Maternal and Child Health Commons^™

Delayed-Interval Delivery In Multiple Gestation Pregnancies: Neonatal Mortality, Morbidity, And Development, Nicolas J Bouey, Shampa Saha, Deanne E Wilson-Costello, Matthew A Rysavy, Michele Walsh, Myra H Wyckoff, Anna Maria Hibbs

Faculty, Staff and Student Publications

OBJECTIVE: Delayed-interval delivery (DID) is the delivery of the first fetus in a multiple gestation pregnancy without prompt delivery of the remaining fetus(es). We aimed to assess infant outcomes of DID.

STUDY DESIGN: We performed a retrospective cohort study of infants born 22-28 weeks' gestation or weighing 401-1500 g. DID was defined as a passage of >24 h between the birth of firstborn and retained infants. Rates of mortality, morbidity, and developmental outcomes were compared within DID multiples, to other multiples not born by DID, and all infants in the Generic Database and follow-up datasets (excluding DID-born).

RESULTS: DID-born multiples …

An Optimized Cell-Based Assay To Assess Influenza Virus Replication By Measuring Neuraminidase Activity And Its Applications For Virological Surveillance, Mira C Patel, Daniel Flanigan, Chenchen Feng, Anton Chesnokov, Ha T Nguyen, Anwar Abd Elal, John Steel, Rebecca J Kondor, David E Wentworth, Larisa V Gubareva, Vasiliy P Mishin

Faculty, Staff and Student Publications

Year-round virological characterization of circulating epidemic influenza viruses is conducted worldwide to detect the emergence of viruses that may escape pre-existing immunity or acquire resistance to antivirals. High throughput phenotypic assays are needed to complement the sequence-based analysis of circulating viruses and improve pandemic preparedness. The recent entry of a polymerase inhibitor, baloxavir, into the global market further highlighted this need. Here, we optimized a cell-based assay that considerably streamlines antiviral and antigenic testing by replacing lengthy immunostaining and imaging procedures used in current assay with measuring the enzymatic activity of nascent neuraminidase (NA) molecules expressed on the surface of …

Standards For Evaluating Neonatal Growth Outcomes Using Individualized Pathological Growth Potential Realization Indices, Russell L Deter, Wesley Lee, Roberto Romero

Faculty, Staff and Students Publications

OBJECTIVE: Provide standards for detecting neonatal growth abnormalities with the average pathological Growth Potential Realization Index (av. pGPRI).

METHODS: Individualized Growth Assessment (IGA) evaluations of 117 neonates with normal growth outcomes were carried out using measurements of WT, HC, AC, ThC and CHL. Growth Potential Realization Index (GPRI) values for each parameter were calculated from predicted and actual birth measurements, the former obtained using Rossavik size models derived from the second-trimester growth potential estimates. Subtraction of either the upper and lower boundaries of GPRI reference ranges from these GPRI measurements gave + pGPRI and - pGPRI measurements. GPRI's within their …

Lack Of Consensus Among Healthcare Professionals At A Large Academic Medical Center On The Use Of Exome Sequencing For Prenatal Diagnosis, Kylie Johnson, Hadi Erfani, Mohamad Ali Maktabi, Ignatia Van Den Veyver, Salma Nassef

Center for Medical Ethics and Health Policy Staff Publications

Prenatal exome sequencing (ES) is increasingly used for prenatal diagnosis because emerging data indicate it has incremental diagnostic benefit in pregnancies with fetal anomalies without identified genetic abnormalities by karyotyping and chromosomal microarray analysis. The aim of this study was to evaluate the medical community's attitude toward the clinical utility and use of exome sequencing for prenatal diagnosis and to address differences in attitudes and responses by type of practitioner, level of training, and years passed since last full-time training. We analyzed the answers of 109 trainees and professionals in the fields of genetic counseling, laboratory science, and medicine to …

A Mixed Methods Assessment Of Menstrual Hygiene Management And School Attendance Among Schoolgirls In Edo State, Nigeria., Madeline Tomlinson

