Maternal and Child Health Commons^™

Risk And Protective Factors Associated With Teenage Pregnancy And Intergenerational Interventions: A Scoping Review Protocol, Zamasomi Luvuno, Wilbroda Hlolosile Chiya, Silingene Joyce Ngcobo, Deshini Naidoo, Serwaa Omowale, Tracy Zhandire, Elizabeth Musili Joseph-Shehu, Busisiwe Purity Ncama, Sinegugu E Duma

Faculty, Staff and Student Publications

Introduction: Teenage pregnancy remains a critical global health issue, particularly in low- and middle-income countries. The intergenerational transmission of teenage pregnancy underscores the need for targeted interventions. Existing research on intergenerational approaches is fragmented, with varying methodologies and outcomes. This scoping review seeks to address this gap by answering the following research questions: What are the available intergenerational interventions for teenage pregnancy, and what are the associated risks and protective factors for early and late teenage pregnancy?

Methods and analysis: This study does not involve primary data collection and therefore does not require ethical approval. The review will be conducted …

Supporting The Mental Health Of Adolescent Mothers In Kenya And Mozambique: Pilot Protocol For The Thriving Mamas Programme, Tatiana Taylor Salisbury, Maria Suzana Bata Maguele, Fernando Chissale, Málica De Melo, Margrette Hanselmann, Kethakie Lamahewa, Evaline Chepchirchir Langat, Flávio Mandlate, Lucy Nyaga, Marleen Temmerman

Centre of Excellence in Women and Child Health

Background: Poor mental health among adolescent girls during pregnancy and the year after birth (the perinatal period) has been found to have a significant detrimental effect on girls and their children. The Innovative approaches to adolescent perinatal wellbeing (INSPIRE) project co-designed an intervention (Thriving Mamas) to improve adolescent perinatal mental health in Kenya and Mozambique. The aim of the current study is to pilot test the co-designed intervention to understand how it can be adapted for further testing or scale-up.

Methods :A mixed-method, pilot cluster-randomised, efectiveness-implementation Hybrid Type II trial will be conducted among 80 adolescent girls (aged 15–19 years) …

Epidemiology Of Shigella Species And Serotypes In Children: A Retrospective Substudy Of The Mal-Ed Observational Birth Cohort Study, Elizabeth T. Rogawski Mcquade, Jie Liu, Mustafa Mahfuz, Alexandre Havt, Furqan Kabir, Adil Kalam, Fatima Aziz, Sahrish Muneer, Najeeha Talat Iqbal, Zulfiqar Ahmed Bhutta

Department of Paediatrics and Child Health

Background: Shigellosis is a leading cause of diarrhoea in children globally. We aimed to assess the burden of specific Shigella species and Shigella flexneri serotypes, characterise their clinical syndromes and natural immunity, and evaluate their relevance as causes of diarrhoea and linear growth faltering.
Methods: In the MAL-ED birth cohort study, children younger than 17 days were enrolled from Nov 3, 2009, to Feb 29, 2012, in Bangladesh, Brazil, India, Nepal, Pakistan, Peru, Tanzania, and South Africa and were followed up for 2 years. In this retrospective substudy, we retested Shigella quantitative PCR-positive diarrhoeal and non-diarrhoeal stool samples with molecular …

Development Of A Light-Based Platform To Assess Cervical Mucus Barrier Function And Physical Mucus Properties, Elizabeth J. Buzbee

McKelvey School of Engineering Graduate Student Theses & Dissertations

Preterm birth is the leading cause of neonatal morbidity and mortality worldwide, yet current clinical tools for predicting its risk lack specificity and reliability. Cervical mucus plays a crucial role in maintaining pregnancy by forming a barrier that protects the uterus against infection. This study investigates the use of laser speckle rheology as a noninvasive technique to assess cervical mucus biomechanics. Synthetic cervical mucus was fabricated at varying hydration levels and tested using a conventional rheometer that confirmed that the mechanical properties of the synthetic mucus samples were representative of physiological cervical mucus. These results were compared to the complex …

A Modified Sir Model Used To Investigate The Relationship Between Congenital And Adult Syphilis, Kaleesta R. Waysman

