Search results for: early birth

Authors: Behnaz Farahani, Abbas Mirzaei

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This study explores association between circadian rhythm pattern and some demographic incidences. The participants targeting 193 (97 females and 96 males between the ages of 20-30 years) Iranian bachelor students from Islamic Azad University who completed the self-reported over the 2nd semester 2011-2012 university year. The questionnaire has been tailored amalgamation of Horn & Östberg Questionnaire (MEQ) and Demographic Incidences Questionnaire in order to measure the students circadian rhythm pattern and their Demographic Incidences. The finding of this quantitative, descriptive, cross-sectional analysis confirmed the hypothesis in that 'circadian rhythm pattern' was positively associated with the demographic indices like age, marital status, gender, day in week and month of the birth time, and parent’s age and educational level at the time of the birth of the samples.

Keywords: circadian rhythm pattern, demographic incidences, morning type, evening type

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Authors: Juliana Shimara Pires Ferrão, Letícia Palmeira Pinto, Francisco Palma Rennó, Francisco Javier Hernandez Blazquez

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The ruminant stomach is a complex and multi-chambered organ. Although the true stomach (abomasum) is fully differentiated and functional at birth, the same does not occur with the rumen chamber. At this moment, rumen papillae are small or nonexistent. The papillae only fully develop after weaning and during calf growth. Papillae development and ruminal epithelium specialization during the fetus growth and at birth must be two interdependent processes that will prepare the rumen to adapt to ruminant adult feeding. The microscopic study of rumen epithelium at these early phases of life is important to understand how this structure prepares the rumen to deal with the following weaning processes and its functional activation. Samples of ruminal mucosa of bovine fetuses (110- and 150 day-old) and newborn calves were collected (dorsal and ventral portions) and processed for light and electron microscopy and immunohistochemistry. The basal cell layer of the stratified pavimentous epithelium present in different ruminal portions of the fetuses was thicker than the same portions of newborn calves. The superficial and intermediate epithelial layers of 150 day-old fetuses were thicker than those found in the other 2 studied ages. At this age (150 days), dermal papillae begin to invade the intermediate epithelial layer which gradually disappears in newborn calves. At birth, the ruminal papillae project from the epithelial surface, probably by regression of the epithelial cells (transitory cells) surrounding the dermal papillae. The PCNA cell proliferation index (%) was calculated for all epithelial samples. Fetuses 150 day-old showed increased cell proliferation in basal cell layer (Dorsal Portion: 84.2%; Ventral Portion: 89.8%) compared to other ages studied. Newborn calves showed an intermediate index (Dorsal Portion: 65.1%; Ventral Portion: 48.9%), whereas 110 day-old fetuses had the lowest proliferation index (Dorsal Portion: 57.2%; Ventral Portion: 20.6%). Regarding the transitory epithelium, 110 day-old fetuses showed the lowest proliferation index (Dorsal Portion: 44.6%; Ventral Portion: 20.1%), 150 day-old fetuses showed an intermediate proliferation index (Dorsal Portion: 57.5%; Ventral Portion: 71.1%) and newborn calves presented a higher proliferation index (Dorsal Portion: 75.1%; Ventral Portion: 19.6%). Under TEM, the 110- and 150 day-old fetuses presented thicker and poorly organized basal cell layer, with large nuclei and dense cytoplasm. In newborn calves, the basal cell layer was more organized and with fewer layers, but typically similar in both regions of the rumen. For the transitory epithelium, fetuses displayed larger cells than those found in newborn calves with less electrondense cytoplasm than that found in the basal cells. The ruminal dorsal portion has an overall higher cell proliferation rate than the ventral portion. Thus we can infer that the dorsal portion may have a higher cell activity than the ventral portion during ruminal development. Moreover, the basal cell layer is thicker in the 110- and 150 day-old fetuses than in the newborn calves. The transitory epithelium, which is much reduced, at birth may have a structural support function of the developing dermal papillae. When it regresses or is sheared off, the papillae are “carved out” from the surrounding epithelial layer.

Keywords: bovine, calf, epithelium, fetus, hematoxylin-eosin, immunohistochemistry, TEM, Rumen

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Authors: Kanak Parmanandani

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The present study aims to explore the impact of perceived parenthood styles in early nonage on attachment styles, and how it affects the emotional capacity of youthful grown-ups. Current studies suggest that there are 4 attachment styles. An existent gets attached to their significant other and important people, and understanding attachment styles helps to dissect a person’s nonage and duly understand an existent. Parenthood styles play a major part in children’s early development, and how they see the world and the people around them. A parent plays a huge part in the emotional development of a child. Both parents must be present to give their children a healthy terrain to grow up.

Keywords: parent styles, attachment styles, early development, parenting styles

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Authors: Sarah-Anne Schumann, Chintan Shah, Sandeep Ponniah, Syeachia Dennis

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Effective interventions to prevent childhood obesity include limiting sugar-sweetened beverage intake (SOR: B, longitudinal study), school and home based strategies to reduce total screen time and increase physical activity, behavioral and dietary counseling, and support for parents and families (SOR: A, meta-analysis of randomized and non-randomized controlled trials). Risk factors for childhood obesity include maternal pre-pregnancy weight, high infant birth weight, early infant rapid weight gain and maternal smoking during pregnancy which may provide opportunities to intervene and prevent childhood obesity (SOR: B, meta-analysis of observational studies).

Keywords: childhood, obesity, prevent obesity, interventions to prevent obesity

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Authors: Nick Alex

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Consciousness is inseparably connected with energy. Based on panpsychism, consciousness is a fundamental substance that emerged with the birth of the Universe from a continuous four-dimensional continuum. It consists of a physicalist form of consciousness characteristic of all matter and a mental form characteristic of neural networks. Due to the physicalist form of consciousness, metabolic processes were formed, and life in the form of living matter emerged. It is the same for all living matter. Mental consciousness began to develop 3000 million years after the birth of the Universe due to the physicalist form of consciousness, with the emergence of neural networks. Mental consciousness is individualized in contrast to physicalist consciousness. It is characterized by cognitive abilities, self-identity, and the ability to influence the world around us. Each level of consciousness is in its own homeostasis environment.