Electronic Theses and Dissertations

Menstrual hygiene in lower-middle-income countries (LMICs) is limited and has been linked to many health, educational and social effects. However, the prevalence, details, and impact of menstrual hygiene management have not been well characterized in rural and peri-urban settings across Nigeria. The overall purpose of this research was to investigate menstrual hygiene management (MHM) among adolescent schoolgirls in peri-urban areas of Edo State, Nigeria; and to determine the educational consequences associated with poor MHM. MHM was measured using previously validated questions that were adapted after a formative assessment of MHM within the Edo State community. We used a mixed methods …

Pregnancy And Childbirth: Male Partner Involvement In Uasin Gishu, Kenya, Kamau Tabitha, Roselyter Riang’A, Mwanzia Lydia, Buluku Elizabeth, Sawe Caroline, Wambugu Beth, Patel Kirtika, Mutai Judith, Pauline Mwenje, Kemboi Sharon

Population Health, East Africa

Introduction: In many African countries, pregnancy and childbirth has traditionally beenregarded as a woman’s affair. As a result, male partner involvement and participationin pregnancy and childbirth has been minimal, which is thought to have contributed tothe high rate of maternal and neonatal morbidities and mortalities. Male partners areoften key decision-makers in African households for cultural reasons, yet their role inpregnancy and childbirth is not clearly defined. The aim of this study was to examine anddocument male partner involvement in maternal healthcare in Kenya.

Methods: A health facility-based cross-sectional descriptive study design was used.Systematic random sampling was used to …

Knowledge, Attitudes, And Practices (Kap) Towards Covid-19 Pandemic Among Pregnant Women In A Tertiary Hospital In Karachi, Pakistan, Sumaira Naz, Syeda Dur E Shawar, Shamila Saleem, Ayesha Malik, Amir Raza

Department of Obstetrics & Gynaecology

Background: The aim of this study was to evaluate the knowledge, attitude, and practices (KAP) of the pregnant population during the COVID-19 pandemic in a tertiary care hospital.
Methods: This cross-sectional study was conducted at Aga Khan University Hospital, Karachi, Pakistan. KAP towards COVID-19 was assessed using 21-item questionnaires. A score for each category was calculated and points were summed. The outcome variables of KAP were compared with demographic characteristics. Data were analyzed by using SPSS 19.
Results: A total of 377 patients participated in the study. The majority of the patients were multiparous (36.8%) in the age group of …

An Ai-Driven Clinical Care Pathway To Reduce 30-Day Readmission For Chronic Obstructive Pulmonary Disease (Copd) Patients, Lin Wang, Guihua Li, Chika F Ezeana, Richard Ogunti, Mamta Puppala, Tiancheng He, Xiaohui Yu, Solomon S Y Wong, Zheng Yin, Aaron W Roberts, Aryan Nezamabadi, Pingyi Xu, Adaani Frost, Robert E Jackson, Stephen T C Wong

Faculty, Staff and Student Publications

Healthcare regulatory agencies have mandated a reduction in 30-day hospital readmission rates and have targeted COPD as a major contributor to 30-day readmissions. We aimed to develop and validate a simple tool deploying an artificial neural network (ANN) for early identification of COPD patients with high readmission risk. Using COPD patient data from eight hospitals within a large urban hospital system, four variables were identified, weighted and validated. These included the number of in-patient admissions in the previous 6 months, the number of medications administered on the first day, insurance status, and the Rothman Index on hospital day one. An …

Tip-Over Injuries Among Children: Data From An Urban Emergency Department Of Karachi, Pakistan, Rubaba Naeem, Asrar Ali, Ahmed Raheem Buksh, Ayesha Quddusi, Uzma Rahim Khan

Department of Emergency Medicine

Introduction: Most unintentional injuries among children occur in the home environment. Tip-overs, defined as incidents where heavy objects fall on children due to some type of interaction, are one of the reasons for injuries inside the home. This study aims to determine injury patterns and outcomes for child injuries resulting from tip-overs in the home environment as reported in the emergency department.
Methods: We performed a retrospective chart review of pediatric (under 18 years) tip-overs injuries occurred in years 2010 to 2015 at the Aga Khan University Hospital. Furthermore, parents of injured children participated in phone interviews to provide information …

