Journal of Global Health最新文献

{"title":"Impact of the COVID-19 pandemic on small vulnerable newborns: an interrupted time series analysis in Peru and Brazil.","authors":"Kim N Cajachagua-Torres, Mariana Otero Xavier, Hugo G Quezada-Pinedo, Carlos A Huayanay-Espinoza, Alvaro Gonzalo Oviedo Rios, Agbessi Amouzou, Abdoulaye Maïga, Nadia Akseer, Alicia Matijasevich, Luis Huicho","doi":"10.7189/jogh.15.04026","DOIUrl":"10.7189/jogh.15.04026","url":null,"abstract":"<p><strong>Background: </strong>We examined COVID-19's impact on the number of small vulnerable newborns (SVN) at national and regional levels in Peru and Brazil.</p><p><strong>Methods: </strong>Using national birth registries, we examined monthly numbers of preterm (PT), low birthweight (LBW), and small for gestational age (SGA) newborns. We analysed COVID-19's impact on SVN using two interrupted time series models. We estimated SVN's expected numbers in the absence of the pandemic using mixed-effects regressions and calculated percent changes by comparing these estimates to observed during the pandemic. Incidence rate ratios (IRR) were estimated using Poisson regression.</p><p><strong>Results: </strong>In Peru, the average percent changes in PT, LBW, and SGA births were -17%, -11%, and -3% in 2020, and -10%, -4%, and +2% in 2021, respectively. The IRR of PT and LBW declined throughout the pandemic, while SGA IRR increased in August 2020-November 2020 and May 2021-December 2021. The Coast region experienced the greatest drop in PT, LBW, and SGA IRR in 2020, followed by a slight increase in 2021, whereas the Highlands and Amazon regions had increased LBW and SGA IRR. In Brazil, the percent changes in PT, LBW, and SGA births were +1%, -3%, and -8% in 2020, and +1%, 0%, and -1% in 2021, respectively. Most PT, LBW, and SGA IRRs decreased during the pandemic, except in the Northeast and Southeast regions, where PT increased in 2020. All regions experienced declines in LBW and SGA in 2020, with the Central-West and South regions showing the greatest LBW declines and Central-West region the highest SGA decrease.</p><p><strong>Conclusions: </strong>No significant worsening of neonatal outcomes were observed during the COVID-19 pandemic. In Peru, PT and LBW births declined, while SGA increased from August 2020. In Brazil, PT births slightly increased, while LBW and SGA births declined in 2020, remaining stable in 2021.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"15 ","pages":"04026"},"PeriodicalIF":4.5,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11783137/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global antibiotic prescription practices in hospitals and associated factors: a systematic review and meta-analysis.","authors":"Rui Chen, Jinxi Li, Chan Wang, Pengfei Zhou, Qihua Song, Jianxiong Wu, Qinnan Li, Hui Li, Yanhong Gong, Tao Zeng, Yu Fang, Xiaoxv Yin","doi":"10.7189/jogh.15.04023","DOIUrl":"10.7189/jogh.15.04023","url":null,"abstract":"<p><strong>Background: </strong>The prevalence of antibiotic prescribing among total prescriptions, the percentage of combined antibiotic prescribing among prescriptions containing at least one antibiotic, and factors influencing hospital antibiotic prescribing are currently unknown. In this systematic review, we aimed to summarise antibiotic prescribing in hospitals worldwide and identify the associated factors.</p><p><strong>Methods: </strong>We searched PubMed/MEDLINE, Ovid/Embase, and the Web of Science for articles published between 1 January 2000 and 28 February 2023 that reported antibiotic prescribing in hospitals or the associated factors. Four reviewers independently screened studies, extracted data, and assessed the risk of bias. We used meta-analysis with random-effects models to estimate the pooled effect sizes.</p><p><strong>Results: </strong>We included 403 studies covering 93 economies. The pooled prevalence of antibiotic prescribing among total prescriptions was 34.3% (95% CI = 29.6-39.3) in outpatient settings and 47.7% (95% CI = 45.8-49.5) in inpatient settings. The pooled percentages of antibiotics in the 'access' group were 48.5% (95% CI = 34.5-62.7) in outpatient settings and 43.8% (95% CI = 39.2-48.5) in inpatient settings. Subgroup analysis showed the prevalence of antibiotic prescribing was significantly higher in low-income compared to high-income economies. Additionally, there was a rising trend of the prevalence in inpatient settings over time. The studies showed that patients' gender, education level, health status, and physicians' work experience were associated with hospital antibiotic prescribing.</p><p><strong>Conclusions: </strong>The global prevalence of antibiotic prescribing in hospitals is high, with significant disparities across regions. Multifaceted measures with multi-sectoral cooperation are required, such as regulatory interventions, professional training for physicians, and public health education.