can be achieved through preconception care using minimal additional resources.

Linking weather and health outcomes: Examining the potential influences of weather factors and particulate matter pollution on adverse pregnancy outcomes in the Kavre district, Nepal

IntroductionAdverse pregnancy outcomes (APOs) include stillbirth, preterm birth, and low birthweight (LBW). Studies exploring the impact of weather factors and air pollution on APOs are scarce in Nepal. We examined the impacts of prenatal exposure to temperature, precipitation, and air pollution (PM2.5) on APOs among women living in Kavre, Nepal. MethodsWe conducted a hospital and rural health centers-based historical cohort study that included health facility birth records (n = 1716) from the Nepali fiscal year 2017/18 through 2019/20. We linked health records to temperature, precipitation, and PM2.5 data for Kavre for the six months preceding each birth. A random intercept model was used to analyze birthweight, while a composite APO variable, was analyzed using multivariable logistic regression in relation to environmental exposures. ResultsThe proportion of LBW (<2500 gm), preterm birth (babies born alive before 37 weeks of gestation), and stillbirth was 13%, 4.3%, and 1.5%, respectively, in this study. Overall, around 16% of the study participants had one or more APOs. Total precipitation (β: 0.17, 95% CI 0.01 to 0.33, p = 0.03) had a positive effect on birthweight in the wetter season. Negative effects for mean maximum (β: 33.37, 95% CI -56.68 to −10.06, p = 0.005), mean (β: 32.35, 95% CI -54.44 to −10.27, p = 0.004), and mean minimum temperature (β: 29.28, 95% CI -49.58 to −8.98, p = 0.005) on birthweight was also observed in the wetter season. ConclusionA positive effect of temperature (mean maximum, mean, and mean minimum) and total precipitation on birthweight was found in the wetter season. This study emphasizes the need for future research using larger cohorts to elucidate these complex relationships in Nepal.

Social Inequalities in Child Development: Analysis of Low-Birth-Weight Trends in Brazil, 2010-2020.

Low birth weight (LBW) is a global issue prevalent in low-income countries. Economic assessments of interventions to reduce this burden are crucial to guide health policies. However, there is a relative scarcity of research that illustrates the magnitude of LBW by country and region to support the design of public policies. This study aimed to analyze the temporal trend of fetal growth in newborns in Brazil between 2010 and 2020. A time series study was conducted using data from the Live Births Information System (SINASC), which is managed by the Department of Information and Informatics of the Unified Health System (DATASUS) of the Brazilian Ministry of Health. The Prais-Winsten linear model was applied to analyze the annual proportions of LBW. The annual percentage changes (APC) and their respective 95% confidence intervals (95%CI) were calculated. Prevalence rate averages of LBW were calculated and displayed on thematic maps to visualize the evolution dynamics in each Federation Unit (FU). A total of 31,887,329 women from all Federative Units of Brazil were included in the study from 2010 to 2020. The Southeast region had the largest proportion of participants, with records from 2015 accounting for 9.5% of the total. Among the women in the study, 49.6% were between the ages of 20 and 29, and the majority (75.5%) had between 8 and 12 years of schooling. The newborns of these women were predominantly male (58.8%) and non-white (59.5%). The study found that there was a trend towards stabilization of increasing proportions of LBW in the North, Northeast, and Centre-West regions between 2010 and 2020. In Brazil and other regions, these tendencies remained stable. To improve living conditions and reduce social inequalities and health inequities, public policies and actions are necessary. Strengthening the Unified Health System (SUS), income transfer programs, quota policies for vulnerable groups, and gender equality measures such as improving access to education for women and the labor sector are among the suggested approaches.

