Type Of Birth Research Articles

Factors Influencing Milk Yield During Lactation of D’man Ewes in its Cradle in Algeria

Abstract A study was conducted at the National Institute of Agricultural Research (Adrar station) between 2017 and 2019 to assess the milk yield potential of prolific D’man ewes. A total of 210 daily milk production records from (of) 21 D’man ewes were collected during three successive lambings with the weighing method before and after feeding followed by manual milking. In addition, the effects of birth type, lambing rank, birth season and weight of ewes to the struggle (at breeding) on milk production were analyzed. The least-squares averages of daily and total milk production of D’man ewes were 0.85 ± 0.03 kg and 59.1 ± 0.96 kg, respectively, and the highest daily milk yield was observed in the second week of lactation. Ewes suckling more than two lambs had the highest milk yield. Indeed, ewes with triplets or more (+57.3%) and twins (+22.1%) have a significantly higher milk yield (P<0.01) than ewes nursing single lambs. The effect of the other factors was not significant on milk production of D’man ewes. It can be concluded that increasing the quantity of milk produced per ewe according to the number of lambs suckled will help to make the most of multiple lambings thanks to a low mortality rate and improved growth, especially during the first month of lactation.

Analysis of Postpartum Blues In Partworld Mothers In The Working Area of The Kedaung Barat Health Center, Tangerang District, 2023

Postpartum Blues is influenced by age, education, parity, type of delivery, physical fatigue, husband's support, and family support. This research aims to determine the factors associated with the incidence of postpartum blues in the Kedaung Barat Health Center Working Area, Tangerang Regency in 2023. This research design uses a cross-sectional quantitative descriptive approach. Research respondents The population in this study was parturient mothers in the West Kedaung Health Center Working Area, Tangerang Regency, in October-December 2023, totaling 183 people. The sampling technique used is proportional sampling. The results of the research showed that the frequency distribution of postpartum blues was 20%, the age of postpartum mothers who were not at risk was 20-35 years, 65.7%, mothers with low education were 77.1%, multiparous mothers were 57.1%, and the type of birth was normal. 82.9%, 61.4% of postpartum mothers experienced physical fatigue, 57.1% of mothers did not receive husband support, and 58.6% of mothers did not receive family support. Postpartum mothers need to know information about postpartum blues so that mothers can prevent or overcome the occurrence of postpartum blues.

Women’s preference for a vaginal birth in Brazilian private hospitals: effects of a quality improvement project

BackgroundIn 2015, a quality improvement project called “Adequate Childbirth Project” (PPA) was implemented in Brazilian private hospitals in order to reduce cesarean sections without clinical indication. The PPA is structured in four components, one of which is directed at women and families. The objective of this study is to evaluate the effects of PPA on women’s preference for vaginal birth (VB) at the end of pregnancy.MethodsEvaluative research conducted in 12 private hospitals participating in the PPA. Interviews were carried out in the immediate postpartum period and medical record data were collected at hospital discharge. The implementation of PPA activities and women’s preference for type of birth at the beginning and end of pregnancy were compared in women assisted in the PPA model of care and in the standard of care model, using a chi-square statistical test. To estimate the effect of PPA on women’s preference for VB at the end of pregnancy, multiple logistic regression was performed with selection of variables using a causal diagram.ResultsFour thousand seven hundred ninety-eight women were interviewed. The implementation of the planned activities of PPA was less than 50%, but were significantly more frequent among women assisted in the PPA model of care. Women in this group also showed a greater preference for VB at the beginning and end of pregnancy. The PPA showed an association with greater preference for VB at the end of pregnancy in primiparous (OR 2.54 95% CI 1.99–3.24) and multiparous women (OR 1.44 95% CI 0.97–2.12), although in multiparous this association was not significant. The main factor associated with the preference for VB at the end of pregnancy was the preference for this type of birth at the beginning of pregnancy, both in primiparous (OR 18.67 95% CI 14.22–24.50) and in multiparous women (OR 53.11 95% CI 37.31–75.60).ConclusionsThe PPA had a positive effect on women’s preference for VB at the end of pregnancy. It is plausible that more intense effects are observed with the expansion of the implementation of the planned activities. Special attention should be given to information on the benefits of VB in early pregnancy.