Honors Thesis

A complex SIR model integrating the relationship between adult and congenital syphilis was developed. The goal of the project was to determine the specific population(s) or control strategies that should be enforced, altered, or removed to decrease the number of children experiencing clinical sequelae due to congenital syphilis. Early clinical sequelae include hydrops fetalis, preterm birth, central nervous system infection, hepatosplenomegaly, hyperbilirubinemia, cholestasis, hemolytic anemia, snuffles, osteochondritis, and lesions or rashes in the palms and soles. Late clinical sequelae include interstitial keratitis, hearing loss, Hutchinson teeth, saber shins, Clutton joints, mulberry molars, and saddle nose. After implementing real-world data into …

Relationship Between Maternal Iron Indices In The Second Trimester With Cord Blood Iron Indices And Pregnancy Outcomes: A Prospective Cohort Study, J.P. Akshaykirthan, Manjunath S. Somannavar, M.S. Deepthy, Umesh Charantimath, S. Yogeshkumar, Amaresh Patil, Mrutyunjaya B. Bellad, Richard Derman, Shivaprasad S. Goudar

Global Health Articles

Background/Objectives: Iron deficiency anemia in pregnancy poses risks to mothers and infants. This study aimed to correlate maternal iron indices in the second trimester with cord blood indices and pregnancy outcomes.

Methods: This prospective cohort study was nested within the RAPIDIRON Trial (Reducing Anaemia in Pregnancy in India) at Jawaharlal Nehru Medical College, Karnataka, India. A total of 292 pregnant women with moderate anemia who received oral iron supplementation were enrolled from April 2021 to May 2023. Maternal iron indices were measured at multiple time points and correlated with cord blood indices and pregnancy outcomes.

Results: Increased hemoglobin levels were …

Beyond Opioids: The Role Of Polysubstance Exposure In Neonatal Abstinence Syndrome Treatment And Hospitalization, Caelyn Harrison

Undergraduate Honors Theses

This thesis explores the impact of prenatal polysubstance exposure, specifically focusing on the need for pharmacological treatment for Neonatal Abstinence Syndrome (NAS) and the duration of their hospital stay. A retrospective analysis of 462 infants, including 121 exposed to polysubstances during pregnancy, showed significant associations between polysubstance exposure and adverse neonatal outcomes. Infants with prenatal polysubstance exposure were more likely to require pharmacological treatment for NAS (52.8%) compared to non-exposed infants (38.7%), as determined by chi-square analysis (χ²(1, N = 462) = 7.36, p = .007). Additionally, infants exposed to polysubstances experienced longer hospital stays on average (M = 14.88 …

A Comprehensive Literature Review Of Barriers To Hormone Therapy Utilization: Strategies For Improving Menopause Management In Women Aged 40-60, Suhan Lee

Capstone Experience: Master of Public Health

Menopause is a natural transition marked by the cessation of ovarian activity, often accompanied by vasomotor symptoms (VMS), genitourinary syndrome of menopause (GSM), and psychological changes that significantly impact women’s quality of life. Hormone therapy (HT) has been the primary treatment for managing menopausal symptoms, particularly VMS, providing substantial relief when initiated within 10 years of menopause. Despite its effectiveness, HT usage has declined dramatically over the past two decades primarily due to barriers such as stigma, safety, misinformation, provider hesitancy, financial barriers, and cultural beliefs. This comprehensive literature review explores key factors influencing HT decision-making, including the media’s role …

The State Of Abortion Training In Medical School And Family Medicine Residency Curricula: A Scoping Literature Review, Eric James Reece

Capstone Experience: Master of Public Health

This project aims to assess how abortion education has been integrated into medical training over the past decade, with a particular focus on understanding its current state in medical schools and family medicine residencies, including those offering specialized programs affiliated with RHEDI (Reproductive Health Education in Family Medicine) and TEACH (Training in Early Abortion for Comprehensive Healthcare). Given the ever-evolving legal landscape following the June 4^th, 2022 Supreme Court case of Dobbs v. Jackson Women’s Health Organization, this review explores how both federal- and state-level legal restrictions impact access to abortion training and attempts to identify gaps …

Small For Gestational Age Sub-Groups Have Differential Morbidity, Growth And Neurodevelopment At Age 2: The Interbio-21st Newborn Study, Aris T. Papageorghiou, María C. Restrepo-Méndez, Rose Mcgready, Fernando C. Barros, Francois Nosten, Shama Munim, Roseline Ochieng, Rachel Craik, Hellen C. Barsosio, James A. Berkley

Paediatrics and Child Health, East Africa

Background :Small for Gestational Age (SGA) is a complex perinatal syndrome associated with increased neonatal morbidity, mortality, and impaired childhood growth and neurodevelopment. Current classifications rely primarily on birth weight, which does not capture the heterogeneity of the condition nor predict long-term health outcomes. Here we aim to identify and characterise distinct SGA sub-groups and assess their neonatal and early childhood health trajectories.