</p><p><strong>Registration: </strong>PROSPERO: CRD42022354076.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"15 ","pages":"04023"},"PeriodicalIF":4.5,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11781807/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Colonial transition as a major mediator of global health transition: lessons from the 2024 New Caledonia crisis.","authors":"Pierre-Henri Moury, Marcelin Tromhae, Cécile Cazorla, Mathieu Série, Antoine Flahault, Emmanuel Couadau, Cynthia Fleury, Morgan Mangeas, Thierry De Greslan","doi":"10.7189/jogh.15.03004","DOIUrl":"10.7189/jogh.15.03004","url":null,"abstract":"","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"15 ","pages":"03004"},"PeriodicalIF":4.5,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11781806/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes in the provision and utilisation of health care services for chronic health conditions during the COVID-19 pandemic in rural northeast South Africa: an interrupted time series analysis.","authors":"Chodziwadziwa W Kabudula, Morelearnings Sibanda, Jessica Price, Jacques Du Toit, Nkosinathi Masilela, Kathleen Kahn, Francesc Xavier Gómez-Olivé, Susan Goldstein, Evelyn Thsehla, Micheal Kofi Boachie, Karen Hofman, Stephen Tollman","doi":"10.7189/jogh.15.04022","DOIUrl":"10.7189/jogh.15.04022","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic has impacted the provision and utilisation of health care services with varying magnitude across settings due to spatial temporal variation in the burden of COVID-19 cases and the roll-out of local COVID-19 response policies. This study assesses changes in the provision and utilisation of health care services for three major chronic health conditions (HIV/AIDS, hypertension, and diabetes) over the pre-COVID-19 and COVID-19 pandemic periods in a rural South African sub-district of Agincourt.</p><p><strong>Methods: </strong>Segmented interrupted time series regression models are applied to assess changes in the number of medication collection visits and new diagnoses for HIV/AIDS, hypertension, and diabetes from 1 January 2018 to 30 September 2021 covering the pre- COVID-19 period and the first three waves of the COVID-19 pandemic.</p><p><strong>Results: </strong>The number of medication collection visits for HIV/AIDS, hypertension, and diabetes dropped following the imposition of level 5 lockdown. Despite some improvements over the course of the pandemic, by the end of the third wave in September 2021, visits remained below the pre-COVID-19 era. The number of clinic visits for new diagnoses of HIV/AIDS and hypertension also fell after the introduction of level 5 lockdown. Although the number of new visits for HIV/AIDS bounced back to the pre-COVID-19 trends by the end of the third wave, the number of visits for new hypertension diagnoses remained significantly lower than expected. Referrals for collection of medications from the Central Chronic Medicines Dispensing and Distribution (CCMDD) programme, as an alternative to collection from clinics, increased exponentially over the course of the pandemic.</p><p><strong>Conclusions: </strong>Although the increased adoption of the CCMDD programme can in part account for decreased medication collection visits which persisted well after lockdown measures were lifted, marked reductions in the number of newly diagnosed cases of hypertension warrant concern. A deeper assessment of the appropriateness of referrals to the CCMDD programme as well as the longer-term effects on morbidity and mortality of missed treatment and/or delayed diagnosis is needed for a more granular understanding of the true ramifications of the COVID-19 pandemic and associated lockdown policies in the Agincourt subdistrict and other rural African settings.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"15 ","pages":"04022"},"PeriodicalIF":4.5,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11783134/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emergency planned re-infusion therapy and hospitalisation for community-acquired pneumonia: a retrospective case-control study.","authors":"Sheng-Xian Chen, Zhi-Kai Yang, Lin Lin, Hou-Zhen Liao, Xiao-Ting Xiang, Di Liu, Jian-Shan Huang","doi":"10.7189/jogh.15.04044","DOIUrl":"10.7189/jogh.15.04044","url":null,"abstract":"<p><strong>Background: </strong>Community-acquired pneumonia (CAP) is a frequent reason for emergency department visits and leads to increased direct medical costs, particularly due to hospitalisation. This study aims to examine the differences between emergency planned re-infusion therapy and hospitalisation in patients with CAP.