The Association of Neighborhood Social Capital and Ethnic (Minority) Density with Pregnancy Outcomes in the Netherlands

Background

Perinatal morbidity rates are relatively high in the Netherlands, and significant inequalities in perinatal morbidity and mortality can be found across neighborhoods. In socioeconomically deprived areas, ‘Western’ women are particularly at risk for adverse birth outcomes. Almost all studies to date have explained the disparities in terms of individual determinants of birth outcomes. This study examines the influence of neighborhood contextual characteristics on birth weight (adjusted for gestational age) and preterm birth. We focused on the influence of neighborhood social capital – measured as informal socializing and social connections between neighbors – as well as ethnic (minority) density.

Methods

Data on birth weight and prematurity were obtained from the Perinatal Registration Netherlands 2000–2008 dataset, containing 97% of all pregnancies. Neighborhood-level measurements were obtained from three different sources, comprising both survey and registration data. We included 3.422 neighborhoods and 1.527.565 pregnancies for the birth weight analysis and 1.549.285 pregnancies for the premature birth analysis. Linear and logistic multilevel regression was performed to assess the associations of individual and neighborhood level variables with birth weight and preterm birth.

Results

We found modest but significant neighborhood effects on birth weight and preterm births. The effect of ethnic (minority) density was stronger than that of neighborhood social capital. Moreover, ethnic (minority) density was associated with higher birth weight for infants of non-Western ethnic minority women compared to Western women (15 grams; 95% CI: 12,4/17,5) as well as reduced risk for prematurity (OR 0.97; CI 0,95/0,99).

Conclusions

Our results indicate that neighborhood contexts are associated with birth weight and preterm birth in the Netherlands. Moreover, ethnic (minority) density seems to be a protective factor for non-Western ethnic minority women, but not for Western women. This helps explain the increased risk of Western women in deprived neighborhoods for adverse birth outcomes found in previous studies.     

AnthWest,occurrence records for wool carder bees of the genus Anthidium (Hymenoptera,Megachilidae, Anthidiini) in the Western Hemisphere

This paper describes AnthWest, a large dataset that represents one of the outcomes of a comprehensive, broadly comparative study on the diversity, biology, biogeography, and evolution of Anthidium Fabricius in the Western Hemisphere. In this dataset a total of 22,648 adult occurrence records comprising 9657 unique events are documented for 92 species of Anthidium, including the invasive range of two introduced species from Eurasia, A. oblongatum (Illiger) and A. manicatum (Linnaeus). The geospatial coverage of the dataset extends from northern Canada and Alaska to southern Argentina, and from below sea level in Death Valley, California, USA, to 4700 m a.s.l. in Tucumán, Argentina. The majority of records in the dataset correspond to information recorded from individual specimens examined by the authors during this project and deposited in 60 biodiversity collections located in Africa, Europe, North and South America. A fraction (4.8%) of the occurrence records were taken from the literature, largely California records from a taxonomic treatment with some additional records for the two introduced species. The temporal scale of the dataset represents collection events recorded between 1886 and 2012. The dataset was developed employing SQL server 2008 r2. For each specimen, the following information is generally provided: scientific name including identification qualifier when species status is uncertain (e.g. “Questionable Determination” for 0.4% of the specimens), sex, temporal and geospatial details, coordinates, data collector, host plants, associated organisms, name of identifier, historic identification, historic identifier, taxonomic value (i.e., type specimen, voucher, etc.), and repository. For a small portion of the database records, bees associated with threatened or endangered plants (~ 0.08% of total records) as well as specimens collected as part of unpublished biological inventories (~17%), georeferencing is presented only to nearest degree and the information on floral host, locality, elevation, month, and day has been withheld. This database can potentially be used in species distribution and niche modeling studies, as well as in assessments of pollinator status and pollination services. For native pollinators, this large dataset of occurrence records is the first to be simultaneously developed during a species-level systematic study.     

