Introduction Low birth weight (LBW) is a well-known contributing factor to neonatal health, emphasizing the importance of maternal health and socio-economic conditions. The birth weight of a newborn is a major public health problem, which is more common in low-middle-income countries (LMICs). Objective The objective of this study is to assess the association of different socio-economic and maternal factors with LBW babies in Lahore. Methods This case-control study was carried out at the Obstetrics and Gynecological Department in Mayo Hospital, Lahore, Pakistan from September 25, 2023 to December 31, 2023. A total of 186 mothers who delivered in the maternity ward, categorized into two groups (93 cases and 93 controls), were included and data was collected with the help of a self-administered structured tool. A chi-square test was used to identify maternal risk factors significant for LBW babies. The strength of association between maternal risk factors and LBW babies was presented using the odds ratio (OR) with the respective 95% confidence interval (CI). Results The study revealed that maternal anemia [OR: 3.378, 95% CI: 1.568, 7.275] and inadequate nutritional status [OR: 1.031, 95% CI: 0.014, 0.071] were more likely to cause delivery of LBW babies. Regarding socio-demographic factors, household income < 25000 [OR: 5.185, 95% CI: 2.770, 9.707] and illiterate mothers [OR: 3.325, 95% CI: 1.820, 6.074] were associated with increased likelihood of LBW babies. Maternal age < 20 had a strong association [OR: 10.920, 95% CI: 2.455,48.575] with delivery of LBW children.  Conclusion The study concludes that multiple risk factors including anemia, inadequate nutritional status, household income < 25000, illiterate mother, and maternal age < 20 are strongly associated with LBW babies. It is apparent that a multimodal strategy is necessary to reduce the risk of LBW babies.

UNASSIGNED: The etiology and risk factors of congenital vertebral anomalies are mainly unclear in isolated cases. Also, there are no reports on the risk factors for different subgroups of vertebral anomalies. Therefore, we assessed and identified potential maternal risk factors for these anomalies and hypothesized that diabetes, other chronic diseases, smoking, obesity, and medication in early pregnancy would increase the risk of congenital vertebral anomalies.
UNASSIGNED: All cases with congenital vertebral anomalies were identified in the Finnish Register of Congenital Malformations from 1997 to 2016 for this nationwide register-based case-control study. Five matched controls without vertebral malformations were randomly selected. Analyzed maternal risk factors included maternal age, body mass index, parity, smoking, history of miscarriages, chronic diseases, and prescription drug purchases in early pregnancy.
UNASSIGNED: The register search identified 256 cases with congenital vertebral malformations. After excluding 66 syndromic cases, 190 non-syndromic malformations (74 formation defects, 4 segmentation defects, and 112 mixed anomalies) were included in the study. Maternal smoking was a significant risk factor for formation defects (adjusted odds ratio 2.33, 95% confidence interval 1.21-4.47). Also, pregestational diabetes (adjusted odds ratio 8.53, 95% confidence interval 2.33-31.20) and rheumatoid arthritis (adjusted odds ratio 13.19, 95% confidence interval 1.31-132.95) were associated with mixed vertebral anomalies.
UNASSIGNED: Maternal pregestational diabetes and rheumatoid arthritis were associated with an increased risk of mixed vertebral anomalies. Maternal smoking increases the risk of formation defects and represents an avoidable risk factor for congenital scoliosis.
UNASSIGNED: III.

BACKGROUND: Cordocentesis is used in clinical situations in which lower-risk diagnostic procedures do not deliver the desired results. The aim of this study was to evaluate the risk for procedure-related complications and fetal loss in correlation to maternal risk factors.
METHODS: This is a multicenter retrospective study investigating the complications, risk factors and perinatal outcome of diagnostic cordocentesis between 1998 and 2019 in three different centers.
RESULTS: A total of 1806 cordocenteses were performed and procedure-related complications (IUFD within 48 h, contractions, bradycardia, unsuccessful puncture, chorioamniotic separation) were noted in 1.6% of cases. Fetuses with chromosomal aberrations, intrauterine growth restriction and hydropic fetuses had a significantly higher rate of fetal loss compared to other indications. Fetal blood sampling (FBS) performed before 17+0 weeks of gestation was associated with a higher risk of procedure-related complications. Maternal BMI ≥ 40 increased the risk for fetal loss, whereas maternal age, number of previous miscarriages, number of previous abortions, history of vaginal bleeding or nicotine abuse did not affect the risk for complications or overall fetal loss rate.
CONCLUSIONS: In the hands of experienced operators, FBS is a safe way to further fetal diagnostics, and the risk of complications is low.