Immunity To Poliovirus In Afghanistan: A Household Sampling Method For Serological Assessment Based On Geographical Information Systems, Amalia Mendes, Ari Whiteman, Benjamin Nygren, Brian Kaplan, Imtiaz Hussain, Sajid Bashir Soofi, Maureen Martinez, Noha H. Farag

Department of Paediatrics and Child Health

Afghanistan continues to experience challenges affecting polio eradication. Mass polio vaccination campaigns, which aim to protect children under the age of 5, are a key eradication strategy. To date, the polio program in Afghanistan has only employed facility-based seroprevalence surveys, which can be subject to sampling bias. We describe the feasibility in implementing a cross-sectional household poliovirus seroprevalence survey based on geographical information systems (GIS) in three districts. Digital maps with randomly selected predetermined starting points were provided to teams, with a total target of 1,632 households. Teams were instructed to navigate to predetermined starting points and enrol the closest …

Impact Of Social Determinants Of Health On Early Hearing Detection And Intervention Screening/Diagnosis Outcomes, Nannette Nicholson, Ellen A. Rhoades, Rachel E. Glade, Laura Smith-Olinde

Journal of Early Hearing Detection and Intervention

Purpose

We reviewed how Social Determinants of Health relate to health inequities and disparities for Early Hearing Detection and Intervention (EHDI) programs. Then, we examine links between specific sociodemographic factors (maternal age, maternal education, ‘race’/ethnicity) and hearing screening and diagnostic audiology follow-up for newborns in the U.S. and its territories.

Methods

Maternal demographic, hearing screening and diagnostic data extracted from publicly available Centers for Disease Control and Prevention (CDC) records were reported to CDC by personnel responsible for EHDI programs. Data were subjected to statistical analysis using analysis of variance and multiple regression techniques.

Results

Results showed no significant differences …

Assessing Impact Of Covid-19 Pandemic On Receipt And Timeliness Of Newborn Hearing Screening And Diagnostic Services Among Infants Born In Four States, Suhana Ema, Sana Charania, Xidong Deng, Charles Rose, Craig A. Mason, Marcus Gaffney, Brandt Culpepper, Michael Lo, Tri Tran, Marcia Fort

Journal of Early Hearing Detection and Intervention

The study compares receipt and timeliness of newborn hearing screening and follow-up diagnostic services between the pre-pandemic birth cohort and the pandemic birth cohort in four participating states. Findings from this study will help inform state Early Hearing Detection and Intervention (EHDI) programs in the future should major public health event occur again.

Likely Impact Of The Covid-19 Pandemic On Newborn Hearing Screening And Follow-Up Services In The United States In 2020, Kelly Dundon, Suhana Alam, Xidong Deng, Mia Morrison, Treeby Brown, Karl R. White, Linda Hazard, Macia Fort, Kirsten R. Coverstone, Craig Mason, Marcus Gaffney

Journal of Early Hearing Detection and Intervention

This perspective aims to highlight aspects of the Early Hearing Detection and Intervention (EHDI) newborn hearing screening and follow-up processes that were impacted by the COVID-19 pandemic and considers factors that likely impacted follow-up after newborn hearing screening among infants born in the United States during 2020. Efforts to minimize the potential impact of missed or delayed identification of hearing loss in infants and young children will also be discussed to help guide future program improvement activities.

Psychometric Properties Of The Sindhi Version Of The Mood And Feelings Questionnaire (Mfq) In A Sample Of Early Adolescents Living In Rural Pakistan, Janavi Shetty, Florence Perquier, Susan C. Campisi, Yaqub Wasan, Madison Aitken, Daphne J. Korczak, Suneeta Monga, Sajid Bashir Soofi, Peter Szatmari, Zulfiqar Ahmed Bhutta

Centre of Excellence in Women and Child Health

There is a need for reliable and valid screening tools that assess depressive symptoms in adolescents in Pakistan. To address this need, the present study examined the psychometric properties and factor structure of a Sindhi-translated and adapted version of the child-report Mood and Feelings Questionnaire (MFQ-C) and the Short Mood and Feelings Questionnaire (SMFQ-C) in a community sample of adolescents living in Matiari, Pakistan. Questionnaires were translated into Sindhi and administered by study psychologists to 1350 participants (52.3% female) 9.0 to 15.9 years old. Measurement structure was examined using confirmatory factor analysis. Internal consistency was estimated, and convergent and divergent …