Modelling distributions of Aedes aegypti and Aedes albopictus using climate,host density and interspecies competition

Florida faces the challenge of repeated introduction and autochthonous transmission of arboviruses transmitted by Aedes aegypti and Aedes albopictus. Empirically-based predictive models of the spatial distribution of these species would aid surveillance and vector control efforts. To predict the occurrence and abundance of these species, we fit a mixed-effects zero-inflated negative binomial regression to a mosquito surveillance dataset with records from more than 200,000 trap days, representative of 53% of the land area and ranging from 2004 to 2018 in Florida. We found an asymmetrical competitive interaction between adult populations of Aedes aegypti and Aedes albopictus for the sampled sites. Wind speed was negatively associated with the occurrence and abundance of both vectors. Our model predictions show high accuracy (72.9% to 94.5%) in validation tests leaving out a random 10% subset of sites and data since 2017, suggesting a potential for predicting the distribution of the two Aedes vectors.     

A geographic distribution database of Mononychellus mites (Acari,Tetranychidae) on cassava (Manihot esculenta)

The genus Mononychellus is represented by 28 herbivorous mites. Some of them are notorious pests of cassava (Manihot esculenta Crantz), a primary food crop in the tropics. With the exception of Mononychellus tanajoa (Bondar), their geographic distribution is not widely known. This article therefore reports observational and specimen-based occurrence data of Mononychellus species associated with cassava. The dataset consists of 1,513 distribution records documented by the International Center for Tropical Agriculture (CIAT) between 1975 and 2012. The specimens are held at CIAT’s Arthropod Reference Collection (CIATARC). Most of the records are from the genus’ native range in South America and were documented between 1980 and 2000. Approximately 61% of the records belong to M. tanajoa, 25% to M. caribbeanae (McGregor), 10% to M. mcgregori (Flechtmann and Baker) and 2% to M. planki (McGregor). The complete dataset is available in Darwin Core Archive format via the Global Biodiversity Information Facility (GBIF).     

Patterns of low birth weight in the Bengali newborns

This paper examines the distribution of low birth weight (2500 g or less) by gestation time, sex, maternal age, parity (birth order), socioeconomic conditions, and season of birth among 5117 single live births born to Bengali mothers at the Ramakrishna Mission Seva Pratisthan Hospital in Calcutta, India. Preterm infants have low birth weight significantly more often than their full term counterparts. Female infants have low birth weights significantly more often than male infants. The infants of poor mothers have lower birth weights in higher order births more often than infants of higher orders born to well-off mothers. Teenaged mothers produce low birth weight babies significantly more often than older mothers. Although the relationship is not significant, low birth weight infants occur more often among 1st and late born infants and less often among 2nd born infants. The season of birth is not significantly associated with birth weight. Less than 10% of low birth weight infants are pre-term, while the rest are full term. The great majority of low birth weight infants are small-for-gestational-age; the minority are small due to curtailed gestational age. The proportion of infants weighing less than 2001 g is only 9%; this figure tallies closely with earlier studies of India.     

Birth defects prevalence among infants of Persian Gulf War veterans born in Hawaii, 1989-1993

BACKGROUND: Gulf War veterans (GWVs) have expressed concern about possible teratogenic exposures. However, epidemiologic studies on birth defects prevalence among their progeny have been limited to military hospitals, anomalies diagnosed among newborns, or self-reported data. To measure the prevalence of selected birth defects among infants of GWVs and nondeployed veterans (NDVs) in Hawaii, using birth defects surveillance records. METHODS: Personal identifiers of 684,645 GWVs and 1,587,102 NDVs and their families were matched against birth certificate records of 99,545 live births reported to the State of Hawaii Department of Health between 1989 and 1993 to identify births to military personnel. These births were matched with records from the Hawaii Birth Defects Program. RESULTS: A total of 17,182 military infants (3,717 GWV infants and 13,465 NDV infants) were identified. Of these, 367 infants (2.14/100 live births) were identified with one or more of 48 major birth defects diagnoses. The prevalence of the 48 birth defects were similar for GWV and NDV infants during the prewar and postwar periods, and among GWV infants who were conceived before and after the Gulf war. CONCLUSIONS: The results must be interpreted with caution because of the small number of affected infants in each birth defects category. This study demonstrated the feasibility of measuring birth defects prevalence among military infants through multiple data linkage. Further, it included live births to parents who had separated from the military, births in civilian hospitals, and birth defects diagnosed through the first year of life.     

