Too many babies are born too small

Around one in seven of all babies worldwide are born with a low birthweight

More than 20 million babies were born with a low birthweight (less than 2500g; 5.5 pounds) in 2015—around one in seven of all births worldwide according to the first-ever estimates documenting this major health challenge.

These findings and more are documented in a new research paper developed by experts from the World Health Organization, UNICEF and the London School of Hygiene & Tropical Medicine, published in The Lancet Global Health.

More than 80% of the world’s 2.5 million newborns who die every year are of low birthweight. Those low birthweight babies who survive have a greater risk of stunting, and developmental and physical ill health later in life, including diabetes and cardiovascular disease.

“Low birthweight is a complex clinical entity composed of intrauterine growth restriction and preterm birth,” says co-author Dr Mercedes de Onis from the Department of Nutrition at WHO.

“This is why reducing low birthweight requires an understanding of the underlying causes in a given country. For example, in Southern Asia a large proportion of low birthweight babies are born at term but with intrauterine growth restriction, which is associated with maternal undernutrition, including maternal stunting.

“Conversely, preterm birth is the major contributor to low birthweight in settings with many adolescent pregnancies, high prevalence of infection, or where pregnancy is associated with high levels of fertility treatment and caesarean sections (like in USA and Brazil). Understanding and tackling these underlying causes in high-burden countries should be a priority.”

Although close to three-quarters were born in Southern Asia and sub-Saharan Africa, the problem remains substantial in high-income countries in Europe, North America, Australia and New Zealand. High-income countries have seen virtually no progress.

What is being done to tackle this major public health problem

Reducing the incidence of low birth weight requires a comprehensive global strategy, which must include improving maternal nutritional status; treating pregnancy-associated conditions such as pre-eclampsia (hypertensive disease of pregnancy); and providing adequate maternal care, perinatal clinical services and social support.

Affordable, accessible and appropriate health-care is critical for preventing and treating low birthweight. Reductions in death, illness and disability in newborn babies will only be achieved if pregnancy care is fully integrated with appropriate care for low birthweight babies.

Source:
https://www.who.int/news-room/detail/16-05-2019-too-many-babies-are-born-too-small

Men, your biological clock is ‘also’ ticking…here is how that could be a problem

Men who delay starting a family have a ticking “biological clock” — just like women — that may affect the health of their partners and children, according to Rutgers researchers.

The study, which reviewed 40 years of research on the effect of parental age on fertility, pregnancy and the health of children, was published in the journal Maturitas.

“While it is widely accepted that physiological changes that occur in women after 35 can affect conception, pregnancy and the health of the child, most men do not realize their advanced age can have a similar impact,” said study author Gloria Bachmann, director of the Women’s Health Institute at Rutgers Robert Wood Johnson Medical School.

While the medical profession has no clearly accepted definition of when advanced paternal age begins — it ranges from 35 to 45 — infants born to fathers over 45 have risen 10 percent in the United States over the past 40 years, likely due to assisted reproductive technology.

The study found that men 45 and older can experience decreased fertility and put their partners at risk for increased pregnancy complications such as gestational diabetes, preeclampsia and preterm birth. Infants born to older fathers were found to be at higher risk of premature birth, late still birth, low Apgar scores, low birth weight, higher incidence of newborn seizures and birth defects such as congenital heart disease and cleft palate. As they matured, these children were found to have an increased likelihood of childhood cancers, psychiatric and cognitive disorders, and autism.

Bachmann attributes most of these outcomes to a natural decline in testosterone that occurs with aging, as well as sperm degradation and poorer semen quality, but she said that some correlations need more research. “In addition to advancing paternal age being associated with an increased risk of male infertility, there appears to be other adverse changes that may occur to the sperm with aging. For example, just as people lose muscle strength, flexibility and endurance with age, in men, sperm also tend to lose ‘fitness’ over the life cycle,” she said.

Damage to sperm from stresses of aging can lead to a decrease in sperm number and a change in the sperm and egg that is passed from parent to offspring and becomes incorporated into the DNA of cells in the offspring’s body. “In addition to decreasing fertilization potential, this can also influence the pregnancy itself, as is noted by increased pregnancy risks when conception is successful,” she said.

These germline or heredity mutations also may contribute to the association of advancing paternal age and disorders in the offspring, such as these children being diagnosed with autism and schizophrenia. “Although it is well documented that children of older fathers are more likely to be diagnosed with schizophrenia — one in 141 infants with fathers under 25 versus one in 47 with fathers over 50 — the reason is not well understood,” she said. “Also, some studies have shown that the risk of autism starts to increase when the father is 30, plateaus after 40 and then increases again at 50.”

The study also found that older men struggled with fertility issues even if their partner was under 25.

“While women tend to be more aware and educated than men about their reproductive health, most men do not consult with physicians unless they have a medical or fertility issue,” Bachmann said.

She recommended that physicians counsel older men as they do older women on the effect their age will have on conception, pregnancy and the health of their child. If men plan on delaying fatherhood, they should consider banking sperm before their 35th — or at least by their 45th birthday — to decrease the increased risks to the health of the mother and child.