Pregnancy Outcomes Of Patients With Ultrasound-Indicated And History-Indicated Mcdonald Cervical Cerclage, Zaibunnisa Memon, Naureen Anjum, Zahra Hoodbhoy

Department of Obstetrics & Gynaecology

Objective: To assess pregnancy outcomes of patients with ultrasound-indicated and history-indicated McDonald cervical cerclage.
Materials and methods: This was a cross-sectional study of pregnant women who had cervical cerclage performed at Aga Khan University Hospital, Karimabad campus. We obtained Institutional Review Board approval and reviewed the medical records of patients. A purposive continuous sampling technique was used. A total of 88 patients were included. There were no exclusion criteria. Outcome data were collected from the medical record of patients from January 2010 to December 2016.
Results: Analysis reported a statistically significant lower gravidity and parity in the scan-indicated group as …

Effect Of Dexamethasone On Newborn Survival At Different Administration-To-Birth Intervals: A Secondary Analysis Of The Who Action (Antenatal Corticosteroids For Improving Outcomes In Preterm Newborn)-I Trial, Who Action Trials Collaborators, Olufemi T. Oladapo, Joshua P. Vogel, Gilda Piaggio, My Huong Nguyen, Fernando Althabe, Rajiv Bahl, Suman P. N. Rao, Shabina Ariff, Sajid Bashir Soofi, Lumaan Sheikh

Department of Paediatrics and Child Health

Background: The WHO ACTION-I trial demonstrated that dexamethasone significantly reduced neonatal mortality when administered to women at risk of early preterm birth in low-resource countries. We conducted a secondary analysis to determine how these benefits can be optimised, by evaluating the effect of dexamethasone compared to placebo on newborn mortality and severe respiratory distress outcomes at different administration-to-birth intervals, and identifying the interval with the greatest benefits.
Methods: The WHO ACTION-I trial was a multi-country, individually-randomised, parallel-group, double-blind, placebo-controlled trial. It was conducted in 29 hospitals across Bangladesh, India, Kenya, Nigeria, and Pakistan. Women with a viable singleton or multiple …

Team Engagement & Obstetrics Transformation Committee, Colette Dumais, Faye Weir, Lynn Willey, Kristen Heanssler, Brittany Babb, Suneela Nayak, Natalia Johnson, Rebecca Brookes, Obstetrics Transformation Committee,Maine Medical Center

Operations Transformation

Gallup defines employee engagement as the involvement and enthusiasm of employees in their work and workplace. Employee engagement helps to measure and manage employees' perspectives on the crucial elements of workplace culture. Based on over 50 years of employee engagement research, engagement employees produce better outcomes (better patient care) than other employees. Based on the unit survey, team members, with the support of local leaders, formed the Transformation Committee. This Committee was developed as a shared governance, team led model to address process improvement needs and create a culture of active engagement in problem solving.

Evaluation Of Pharmaceutically Compounded Oral Caffeine On The Impact Of Medication Adherence And Risk Of Readmission Among Preterm Neonates: A Single-Center Quasi-Experimental Study, Gul Ambreen, Manoj Kumar, Amin Ali, Syed Akbar Ali Shah, Syed Muzaffar Saleem, Ayesha Tahir, Muhammad Sohail Salat, Muhammad Shahzad Aslam, Kashif Hussain

Department of Biological & Biomedical Sciences

Background: Caffeine is available in an ampoule, used via parenteral and enteral routes in preterm neonates to treat apnea of prematurity (AOP) in neonates of gestational age ≥ 35-40 weeks. A longer duration of therapy has a higher risk of medication non-adherence due to higher costs and inappropriate dosage forms. Pharmaceutically compounded oral caffeine (PCC) could be an appropriate alternate dosage form. The researchers aimed to determine the impact of PCC on medication-related factors influencing medication adherence (MA) and the frequency of hospital readmission with apnea (HRA) in preterm neonates.
Methods: We conducted a single-center quasi-experimental study for this quality …