Contribution of preterm delivery to perinatal mortality.

A detailed retrospective analysis was made of the records of 486 preterm infants, who accounted for 5-1% of all births during 1973 and 1974. Whereas preterm delivery did not contribute to perinatal mortality in terms of stillbirth, it outweighed all other causes in terms of early neonatal deaths. Preterm birth was responsible for 85% of the early neonatal deaths not due to lethal congenital deformities. Early neonatal mortality rates were closely linked both to gestational age and birth weight and to the reason for preterm birth. Early neonatal mortality was high (97 per 1000) when preterm labour was spontaneous, whether or not associated with material or fetal disease or with multiple pregnancy, but low (27 per 1000) when preterm delivery was elective. Preventing spontaneous preterm labour would considerably reduce neonatal mortality in our community.     

Machine learning approaches for the prediction of lameness in dairy cows

Lameness is one of the costliest health problems, as well as a welfare concern in dairy cows. However, it is difficult to detect cows with possible lameness, or the ones that are at risk of becoming lame e.g. in the next week or so. In this study, we investigated the ability of three machine learning algorithms, Naïve Bayes (NB), Random Forest (RF) and Multilayer Perceptron (MLP), to predict cases of lameness using milk production and conformation traits. The performance of these algorithms was compared with logistic regression (LR) as the gold standard approach for binary classification. We had a total of 2 535 lameness scores (2 248 sound and 287 unsound) and 29 predictor features from nine dairy herds in Australia to predict lameness incidence. Training was done on 80% of the data within each herd with the remainder used as validation set. Our results indicated that in terms of area under curve of receiver operating characteristics, there were negligible differences between LR (0.67) and NB (0.66) while MLP (0.62) and RF (0.61) underperformed compared to the other two methods. However, the F1-score in NB (27%) outperformed LR (1%), suggesting that NB could potentially be a more reliable method for the prediction of lameness in practice, given enough relevant data are available for proper training, which was a limitation in this study. Considering the small size of our dataset, lack of information about environmental conditions prior to the incidence of lameness, management practices, short time gap between production records and lameness scoring, and farm information, this study proved the concept of using machine learning predictive models to predict the incidence of lameness a priori to its occurrence and thus may become a valuable decision support system for better lameness management in precision dairy farming.     

An analysis for temporal variation in Down syndrome births in Ohio, 1970–1979

Our study investigates the epidemiology of Down syndrome (DS) in the state of Ohio during the 1970s. The occurrence of DS births was examined to learn if statistically significant temporal variation was present among these data. Both monthly and annual numbers of DS births, adjusted for changing numbers of live births, were tested for such variation; furthermore, the data were analyzed for cyclic variation by attempting to fit simple trigonometric functions to the data.

Individuals with DS were ascertained using the records of cytogenetics laboratories and birth certificate records. Demographic data such as race, date of birth, and maternal age were collected on these individuals using their birth certificates as the data source. Appropriate parallel live-birth data were obtained from the Ohio Department of Health. The total number of affected individuals ascertained was 1,364, 66.7% of the total estimated population size. The data analysis was restricted to whites only (1,203 individuals) because they represented a more homogeneous sample than the total.

Monthly and annual variation in the numbers of live births was removed by producing single-year maternal-age adjusted numbers of DS births using the total Ohio white live births as the reference population. Analysis of covariance using single-year maternal ages ≤ 16 and ≥ 45 as the covariate was used to analyze the adjusted numbers of DS births for temporal variation.

No significant differences were detected among the annual adjusted numbers of DS births (P = .24), nor were there differences among the monthly adjusted numbers of DS (P = .37). The modes of ascertainment were tested to learn if there were annual or monthly differences in the method of ascertainment. No significant differences were detected for these data (P = .82 and P = .85, respectively). Furthermore, the data were separated into the maternal-age categories < 35 and ≥ 35, and annual and monthly adjusted DS births to these two maternal-age categories were examined for temporal variation. No significant differences were found among these data, P > .10 for all four of the tests. No simple cyclic functions were found to fit either the annual or monthly data.

