Births, economic growth, mortality and murder in a developing country

Background: In 1960, total fertility rate in Jamaica was 5.6 children per woman which declined by 57.5% in 2008. The reduction in fertility is primarily attributable to contraceptive measures;but murder and other selected macroeconomic variables have never been included in the literature. Objectives: This study examines murder, mortality, and selected macroeconomic variables are factors of births, using data for Jamaica from 1989-2009. Methods: The study is a secondary data analysis of statistics on Jamaica from 1989 - 2009 but also includes data on births from 1900s. Find- ings: In the decade of the 1950s, births increased by 79.9% over the decade of 1900s, grew by 22.4% in the 1960s over the previous decade and declined by 17.6% in 2000s compared with the 1990s. Four emerged as statistically significant predictors of lnbirth—inflation, GDP per capita growth, mortality and murder, with an explanatory power of 90.6%—F = 19.291, P s = 0.962), when murder was excluded and replaced by annual exchange rate, the factors influencing lnbirth was exchange rate, inflation, unemployment, GDP per capita growth and mortality—all factors account for 92.2% of the variability in lnbirth—F = 30.572, P < 0.0001. Conclusion: Murder is more that a crime it is a cause of birth decline, suggesting that public health practitioners as well as epidemiologists must take this factor into account as it is a birth determinant.

More Than Eight Million Births Averted In Shandong

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A Village Known for Extra Births

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A Prosperous Cooperative with Fewer Births

Nonglian Village of Sheyang County,Yancheng City.Jiangsu Province has 454 families(1,460 people)and 356 women of childbearing age.In the past,the village was povcrty-stricken and plagued with unwanted births.Between 1980 and 1990.more than 100 unplanned children were bom.

Maternal risk factors for low birth weight for term births in a developed region in China:a hospital-based study of 55,633 pregnancies

Low birth weight （LBW） is an important risk factor for neonatal and infant mortality and morbidity in adults.. How- ever, no large scale study on the prevalence of LBW and related maternal risk factors in China has been published. To explore the effects of maternal factors on LBW for term birth in China, we conducted a hospital-based retrospective study of 55, 633 Chinese pregnancy cases between 2001 and 2008. Maternal sociodemographic data, history of infer- tility and contraceptive use were obtained. Their medical status and diseases during pre-pregnancy were examined by physical examination at the first antenatal care visit. Maternal medical status before childbirth and pregnancy outcomes, including body weight, infant gender, multiple pregnancy and congenital anomalies, were recorded. Univariate and multivariate logistic regression, and linear regression were used to investigate the relationship be- tween maternal factors and term LBW. The general incidence of term LBW was 1.70% in the developed area of China. After preliminary analysis using the univariate model, low primary education, anemia, hypertensive disor- ders, placental previa, oligohydramnios and premature rupture of membrane were predicted as independent factors of term LBW in the multivariate model. Furthermore, the decrease in annual frquencies of these risk factors were major causes of gradual decline in the incidence of LBW （from 2.43% in 2001 to 1.21% in 2008）. The study dem- onstrated that among maternal factors, primary education, anemia and hypertensive disorders could contribute to LBW for term birth even in the most developed area of China.

Live births from in vitro fertilization-embryo transfer following the administration of gonadotropin-releasing hormone agonist without gonadotropins:Two case reports

