PROVIDE Training Compendium brings lifesaving mothers’ own milk to NICU infants
by The Editorial TeamRush University Medical Center has produced PROVIDE – A Training Compendium on Providing Mothers’ Own Milk in NICU Settings, to train healthcare professionals in mothers’ own milk (MOM) feeding practices in neonatal intensive care units (NICUs) worldwide. It is available on The Global Health Network’s knowledge platform LactaHub: www.lactahub.org/nicu-training
The authors aimed to assess the effect of a quality improvement package for intrapartum and immediate newborn care on stillbirth and preterm neonatal survival in Kenya and Uganda, where evidence-based practices are often underutilised. This unblinded cluster-randomised controlled trial was done in western Kenya and eastern Uganda at facilities that provide 24-h maternity care with at least 200 births per year. Findings suggests that fresh stillbirth and neonatal mortality among low-birthweight and preterm babies can be decreased using a package of interventions that reinforces evidence-based practices and invests in health system strengthening.
Unintended pregnancy and abortion by income, region, and the legal status of abortion: estimates from a comprehensive model for 1990–2019
by Bearack et alThe authors developed a model that simultaneously estimated incidence of unintended pregnancy and abortion within a Bayesian framework. The findings suggest that between 1990–94 and 2015–19, the global unintended pregnancy rate has declined, whereas the proportion of unintended pregnancies ending in abortion has increased. As a result, the global average abortion rate in 2015–19 was roughly equal to the estimates for 1990–94. Our findings suggest that people in high-income countries have better access to sexual and reproductive health care than those in low-income countries. Our findings indicate that individuals seek abortion even in settings where it is restricted. These findings emphasise the importance of ensuring access to the full spectrum of sexual and reproductive health services, including contraception and abortion care, and for additional investment towards equity in health-care services.
Cost-effectiveness analysis of Baby-Friendly Hospital Initiative in promotion of breast-feeding and reduction of late neonatal infant mortality in Brazil
by Osvaldinete Lopes de Oliveira Silva et alThe objective of this study was to analyse the cost-effectiveness of Baby-Friendly Hospital Initiative (BFHI) in promoting breast-feeding during the first hour of life (BFFHL) and reducing late neonatal mortality. Cost-effectiveness analysis showed that BFHI was highly cost-effective in raising BFFHL by 32·0 % at lower cost in comparison with non-BFHI. In addition, BFHI was cost-effective in reducing late neonatal mortality rate by 13·0 % from all causes and by 13·1 % of infant mortality rate from infections.
Characteristics of Women of Reproductive Age With Laboratory-Confirmed SARS-CoV-2 Infection by Pregnancy Status - United States, January 22-June 7, 2020
by Ellington et alThe objective of the study was to assess the prevalence and severity of COVID-19 among pregnant U.S. women and determine whether signs and symptoms differ among pregnant and nonpregnant women. Findings suggest that among women of reproductive age with COVID-19, pregnant women are more likely to be hospitalized and at increased risk for ICU admission and receipt of mechanical ventilation compared with nonpregnant women, but their risk for death is similar. To reduce occurrence of severe illness from COVID-19, pregnant women should be counseled about the potential risk for severe illness from COVID-19, and measures to prevent infection with SARS-CoV-2 should be emphasized for pregnant women and their families
Pregnancy and Postpartum Outcomes in a Universally Tested Population for SARS-CoV-2 in New York City: A Prospective Cohort Study
by Prabhu et alThis prospective cohort study aimed to describe differences in outcomes between pregnant women with and without COVID-19. Among pregnant women with COVID-19 at delivery, the study observed increased cesarean delivery rates and increased frequency of maternal complications in the postpartum period. Additionally, intraplacental thrombi may have maternal and fetal implications for COVID-19 infections remote from delivery.
Clinical Findings and Disease Severity in Hospitalized Pregnant Women With Coronavirus Disease 2019 (COVID-19)
by Savasi et alThe objective of this study was to investigate the clinical evolution of coronavirus disease 2019 (COVID-19) in hospitalized pregnant women and potential factors associated with severe maternal outcomes. In the study cohort, one in five women hospitalized with COVID-19 infection delivered urgently for respiratory compromise or were admitted to the ICU. None, however, died. Increased pregestational BMI and abnormal heart and respiratory rates on admission were associated with severe disease.
In this trial, the authors investigated whether a primarily telehealth lifestyle intervention reduced excess gestational weight gain (GWG) among women with overweight or obesity. Evidence-based programme showed that health-care delivery systems could further adapt to meet the needs of their clinical settings to prevent excess GWG and improve healthy behaviours and markers of insulin resistance among women with overweight or obesity by using telehealth lifestyle interventions.