The Ohio study reported here showed that through the use of a large sample, controlling for variation in the numbers of live births, and the use of detailed statistical tests, no significant temporal variation in the occurrence of DS births existed during the 1970s.

     

Altered Glutamatergic Metabolism Associated with Punctate White Matter Lesions in Preterm Infants

Preterm infants (∼10% of all births) are at high-risk for long-term neurodevelopmental disabilities, most often resulting from white matter injury sustained during the neonatal period. Glutamate excitotoxicity is hypothesized to be a key mechanism in the pathogenesis of white matter injury; however, there has been no in vivo demonstration of glutamate excitotoxicity in preterm infants. Using magnetic resonance spectroscopy (MRS), we tested the hypothesis that glutamate and glutamine, i.e., markers of glutamatergic metabolism, are altered in association with punctate white matter lesions and “diffuse excessive high signal intensity” (DEHSI), the predominant patterns of preterm white matter injury. We reviewed all clinically-indicated MRS studies conducted on preterm infants at a single institution during a six-year period and determined the absolute concentration of glutamate, glutamine, and four other key metabolites in the parietal white matter in 108 of those infants after two investigators independently evaluated the studies for punctate white matter lesions and DEHSI. Punctate white matter lesions were associated with a 29% increase in glutamine concentration (p = 0.002). In contrast, there were no differences in glutamatergic metabolism in association with DEHSI. Severe DEHSI, however, was associated with increased lactate concentration (p = 0.001), a marker of tissue acidosis. Findings from this study support glutamate excitotoxicity in the pathogenesis of punctate white matter lesions, but not necessarily in DEHSI, and suggest that MRS provides a useful biomarker for determining the pathogenesis of white matter injury in preterm infants during a period when neuroprotective agents may be especially effective.     

Survival of extremely premature babies in a geographically defined population: prospective cohort study of 1994-9 compared with 2000-5

Objective To assess changes in survival for infants born before 26 completed weeks of gestation.Design Prospective cohort study in a geographically defined population.Setting Former Trent health region of the United Kingdom.Subjects All infants born at 22+0 to 25+6 weeks’ gestation to mothers living in the region. Terminations were excluded but all other births of babies alive at the onset of labour or the delivery process were included.Main outcome measures Outcome for all infants was categorised as stillbirth, death without admission to neonatal intensivecare, death before discharge from neonatal intensivecare, and survival to discharge home in two time periods: 1994-9 and 2000-5 inclusive.Results The proportion of infants dying in delivery rooms was similar in the two periods, but a significant improvement was seen in the number of infants surviving to discharge (P<0.001). Of 497 infants admitted to neonatal intensive care in 2000-5, 236 (47%) survived to discharge compared with 174/490 (36%) in 1994. These changes were attributable to substantial improvements in the survival of infants born at 24 and 25 weeks. During the 12 years of the study none of the 150 infants born at 22 weeks’ gestation survived. Of the infants born at 23 weeks who were admitted to intensive care, there was no significant improvement in survival to discharge in 2000-5 (12/65 (18%) in 2000-5 v 15/81 (19%) in 1994-9).Conclusions Survival of infants born at 24 and 25 weeks of gestation has significantly increased. Although over half the cohort of infants born at 23 weeks wasadmitted to neonatalintensive care, there was no improvement in survival at this gestation. Care for infants born at 22 weeks remained unsuccessful.     

Renal agenesis and dysgenesis: are they increasing?