Keywords: continuum, physicalism, neurons, metabolism

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Authors: Freya Harding, Anne Gatuguta, Chi Eziefula

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Introduction Research shows the quality of experiences of pregnancy, birth, and postpartum impacts the health and well-being of the mother and baby. This is recognised by the WHO in their recommendations ‘Intrapartum care for a positive childbirth experience’. The COVID-19 pandemic saw the transformation of the NHS Maternity services to prevent the transmission of COVID-19. Physical and social isolation may have affected women’s experiences of pregnancy, birth and postpartum; especially those of healthcare. Examples of such changes made to the NHS include both the reduction in volume of face-to-face consultations and restrictions to visitor time in hospitals. One notable detriment due to these changes was the absence of a partner during certain stages of birth. The aim of this study was to explore women’s experiences of pregnancy, birth, and postnatal period during the COVID-19 pandemic in the UK. Methods We collected qualitative data from women who had given birth during the COVID-19 pandemic. In-depth, semi-structured interviews were conducted with twelve participants recruited from mother and baby groups in Southeast England. Data were audio-recorded, transcribed verbatim, and analysed thematically using both inductive and deductive approaches. Ethics permission was granted from Brighton and Sussex Medical School (ER/BSMS9A83/1). Results Interviews were conducted with 12 women who gave birth between May 2020 and February 2021. Ages of the participants ranged between 28 and 42 years, most of which were white British, with one being Asian British. All participants were heterosexual and either married or co-habiting with their partner. Five participants worked in the NHS, and all participants had professional occupations. Women felt inadequately supported both socially and medically. An appropriate sense of control over their own birthing experience was lacking. Safety mechanisms, such as in-person visits from the midwife, had no suitable alternatives in place. Serious health issues were able to “slip through the net.” Mental health conditions in some of those interviewed worsened or developed. Similarly, reduced support from partners during birth and during the immediate postpartum period at the hospital, coupled with reduced ward staffing, resulted in some traumatic experiences; particularly for women who had undergone caesarean section. However, some unexpected positive effects were reported; one example being that partners were able to spend more time with their baby due to furlough schemes and working from home. Similarly, emergency care was not felt to have been compromised. Overall, six themes emerged: (1) Self-reported traumatic experiences, (2) Challenges of caring for a baby with reduced medical and social support, (3) Unexpected benefits to the parenting experience, (4) The effects of a sudden change in medical management (5) Poor communication from healthcare professionals (6) Social change; with subthemes of support accessing medical care, the workplace, family and friends, and antenatal & baby groups. Conclusions The results indicate that the healthcare system was unable to adequately deliver maternity care to facilitate positive pregnancy, birth, and postnatal experiences during the heights of the pandemic. The poor quality of such experiences has been linked an increased risk of long-term health complications in both the mother and child.

Keywords: pregnancy, birth, postpartum, postnatal, COVID-19, maternity, social support, qualitative, pandemic

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Authors: Supalak Fakkhum, Wannita Pochanakul

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This research is qualitative research that aims to study the application of local wisdom in health care of early childhood at Ban Nam Chieo Community, Laem Ngop, Trat Province. The target is one folk medicine healer and 45 parents who have children or grandchildren aged between 0-5 years. The folk medicine healer was interviewed and observed during early childhood health care practice. Parents were interviewed. The results showed that local wisdom in health care of early childhood are as follows: 1. Local wisdom about early childhood diseases: It is believed that the disease was determined while the child was still in the womb, in the third month of pregnancy. When a child is born, they will have La, La-ong and Saang diseases, which are URI (upper respiratory infection) and DI (diarrhea) diseases. Supernatural aspect is also considered. 2. The treatment is chosen to match the symptoms of the disease. Caring for early childhood includes psychological therapy by rituals and spells. 3. For local wisdom concerning prevention and health promotion, parents normally bring their child to folk medicine healers for “throat paint” as an act of protection and health promotion. Folk healers often prescribe food according to belief and local wisdom.

Keywords: local wisdom, early childhood, folk medicine, healer

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Authors: Anne Tan, Kok-Sing Tang, Audrey Cooke

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Play has always been a prominent pedagogy in early childhood. However, there is growing evidence of success in students’ learning using explicit instruction, especially in literacy in the early years. There is also limited research using explicit instruction in early childhood mathematics, and play is usually prominently mentioned. This proposed research aims to investigate the possibilities and benefits of integrating guided play with explicit instruction in early childhood mathematics education. While play has traditionally been a prominent pedagogy in early childhood, there is growing evidence of success in student learning through explicit instruction, particularly in literacy. However, limited research exists on the integration of explicit instruction in early childhood mathematics, where play remains prominently mentioned. This study utilises a multiple case study methodology to gather data and provide immediate opportunities for curriculum improvement. The research will commence with semi-structured interviews to gain insights into educators' background knowledge. Highly structured observations will be conducted to record the frequency and manner in which guided play is integrated with specific elements of explicit instruction during mathematics teaching in early childhood. To enhance the observations, video recordings will be made using cameras with video settings and Microsoft Teams meeting recordings. In addition to interviews and observations, educators will maintain journals and use the Microsoft Teams platform for self-reflection on the integration of guided play and explicit instruction in their classroom practices and experiences. The study participants will include educators with early childhood degrees and students in years one and two. The primary goal of this research is to inform the benefits of integrating two high-impact pedagogies, guided play, and explicit instruction, for enhancing student learning outcomes in mathematics education. By exploring the integration of these pedagogical approaches, this study aims to contribute to the development of effective instructional strategies in early childhood mathematics education.

Keywords: early childhood, early childhood mathematics, early childhood numbers, guided play, play-based learning, explicit instruction

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Authors: M. Akoz, O. B. Citil, I. Aydin

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Colostrum secreted by the mammary glands after birth in the early days, a high proportion of fat, protein and ash containing a secretion containing low amounts of casein and lactose. Especially immunoglobulins contain high proportions. Maternal immunoglobulins own immune system to protect the newborn against neonatal disease until development are very important matter. However, colostrum is transferred to the offspring due to placental barrier in ruminants. Immunoglobulins are absorbed through the intestinal epithelium but absorption can vary under the influence of some factors. These factors are among the priority ones taking colostrum first time, amount, concentration, the metabolic status of the newborn. intestinal absorption of immunoglobulins occurs over the first 24 h high. Absorption from the gut after nine hours, 50% after 24 hours was only 11%. On the other hand pup's digestive system degrade the enzymes after 24 hours immunoglobulins. Bovine colostrum in the composition while basic immune IgG, IgA and IgM are also available. Total IgG in colostrum of ruminants, while in other species is a greater amount in blood serum.