Gut Microbiota and Symptom Expression and Severity in Neonatal Abstinence Syndrome.

Problem: Neonatal abstinence syndrome (NAS) affecting neonates with fetal exposure to opioids, is defined by expression and severity of symptoms. The pathophysiology behind symptoms variability is lacking. The study aims were to examine (a) differences in gut microbiota of neonates with and without NAS, (b) the relationships between gut microbiota and symptom expression and NAS severity, and (c) the changes in the neonate gut microbiota diversity during the course of NAS treatment. Methods: A cross-sectional observational design was used to examine differences in microbiota and a longitudinal, repeated measures approach was used to determine relationships between gut microbiota and NAS symptoms. Symptom data were collected using the Finnegan Neonatal Abstinence Scoring Tool and the Neonatal Pain Agitation and Sedation Scale. Stool samples were collected for microbiome analyses with 16S rRNA microbiome sequencing. Results: Differences in alpha and beta diversity between neonates with and without NAS were seen. Relative abundance results revealed 18 taxa were different in neonates with NAS compared to neonates without NAS. No differences were found in alpha or beta diversity in neonates with NAS between enrollment and hospital discharge. There was increased abundance of Escherichia-Shigella and Bacteriodes genera related to higher symptom scores. Discussion: Differences in alpha and beta diversity between neonates with and without NAS may be due to differences in birth mode and type of feeding. The findings of specific increased bacteria related to increased symptoms in the neonates with NAS may also be influenced by birth mode and type of feeding.

A new classification allowing assessment of instrumental vaginal-birth practices.

Instrumental vaginal birth, a very common intervention in obstetrics, concerns nearly one in eight women in France. Instrumentally assisted vaginal childbirth can be for maternal and/or fetal indications. Although it reduces recourse to caesarean section, it is subject to risks. Practices concerning instrumental birth are disparate, varying among different practitioners, maternity units and countries, and it is essential to be able to evaluate them. Our objective was to create a classification tool of women requiring instrumental birth to facilitate the analysis of practices within our maternity unit as well as to enable temporal and geographical comparisons. We propose a simple and robust classification based on the same principles as Robson's classification. It is made up of seven totally inclusive and mutually exclusive groups. Our classification was refined and validated using the Delphi method by a panel of 14 experts from throughout France, and tested in our maternity unit using data from throughout 2021. The seven clinically relevant groups are based on five obstetric criteria (multiplicity, presentation, gestational age, previous type of birth, induction of labor). To classify each woman in a group, five successive questions are posed in a predefined order. The classification has been validated by the experts with highly satisfactory overall agreement. In order to improve the quality of care, we propose a tool to standardize the evaluation of instrumental vaginal birth practice (called the "Isère classification", after the county where we work in south-eastern France). It will also facilitate the comparison the practices among different maternity units in a network, a country or even among different countries.

The effect of parity on time to initiate complementary feeding among mother-infant pairs in Awi Zone, Northwest Ethiopia

IntroductionDespite strategies and recommendations for complementary feeding initiation were applied globally, mothers initiated complementary feeding to the infants on time was low. Previous works of literatures were not identified the effect of parity on time to initiate complementary feeding. Particularly, evidences regarding to this in Ethiopia is scanty. Therefore, this study aimed to identify the effect of parity on time to initiate complementary feeding among mother-infants pairs in Northwest Ethiopia.MethodsA community-based prospective cohort study was carried out among 732 primipara, and 1464 multipara mothers who had a live birth in Northwest Ethiopia. Data were collected using Kobo collect software at the start of and on a monthly bases until the end of the follow up period. Parity as exposure variable and other confounders were analyzed using cox proportional hazard regression. Kaplan-Meier survival curve and the Schoenfeld residuals global test (P-value = 0.4861) was performed. Hazard ratio (HR) with 95% confidence intervals (CI) was used to declare statistical significance of predictors.ResultsThe overall incidence rate of initiation of complementary feeding among primipara and multipara mothers were 16.27 (95%CI: 15.04, 17.61) and 13.30 (95%CI: 12.53, 14.12) person months’ observations respectively. The median time to initiate complementary feeding among primipara and multipara mothers for their infants was 5 and 6 months respectively. Primipara mothers had a 30% higher rate to initiate complementary feeding early (AHR = 1.30, 95%CI: 1.17, 1.43). Age from 15 to 24 and 25–34 years (AHR = 1.69, 95%CI: 1.36, 2.09; and AHR = 1.45, 95%CI: 1.17, 1.81) and Birth type (twin) (AHR = 1.29, 95%CI: 1.02, 1.64) were statistically significant predictors for time to initiate complementary feeding.ConclusionsParity was identified as a statistically significant predictor for time to initiate complementary feeding. The incidence rate of early and late initiation of complementary feeding was higher among primipara than multipara mothers. Besides, the median time to initiate complementary feeding was earlier among primipara than multipara mothers. So, a parity based complementary feeding practice education should be advocated to tackle the gap and further reduce infants and children malnutrition. Relatively younger age and twin delivered mothers initiated complementary feeding against the recommendation. Therefore, intervention considering such statistically significant predictors could have a public health importance.

