1,232 research outputs found

    Women’s preconception health in England: a report card based on cross-sectional analysis of national maternity services data 2018/19

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    Objective: to present the first national-level report card on the state of women’s preconception health in England.Design: cross-sectional population-based study.Setting: maternity services, England.Population: all pregnant women in England with a first antenatal (booking) appointment recorded in the national Maternity Services Dataset (MSDS) from April 2018 to March 2019 (N=652,880). Methods: we analysed the prevalence of 32 preconception indicator measures in the overall population and across sociodemographic subgroups. Ten of these indicators were prioritised for ongoing surveillance based on modifiability, prevalence, data quality and ranking by multidisciplinary UK experts. Results: the three most prevalent indicators were: proportion of the 22.9% of women who smoked one year before pregnancy who did not quit smoking before pregnancy (85.0%), not taken folic acid supplementation before pregnancy (72.7%), and previous pregnancy loss (38.9%). Inequalities were observed by age, ethnicity and area-based deprivation level. The 10 indicators prioritised were: not taking folic acid supplementation before pregnancy, obesity, complex social factors, living in a most deprived area, smoking around the time of conception, overweight, pre-existing mental health condition, pre-existing physical health condition, previous pregnancy loss and previous obstetric complication.Conclusions: our findings suggest important opportunities to improve the state of preconception health and reduce sociodemographic inequalities for women in England. In addition to MSDS data, other national data sources that record further and possibly better-quality indicators could be explored and linked to build a comprehensive surveillance infrastructure. <br/

    Global, regional, and national sex-specific burden and control of the HIV epidemic, 1990-2019, for 204 countries and territories: the Global Burden of Diseases Study 2019

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    10.1016/S2352-3018(21)00152-1LANCET HIV810E633-E65

    Persistence of the immune response after two doses of ChAdOx1 nCov-19 (AZD1222): 1 year of follow up of two randomised controlled trials

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    The trajectory of immune responses following the primary dose series determines the decline in vaccine effectiveness over time. Here we report on maintenance of immune responses during the year following a two-dose schedule of ChAdOx1 nCoV-19/AZD1222, in the absence of infection, and also explore the decay of antibody after infection. Total spike-specific IgG antibody titres were lower with two low doses of ChAdOx1 nCoV-19 vaccines (two low doses) (P = 0.0006) than with 2 standard doses (the approved dose) or low dose followed by standard dose vaccines regimens. Longer intervals between first and second doses resulted in higher antibody titres (P &lt; 0.0001); however, there was no evidence that the trajectory of antibody decay differed by interval or by vaccine dose, and the decay of IgG antibody titres followed a similar trajectory after a third dose of ChAdOx1 nCoV-19. Trends in post-infection samples were similar with an initial rapid decay in responses but good persistence of measurable responses thereafter. Extrapolation of antibody data, following two doses of ChAdOx1 nCov-19, demonstrates a slow rate of antibody decay with modelling, suggesting that antibody titres are well maintained for at least 2 years. These data suggest a persistent immune response after two doses of ChAdOx1 nCov-19 which will likely have a positive impact against serious disease and hospitalization.</p