UNASSIGNED: Previous studies have linked exposure to concentrated animal feeding operations (CAFOs) with various health outcomes. However, relatively few studies evaluated the impacts of CAFOs on adverse birth outcomes, despite significant public health concerns regarding maternal and child health.
UNASSIGNED: This cross-sectional study investigated the risk of adverse birth outcomes associated with CAFOs exposure and evaluated disparities in exposure to CAFOs and associated health outcomes.
UNASSIGNED: We obtained individual-level birth records from 2003 to 2020 from the Pennsylvania Department of Health. We considered two adverse birth outcomes: (1) preterm birth (PTB); and (2) low birth weight (LBW). Exposure was considered as a binary indicator (presence or absence of CAFO) and as categories based on level of exposure. Logistic regression was applied to estimate the association between CAFOs exposure and adverse birth outcomes. Models were adjusted for infant\'s sex, maternal demographics (age, race/ethnicity, education), prenatal BMI, prenatal care, smoking status, marital status, plurality, WIC status, and urban/rural indicator. We examined both disparities in exposure and in health response.
UNASSIGNED: Presence of CAFOs was associated with higher risk of PTB, with an increasing trend with higher levels of CAFOs exposure. Compared to the no CAFO exposure group, the odds ratios for PTB were 1.022 (95 % confidence interval 1.003, 1.043), 1.066 (1.034, 1.100), 1.069 (1.042, 1.097) for low, medium, and high CAFOs exposure groups, respectively. Some maternal characteristics were associated with a higher CAFO-related risk of PTB. Similar associations were observed for LBW for some characteristics such as mother\'s race/ethnicity, education, WIC status, and urbanicity, although some findings were not statistically significant.
UNASSIGNED: Our findings suggest that presence of CAFOs increases risk of preterm birth. Our results indicate that some maternal characteristics may be associated with higher risk of CAFO-related PTB or LBW. This study can inform future research on disparities in CAFO exposure and associated health burden.

UNASSIGNED: Due to the incomplete standardization of the etiology and diagnostic criteria for fetal growth restriction (FGR), there has been uncertainty in the early prediction of FGR. The comprehensive estimation of FGR was mainly based on various factors, such as maternal characteristics and medical history, nuchal translucency (NT), and serum biochemical markers [pregnancy-associated plasma protein-A (PAPP-A) and free beta human chorionic gonadotropin (free β-hCG)]. Herein, we performed a retrospective cohort study to investigate the correlation and diagnostic value of maternal markers such as PAPP-A, free β-hCG, and NT in the first trimester with maternal characteristics, so as to provide theoretical basis for perinatal care and the application of low-dose aspirin.
UNASSIGNED: A retrospective cohort study was conducted to analyze the data of an FGR group and a non-FGR group. Chi-square test and Mann-Whitney U test were used for univariate analysis of qualitative or quantitative data, respectively. Modified Poisson regression calculated the relative risk (RR) and 95% confidence interval (CI) of perinatal variables; P<0.05 was considered statistically significant.
UNASSIGNED: The multiple of median (MoM) of PAPP-A level and NT in the FGR group were lower than those of the non-FGR group [0.63 (0.12-2.08) vs. 1.01 (0.28-2.41) MoM, 1.30 (0.80-2.07) vs. 1.40 (0.80-2.20) cm, P<0.05]. The weight, score, and length of newborns in the FGR group were lower than those in the non-FGR group (all P<0.001). Modified Poisson regression analysis showed that gestational hypertension (GH) [RR =1.836 (95% CI: 1.188-2.836)], oligohydramnios [1.420 (95% CI: 1.022-1.973)], premature rupture of membranes (PROM) [0.641 (95% CI: 0.425-0.969)], female infant [1.539 (95% CI: 1.098-2.157)], low infant length [5.700 (95% CI: 3.416-9.509)], low birth weight [1.609 (95% CI: 1.012-2.559), and increased PAPP-A MoM [0.533 (95% CI: 0.369-0.769)] were associated with FGR. The cut-off value of PAPP-A + free β-hCG + NT for predicting FGR was 0.190, with a sensitivity of 0.547 and a specificity of 0.778.
UNASSIGNED: Early screening markers combined with perinatal characteristics have better diagnostic value in predicting FGR and provide a scientific basis for the clinical use of low-dose aspirin to prevent FGR.

