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Message From Director

Message From Director
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Cairo , Al-qahirah , Egypt , Pascale-allotey , Reproductive-health , Research-training-in-human-reproduction , World-bank , International-conference-on-population , World-health-assembly , Sustainable-development-goals , Bank-special-programme-of-research , Department-of-sexual

SARS-CoV-2 positivity in offspring and timing of mother-to-child transmission: living systematic review and meta-analysis

Objectives To assess the rates of SARS-CoV-2 positivity in babies born to mothers with SARS-CoV-2 infection, the timing of mother-to-child transmission and perinatal outcomes, and factors associated with SARS-CoV-2 status in offspring.

Design Living systematic review and meta-analysis.

Data sources Major databases between 1 December 2019 and 25 April 2022.

Study selection Cohort studies of pregnant and recently pregnant women (including after abortion or miscarriage) who sought hospital care for any reason and had a diagnosis of SARS-CoV-2 infection, and also provided data on offspring SARS-CoV-2 status and risk factors for positivity. Case series and case reports were also included to assess the timing and likelihood of mother-to-child transmission in SARS-CoV-2 positive babies.

Data extraction Two reviewers independently extracted data and assessed study quality. A random effects model was used to synthesise data for rates, with associations reported using odds ratios and 95% confidence intervals. Narrative syntheses were performed when meta-analysis was inappropriate. The World Health Organization classification was used to categorise the timing of mother-to-child transmission (in utero, intrapartum, early postnatal).

Results 643 studies (343 cohort studies, 300 case series and case reports; 44 552 mothers, 30 822 babies) were included. Overall, 2.7% (95% confidence interval 2.1% to 3.5%; 210 studies, 24 040 babies) born to mothers with SARS-CoV-2 infection tested positive for the virus with reverse transcriptase polymerase chain reaction (RT-PCR). Of the 1107 SARS-CoV-2 positive babies with data on the timing of exposure and type and timing of tests, 32 had confirmed mother-to-child transmission: 20 in utero (857 assessed), three intrapartum (35 assessed), and nine during the early postnatal period (144 assessed). Of the 1213 SARS-CoV-2 positive babies with outcome data, 64 were stillbirths, 36 were neonatal deaths, and nine were early pregnancy losses; 1104 babies were alive at the end of follow-up. Severe maternal covid-19 (odds ratio 3.5, 95% confidence interval 1.5 to 8.1), maternal death (14.1, 4.1 to 48.0), maternal postnatal infection (5.0, 1.2 to 20.1), caesarean section (1.4, 1.1 to 1.8), and preterm delivery (1.5, 1.2 to 1.9) were associated with SARS-CoV-2 positivity in offspring. Positivity rates in offspring using RT-PCR varied between regions, ranging from 0.1% (95% confidence interval 0.0% to 0.5%) in studies from North America to 8.5% (4.6% to 13.3%) in studies from Latin America and the Caribbean.

Conclusion SARS-CoV-2 positivity rates are low in babies born to mothers with SARS-CoV-2 infection. Evidence confirms vertical transmission of SARS-CoV-2, although this is rare. Severity of maternal covid-19 is associated with SARS-CoV-2 positivity in offspring.

Systematic review registration PROSPERO CRD42020178076.

Readers’ note This article is a living systematic review that will be updated to reflect emerging evidence. Updates may occur for up to two years from the date of original publication. This version is update 1 of the original article published on 16 March 2022 ( BMJ 2022;376:e067696), and previous updates can be found as data supplements (<https://www.bmj.com/content/376/bmj.e067696/related#datasupp>).

No additional data available.

United-states , Wanfang , Jiangxi , China , Ottawa , Ontario , Canada , America , China-national-knowledge-infrastructure , Katie-team , World-health-organization-library

Rethinking self-care through an Indigenous lens—the importance of community

Insights from Indigenous health systems in Australia show why relational self-care is important for the wellbeing of people, communities, and the planet, argue Pat Dudgeon and colleagues

Western self-care tends to centre on practices that are aimed at supporting the health of individuals. Activities such as self-medication, rehabilitation, and accessing healthcare services are all generally focused on preventing disease and managing health in an individual. Indigenous self-care, on the other hand, includes these practices but also engages in a continuum of healing that supports the collective wellbeing of communities and the environment. The holistic, collective, and relational approach to health and wellbeing that underpins Indigenous self-care can enrich the understanding of self-care taught by mainstream medicine and improve public and environmental health.