In the last few years, there has been a gradually increasing rate of caesarean section deliveries worldwide that negatively affects both mothers\' and children\'s health. The present survey intended to explore the relations of common maternal risk factors with the prevalence of caesarean sections. This is a cross-sectional study including 5182 healthy mothers from geographically diverse regions of Greece, which has applied relevant inclusion and exclusion criteria. An elevated 56.4% incidence of caesarean sections was noted. The prevalence of caesarean section deliveries was estimated to be 51.5% in private hospitals and 48.5% in public hospitals. Maternal age, pre-pregnancy overweight/obesity, excess gestational weight gain, preterm birth, financial status, smoking habits, and private type of birth hospital were considerably associated with a high probability of caesarean section, regardless of several confounders. In conclusion, caesarean section rates are constantly increasing, and various maternal risk factors additively elevate its incidence, which additionally enhances the likelihood of postpartum complications for both the mothers and their infants. Public health procedures and approaches are strongly recommended to notify future mothers of the potential risk factors that may result in adverse pregnancy outcomes of caesarean section delivery, highlighting its use only for emergency medical reasons and also promoting healthier nutritional and lifestyle habits that may reduce the increasing prevalence of caesarean section deliveries.

Background Low birth weight (LBW) is at the forefront of 100 core health issues that are used as indicators to assess the global nutrition monitoring framework as reported by the World Health Organization (WHO). Several factors could contribute to LBW, which essentially include intrauterine growth retardation and premature delivery/birth. Moreover, LBW predisposes neonates to several developmental disturbances including both physical and mental disorders. Given that LBW is more common in poor and developing countries, there is not much reliable data that could be used to formulate strategies for controlling this problem. This study, therefore, attempts to assess the prevalence of LBW among newborn babies and its associated maternal risk factors. Methods This hospital-based cross-sectional study was carried out between June 2016 and May 2017 (one year) and included 327 LBW babies. A predefined and prevalidated questionnaire was used to obtain data for the study. The data collected included age, religion, parity, birth spacing, pre-pregnancy weight, weight gain during pregnancy, height, mother\'s education, occupation, family income, socioeconomic status, obstetric history, previous history of stillbirths and abortions, and history of any LBW baby. Results The prevalence of LBW was noted to be 36.33%. The occurrence of LBW babies was predominant among mothers who were aged <19 years (62.26%) and >35 years (57.14%). Grand multipara women showed the highest rates (53.70%) of LBW babies. Additionally, LBW was predominantly noticed among newborns (46.66%) with a birth spacing of <18 months, those born to mothers with pre-pregnancy weight of <40 Kg (94.04%), mothers with a height of <145 cm (83.46%), mothers who gained <7 kg during the pregnancy (82.20%), illiterate mothers (43.75%), and mothers who were agricultural workers (63.76%). Other maternal factors that could predispose to LBW included lower monthly income (66.25%), low socioeconomic status (52.90%), less number of antenatal visits (59.65%), low blood hemoglobin (100%), history of strenuous physical activities (48.66%), smoking and/or tobacco chewing habit (91.42%), alcoholism (66.66%), lack of iron and folic acid supplementation during pregnancy (64.58%), history of stillbirths (51.51%), and mothers suffering from chronic hypertension, preeclampsia, and eclampsia (47.61%), and tuberculosis (75%). Religion-wise, Muslim mothers revealed the highest prevalence (48.57%) of LBW, followed by Hindus (37.71%) and Christians (20%). The mother\'s age, pre-pregnancy weight, weight gain during pregnancy, height of the mother, hemoglobin concentration, weight of the baby, and length of the newborn (p≤0.05) could influence the health of the newborn. However, maternal infections, previous bad obstetrics history, presence of systemic illnesses, and protein and calorie supplementation (p≥0.05) had no significant impact on birth weight. Conclusions The results showed that multiple factors are responsible for LBW. Maternal factors such as weight, height, age, parity, weight gained during pregnancy, and anemia during pregnancy could predispose to delivering LBW babies. Additionally, other risk factors for LBW identified in this study were the literacy level of mothers, occupation, family income, socioeconomic status, antenatal care, strenuous physical activity during pregnancy, smoking/tobacco chewing, alcohol/toddy consumption, and iron and folic acid supplementation during pregnancy.