Keywords: immunoglobulin, ruminants, colostrum, immune system

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Authors: Taddese Alemu Zerfu, Melaku Umeta Deressa, Kaleab Baye

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Background: Maternal and child under-nutrition is the underlying cause of 3•5 million annual deaths, globally. Anemia during pregnancy is among the leading nutritional disorders with serious short and long term consequences to both the mother and fetus. Objective: Examine the effect of dietary diversity on maternal anemia, nutritional status and key pregnancy outcomes of pregnancy. Methods: A prospective cohort study design, involving a total of 432 eligible pregnant women, in their second antenatal care visit was conducted between August 2014 to March, 2015. The individual dietary diversity status of mothers was used as the exposure variable to select, enroll and follow the mothers. All mothers were enrolled during second antenatal care visit and followed until delivery. Epi-data, SPSS and STATA software are used to enter and analyze the data. Chi-square test, independent 't'-test, and GLM are used to calculate risk, association and differences between key variables at P < 0.05. Results: Study participants did not differ in many of the basic characteristics (p < 0.05). The incidence of maternal anemia increased significantly from 28.6% to 32.1% between baseline and term. Pregnant mothers with inadequate dietary diversity groups had more (56% at baseline and 68% at term) risk of anemia than the comparison (adequate) groups, (RR, 1.56 and 1.68; 95% CI, 1.24 - 1.83 and 1.39 - 2.04). The overall incidence of still birth, low birth weight and pre-term birth was 4.5%, 9.1% and 13.6%, respectively. The variation of these outcomes was significant across study groups (P < 0.05). Conclusion and recommendations: Dietary diversity status of pregnant mothers has significant effect on the incidence of anemia and key pregnancy outcomes in resource limited settings, like rural Ethiopia. Therefore, apart from the ongoing routine IFA supplementation, special emphasis should be given to dietary diversity of mothers to improve related outcomes of pregnancy and maternal health.

Keywords: anemia, birth weight, dietary diversity, pregnancy, pregnancy outcome

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Authors: J. Jebunnesa, Y. Budd, T. Mason

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COVID-19 changed the pedagogical expectations of early childhood education as many teachers across Australia had to quickly adapt to new teaching practices such as remote teaching. An important factor in the successful implementation of any new teaching and learning approach is teacher preparation, however, due to the pandemic, the transformation to remote teaching was immediate. A timely question to be asked is how early childhood teachers managed the transition from face-to-face teaching to remote teaching and what was learned through this time. This study explores the experiences of early childhood educators in Australia during COVID-19 lockdowns. Data were collected from an online survey conducted through the official Facebook forum of “Early Childhood Education and Care Australia,” and a constructivist grounded theory methodology was used to analyse the data. Initial research results suggest changing expectations of teachers’ roles and responsibilities during the lockdown, with a significant category related to transitioning teacher identities emerging. The concept of transitioning represents the shift from the role of early childhood educator to educational innovator, essential worker, social worker, and health officer. The findings illustrate the complexity of early childhood educators’ roles during the pandemic.

Keywords: changing role of teachers, constructivist grounded theory, lessons learned, teaching during COVID-19

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Authors: Linghua Kong, Xinxia Chen, Mika Gissler, Catharina Lavebratt

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Background: Prenatal exposure to preeclampsia has been associated with an increased risk of offspring attention-deficit/hyperactivity disorders (ADHD), autism spectrum disorder (ASD), and intellectual disability. However, little is known about the association between prenatal exposure to severe preeclampsia and neurodevelopmental and psychiatric disorders in offspring. Objective: This study aimed to assess the risk of maternal preeclampsia combined with perinatal problems, specifically low birth weight and prematurity, on offspring neuropsychiatric disorders. Methods: All singleton live births in Finland between 1996 and 2014 (n=1 012 723) were followed up in nation-wide registries until 2018. Main exposures included pre-eclampsia, small for gestational age, and delivery before 34 gestational weeks. Offspring neurodevelopmental and psychiatric disorders (ICD-10 codes) were examined as outcomes variables. Offspring birth year, sex, maternal age at delivery, parity, marital status at birth, mother's country of birth, maternal smoking, maternal gestational diabetes, maternal use of psychotropic medication during pregnancy, and maternal systemic inflammatory diseases were used as covariates. Risks for neurodevelopmental and psychiatric disorders were estimated using Cox proportional hazards modeling. Results: Of the 1 012 723 offspring, 25 901 (2.6%) were exposed to preeclampsia, and 93 281 (9.2%) were diagnosed with a neuropsychiatric disorder. Compared to births unexposed to preeclampsia, small for gestational age or delivery before 34 gestational weeks, those exposed to preeclampsia only had a 21% increase in the likelihood of any neuropsychiatric disorders after adjusting for potential confounding (adjusted HR=1.21, 95% CI: 1.15-1.26), while exposure to preeclampsia combined with small for gestational age or delivery before 34 gestational weeks had a more than twofold increased risk of having a child with neuropsychiatric disorders (adjusted HR=2.16, 95% CI: 2.02-2.32). The adjusted HR for neuropsychiatric disorders in offspring with small for gestational age or delivery before 34 gestational weeks only was 1.79 (95% CI: 1.73-1.83). In addition, the risk estimate in offspring exposed to both preeclampsia and perinatal problems was greater than those only exposed to preeclampsia for having personality disorders (adjusted HR=1.66; 95% CI: 1.07-2.57), intellectual disabilities (adjusted HR=3.47; 95% CI: 2.86-4.22), specific developmental disorders (adjusted HR=2.91; 95% CI: 2.69-3.15), ASD (adjusted HR=1.75; 95% CI: 1.42-2.17), ADHD and conduct disorders (adjusted HR=2.00; 95%CI: 1.76-2.27), and other behavioral and emotional disorders (adjusted HR=2.09; 95% CI: 1.84-2.37). Conclusion: In utero exposure to severe preeclampsia increased the risk of several neurodevelopmental and psychiatric disorders in offspring. Our findings are relevant to women with hypertensive disorders with regard to pregnancy consultation and management and may yield effective clues for the prevention of neurodevelopmental and psychiatric disorders in childhood.

Keywords: low birth weight, neurodevelopmental disorders, preeclampsia, prematurity, psychiatric disorders

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Authors: Al Asyary, Meita Veruswati, Dian Ayyubi

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Sukabumi municipal has highest rank for maternal mortality in Indonesia with 102 by 100,000 live birth with almost 80% of birth were not attended by skilled birth attendant (SBA). Although universal health coverage has been implemented, availability and sufficiency of SBA, such as midwife in this developing country, are problematic agenda for the quality of public healthcare as well as decreasing maternal mortality rate. This study aims to describe the equal distribution of midwives in Sukabumi municipal as support of government’s program named Millennium Development Goals (MDGs) that suppressed maternal mortality rate in Indonesia. We conducted an observational study with Workload Indicator of Staffing Need (WISN) analysis to present the dispersion of midwives by their activities and workloads in 37 Puskesmas. We also generated in-depth interview with several executive chief of health sections, including chief of health offices in Sukabumi municipal. It resulted inferentially that several activities in midwives’ program were differed at once of existing than needed condition ideally (ρ value = 0.002 < 0.05). Meanwhile, decision for midwives’ procurement and placement were held by un-systematically procedure such as based on where the midwife was staying, and it also progressed by neighborhood issue priorities. The absence of formal regulation in local government is a serious problem that indicated poor political commitment, while access to SBA shall be focused carefully.