暂无摘要。

BACKGROUND: The prevalence of low-birthweight infants is increasing in Indonesia. A low birth weight can have a negative effect on a child\'s development. Understanding the factors influencing low birth weight may enable preventative actions.
OBJECTIVE: To analyse the determinant factors of low-birthweight infants in frontier, outermost and underdeveloped regions in Indonesia.
METHODS: A cross-sectional study was conducted using a secondary dataset from the Indonesian National Socioeconomic Survey, 2019-2021. The sample included 27,678 inhabitants aged 16-64 years. The Indonesian regions of Nusa Tenggara Timur, Nusa Tenggara Barat, Sulawesi Tengah, Sulawesi Tenggara, Gorontalo, Maluku, Maluku Utara, Papua and Papua Barat were included. A multilevel logistic regression was conducted to determine the relationship between variables. p < 0.05 was considered to indicate significance in the fixed-effects model findings.
RESULTS: Women who lived in a rural area [OR 1.176, 95 % confidence interval (CI) 0.088-0.235] and had never used contraception (OR 1.227, 95 % CI 0.096-0.313) were more likely to have low-birthweight infants. In contrast, water resources, social assistance/welfare, maternal age and gross domestic product per capita had no significant effect on the prevalence of low-birthweight infants.
CONCLUSIONS: Living in a rural area and lifetime non-use of contraception were found to be significant risk factors for low birth weight in frontier, outermost and underdeveloped regions in Indonesia. Increasing health facilities in rural areas and establishing programmes on the use of contraception may be positive strategies to reduce the prevalence of low-birthweight infants.

BACKGROUND: Infant survival is an important factor in any community\'s health. Low birth weight affects babies not only during their infancy but also has long-term consequences for their health as adults. Unfortunately, Sub-Saharan Africa as a region is still dealing with the burden of Low birth weight (LBW), and Tanzania as a part of this region is no exception. So this study aimed to determine the Magnitude of Low Birth Weight and Its Associated Maternal Factors among Women of Reproductive Age who gave birth to live babies.
METHODS: The study used analytical cross-sectional study design to analyze secondary data from the Tanzania Demographic and Health Survey and Malaria Indicators Survey 2015-2016. A total of 4,644 women of reproductive age who gave birth to live babies within five years preceding the survey were included in the study. Both bivariate and multivariable logistics regression analyses were used to assess maternal factors associated with low birth weight.
RESULTS: The prevalence of LBW was 262(6.2%). After adjusting for confounders, the maternal factors associated with LBW were Age group of a pregnant woman [Less than 20 years (aOR = 1.907 CI = 1.134-3.205) in reference to those aged more than 34years], Number of ANC visits made [Inadequate visits (aOR = 1.612 CI = 1.266-2.05)], parity [para 2-4 (aOR = 0.609 CI = 0.453-0.818), para 5+ (aOR = 0.612 CI = 0.397-0.944)] and area of residence [Unguja (aOR = 1.981 CI = 1.367-2.87).
CONCLUSIONS: The prevalence of low birth weight in Tanzania remains high. Women\'s age, parity, number of Antenatal care visits (ANC), and area of residence were found to be maternal factors associated with LBW. Thus, early prenatal diagnosis of risk factors for low birth weight in high-risk pregnant women may help to reduce the LBW burden in Tanzania and its detrimental effects.

UNASSIGNED: The high neonatal mortality rate in low- and middle-income countries (LMICs) such as Nigeria has lasted for more than 30 years to date with associated nursing fatigue. Despite prominent hard work, technological improvements, and many publications released from the country since 1990, the problem has persisted, perhaps due to a lack of intervention scale-up. Could there be neglected discoveries unwittingly abandoned by Nigerian policymakers over the years, perhaps locked up in previous publications? A careful review may reveal these insights to alert policymakers, inspire researchers, and refocus in-country research efforts towards impactful directions for improving neonatal survival rates. The focus was to determine the prevailed effectiveness of LMIC medical academia in creating solutions to end the high neonatal mortality rate.
UNASSIGNED: An unconventional systematic review protocol structure following the PRISMA 2020 checklist was designed and registered at INPLASY (registration number: INPLASY202380096, doi: 10.37766/inplasy2023.8.0096). A jury of paediatricians was assembled and observed by a team of legal professionals. The jury searched the literature from 1990 to the end of 2022, extracted newborn-related articles about Nigeria, and assessed and debated them against expected criteria for solution creation, translation, scale-up, sustainability, and national coverage. Each juror used preset criteria to produce a verdict on the possibility of a published novel idea being a potential game-changer for improving the survival rate of Nigerian neonates.
UNASSIGNED: A summation of the results showed that 19 out of 4,286 publications were assessed to possess potential strategies or interventions to reduce neonatal mortality. Fourteen were fully developed but not appropriately scaled up across the country, hence denying neonates proper access to these interventions.
UNASSIGNED: Nigeria may already have the required game-changing ideas to strategically scale up across the nation to accelerate neonatal survival. Therefore, LMIC healthcare systems may have to look inward to strengthen what they already possess.
UNASSIGNED: https://inplasy.com/, identifier (INPLASY202380096).

