OBJECTIVES

Adiposity rebound (AR), the childhood period at which body mass index (BMI) rises from its lowest point, is linked to increased risk of later obesity. The study aims to determine the average age at AR, describe baseline characteristics and analyze the correlation between these characteristics and timing of AR in a population of Filipino pediatric outpatients.

Seven subjects born between 2016 and 2019 from a University Hospital Outpatient Department participated in this cross-sectional analytic study. Childhood anthropometrics were retrospectively collected to determine the age at AR by plot visual inspection. Sex, birth weight and gestational age were obtained from hospital records; breastfeeding duration, maternal BMI, parental obesity, maternal age, maternal smoking, education, parity and family income were gathered through a questionnaire completed by mothers or guardians. Associations were assessed using bootstrap univariate linear regression.

The mean age at AR was 3.2 years (SD = 1.2). Vaginal delivery was significantly associated with later age at AR compared to cesarean section (p = 0.035). Socioeconomic status at ages 2 to 5 showed positive association with delayed AR. Higher monthly family income (≥₱19,000) at ages 2 to 5 years was significantly associated with delayed age at AR. Other baseline childhood and parental factors showed no significant correlation with age at AR.

These results highlight the complex and context-dependent nature of AR, emphasizing the need for further studies to better understand and mitigate early obesity risk in Filipino children.

Chemical exposure during prenatal development has significant implications for both maternal and child health. Compared to blood, saliva is a non-invasive and less resource-intensive, alternative. Given the temporal variability of xenobiotic metabolites (XM), repeated sampling is essential. Therefore, saliva offers a valuable tool for the longitudinal assessment of prenatal exposomes. Despite its potential, no studies have explored saliva for XM measurement. This study pioneered using saliva to assess XM detectability and investigate the associations between prenatal XM and endogenous metabolomes in pregnant women. Saliva samples were analysed using mass spectrometry from 80 pregnant women at 24-34 weeks gestation. Metabolomes and exposomes were annotated using the Human Metabolome and U.S. Environmental Protection Agency databases. Metabolome-XM associations were clustered using Glay community clustering. Linear regression models, adjusted for age, estimated associations between catecholamines and XMs. XM levels were validated in a cohort of women (n = 14) with and without preeclampsia. Our study identified 582 metabolomes and 125 XM in saliva, demonstrating its potential as a matrix for exposure measurement. After false discovery rate correction, 18 109 significant metabolome-XM associations were identified. Community clustering revealed 37 connected clusters, with the largest cluster (238 nodes) enriched in tyrosine and catecholamine metabolism. Food-contact-chemicals and food-additives were significantly associated with higher catecholamine and their metabolite levels. Subgroup analyses revealed higher concentrations of these chemicals in women with preeclampsia compared to healthy controls. This study demonstrates that saliva contains valuable molecular data for measuring exposomes. Food-related chemicals were associated with higher catecholamine levels, which may be relevant to the prevalence of hypertensive crises in pregnancy.
Humans ; Female ; Pregnancy ; Saliva/metabolism* ; Pre-Eclampsia/metabolism* ; Xenobiotics/analysis* ; Adult ; Metabolome ; Maternal Health ; Mass Spectrometry

BACKGROUND

This study explores the professional functions and experiences of male midwives in the Province of Aurora, highlighting their roles, challenges, and contributions to maternal and child healthcare in a traditionally female-dominated profession.

This study aims to investigate the professional functions and lived experiences of male midwives in the Province of Aurora.

This research employed a qualitative ethnographic design using semi-structured interviews to collect data. Participants were six male midwives practicing in Aurora. Data collection was conducted via mobile phone interviews from August to September 2024. A purposive sampling technique was utilized to select participants. The study adhered to ethical guidelines, receiving approval from the University of Northern Philippines Ethics Review Committee Code: 2024-251, and informed consent was obtained from all participants. Data were analyzed using qualitative content analysis. Qualitative inductive content analysis as described by Padgett was utilized to allow for data-driven analysis without pre-defined themes, making it suitable for exploring the diverse experiences of male midwives.