BACKGROUND The prevalence of female infertility between the ages of 25 and 44 is 3.5%to 16.7%in developed countries and 6.9%to 9.3%in developing countries.This means that infertility affects one in six couples and is recognized by the World Health Organization as the fifth most serious global disability.The International Committee for Monitoring Assisted Reproductive Technology reported that the global total of babies born as a result of assisted reproductive technology procedures and other advanced fertility treatments is more than 8 million.Advancements in controlled ovarian hyperstimulation procedures led to crucial accomplishments in human fertility treatments.The European Society for Human Reproduction and Embryology guideline on ovarian stimulation gave us valuable evidence-based recommendations to optimize ovarian stimulation in assisted reproductive technology.Conventional ovarian stimulation protocols for in vitro fertilization(IVF)–embryo transfer are based upon the administration of gonadotropins combined with gonadotropin-releasing hormone(GnRH)analogues,either GnRH agonists(GnRHa)or antagonists.The development of ovarian cysts requires the combination of GnRHa and gonadotropins for controlled ovarian hyperstimulation.However,in rare cases patients may develop an ovarian hyper response after administration of GnRHa alone.CASE SUMMARY Here,two case studies were conducted.In the first case,a 33-year-old female diagnosed with polycystic ovary syndrome presented for her first IVF cycle at our reproductive center.Fourteen days after triptorelin acetate was administrated(day 18 of her menstrual cycle),bilateral ovaries presented polycystic manifestations.The patient was given 5000 IU of human chorionic gonadotropin.Twenty-two oocytes were obtained,and eight embryos formed.Two blastospheres were transferred in the frozen-thawed embryo transfer cycle,and the patient was impregnated.In the second case,a 37-year-old woman presented to the reproductive center for her first donor IVF cycle.Fourteen days after GnRHa administration,the transvaginal ultrasound revealed six follicles measuring 17-26 mm in the bilateral ovaries.The patient was given 10000 IU of human chorionic gonadotropin.Three oocytes were obtained,and three embryos formed.Two high-grade embryos were transferred in the frozen-thawed embryo transfer cycle,and the patient was impregnated.CONCLUSION These two special cases provide valuable knowledge through our experience.We hypothesize that oocyte retrieval can be an alternative to cycle cancellation in these conditions.Considering the high progesterone level in most cases of this situation,we advocate freezing embryos after oocyte retrieval rather than fresh embryo transfer.

Do Protease Inhibitors Increase Preterm Births in Human Immunodeficiency Virus-Infected Patients?

Objective: To compare preterm delivery (PTD) rates in HIV-infected patients on a protease inhibitor (PI)-based and a PI-sparing regimen. Study Design: This is a retrospective review of records of HIV-infected pregnant women between 2000 and 2007 at University Hospital, Newark, NJ. Patients were grouped according to PI exposure during pregnancy. Rates of preterm birth were compared, and the analysis was performed irrespectively of the etiology or indication of the preterm birth. Multivariate analysis including substance use, PI use, initial CD4 count, and history of PTD was performed. Results: There were 129 pregnant women in the PI group and 59 in the PI-sparing group. The PTD rate did not differ between the PI group and PI-sparing group (27.9% vs 25.4%, P = 0.72). 28.6% of those who delivered preterm had a previous PTD compared to 8.4% of those who delivered at term (P = 0.0019). Patients who delivered preterm had a higher rate of substance use (37.3% vs 19.7%, P = 0.0128). In the multivariate analysis, only history of PTD was significant (P = 0.018). Conclusion: Contrary to other studies, PIs were not associated with PTD. Other known risk factors of PTD, specifically past PTD and substance use, should be considered and targeted for risk reduction during pregnancy.

Role of Vaginal Progesterone in Prevention of Preterm Labor in Women with Previous History of One or More Previous Preterm Births

Objective: To evaluate whether prophylactic administration of 200 mg vaginal progesterone can reduce the incidence of preterm birth in women with documented history of preterm birth Setting: Obstetrics and Gynecology Department, Zagazig University Hospital, Egypt. Methods: Ninety patients with previous history of preterm birth prior to 37 week presenting with singleton pregnancy between 20 - 24 weeks were randomly allocated to receive either the progesterone 200 mg vaginal suppository or no treatment. Results: The incidence of preterm labor before 37 weeks of gestation was significantly lower in the study group than in the control group (22.2% vs. 53.3%) especially in earlier gestational ages. While, the mean birth weight was significantly higher in the study group than in control group (2872.67 ± 565.76 gm vs. 2487.78 ± 742.40 gm). The neonatal morbidities and mortality associated with preterm labor were significantly lower in the study group than in the control group as shown by lower incidence of neonatal RDS (13.3% vs. 31.1%;P = 0.043) and lower incidence of the need for NICU admission (15.6% vs. 35.5%;P = 0.03). Conclusion: Administration of prophylactic vaginal progesterone (200 mg, daily) can significantly reduce the rate of preterm birth before 37, 32 and 28 wks of gestation among women with previous spontaneous preterm birth. In addition, the rates of RDS and admission to NICU were significantly decreased among infants of women assigned to progesterone treatment. Also, there was an additional benefit of vaginal progesterone for prevention of preterm birth in women who had prior spontaneous preterm birth and cervical length 25 mm.