Data from the Birth Defects Monitoring Program (BDMP) of the Centers for Disease Control (CDC) suggest that the birth prevalence of renal agenesis and dysgenesis combined is increasing. Medical records were reviewed for 1,404 of 1,669 (84%) infants in the BDMP with renal agenesis or dysgenesis noted on the newborn discharge summary to assess whether the observed trend reflects a true increase in one or both conditions or if it reflects changes in diagnostic, coding, or surveillance practices over time. For 1970-1982, the average rate per 100,000 live births and stillbirths was 3.5 for autopsy-confirmed bilateral renal agenesis and 1.7 for autopsy-confirmed bilateral renal dysgenesis. The birth prevalence of autopsy-confirmed bilateral renal agenesis fluctuated within this time period, peaking in 1975, while the rate of autopsy-confirmed bilateral renal dysgenesis increased steadily by 0.2 cases/100,000 births per year (P less than 0.001) with small peaks in 1976 and 1979. Unilateral renal agenesis or dysgenesis accounted for 17% of the confirmed cases, but most were detected by autopsy among infants who died shortly after birth rather than by diagnostic procedures such as ultrasound. Diagnostic information in the medical record suggested that the increase in the birth prevalence of renal agenesis and dysgenesis combined in the BDMF is due primary to the increasing prevalence of renal dysgenesis. Since medical records did not include sufficient information on risk factors, detailed analytic studies are needed to identify maternal risk factors that might account for the apparent increase in renal dysgenesis over time.     

Sex ratios among Canadian liveborn infants of mothers from different countries

Background:

There has been much discussion about whether female feticide occurs in certain immigrant groups in Canada. We examined data on live births in Ontario and compared sex ratios in different groups according to the mother’s country or region of birth and parity.

Methods:

We completed a population-based study of 766 688 singleton live births between 2002 and 2007. We used birth records provided by Ontario Vital Statistics for live births in the province between 23 and 41 weeks’ gestation. We categorized each newborn according to the mother’s country or region of birth, namely Canada (n = 486 599), Europe (n = 58 505), South Korea (n = 3663), China (n = 23 818), Philippines (n = 15 367), rest of East Asia (n = 18 971), Pakistan (n = 18 018), India (n = 31 978), rest of South Asia (n = 20 695) and other countries (n = 89 074). We calculated male:female ratios and 95% confidence intervals (CIs) for all live births by these regions and stratified them by maternal parity at the time of delivery (0, 1, 2 or ≥ 3).

Results:

Among infants of nulliparous women, the male:female ratio was about 1.05 overall. As parity increased, the ratio remained unchanged among infants of Canadian-born women. In contrast, the male:female ratio was significantly higher among infants of primiparous women born in South Korea (1.20, 95% CI 1.09–1.34) and India (1.11, 95% CI 1.07–1.15) than among infants of Canadian-born primiparous women. Among multiparous women, those born in India were significantly more likely than Canadian-born women to have a male infant (parity 2, ratio 1.36, 95% CI 1.27–1.46; parity ≥ 3, ratio 1.25, 95% CI 1.09–1.43).

Interpretation:

Our study of male:female ratios in Ontario showed that multiparous women born in India were significantly more likely than multiparous women born in Canada to have a male infant.Although there are some myths about correctly guessing the sex of a fetus,¹ modern-day prenatal ultrasound enables the identification of whether a fetus is a boy or girl with 99% accuracy.² There has been much discussion about whether female fetuses are at higher risk of pregnancy termination than male fetuses in certain ethnic groups. In India, a study of data from the National Family Health Survey for 265 516 births showed a sharp increase in the male:female ratio among second-order births when the firstborn was a girl, and no significant increase when the firstborn was a boy.³ The authors attributed this trend to the practice of selective abortion of female fetuses. A recent editorial⁴ and news item⁵ in CMAJ suggested that female feticide may also be occurring in Canada.⁶ Rather than using live-birth statistics, the Canadian study cited in CMAJ used data from the 2001 and 2006 Canada Census long-form questionnaires, which were completed by 20% of the population and relied on self-reporting of additional information, including the number of family members in a given household.We used contemporary data on live births in Ontario, Canada’s most populous and ethnically diverse province, and compared sex ratios among infants of Canadian-born women with sex ratios in different immigrant groups. We focused on immigrant groups from countries purported to have the highest rates of preference for a son following the birth of one or more daughters.^3–6 We determined whether the male:female ratio increased with increasing parity in certain immigrant groups, as has been previously suggested.^3,6     

Mid-infrared prediction of lactoferrin content in bovine milk: potential indicator of mastitis