Exposure To Unpredictability And Mental Health: Validation Of The Brief Version Of The Questionnaire Of Unpredictability In Childhood (Quic-5) In English And Spanish, Natasha G. Lindert, Megan Y. Maxwell, Sabrina R. Liu, Hal S. Stern, Tallie Z. Baram, Elysia Poggi Davis, Victoria B. Risbrough, Dewleen G. Baker, Caroline M. Nievergelt, Laura M. Glynn

Psychology Faculty Articles and Research

Unpredictability is increasingly recognized as a primary dimension of early life adversity affecting lifespan mental health trajectories; screening for these experiences is therefore vital. The Questionnaire of Unpredictability in Childhood (QUIC) is a 38-item tool that measures unpredictability in childhood in social, emotional and physical domains. The available evidence indicates that exposure to unpredictable experiences measured with the QUIC predicts internalizing symptoms including depression and anxiety. The purpose of the present study was to validate English and Spanish brief versions (QUIC-5) suitable for administration in time-limited settings (e.g., clinical care settings, large-scale epidemiological studies). Five representative items were identified from …

Evaluation Of Mrna-1273 Vaccine In Children 6 Months To 5 Years Of Age, Evan J Anderson, C Buddy Creech, Vladimir Berthaud, Arin Piramzadian, Kimball A Johnson, Marcus Zervos, Fredric Garner, Carl Griffin, Khozema Palanpurwala, Mark Turner, Jeffrey Gerber, Richard L Bennett, Kashif Ali, Madhavi Ampajwala, Gary Berman, Jennifer Nayak, Carey Chronis, Barbara Rizzardi, William J Muller, Christopher A Smith, George Fuchs, Daniel Hsia, Joanne E Tomassini, Dianne Delucia, Caroline Reuter, Barbara Kuter, Xiaoping Zhao, Weiping Deng, Honghong Zhou, Daniela Ramirez Schrempp, Kelly Hautzinger, Bethany Girard, Karen Slobod, Roderick Mcphee, Rolando Pajon, Anne Aunins, Rituparna Das, Jacqueline M Miller, Sabine Schnyder Ghamloush, Kidcove Study Group

Faculty, Staff and Student Publications

BACKGROUND: The safety, reactogenicity, immunogenicity, and efficacy of the mRNA-1273 coronavirus disease 2019 (Covid-19) vaccine in young children are unknown.

METHODS: Part 1 of this ongoing phase 2-3 trial was open label for dose selection; part 2 was an observer-blinded, placebo-controlled evaluation of the selected dose. In part 2, we randomly assigned young children (6 months to 5 years of age) in a 3:1 ratio to receive two 25-μg injections of mRNA-1273 or placebo, administered 28 days apart. The primary objectives were to evaluate the safety and reactogenicity of the vaccine and to determine whether the immune response in these …

Speech-Language Disorder Severity, Academic Success, And Socioemotional Functioning Among Multilingual And English Children In The United States: The National Survey Of Children’S Health, Martin L Blakely, Matthew A Rysavy, Kevin P Lally, Barry Eggleston, Claudia Pedroza, Jon E Tyson

Faculty, Staff and Student Publications

Randomized controlled trials (RCTs) are challenging, but are the studies most likely to change practice and benefit patients. RCTs investigating neonatal surgical therapies are rare. The Necrotizing Enterocolitis Surgery Trial (NEST) was the first surgical RCT conducted by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Neonatal Research Network (NRN), and multiple lessons were learned. NEST was conducted over a 7.25-year enrollment period and the primary outcome was death or neurodevelopmental impairment (NDI) at 18-22 months corrected age. Surgical investigators designing clinical trials involving neonatal surgical treatments have many considerations to include, including how to …

Outcome Prediction In Newborn Infants: Past, Present, And Future, Vivek V Shukla, Matthew A Rysavy, Abhik Das, Jon E Tyson, Edward F Bell, Namasivayam Ambalavanan, Waldemar A Carlo

Faculty, Staff and Student Publications

The perinatal and neonatal periods are the periods of considerable organ development and maturation. Perinatal and neonatal illnesses can result in mortality and morbidities that burden families and the healthcare system. Outcome prediction is essential for informing perinatal and intensive care management, prognosis, and post-discharge interventions. The Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network (NRN) research databases include hospital and neurodevelopment follow-up outcomes of infants with various underlying diseases and conditions receiving intensive care, providing a unique opportunity to assess outcome risk prediction. The NRN has developed outcome risk prediction tools for use …

