Association of traffic-related air pollution with Newborn's anthropometric indexes at birth.

An emerging body of evidence has associated exposure to traffic-related air pollution (TRAP) during pregnancy with birth outcomes. However, the evidence on the association of TRAP exposure and neonatal anthropometric measurements (NAPM) in low and middle-income countries is very scarce yet. Therefore, we investigate the association of prenatal exposure to indicators of traffic and ambient particulate matter (PM) with NAPM. This cross-sectional study was based on hospital medical records of 4053 mother-neonate pairs between May 16, 2016, and December 5, 2018. PMs were estimated at residential addresses based on validated spatiotemporal models. Moreover, total street length in 100, 300 and 500m buffers around the home, residential distance to the ring road, major roads, heavy-traffic lights, gas station, motorway junction, bank, square, bus terminal, public parking and industrial land-use were calculated as indicators of traffic. The head circumference (HC), birth weight (BW) and birth length (BL) of neonates were collected as NAPM. Multivariate regression models were applied to evaluate the relationship between PMs and indicators of traffic with NAPM, controlled for relevant covariates. The median (IQR) of BW, BL, and HC of newborns were 3250 (592) gr, 51.0 (3.5) cm, 35 (2) cm, respectively. The adjusted models revealed that higher exposure to PM2.5 and PM10 was significantly related with lower BW and BL. Similar results were observed for total street length in a 100 m buffer around maternal home with BW and BL. Moreover, higher distance to heavy traffic lights was significantly associated with higher BW and BL. An IQR increase in PM10 was significantly related to lower HC (95% CI: 0.11, -0.01, P-value = 0.03). An increase in distance from residential address to heavy traffic lights, ring roads, bus terminal, and transportation land-use was associated with higher HC. Overall, our findings suggested that higher prenatal exposure to TRAP was related with lower BW, BL and HC.

Assessing fear of childbirth and its predictors among Hungarian pregnant women using Wijma Delivery Expectancy/Experience Questionnaire subscales.

This study aimed to assess fear of childbirth (FOB) among Hungarian pregnant women and determine predictors based on WDEQ-A subscales. This cross-sectional study was conducted among 423 healthy pregnant women during their third trimester. A socio-demographic and obstetrics characteristics, the Hungarian version of WDEQ-A, Beck Depression Inventory-Short Form and Beck Anxiety Inventory were used. The analysis was performed using multivariate linear regression. Among four WDEQ-A subscales, Fear (19%) and Lack of positive emotion (13%) obtained the largest and smallest percentages of cases with severe FOB. The nulliparous obtained significantly higher mean score in subscales Isolation and Lack of positive emotion compared to the multiparous. Anxiety was the most common predictor for all subscales in both groups. In the nulliparous group, significant predictors included economic hardship for Moment of birth, being a housewife for Fear, and wanted pregnancy for Lack of positive emotion. In the multiparous women, the strongest significant predictors were being married, previous elective caesarean section and being a housewife for subscales Isolation, Moment of birth, and Fear, respectively. Assessing FOB using WDEQ-A among Hungarian women revealed different mean scores and predisposing factors for each subscale. The topic should be further explored relative to its constituent factors.

The association between exposure to polycyclic aromatic hydrocarbons and birth outcomes: A systematic review and meta-analysis of observational studies.

Exposure to polycyclic aromatic hydrocarbons (PAHs) has been linked to adverse birth outcomes; however, to date, the available studies on such relations, with the exception of birth weight, has not been systematically synthesized. We conducted a systematic review and meta-analysis of the available observational studies on the association of maternal exposure to PAHs and their metabolites during pregnancy with indicators of fetal growth and gestational age at delivery. We searched Web of Science, PubMed and Scopus systematically for all relevant published papers in English until 13 January 2023. Random effects meta-analysis was applied to synthesize the association estimates. Publication bias was assessed using Egger's regression. A total of 31 articles were included in our review (n = 703,080 participants). Our quality assessment of reviewed papers showed that 19 research had excellent, nine had good, and three had fair quality. Most of the reviewed studies on exposure to PAHs and their metabolites with gestational age and preterm birth (seven studies) reported no statistically significant association. Eight studies were eligible for our meta-analysis. Results of the meta-analysis indicated that higher levels of maternal urinary 1-OHP was associated with lower birth weight, birth length and head circumference and a higher risk of low birth weight (LBW). However, these associations were not statistically significant. Similarly, the combined association between maternal urinary 1-OHP and newborn's Ponderal index (PI) and Cephalization index were not statistically significant. Overall, our systematic review and meta-analysis suggested a potential adverse impact of exposure to PAHs on LBW, HC, and CC; however, further studies are required to be able to draw concrete conclusions on such associations.

Signs, Symptoms, and Side-Effects Presented by Different Types of COVID-19 Vaccines: A Prospective Cohort Study.