</p><p><strong>Methods: </strong>This retrospective case-control study involved 1889 CAP patients treated at the Emergency Internal Medicine Department of Class A tertiary Hospital in China from 1 January 2020 to 31 December 2022. Patients were divided into groups receiving either emergency planned re-infusion therapy or hospitalisation. Independent sample t tests and χ² tests were used to compare the clinical outcomes and economic impacts between the two groups across different pneumonia severity index (PSI) classifications.</p><p><strong>Results: </strong>The study enrolled 1889 CAP patients. For PSI I-II patients, the improvement rates were 99.51% in the emergency planned re-infusion therapy group and 99.69% in the hospitalisation group, showing no statistically significant difference (P > 0.05). Similarly, no significant difference was observed for PSI III patients (84.16 vs. 89.82%). However, significant differences emerged for PSI IV patients, with improvement rates of 50% in the emergency planned re-infusion therapy group and 90.59% in the hospitalisation group (P < 0.001). Statistically significant differences were also noted in treatment duration (5.13 ± 1.65 days vs. 7.60 ± 3.93 days, P < 0.001) and total treatment costs (1921.57 Chinese Yuan (CNY) ± 923.16 vs. 9083.80 CNY ± 3583.55, P < 0.001) between the two groups.</p><p><strong>Conclusions: </strong>Emergency planned re-infusion therapy for CAP is an effective and cost-efficient alternative that can reduce both treatment duration and costs, particularly for patients with PSI I-III. It is recommended that emergency physicians give priority to emergency re-infusion therapy for patients with PSI I-III. In addition, it is recommended that hospitals strengthen the classification and treatment training programmes for emergency department physicians to recognise the patients with PSI I-IV.</p><p><strong>Registration: </strong>The hospital^'s ethics committee (XMCGIRB2024034-01).</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"15 ","pages":"04044"},"PeriodicalIF":4.5,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11783337/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global infectious disease surveillance: bridge a 30-metre gap between the International Civil Aviation Organization and the World Anti-Doping Agency.","authors":"Jie Huang, Mehmet Güllüoğlu, Ole Döring, Haidong Wang, Jiaying Li, Yao Liu","doi":"10.7189/jogh.15.03010","DOIUrl":"10.7189/jogh.15.03010","url":null,"abstract":"<p><p>The global aviation industry faced unprecedented challenges during the COVID-19 pandemic. As a result, the international civil aviation industry now has strong incentives to prevent and control future pandemics. It is almost unbelievable that the headquarters of the International Civil Aviation Organization (ICAO) is located right next to the headquarters of the World Anti-Doping Agency (WADA). While the vision and mission of these two organizations may seem completely different, we propose that ICAO could adopt a system similar to that of WADA to enhance its contribution to global infectious disease surveillance.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"15 ","pages":"03010"},"PeriodicalIF":4.5,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11783135/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Temporal trends of liver cancer burden, comparative analysis of risk factors and trend forecasts to 2024 in China, USA, the Republic of Korea, and Mongolia: an analysis based on multiple data sources from Global Burden of Disease 2019, the Global Cancer Observatory, and Cancer Incidence in Five Continents.","authors":"Xing Yao, Xinchun Ling, Ziyi Zhu, Xiaolu Cao, Shaoliang Tang","doi":"10.7189/jogh.15.04040","DOIUrl":"10.7189/jogh.15.04040","url":null,"abstract":"<p><strong>Background: </strong>Liver cancer represents a significant burden of disease globally, with variations in liver cancer status among countries. In this study, we aimed to evaluate the epidemiological burden of liver cancer in four representative countries - China, the USA, the Republic of Korea, and Mongolia - and cover the highest number of incidence cases, the highest prevalence rates and the burden in developed countries. In addition, we intended to predict the trends in liver cancer in these countries over the next six years.</p><p><strong>Methods: </strong>We collected epidemiological data on liver cancer from the Global Burden of Disease 2019, the Global Cancer Observatory, and Cancer Incidence in Five Continents databases to conduct data source triangulation. We calculated time trends using Joinpoint regression and predicted incidence rates using an autoregressive integrated moving average model. Aetiological studies were conducted for different countries based on changes in incidence causes.