Keywords: developing country, health professional resources, health policy, need assessment

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Authors: Anthony J. Kondracki, Bonzo Reddick, Jennifer L. Barkin

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Background: Many pregnancies in the United States are affected each year with the most common sexually transmitted infections (STIs), including Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), and Treponema pallidum (TP, syphilis), and the rate of congenital syphilis has reached a 20-year high. We sought to estimate the prevalence of CT, NG, and TP in pregnancy and the risk of preterm birth (PTB) (<37 weeks gestation) and low birthweight (LBW) (<2500g) deliveries according to utilization of prenatal care (PNC) during the COVID-19 pandemic. Methods: This study was based on the 2020 National Center for Health Statistics (NCHS) Natality File restricted to singleton births (N=3,512,858). We estimated the prevalence of CT, NG, TP, PTBand LBW across timing and the number of prenatal care (PNC) visits attended. In multivariable logistic regression models, adjusted odds ratios of PTB and LBW were assessed according to STIs and PNC status. E-values, based on effect size estimates and the lower bound of the 95% confidence intervals (CIs) of the association, examined the potential impact of unmeasured confounding. Results: CT (1.8%) was most prevalent in pregnancy, followed by NG (0.3%) and TP (0.1%). The strongest predictors of PTB and LBW were maternal NG (12.2% and 12.1%, respectively), late initiation/no PNC (8.5% and 7.6%, respectively), and ≤10 prenatal visits (13.1% and 10.3%, respectively). The odds of PTB and LBW were 2.5- to 3-fold greater for each STI in women who received ≤10 compared to >10 prenatal visits. E-values demonstrated the minimum strength of potential unmeasured confounding necessary to explain away observed associations. Conclusions: Timely initiation and receipt of recommended number of prenatal visits benefits screening and treatment of all women for STIs, including NG to substantially reduce infant morbidity and mortality related to PTB and LBW among infants born during the COVID-19 pandemic.

Keywords: COVID-19 pandemic, sexually transmitted infections, preterm birth, low birthweight, prenatal care

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Authors: M. Keršič, M. Lužnik, J. Lužnik

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Cervical dilatation and membrane herniation before 26th week of gestation poses very high risk for extremely and very premature childbirth. Cerclage with mesh cap (mesh cerclage, MC) can greatly diminish this risk and provide additional positive effects. Between 2005 and 2014, MC has been performed in 9 patients with singleton pregnancies who had prolapsed membranes beyond external cervical/uterine os before 25th week of pregnancy (one in 29th). With patients in general anaesthesia, lithotomy and Trendelenburg position (about 25°) prolapsed membranes were repositioned in the uterine cavity, using tampon soaked in antiseptic solution (Skinsept mucosa). A circular, a type of purse-string suture (main band) with double string Ethilon 1 was applied at about 1 to 1.5 cm from the border of the external uterine os - 6 to 8 stitches were placed, so the whole external uterine os was encircled (modified McDonald). In the next step additional Ethilon 0 sutures were placed around all exposed parts of the main double circular suture and loosely tightened. On those sutures, round tailored (diameter around 6 cm) mesh (Prolene® or Gynemesh* PS) was attached. In all 9 cases, gestation was prolonged on average for 9 weeks and 4 days (67 days). In four cases maturity was achieved. Mesh was removed in 37th–38th week of pregnancy or if spontaneous labour began. In two cases, a caesarean section was performed because of breech presentation. In the first week after birth in 22nd week one new born died because of immaturity (premature birth was threatening in 18th week and then MC was placed). Ten years after first MC, 8 of 9 women with singleton pregnancy and MC performed have 8 healthy children from these pregnancies. Mesh cerclage successfully closed the opened cervical canal or uterine orifice and prevented further membrane herniation and membrane rupture. MC also provides a similar effect as with occluding the external os with suturing but without interrupting the way for excretion of abundant cervical mucus. The mesh also pulls the main circular band outwards and thus lowers the chance of suture cutting through the remaining cervix. MC prolonged gestation very successfully (mean for 9 weeks and 4 days) and thus increased possibility for survival and diminished the risk for complications in very early preterm delivered survivors in cases with cervical dilatation and membrane herniation before 26th week of gestation. Without action possibility to achieve at least 28th or 32nd week of gestation would be poor.

Keywords: cervical insufficiency, mesh cerclage, membrane protrusion, premature birth prevention, physical exam-indicated cerclage, rescue cerclage

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Authors: Amy Claridge, Tishra Beeson

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Background: Maternal depression is a serious health concern impacting between 10-16% of birthing persons. It is associated with difficulty in emotional interaction and the formation of attachment bonds between parent and infant. Longitudinally, maternal depression can have severe, lasting impacts on both parent and child, increasing the risk for mental, social, and physical health issues. Rates of prenatal depression have been higher among individuals who were pregnant during the first year of the COVID-19 pandemic. Pregnant persons are considered a high-risk group for poor clinical outcomes from COVID-19 infection and may also have faced or continue to face additional stressors such as financial burdens, loss of income or employment, and the benefits accompanying employment, especially among those in the United States (U.S.). It is less clear whether individuals who gave birth during the pandemic continue to experience high levels of depressive symptoms or whether symptoms have been reduced as a pandemic response has shifted. The current study examined longitudinal reports of depressive symptoms among individuals in the U.S. who gave birth between March 2020 and September 2021. Methods: This mixed-method study involved surveys and interviews with birthing persons (18-45 years old) in their third trimester of pregnancy and at 8 weeks postpartum. Participants also completed a follow-up survey at 12-18 months postpartum. Participants were recruited using convenience methods via an online survey. Survey participants included 242 U.S. women who self-reported depressive symptoms (10-item Edinburgh Postnatal Depression Scale) at each data collection wave. A subset of 23 women participated in semi-structured prenatal and 8-week postpartum qualitative interviews. Follow-up interviews are currently underway and will be integrated into the presentation. Preliminary Results: Prenatal depressive symptoms were significantly positively correlated to 8-week and 12-18-month postpartum depressive symptoms. Participants who reported clinical levels of depression prenatally were 3.29 times (SE = .32, p < .001) more likely to report clinical levels of depression at 18 months postpartum. Those who reported clinical depression at 8-weeks postpartum were 6.52 times (SE = .41, p < .001) more likely to report clinical levels of depression at 18 months postpartum. Participants who gave birth earlier in the pandemic reported significantly higher prenatal (t(103) = 2.84, p < .01) and 8-week postpartum depressive symptoms (t(126) = 3.31, p < .001). Data from qualitative interviews contextualize the findings. Participants reported negative emotions during pregnancy, including sadness, grief, and anxiety. They attributed this in part to their experiences of pregnancy during the pandemic and uncertainty related to the birth experience and postpartum period. Postpartum interviews revealed some stressors specific to childbirth during the COVID-19 pandemic; however, most women reflected on positive experiences of birth and postpartum. Conclusions: Taken together, findings reveal a pattern of persistent depressive symptoms among U.S. parents who gave birth during the pandemic. Depressive symptoms are of significant concern for the health of parents and children, and the findings of this study suggest a need for continued mental health intervention for parents who gave birth during the pandemic. Policy and practice implications will be discussed.