Analysis revealed six key themes: Diverse professional functions, gender bias and stereotyping, patient reluctance and shyness, cultural influences, experiences of discrimination and prejudice, and daily challenges and rewards in practice. The findings underscore the commitment of male midwives to providing quality care despite societal and professional barriers. Under the Functions theme, male midwives described their roles as not only caregivers but also as advocates for gender inclusivity in midwifery. In terms of experiences, some reported feelings of isolation and the need to prove their competence in a field dominated by women. However, they also shared empowering stories of camaraderie with female colleagues and the satisfaction derived from breaking down gender barriers.

Male midwives play a vital role in maternal and newborn healthcare, navigating challenges such as gender bias and patient hesitancy. Strengthening administrative support, promoting inclusivity, and updating policies can enhance their professional integration. Advocacy efforts from professional organizations are necessary to address workplace challenges and recognize their contributions to healthcare.

OBJECTIVE: Exposure to polycyclic aromatic hydrocarbons (PAHs) or metal(loid)s individually has been associated with neural tube defects (NTDs). However, the impacts of PAH and metal(loid) co-exposure and potential interaction effects on NTD risk remain unclear. We conducted a case-control study in China among population with a high prevalence of NTDs to investigate the combined effects of PAH and metal(loid) exposures on the risk of NTD. METHODS: Cases included 80 women who gave birth to offspring with NTDs, whereas controls were 50 women who delivered infants with no congenital malformations. We analyzed the levels of placental PAHs using gas chromatography and mass spectrometry, PAH-DNA adducts with ³²P-post-labeling method, and metal(loid)s with an inductively coupled plasma mass spectrometer. Unconditional logistic regression was employed to estimate the associations between individual exposures and NTDs. Least absolute shrinkage and selection operator (LASSO) penalized regression models were used to select a subset of exposures, while additive interaction models were used to identify interaction effects. RESULTS: In the single-exposure models, we found that eight PAHs, PAH-DNA adducts, and 28 metal(loid)s were associated with NTDs. Pyrene, selenium, molybdenum, cadmium, uranium, and rubidium were selected through LASSO regression and were statistically associated with NTDs in the multiple-exposure models. Women with high levels of pyrene and molybdenum or pyrene and selenium exhibited significantly increased risk of having offspring with NTDs, indicating that these combinations may have synergistic effects on the risk of NTDs. CONCLUSION Our findings suggest that individual PAHs and metal(loid)s, as well as their interactions, may be associated with the risk of NTDs, which warrants further investigation.
Humans ; Neural Tube Defects/chemically induced* ; Polycyclic Aromatic Hydrocarbons/adverse effects* ; Female ; Case-Control Studies ; China/epidemiology* ; Adult ; Pregnancy ; Environmental Pollutants ; Maternal Exposure/adverse effects* ; Metals/toxicity* ; Young Adult ; Risk Factors

BACKGROUND

Social determinants of health are wider set of forces and systems that greatly influence an individual’s health outcomes.

This study aims to determine the socio-economic indicators that influence certain health indicators focusing on maternal and children under-5 health.

Selected data from from the World Health Organization (WHO), World Bank, and International Labor Organization (ILO) were primarily used to model health outcomes such as mortality rates, disability-adjusted life years, and deaths and injuries due to occupational injuries. A total of 194 countries were considered as respondents in this study. Linear hierarchical multiple regression was used to determine the relationship of social determinants of health on life expectancy at birth, maternal mortality ratio (per 100,000 live births), under-5 years mortality ratio, prevalence of overweight in children under-5 years, and death rate (per 100,000 population).

Data from 194 countries shows that the global average life expectancy is 55.7 years. The global average maternal mortality ratio is 1119.509 per 100,000 live births, and maternal mortality is significantly increased by factors such as increase in total vulnerable employment, total unemployment, and CPIA gender equality rating. Focusing on children’s health outcomes, the global average under-5 mortality rate was 102.247 per 100,000 live births. Mortality rate for children under-5 increases with total vulnerable employment and total unemployment, while adult literacy rate, 1 medical doctor per 10,000 population, and food safety level decreases under-5 mortality rates. The global overweight prevalence in children under-5 is 10.389%. The increase in average monthly earnings of employees working in service and sales increases its prevalence. For death rate, the global average is 682.818 per 100,000 population. This is further positively affected by an increase in rural population and total unemployment. On the other hand, adult literacy rate decreases death rate.