UNASSIGNED: Malnourished pregnant women are at increased risk of micronutrient deficiency. We assessed the vitamin B12 status in both malnourished and normally nourished pregnant women and their neonates. Additionally, we studied the association between maternal B12 levels, cord B12 levels and neonatal anthropometry.
UNASSIGNED: This cross-sectional study enrolled 63 malnourished and 63 normally nourished mothers and neonates. Maternal and cord blood samples were collected at the time of delivery for estimation of vitamin B12 levels. Maternal and cord vitamin B12 levels were compared using the Mann-Whitney U test. Neonatal anthropometry was correlated with maternal and cord B12 levels using Spearman\'s correlation. Data were analyzed using SPSS version 25.
UNASSIGNED: Mean maternal age was 26.58 yrs. The median cord B12 levels were lower than the maternal B12 levels. Maternal B12 levels showed a strong positive correlation with cord B12 levels (rho = 0.879; p < 0.001). Maternal (p < 0.001) and cord (p < 0.001) vitamin B12 levels were significantly lower in the malnourished group than in the normally nourished group. In malnourished group, 66.8% mothers and 95.2% neonates were Vitamin B12 deficient, whereas 1.5% mothers and 4.7% neonates were vitamin B12 deficient in normally nourished group. In the malnourished group, maternal B12 levels were positively correlated with birth weight (rho 0.363, p = 0.003) and length (rho 0.330, p =0.008), whereas cord B12 levels were positively correlated with birth weight in the normally nourished group. (rho 0.277 p= 0.028).
UNASSIGNED: High rates of vitamin B12 deficiency were observed in malnourished mothers and neonates. There was a positive correlation between birth weight, length, and maternal vitamin B12 levels in malnourished mothers. These findings emphasize the need to address maternal malnutrition and vitamin B12 deficiency to improve neonatal health.

OBJECTIVE: In March 2021, the Japanese Ministry of Health, Labour and Welfare revised the optimal gestational weight gain standards. In this study, we examined whether this revision affected gestational weight gain and low birth weight rates.
METHODS: We analyzed the records of singleton pregnant women who underwent checkups from their 1st trimester and delivered at our institute after 37 weeks between 2020 and 2021 (before the revision) and between 2022 and 2023 (after the revision). Pregnancy outcomes were assessed in the following four groups stratified by pre-pregnancy body mass index (BMI): underweight (BMI: <18.5 kg/m2), normal-weight (BMI: 18.5-24.9 kg/m2), overweight (BMI: 25-29.9 kg/m2), and obese (BMI: ≥30 kg/m2). Leaflets on the optimal gestational weight gain standards for each group were distributed to all pregnant women at the first prenatal checkup.
RESULTS: In each group, gestational weight gain did not change before and after the revision, with the corresponding values of 10.8 kg and 11.1 kg in the underweight (p = 0.94), 10.7 kg and 10.4 kg in the normal weight (p = 0.14), 9.7 kg and 9.2 kg in the overweight (p = 0.32), and 7.4 kg and 6.7 kg in the obese (p = 0.44) groups. Furthermore, the prevalence of low birth weight did not decrease in all groups.
CONCLUSIONS: No significant differences in gestational weight gain or low birth weight were observed after the revision of the 2021 gestational weight gain recommendations. Merely distributing leaflets to pregnant women may not be sufficient to improve gestational weight gain or reduce low birth weight rates.

