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PloS One 2024Provision of quality antenatal care (ANC) to pregnant women is essential for reducing maternal and newborn mortality. ANC provides an opportunity for early...
INTRODUCTION
Provision of quality antenatal care (ANC) to pregnant women is essential for reducing maternal and newborn mortality. ANC provides an opportunity for early identification of conditions that increase the risk of adverse pregnancy outcomes. However, there is limited evidence regarding the quality of ANC received by women in Malawi. This study aimed to assess the quality of ANC and associated factors in Malawi.
MATERIALS AND METHODS
National representative data from the 2019-2020 Malawi Multiple Indicator Cluster Survey was used for this cross-sectional study. A total of 6,287 weighted sample of women aged 15 to 49 years who had a live birth and received ANC at least once within two years preceding the survey were included in the analysis. Descriptive statistics were used to estimate the magnitude of quality ANC and multivariable logistic regression was computed to identify associated factors.
RESULTS
Of the 6,287 women, only 12.6% (95% CI: 11.4-13.9) received quality ANC. The likelihood of receiving quality ANC was significantly higher among women who had four to seven ANC contacts (AOR = 2.10; 95% CI: 1.79-2.49), made at least eight ANC contacts (AOR = 3.40; 95% CI: 1.90-6.09) and started ANC within the first trimester (AOR = 1.30; 95% CI: 1.10-1.53). On the other hand, women who had only primary education (AOR = 0.62; 95% CI:0.48-0.82) and had five or more births (AOR = 0.56; 95% CI: 0.40-0.78) were less likely to receive quality ANC.
CONCLUSION
The findings reveal that quality of ANC in Malawi is low. These findings suggest the need for targeted interventions aimed at improving access to and utilization of ANC services among women with lower education and higher parity. Strengthening efforts to promote early ANC initiation and increasing the number of ANC contacts could significantly enhance the quality of ANC received by women in Malawi.
Topics: Humans; Female; Malawi; Prenatal Care; Adult; Pregnancy; Adolescent; Cross-Sectional Studies; Young Adult; Middle Aged; Quality of Health Care; Surveys and Questionnaires
PubMed: 38865367
DOI: 10.1371/journal.pone.0305294 -
Beijing Da Xue Xue Bao. Yi Xue Ban =... Jun 2024To compare the association between body mass index (BMI) trajectories determined by different methods and the risk of overweight in early childhood in a prospective...
OBJECTIVE
To compare the association between body mass index (BMI) trajectories determined by different methods and the risk of overweight in early childhood in a prospective cohort study, and to identify children with higher risk of obesity during critical growth windows of early childhood.
METHODS
A total of 1 330 children from Peking University Birth Cohort in Tongzhou (PKUBC-T) were included in this study. The children were followed up at birth, 1, 3, 6, 9, 12, 18, and 24 months and 3 years of age to obtain their height/length and weight data, and calculate BMI Z-score. Latent class growth mixture modeling (GMM) and longitudinal data-based -means clustering algorithm (KML) were used to determine the grouping of early childhood BMI trajectories from birth to 24 mouths. Linear regression was used to compare the association between early childhood BMI trajectories determined by different methods and BMI Z-score at 3 years of age. The predictive performance of early childhood BMI trajectories determined by different methods in predicting the risk of overweight (BMI Z-score > 1) at 3 years was compared using the average area under the curve (AUC) of 5-fold cross-validation in Logistic regression models.
RESULTS
In the study population included in this research, the three-category trajectories determined using GMM were classified as low, medium, and high, accounting for 39.7%, 54.1%, and 6.2% of the participants, respectively. The two-category trajectories determined using the KML method were classified as low and high, representing 50. 3% and 49. 7% of the participants, respectively. The three-category trajectories determined using the KML method were classified as low, medium, and high, accounting for 31.1%, 47.4%, and 21.5% of the participants, respectively. There were certain differences in the growth patterns reflected by the early childhood BMI trajectories determined using different methods. Linear regression analysis found that after adjusting for maternal ethnicity, educational level, delivery mode, parity, maternal age at delivery, gestational week at delivery, children' s gender, and breastfeeding at 1 month of age, the association between the high trajectory group in the three-category trajectories determined by the KML method (manifested by a slightly higher BMI at birth, followed by rapid growth during infancy and a stable-high BMI until 24 months) and BMI Z-scores at 3 years was the strongest. Logistic regression analysis revealed that the three-category trajectory grouping determined by the KML method had the best predictive performance for the risk of overweight at 3 years. The results were basically consistent after additional adjustment for the high bound score of the child' s diet balanced index, average daily physical activity time, and screen time.