Proportion of Low Birth weight and Associated Maternal Risk Factors in a Developing Country, Bangladesh

Introduction: Though the health situation of Bangladesh has been improved substantially over the years, the low birth weight (LBW) rate is still pretty high. LBW has been associated with high probability of infection, malnutrition, mental deficiencies and behavioural and learning problem in later life. The principle focus of this study was to ascertain the proportion of LBW and its associated maternal risk factors identification. Materials &amp; methods: It was a cross-sectional type of descriptive study done at two tertiary level hospitals – Rajshahi Medical College Hospital and Islami Bank Medical College Hospital. A total of 270 mothers were interviewed within 1 month of their delivery. The purposively selected participants were asked about their socio-demographic characters and other associated factors related to birth of the babies. Weights of the babies at birth were documented from hospital records. Result: Proportion of LBW was found 28.1% with no significant sex variation. Majority of the LBW babies were found in mothers of 15-20 years of age group. Mothers’ educational qualifications, occupations, early age pregnancy and type of pregnancy were associated significantly for LBW. Less than 37 weeks of gestational age of baby, home delivery, NVD were also significant risk factors of LBW. Residence and sex of neonate were not significantly associated with LBW. Conclusion: Proportion of LBW in tertiary care hospitals were found 28.1%. Early maternal pregnancy, lower gestational age, higher parity, NVD and home delivery played an important role in the incidence of LBW. TAJ 2023; 36: No-2: 207-214

Breathing in the future: prenatal exposure to air pollution and infants' health outcomes in the USA

ObjectivesThis study aimed to investigate the impact of air pollution on birth outcomes in the USA over several decades. Study designApproximately 70 million birth records were assessed for the years 1980–2020. This study focussed on seven measures of birth outcomes, including birth weight, low birth weight, very low birth weight, full-term birth weight, foetal growth, gestational age and very premature birth. MethodsAn instrumental variable identification strategy was used that exploited within county-month and within month-year of birth variations in exposure to precipitation-induced changes in air pollution. ResultsAir pollution was found to have negative and large effects on a wide range of birth outcomes. The study findings suggest that a one-standard-deviation increase in ozone was associated with a 6.4% and 12.8% increase (from the mean) in the proportion of low birth weight and very preterm birth infants, respectively. Further analyses suggest that these effects were heterogeneous across trimesters of pregnancy and reveal larger impacts during the second and third trimesters. ConclusionsThe results suggest that the ordinary least square estimates of previous studies considerably underestimate the true effects of pollution on birth outcomes. Policies that aim to improve the health capital of future generations should allocate more resources and initiatives to improving environmental air quality.

Disparities in Obstetric, Neonatal, and Birth Outcomes Among Syrian Women Refugees and Jordanian Women.

Objectives: To compare obstetric and neonatal characteristics and birth outcomes between Syrian refugees and native women in Jordan. Methods: We used the Jordan Stillbirths and Neonatal Deaths Surveillance System to extract sociodemographic and obstetric characteristics of the mothers and birth characteristics of newborns. Multivariate analysis was used to compare the characteristics of 26,139 Jordanian women (27,468 births) and 3,453 Syrian women refugees (3,638 births) who gave birth in five referral hospitals (May 2019 and December 2020). Results: The proportions of low birthweight (14.1% vs. 11.8%, p < 0.001) and small for gestational age (12.0% vs. 10.0%, p < 0.001) newborns were significantly higher for those born to Syrian women compared to those born to Jordanian women. The stillbirth rate (15.1 vs. 9.9 per 1,000 births, p = 0.003), the neonatal death rate (21.2 vs. 13.2 per 1,000 live births, p < 0.001), and perinatal death rate (21.2 vs. 13.2 per 1,000 births, p < 0.001) were significantly higher for the Syrian births. After adjusting for sociodemographic and obstetric characteristics of women, only perinatal death was statistically significantly higher among Syrian babies compared to Jordanian babies (OR = 1.3, 95% CI: 1.1-1.7, p = 0.035). Conclusion: Syrian refugee mothers had a significantly higher risk of adverse obstetric and neonatal outcomes including higher rate of perinatal death compared to Jordanian women.

The Associated Factors of Low Birthweight Among Term Singletons in Japan: A Pregnancy Birth Registry Analysis.