Time to death and its determinants of under-five children in rural Ethiopia by using shared frailty

Under-five (U5M) is one of the most significant and sensitive measures of the community's health. Children who live in rural areas are more likely than those who live in urban areas to die before the age of five. Therefore, the study aimed to assess the Survival status of under-five mortality and its determinants in rural Ethiopia. The 2019 Ethiopia Mini Demographic and Health Survey was used in this study as a secondary source (EMDHS). A total of 4426 weighted under-five children were included in the study. To determine survival time and identify predictors of death among children under the age of five, the Cox's gamma shared frailty model and the Kaplan Meier model, respectively, were used. An adjusted Hazard Ratio (AHR) along with a 95% Confidence Interval (CI) were used to measure the size and direction of the association. The Study showed that in rural Ethiopia, 6.03% of children died before celebrating their first birthday. The median age of under-five mortality in rural Ethiopia was estimated to be 29 Months. The hazard of death among under-five children and those who had given birth to two children in the last five years was 4.99 times less likely to be at risk of dying than those who had given birth to one Child in the previous five years (AHR 4.99, 95% CI 2.97, 8.83). The Study Concluded that under-five mortality remained high in rural Ethiopia. In the final model, the Age of Mothers, Sex of Household, Breastfeeding, Types of Birth, Sex of Child, Educational Level of Mothers, Wealth Index, Child ever born, Marital Status, and Water Source were significant predictors of under-five mortality. Twins and children who are not breastfed should receive additional attention, along with improving water resources for households and mothers income.

Impact of Genital Infections and Antibiotic Use on Incidence of Preterm Birth: A Retrospective Observational Study.

This study investigates the complex interplay among genital infections, antibiotic usage, and preterm birth. This study aims to identify common genital pathogens associated with preterm births, assess the impact of various antibiotic treatments on pregnancy outcomes, and understand antibiotic resistance patterns among these pathogens. This study included 71 pregnant women who experienced preterm birth and 94 women with genital infections who delivered at term. Various maternal characteristics, medical history, signs and symptoms, gestational weight, gestational age, type of birth, vaginal pH, Nugent scores, and vaginal flora were analyzed. Antibiotic resistance patterns of isolated microorganisms were also examined. The prevalence of sexually transmitted diseases (STDs) and genital herpes was significantly higher in the preterm group. Preterm births were associated with fever, pelvic pain, vaginal spotting, and fatigue. Vaginal pH levels and Nugent scores were significantly higher in the preterm group, indicating disturbed vaginal flora. The presence of Extended-Spectrum Beta-Lactamases (ESBLs) was a particularly strong risk factor, increasing by more than four times the odds of preterm birth (OR = 4.45, p = 0.001). Vancomycin-Resistant Enterococci (VRE) presence was another critical factor, with a four-fold increase in the odds of preterm birth (OR = 4.01, p = 0.034). The overall presence of Multidrug-Resistant (MDR) organisms significantly increased the odds of preterm birth (OR = 3.73, p = 0.001). Specific pathogens like Chlamydia trachomatis (OR = 3.12, p = 0.020) and Mycoplasma hominis (OR = 3.64, p = 0.006) were also identified as significant risk factors. Ureaplasma urealyticum also showed a significantly higher risk of preterm birth (OR = 2.76, p = 0.009). This study highlights the importance of screening for and treating genital infections during pregnancy, especially STDs and genital herpes, as they can significantly increase the risk of preterm birth. Additionally, the presence of specific microorganisms and antibiotic resistance patterns plays an essential role in preterm birth risk. Early detection and targeted antibiotic treatment may help mitigate this risk and improve pregnancy outcomes.