Objectives: To refine the classification of SGA by identifying sub-groups based on maternal, fetal, and environmental factors and evaluating their associations with neonatal morbidity, growth, and neurodevelopment at age 2.

Study Design: Prospective Cohort Study. In six …

Maternal Responsiveness To Infant Hunger Cues: Is It Possible To Mitigate Risk Of Obesity Starting In Infancy?, Arrianna A. Powers

Rowan-Virtua Research Day

Background: Childhood obesity is becoming a predominant health concern with over 37 million children under the age of 5 being overweight. Instances of rapid weight gain in infancy correlate to greater risk for obesity later on in life.

Methods: This study aimed to look at feeding modality and style for their impact on maternal responsiveness to infant hunger cues and RWG. A database search identified 21 studies eligible to be included in the review out of 150.

Discussion: Key findings showed breast-feeding mothers were most responsive to hunger cues, breastfed infants expressed greater cues than their formula-fed peers, and responsive …

Volatile Anesthetic Exposure During Organogenesis (Weeks 6-9): Implications For Fetal Brain Development, Cheryce Daniel, Kylon Coombs

Rowan-Virtua Research Day

Organogenesis, particularly during gestational weeks 6 through 9, represent a critical window for fetal brain development. During this period, neurogenesis, neural tube closure and synaptic organization are actively occurring. Disruption of these processes, especially from exogenous agents, can result in lasting developmental consequences.

The U.S Food and Drug Administration has issued warnings regarding the use of anesthetic agents such as isoflurane, sevoflurane, and desflurane. Noting the potential risk of neurotoxic effects on the developing brain. This warning is particularly highlighted when administered drugs are present for long periods of time or during repeated procedures. The goal of this literature review …

Adherence To Follow-Up Among High-Risk Nicu Patients, Iryna Muryn, Susan Mbullah Ndimah, Lisa Renee Eiland, Tara Lozy

Rowan-Virtua Research Day

Background:

Preterm infants, especially those ≤32 weeks' gestational age (GA) are at increased risk of vision and hearing loss. Risks of both vision and hearing loss can be ameliorated and in some cases prevented by conscientious screening, follow up and treatment. Universally, infants ≤32 weeks are cared for in neonatal intensive care units and there is considerable confidence that screenings and treatment occur according to established guidelines. At hospital discharge, follow up responsibility shifts to infant caretakers likely resulting in reduced compliance.

Objective:

We aimed to determine if preterm infants at risk for vision and hearing loss, attended follow up …

Literature Review: Prazosin Used For Ptsd In Pregnancy, Afshan Khan, Natali Sharma, Rebekah M. Dietrich, Martin Forsberg

Rowan-Virtua Research Day

Posttraumatic Stress Disorder (PTSD) affects 3–4% of pregnant and postpartum individuals and is associated with complications such as preterm birth, low birth weight, and postpartum depression. Pharmacologic treatment options during pregnancy are limited by concerns about fetal safety.

Methods: A literature review was conducted focusing on studies reporting maternal or neonatal outcomes following prazosin exposure in pregnancy.

Results: One observational study of 11 pregnancies found 54.5% had uneventful outcomes, with rates of preterm birth, miscarriage, and preeclampsia similar to the general population. Hypotension and limited lactation data remain concerns.

Conclusion: Early evidence suggests prazosin may be a relatively safe and …

Pain Management In Pregnant Women With Opioid Use Disorder: A Systematic Review, Adeena Javed

Rowan-Virtua Research Day

Background: The prevalence of opioid use disorder (OUD) among pregnant individuals has risen significantly, posing challenges in managing labor and postpartum pain. Factors such as opioid tolerance, opioid-induced hyperalgesia, and concerns about relapse complicate analgesic strategies. Despite these complexities, evidence-based guidelines for pain management in this population remain limited.

Hypothesis: Pregnant women with OUD experience disparities in pain management during labor and postpartum periods, leading to suboptimal outcomes.