Keywords: maternal mental health, perinatal depression, postpartum depression, covid-19 pandemic

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Authors: Ramin Zargarbashi, Hamid Rabie, Behnam Panjavi, Hooman Kamran, Seyedarad Mosalamiaghili, Zohre Erfani, Seyed Peyman Mirghaderi, Maryam Salimi

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Background: Posterior shoulder dislocation is one of the disabling complications of brachial plexus birth injury (BPBI), and various treatment options, including capsule and surrounding muscles release for open reduction, humeral derotational osteotomy, and tendon transfers, have been recommended to manage it. In the present study, we aimed to determine the clinical outcome of open reduction with soft tissue release, tendon transfer, and glenoid osteotomy inpatients with BPBI and posterior shoulder dislocation or subluxation. Methods: From 2018 to 2020, 33 patients that underwent open reduction, glenoid osteotomy, and tendon transfer were included. The glenohumeral deformity was classified according to the Waters radiographic classification. Functional assessment was performed using the Mallet grading system before and at least two years after the surgery. Results: The patients were monitored for 26.88± 5.47 months. Their average age was 27.5±14 months. Significant improvement was seen in the overall Mallet score (from 13.5 to 18.91 points) and its segments, including hand to mouth, hand to the neck, global abduction, global external rotation, abduction degree, and external rotation degree. Hand-to-back score and the presence of trumpet sign were significantly decreased in the post-operation phase (all p values<0.001). The above-mentioned variables significantly changed for both infantile and non-infantile dislocations. Conclusion: Our study demonstrated that open reduction along with glenoid osteotomy improves retroversion, and muscle strengthening with different muscle transfers is an effective technique for BPBI.

Keywords: birth injuries, nerve injury, brachial plexus birth palsy, Erb palsy, tendon transfer

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Authors: Phang Moon Leng

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Automated Early Warning Scores is a newly developed clinical decision tool that is used to streamline and improve the process of obtaining a patient’s vital signs so a clinical decision can be made at an earlier stage to prevent the patient from further deterioration. This technology provides immediate update on the score and clinical decision to be taken based on the outcome. This paper aims to study the use of an automated early warning score system on whether the technology has assisted the hospital in early detection and escalation of clinical condition and improve patient outcome. The hospital adopted the Modified Early Warning Scores (MEWS) Scoring System and MEWS Clinical Response into Philips IntelliVue Guardian Automated Early Warning Score equipment and studied whether the process has been leaned, whether the use of technology improved the usage & experience of the nurses, and whether the technology has improved patient care and outcome. It was found the steps required to obtain vital signs has been significantly reduced and is used more frequently to obtain patient vital signs. The number of deaths, and length of stay has significantly decreased as clinical decisions can be made and escalated more quickly with the Automated EWS. The automated early warning score equipment has helped improve work efficiency by removing the need for documenting into patient’s EMR. The technology streamlines clinical decision-making and allows faster care and intervention to be carried out and improves overall patient outcome which translates to better care for patient.

Keywords: automated early warning score, clinical quality and safety, patient safety, medical technology

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Authors: Horea-Serban Raluca-Ioana, Istrate Marinela

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The first part of the paper analyzes the dynamics of the total fertility rate both at the national and regional level, pointing out the regional disparities in the distribution of this indicator. At the same time, we also focus on the collapse of the number of live births, on the changes in the fertility rate by birth rank, as well as on the failure of acquiring the desired number of children. The second part of the study centres upon a survey applied to urban families with 3 and more than 3 offspring. The preliminary analysis highlights the fact that an increased fertility (more than 3rd rank) is triggered by the parents’ above the average material condition and superior education. The current situation of Romania, which is still passing through a period of relatively rapid demographic changes, marked by numerous convulsions, requires a new approach, in compliance with the recent interpretations appropriate to a new post-transitional demographic regime.

Keywords: fertility rate, family size intention, third birth rank, regional disparities

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Authors: D. Zahraddeen, N. M. Lemu, P. P. Barje, I. S. R. Butswat

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This study was conducted to investigate some of the factors affecting the optimum reproductive capacity of the indigenous breeds of sheep in Nigeria. A total of 767 sheep of different breeds were investigated. The reproductive indices considered were birth/weaning weights, litter size, parity, mortality, reproductive problems/disorders, body condition score (BCS), as well as growth traits. The results showed that litter size, parity, and BCS had significant (p < 0.05) effects on birth/weaning weights, mortality rates and growth traits of the sheep breeds studied. Similarly, the rearing method/system significantly (p < 0.05) influenced other reproductive traits such as birth/weaning weights, mortality, growth performance of lambs. However, the major reproductive problems/disorders in the ewes were dystocia (30.94%), retained placenta (16.91%), mastitis (15.83), pregnancy toxaemia (11.51%), uterine prolapse (6.48%) and vaginal prolapse (3.24%). In the rams, the incidence of reproductive problems included cryptorchidism (1.08%), orchitis (2.87%) and scrotal dermatophilosis (1.79%), among others. This study concludes that the four breeds of sheep (Balami, Yankasa, Uda, and West African Dwarf sheep) and their crosses exhibited varied genetic make-up and potentials. However, the large number of sheep farmers practicing the extensive production system might be responsible for the low reproductive performance of this species in the country. It is, therefore, recommended that significant improvement could be achieved through enhanced management practices of these animals.

