Monitor Unintended Pregnancy: Overview 2023

Wanneer vrouwen onbedoeld zwanger worden, kan dat een ingrijpende en emotionele gebeurtenis zijn. Het komt niet alleen bij tieners voor, maar ook op andere leeftijden. Het ministerie van VWS(Ministerie van Volksgezondheid, Welzijn en Sport) wil met integraal beleid helpen om onbedoelde zwangerschappen te voorkómen en ervoor zorgen dat vrouwen die onbedoeld zwanger zijn en hun partner/verwekker beter begeleid worden. Ook wil VWS meer aandacht voor personen in een kwetsbare situatie, zoals mensen met psychische problemen, een laag inkomen of een verslaving. Voor hen is de kans groter dat een onbedoelde zwangerschap grote gevolgen heeft, bovenop bestaande zorgen. Met de monitor Onbedoelde Zwangerschappen verzamelt het RIVM hiervoor cijfers. Dit is het cijferoverzicht 2023, waarin we de meest recente cijfers presenteren (veelal uit 2022). Voor het eerst zijn nu cijfers bekend over onbedoelde zwangerschappen. In de eerdere cijferoverzichten 2020, 2021 en 2022 werden als alternatief cijfers over ongeplande zwangerschappen gepresenteerd. Een onbedoelde zwangerschap is ontstaan zonder dat dit de wens of planning was. Toch kan zij (in de loop van de zwangerschap) wel gewenst zijn. Net als in het cijferoverzicht 2022 hadden op basis van huisartsenregistraties 3,3 op de 1.000 vrouwen in 2022 een ongewenste zwangerschap. Het aantal tienermoeders is ongeveer hetzelfde als een jaar eerder (1385). Het aantal abortussen nam iets toe: in 2022 waren er 9,9 zwangerschapsafbrekingen per 1.000 vrouwen. In 2021 waren dat er 8,7. De reden daarvan is niet bekend. Er is iets meer hulp gezocht bij de keuze om de zwangerschap al dan niet voort te zetten (keuzehulp). In 2022 zijn 1052 keuzehulptrajecten gevoerd, in 2021 waren dat er 918. In 82 procent van de gemeenten werken hulpverleners met het programma Nu Niet Zwanger. Met dit programma helpen zij mensen bewuster na te denken over hun kinderwens en het gebruik van anticonceptie.An unintended pregnancy can be a profound and emotional event. It occurs not only in teenagers, but also at other ages. Through an integrated policy, the Ministry of Health, Welfare and Sport wants to help prevent unintended pregnancies and provide better support for unintentionally pregnant women and their partner/father of the child. The Ministry also wants to pay greater attention to people in vulnerable situations, such as those with mental health issues, a low income or addiction, as an unintended pregnancy – on top of existing issues – is more likely to have far-reaching consequences for these groups. RIVM collects information on this topic through the Monitor Unintended Pregnancy. This is the overview of 2023, in which we present the most recent information (mainly from 2022). For the first time, numbers are available on unintended pregnancies. In the previous overviews from 2020, 2021 and 2022, numbers on unplanned pregnancies were presented as an alternative. An unintended pregnancy occurs without the desire to become pregnant or planning for it. It may, however, become desired later (during the course of the pregnancy). As in the 2022 overview, based on GP registrations, 3.3 out of every 1,000 women had an unwanted pregnancy in 2022. The number of teenage mothers was also roughly the same as the year before (1,385). The number of abortions increased slightly: there were 9.9 abortions per 1,000 women in 2022, compared to 8.7 in 2021. The reason for this is unknown. Slightly more help was sought in deciding whether or not to continue the pregnancy (decision-making support), with 1,052 decision-making support procedures conducted in 2022, compared to 918 in 2021. In 82 per cent of the municipalities, the programme Not Pregnant Now (in Dutch: Nu Niet Zwanger) is being used by care providers. This programme helps people think more profoundly about their desire to have children and the use of contraception

An unusual outbreak in the Netherlands: community-onset impetigo caused by a meticillin-resistant with additional resistance to fusidic acid, June 2018 to January 2020.