The Reading Profiles Of Late Elementary English Learners With And Without Dyslexia, Pia Tohme, Rudy Abi-Habib, Elma Nassar, Nouran Hamed, Gaël Abou-Ghannam, Gihad E Chalouhi

Faculty, Staff and Student Publications

This study aimed to assess the impact of the COVID-19 stress and anxiety on prenatal attachment during the second trimester of gestation. Pregnancy is an important stage for mothers-to-be in creating representations of themselves as a "mother", with the developing attachment relationship to the unborn child considered as a milestone in the future parent's developmental trajectory. The outbreak of the COVID-19 pandemic and the national health measures installed can hence have consequences on these representations and on prenatal attachment. Our sample consisted of 95 mothers that were recruited from a prenatal ultrasound screening center. Results suggested that the COVID-19 pandemic …

Dexterity Of The Less Affected Hand In Children With Hemiplegic Cerebral Palsy, Matthew B Burn, Gloria R Gogola

Faculty, Staff and Student Publications

BACKGROUND: To determine if the "unaffected" hand in children with hemiplegic cerebral palsy (CP) is truly unaffected.

METHODS: We performed a retrospective review of manual dexterity as measured by the Functional Dexterity Test (FDT) in 66 children (39 boys, 27 girls, mean age: 11 years 4 months) with hemiplegic CP. Data were stratified by Manual Ability Classification System (MACS) level, birth weight, and gestational age at birth, and compared with previously published normative values.

RESULTS: The FDT speed of the less affected hand is significantly lower than typically developing (TD) children (

CONCLUSIONS: Both dexterity and rate of fine motor …

Risk Factors For Community-Acquired Bacterial Infection Among Young Infants In South Asia: A Longitudinal Cohort Study With Nested Case-Control Analysis, Nicholas E Connor, Mohammad Shahidul Islam, Luke C Mullany, Nong Shang, Zulfiqar A Bhutta, Anita K M Zaidi, Sajid Soofi, Imran Nisar, Pinaki Panigrahi, Kalpana Panigrahi, Radhanath Satpathy, Anuradha Bose, Rita Isaac, Abdullah H Baqui, Dipak K Mitra, Qazi Sadeq-Ur Rahman, Tanvir Hossain, Stephanie J Schrag, Jonas M Winchell, Melissa L Arvay, Maureen H Diaz, Jessica L Waller, Martin W Weber, Davidson H Hamer, Patricia Hibberd, A S M Nawshad Uddin Ahmed, Maksuda Islam, Mohammad Belal Hossain, Shamim A Qazi, Shams El Arifeen, Gary L Darmstadt, Samir K Saha

Faculty, Staff and Student Publications

OBJECTIVE: Risk factors predisposing infants to community-acquired bacterial infections during the first 2 months of life are poorly understood in South Asia. Identifying risk factors for infection could lead to improved preventive measures and antibiotic stewardship.

METHODS: Five sites in Bangladesh, India and Pakistan enrolled mother-child pairs via population-based pregnancy surveillance by community health workers. Medical, sociodemographic and epidemiological risk factor data were collected. Young infants aged 0-59 days with signs of possible serious bacterial infection (pSBI) and age-matched controls provided blood and respiratory specimens that were analysed by blood culture and real-time PCR. These tests were used to build …

Neurodevelopment And Recovery From Wasting, Harriet M. Babikako, Celine Bourdon, Emmie Mbale, Peace Aber, Annet Birabwa, Josephine Chimoyo, Wieger Voskuijl, Zaubina Kazi, John Mukisa, Ali Faisal Saleem

Department of Paediatrics and Child Health

Background and objectives: Acute illness with malnutrition is a common indication for hospitalization among children in low- and middle-income countries. We investigated the association between wasting recovery trajectories and neurodevelopmental outcomes in young children 6 months after hospitalization for an acute illness.
Methods: Children aged 2 to 23 months were enrolled in a prospective observational cohort of the Childhood Acute Illness & Nutrition Network, in Uganda, Malawi, and Pakistan between January 2017 and January 2019. We grouped children on the basis of their wasting recovery trajectories using change in mid-upper arm circumference for age z-score. Neurodevelopment was assessed with the …