</p><p><strong>Results: </strong>Between 1990-2019, age-standardised rates (ASR) values for liver cancer declined globally. The downward trend was most pronounced in China, where the average annual percentage change of age-standardised incidence rate (ASIR) reached -3.13 (95% confidence interval (CI) = -2.90, -3.35), much higher than the world average of -1.16 (95% CI = -0.96, -1.36). The ASIR in the USA continued improving and reached 5.23 × 10⁵ in 2019. With age, the ASR for liver cancer in various countries generally shows an upward trend. Hepatitis B virus (HBV) remains the main causative agent of liver cancer in China and Korea. In Mongolia, both HBV and hepatitis C virus account for a large proportion of liver cancer. In the USA, the proportion of liver cancer cases from alcohol consumption has increased annually.</p><p><strong>Conclusions: </strong>The ASR for liver cancer has declined over the past 30 years in most countries but has worsened in some due to ageing and unhealthy lifestyles.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"15 ","pages":"04040"},"PeriodicalIF":4.5,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11783136/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Behavioural interventions targeting the prevention and treatment of young children's mental health problems in low- and middle-income countries: a scoping review.","authors":"Getachew Mullu Kassa, Zhiyuan Yu, Fentahun Minwuyelet, Deborah Gross","doi":"10.7189/jogh.15.04018","DOIUrl":"10.7189/jogh.15.04018","url":null,"abstract":"<p><strong>Background: </strong>Globally, 10% of children and adolescents live with mental health problems and often lack high-quality care. Over 80% of people facing mental health issues reside in low- and middle-income countries (LMICs). Failing to address children's mental health may prolong these challenges into adulthood, impeding their chances for a healthy life. This scoping review aims to describe the types, implementation strategies, effectiveness, and gaps of existing interventions for preventing and treating mental health problems in early childhood (<10 years) in LMICs.</p><p><strong>Methods: </strong>The study employed a scoping review of experimental studies published 2007-2023. Major databases including PubMed, Embase, Web of Science, and PsycINFO were searched using key terms related to the population (children), intervention (mental and/or behavioural health programmes), and outcome (mental health problems). Three authors independently conducted search strategy, article screening, data extraction, and quality assessment. The findings were presented using descriptive analysis and narrative synthesis.</p><p><strong>Results: </strong>Of 39 499 identified articles, 33 were included in the study, covering 7629 children and published between 2009-2022. Seventeen studies (51.5%) were from upper-middle-income countries, 13 (39.4%) were from lower-middle-income, and three (9.1%) were from low-income countries. Enrolment was community-based in 23 studies and health-facility based in 10 studies; the majority (79%) focused on children aged 3-8 years old. Almost two-third (63.6%) of studies were conducted in urban settings. Programmes encompassed various interventions such as parenting programmes (33.3%). A majority of studies (57.5%) employed group therapy for delivering the programme, with mental health professionals (21.2%) acting as the primary intervention providers. Interventions were primarily received by children (39.4%), followed by mothers/caregivers (33.3%). Most studies explored disruptive disorders (20 studies), social and behavioural problems (16 studies), and anxiety disorders (12 studies). Statistically significant intervention effects on child mental health outcomes were reported for 90% of published studies.</p><p><strong>Conclusions: </strong>Diverse behavioural programmes that improve the mental health of young children are available and effective in LMICs. Most interventions were delivered in urban settings and focus was on the use of health care professionals. Diverse intervention approaches, including parenting programmes and group therapy, were effective in addressing various mental health issues among young children.