Lactoferrin (LTF) is a milk glycoprotein favorably associated with the immune system of dairy cows. Somatic cell count is often used as an indicator of mastitis in dairy cows, but knowledge on the milk LTF content could aid in mastitis detection. An inexpensive, rapid and robust method to predict milk LTF is required. The aim of this study was to develop an equation to quantify the LTF content in bovine milk using mid-infrared (MIR) spectrometry. LTF was quantified by enzyme-linked immunosorbent assay (ELISA), and all milk samples were analyzed by MIR. After discarding samples with a coefficient of variation between 2 ELISA measurements of more than 5% and the spectral outliers, the calibration set consisted of 2499 samples from Belgium (n = 110), Ireland (n = 1658) and Scotland (n = 731). Six statistical methods were evaluated to develop the LTF equation. The best method yielded a cross-validation coefficient of determination for LTF of 0.71 and a cross-validation standard error of 50.55 mg/l of milk. An external validation was undertaken using an additional dataset containing 274 Walloon samples. The validation coefficient of determination was 0.60. To assess the usefulness of the MIR predicted LTF, four logistic regressions using somatic cell score (SCS) and MIR LTF were developed to predict the presence of mastitis. The dataset used to build the logistic regressions consisted of 275 mastitis records and 13 507 MIR data collected in 18 Walloon herds. The LTF and the interaction SCS × LTF effects were significant (P < 0.001 and P = 0.02, respectively). When only the predicted LTF was included in the model, the prediction of the presence of mastitis was not accurate despite a moderate correlation between SCS and LTF (r = 0.54). The specificity and the sensitivity of models were assessed using Walloon data (i.e. internal validation) and data collected from a research herd at the University of Wisconsin – Madison (i.e. 5886 Wisconsin MIR records related to 93 mastistis events – external validation). Model specificity was better when LTF was included in the regression along with SCS when compared with SCS alone. Correct classification of non-mastitis records was 95.44% and 92.05% from Wisconsin and Walloon data, respectively. The same conclusion was formulated from the Hosmer and Lemeshow test. In conclusion, this study confirms the possibility to quantify an LTF indicator from milk MIR spectra. It suggests the usefulness of this indicator associated to SCS to detect the presence of mastitis. Moreover, the knowledge of milk LTF could also improve the milk nutritional quality.     

Hospital Utilisation in Indigenous and Non-Indigenous Infants under 12 Months of Age in Western Australia,Prospective Population Based Data Linkage Study

BackgroundIndigenous infants (infants aged under 12 months) have the highest hospital admission and emergency department presentation risks in Australia. However, there have been no recent reports comparing hospital utilisation between Indigenous and non-Indigenous infants.MethodsOur primary objective was to use a large prospective population-based linked dataset to assess the risk of all-cause hospital admission and emergency department presentation in Indigenous compared to non-Indigenous infants in Western Australia (WA). Secondary objectives were to assess the effect of socio-economic status (Index of Relative Socio-Economic Disadvantage [IRSD]) on hospital utilisation and to understand the causes of hospital utilisation.FindingsThere were 3,382 (5.4%) Indigenous and 59,583 (94.6%) non-Indigenous live births in WA from 1 January 2010 to 31 December 2011. Indigenous infants had a greater risk of hospital admission (adjusted odds ratio [aOR] 1.90, 95% confidence interval [95% CI] 1.77–2.04, p = <0.001) and emergency department presentation (aOR 2.15, 95% CI 1.98–2.33, p = <0.001) compared to non-Indigenous infants. Fifty nine percent (59.0%) of admissions in Indigenous children were classified as preventable compared to 31.2% of admissions in non-Indigenous infants (aOR 2.12, 95% CI 1.88–2.39). The risk of hospital admission in the most disadvantaged (IRSD 1) infants in the total cohort (35.7%) was similar to the risk in the least disadvantaged (IRSD 5) infants (30.6%) (aOR 1.04, 95% CI 0.96–1.13, p = 0.356).InterpretationWA Indigenous infants have much higher hospital utilisation than non Indigenous infants. WA health services should prioritise Indigenous infants regardless of their socio economic status or where they live.     