Keywords: sheep, breeds, reproduction, disorders

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Authors: Adam L. Miller

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The aim of this paper is to look back to the very beginning of cinematic history and explore the connection between the differing technology used, and the varying styles adopted by early filmmakers. The paper will be structured chronologically, first looking at the advances that predated Thomas Edison and his Kinetograph and Kinetogram. This paper will then explore how Edison’s technology and films varied from the Lumiere brothers and their Cinematograph. Finally, the paper will go on to draw parallels and differences between French filmmakers such as Alice Guy and George Melies, and American filmmakers like Edwin S. Porter and D. W. Griffith.

Keywords: film studies, early cinema, silent cinema, early cinematic technology, Thomas Edison, Alice Guy, George Melies, Edwin S. Porter, Lumiere brothers, D. W. Griffith

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Authors: Ana Mouta, Ana Paulino

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The following text presents the ik.model, a theoretical framework that guided the pedagogical implementation of meaningful educational technology-based projects in formal education worldwide. In this paper, we will focus on how this framework has enabled the development of media literacy projects for early childhood education during the last three years. The methodology that guided educators through the challenge of systematically merging analogic and digital means in dialogic high-quality opportunities of world exploration is explained throughout these lines. The effects of this methodology on early age media literacy development are considered. Also considered is the relevance of this skill in terms of post-contemporary challenges posed to learning.

Keywords: early learning, ik.model, media literacy, pedagogy

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Authors: Maria L. G. Lourenço, Keylla H. N. P. Pereira, Viviane Y. Hibaru, Fabiana F. Souza, Joao C. P. Ferreira, Simone B. Chiacchio, Luiz H. A. Machado

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Anasarca is generalized congenital edema that is often lethal. The condition is transmitted hereditarily and is autosomal dominant, with a racial predisposition in French Bulldogs and English Bulldogs. This study aims at reporting a case of anasarca treatment in neonates. The fetuses of a one year and six months old, primiparous English Bulldog mother were diagnosed with anasarca during an ultrasound examination performed at the 55th day of pregnancy and, therefore, an elective cesarean section was scheduled to prevent fetal dystocia. At birth, all puppies presented anasarca, and one of the six was stillborn. The newborns presented cyanosis, dyspnea, bradycardia, absent reflexes, low vitality scores (3/10), and hypothermia ( < 32ºC). The weight of the puppies at the time of birth varied between 347 and 373 grams, about 100 grams above the average weight estimated for the breed. Immediate neonatal care was applied with oxygen therapy via a mask, aminophylline (0.2 ml/100 g/PV/sublingual), and slow heating. After 10 minutes, there was a significant improvement in the neonatal parameters. The anasarca was treated with the drug furosemide, administered subcutaneously, at a dose of 0.2 mg per 100 grams of weight, every three hours. The stimulation for urination of newborns was performed every 30 minutes, and weight loss was monitored every 30 minutes. Five grams of potassium chloride were administered orally for every 30 grams of weight loss to counterbalance the loss of potassium caused by the diuretic medication. After 15 hours, the neonates reached the ideal weight for the breed, around 209 to 230 grams. In total, four neonates received five doses of furosemide, while one received six doses. The puppies are currently ten months old, healthy and neutered. Anasarca should not be ignored and is considered potentially lethal and an indication for euthanasia in all cases. Early intervention is of utmost importance for the survival of these patients.

Keywords: Walrus syndrome, congenital edema, water puppy syndrome, puppies

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Authors: Terryann Clark, Kabir Dasgupta, Sonia Lewycka, Gail Pacheco, Alexander Plum

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This paper focused on two main research aims using data from the Growing Up in New Zealand (GUINZ) birth cohort: 1. To examine ethnic differences in life-course trajectories in the use and experience of healthcare services in early childhood years (namely immunisation, dental checks and use of General Practitioners (GPs)) 2. To quantify the contribution of relevant explanatory factors to ethnic differences. Current policy in New Zealand indicates there should be, in terms of associated direct costs, equitable access by ethnicity for healthcare services. However, empirical evidence points to persistent ethnic gaps in several domains. For example, the data highlighted that Māori have the lowest immunisation rates, across a number of time points in early childhood – despite having a higher antenatal intention to immunise relative to NZ European. Further to that, NZ European are much more likely to have their first-choice lead maternity caregiver (LMC) and use child dental services compared to all ethnicities. Method: This research explored the underlying mechanisms behind ethnic differences in the use and experience of child healthcare services. First, a multivariate regression analysis was used to adjust raw ethnic gaps in child health care utilisation by relevant covariates. This included a range of factors, encompassing mobility, socio-economic status, mother and child characteristics, household characteristics and other social aspects. Second, a decomposition analysis was used to assess the proportion of each ethnic gap that can be explained, as well as the main drivers behind the explained component. The analysis for both econometric approaches was repeated for each data time point available, which included antenatal, 9 months, 2 years and 4 years post-birth. Results: The following findings emerged: There is consistent evidence that Asian and Pacific peoples have a higher likelihood of child immunisation relative to NZ Europeans and Māori. This was evident at all time points except one. Pacific peoples had a lower rate relative to NZ European for receiving all first-year immunisations on time. For a number of potential individual and household predictors of healthcare service utilisation, the association is time-variant across early childhood. For example, socio-economic status appears highly relevant for timely immunisations in a child’s first year, but is then insignificant for the 15 month immunisations and those at age 4. Social factors play a key role. This included discouragement or encouragement regarding child immunisation. When broken down by source, discouragement by family has the largest marginal effect, followed by health professionals; whereas for encouragement, medical professionals have the largest positive influence. Perceived ethnically motivated discrimination by a health professional was significant with respect to both reducing the likelihood of achieving first choice LMC, and also satisfaction levels with child’s GP. Some ethnic gaps were largely unexplained, despite the wealth of factors employed as independent variables in our analysis. This included understanding why Pacific mothers are much less likely to achieve their first choice LMC compared to NZ Europeans; and also the ethnic gaps for both Māori and Pacific peoples relative to NZ Europeans concerning dental service use.