Progress in reducing the global low birthweight (LBW) has been insufficient. Although the focus has been on preventing preterm birth, evidence regarding LBW in term births is limited. Despite its low preterm birth prevalence, Japan has a higher LBW proportion than other developed countries. This study aimed to examine the prevalence of LBW in term singleton births and its associated factors using a national database. We retrospectively analyzed the data of neonates registered in the Japan Society of Obstetrics and Gynecology Successive Pregnancy Birth Registry System who were born 2013-2017. Exclusion criteria included stillbirths, delivery after 42 gestational weeks, and missing data. Logistic regression analyses were performed to investigate the maternal and perinatal factors associated with LBW in term singletons using the data of 715,414 singleton neonates. The overall prevalence of LBW was 18.3%, and 35.7% of LBWs originated from singleton term pregnancies. Multiple logistic regression analyses indicated that both modifiable and non-modifiable factors were independently associated with LBW in term neonates. The modifiable maternal factors included pre-pregnancy underweight, inadequate gestational weight gain, and smoking during pregnancy, while the non-modifiable factors included younger maternal age, nulliparity, hypertensive disorders of pregnancy, cesarean section delivery, female offspring, and congenital anomalies. Using the Japanese pregnancy birth registry data, more than one-third of LBWs were found to originate from singleton term pregnancies. Both modifiable and non-modifiable factors were independently associated with LBW in term neonates. Prevention strategies on modifiable risk factor control will be effective in reducing LBW worldwide.

Adverse Birth Outcomes among Indigenous in Kelantan, Malaysia for the Years 2018–2020: Proportions and Associated Maternal Factors

Abstract: This study aimed to measure the proportion of adverse birth outcomes among all births and maternal factors associated with low birth weight among Indigenous (Orang Asli) infants in Kelantan, Malaysia. Proportionate stratified random sampling was done to select 327 samples from five antenatal centres involved with Orang Asli in Kelantan. Multiple logistic regression analysis was used to determine maternal factors associated with low birth weight among Orang Asli infants. The proportion of low birth weight was measured at 16.2% (substantially exceeding the national rate), preterm birth at 7.3%, stillbirth at 0.6%, early neonatal death at 0.6%, and macrosomia at 0.9%,. Maternal factors associated with low birth weight infants include primiparity (AdjOR: 2.88; 95% CI: 1.44,5.78), anaemia in pregnancy (AdjOR: 2.33; 95%CI: 1.18,4.61) and hypertension (AdjOR: 4.21; 95%CI: 1.23,14.44). In conclusion, far-reaching antenatal services and nutrition policy are essential to reduce the proportions of low birth weight among Orang Asli.

The Relationship Between Regional Growth in Neonatal Intensive Care Capacity and Perinatal Risk.

The supply of US neonatal intensive care unit (NICU) beds and neonatologists is known to vary markedly across regions, but there have been no investigation of patterns of recent growth (1991-2017) in NICUs in relation to newborn need. The objective of this study was to test the hypothesis that greater growth in NICU capacity occurred in neonatal intensive care regions with higher perinatal risk. A longitudinal ecological analysis with neonatal intensive care regions (n=246) as the units of analysis. Associations were tested using linear regression. All US live births ≥400g in 1991 (n=4,103,528) and 2017 (n=3,849,644). Primary measures of risk were the proportions of low-birth weight and very low-birth weight newborns and mothers who were Black or had low educational attainment. Over 26 years, the numbers of NICU beds and neonatologists per live birth increased 42% and 200%, respectively, with marked variation in growth across regions (interquartile range: 0.3-4.1, beds; neonatologists, 0.4-1.0 per 1000 live births). A weak association of capacity with perinatal risk in 1991 was absent in 2017. There was no meaningful (ie, clinical or policy relevant) association between regional changes in capacity and regions with higher perinatal risk or lower capacity in 1991; higher increases in perinatal risk were not associated with higher capacity growth. The lack of association between newborn medical needs and the supply of NICU resources raises questions about the current effectiveness of newborn care at a population level.