Dataset of Passerine bird communities in a Mediterranean high mountain (Sierra Nevada,Spain)

In this data paper, a dataset of passerine bird communities is described in Sierra Nevada, a Mediterranean high mountain located in southern Spain. The dataset includes occurrence data from bird surveys conducted in four representative ecosystem types of Sierra Nevada from 2008 to 2015. For each visit, bird species numbers as well as distance to the transect line were recorded. A total of 27847 occurrence records were compiled with accompanying measurements on distance to the transect and animal counts. All records are of species in the order Passeriformes. Records of 16 different families and 44 genera were collected. Some of the taxa in the dataset are included in the European Red List. This dataset belongs to the Sierra Nevada Global-Change Observatory (OBSNEV), a long-term research project designed to compile socio-ecological information on the major ecosystem types in order to identify the impacts of global change in this area.     

Vitamin D3 supplementation during pregnancy and lactation for women living with HIV in Tanzania: A randomized controlled trial

BackgroundObservational studies suggest that vitamin D deficiency among people living with HIV is associated with a greater risk of disease progression and death. Low levels of vitamin D in pregnancy are also associated with poor fetal and infant growth. Therefore, vitamin D supplementation may improve clinical outcomes for pregnant women living with HIV and improve fetal and postnatal growth for their infants.Methods and findingsWe conducted a randomized, triple-blind, placebo-controlled trial of vitamin D₃ supplementation among pregnant and lactating women living with HIV in Dar es Salaam, Tanzania (ClinicalTrials.gov {"type":"clinical-trial","attrs":{"text":"NCT02305927","term_id":"NCT02305927"}}NCT02305927). Participants were randomized with 1:1 allocation stratified by study clinic to receive either daily 3,000 IU vitamin D₃ supplements or matching placebo supplements from the second trimester of pregnancy (12–27 weeks) until 1 year postpartum. The primary outcomes were (i) maternal HIV progression or death, (ii) small-for-gestational-age (SGA) live births (<10th percentile), and (iii) infant stunting at 1 year of age (length-for-age z-score < −2). We also examined the effect of vitamin D₃ supplementation on secondary maternal and infant health outcomes, maternal and infant serum 25-hydroxyvitamin D (25[OH]D) concentrations, and maternal hypercalcemia. An intent-to-treat analysis was used as the primary analytic approach. We enrolled 2,300 pregnant women between June 15, 2015, and April 17, 2018, and follow-up of mothers and infants was completed on October 20, 2019. There were 1,148 pregnant women randomly assigned to the vitamin D₃ group, and 1,152 to the placebo group. The proportion of mothers lost to follow-up at 1 year postpartum was 6.6% in the vitamin D₃ group (83 of 1,148) and 6.6% in the placebo group (76 of 1,152). The proportion of children lost to follow-up at 1 year of age was 5.5% in the vitamin D₃ group (59 of 1,074 live births) and 5.2% in the placebo group (57 of 1,093 live births). There was no difference in the risk of maternal HIV progression or death, with 166 events during 1,461 person-years of follow-up in the vitamin D₃ group and 141 events during 1,469 person-years of follow-up in the placebo group (hazard ratio 1.21, 95% CI 0.97 to 1.52, p = 0.09). There was no difference in the risk of SGA birth between the vitamin D₃ (229 SGA births among 1,070 live births) and placebo groups (236 SGA births among 1,091 live births) (relative risk 1.03, 95% CI 0.87 to 1.22, p = 0.70). There was also no difference in the risk of infant stunting at 1 year of age between the vitamin D₃ (407 events among 867 infants) and placebo groups (413 events among 873 infants) (relative risk 1.00, 95% CI 0.92 to 1.10, p = 0.95). In terms of adverse events, no cases of maternal hypercalcemia were identified. One hypersensitivity reaction to the trial supplements occurred for a pregnant woman in the placebo group. A limitation of our study is that our findings may not be generalizable to HIV-negative pregnant women or contexts where severe vitamin D deficiency is prevalent.ConclusionsThe trial findings do not support routine vitamin D supplementation for pregnant and lactating women living with HIV in Tanzania.Trial registrationClinicalTrials.gov Identifier: {"type":"clinical-trial","attrs":{"text":"NCT02305927","term_id":"NCT02305927"}}NCT02305927.