Keywords: child health, cohort analysis, ethnic disparities, primary healthcare

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Authors: Md. Rashed Aalm, Md. Nuruzzaman Khan, Yothin Sawangdee

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Background: Around 47% of the total pregnancies are unintended in Bangladesh, which lead to several adverse consequences, including maternal and child mortality. Use of menstrual regulation (MR) can help women to reduce unintended pregnancy related adverse consequences. We explored the prevalence and determinants of MR services among ever-married women in Bangladesh. Methods: Total of 14,346 ever-married women data were analysed from the 2017 Bangladesh Demographic and Health Survey. Our study variable was use or non-use of MR services. Individual, household, and community level factors were the explanatory factors. Multilevel mixed-effect Poisson regression model was used to determine the factors associated with MR services in Bangladesh. Results: Nearly 7% of the total women in Bangladesh use MR services. Use of MR services was found higher among women who were aged 20-30 ages (IRR 1.60, 95% CI: 1.17–2.17), who were overweight (IRR 1.43, 95% CI: 1.13–1.81), had at least 1 child (IRR 2.97, 95% CI: 2.34– 3.77) or > 2 children (IRR 3.22, 95% CI: 2.45–4.20), and the birth preceding birth interval was(2 – 4) years (IRR 1.56, 95% CI: 1.13–2.15). Around 1.39 times (95% CI: 1.11–1.73) higher likelihood of MR was found among women whose husbands were engage with business. At the community level, MR service was found lower among the women who resided in the community with higherilliteracy (IRR 0.67, 95% CI: 0.42–0.96) and the Mymensingh division (IRR 0.39, 95% CI: 0.31–0.91). Conclusion: Use of MR service is comparatively low, which indicate a significant proportion of unintended pregnancy continued toward life-birth. This could be responsible for higher adverse maternal and child health outcomes in Bangladesh. Initiatives should be taken to ensure MR services is available when women need this service.

Keywords: menstrual regulation, pattern, risk, maternal health, Bangladesh

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Authors: Kavita Khoiwal, Vatsla Dadhwal, K. Aparna Sharma, Dipika Deka, Plabani Sarkar

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Introduction: About 2.4 million (1.93 - 3.04 million) people are living with HIV/AIDS in India. Of all HIV infections, 39% (9,30,000) are among women. 5.4% of infections are from mother to child transmission (MTCT), 25,000 infected children are born every year. Besides the risk of mother to child transmission of HIV, these women are at risk of the higher adverse pregnancy outcome. The objectives of the study were to compare the obstetric and neonatal outcome in women who are HIV positive with low-risk HIV negative women and effect of antiretroviral drugs on preterm birth and IUGR. Materials and Methods: This is a retrospective case record analysis of 212 HIV-positive women delivering between 2002 to 2015, in a tertiary health care centre which was compared with 238 HIV-negative controls. Women who underwent medical termination of pregnancy and abortion were excluded from the study. Obstetric outcome analyzed were pregnancy induced hypertension, HIV positive intrauterine growth restriction, preterm birth, anemia, gestational diabetes and intrahepatic cholestasis of pregnancy. Neonatal outcome analysed were birth weight, apgar score, NICU admission and perinatal transmission.HIV-positiveOut of 212 women, 204 received antiretroviral therapy (ART) to prevent MTCT, 27 women received single dose nevirapine (sdNVP) or sdNVP tailed with 7 days of zidovudine and lamivudine (ZDV + 3TC), 15 received ZDV, 82 women received duovir and 80 women received triple drug therapy depending upon the time period of presentation. Results: Mean age of 212 HIV positive women was 25.72+3.6 years, 101 women (47.6 %) were primigravida. HIV positive status was diagnosed during pregnancy in 200 women while 12 women were diagnosed prior to conception. Among 212 HIV positive women, 20 (9.4 %) women had preterm delivery (< 37 weeks), 194 women (91.5 %) delivered by cesarean section and 18 women (8.5 %) delivered vaginally. 178 neonates (83.9 %) received exclusive top feeding and 34 neonates (16.03 %) received exclusive breast feeding. When compared to low risk HIV negative women (n=238), HIV positive women were more likely to deliver preterm (OR 1.27), have anemia (OR 1.39) and intrauterine growth restriction (OR 2.07). Incidence of pregnancy induced hypertension, diabetes mellitus and ICP was not increased. Mean birth weight was significantly lower in HIV positive women (2593.60+499 gm) when compared to HIV negative women (2919+459 gm). Complete follow up is available for 148 neonates till date, rest are under evaluation. Out of these 7 neonates found to have HIV positive status. Risk of preterm birth (P value = 0.039) and IUGR (P value = 0.739) was higher in HIV positive women who did not receive any ART during pregnancy than women who received ART. Conclusion: HIV positive pregnant women are at increased risk of adverse pregnancy outcome. Multidisciplinary team approach and use of highly active antiretroviral therapy can optimize the maternal and perinatal outcome.

Keywords: antiretroviral therapy, HIV infection, IUGR, preterm birth

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Authors: Sadia Munir, Diana White, Aya Albahri, Pratiwi Hastania, Eltahir Mohamed, Mahmood Khan, Fathima Mohamed, Ayat Kadhi, Haila Saleem

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Preeclampsia is a major complication of pregnancy. Prediction and management of preeclampsia is a challenge for obstetricians. To our knowledge, no major progress has been achieved in the prevention and early detection of preeclampsia. There is very little known about the clear treatment path of this disorder. Preeclampsia puts both mother and baby at risk of several short term- and long term-health problems later in life. There is huge health service cost burden in the health care system associated with preeclampsia and its complications. Preeclampsia is divided into two different types. Early onset preeclampsia develops before 34 weeks of gestation, and late onset develops at or after 34 weeks of gestation. Different genetic and environmental factors, prognosis, heritability, biochemical and clinical features are associated with early and late onset preeclampsia. Prevalence of preeclampsia greatly varies all over the world and is dependent on ethnicity of the population and geographic region. To authors best knowledge, no published data on preeclampsia exist in Qatar. In this study, we are reporting the incidence of preeclampsia in Qatar. The purpose of this study is to compare the incidence and risk factors of both early onset and late onset preeclampsia in Qatar. This retrospective longitudinal cohort study was conducted using data from the hospital record of Women’s Hospital, Hamad Medical Corporation (HMC), from May 2014-May 2016. Data collection tool, which was approved by HMC, was a researcher made extraction sheet that included information such as blood pressure during admission, socio demographic characteristics, delivery mode, and new born details. A total of 1929 patients’ files were identified by the hospital information management when they apply codes of preeclampsia. Out of 1929 files, 878 had significant gestational hypertension without proteinuria, 365 had preeclampsia, 364 had severe preeclampsia, and 188 had preexisting hypertension with superimposed proteinuria. In this study, 78% of the data was obtained by hospital electronic system (Cerner) and the remaining 22% was from patient’s paper records. We have gone through detail data extraction from 560 files. Initial data analysis has revealed that 15.02% of pregnancies were complicated with preeclampsia from May 2014-May 2016. We have analyzed difference in the two different disease entities in the ethnicity, maternal age, severity of hypertension, mode of delivery and infant birth weight. We have identified promising differences in the risk factors of early onset and late onset preeclampsia. The data from clinical findings of preeclampsia will contribute to increased knowledge about two different disease entities, their etiology, and similarities/differences. The findings of this study can also be used in predicting health challenges, improving health care system, setting up guidelines, and providing the best care for women suffering from preeclampsia.