Preeclampsia is one of the most worrisome complications during pregnancy, affecting approximately 1 out of 20 women worldwide. Preeclampsia is mainly characterized by a sustained hypertension, proteinuria, also involving a significant organ dysfunction. Moreover, 25% of the cases could be classified as severe preeclampsia (SP), a serious condition that could be life-threatening for both the mother and fetus. Although there are many studies focusing on preeclampsia, less efforts have been made in SP, frequently limited to some specific situations. Thus, the present study aims to conduct a comparative analysis of risk factors, maternal characteristics, obstetric and neonatal outcomes and maternal complications in patients with severe preeclampsia versus patients without severe preeclampsia. Hence, 235 cases and 470 controls were evaluated and followed in our study. We described a set of variables related to the development of severe preeclampsia, including maternal age > 35 years (69.8%), gestational (26.8%) or chronic arterial hypertension (18.3%), obesity (22.6%), use of assisted reproduction techniques (12.3%), prior history of preeclampsia (10.2%) and chronic kidney disease (7.7%) All patients had severe hypertension (>160 mmHg) and some of them presented with additional complications, such as acute renal failure (51 cases), HELLP syndrome (22 cases), eclampsia (9 cases) and acute cerebrovascular accidents (3 cases). No case of maternal death was recorded, although the SP group had a higher cesarean section rate than the control group (60% vs. 20.9%) (p < 0.001), and there was a notably higher perinatal morbidity and mortality in these patients, who had a prematurity rate of 58.3% (p < 0.001) and 14 perinatal deaths, compared to 1 in the control group. Overall, our study recognized a series of factors related to the development of SP and related complications, which may be of great aid for improving the clinical management of this condition.

BACKGROUND: Neonatal respiratory distress syndrome (NRDS) is strongly associated with premature birth, but it can also affect term neonates. Unlike the extent of research in preterm neonates, risk factors associated with incidence and severity of NRDS in term neonates are not well studied. In this study, we examined the association of maternal and neonatal risk factors with the incidence and severity of NRDS in term neonates admitted to Neonatal Intensive Care Unit (NICU) in Cyprus.
METHODS: In a prospective, case-control design we recruited term neonates with NRDS and non-NRDS admitted to the NICU of Archbishop Makarios III hospital, the only neonatal tertiary centre in Cyprus, between April 2017-October 2018. Clinical data were obtained from patients\' files. We used univariate and multivariate logistic and linear regression models to analyse binary and continuous outcomes respectively.
RESULTS: During the 18-month study period, 134 term neonates admitted to NICU were recruited, 55 (41%) with NRDS diagnosis and 79 with non-NRDS as controls. In multivariate adjusted analysis, male gender (OR: 4.35, 95% CI: 1.03-18.39, p = 0.045) and elective caesarean section (OR: 11.92, 95% CI: 1.80-78.95, p = 0.01) were identified as independent predictors of NRDS. Among neonates with NRDS, early-onset infection tended to be associated with increased administration of surfactant (β:0.75, 95% CI: - 0.02-1.52, p = 0.055). Incidence of pulmonary hypertension or systemic hypotension were associated with longer duration of parenteral nutrition (pulmonary hypertension: 11Vs 5 days, p < 0.001, systemic hypotension: 7 Vs 4 days, p = 0.01) and higher rate of blood transfusion (pulmonary hypertension: 100% Vs 67%, p = 0.045, systemic hypotension: 85% Vs 55%, p = 0.013).
CONCLUSIONS: This study highlights the role of elective caesarean section and male gender as independent risk factors for NRDS in term neonates. Certain therapeutic interventions are associated with complications during the course of disease. These findings can inform the development of evidence-based recommendations for improved perinatal care.