Impact of the First and Second Lockdown for COVID-19 Pandemic on Preterm Birth, Low Birth Weight, Stillbirth, Mode of Labor, and of Delivery in Lombardy, Italy

We investigated the effect of lockdown measures implemented in Lombardy on selected obstetric and perinatal outcomes. Births that occurred during the two lockdowns imposed (i.e., the first from 16 March to 2 June 2020 and the second from 3 November 2020 to 5 April 2021) and the comparison periods (i.e., the first from 16 March to 2 June 2018 and the second from 3 November 2018 to 5 April 2019) were identified using regional healthcare databases. The distribution of births according to the selected outcomes was computed and the Chi-square test was used for testing differences in the periods compared. During the two lockdowns, we observed a lower proportion of low birth weight, from 6.8% in the comparison period to 6.1% in the first lockdown (p = 0.019), and from 6.5% to 6.1% in the second one (p = 0.109). The proportion of preterm births decreased from 6.8% to 6.3% in the first lockdown (p = 0.097), and from 6.2% to 6.0% in the second one (p = 0.172). No differences in stillbirth rate emerged for both lockdowns. Induction of labor was more frequent during both lockdowns, from 28.6% to 32.7% in the first (p < 0.0001), and from 29.9% to 33.2% in the second one (p < 0.0001). Cesarean section was less frequent during the second lockdown.

Effectiveness of intermittent screening and treatment of malaria in pregnancy on maternal and birth outcomes in selected districts in Rwanda: A cluster randomized controlled trial.

Malaria during pregnancy can cause serious consequences including maternal anemia and low birthweight (LBW). Routine antenatal care (ANC) in Rwanda includes malaria symptom screening at each ANC visit. This cluster randomized controlled trial investigated whether adding intermittent screening with a malaria rapid diagnostic test (RDT) at each routine ANC visit and treatment of positives during pregnancy (ISTp) is more effective than routine ANC for reducing malaria prevalence at delivery. Between September 2016- June 2018, pregnant women initiating ANC at 14 health centers in Rwanda were enrolled into ISTp or control arms. All women received an insecticide-treated bed net at enrolment. Hemoglobin concentration, placental and peripheral parasitemia, newborn outcome, birthweight, and prematurity were assessed at delivery. 975 were enrolled in ISTp and 811 in the control. Routine ANC plus ISTp did not significantly reduce PCR-confirmed placental malaria compared to control (adjusted relative risk [aRR] 0.94, 95% confidence interval [CI] 0.59-1.50, p=0.799). ISTp had no impact on anemia (aRR 1.08, 95% CI 0.57-2.04, p=0.821). The mean birthweight of singleton newborns was not significantly different between arms (3054gm vs 3096gm, p=0.395), however women in the ISTp arm had a higher proportion of LBW (aRR = 1.59, 95% CI 1.02-2.49, p=0.042). This is the only study to compare ISTp to symptomatic screening at ANC in a setting where intermittent preventive treatment is not routinely provided. ISTp did not reduce the prevalence of malaria or anemia at delivery and was associated with an increased risk of LBW. NCT03508349.

Women's occupational status during pregnancy and preventive behaviour and health outcomes between 1998 and 2016 in France

Despite an improvement in preventive care and perinatal health in previous decades, social inequalities persist, particularly to the disadvantage of isolated or unemployed women. The objective was to analyse the evolution between 1998 and 2016 of the association between women's occupational status and perinatal outcomes. Data came from four national surveys performed in 1998, 2003, 2010 and 2016. Occupational status was defined by maternal employment status and type of occupation during pregnancy. Preventive behaviours (initiation of antenatal care, antenatal classes, breast feeding) and health outcomes (hospitalization, preterm birth, birth weight below the 10th percentile) were analysed by occupational status adjusted for other maternal characteristics, for each study year. The studied sample included 12,497 women in 1998, 13,290 in 2003, 13,209 in 2010 and 11,179 in 2016. The proportion of employed women increased from 66% to 75% between 1998 and 2016, and that of housewives decreased from 22% to 12%. The proportion of preterm births globally increased between 1998 and 2016, especially for housewives. The proportion of low birthweight for gestational age (LBWGA) remained similar over the years. From 1998 to 2016, the differences between occupational groups persisted for preterm births and LBWGA. Occupational groups exhibited strong social differences in preventive care over the entire study period and persisted in the recent data. As a major social indicator, women's occupational status during pregnancy has to be considered as a risk factor of poor preventive behaviour and unfavourable perinatal outcomes.