Relational self-care is a practice that aligns with the Indigenous ethical principle of collective flourishing or “living well.” To take one example, the Yawuru people of west Kimberley, Australia use the health and wellbeing term “mabu liyan,” which refers to “relationships beyond the individual” and “is a …

Australia , Australians , Pat-dudgeon , Rachael-hinton , Abigail-bray , Paul-simpson , Emma-carlin , National-empowerment , World-bank-special-programme-for-human-reproduction , National-empowerment-project , World-bank-special-programme , Human-reproduction

"Two eyed seeing"—embracing both Indigenous and western perspectives in healthcare

Nel Wieman and Unjali Malhotra call for a “two eyed seeing” approach to healthcare, informed by both Indigenous and biomedical knowledge

In Canada, genocidal policies and systems have devastated Indigenous peoples’ determinants of health.1 For example, as a consequence of the Indian Reserve System many Indigenous peoples live in isolated areas with limited or no access to healthcare, education, or employment opportunities.2 Furthermore, the colonial legacy of anti-Indigenous racism is prevalent across Canada, including its healthcare systems, so many Indigenous people fear accessing healthcare services.34

One way to make healthcare more equitable and effective for Indigenous peoples is to incorporate their knowledge, beliefs, values, practices, medicines, and models of health and healing alongside those of western medicine in delivering healthcare. Known as “two eyed seeing,” this approach to healthcare sees from one eye with the strengths of Indigenous knowledge and ways of knowing, and from the other eye with the strengths of western knowledge, respectfully embracing both.5 Two eyed seeing acknowledges that Indigenous methods and treatments are as valid as those used in mainstream medicine, and it allows Indigenous peoples to be partners in their own healthcare (video 1).

Video 1
Ways of being: supporting self-care

Communities, Alliances & Networks

At the First Nations Health Authority (FNHA) we advocate for and use the two eyed seeing approach in our work to improve healthcare programmes, services, and health outcomes for First …

Canada , United-kingdom , British , U-malhotra-unjali , Unjali-malhotra , Rachael-hinton , Nel-wieman , Paul-simpson , Indian-residential-school-system , World-bank-special-programme-for-human-reproduction , First-nations-health-authority , Indian-reserve-system

Enhancing Pregnancy and Birthing Experience for Women

Enhancing Pregnancy and Birthing Experience for Women
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Cambodia , Global-public-health , World-health-organization , Research-training-in-human-reproduction , World-bank-special-programme-of-research , World-bank-special-programme , Research-training , Human-reproduction , Public-health , Behavioural-change-wheel ,

Improving the experience of pregnant and birthing women

A growing body of evidence shows that the mistreatment of women in maternal health care is a reality worldwide. For several years, the World Health Organization (WHO) and HRP (the UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction) have been documenting this human rights violation, and its impact on health and wellbeing. The WHO guideline on intrapartum care for positive childbirth experience includes a number of related

World-health-organization , World-bank-special-programme-of-research , Research-training-in-human-reproduction , World-bank-special-programme , Research-training , Human-reproduction , Health-women-authors-mistreatment-research-change-childbirth-item-maternal-pregnant-sectionhealth-who-womensrights ,

Improving the experience of pregnant and birthing women - World

Improving the experience of pregnant and birthing women - World
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Abortion

Fact sheet on preventing unsafe abortion: Scope of the problem, who is at risk, signs and symptoms, treatment and care, prevention and control and economic impact.

United-states , American , Meulen-rodgers , Johnson-jr , Lancet-glob-health , World-bank-special-programme-of-research , Institute-of-development , Research-training-in-human-reproduction , Latin-american , Global-abortion-policies , World-bank-special-programme , Research-training

WHO's Health for All Film Festival: Sexual and Reproductive Health and Rights (SRHR) special session

WHO is proud to screen winning films from the Health for All Film Festival (HAFF) at the upcoming Women Deliver 2023 Conference in Kigali, Rwanda. Women Deliver is a global advocacy network championing gender equality, health and rights, with a focus on sexual and reproductive health and rights (SRHR).T of Efun has used her film a lot in communities in Nigeria to raise awareness and discussions about FGM.

Kigali , W09- , Rwanda , Nigeria , Nigerian , Pascale-allotey , Vulvo-dynia , Anita-abada , Department-of-sexual , World-bank-special-programme-of-research , Health-for-all-film-festival , Reproductive-health

Wisal Ahmed

Wisal Ahmed
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Seattle , Washington , United-states , University-of-washington , Wisal-ahmed , Department-of-sexual , World-health-organization , Reproductive-health , Research-training-in-human-reproduction , Bank-special-programme-of-research , World-bank-special-programme , Research-training