Socio-economic factors such as income, education, employment, and government support influence maternal and children under-5 health indicators. Thus, programs, projects, and activities that aim to positively affect the health of the public should be holistic and should also focus on positively altering the health behavior of the public.

BACKGROUND

Antenatal care (ANC) is a key maternal health intervention designed to prevent poor pregnancy outcomes, while pregnancy tracking by community healthcare workers (CHWs) serves as an important strategy to monitor its effective implementation and utilization. In Mati City, Davao Oriental, Philippines, a consistent decline in ANC quality and a rise in maternal and infant mortality have been observed, which may be linked to gaps in the implementation of maternal healthcare programs.

To address this concern, the study aims to analyze the strategies and challenges faced by CHWs in pregnancy tracking, assess the perceptions of health officials regarding these gaps, and recommend governance strategies to enhance the overall quality of ANC services.

A qualitative research design was employed, using purposive sampling to select Barangay Health Workers, midwives, and nurses for the focus group discussions, while the City Mayor, City Health Officer, and City Councilor on Health participated as key informants. Thematic analysis was conducted on manually transcribed data while adhering to strict ethical considerations.

Findings revealed that proper implementation and monitoring of maternal healthcare services are crucial for effective pregnancy tracking. CHWs play a significant role in health service delivery; however, gaps such as weak health promotion efforts adversely affect community engagement, health-seeking behavior, and sociocultural dynamics, highlighting the need for stronger policy enforcement and sustained local government support. Systemic and logistical challenges must also be addressed to improve service delivery. Effective maternal healthcare requires robust policy implementation and close collaboration among local government units. A sustainable maternal health system further depends on depoliticized legislative processes, improved health financing, and continuous investments in primary healthcare and infrastructure. Based on these findings, the study developed the Strengthen, Empower, Engage, and Key Policy Reforms Framework – an innovative governance approach aimed at reducing maternal healthcare disparities through multisectoral collaboration, depoliticized legislative action, and evidence-based maternal health interventions.

Adopting the SEEK framework may enable local governments to ensure equitable access to high-quality ANC and ultimately improve maternal and infant health outcomes.

BACKGROUND

Facility-based delivery (FBD) is a key intervention for reducing maternal and neonatal mortality. Despite policies discouraging home births, 11% of all deliveries in the Philippines occur outside health facilities. The health belief model (HBM) suggests that healthcare-seeking is influenced by perceived risks, benefits and barriers, and cues to action.

To examine how HBM indicators are associated with the likelihood of FBD and to assess the added value of increasing antenatal care (ANC) contacts from four to eight in line with recommendations by the World Health Organization.

Using data from the 2017 National Demographic and Health Survey, we ran logistic regression models on a sample of 6551 women with a recent live birth to estimate how HBM indicators were linked to the probability of FBD.

FBD was more likely among women with higher pregnancy risks (first birth and delivery complications) and those facing fewer barriers to health care (higher education, wealthier households, public health insurance coverage, urban residence, and not Muslim). Being Muslim had the largest negative impact on the probability of FBD (-19% points). Having at least eight (instead of four) ANC contacts increased the probability of FBD by 6% points.

FBD in the Philippines is shaped by perceived risks, socioeconomic and cultural barriers, and ANC contacts as cues to action. Increasing antenatal contacts was associated with a higher likelihood of FBD. Policies should therefore prioritize expanding affordable, accessible, and culturally responsive maternal healthcare services to reduce inequalities, rather than penalizing home births.

BACKGROUND

Advanced maternal age is associated with diminished IVF outcomes, including reduced live birthrates and increased miscarriage risk.

To determine clinical profiles and reproductive outcomes of Filipino women of advanced age who underwent autologous IVF at the Center for Advanced Reproductive Medicine and Infertility at St. Luke’s Medical Center Global City from January 1 , 2018 to December 31, 2024.