Detection of Booroola Polymorphism of Bone Morphogenetic Protein Receptor 1b and Embrapa Polymorphism of Growth Differentiation Factor 9 in Sheep in Thailand.

This study aimed to investigate the appearance and frequencies of the Booroola polymorphism of the bone morphogenetic protein receptor 1b (BMPR1B) gene (FecB) and the Embrapa polymorphism of the growth differentiation factor 9 (GDF9) gene (FecGE) in sheep in Thailand. A total of 454 crossbred sheep blood samples were collected from four provinces in Thailand during August 2022 to July 2023. The polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method was used to identify the FecB and FecGE genotypes. The history of ewe birth types was collected from the owners to analyze the association between fecundity (Fec) genotypes and the history of birth types. The genotypic frequencies of FecB for homozygous genotype (B/B), heterozygous genotype (+/B), and wildtype (+/+) were 0.22%, 1.54%, and 98.24%, respectively. Meanwhile, the genotypic frequencies of FecGE for homozygous genotype (E/E), heterozygous genotype (+/E), and wildtype (+/+) were 0.00%, 2.42%, and 97.58%, respectively. Furthermore, three ewes exhibited both FecB and FecGE genotypes. Fisher's exact test revealed that possession of the FecB genotype was associated with multiple births (p < 0.01). Both FecB and FecGE mutations were identified in crossbred sheep in Thailand. Sheep containing FecB allele could be alternative candidates to be selected to improve the prolificacy of crossbred sheep in Thailand.

Beyond Birth: Pioneering Insights into Colostrum Quality Variation among Bitches with Different Types of Parturition.

This study deals with the immunological quality of canine colostrum in relation to the different parturition modes in bitches. It included four groups of bitches, who underwent vaginal parturition (VP), emergency cesarean section (EM-CS), elective cesarean section (EL-CS), or elective cesarean section with aglepristone injection 24 h prior to surgery (EL-A). Colostrum samples from 40 bitches of 18 breeds were taken immediately after the birth of the first puppy or directly after surgery, and four hours later. The concentrations of immunoglobulin G (IgG) and IgA were measured using ELISA tests. The initial IgG concentration was 18.3 ± 10.2 g/L, and the IgA concentration was 13.7 ± 5.8 g/L, respectively. Significantly lower IgG and IgA concentrations were observed in the EL-CS group compared to other groups. The administration of aglepristone led to an increase in IgG and IgA concentrations. Despite the lower immunoglobulin levels with EL-CS, the survival rate of the puppies was not affected. The study shows that immunoglobulin concentrations in colostrum vary between bitches, with the type of birth significantly influencing the levels. Progesterone withdrawal before birth could play a decisive role in increasing IgG and IgA concentrations in the mammary glands of the bitches.