Comparative Analysis of Variations in Human Sex Ratios of Live Births Among African Populations and at Global Levels

Definition： The final net live birth delivery from the mother＇s womb, with distinct male and female genetic traits, forms a ratioof male live births per 100 female live births, termed as Sex Ratio at Birth （SRB）. Study areas and source of data： The studyareas are Africa and major worldwide continents and countries. The basic data are compiled from the National Populationand Housing Censuses, Demographic Sample Surveys, Demographic and Health Surveys, and Vital Registration Systems.Analytical approaches： The factors influencing the variations in SRB are identified by reviewing various documents, analysisof variance （ANOVA） techniques, and statistical measures of central tendency and dispersion. Results： The ratios areconsistently higher for advanced countries than the developing countries, with highest for China and India. The ANOVAresults show slight differences among the S0 African countries but show differences among the African regional states,whereas the standard deviation of the SRB among the advanced countries, including some Asian and Latin Americancountries shows non-significant variations. In conclusion, the mean SRB for African populations is 103 as against 106 forother countries.

Brain age estimation:premise,promise,and problems

Premise:The com bined effects of modern healthcare practices which prolong lifespan and declining birthrates have created unprecedented changes in age demographics worldwide that are especially pronounced in Japan,South Korea,Europe,and North America.Since old age is the most significant predictor of dementia,global healthcare systems must rise to the challenge of providing care for those with neurodegenerative disorders.

Declining number of births in China: a decomposition analysis

Recent drastic changes in marriage and fertility behaviour have a considerable impact on China’s annual number of births.Population momentum and changing fertility policy largely determine the changing number of births in China over the past two decades.While the annual number of births have been steadily fluctuat-ing around 16-18 million,contrary trends in the number of the first births and the second births have been observed.The two-child policy produced marked effects on the rising number of the second births,which is however to a large extent offset by the declining number of the first births resulting from rapidly postponing age at first marriage.A decomposition analysis demonstrates that all demographic factors are depressing birth numbers,including the size of reproductive-age women and its age structure,proportion married and marital fertility in the very recent years.China’s seventh population census conducted in 2020 suggests a more rapid decline in birth numbers,marking the start of a lowest-low fertility in Chinese history.

The impact of child births on female labor force participation in China

Adjustments to fertility policy in recent years have led to changes in fertility level and these have had an impact on the overall population and have implications for labor force participation.In particular,fertility policy adjustments have had a direct influence on the female labor force.This paper uses data from China Family Panel Studies in 2016 to test the impact that increases in the number of child births that have occurred as result of shifts in fertility level are having on women’s labor force participation.Our findings show that the influence of the number of children on the participation of married women in the labor force is shown by a“U-shaped”non-linear relationship dominated by substitution effect and income effect.The turn-ing point of urban married women from the substitution effect to the income effect occurs earlier than it does for rural married women.This means that urban married women are more sensitive to the economic pressure that results from child births.Therefore,the Universal Two-Child policy,introduced at the beginning of 2016,inevitably has a direct negative effect on women’s labor force participation.Help-ing women to maintain work-family balance has become a problem that must be addressed at present.

Effects of greenness on preterm birth: A national longitudinal study of 3.7 million singleton births

Exposure to greenness may lead to a wide range of beneficial health outcomes.However,the effects of greenness on preterm birth(PTB)are inconsistent,and limited studies have focused on the subcategories of PTB.A total of 3,751,672 singleton births from a national birth cohort in China's Mainland were included in this study.Greenness was estimated using the satellitebased Normalized Difference Vegetation Index(NDVI)and Enhanced Vegetation Index with 500-m and 1,000-m buffers around participants’addresses.The subcategories of PTB(20-36 weeks)included extremely PTB(EPTB,20-27 weeks).