This retrospective cohort study analyzed 667 Filipino women aged 38 years and above who underwent autologous IVF/ICSI-ET from 2018 to 2024. Clinical profiles and reproductive outcomes were compared across age groups and embryo transfer types.

Results showed significant age-related decline identified in reproductive outcomes such as clinical pregnancy and live birth rates, coupled with elevated miscarriage rates in older women. Frozen embryo transfers demonstrated superior outcomes versus fresh transfers. While PGT-A improved embryo selection, it did not fully mitigate age-related declines.

These findings underscore the persistent negative impact of advanced maternal age on IVF success, highlighting the importance of early fertility intervention, individualized treatment strategies, and context-specific research in resource-constrained settings.

Severe combined immunodeficiency (SCID) represents a group of genetically heterogeneous disorders characterized by mutations that lead to profound defects in both humoral and cellular immunity. Transplacental maternal engraftment (TME) is a frequently observed complication in SCID. While most cases of SCID with TME exhibit no substantial impact on disease progression, a subset of patients may encounter diagnostic delays or therapeutic challenges due to TME interference. Furthermore, TME may predispose these individuals to graft-versus-host disease (GVHD) prior to hematopoietic stem cell transplantation, thereby increasing diagnostic complexity and treatment risks. This review systematically examines the etiology and clinical manifestations of SCID associated with TME, analyzes its implications for disease management, and evaluates current detection methodologies. The synthesized evidence provides a theoretical foundation for future research and offers potential insights into the clinical diagnosis and management of SCID associated with TME.
Humans ; Severe Combined Immunodeficiency/diagnosis* ; Pregnancy ; Female ; Hematopoietic Stem Cell Transplantation/adverse effects* ; Maternal-Fetal Exchange/immunology* ; Graft vs Host Disease/etiology* ; Animals ; Placenta/immunology*

BACKGROUND: Dental caries is a chronic childhood disease and one of the most prevalent public health problems worldwide. Lead is a heavy metal that is taken up by the teeth and bones. However, the association between lead exposure during pregnancy, when the tooth germs are formed, and the prevalence of dental caries in the primary dentition remains unclear. This study aimed to examine the association between maternal blood lead levels and the prevalence of dental caries in the primary dentition of children. METHODS: This cross-sectional study was conducted as an Adjunct Study to the Japan Environment and Children's Study (JECS), which is an ongoing nationwide birth-cohort study. Among children participating in the JECS at the University of Occupational and Environmental Health Sub-Regional Center, those aged 7-8 years underwent oral examination and questionnaire administration. The dft (i.e., sum of the number of decayed and filled primary teeth) was then determined. The dft numerically expresses the dental caries prevalence in the primary dentition (larger value indicates more prevalent dental caries). Poisson regression analyses with robust standard errors were performed to evaluate the association between maternal blood lead levels during pregnancy, measured using frozen samples, and the dft. RESULTS: The study included 139 children, of whom 54.7% were girls, and 89.2% were 7 years old. The median maternal blood lead level was 6.1 ng/g (25-75 percentile, 5.0-7.3). The median dft was 0 (25-75 percentile, 0-4). After adjusting for covariates including age, sex, and oral health status and behavior, maternal blood lead levels were significantly associated with increased dft (prevalence ratio, 1.6; 95% confidence interval, 1.3-1.8; per one standard deviation increase in natural log-transformed maternal blood lead levels). CONCLUSIONS This study found an association between maternal blood lead levels and the prevalence of dental caries in the primary dentition of children aged 7-8 years. Maternal exposure to lead during mid- to late-term pregnancy may affect the caries susceptibility of children after birth.
Humans ; Lead/blood* ; Female ; Dental Caries/epidemiology* ; Prevalence ; Tooth, Deciduous ; Male ; Japan/epidemiology* ; Child ; Cross-Sectional Studies ; Pregnancy ; Adult ; Maternal Exposure/adverse effects* ; Environmental Pollutants/blood* ; Prenatal Exposure Delayed Effects/epidemiology*