73 Deworming to improve growth in early-weaned spring born hair sheep lambs

Abstract In lambs, the stress of weaning and the lack of a fully developed immune system can increase susceptibility to gastrointestinal nematodes (GIN). Lack of an effective GIN control strategy around this time can have a significant impact on lamb growth, productivity and mortality. The objective of this study was to determine the influence of deworming at weaning on growth performance in hair sheep lambs. St. Croix (STX) and Barbados Blackbelly (BB) lambs used in the study were born on pasture, weaned at 60.2 ± 0.4 d of age, and transitioned in pens for 87 d post-weaning before turning out to pasture. After accounting for initial FAMACHA eyelid color score, breed, and birth type (single or multiple) at weaning, 54 STX (n = 32) and BB (n = 22) lambs weighing 11.7 ± 0.4 kg were dewormed (DEW) or not (CON) with a combination of levamisol (Prohibit; 8 mg/kg BW) moxidectin (Cydectin; 0.2 mg/kg BW) and albendazole (Valbazen; 7.5 mg/kg BW). To evaluate the effect of deworming treatment, BW and body condition scores (BCS; scale 1-5) were recorded at weaning and at end of transition to pasture. Blood and fecal samples were also collected for determination of packed cell volume (PCV) and fecal egg counts (FEC). Pooled treatment group feces (d 0 – 98) were collected and cultured to determine GIN genera at weaning. Data were analyzed using repeated measures in a mixed model, and FEC were log transformed prior to analysis. There was a mixed population of GIN at weaning averaging 65% and 35% for H. contortus and Tricostrongylus spp. At weaning, BCS, PCV, and FEC were similar between treatment groups and averaged 1.6 ± 0.07, 36.5 ± 0.6%, and 399 ± 54.4 epg, respectively. Combination deworming reduced FEC by 99%. At turnout, DEW lambs (2.3 ± 0.1) tended (P = 0.08) to have greater BCS than CON lambs (2.0 ± 0.1) and PCV was greater (P &amp;lt; 0.001) in DEW versus CON lambs (37.2 ± 0.9 and 33.3 ± 0.8%, respectively). There was also a tendency (P = 0.09) for breed to influence BCS (2.3 ± 0.1 and 2.0 ± 0.1 for BB and STX, respectively). The FEC at turnout was not influenced by treatment or breed (496.7 ± 75.1 epg). Additionally, DEW lambs (131.8 ± 5.2) tended (P = 0.09) to grow faster than CON (119.9 ± 4.7 g/d) lambs, a difference more pronounced in STX DEW (g/d) than STX CON lambs (136 ± 6.1 vs 110 ± 6.5 g/d; P &amp;lt; 0.05). Even though deworming tended to promote faster growth rates in lambs used in this study, alternative, more sustainable, parasite control strategies should be considered in the wake of increasing dewormer resistance.

Genetic parameters for ewe lifetime productivity traits in Central Anatolian Merino sheep

Rapidly increasing population size, recent breaks in production and supply chains, due to pandemics, and those further expected because of climate change emphasize the compelling importance of animal productivity. Traits associated with the productivity of ewes have a direct impact on the overall productivity, profitability and efficiency of sheep farms. Therefore, the objective of the current study was to estimate the variance components, heritabilities as well as genetic and phenotypic correlations, for traits associated with the lifetime productivity of Central Anatolian Merino ewes. Birth and weaning records of lambs for each ewe as well as environmental factors such as sex and birth type were utilized for deriving ewe lifetime productivity traits. Genetic parameter estimations involved observations from 3101 Central Anatolian Merino ewes, encompassing mean and total lamb birth weight per ewe (MBW and TBW), mean and total lamb weaning weight per ewe (MWW and TWW), and the mean and total number of lambs weaned (MNLW and TNLW). This analysis utilized a pedigree comprising 13229 animals. Average Information Restricted Maximum Likelihood (AIREML) based Animal Linear Mixed Model estimations for the decomposition of (co)variance components were implemented based on pedigree-derived numerator relationship matrix by also accounting for the number of parities as a fixed factor. Low to moderate heritability estimates, ranging between 0.29 and 0.42, were observed for the lifetime productivity traits of the breed. A wide range of genetic and phenotypic correlations (between −0.56 and 0.99) was observed among the traits of interest. The outcomes of the study are anticipated to significantly enhance the global sheep production systems by uncovering the essential parameters for incorporating ewe’s lifetime reproductive performance and productivity into the selection indices. This will also benefit Central Anatolian Merino farmers, who form a large proportion of sheep producers in Turkey.

Trends, patterns and predictors of high-risk fertility behaviour among Indian women: evidence from National Family Health Survey.