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"15 ","pages":"04018"},"PeriodicalIF":4.5,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11758180/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143030188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pandemic preparedness in Vietnam: a review of health system resilience and areas for improvement.","authors":"Bach Xuan Tran, Taufique Joarder, Vincent Junxiong Pang, Clara Marin Carballo, Hoa Thi Do, Cuong Tat Nguyen, Linh Gia Vu, Ngo Van Toan, Shenglan Tang","doi":"10.7189/jogh.15.03001","DOIUrl":"10.7189/jogh.15.03001","url":null,"abstract":"<p><p>In this viewpoint, we explore Vietnam's health system vulnerabilities and its national response to the COVID-19 pandemic, as well as critical areas of health system resilience, including health financing, workforce distribution, information systems, and governance. While Vietnam achieved early success through strong governance and mass vaccination campaigns, the pandemic revealed weaknesses in resource procurement, workforce imbalance, and limitations of its health information system. There are challenges in ensuring the rapid disbursement of financial resources and reliance on imported medical supplies, which delayed response times. Uneven healthcare workforce distribution, particularly in rural areas, further strained the health system. Although telemedicine and digital health solutions were implemented, weak digital infrastructure and inadequate information technology literacy hindered their effectiveness. Governance efforts, while generally strong, highlighted the need for better coordination and role clarity during health emergencies. Our findings identify areas for improvement, including effective resource mobilisation and allocation, enhanced digital infrastructure, expanded telemedicine access, and better support for healthcare workers. Governance enhancements, such as improved priority setting and interagency coordination, were also critical. These insights offer valuable guidance for strengthening Vietnam's health system and ensuring greater preparedness for future pandemics, but could also help other low- and middle-income countries facing similar challenges.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"15 ","pages":"03001"},"PeriodicalIF":4.5,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11758170/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143030190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Alkaline phosphatase of late pregnancy promotes the prediction of adverse birth outcomes.","authors":"Bin Zhang, Zhaolong Zhan, Sijie Xi, Yinglu Zhang, Xiaosong Yuan","doi":"10.7189/jogh.15.04028","DOIUrl":"10.7189/jogh.15.04028","url":null,"abstract":"<p><strong>Background: </strong>Adverse birth outcomes (ABO), such as preterm birth (PTB), small and large for gestational age (SGA/LGA), can compromise both the short- and long-term health of mothers and their foetuses. The purpose of this observational study was to investigate the association between maternal serum alkaline phosphatase (ALP) levels in late pregnancy and the risk of ABO, and to evaluate its predictive value of maternal ALP levels for ABO in women with singleton pregnancies.</p><p><strong>Methods: </strong>A total of 11 853 consecutive pregnant women underwent hepatic and renal function tests, lipid profile assessments, ALP and high-sensitivity C-reactive protein levels measurements upon admission for labour. Their clinical perinatal parameters and outcomes were also analysed.</p><p><strong>Results: </strong>The prevalence of PTB, SGA, and LGA in this study was 7.2% (n = 849), 8.9% (n = 1053), and 15.6% (n = 1844), respectively. With increasing quartiles of maternal serum ALP levels, the foetal gestational age increased by 0.58 weeks (95% confidence interval (CI) = 0.50-0.66), 0.78 weeks (95% CI = 0.70-0.86), and 0.98 weeks (95% CI = 0.90-1.06), respectively, and the birth weight increased by 62.91 g (95% CI = 43.96-81.86), 91.54 g (95% CI = 72.41-110.67), and 117.92 g (95% CI = 98.18-137.67), respectively. Compared to women in the bottom quartile of ALP, those in the top quartile had a lower risk of PTB (adjusted odds ratio (OR) = 0.14; 95% CI = 0.11-0.18), a lower risk of SGA (adjusted OR = 0.65; 95% CI = 0.53-0.80), and a higher risk of LGA (adjusted OR = 1.92; 95% CI = 1.62-2.28). Sensitivity analyses conducted among individuals without advanced maternal age, obesity, multiparity, pregnancy complications, and PTB (for SGA/LGA) validated the consistency of these results. More importantly, adding ALP to the established model significantly increased the area under the curve (AUC) for predicting adverse birth outcomes: for PTB, the AUC increased from 0.761 to 0.809 (P < 0.001); for SGA, it increased from 0.754 to 0.759 (P = 0.014); and for LGA, it increased from 0.750 to 0.755 (P < 0.001).</p><p><strong>Conclusions: </strong>Maternal serum ALP levels in late pregnancy are significantly associated with the risk of ABO. When combined with clinical characteristics and routine laboratory results, ALP has incremental predictive value for ABO, particularly for PTB.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"15 ","pages":"04028"},"PeriodicalIF":4.5,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11758466/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143030186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}