Maternal determinants of low birth weight- a record-based study from a tertiary care centre in central India

Background: Birth weight is a major determinant of child’s health and nutrition. There are various factors which determine birth weight like maternal age, parity, socio economic status etc. A new born weighing less than 2.5 kg is classified as a low birth weight (LBW) baby. Low birth weight can be prevented by improving health status and socio-economic status of the community, improving antenatal care and also by providing proper health education. Methods: A record-based study was carried out in a tertiary care facility of central India. Labour room records from January 2021 to December 2021 were reviewed. The details on birth weight, gender, gestational age, parity, and mode of delivery were obtained and recorded. The data obtained was entered in Microsoft office excel software. Statistical analysis was carried out with the help of open Epi. Results: Out of 4266 records which were studied 46.65% mothers were in the age group 21-25 years and 53.52% were multiparas. The proportion of LBW was found to be 41.30%. LBW was found to have a significant association between age of mother, parity, residence and gender of the baby. Conclusions: In this study, sociodemographic factors, maternal age and multiparity has contributed substantially to LBW. Hospitals should inform pregnant women about the importance of appropriate age at conception. It is high time to discuss the aftereffects of older maternal age in detail and to focus more on biological components underlying these associations.

Altitude and Its Association with Low Birth Weight among Children of 151,873 Peruvian Women: A Pooled Analysis of a Nationally Representative Survey.

The aim of this study was to determine the relationship between the altitude of residence and the low birth weight (LBW) of the children of pregnant Peruvian women using a nationally representative database. An analysis of individual-level data from the last 13 years (from 2009 to 2021) of the Demographic and Family Health Survey was performed. The outcome variable was LBW, defined as birth weight less than 2500 g, while the independent variable was the altitude of residence in meters above sea level (masl). To estimate the association between the two variables, the crude and adjusted generalized linear model of the Poisson family with a log link was used along with crude and adjusted prevalence ratios, which were estimated with their respective 95% confidence interval. A total of 151,873 women aged 15-49 years were included between 2009 and 2021. The pooled proportion of LBW was 7.0%. As the main finding, the children of mothers residing at an altitude from 2500 to 3499 masl and ≥3500 masl had a higher probability of LBW. It was found that the children of mothers residing at an altitude above 2500 masl were more likely to have LBW. Our results will help to strengthen the cultural practice of maternal health care and increase its coverage in women residing in high-altitude regions.

Determinants of low birth weight in the health district of Bounkiling in Senegal

Aim: Low birth weight (LBW), 9.1 million deaths per year, is a global health issue. The proportion of LBW in Senegal is estimated at 12% (in 2017) and is at 11.7% (in 2017) in the region of Sedhiou. In this regard, rigorous management is required to address this issue, especially in rural areas. The objective of the study was to identify the determinants of LBW.Methodology: This is a case-control study which has been conducted in the district of Bounkiling. Socio-demographic characteristics of the mothers, their obstetrical and medical history, and information on the health status of the newborn in the case group were compared with that of the controls. Bivariate and multivariate analyses are performed using Epi info 7 software to identify the determinants.Results: Low-weights accounted for 97.05% of LBW. The sex ratio was 0.87 in favor of girls. The Apgar score at birth was not good for 31.4% of newborns. Teenage mothers accounted for 17.08%. The multivariate analysis showed that the determinants of LBW (p &lt; 0.05) were the female sex of the newborn, the Apgar score at birth, the maternal age &lt;=19 years, the household income &lt; 83.96 USD, maternal history of low birth weight and physical labor during pregnancy.&#x0D; Conclusion: Strengthening communication on early marriages and pregnancies, empowering women and improving pregnancy monitoring would be levers to counter the determinants of low birth weight.