UNASSIGNED: Ethno-racial inequalities are critical determinants of health outcomes. We quantified ethnic-racial inequalities on adverse birth outcomes and early neonatal mortality in Brazil.
UNASSIGNED: We conducted a cohort study in Brazil using administrative linked data between 2012 and 2019. Estimated the attributable fractions for the entire population (PAF) and specific groups (AF), as the proportion of each adverse outcome that would have been avoided if all women had the same baseline conditions as White women, both unadjusted and adjusted for socioeconomics and maternal risk factors. AF was also calculated by comparing women from each maternal race/skin colour group in different groups of mothers\' schooling, with White women with 8 or more years of education as the reference group and by year.
UNASSIGNED: 21,261,936 newborns were studied. If all women experienced the same rate as White women, 1.7% of preterm births, 7.2% of low birth weight (LBW), 10.8% of small for gestational age (SGA) and 11.8% of early neonatal deaths would have been prevented. Percentages preventable were higher among Indigenous (22.2% of preterm births, 17.9% of LBW, 20.5% of SGA and 19.6% of early neonatal deaths) and Black women (6% of preterm births, 21.4% of LBW, 22.8% of SGA births and 20.1% of early neonatal deaths). AF was higher in groups with fewer years of education among Indigenous, Black and Parda for all outcomes. AF increased over time, especially among Indigenous populations.
UNASSIGNED: A considerable portion of adverse birth outcomes and neonatal deaths could be avoided if ethnic-racial inequalities were non-existent in Brazil. Acting on the causes of these inequalities must be central in maternal and child health policies.
UNASSIGNED: Bill & Melinda Gates Foundation and Wellcome Trust.

BACKGROUND: while most gut microbiota research has focused on term infants, the health outcomes of preterm infants are equally important. Very-low-birth-weight (VLBW) or extremely-low-birth-weight (ELBW) preterm infants have a unique gut microbiota structure, and probiotics have been reported to somewhat accelerate the maturation of the gut microbiota and reduce intestinal inflammation in very-low preterm infants, thereby improving their long-term outcomes. The aim of this study was to investigate the structure of gut microbiota in ELBW neonates to facilitate the early identification of different types of low-birth-weight (LBW) preterm infants.
METHODS: a total of 98 fecal samples from 39 low-birth-weight preterm infants were included in this study. Three groups were categorized according to different birth weights: ELBW (n = 39), VLBW (n = 39), and LBW (n = 20). The gut microbiota structure of neonates was obtained by 16S rRNA gene sequencing, and microbiome analysis was conducted. The community state type (CST) of the microbiota was predicted, and correlation analysis was conducted with clinical indicators. Differences in the gut microbiota composition among ELBW, VLBW, and LBW were compared. The value of gut microbiota composition in the diagnosis of extremely low birth weight was assessed via a random forest-machine learning approach.
RESULTS: we briefly analyzed the structure of the gut microbiota of preterm infants with low birth weight and found that the ELBW, VLBW, and LBW groups exhibited gut microbiota with heterogeneous compositions. Low-birth-weight preterm infants showed five CSTs dominated by Enterococcus, Staphylococcus, Klebsiella, Streptococcus, Pseudescherichia, and Acinetobacter. The birth weight and clinical indicators related to prematurity were associated with the CST. We found the composition of the gut microbiota was specific to the different types of low-birth-weight premature infants, namely, ELBW, VLBW, and LBW. The ELBW group exhibited significantly more of the potentially harmful intestinal bacteria Acinetobacter relative to the VLBW and LBW groups, as well as a significantly lower abundance of the intestinal probiotic Bifidobacterium. Based on the gut microbiota\'s composition and its correlation with low weight, we constructed random forest model classifiers to distinguish ELBW and VLBW/LBW infants. The area under the curve of the classifiers constructed with Enterococcus, Klebsiella, and Acinetobacter was found to reach 0.836 by machine learning evaluation, suggesting that gut microbiota composition may be a potential biomarker for ELBW preterm infants.
CONCLUSIONS: the gut bacteria of preterm infants showed a CST with Enterococcus, Klebsiella, and Acinetobacter as the dominant genera. ELBW preterm infants exhibit an increase in the abundance of potentially harmful bacteria in the gut and a decrease in beneficial bacteria. These potentially harmful bacteria may be potential biomarkers for ELBW preterm infants.