Trends in the Prevalence of Births with Chromosomal Abnormalities—Haidian District,Beijing Municipality,China,2013–2022

Summary What is already known about this topic?The primary causes of early miscarriage and stillbirth are chromosomal abnormalities(CAs)whose prevalence has been observed to increase in recent years.What is added by this report?According to data received from a hospital-based birthdefect surveillance system in the Haidian District,Beijing,there was a significant increase in the prevalence of CAs along with most subtypes from 2013 to 2022.

Epidemiological characteristics of live births with esophageal atresia in Sao Paulo State,Brazil,from 2005 to 2018

Background The estimated prevalence of esophageal atresia(EA)is 1 in 2500–4500 live births(LBs).Researchers have already identified risk factors,but the mechanisms are still unknown.The aim of this study is to identify EA prevalence trends and its risk factors in the São Paulo State(SPS)population database.Methods We conducted a population-based study using all EA cases identified by the Live Births Information System across 14 years(2005–2018)to estimate EA prevalence trends in recent years,stratified by maternal age and SPS geographical clusters.We calculated the prevalence trends,regression coefficient(β),annual percent change(APC),and 95%confidence interval(CI).Results We found 820 EA cases among 8,536,101 LBs with a prevalence of 1.0/10,000 LBs in SPS,Brazil.There was no significant difference in distribution by sex.Among all the cases,the majority(65%)were Caucasian;51.8%were born at term;43%had weight of≥2500 g;95.4%were singleton;and 73.4%of births were by cesarean section.From 2005 to 2018,there was an increasing trend of EA prevalence(APC=6.5%)with the highest APC of 12.2%.The highest EA prevalence rate(1.7/10,000 LB)was found in the group with maternal age of≥35 years.No significant seasonal variation was found based on the conception month(p=0.061).Conclusions EA had an increasing prevalence trend in SPS,Brazil,in recent years,with the highest prevalence rate in the group with maternal age of≥35 years.No seasonality was observed.This population-based study is the first to summarize the current epidemiology of EA in SPS LB.

The Questions On Jun Zhu′s Paper: A Model of the Age Patterns of Births by Parity in Natural Fertility Populations

When we read Mr. Jun Zhu′s paper: a model of the age patterns of births by parity in natural fertility populations published in Mathematical Population Studies, Vol.4(3), pp.153～173, 1994, it really surprised us by his creative ideas and perfect results. We studied the paper deliberately because it is a remarkable work, and could be a significant contribution to the modeling of fertility analysis. As some contents not perceivable to us, we would expect to discuss with Mr. Jun Zhu to make a clear comprehension of the models in the paper. Our aim is to lead the models and the theory more reliable and practical.

The Impact of New Adjustments to the Family Planning Policy on the Number of Live Births in Four Developed Urban Areas—China,2013−2019

What is already known on this topic?Due to shifting circumstances in China,the government has adjusted the child-bearing policy to allow couples to have a second child.This has affected the total number of live births,especially in more developed urban areas.What is added by this report?The total number of live births in the 4 monitoring cities including Chengdu,Wuhan,Shenzhen,and Beijing during 2014–2019 increased by 33.0%,20.3%,10.7%,and 8.2%,respectively.From 2014 to 2017,the proportion of total live births that were policy related increased in each city:Chengdu(2.0%to 35.0%),Wuhan(1.0%to 25.1%),Shenzhen(0.6%to 39.4%),and Beijing(3.1%to 30.2%).What are the implications for public health practice?Our results showed that the implementation of the new adjusted family planning policy alleviated the downward trends in total live births and is unlikely to lead a baby boom as estimated by previous studies.