The concern about post-COVID-19 vaccine complications still remains. In addition, the evidence on Sinopharm, Sputnik V, Covaxin, and, in particular, COVIran Barekat, as well as comparisons between them by dosage after post-vaccination, is scarce. This study aimed to investigate and compare the prevalence of self-reported post-vaccination signs and symptoms following the first and second doses of different types of COVID-19 vaccines. Research design and methods: This prospective cohort study was conducted on more than 1500 health professionals who had received at least one dose of any type of Sputnik V, Sinopharm, Oxford AstraZeneca, Covaxin, and COVIran Barekat vaccines in Iran. The survey questionnaire was sent to participants online, 28 days after receiving each dose of the vaccine. Results: About 73% of health professionals reported at least one post-vaccination sign or symptom, developing mostly within the first 12 h (69.9%) and lasting up to 12 h (59.0%). Pain and tenderness at the injection site, fever, and muscle pain were the most common post-vaccination signs and symptoms in all vaccines, which were significantly higher in the Oxford AstraZeneca vaccine (p < 0.001) for both the first and second doses. The incidence rate of all post-vaccination signs and symptoms was significantly higher in the first dose than in the second dose (p < 0.05). Conclusion: The Oxford AstraZeneca vaccine showed the highest incidence rate, onset, and lasting time of signs and symptoms in both doses; however, they were not life-threatening. The onset time of signs and symptoms was significantly higher for the COVIran Barekat and Oxford AstraZeneca vaccines in both the first and second doses.

Does institutional maternity services contribute to the fear of childbirth? A focus group interview study.

BACKGROUND: The quality of institutional maternity services offered significantly determine the health outcomes of pregnant women and their infants. OBJECTIVES: The study aimed at understanding perceptions and experiences of new mothers diagnosed with the fear of childbirth in Kenya; regarding the institutional maternity services offered and if they contribute to the fear of childbirth (FOC). METHODS: This was a qualitative descriptive study. A total of 29 women who had given birth recently in a maternity institution, and had been screened with the fear of childbirth at 32 weeks' gestation period participated in focus group interviews. The Framework for Assessing the Quality of Care of institutional maternity services (FAQC) developed by the University of Southampton was adopted in this study. Thematic analyses were used. RESULTS: It was reported that institutional maternity services contributed directly and indirectly to FOC. The direct contribution included the performance of unintended caesarian sections, severe and prolonged labour pains and negative attitude of healthcare providers. The indirect contribution was in form of challenges in the provision of care and the experience of care in the maternity institutions. In the provision of care; human and physical resources, inadequate referral systems, and inadequate management of emergencies were reported. In the experience of care; lack of cognition, respect, dignity, equity and inadequacies in emotional support were reported. CONCLUSION: The study identified systemic challenges related to both the provision and the experience of care. Therefore, there is need to astutely analyze all critical steps identified in the FAQC, as this will greatly improve the uptake of institutional maternity services.

Prevalence of fear of childbirth in a sample of gravida women in Kenya.

OBJECTIVE: The aim of the study was to determine the prevalence of fear of childbirth (FOC) using a sample of gravida women in Kenya, a developing country where it is not fully acknowledged. MATERIALS AND METHODS: This were a cross-sectional study on gravida women visiting health facilities to receive routine antenatal care. The study applied multistage sampling to enrol eligible expectant women. A researcher-developed questionnaire was used alongside Wijma Delivery Expectancy/Experience Questionnaire (version A) to collect respondents' demographic characteristics and to measure their fear of childbirth levels, respectively. RESULTS: Approximately 29.5% had low, 40.4% moderate, 22.1% high, and 8% recorded severe FOC levels. Comparing by parity, the prevalence of severe FOC was higher on primigravida at 13.8% than multigravida, 8.0%. The results revealed a significant relationship between marital status (p = 0.045), parity (p = 0.000), literacy status (p = 0.000), regular check-up of pregnancy at health facilities (p = 0.003), having trust in healthcare providers (p = 0.000), and physical activity for gravida women with fear of childbirth (p = 0.000). CONCLUSION: From the findings, special attention on the identified predictors of fear of childbirth during prenatal sessions would help in managing fear of childbirth before they give birth.

Predicting the Risk of Opioid Use Disorder Based on Early Maladaptive Schemas.

Substance use is a globally devastating social problem. Early maladaptive schemas (EMSs) are inefficient mechanisms leading directly or indirectly to psychological distress. The current study aimed to assess the role of EMSs in predicting opioid use disorder. The cross-sectional study was conducted in 2013 in Bojnurd at northeast of Iran on 60 male opioid users who received Methadone Maintenance Treatment (MMT) and 60 control males. The opioid users were selected randomly from MMT clinics and control subjects were selected and matched with opioid users using demographic variables. The subjects completed the Young Schema Questionnaire-Short Form (YSQ-SF). Except for SS (self-sacrifice), EG (entitlement/grandiosity), US (unrelenting standards), and FA (Failure to Achieve), the mean of other maladaptive schemas in the opioid user group were significantly higher than that of the control group, adjusted for multiple comparisons. Multivariate analysis of variance (MANOVA) indicated significant differences in maladaptive schemas between the two groups. Logistic regression identified that Emotional Deprivation, Mistrust/Abuse, and Unrelenting Standards can predict opioid use. As a result, the risk of opioid-related disorders in people with higher YSQ-SF scores in these schemas is higher. The findings conclude that the existence of underlying EMS may constitute a vulnerability factor for developing opioid use disorders later on in life. Provided the vast amount of scientific literature in evidence-based treatments focusing on EMSs, maladaptive schemas and related core beliefs can be detected and treated in adolescence to prevent the enactment of the schema and psychological distress likely to induce opioid use.