Numerous studies have demonstrated that high-risk fertility behaviour (HRFB), which includes maternal age below 18 or above 34 years, short birth intervals (less than 24 months), and high parity (birth order above 4), is associated with adverse maternal and child health outcomes. There is a substantial research gap in the domain of high-risk fertility behaviour in the Indian context. Therefore, this study is designed to investigate the current trends and patterns in the prevalence of high-risk births among Indian women, with a primary focus on identifying contributing factors associated with this prevalence. The study utilized data from the nationally representative National Family Health Survey (NFHS), which has been conducted in five rounds since 1992-93. Data from all rounds were used to assess the overall trend. However, data from the most recent round of NFHS, conducted during 2019-21, were employed to evaluate current levels and patterns of HRFB prevalence and to identify socio-economic and demographic predictors of HRFB using binomial and multinomial logistic regression models. The prevalence of HRFB has exhibited a consistent decreasing pattern from 1992 to 93 to 2019-21 in India. However, 29.56% of married women continue to experience high-risk births with notably higher rates in several states (e.g., 49.85% in Meghalaya and 46.41% in Bihar). Furthermore, socio-demographic factors like wealth index, educational level, social group, religion, mass media exposure, family size, age at marriage, type and region of residence, and reproductive factors like birth intention, place and type of delivery, ANC visits and current contraceptive use were identified as significant predictors of high-risk births among women in India. Despite a 20.4 percentage point decline in HRFB prevalence over the past three decades, a significant proportion of women in specific regions and demographic subgroups continue to experience high-risk births. Therefore, the present study recommends interventions aimed at preventing high-risk births among women in India, with particular emphasis on states with high HRFB prevalence and women from socioeconomically disadvantaged backgrounds.

The effect of bubble nasal continuous positive airway pressure application on saliva cortisol levels in full-term neonates

Background Neonates with respiratory distress are commonly treated with bubble nasal continuous positive airway pressure (nCPAP) and undergo many procedures that cause stress-induced pain. Salivary cortisol is a biomarker of alteration in the hypothalamic-pituitary-adrenal axis caused by repeated and long-term exposure to stress.&#x0D; Objective To analyze the effect of bubble nCPAP use on salivary cortisol levels in full-term infants.&#x0D; Methods This study used a one-group pre-test­–post-test design to compare salivary cortisol levels before and 30 minutes after bubble nCPAP application. Salivary cortisol was measured using an ELISA method. Pain was also assessed at the same time points using the Neonatal Infant Pain Scale (NIPS) score. We included infants of 37 0/7 to 42 6/7 weeks’ gestational age with respiratory distress necessitating bubble nCPAP application. Infants with birth weight of &lt;2,500 grams, major congenital anomalies, an APGAR score of &lt;5 at 5 minutes, shock, and infants who had undergone surgery were excluded.&#x0D; Results A total of 38 subjects participated in this study. Prior to bubble nCPAP application, median cortisol levels were significantly lower (1.65 ng/mL) than after bubble nCPAP application (6.8 ng/mL) (p value?). There were no significant differences in cortisol increase based on gender, type of birth, or salivary cortisol sampling time. There were significant differences in pain level after the 30-minute nCPAP application.&#x0D; Conclusion An increase in cortisol levels and pain scale scores during administration of bubble nCPAP indicates a pain response in full-term neonates; therefore, this procedure should be accompanied by pain or stress management.

Influence of the Physical Environment on Maternal Care for Culturally Diverse Women: A Narrative Review.

This narrative literature review aims to develop a framework that can be used to understand, study, and design maternal care environments that support the needs of women from diverse racial and ethnic groups. Childbirth and the beginning of life hold particular significance across many cultures. People's cultural orientation and experiences influence their preferences within healthcare settings. Research suggests that culturally sensitive care can help improve the experiences and outcomes and reduce maternal health disparities for women from diverse cultures. At the same time, the physical environment of the birth setting influences the birthing experience and maternal outcomes such as the progression of labor, the use of interventions, and the type of birth. The review synthesizes articles from three categories: (a) physical environment of birthing facilities, (b) physical environment and culturally sensitive care, and (c) physical environment and culturally sensitive birthing facilities. Fifty-five articles were identified as relevant to this review. The critical environmental design features identified in these articles were categorized into different spatial scales: community, facility, and room levels. Most studies focus on maternal or culturally sensitive care settings outside the United States. Since the maternal care environment is an important aspect of their culturally sensitive care experience, further studies exploring the needs and perspectives of racially and ethnically diverse women within maternal care settings in the United States are necessary. Such research can help future healthcare designers contribute toward addressing the ongoing maternal health crisis within the country.