Perinatal Depressive and Anxiety Symptoms of Pregnant Women Along With COVID-19 Outbreak in China
by Wu et alThe aim of the present study is to examine the impact of COVID-19 outbreak on the prevalence of depressive and anxiety symptoms and the corresponding risk factors among pregnant women across China. Findings suggest that major life-threatening public health events such as the COVID-19 outbreak may increase the risk for mental illness among pregnant women including thoughts of self-harm. Strategies targeting maternal stress and isolation such as effective risk communication and the provision of psychological first aid may be particularly useful to prevent negative outcomes for women and their fetuses.
DNDi short film about new treatment for sleeping sickness awarded Grand Prix at inaugural WHO film festival
by The Editorial TeamSurvey launched to establish what research funders should prioritise for COVID-19
by The Editorial TeamCOVID19 During Pregnancy: A Systematic Review of Reported Cases
by Anna Nunzia Della Gatta et alThe objective of thsi study was to conduct a systematic review of the outcomes reported for pregnant patients with COVID 19. Fidnings suggest that although vertical transmission of SARS-Cov2 has been excluded thus far and the outcome for mothers and fetuses has been generally good, the high rate of preterm cesarean delivery is a reason for concern. These interventions were typically elective, and it is reasonable to question whether they were warranted or not. COVID-19 associated with respiratory insufficiency in late pregnancies certainly creates a complex clinical scenario.
The objective of the study was to evaluate the clinical characteristics and outcomes in pregnancy and the vertical transmission potential of SARS-CoV-2 infection. Findings suggest that ARS-CoV-2 infection during pregnancy is not associated with an increased risk of spontaneous abortion and spontaneous preterm birth. There is no evidence of vertical transmission of SARS-CoV-2 infection when the infection manifests during the third-trimester of pregnancy.
Perinatal Aspects on the covid-19 Pandemic: A Practical Resource for Perinatal-Neonatal Specialists
by Francis Mimouni et alThe objective of this study was to summarize available evidence and provide perinatologists/neonatologists with tools for managing their patients. As the pandemic continues, more data will be available that could lead to changes in current knowledge and recommendations.
The objective of this study was to assess whether vaginal secretions and breast milk of COVID-19 patients contain SARS-CoV-2 virus. In this case series of 13 pregnant women with COVID-19, we observed negative viral test results in vaginal secretion specimens, suggesting that a vaginal delivery may be a safe delivery option. However, additional research is urgently needed to examine breast milk and the potential risk for viral contamination.
Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection in Children and Adolescents A Systematic Review
by Riccardo Castagnoli et alThe objective of this study was to evaluate currently reported pediatric cases of SARS-CoV-2 infection. A total of 815 articles were identified. Eighteen studies with 1065 participants (444 patients were younger than 10 years, and 553 were aged 10 to 19 years) with confirmed SARS-CoV-2 infection were included in the final analysis. All articles reflected research performed in China, except for 1 clinical case in Singapore. Children at any age were mostly reported to have mild respiratory symptoms, namely fever, dry cough, and fatigue, or were asymptomatic. Bronchial thickening and ground-glass opacities were the main radiologic features, and these findings were also reported in asymptomatic patients. Among the included articles, there was only 1 case of severe COVID-19 infection, which occurred in a 13-month-old infant. No deaths were reported in children aged 0 to 9 years. Available data about therapies were limited.
Facing a Pandemic While Pregnant
by Coral Olazagasti et alFacing a Pandemic While Pregnant
Factors Associated With Child Stunting, Wasting, and Underweight in 35 Low- and Middle-Income Countries
by Li et alIn this cross-sectional study of 299 353 children aged 12 to 59 months in 35 low- and middle-income countries, household socioeconomic status and parental nutritional status were the leading factors associated with child undernutrition in pooled analyses and in most country-specific analyses. Environmental conditions, health behaviors, disease prevalence, and maternal reproductive care were less frequently associated with child undernutrition, with substantial heterogeneity among countries.
A sexual and reproductive health and justice policy agenda must be at the heart of the COVID-19 response. The response must ensure that universal health coverage includes pregnant women, adolescents, and marginalised groups and must designate sexual and reproductive health, family planning, and community health centres as essential health providers, reallocating resources accordingly.
Community-based Savings Groups, Women's Agency, and Maternal Health Service Utilisation: Evidence From Mozambique
by Tura et alThis study, using data collected as part of an ongoing programme evaluation, investigates whether participation in Saving Groups (SGs)-a community-owned microfinance intervention focused on poor households - is associated with maternal health service utilisation, and whether this association is mediated by women's agency - as measured by self-efficacy and decision-making autonomy. This study suggests that the impact of SG membership on use of maternal health services goes beyond improvements in household income and may operate through women's agency by giving women the ability to realize their preference for quality health care.