CONCLUSION
This study used different methods to identify early childhood BMI trajectories with varying characteristics, and found that the high trajectory group determined by the KML method was better able to identify children with a higher risk of overweight in early childhood. This provides scientific evidence for selecting appropriate methods to define early childhood BMI trajectories.
Topics: Humans; Body Mass Index; Prospective Studies; Female; Male; Overweight; Child, Preschool; Infant; Risk Factors; China; Pediatric Obesity; Cohort Studies; Infant, Newborn
PubMed: 38864122
DOI: 10.19723/j.issn.1671-167X.2024.03.003 -
Journal of Family & Reproductive Health Mar 2024A cesarean delivery is regarded as a comparatively favourable and secure approach to childbirth when contrasted with vaginal delivery. Over the past decade, its...
OBJECTIVE
A cesarean delivery is regarded as a comparatively favourable and secure approach to childbirth when contrasted with vaginal delivery. Over the past decade, its frequency has risen in both industrialized and developing nations. Maternal request for cesarean delivery has been explained for the escalating rate along with other factors like anxiety, fear of childbirth, previous cesarean delivery, previous negative vaginal birth experience, maternal age, maternal education, and socioeconomic factors. Hence, this study was undertaken to assess pregnant women's tendency to have a cesarean birth and to investigate the factors associated with the inclination for cesarean delivery.
MATERIALS AND METHODS
A hospital-based cross-sectional study was carried out in the Department of Obstetrics and Gynaecology of a tertiary care hospital, a systematic sampling procedure was utilized, and 368 antenatal mothers after 36 weeks of gestation, who do not have any specific medical reasons against vaginal delivery were included in the study. Data collection was done by questionnaire. The information regarding socio-demographic factors, preexisting comorbidities, current obstetric risk factors, emotional factors, previous delivery experience, and their information preference toward the mode of delivery were collected. Univariate and multivariate analysis were performed to identify the independent variables associated with preference for cesarean delivery.
RESULTS
The preference for cesarean delivery and non-preference for cesarean delivery was 114 (30.9%) and 201 (54.6%), respectively whereas 53 (14.4%) participants remained neutral. The Chi-square analysis revealed a notable connection between the inclination towards a preference for cesarean delivery and factors such as obstetric score, parity, comorbidities, and among obstetric risk factors such as pregnancy after in-vitro fertilization (IVF), with a history of abortion, and having a prior history of cesarean delivery. Nevertheless, no meaningful association was observed between the preference for cesarean delivery and the remaining variables. On multivariate logistic analysis, independent variables like preexisting anxiety or depression, pregnancy through IVF, and having a history of previous cesarean delivery have increased the odds of preferring cesarean delivery. The independent variables like increasing gestational age, graduates, and unemployed have decreased the odds of preferring a cesarean delivery.
CONCLUSION
In conclusion, the prevalence of cesarean delivery is influenced by a complex interplay of medical, cultural, socioeconomic, and healthcare system factors. While cesarean delivery is essential in cases of medical necessity, efforts should be made to avoid unnecessary cesarean delivery that does not provide clear benefits over vaginal delivery. Balancing the risks and benefits of cesarean delivery and promoting evidence-based obstetric practices are crucial for ensuring optimal maternal and infant outcomes.
PubMed: 38863842
DOI: 10.18502/jfrh.v18i1.15435 -
Translational Animal Science 2024Calcium (Ca) and phosphorus (P) are minerals involved in biological functions and essential structural components of the skeleton. The body tightly regulates Ca and P to...