BACKGROUND: Survival of newborns and long term complications are highly correlated with birth weight. The low birth weight rate is an indicator of a public health problem that includes long-term maternal malnutrition, ill health, and poor health care at population level during pregnancy. On an individual basis, low birth weight is an important predictor of newborn health and survival. We aimed to assess the magnitude of low birth weight and its associated factors among women who delivered in Debre Tabor Hospital (DTH), Amhara, Ethiopia.
METHODS: Facility based cross sectional study was employed on 282 mothers who delivered in DTH from December 2018 to March 2019. Single population proportion formula was used to calculate sample size. Data entry was completed in a template prepared in EpiData version 3.1 and analyzed by Statistical Package for Social Sciences (SPSS) version 20. Descriptive statistics were performed to describe the characteristics of the study participants. Crude and adjusted odds ratio with 95% confidence interval were used to identify the significance of association. A p value of < 0.05 was used to decide the significance of the association.
RESULTS: Of a total 282 interviewed mothers who delivered in DTH 12.0% (95%, CI: (8.5, 15.2%)) delivered low birth weight baby. Place of residence (AOR = 0.32, 95%, CI: (0.12, 0.85)), gravidity (AOR = 0.17, 95%, CI: (0.03, 0.97)), status of pregnancy (AOR = 0.29, 95%, CI: (0.09, 0.92)), and hemoglobin levels (AOR = 9.82, 95%, CI: (1.83, 52.73)) were found to be the significant predictors of low birth weight in this study.
CONCLUSIONS: Place of residence, status of pregnancy, gravidity, and level of hemoglobin were found to be statistically significant with low birth weight. Women who lived in urban areas, who had planned pregnancy, and gravida of < 5 had lower risk of giving low birth weight baby. Whereas, women who had hemoglobin level of < 11 mg/dl were more likely to deliver low birth weight baby. Being a multi-factorial problem, integrated and holistic approach shall be followed to reduce the prevalence, morbidity and mortality related to low birth weight.

BACKGROUND: Prematurity and low birth weight are significant predictors of perinatal morbidity and mortality and are influenced by the overall health and socioeconomic status of the pregnant mother. Although Cyprus is characterized by the highest prematurity rate in Europe (13.1% in 2014), the relationship between maternal health and socioeconomic characteristics with prematurity and low birth weight has never been investigated. We aimed to investigate the association of maternal demographic, clinical and socioeconomic characteristics with premature delivery and low neonatal birth weight in Cyprus.
METHODS: In a case-control design, questionnaire data were collected from 348 women who gave birth prematurely (cases) and 349 women who gave birth at term (controls). Information was obtained on gestation duration and birth weight as well as maternal demographic, socioeconomic and clinical profiles, including parameters such as smoking, body mass index, alcohol consumption, presence of gestational diabetes and mental health factors.
RESULTS: Premature delivery was associated with greater maternal age (OR: 1.12, 95% CI: 1.06-1.18), absence of gestational diabetes (OR: 0.53, 95% CI: 0.30-0.97), long working hours (OR: 3.77, 95% CI: 2.08-6.84) and emotional stress (OR: 8.5, 95% CI: 3.03-23.89). Within the cases group, emotional stress was also associated with lower birth-weight (β: -323.68 (95% CI: -570.36, - 77.00).
CONCLUSIONS: The findings of this study demonstrate the positive association of maternal psychological factors, working conditions as well as maternal age with prematurity and low birth weight in Cyprus. Additional, prospective, studies are needed in the country to further investigate these associations and inform public health intervention measures.

The objective of this study is to determine which maternal events and diagnoses in the two years before childbirth are associated with higher risk for having a first child taken into care at birth by child protection services. A population-based retrospective cohort of women whose first child was born in Manitoba, Canada between 2002 and 2012 and lived in the province at least two years before the birth of their first child (n=53,565) was created using linkable administrative data. A logistic regression model determined the adjusted odds ratios (AOR) of having a child taken into care at birth. Characteristics having the strongest association with a woman\'s first child being taken into care at birth were mother being in care at the birth of her child (AOR=11.10; 95% CI=8.38-14.71), substance abuse (AOR=8.94; 95% CI=5.08-15.71), schizophrenia (AOR=6.69; 95% CI=3.89-11.52) developmental disability (AOR=6.45; 95% CI=2.69-14.29), and no prenatal care (AOR=5.47; 95% CI=3.56-8.41). Most characteristics of women deemed to be at high risk for having their child taken into care at birth are modifiable or could be mitigated with appropriate services.