How did women’s education and differential family planning policies shape transition to second and third births in historical China? New evidence from micro data

The influence of China’s family planning policies on fertility transition is widely acknowledged in research studies.However,little is known about how improve-ments in women’s education have shaped reproductive decisions of Chinese women across different family planning regimes,particularly at micro level.This study uses retrospective pooled birth history data from five consecutive population and fam-ily planning surveys collected over the period 1982-2006 to systematically examine the interrelationship between family planning policies and women’s education,and their interactive effect on the second and third birth transitions.We hypothesize that family planning policies had a differential influence on educational groups in reduc-ing the transition to second and third births.The results from discrete time com-plementary log-log survival models provide strong evidence of differential repro-ductive behavior of education groups across time in China,and the simultaneous influence of women’s education and family planning policies in lowering risks to higher parities.The rates of progression to second and third births tend to be lower after the introduction of rigid family planning policies,and more importantly,the policy impact persisted even after adjusting for demographic and socioeconomic factors.The increase in women’s education overall had a depressing effect on transi-tion to higher parities,and family planning policies implemented overtime have had differential effects on women from different educational groups.The findings show that both family planning policies and women’s education have been instrumental in shaping fertility behavior in China.

Nomogram to predict severe retinopathy of prematurity in Southeast China

AIM:To define the predictive factors of severe retinopathy of prematurity(ROP)and develop a nomogram for predicting severe ROP in southeast China.METHODS:Totally 554 infants diagnosed with ROP hospitalized in the Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University and hospitalized in Taizhou Women and Children’s Hospital were included.Clinical data and 43 candidate predictive factors of ROP infants were collected retrospectively.Logistic regression model was used to identify predictive factors of severe ROP and to propose a nomogram for individual risk prediction,which was compared with WINROP model and Digirop-Birth model.RESULTS:Infants from the Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University(n=478)were randomly allocated into training(n=402)and internal validation group(n=76).Infants from Taizhou Women and Children’s Hospital were set as external validation group(n=76).Severe ROP were found in 52 of 402 infants,12 of 76 infants,and 7 of 76 infants in training group,internal validation group,and external validation group,respectively.Birth weight[odds ratio(OR),0.997;95%confidence interval(CI),0.996-0.999;P<0.001],multiple births(OR,1.885;95%CI,1.013-3.506;P=0.045),and non-invasive ventilation(OR,0.288;95%CI,0.146-0.570;P<0.001)were identified as predictive factors for the prediction of severe ROP,by univariate analysis and multivariate analysis.For predicting severe ROP based on the internal validation group,the areas under receiver operating characteristic curve(AUC)was 78.1(95%CI,64.2-92.0)for the nomogram,32.9(95%CI,15.3-50.5)for WINROP model,70.2(95%CI,55.8-84.6)for Digirop-Birth model.In external validation group,AUC of the nomogram was also higher than that of WINROP model and Digirop-Birth model(80.2 versus 51.1 and 63.4).The decision curve analysis of the nomogram demonstrated better clinical efficacy than that of WINROP model and Digirop-Birth model.The calibration curves demonstrated a good consistency between the actual severe ROP incidence and the predicted probability.CONCLUSION:Birth weight,multiple births,and noninvasive ventilation are independent predictors of severe ROP.The nomogram has a good ability to predict severe ROP and performed well on internal validation and external validation in southeast China.

Neonatal tachypnea caused by diaphragmatic paralysis:A case report

BACKGROUND Diaphragmatic paralysis is typically associated with phrenic nerve injury.Neonatal diaphragmatic paralysis diagnosis is easily missed because its manifestations are variable and usually nonspecific.CASE SUMMARY We report a 39-week-old newborn delivered via vaginal forceps who presented with tachypnea but without showing other birth-trauma-related manifestations.The infant was initially diagnosed with pneumonia.However,the newborn still exhibited tachypnea despite effective antibiotic treatment.Chest radiography revealed right diaphragmatic elevation.M-mode ultrasonography revealed decreased movement of the right diaphragm.The infant was subsequently diagnosed with diaphragmatic paralysis.After 4 weeks,tachypnea improved.Upon re-examination using M-mode ultrasonography,the difference in bilateral diaphragmatic muscle movement was smaller than before.CONCLUSION Appropriate use of M-mode ultrasound to quantify diaphragmatic excursions could facilitate timely diagnosis and provide objective evaluation.