The association between cesarean birth and breastfeeding initiation in Odisha, India: A mother fixed effects analysis.

Cesarean births are becoming more common in India, with health implications for both mothers and infants. Between 2005 and 2015, the proportion of cesarean births to total births in India roughly doubled, from 9% to 17%. We analyze Annual Health Survey data from the state of Odisha in eastern India. These population-level, longitudinal data on births between 2007 and 2011 allows us to estimate the association between cesarean birth and breastfeeding outcomes using mother fixed effects. Mother fixed effects allow comparisons of siblings born to the same mother who experienced different types of births (vaginal and cesarean). This empirical strategy controls for many potential observable and unobservable confounders in the relationship. Ordinary Least Squares linear probability models without mother fixed effects find that babies born by cesarean in Odisha are about 14 percentage points (p<0.001) more likely to experience delayed initiation of breastfeeding (that is, not being breastfed in the first 24 hours) compared with babies born vaginally. After introducing mother fixed effects, we find that babies born by cesarean are 11 percentage points more likely to (p<0.001) experience delayed initiation of breastfeeding. Because breastfeeding success is important for protecting against infectious disease in this context, future research should investigate whether cesarean birth impacts other aspects of breastfeeding as well.

Impact of Cesarean Delivery on Childhood Neurocognitive Development

Starting from the words of Victor Marin - "the end is a bad beginning", this narrative review aims to draw attention to the impact played by the perinatal period on the balance and subsequent evolution of the child at the beginning of the journey. The medical literature of the last decade is strongly developed regarding the homeostatic imbalances induced by the type of delivery of the fetus on it. Among these we briefly state intestinal or pulmonary dysbiosis, entities frequently incriminated in escalating the predisposition towards the development of atopy, autoimmune, cardio-vascular, gastrointestinal, metabolic, renal or neurological diseases. Neurocognitive integrity is defined by its importance both in terms of the child's optimal transition to adolescence and later to adult life, as well as in its psycho-social integration. We will therefore develop in the following current considerations regarding the development of the neurological system, emphasizing its variability depending on the type of birth. The desired practical purpose is to raise awareness of the unwanted effects of cesarean section, to discourage its choice when medical considerations are not in question and thus to reduce the burden induced by neurological disorders both on the patient and the family, as well as on the global medical system.

Gut bacterial markers involved in association of dietary inflammatory index with visceral adiposity

ObjectiveTo deepen the understanding of the influence of diet on weight gain and metabolic disturbances, we examined associations between diet-related inflammation and body composition and fecal bacteria abundances in participants of the Nutritionists’ Health Study. MethodsEarly-life, dietary and clinical data were obtained from 114 women aged ≤45 years. A validated food frequency questionnaire was used to calculate the energy-adjusted dietary inflammatory index (E-DII). Participants’ data were compared by E-DII quartiles using ANOVA or Kruskal-Wallis. Associations of DXA-determined body composition with the E-DII were tested by multiple linear regression using DAG-oriented adjustments. Fecal microbiota was analyzed targeting the V4 region of the 16S rRNA gene. Spearman correlation coefficients were used to test linear associations; differential abundance of genera across the E-DII quartiles was assessed by pair-wise comparisons. ResultsE-DII score was associated with total fat (b=1.80, p<0.001), FMI (b=0.08, p<0.001) and visceral fat (b=1.19, p=0.02), independently of maternal BMI, birth type and breastfeeding. E-DII score was directly correlated to HOMA-IR (r=0.30; p=0.004), C-reactive protein (r=0.29; p=0.003) and to the abundance of Actinomyces, and inversely correlated to the abundance of Eubacterium.xylanophilum.group. Actinomyces were significantly more abundant in the highest (most proinflammatory) E-DII quartile. ConclusionsAssociation of E-DII with markers of insulin resistance, inflammation, body adiposity and certain gut bacteria are consistent with beneficial effects of anti-inflammatory diet on body composition and metabolic profile. Bacterial markers, such as Actinomyces, could be involved in the association between the dietary inflammation with visceral adiposity. Studies designed to explore how a pro-inflammatory diet affects both central fat deposition and gut microbiota are needed.