Christopher R. Sudfeld and colleagues, investigate the impact of vitamin D supplementation on clinical outcomes for pregnant women living with HIV, and growth outcomes for their infants.     

Association of macrosomia with perinatal and postneonatal mortality among First Nations people in Quebec

Background

High prevalence of infant macrosomia (up to 36%, the highest in the world) has been reported in some First Nations communities in the Canadian province of Quebec and the eastern area of the province of Ontario. We aimed to assess whether infant macrosomia was associated with elevated risks of perinatal and postneonatal mortality among First Nations people in Quebec.

Methods

We calculated risk ratios (RRs) of perinatal and postneonatal mortality by birthweight for gestational age, comparing births to First Nations women (n = 5193) versus women whose mother tongue is French (n = 653 424, the majority reference group) in Quebec 1991–2000.

Results

The prevalence of infant macrosomia (birthweight for gestational age > 90th percentile) was 27.5% among births to First Nations women, which was 3.3 times (confidence interval [CI] 3.2–3.5) higher than the prevalence (8.3%) among births to women whose mother tongue is French. Risk ratios for perinatal mortality among births to First Nations women were 1.8 (95% CI 1.3–2.5) for births with weight appropriate for gestational age, 4.1 (95% CI 2.4–7.0) for small-for-gestational-age (< 10th percentile) births and < 1 (not significant) for macrosomic births compared to births among women whose mother tongue is French. The RRs for postneonatal mortality were 4.3 (95% CI 2.7–6.7) for infants with appropriate-for-gestational-age birthweight and 8.3 (95% CI 4.0–17.0) for infants with macrosomia.

Interpretation

Macrosomia was associated with a generally protective effect against perinatal death, but substantially greater risks of postneonatal death among births to First Nations women in Quebec versus women whose mother tongue is French.A trend toward higher birthweights has emerged in recent decades.^1–3 Reflected in this trend is a rise in the prevalence of infant macrosomia, commonly defined as either a birthweight greater than 4000 g or a birthweight for gestational age greater than the 90th percentile relative to a fetal growth standard.^4–8 Maternal obesity, impaired glucose tolerance and gestational diabetes mellitus are important risk factors for infant macrosomia^9,10 and are known to afflict a much higher proportion of people in Aboriginal populations than in the general population.^11–14 This is true especially for Aboriginal populations in which a traditional lifestyle has changed to a less physically active, modern lifestyle in recent decades. A high prevalence of infant macrosomia (up to 36%, which, to the best of our knowledge, is the highest in the world) has been reported in some First Nations communities of Quebec and eastern Ontario in Canada.^15–17 However, little is known about the implications of this high prevalence for perinatal and infant health of First Nations people in these regions. We examined whether infant macrosomia was associated with increased risk for perinatal and postneonatal death among First Nations infants in Quebec.     

The Myriapoda and Onychophora collection (MY) of the Muséum national d’Histoire naturelle (MNHN,Paris)

The Myriapoda and Onychophora collection dataset inventories the occurrence records of the collection of myriapods and onychophorans in the Muséum national d’Histoire naturelle, Paris. The dataset currently consists of 202 lots of onychophorans, representing all of those present, and almost ten thousand (9 795) lots of myriapods, representing 33 to 40% of the MNHN Myriapoda collection. This collection, which is of key historic importance, represents the results of two centuries of myriapod and onychophoran studies. The sources of the collection are worldwide, with a high representation for metropolitan France for the myriapods. None of the occurrences are yet georeferenced. Access to the dataset via the data portals of the MNHN and the GBIF has been made possible through the e-ReColNat project (ANR-11-INBS-0004).The Myriapoda and Onychophora collection of MNHN is actively expanding, hence both the collection and dataset are in continuous growth. The dataset can be accessed through the portals of GBIF at http://www.gbif.org/dataset/3287044c-8c48-4ad6-81d4-4908071bc8db and the MNHN at http://science.mnhn.fr/institution/mnhn/collection/my/item/search/form.