Co-authors of the study are Nancy Phillips, associate professor in the Department of Obstetrics, Gynecology and Reproductive Science at Rutgers Robert Wood Johnson Medical School, and Leahannah Taylor, a graduate student at Rutgers Graduate School of Biomedical Sciences.

Source: https://news.rutgers.edu/research-news/older-fathers-put-health-partners-unborn-children-risk-rutgers-study-finds/20190510#.XNwTw8j7TIX

7 Things to Watch at the 2019 World Health Assembly—#WHA72 | Global Health NOW

An Ebola outbreak rages.

Prices of medicines and vaccines continue to climb skyward.

Health care costs force 100 million people into extreme poverty.

The globe’s preeminent health organization has been massively reorganized—and needs a new budget.

Each year in May, delegates from 194 member states convene to set WHO’s priorities. They’ll have plenty to discuss. Since last year, WHO Director-General Tedros Adhanom Ghebreyesus has advocated for universal health coverage, restructured WHO, proposed a new budget and tackled other major objectives.

Read more here.

We’ve been nominated for a Bloggers Award…here is what you need to know

This blog, Kalunde’s Scribbles kalundethescribe.wordpress.com has been nominated for the 2019 Bloggers Association of Kenya Awards.

Exciting news! It is listed in the Public Health Blog category. Category 16.

To win the award, we need your vote!

How do I win? Your vote! What do you need to do? Go to vote here http://vote.bakeawards.co.ke. Scroll to Category 16. Select option e.

Ahsante. Thanks. Merci.

Digital media use and depression: Research on Chinese adolescents shows link

Adolescents in China who either spend more time on watching TV or surfing the Web, or less time in non-screen activities, including physical activity, are at risk and significantly more likely to experience depression.

The new study published in the journal Heliyon, shows a greater association with depression in girls over boys was also found as the use of new digital media grows across the country.

The Internet has become an integral part of life with social media representing a sizable portion of that usage. More than two billion people globally used digital media in 2016, and this is predicted to rise to nearly three billion by 2020.

“…access to these digital media may have detrimental outcomes, such as distraction from work or school, the spread of false information about individuals, online bullying, and reduced face-to-face social interactions, all of which can lead to anxiety, depression, and suicidality,”
explained lead investigator Jie Zhang, PhD, Central University of Finance and Economics, Beijing, China, and State University of New York Buffalo State, Buffalo, NY, USA.

The number of digital media users in China has also been increasing rapidly. Earlier studies have reported that conduct problems, depressive symptoms, and suicide in nearly all developed countries have escalated since the Second World War.

“Digital media, as compared to more traditional media such as television, have profoundly changed the modern life of the average Chinese citizen,” explained Dr. Zhang.

He added: “They can now shop, navigate to travel, browse information, consume various entertainment media, and communicate with one another in an unprecedented manner, and adolescents also spend more and more time using digital media.”

In China, adolescents are facing serious psychological difficulties. Recent evidence shows that the prevalence of depressive symptoms among Chinese students ranges from 11.7 percent to 22.9 percent, representing a significant public health concern, given the established link between depression and suicide in China.

“The new digital media, if not appropriately managed, creates public health hazards in adolescents,” commented Dr. Zhang. “There are numerous and significant differences in economy, culture, and education between China and western countries, as well as clear differences in adolescent depression and suicide behavior. Therefore, it may not be appropriate to make inferences about how digital media impacts negative outcomes among Chinese adolescents from findings that utilize samples from western countries.

Investigators in this study designed a cross-sectional study to evaluate the association between new digital media and depressive symptoms in a representative Chinese adolescent sample. They surveyed more than 16,000 Chinese adolescents 12-to-18-years of age using data from the 2013-2014 China Education Panel Survey (CEPS).

The first goal was to investigate factors that might impact depression, specifically comparing traditional screen time (watching TV); digital media screen time (online); non-screen time (sports, exercise, reading, and cultural activities); and experiencing depressive symptoms among adolescents. The study also examined the potential influence of gender, grade level in school, hometown, number of children in the family, and socioeconomic status on depressive symptoms. The second goal was to compare associations across different economic groups.

The researchers found that greater media consumption screen time is related to depression among Chinese adolescents, although online screen time is a stronger predictor. The present study also showed that digital media had a greater impact on depression among girls, which is consistent with evidence of greater depression and suicide among women compared to men in China.

The less economically developed western area of China showed the strongest link between digital media and depression, although this association was still significant in all economic regions. The influence of traditional screen time was more inconsistent within the group studied, with TV time predicting depression only in the eastern area and lax parental TV control buffering depression only in the eastern and western areas. Further, the present study highlights that non-screen time can decrease depression, although the exact nature and strength of this relationship varies across economic regions.

“However, our study can be used to warn Chinese adolescents to reduce the time they devote to digital media and advise them to spend more time on non-screen activities, such as outdoor activities and face to face communication. We hope these results will help reduce depressive symptoms among Chinese adolescents,” Dr. Zhang added.