A Higher Maternal Education Level Could Be a Critical Factor in the Exceeded Cesarean Section Delivery in Indonesia.

Cesarean section (CS) could be life-saving with medically indicated, but without it, both women and children could be at risk. The maximum rate for CS is 15%, but it tends to exceed globally. We aimed to analyze the education level's role in the delivery of CS in Indonesia. We used the 2017 Indonesia Demographic and Health Survey data. The study sampled 15,357 women who delivered in five last years. Besides delivery mode and education level, the study also used nine control variables: residence, age, marital, employment, parity, wealth, insurance, antenatal care, and birth type. The study employed a binary logistics regression. The results show women with secondary education (16.5% CS) are 2.174 times (AOR 2.174; 95% CI 1.095-4.316), and higher education (33% CS) are 3.241 (AOR 3.241; 95% CI 1.624-6.469) times more likely to deliver by CS than no-school education (4.4% CS). There was no significant difference between primary (9.1%) and no-education women. Apart from education, primiparous women, age 34-34 yr, attending antenatal care ≥4 times, non-poorest, having insurance, living in the city, and being unemployed also related to higher risk of CS. Exceeded CS in Indonesia occurs mostly in higher education women. Higher education women were more likely to access more information and technology, therefore health promotion on healthy normal birth on social media or m-Health (mobile device-based health promotion) and involving health authorities at every level were suitable to reduce the overuse of the CS.

Birth Outcomes of Twin’s Pregnancy and Associated Factors in Selected Public Hospitals of Addis Ababa, Ethiopia, 2022

Background: Twin birth is a type of multiple births when the mother gives birth to two offspring from the same pregnancy. The prevalence rates range from less than 8 twin pregnancies per 1,000 births in the East and Southern Asia, India, and Oceania to 17 or more per 1,000 births in Africa. There are factors to increase the negative birth outcome of twin delivery; from these, some of them are associated with increased maternal age, prim parity, low birth weight, chronic disease, low ANC follow-up, and PROM. Adverse birth outcome for twin delivery is a critical health issue in developing countries such as Ethiopia. It resulted in many bad consequences, neonatal and infant morbidity and mortality. Objective: The objective of this study was to assess birth out come and associated factors of twin’s pregnancy in selected public Hospitals, Addis Ababa, Ethiopia. Methods: Facility based cross sectional study was conducted on 246 maternal records of twin delivery in selected public hospitals of Addis Ababa to assess birth out come and associated factors of twin’s pregnancy from December, 2020-June, 2021.A pretested questionnaire which will be analyzed by SPSS and result will be reported in tables, bivariate and multivariate regression will be done to show correlations by Crude and adjusted odds ratio. A confidence limit of 95% and p- value less than 0.05 will be used as cut of point to see presence of statistical significance. Result: The prevalence of adverse birth outcome (Both maternal and fetal) among twin delivery in the three selected public hospitals of Addis Ababa is 234 (95%). majority, 156(63.4%) were in the age group 18-28 years, with the mean age of 29.78 and Standard deviation of±6.53.Most of the mothers 227(92%) were married. Mothers who had Pregnancy induced hypertension (AOR= 10.465, 95% CI (2.922-37.474)), Mothers who had ruptured membrane before the onset of Labor (AOR= 3.577, 95% CI (1.198-10.682)) and Mothers who labor for more than 12 hours were (AOR= 3.324, 95% CI (1.101-10.034)) were significantly associated with adverse maternal birth outcome. While mothers who had ANC follow up at private clinic (AOR= 0.252, 95% CI (0.098-0.649)) and Mothers who live outside Addis Ababa were unlikely to have adverse fetal outcome (AOR= 0.343, 95% CI (0.143-0.826)). Conclusion: Adverse birth outcome of Twins pregnancy is relatively higher when compared to similar studies conducted in Ethiopia. The Health facilities should have effective risk assessment in Antenatal care unit and labor ward. It is also recommended to have guidelines and protocols for the management of twin’s pregnancy. Since the Prevalence of Adverse twin’s Birth outcome is higher greater attention should be given on both Antepartum and Intrapartum care.