COVID-19 and pregnancy: a national registry based study Background: According to a cohort study involving 2,130 pregnant women from 16 countries, the impact of COVID-19 on maternal morbidity and mortality was higher in low- and middle-income countries. Other one study found that the coronavirus pandemic increased maternal mortality by 1.37 times. The COVID-19-related mortality risk is 3 times higher in pregnant women than in the general population. In our country, there is a lack of evidence that determine the impact of COVID-19 on maternal mortality based on the national registration system. We aimed to study the relationship between COVID-19 and maternal mortality and complications based on national registry data Materials and methods: The study was conducted between February 20, 2022 and March 1, 2022 based NCMCH. The impact of the coronavirus pandemic on maternal mortality was performed based on the 2020-2021 maternal mortality data of Mongolia through a retrospective and time series analysis. In order to estimated factors that affect the complications of a pregnant women’s COVID-19 infection, it was conducted a retrospective study design based on the database of pregnant women diagnosed with a COVID-19 infection. The study data was collected through a prepared questionnaire. Results: According to analysis, the maternal mortality rate in Mongolia in 2021 was 1.9 times higher than the predicted rate. In 2021, 67.6% of maternal deaths are due to COVID-19. In 2021, the maternal mortality rate due to Covid-19 was 64.2 per 100,000 live births, which is twice as high as maternal mortality due to other diseases. In 2020-2022, 17,789 pregnant women between the ages of 14 and 46 who were infected with the coronavirus were included in the study to determine the factors affecting the complications of COVID-19. The mean age of the participants was 30 ± 5.8 (95% CI 29.7 – 29.9) and their gestational age was 24 ± 10 weeks. Of all participants, 71.6% was diagnosed and treated in Ulaanbaatar. 52.7% of pregnant mothers diagnosed with coronavirus and presenting with complications have not been vaccinated, which is a relatively high rate compared to the group of pregnant mothers without complications. Not being vaccinated against coronavirus had a 70% increased risk of complications (OR = 1.7, 95.0% CI: 1.4–2.0). However, the probability of hospitalization increased by 20% (OR = 1.2, 95.0% CI: 1.0 – 1.4). The COVID-19 severity depends on the age of the maternal and the length of the pregnancy. Conclusion: The COVID-19 pandemic has had a significant impact on maternal mortality, has increased. The maternal mortality rate in Mongolia is low compared to other countries, but it is higher than the recommended level for reducing maternal mortality. COVID-19 vaccination, on the other hand, reduced the complications of pregnant women and had a protective effect. It is important to build evidence by examining the effects of COVID-19 and vaccines on pregnant women.

Assessing children with disabilities using who international classification of functioning (ICF) Background: In 2021, according to the World Health Organization (WHO), over 1 billion people are estimated to experience disability. The number of children with disabilities globally is estimated at almost 240 million, according to a new UNICEF report. There are approximately 43 million children with disabilities in East Asia and the Pacific. In the 2020 population and housing census of Mongolia, a total of 106.4 thousand people with disabilities were counted, of which 7.6 percent or 8.1 thousand children aged 0-14 were counted. People with disabilities lose some of their ability to labor. WHO recommended that assessment of children with disabilities using both ICD and ICF. Thus, we aim to assess children with disabilities who have neurological disease using International Classification of Functioning and evaluate the validity of this classification. Materials and methods: This was a cross sectional analytical study based on NCMCH. Study materials were collected from children and guardians through standard questionnaires. The questionnaire consisted of 2 groups: general information of the participant and indicators of the scope of the D code of the "ICF" to assess the childhood disability. According to the indicators of the D code range, activity limitations and participation restriction, disabilities were evaluated. Each question in the questionnaire was measured on a 5-point Likert scale from 0 to 4. The statistical analysis was performed using R 3.5.1 program. Validity was assessed using the Rasch model for each question. Questionnaire reliability was assessed by Cronbach's alpha test. Results: The study included 32 children aged 2-15 years. Male children were 62.5% of participants, the mean age was 8±3.1 years. Correlation between questions was high (r = 0.79) and reliability was adequate (α=0.94). As a result of Rasch analysis, the mean and standard deviation of the 36 selected parameters were not significantly different from the standardized mean. 3 indicators that did not meet the analysis criteria were removed, and a total of 33 indicators were used to measure childhood disabilities. Mean infit MNSQ was 1.06, mean outfit MNSQ was 0.93. MNSQ of all participants were 1.0 – 2.0. As a result of Rasch analysis, the mean of 33 indicators of disability is -1.6, the standard deviation is 1.2, the upper limit of the mean is 3.6, and the lower limit is -3.4, and the indicator of D code was stable enough to measure disability. The mean code scores were 2.45±1.3. The mean score of disability level of children diagnosed with cerebral palsy was 2.9±1.09, and children hospitalized with seizures and meningitis was 0.5±0.3. Also, the total mean score was 2.61±1.2 in the group with disability and receiving care, and 1.8±0.21 in the group not receiving care, which was a statistically significant difference. Conclusions: Inter-indicator correlation was good and reliability of the questionnaire was adequate in field use of the 38 indicators of the activity limitations and participation restriction of the International Classification of Functioning, Children's Version (ICF-CY) code range “D”. When evaluated by Rasch analysis, 33 questions were evaluated as structural and stable. The International Classification of Functioning can be used to assess children's disabilities. Discussions: Niels Ove Illum et al. (2015) found that The World Health Organization International Classification of Functioning, Disability and Health child and youth version d code data can provide a coherent measure of severity of disability in children across various diagnoses, ages, and genders. Results were similar to our study.