Risk Factors For Community-Acquired Bacterial Infection Among Young Infants In South Asia: A Longitudinal Cohort Study With Nested Case–Control Analysis, Nicholas E. Connor, Mohammad Shahidul Islam, Luke C. Mullany, Nong Shang, Zulfiqar Ahmed Bhutta, Anita K. M. Zaidi, Sajid Bashir Soofi, Muhammad Imran Nisar, Pinaki Panigrahi, Kalpana Panigrahi

Department of Paediatrics and Child Health

Objective: Risk factors predisposing infants to community-acquired bacterial infections during the first 2 months of life are poorly understood in South Asia. Identifying risk factors for infection could lead to improved preventive measures and antibiotic stewardship.
Methods: Five sites in Bangladesh, India and Pakistan enrolled mother-child pairs via population-based pregnancy surveillance by community health workers. Medical, sociodemographic and epidemiological risk factor data were collected. Young infants aged 0-59 days with signs of possible serious bacterial infection (pSBI) and age-matched controls provided blood and respiratory specimens that were analysed by blood culture and real-time PCR. These tests were used to build …

The Risks Of Birth Defects And Childhood Cancer With Conception By Assisted Reproductive Technology, Barbara Luke, Morton B Brown, Ethan Wantman, Maria J Schymura, Marilyn L Browne, Sarah C Fisher, Nina E Forestieri, Chandrika Rao, Hazel B Nichols, Mahsa M Yazdy, Susan T Gershman, Caitlin R Sacha, Melanie Williams, Mary K Ethen, Mark A Canfield, Kevin J Doody, Michael L Eisenberg, Valerie L Baker, Carrie Williams, Alastair G Sutcliffe, Melissa A Richard, Philip J Lupo

Center for Medical Ethics and Health Policy Staff Publications

Study question: Is there an association between fertility status, method of conception and the risks of birth defects and childhood cancer?

Summary answer: The risk of childhood cancer had two independent components: (i) method of conception and (ii) presence, type and number of birth defects.

What is known already: The rarity of the co-occurrence of birth defects, cancer and ART makes studying their association challenging. Prior studies have indicated that infertility and ART are associated with an increased risk of birth defects or cancer but have been limited by small sample size and inadequate statistical power, failure to adjust for …

Neurodevelopment Assessment Of Small For Gestational Age Children In A Community-Based Cohort From Pakistan, Sabahat Naz, Zahra Hoodbhoy, Ali Jaffar, Sidra Kaleem Jafri, Babar Hasan, Devyani Chowdhury, Melissa Gladstone

Department of Paediatrics and Child Health

Background: Children born small for gestational age (SGA) may experience more long-term neurodevelopmental issues than those born appropriate for gestational age (AGA). This study aimed to assess differences in the neurodevelopment of children born SGA or AGA within a periurban community in Pakistan.
Methods: This was a prospective cohort study in which study participants were followed from the pilot Doppler cohort study conducted in 2018. This pilot study aimed to develop a pregnancy risk stratification model using machine learning on fetal Dopplers. This project identified 119 newborns who were born SGA (2.4±0.4 kg) based on International Fetal and Newborn Growth …

Influenza Vaccination Coverage Among An Urban Pediatric Asthma Population: Implications For Population Health, Sarah J. Parker, Amy M. Delaroche, Alex B. Hill, Rajan Arora, Julie Gleason-Comstock

Urban Studies and Planning Faculty Research Publications

Introduction
Asthma is the most common chronic disease in children. Children with asthma are at high risk for complications from influenza; however annual influenza vaccination rates for this population are suboptimal. The overall aim of this study was to describe the characteristics of a high-risk population of children with asthma presenting to an urban pediatric emergency department according to influenza vaccination status.

Methods
The study was a retrospective chart review of 4355 patients aged 2 to 18 years evaluated in a Michigan pediatric emergency department (PED) between November 1, 2017 and April 30, 2018 with an ICD-10-CM code for asthma …