The Effect of Health Education Using Video Media on Increasing Knowledge of Pregnant Women About Low Birth Weight (LBW) in the Penyinggahan Primary Health Center

Introduction: The proportion of LBW in Indonesia reaches 6.2%. The World Health Assembly (WHA) targets a reduction in the incidence of LBW in 2025 by 30%. Objective: The purpose of this study is to determine the effect of providing health education using the video method on increasing knowledge of pregnant women about LBW in the working area of the Penyinggahan primary Health center. Methods: The design used in this study was a quasi-experimental study with a one-group pre and post-test design. The data collection instrument uses a questionnaire that has been tested for validity and reliability. The population and sample in this study were pregnant women who had a pregnancy check (ANC) at the Penyinggahan primary Health centeras many as 38 respondents. Data analysis using the Wilcoxon test. Results and Discussion: there is a significant difference between the level of knowledge about LBW before and after being given health education using video with the results of the analysis p-value of 0.000&lt;0.05. Conclusion: There is an effect of health education on increasing knowledge of pregnant women about LBW. With the results of this study, it is hoped that it can be considered by the health center to take policies in terms of increasing knowledge using video tools so that it can increase mother's knowledge to prevent the occurrence of LBW

Characteristics of Pregnant Women and Risk Factors of Their Newborn for Admission to a Neonatal Intensive Care Unit in Nepal.

Nepal has progressed gradually in reducing under-5 mortality and neonatal mortality; however, they are still high at 30.8 and 19.8 per 1000 live births, respectively. Neonatal mortality constituted about 64% of the under-5 mortality in 2019, higher than the global average of 47%. This is a prospective study among pregnant women and their newborn babies in Siddhi Memorial Hospital, Bhaktapur, Nepal, from October 2017 to April 2018. Demographic and clinical data, high vaginal swabs of pregnant mothers, and umbilical cord blood were collected. High vaginal swabs were cultured, and umbilical cord blood samples were cultured and tested for inflammatory markers. After discharge to home, neonates were followed for 28 days of life by weekly phone calls. Total number of pregnant mothers enrolled was 151. The median age was 26 years (IQR: 18-40), and the proportion of adolescent mothers was 4.7%. Half of the deliveries were done by the caesarian section, and 8.6% had gestational age <37 weeks. High vaginal swab cultures were positive in 8.2% of the samples (n=135), and Escherichia coli was the most common bacteria. Out of 153 newborn babies (2 were twins), 8 (5.2%) were admitted to the neonatal intensive care unit. The proportion of low birth weight was 13%, and it was independently associated with neonatal intensive care unit admission (adjusted OR=9.4, 95%CI 1.8-50.1; P value= 0.009). Adolescent pregnancies and Low Birth Weight babies were commonly observed. Both of these issues need to be addressed by effective measures that would improve the current situation of maternal and child health in Nepal.

Factors Associated with Low Birthweight in Low-and-Middle Income Countries in South Asia.

Child with Low Birth Weight (LBW) has a higher risk of infant mortality, learning difficulties in childhood due to stunted growth and impaired neurodevelopment, is more likely to develop heart diseases and diabetes in adulthood. This study aimed to evaluate the latest demographic and health surveys (DHSs) across multiple countries in South Asia to determine the factors associated with LBW among these countries. Latest available DHS data across Afghanistan (2015, n = 29,461), Bangladesh (2018, n = 20,127), Nepal (2016, n = 12,862), and Pakistan (2018, n = 15,068) were analysed. Complex survey adjusted generalized linear models were fitted to investigate the association of birth weight with sociodemographic and decision-making factors. Pakistan had the highest proportion of LBW at 18% followed by Afghanistan and Bangladesh at around 14% and Nepal had the lowest (13%). Children born in Pakistan were more likely to have LBW children than Afghanistan (AOR = 2.17, 95% CI = 1.49-3.14). Mothers living in rural areas (AOR = 0.77, 95% CI = 0.61-0.97), with highly educated partners and belonging to richer families were less susceptible to having child with LBW. To reduce 30% LBW in-line with the World Health Organisation's 2025 goal, policymakers in SA should focus on women in urban areas with low-educated partners belonging to poor households to ease LBW burden.

Does neighbourhood crime mediate the relationship between neighbourhood SES and birth outcomes?