Methods: A systematic review was conducted, analyzing peer-reviewed studies from databases including PubMed and Embase. Inclusion criteria encompassed studies focusing on pain management in pregnant women with OUD. Data extraction focused on …

Maternal Health And Nutrition: Combating Maternal Mortality Through Proper Nutrition, Archna Mahendru, Yeisanai Cardona Torres, Maya Blayne Partee, Katarina Rusinak

Rowan-Virtua Research Day

Maternal mortality is an increasing concern in the United States. According to the WHO, from 2018-2022 the Maternal Mortality Rate (MMR) was 23.3 deaths per every 100,000 live births. New Jersey's MMR exceeded this average at 26 per 100,000 during the same period, with 91% of cases deemed preventable. While medical care plays a crucial role, research shows that non-medical determinants such as food insecurity, lack of nutritional education, limited access to transportation, and systemic barriers to health care contribute significantly to maternal health outcomes. Among these factors, proper nutrition plays a critical role before and during pregnancy, particularly in …

Children Born To Mothers With Inflammatory Bowel Disease: A Review Of Pediatric Outcomes, Simran Gandhi, Kush Patel, Harmann Singh

Rowan-Virtua Research Day

Background: Inflammatory Bowel Disease (IBD), comprising Crohn’s disease and ulcerative colitis, frequently affects women during their reproductive years. While the impact of IBD on pregnancy has been widely studied, less is known about the long-term health outcomes in children born to affected mothers, particularly in the context of in utero exposure to immunosuppressive therapies.

Hypothesis: We hypothesize that children born to mothers with well-managed IBD experience normal growth and development, with minimal risk for immune-related complications, despite potential exposure to biologics and other IBD medications during gestation.

Methods: A literature review was conducted using PubMed and Google Scholar. Search terms …

Chemical Exposures In Utero: Phthalates And Congenital Heart Defects, Demi Poulathas

Rowan-Virtua Research Day

Background: Congenital heart defects (CHDs) are the most common type of birth defect. Approximately 80% of CHDs have unknown causes, and phthalates may play a contributing role. Phthalates are ubiquitous environmental chemicals used as plasticizers in a wide range of products, including cosmetics and electronic devices. After entering the body, phthalates bind to the progesterone receptor, which is necessary for fetal development. While multiple studies have explored environmental factors in CHD development, few have examined the effects of phthalates on CHDs in humans. Methods: A literature review was conducted to investigate the relationship between parental occupational phthalate exposure and the …

A Systematic Review Of Weight Loss Interventions Among Black Postpartum Women, Jhelma Velveder Perez

Honors Scholar Theses

Cardiovascular disease is a leading contributor to maternal mortality, which remains disproportionately high among Black women. Obesity and postpartum weight retention exacerbate cardiovascular disease risk and increase the likelihood of complications in future pregnancies. Weight loss during the postpartum period may reduce long-term chronic health risks and mortality for Black women. This systematic review aimed to understand the weight-related health needs of Black postpartum women by evaluating behavioral weight loss interventions within the first year after childbirth. A comprehensive search of the PubMed database identified 3 randomized controlled trials that met inclusion criteria. These studies evaluated home-based programs, mobile health …

The Impact Of Environmental Deficiencies On Maternal Health Outcomes, Zahra Wallizadeh, Emiyah Bullock, Antoinette Jones, Katarina Rusinak

Rowan-Virtua Research Day

This study examines the environmental factors contributing to adverse maternal health outcomes in New Jersey, with particular focus on their disproportionate impact on minority women. Analysis of data from PubMed, Policy Map, NIH, CDC, EPA, and the New Jersey Department of Health reveals that women living in low-income areas face significant environmental challenges, including food deserts, air pollution, unsafe living conditions, inadequate infrastructure, and limited transportation options. These environmental determinants exacerbate maternal stress and contribute to complications such as preterm birth and hypertension. Black women are nearly three times more vulnerable to these adverse outcomes compared to white women, highlighting …

Barriers To Care For Neonatal Abstinence Syndrome In Southern New Jersey, Gabriela Taslitsky, Hijab Zaidi, Nafisa Zalil