In this retrospective observational study, we analysed a community outbreak of impetigo with meticillin-resistant Staphylococcus aureus (MRSA), with additional resistance to fusidic acid (first-line treatment). The outbreak occurred between June 2018 and January 2020 in the eastern part of the Netherlands with an epidemiological link to three cases from the north-western part. Forty nine impetigo cases and eight carrier cases were identified, including 47 children. All but one impetigo case had community-onset of symptoms. Pharmacy prescription data for topical mupirocin and fusidic acid and GP questionnaires suggested an underestimated outbreak size. The 57 outbreak isolates were identified by the Dutch MRSA surveillance as MLVA-type MT4627 and sequence type 121, previously reported only once in 2014. Next-generation sequencing revealed they contained a fusidic acid resistance gene, exfoliative toxin genes and an epidermal cell differentiation inhibitor gene. Whole-genome multilocus sequence typing revealed genetic clustering of all 19 sequenced isolates from the outbreak region and isolates from the three north-western cases. The allelic distances between these Dutch isolates and international isolates were high. This outbreak shows the appearance of community-onset MRSA strains with additional drug resistance and virulence factors in a country with a low prevalence of antimicrobial resistance

In vitro neurotoxicity of particles from diesel and biodiesel fueled engines following direct and simulated inhalation exposure.

Combustion-derived particulate matter (PM) is a major source of air pollution. Efforts to reduce diesel engine emission include the application of biodiesel. However, while urban PM exposure has been linked to adverse brain effects, little is known about the direct effects of PM from regular fossil diesel (PMDEP) and biodiesel (PMBIO) on neuronal function. Furthermore, it is unknown to what extent the PM-induced effects in the lung (e.g., inflammation) affect the brain. This in vitro study investigates direct and indirect toxicity of PMDEP and PMBIO on the lung and brain and compared it with effects of clean carbon particles (CP). PM were generated using a common rail diesel engine. CP was sampled from a spark generator. First, effects of 48 h exposure to PM and CP (1.2-3.9 µg/cm2) were assessed in an in vitro lung model (air-liquid interface co-culture of Calu-3 and THP1 cells) by measuring cell viability, cytotoxicity, barrier function, inflammation, and oxidative and cell stress. None of the exposures caused clear adverse effects and only minor changes in gene expression were observed. Next, the basal medium was collected for subsequent simulated inhalation exposure of rat primary cortical cells. Neuronal activity, recorded using microelectrode arrays (MEA), was increased after acute (0.5 h) simulated inhalation exposure. In contrast, direct exposure to PMDEP and PMBIO (1-100 µg/mL; 1.2-119 µg/cm2) reduced neuronal activity after 24 h with lowest observed effect levels of respectively 10 µg/mL and 30 µg/mL, indicating higher neurotoxic potency of PMDEP, whereas neuronal activity remained unaffected following CP exposure. These findings indicate that combustion-derived PM potently inhibit neuronal function following direct exposure, while the lung serves as a protective barrier. Furthermore, PMDEP exhibit a higher direct neurotoxic potency than PMBIO, and the data suggest that the neurotoxic effects is caused by adsorbed chemicals rather than the pure carbon core

Physical activity, sedentary behaviour, and childhood asthma: a European collaborative analysis

Questionnaire-based current asthma and lung function measured by spirometry (forced expiratory volume in 1 s (FEV1), FEV1/forced vital capacity) at age 6-18 years

Molecular characterization and transcriptional response of Lactuca sativa seedlings to co-exposure to graphene nanoplatelets and titanium dioxide nanoparticles

The widespread use of nanomaterials in agriculture may introduce multiple engineered nanoparticles (ENPs) into the environment, posing a combined risk to crops. However, the precise molecular mechanisms explaining how plant tissues respond to mixtures of individual ENPs remain unclear, despite indications that their combined toxicity differs from the summed toxicity of the individual ENPs. Here, we used a variety of methods including physicochemical, biochemical, and transcriptional analyses to examine the combined effects of graphene nanoplatelets (GNPs) and titanium dioxide nanoparticles (TiO2 NPs) on hydroponically exposed lettuce (Lactuca sativa) seedlings. Results indicated that the presence of GNPs facilitated the accumulation of Ti as TiO2 NPs in the seedling roots. Combined exposure to GNPs and TiO2 NPs caused less severe oxidative damage in the roots compared to individual exposures. Yet, GNPs and TiO2 NPs alone and in combination did not cause oxidative damage in the shoots. RNA sequencing data showed that the mixture of GNPs and TiO2 NPs led to a higher number of differentially expressed genes (DEGs) in the seedlings compared to exposure to the individual ENPs. Moreover, the majority of the DEGs encoding superoxide dismutase displayed heightened expression levels in the seedlings exposed to the combination of GNPs and TiO2 NPs. The level of gene ontology (GO) enrichment in the seedlings exposed to the mixture of GNPs and TiO2 NPs was found to be greater than the level of GO enrichment observed after exposure to isolated GNPs or TiO2 NPs. Furthermore, the signaling pathways, specifically the "MAPK signaling pathway-plant" and "phenylpropanoid biosynthesis," exhibited a close association with oxidative stress. This study has provided valuable insights into the molecular mechanisms underlying plant resistance against multiple ENPs