Calcium (Ca) and phosphorus (P) are minerals involved in biological functions and essential structural components of the skeleton. The body tightly regulates Ca and P to maintain homeostasis. Maternal needs for Ca and P increase during gestation and lactation to support conceptus growth and milk synthesis. Litter size and litter average daily gain (ADG) have a large effect on Ca and P requirements for sows because as they increase, the requirements increase due to a greater need from the sow. The objective of this review was to summarize published literature on Ca and P requirements in gestating and lactating sows derived from empirical data and factorial models. A total of nine empirical studies and seven factorial models were reviewed for determining the Ca and P requirements in gestation. For lactation, there were six empirical studies and seven factorial models reviewed. Empirical studies determined requirements based on the observed effect of Ca and P on bone mineralization, sow and litter performance, and milk characteristics. Factorial models generated equations to estimate Ca and P requirements using the main components of maintenance, fetal and placental growth, and maternal retention in gestation. The main components for factorial equations in lactation include maintenance and milk production. In gestation, the standardized total tract digestible phosphorus (STTD P) requirement estimates from empirical studies range from 5.4 to 9.5 g/d with total Ca ranging from 12.9 to 18.6 g/d to maximize bone measurements or performance criteria. According to the factorial models, the requirements increase throughout gestation to meet the needs of the growing fetuses and range from 7.6 to 10.6 g/d and 18.4 to 38.2 g/d of STTD P and total Ca, respectively, on day 114 of gestation for parity 1 sows. During lactation, STTD P requirement estimates from empirical studies ranged from 8.5 to 22.1 g/d and total Ca ranged from 21.2 to 50.4 g/d. For the lactation factorial models, STTD P requirements ranged from 14.2 to 25.1 g/d for STTD P and 28.4 to 55.6 g/d for total Ca for parity 1 sows with a litter size of 15 pigs. The large variation in requirement estimates makes it difficult to define Ca and P requirements; however, a minimum level of 6.0 and 22.1 g/d of STTD P during gestation and lactation, respectively, appears to be adequate to meet basal requirements. The limited data and high variation indicate a need for future research evaluating Ca and P requirements for gestating and lactating sows.
PubMed: 38863597
DOI: 10.1093/tas/txae087 -
Translational Animal Science 2024Information about the full spectrum of metabolites present in porcine colostrum and factors that influence metabolite abundances is still incomplete. Parity number...
Information about the full spectrum of metabolites present in porcine colostrum and factors that influence metabolite abundances is still incomplete. Parity number appears to modulate the concentration of single metabolites in colostrum. This study aimed to 1) characterize the metabolome composition and 2) assess the effect of parity on metabolite profiles in porcine colostrum. Sows ( = 20) were divided into three parity groups: A) sows in parity 1 and 2 ( = 8), B) sows in parity 3 and 4 ( = 6), and C) sows in parity 5 and 6 ( = 6). Colostrum was collected within 12 h after parturition. A total of 125 metabolites were identified using targeted reversed-phase high-performance liquid chromatography-tandem mass spectrometry and anion-exchange chromatography-high resolution mass spectrometry. Gas chromatography additionally identified 19 fatty acids (FAs). Across parities, colostrum was rich in creatine and creatinine, 1,3-dioleyl-2-palmitatoylglycerol, 1,3-dipalmitoyl-2-oleoylglycerol, and sialyllactose. Alterations in colostrum concentrations were found for eight metabolites among parity groups ( < 0.05) but the effects were not linear. For instance, colostrum from parity group C comprised 75.4% more valine but 15.7%, 34.1%, and 47.9% less citric, pyruvic, and pyroglutamic acid, respectively, compared to group A ( < 0.05). By contrast, colostrum from parity group B contained 39.5% more spermidine than from group A ( < 0.05). Of the FAs, C18:1, C16:0, and C18:2 n6 were the main FAs across parities. Parity affected four FAs (C18:3n3, C14:1, C17:0ai, and C17:1), including 43.1% less α-linolenic acid (C18:3n3) in colostrum from parity group C compared to groups A and B ( < 0.05). Signature feature ranking identified 1-stearoyl-2-hydroxy--glycero-3-phosphatidylcholine and the secondary bile acid hyodeoxycholic acid as the most discriminative metabolites, showing a higher variable importance in the projection score in colostrum from parity group A than from groups B and C. Overall, results provided a comprehensive overview about the metabolome composition of sow colostrum. The consequences of the changes in colostrum metabolites with increasing parity for the nutrient supply of the piglets should be investigated in the future. The knowledge gained in this study could be used to optimize feeding strategies for sows.