Rowan-Virtua Research Day

Neonatal Abstinence Syndrome (NAS) is a spectrum of clinical manifestations seen in newborns due to withdrawal secondary to intrauterine illicit and/or prescription drug exposure. Newborns with NAS present with common signs of withdrawal such as poor feeding, irritability, seizures, hypertonicity, low birth weight, loose stool, and premature birth. Maternal opioid use is the most common cause of NAS and with the increase in opioid use in the past decade the cases of NAS have also increased. This study examines the prevalence and challenges associated with NAS in Southern New Jersey. Our analysis reveals that Atlantic and Gloucester counties reported the …

Planning For Scale: Analysis Of Adaptations And Contextual Factors Influencing Scale-Up Of The Quali-Dec Intervention To Optimize Caesarean Section Use, Soha El-Halabi, Claudia Hanson, Alexandre Dumont, Amanda Cleeve, Helle Mölsted Alvesson, Charles Kaboré, Guillermo Carroli, Pisake Lumbiganon, Quoc Nhu Hung Mac, Ana Pilar Betran

Centre of Excellence in Women and Child Health

Background: Researchers are encouraged to plan for scale through purposeful and guided assessment of scalability of an intervention. This study analysed factors potentially influencing scale-up and synthesised early adaptations of the QUALI-DEC intervention aiming to improve the appropriate use of caesarean section. The intervention consists of opinion leader engagement, audit and feedback for caesarean section, a tool to help women make an informed decision on the mode of birth, and labour companionship.

Methods: We conducted a framework analysis, which was guided by the scalability assessment framework by Zamboni et al., a 34-item checklist with a three-point scale. We used data …

Pregnancy Care Integrating Translational Science, Everywhere (Precise): A Prospective Cohort Study Of African Pregnant And Non-Pregnant Women To Investigate Placental Disorders – Cohort Profile, Rachel Craik, Joseph Akuze, Marie-Laure Volvert, Hannah Blencowe, Moses Mukhanya, Angela Koech, Grace Mwashigadi, Marleen Temmerman, Marvin Ochieng, Emily Mwadime

Centre of Excellence in Women and Child Health

Purpose: The Pregnancies' Care Integrating translational Science, Everywhere Network was established to investigate specific placental disorders (pregnancy hypertension, preterm birth, fetal growth restriction and stillbirth) in sub-Saharan Africa. We created a repository of clinical and social data with associated biological samples from pregnant and non-pregnant women. Alongside this, local infrastructure and expertise in the field of maternal and child health research were enhanced.

Participants: Pregnant women were recruited in participating health facilities in The Gambia, Kenya and Mozambique at their first antenatal visit or at the time a placental disorder was diagnosed (Kenya and The Gambia only). Follow-up study …

Exercise As An Intervention For Postpartum Depression (Ppd), Kylie P. Mistretta

Honors Scholar Theses

Objective: To illustrate the applications of exercise for preventing the development of postpartum depression (PPD) and addressing associated risk factors identified in the literature. Data Sources: PubMed and EBSCO: Academic Search Premier were accessed using the search terms exercise OR physical activity OR yoga AND postpartum depression OR postnatal depression. A secondary search of PubMed was conducted using the search terms exercise AND pregnancy AND depression OR gestational diabetes OR weight gain OR sleep quality.

Study Selection: Studies selected for inclusion were peer-reviewed, published after January 2012, written in English, and relevant to the PPD risk factors examined. Only clinical …

The Influence Of Scientific, Genetic, And Health Literacy On Carrier Screening Decision-Making, Brenna D. Albracht

Dissertations and Theses (Open Access)

For those wishing to assess their reproductive risks and make informed decisions in their reproductive planning, carrier screening for autosomal recessive and X-linked conditions, as well as cell-free DNA (cfDNA) screening for aneuploidy, are recommended during pregnancy. Despite similarities in purpose, sample requirements, insurance coverage, and safety, a lower percentage of individuals elect carrier screening than cfDNA screening, suggesting there may be a disconnect in what patients perceive as valuable information for their pregnancy. Previous studies have attempted to explain the factors associated with carrier screening uptake or decline; however, no models have yet accounted for a patient’s literacy level …

Breaking The Cycle: Reducing Maternal Mortality Disparities In Minnesota, Grace Hambike

Undergraduate Research Symposium 2025

A comparative analysis of Minnesota's maternal mortality rates with states implementing successful maternal health initiatives and a review of policies supporting doulas, midwives, and culturally competent care models. Conclusions show that addressing maternal mortality disparities requires systemic healthcare reforms and culturally competent interventions. Expanding access to doulas, midwives, and community-based care can significantly improve maternal outcomes. Future research should focus on long-term effects of policy changes and continued surveillance of maternal health disparities.

