Injury-related infant mortality in West Virginia, 2010-2014

Background and objective Infant mortality in United States is high relative to other more developed nations. Therefore, there is a need to curb this trend, especially in states with high infant mortality rates. Hence, this research investigated and examined characteristics associated with injury-related infant death in West Virginia. The objective of this retrospective study was to 1) investigate maternal and infant characteristics associated with injury-related infant deaths in West Virginia, 2) examine the relationship between unintentional-injury-related infant death and rurality in West Virginia, holding other variables in the model constant, and 3) compare differences in the unintentional-injury related infant mortality rate between West Virginia and the United States as a whole, stratified by race/ethnicity. Methods De-identified linked birth-infant death data for the period 2010-2014 were sourced from the West Virginia Bureau for Public Health, Charleston WV and the United States linked birth-death vital records from the Centers for Disease Control website. Additionally, 2013 Urban Influence Codes used for urban/rural classification were sourced from the United States Department of Agriculture Economic Research Service. A generalized linear model with binomial distribution was used to determine characteristics associated with injury-related infant death, and a generalized linear mixed model with binomial distribution was used to determine the relationship between unintentional injury-injury related infant death and rurality, holding other variables in the model constant. A non-model-based method, which follows a simple Poisson distribution, was used to calculate the infant mortality rate in West Virginia and the United States, stratified by race. Results Maternal characteristics associated with injury-related infant mortality in West Virginia were race/ethnicity ( = 7.48, p = .03) and smoking during pregnancy ( , p \u3c .00). Risk of a Non-Hispanic Black infant for an injury-related death was 4.0 (95% CI: 1.7 - 9.3) times that of infants of other race/ethnicities. Unintentional injury-relate infant death was significantly associated with rurality, race/ethnicity and a rurality-smoking during pregnancy interaction (p=0.02, p=0.3, and p=0.05 respectively). The relative risk for unintentional injury-related infant death in rural versus urban counties was 1.7 (95% CI: 0.7- 3.8), whereas the unintentional injury-related infant mortality rate for West Virginia and the United States Non-Hispanic Black population was 83.2 (95% CI: 26.8 - 258.0) deaths per 100,000 live births and 57.5 (95% CI: 54.8 - 60.3) deaths per 100,000 live births, respectively. Conclusion Injury-related infant mortality is associated with race/ethnicity and smoking during pregnancy. Smoking during pregnancy and living in rural counties was related to higher risk of unintentional injury-related infant death than living in urban counties, whether or not the mother smoked during pregnancy. In general, the unintentional injury-related infant mortality rate in West Virginia and the nation are similar. Findings should be interpreted with caution due to the small number of cases. Nevertheless, this study provides important information to public health stakeholders, at both the state and local levels, for designing interventions for reduction or prevention of injury-related infant mortality in West Virginia

Maternal Characteristics Associated with Injury-related Infant Death in West Virginia, 2010-2014

Although injury-related deaths have been documented among children and adult populations, insufficient attention has been directed towards injury-related infant deaths. The objective of this retrospective study was to investigate maternal and infant characteristics associated with injury-related infant deaths in West Virginia. Birth and infant mortality data for 2010–2014 were sourced from the West Virginia Bureau for Public Health, Charleston. Relative risk was calculated using log-binomial regression utilizing generalized estimating equations. Maternal characteristics associated with injury-related infant mortality in West Virginia were race/ethnicity ( = 7.48, p = .03), and smoking during pregnancy (, p \u3c .00). Risk of a Black Non-Hispanic infant suffering an injury-related death was 4.0 (95% CL 1.7, 9.3) times that of infants of other races/ethnicities. Risk of an infant dying from an injury-related cause, if the mother smoked during pregnancy, was 2.9 (95% CL 1.6, 5.0) times the risk of such a death if maternal smoking status during pregnancy is unknown or no smoking, controlling for race/ethnicity. This study provides important information to public health stakeholders at both the state and local levels in designing interventions for partial reduction or prevention of injury-related infant mortality in West Virginia

Environmental, socio-demographic and behavioural determinants of malaria risk in the western Kenyan highlands: a case–control study

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/73660/1/j.1365-3156.2009.02370.x.pd

Effects of dietary l-arginine or N-carbamylglutamate supplementation during late gestation of sows on the miR-15b/16, miR-221/222, VEGFA and eNOS expression in umbilical vein

Placental vascular formation and blood flow are crucial for fetal survival, growth and development, and arginine regulates vascular development and function. This study determined the effects of dietary arginine or N-carbamylglutamate (NCG) supplementation during late gestation of sows on the microRNAs, vascular endothelial growth factor A (VEGFA) and endothelial nitric oxide synthase (eNOS) expression in umbilical vein. Twenty-seven landrace × large white sows at day (d) 90 of gestation were assigned randomly to three groups and fed the following diets: a control diet and the control diet supplemented with 1.0% l-arginine or 0.10% NCG. Umbilical vein of fetuses with body weight around 2.0 kg (oversized), 1.5 kg (normal) and 0.6 kg (intrauterine growth restriction, IUGR) were obtained immediately after farrowing for miR-15b, miR-16, miR-221, miR-222, VEGFA and eNOS real-time PCR analysis. Compared with the control diets, dietary Arg or NCG supplementation enhanced the reproductive performance of sows, significantly increased (P < 0.05) plasma arginine and decreased plasma VEGF and eNOS (P < 0.05). The miR-15b expression in the umbilical vein was higher (P < 0.05) in the NCG-supplemented group than in the control group. There was a trend in that the miR-222 expression in the umbilical vein of the oversized fetuses was higher (0.05 < P < 0.1) than in the normal and IUGR fetuses. The expression of eNOS in both Arg-supplemented and NCG-supplemented group were lower (P < 0.05) than in the control group. The expression of VEGFA was higher (P < 0.05) in the NCG-supplemented group than in the Arg-supplemented and the control group. Meanwhile, the expression of VEGFA of the oversized fetuses was higher (P < 0.05) than the normal and IUGR fetuses. In conclusion, this study demonstrated that dietary Arg or NCG supplementation may affect microRNAs (miR-15b, miR-222) targeting VEGFA and eNOS gene expressions in umbilical vein, so as to regulate the function and volume of the umbilical vein, provide more nutrients and oxygen from the maternal to the fetus tissue for fetal development and survival, and enhance the reproductive performance of sows