PubMed: 38863596
DOI: 10.1093/tas/txae062 -
Diabetes, Metabolic Syndrome and... 2024Gestational diabetes mellitus (GDM), a chronic condition leading to glucose intolerance during pregnancy, is common in low- and middle-income countries, posing health...
BACKGROUND
Gestational diabetes mellitus (GDM), a chronic condition leading to glucose intolerance during pregnancy, is common in low- and middle-income countries, posing health risks to both the mother and fetus. Limited studies have been done in Ethiopia, especially using WHO's 2013 universal screening criteria. Therefore, this study aimed to evaluate the risk factors linked to GDM in women attending antenatal (ANC) clinics in Hawassa town public health institutions, located in the Sidama regional state of Ethiopia.
METHODS
An Unmatched case-control study was carried out in Ethiopia's Sidama Region from April 1st to June 10th, 2023, involving 510 pregnant women. The Oral Glucose Tolerance Test (OGTT) was utilized for universal screening and diagnosing GDM based on the updated 2013 WHO diagnostic criteria. Data analysis included descriptive and analytical statistics, with variables having p-values below 0.1 deemed suitable for bivariate analysis. Statistical significance was assessed using the adjusted odds ratio (AOR) with a 95% confidence interval and a p-value < 0.05.
RESULTS
The study involved 633 participants (255 cases and 378 controls), resulting in a 100% response rate, with women having an average age of 29.03 years.Variables such as: age at first conception (AOR=0.97, P=0.01, 95% CI (0.95,0.99)), urban residency (AOR=1.66, P<0.01, 95% CI(01.14,2.40)), widowed marital status (AOR=0.30, P=0.02, 95% CI (0.30,0.90)), parity (AOR=1.10, P<0.01, 95% CI (1.03,1.17)), history of stillbirth (AOR=1.15, P=0.03, 95% CI(1.04,2.30)), and previous cesarean section (AOR=1.86, P=0.01, 95% CI (1.13,2.66)) were identified as independent factors associated with GDM.
CONCLUSION
The study concluded that factors like age at first conception, place of residence, marital status, parity, history of Caesarian section, and stillbirth were independently associated with GDM. Surprisingly, upper arm circumference (MUAC), a proxy for pre-gestational BMI, was not identified as a risk factor for GDM. It is recommended that healthcare providers conduct comprehensive GDM risk assessments in pregnant women to identify and address risk factors, and propose specific screening and intervention strategies.
PubMed: 38863518
DOI: 10.2147/DMSO.S457739 -
Trends in Immunology Jun 2024Despite prevalent diversity and inclusion programs in STEM, gender biases and stereotypes persist across educational and professional settings. Recognizing this enduring...
Despite prevalent diversity and inclusion programs in STEM, gender biases and stereotypes persist across educational and professional settings. Recognizing this enduring bias is crucial for achieving transformative change on gender equity and can help orient policy toward more effective strategies to address ongoing disparities.
PubMed: 38862366
DOI: 10.1016/j.it.2024.05.004 -
Frontiers in Genetics 2024Improving ewe longevity is an important breeding and management goal, as death loss and early culling of mature ewes are economic burdens in the sheep industry. Ewe...