Abstract Background Previous studies have consistently found that women living in low socioeconomic status (SES) neighbourhoods are at higher risk of experiencing adverse birth outcomes compared to women from high SES areas. However, the mechanisms through which neighbourhood SES might influence health at birth remain poorly understood. One of the proposed pathways is the exposure to higher crime rates. The aim of this study is to investigate whether neighbourhood crime mediates the relationship between neighbourhood SES and birth outcomes. Methods A retrospective cohort study including over 1.3 million singleton births occurred in the Netherlands between 2010 and 2017. Individual-level data from the Dutch perinatal registry was linked to quintiles of neighbourhood SES scores and neighbourhood-level crime rates. Using the mediational g-formula, we estimated the total effect, natural direct effect, and natural indirect effect of neighbourhood SES on birth outcomes: small-for-gestational-age (SGA), low birth weight, and preterm birth. The neighbourhood SES intervention settings correspond with a hypothetical improvement in neighbourhood SES from the lowest to the highest quintile. Results The hypothetical improvement in neighbourhood SES resulted in a 6.6% (CI = 5.6%; 7.5%) relative reduction in the proportion of SGA births, an 8.9% (CI = 7.6%; 10.3%) reduction in the proportion of low birth weight, and a 5.1% (CI = 4.0%; 6.1%) decrease of preterm birth. Neighbourhood crime accounted for 29.0% (CI = 25.1%; 32.8%) of the total effect of neighbourhood SES on SGA, and for 8.6% (CI = 5.1%; 11.6%) of the total effect on low birth weight. For preterm birth, we found no evidence of mediation by neighbourhood crime. Conclusions Neighbourhood crime mediates the association between neighbourhood SES and key adverse birth outcomes. Interventions targeted at lowering neighbourhood crime rates could improve birth outcomes in disadvantaged areas. Key messages

Impact of SARS-CoV-2 Infection during Pregnancy and Perinatal Outcome: Findings from Private Hospitals at Dhaka, Bangladesh

Introduction: The pandemic novel corona virus (SARS-CoV- 2) infects pregnant women and affects pregnancy outcome. The perinatal outcome of COVID positive pregnancies attended at private hospitals during the last epidemic peak at Dhaka is unknown. The purpose of the study was to evaluate perinatal outcome among COVID positive and COVID negative pregnant women who delivered in the 2 study hospitals at Dhaka during the last epidemic wave. Methods: This retrospective study was conducted in 2 eminent private medical college&amp; hospitals in Dhaka,namely Popular medical college &amp;hospital (PMCH) and Greenlife medical college hospital (GLMC) over a period of 3 months from July 2021 to September 2021. COVID positive and COVID negative pregnant women who delivered in the study hospitals during the study period were included in this study. Outcome variables were COVID related maternal morbidity mortality, rate of caesarean delivery, stillbirth, preterm birth, low birth weight, neonatal COVID-19 positivity, neonatal death. Results: This study included 60 COVID positive and 60 COVID negative pregnant cases. COVID positive pregnant women delivered at earlier gestational age (weeks) than COVID negative cases(34.46±3.58 vs 36.50±3.20; p=0.001) Among COVID infected pregnancies,severe disease was observed in 15%; O2 support was needed in 68.3% and ICU admission required in 16.7% cases.The caesarean delivery rate ((93.3% vs 80%; p-.032) and preterm delivery rate (63.3% vs 35%; p-.002) were significantly higher among COVID positive cases. About 8.3% COVID affected pregnancies ended up with stillbirth.Maternal death rate due to COVID related complications was 5%.Proportion of low birth weight (LBW) was significantly more in infected pregnancies (65% vs 35%; p 0.001).No newborn from COVID positive mother was tested positive by RT-PCR at 24 hours of age. Conclusion: SARS-CoV-2 infection during pregnancy cancause moderate to severe disease requiring ICU admission and maternal death in 5% among COVID positive cases .It gives rise to more still birth, preterm birth, increasing number of LUCSand LBW. However maternal to neonatal transmission is not evident at 24-hour RT-PCR testing. J Bangladesh Coll Phys Surg 2022; 40: 270-278