Keywords: preeclampsia, incidence, risk factors, maternal

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Authors: Eun Jeong Yu, Inn Soo Kang, Tae Ki Yoon, Mi Kyoung Koong

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Advanced female age is associated with higher cycle cancelation rates, lower clinical pregnancy rate, increased miscarriage and aneuploidy rates in IVF (In Vitro Fertilization) cycles. This retrospective cohort study was conducted at a Cha Fertility Center, Seoul Station. All fresh non-donor IVF cycles performed in women aged 40 years and above from January 2016 to December 2016 were reviewed. Donor/recipient treatment, PGD/PGS (Preimplantation Genetic Diagnosis/ Preimplantation Genetic Screening) were excluded from analysis. Of the 1,166 cycles from 753 women who completed ovulation induction, 1,047 were appropriate for the evaluation according to inclusion and exclusion criterion. IVF cycles were categorized according to age and grouped into the following 1-year age groups: 40, 41, 42, 43, 44, 45 and > 46. The mean age of patients was 42.4 ± 1.8 years. The median AMH (Anti-Mullerian Hormone) level was 1.2 ± 1.5 ng/mL. The mean number of retrieved oocytes was 4.9 ± 4.3. The clinical pregnancy rate and live birth rate in women > 40 years significantly decreased with each year of advancing age (p < 0.001). The clinical pregnancy rate decreased from 21% at the age of 40 years to 0% at ages above 45 years. Live birth rate decreased from 12.3% to 0%, respectively. There were no clinical pregnancy outcomes among 95 patients aged above 45 years of age. The overall miscarriage rate was 40.7% (range, 36.7%-70%). The transfer of at least one good quality embryo was associated with about 4-9% increased chance of a clinical pregnancy rate. Therefore, IVF in old age women less than 46 had a reasonable chance for successful pregnancy outcomes especially when good quality embryo is transferred.

Keywords: advanced maternal age, in vitro fertilization, pregnancy rate, live birth rate

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Authors: Oktavian Prasetia Wardana, Martono Tri Utomo, Risa Etika, Kartika Darma Handayani, Dina Angelika, Wurry Ayuningtyas

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Background: Critically ill neonates are newborn babies with high-risk factors that potentially cause disability and/or death. Scoring systems for determining the severity of the disease have been widely developed as well as some designs for use in neonates. The SNAPPE-II method, which has been used as a mortality predictor scoring system in several referral centers, was found to be slow in assessing the outcome of critically ill neonates in the Neonatal Intensive Care Unit (NICU). Objective: To analyze the predictive value of MSNS on the outcome of critically ill neonates at the time of arrival up to 24 hours after being admitted to the NICU. Methods: A longitudinal observational analytic study based on medical record data was conducted from January to August 2022. Each sample was recorded from medical record data, including data on gestational age, mode of delivery, APGAR score at birth, resuscitation measures at birth, duration of resuscitation, post-resuscitation ventilation, physical examination at birth (including vital signs and any congenital abnormalities), the results of routine laboratory examinations, as well as the neonatal outcomes. Results: This study involved 105 critically ill neonates who were admitted to the NICU. The outcome of critically ill neonates was 50 (47.6%) neonates died, and 55 (52.4%) neonates lived. There were more males than females (61% vs. 39%). The mean gestational age of the subjects in this study was 33.8 ± 4.28 weeks, with the mean birth weight of the subjects being 1820.31 ± 33.18 g. The mean MSNS score of neonates with a deadly outcome was lower than that of the lived outcome. ROC curve with a cut point MSNS score <10.5 obtained an AUC of 93.5% (95% CI: 88.3-98.6) with a sensitivity value of 84% (95% CI: 80.5-94.9), specificity 80 % (CI 95%: 88.3-98.6), Positive Predictive Value (PPV) 79.2%, Negative Predictive Value (NPV) 84.6%, Risk Ratio (RR) 5.14 with Hosmer & Lemeshow test results p>0.05. Conclusion: The MSNS score has a good predictive value and good calibration of the outcomes of critically ill neonates admitted to the NICU.

Keywords: critically ill neonate, outcome, MSNS, NICU, predictive value

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Authors: Joseph L. Mathew, Shourjendra N. Banerjee, R. K. Ratho, Sourabh Dutta, Vanita Suri

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Background: In India and many other developing countries, a single dose of measles vaccine is administered to infants at 9 months of age. This is based on the assumption that maternal transplacentally transferred antibodies will protect infants until that age. However, our previous data showed that most infants lose maternal anti-measles antibodies before 6 months of age, making them susceptible to measles before vaccination at 9 months. Objective: This prospective study was designed to compare susceptibility in pre-term vs term infants, at different time points. Material and Methods: Following Institutional Ethics Committee approval and a formal informed consent process, venous blood was drawn from a cohort of 45 consecutive term infants and 45 consecutive pre-term infants (both groups delivered by the vaginal route); at birth, 3 months, 6 months and 9 months (prior to measles vaccination). Serum was separated and anti-measles IgG antibody levels were measured by quantitative ELISA kits (with sensitivity and specificity > 95%). Susceptibility to measles was defined as antibody titre < 200mIU/ml. The mean antibody levels were compared between the two groups at the four time points. Results: The mean gestation of term babies was 38.5±1.2 weeks; and pre-term babies 34.7±2.8 weeks. The respective mean birth weights were 2655±215g and 1985±175g. Reliable maternal vaccination record was available in only 7 of the 90 mothers. Mean anti-measles IgG antibody (±SD) in terms babies was 3165±533 IU/ml at birth, 1074±272 IU/ml at 3 months, 314±153 IU/ml at 6 months, and 68±21 IU/ml at 9 months. The corresponding levels in pre-term babies were 2875±612 IU/ml, 948±377 IU/ml, 265±98 IU/ml, and 72±33 IU/ml at 9 months (p > 0.05 for all inter-group comparisons). The proportion of susceptible term infants at birth, 3months, 6months and 9months was 0%, 16%, 67% and 96%. The corresponding proportions in the pre-term infants were 0%, 29%, 82%, and 100% (p > 0.05 for all inter-group comparisons). Conclusion: Majority of infants are susceptible to measles before 9 months of age suggesting the need to anticipate measles vaccination, but there was no statistically significant difference between the proportion of susceptible term and pre-term infants, at any of the four-time points. A larger study is required to confirm these findings and compare sero-protection if vaccination is anticipated to be administered between 6 and 9 months.

Keywords: measles, preterm, susceptibility, term infant

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