Improving ewe longevity is an important breeding and management goal, as death loss and early culling of mature ewes are economic burdens in the sheep industry. Ewe longevity can be improved by selecting for positive reproductive outcomes. However, the breeding approaches for accomplishing this come with the challenge of recording a lifetime trait. Characterizing genetic factors underpinning ewe longevity and related traits could result in the development of genomic selection strategies to improve the stayability of sheep through early, informed selection of replacement ewes. Towards this aim, a genome-wide association study (GWAS) was performed to identify genetic markers associated with ewe longevity, reproductive, and production traits. Traits evaluated included longevity (i.e., length of time in the flock), parity and the lifetime number of lambs born, lambs born alive, lambs weaned, and weight of lambs weaned. Ewe records from previous studies were used. Specifically, Rambouillet (n = 480), Polypay (n = 404), Suffolk (n = 182), and Columbia (n = 64) breed ewes (N = 1,130) were analyzed against 503,617 SNPs in across-breed and within-breed GWAS conducted with the Bayesian-information and Linkage-disequilibrium Iteratively Nested Keyway (BLINK) model in R. The across-breed GWAS identified 25 significant SNPs and the within-breed GWAS for Rambouillet, Polypay, and Suffolk ewes identified an additional 19 significant SNPs. The most significant markers were rs411309094 (13:22,467,143) associated with longevity in across-breed GWAS (-value = 8.3E-13) and rs429525276 (2:148,398,336) associated with both longevity (-value = 6.4E-15) and parity (-value = 4.8E-15) in Rambouillet GWAS. Significant SNPs were identified within or in proximity (±50 kb) of genes with known or proposed roles in reproduction, dentition, and the immune system. These genes include and . This study proposes multiple SNPs as candidates for use in selection indices and suggests genes for further research towards improving understanding of the genetic factors contributing to longevity, reproductive, and production traits of ewes.
PubMed: 38859938
DOI: 10.3389/fgene.2024.1398123 -
Optics Express Jun 2024Exceptional points (EPs) in non-Hermitian systems have turned out to be at the origin of many intriguing effects with no counterparts in Hermitian cases. A typically...
Exceptional points (EPs) in non-Hermitian systems have turned out to be at the origin of many intriguing effects with no counterparts in Hermitian cases. A typically interesting behavior is the chiral mode switching by dynamically winding the EP. Most encircling protocols focus on the two-state or parity-time (PT) symmetry systems. Here, we propose and investigate the dynamical encircling of multiple EPs in an anti-PT-symmetric system, which is constructed based on a one-dimensional lattice with staggered lossy modulation. We reveal that dynamically encircling the multiple EPs results in the chiral dynamics via multiple non-Hermiticity-induced nonadiabatic transitions, where the output state is always on the lowest-loss energy sheet. Compared with the PT-symmetric systems that require complicated variation of the gain/loss rate or on-site potentials, our system only requires modulations of the couplings which can be readily realized in various experimental platforms. Our scheme provides a route to study non-Hermitian physics by engineering the EPs and implement novel photonic devices with unconventional functions.
PubMed: 38859511
DOI: 10.1364/OE.524678 -
Optics Express Apr 2024We propose a method for simulating a 1D non-Hermitian Su-Schrieffer-Heeger model with modulated nonreciprocal hopping using a cyclic three-mode optical system. The...
We propose a method for simulating a 1D non-Hermitian Su-Schrieffer-Heeger model with modulated nonreciprocal hopping using a cyclic three-mode optical system. The current system exhibits different localization of topologically nontrivial phases, which can be characterized by the winding number. We find that the eigenenergies of such a system undergo a real-complex transition as the nonreciprocal hopping changes, accompanied by a non-Bloch parity-time symmetry breaking. We explain this phase transition by considering the evolution of saddle points on the complex energy plan and the ratio of complex eigenenergies. Additionally, we demonstrate that the skin states resulting from the non-Hermitian skin effect possess higher-order exceptional points under the critical point of the non-Bloch parity-time phase transition. Furthermore, we investigate the non-Hermitian skin phase transition by the directional mean inverse participation ratio and the generalized Brillouin zone. This work provides an alternative way to investigate the novel topological and non-Hermitian effects in nonreciprocal optical systems.
PubMed: 38859323
DOI: 10.1364/OE.521228