"Health Gatekeepers": The Influence Of Women On Health Practices In Rural, Central Appalachia, Reese Lycan

Senior Theses

Women have historically assumed leadership roles in familial and community health promotion, intervention, and facilitation. While the role of women in family health is globally understood and the historical importance of female leadership has been documented, there remains a gap in knowledge regarding the role of women as “health gatekeepers”. Furthermore, when considering the Appalachian region, there are limited studies regarding women’s place in leadership as far as health is concerned. Therefore, this study employs a hermeneutic phenomenological framework to explore the lived experiences of women in relation to their family and community’s health in rural, Central Appalachia- a region …

Cell-Free Dna Results Indicating Mosaic Monosomy X Of Likely Maternal Origin: Impact On Genetic Counseling Practices And Patient Experiences, Audrey Mcbride, Ashley Cannon, Siddharth Prakash, Aaron W Roberts, Angela Seasely, Anna C E Hurst, Laura Hendon

Faculty, Staff and Student Publications

Objective: To investigate the current genetic counseling practices involving a cfDNA result indicating mosaic monosomy X of likely maternal origin, and to better understand the perspectives of patients who have received this result.

Method: A total of 60 prenatal genetic counselors completed surveys about their experiences with this result, cfDNA consenting practices, and management practices. In addition, qualitative interviews were conducted with 5 patients to gain insight into their experiences with result disclosure and follow-up care.

Results: 95% of genetic counselors reported feeling prepared to counsel on these results. However, responses to current practices varied. Of the genetic counselors surveyed, …

Cost-Effectiveness Of Intrapartum Azithromycin To Prevent Maternal Infection, Sepsis, Or Death In Low-Income And Middle-Income Countries: A Modelling Analysis Of Data From A Randomised, Multicentre, Placebo-Controlled Trial, Jackie K. Patterson, Simon Neuwahl, Sydney Kirsch, Janet L. Moore, Alan T.N. Tita, Waldemar A. Carlo, Adrien Lokangaka, Antoinette Tshefu, Musaku Mwenechanya, Elwyn Chomba, Avinash Kavi, Mrityunjay C. Metgud, Shivaprasad S. Goudar, Richard J. Derman, Poonam Shivkumar, Manju Waikar, Archana Patel, Patricia L. Hibberd, Paul Nyongesa, Fabian Esamai, Osa A. Ekhaguere, Sherri Bucher, Saleem Jessani, Shiyam S. Tikmani, Sarah Saleem, Blair J. Wylie, Robert L. Goldenberg, Sk Masum Billah, Ruth Lennox, Rashidul Haque, William A. Petri, Manolo Mazariegos, Nancy F. Krebs, Jennifer J. Hemingway-Foday, Denise Babineau, Marion Koso-Thomas, Elizabeth M. Mcclure, Melissa Bauserman

Global Health Articles

BACKGROUND: Sepsis is one of the leading causes of maternal mortality globally. In 2023, the Azithromycin Prevention in Labor Use (A-PLUS) trial showed intrapartum azithromycin for women planning a vaginal birth reduced the risk of maternal sepsis or death and infection. We aimed to evaluate the cost-effectiveness of intrapartum azithromycin for pregnant people planning a vaginal birth in low-income and middle-income countries (LMICs) using A-PLUS trial data.

METHODS: We compared the benefits and costs of intrapartum azithromycin versus standard care across 100 000 model simulations using data from the A-PLUS trial and a probabilistic decision tree model that included 24 …

Neonatal Outcomes In Periviable Births Weighing ≤ 500 Grams, Bijan Morshedi, Diego Maurente, Ursula Griffiths-Randolph, Elisabeth Kamano, Katharine Hopkins, Dana Baraki, Juliana Martins, Steven Warsof

Eastern Virginia Medical Journal

Background: The average rate of preterm birth in the US in 2021 was 10.1%. Although the rate of mortality from preterm birth has been decreasing, complications remain the leading cause of death in infants under the age of 5 years worldwide. Gestational age (GA) and birth weight (BW) remain the 2 most important variables for predicting survivability in preterm births, and lower GA and BW are both correlated with lower survivability.

Objective: To explore outcomes of neonates born in the periviable period (20 weeks and 0 days to 25 weeks and 6 days) with BW ≤ 500 g and to …