Fifth Article

I decided to do my fifth, and final, blog analysis on a scientific article created by D. Collison, C. Dey, G. Hannah and L. Stevenson. The title of their article being “Income inequality and child mortality in wealthy nations”. The background began by giving the reader some insight and previous knowledge to the topic these four scientists planned to cover within the context of their article. Just as my group had suspected for our research topic, there is a relationship between income inequalities and mortality in children. Many articles that these scientists read to prepare themselves for their research stated the same theory. They decided to investigate it further with their research by looking at wealthier countries and their child mortality ratings. They focused on the years between 2003-2006 and what information UNICEF had to offer from this time period. They also looked at Gini coefficients, Pearson correlation coefficients and longitudinal child mortality data. The Gini coefficient is something that is specifically used for income inequalities and it portrays the variations in the set of income inequality data that one is observing. Unfortunately, our article states that Gini coefficients are decreasing in popularity for being an inequality measure and there is no real indicator as to why. Pearson correlation coefficients measure the severity of linear correlation between two points. The closer to 1 the value is then the stronger the points correlate to a linear line. The longitudinal child mortality data observes as to how these things differ over time and how they react. A few of the countries that were observed were the United Kingdom, Canada, Australia, New Zealand and the United States. These countries have shown worsening child mortality rates since the year of 1960. The results showed that for the Gini coefficient for the 21 countries in question was a 0.77 correlation for the child mortality rates. The Pearson correlation coefficient showed a strong correlation value as well, 0.76, for the relationship between child mortality and income inequality. The longitudinal data shows the worsening rates as time progresses, as I mentioned before in this analysis. The scientists found that if they removed the United States from the data the correlation rates decreased significantly. The Gini coefficient after the United States was removed resulted in a value of 0.63. That is a 0.14 decrease just by removing one country from the data set, which leads them to believe the United States has an apparent issue with child mortality rates and income inequality. This is strange as the United States has exceptionally high-income rates but astoundingly awful child mortality rates. They concluded that their findings just strengthen the argument that child mortality rates are affected by income inequalities. I feel like this article will be a great resource for our research project as it clarifies and supports some of the claims that we state in our introduction.
Citation:
Collison, D., Dey, C., Hannah, G., & Stevenson, L. (2007). Income inequality and child mortality in wealthy nations. Journal of Public Health, 29(2), 114-117.

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Fourth Article

For my fourth article, I researched the topic of stillbirth in low to middle income countries. Aminu and his colleagues had very little background information going into this research. They knew out of the 2.6 million infant deaths per year that involved still birth that 98% of them derived from a developing country (Aminu). They wanted to research what factors and causes lead to stillbirths. Aminu and his colleagues had simple methods for conducting their research, much like how we are conducting research for our projects in class. They searched on a scholarly database for articles that had been published by other researchers. Any article that included factors of or causes behind stillbirths taken from a developing country setting were added to the pool of research material they would later analyze. Many of the developing countries involved had an astounding rate of “over 30 per 1000 births” that resulted in stillbirth, that is 3% of all births (Aminu). They also wanted to keep the period between 2000 and 2013. At the end of their data collection, the team had 142 studies that covered 49 developing countries to look through and analyze (Aminu). They found that many factors played into stillbirths; maternal factors, access to care, fetal factors, socioeconomic factors and education (Aminu). They also found a few different causes for stillbirths; maternal disease, congenital anomalies, placental conditions, intrapartum causes and trauma, umbilical causes, amniotic and uterine causes, and unknown causes (Aminu). Maternal disease was the leading cause for still birth of all the causes ranging between 8 – 50% of stillbirths (Aminu). One major obstacle that these researchers ran into was the lack of agreement on the definition of stillbirth. “The World Health Organization (WHO) defines stillbirth as a baby born dead at 28 weeks of gestation or more, with a birthweight of ≥1000 grams, or a body length of ≥35 centimeters” (Aminu). Many researchers disagreed on classifications for causes and factors of stillbirths as well. This made concluding any major results to be very difficult for Aminu and his colleagues. They concluded that the main factors associated with stillbirths are poverty, lack of education and maternal age (Aminu). Maternal age affects the chance of stillbirths mostly when the mother is either older than 35 or younger than 20 years of age (Aminu). The major cause of still birth remains to be maternal factors. These maternal factors include diseases such as syphilis, positive HIV, malaria and diabetes (Aminu). From all the stillbirth data that was recovered by this team of researchers a large portion of the stillbirths remained unclassified when it came to causes and factors, between 3.8 and 57.4% (Aminu). In conclusion, this research found some astonishing results but a lot still needs to be done to clarify them further. More physical research must be obtained, definitions of terms must be set in agreement for all countries and classification systems must be created so cause of death can truly be determined and recorded.

Citation:
Aminu, et al. “Causes of and Factors Associated with Stillbirth in Low‐ and Middle‐Income Countries: a Systematic Literature Review.” BJOG: An International Journal of Obstetrics &Amp; Gynaecology, vol. 121, no. s4, 2014, pp. 141–153.

Third Article

In my third article, I will be investigating the importance of delivering infants inside a hospital instead of an at-home setting. This research mainly focuses on the developing country of Bangladesh, younger mothers and the mortality rates that result from these at-home deliveries. The article starts by addressing some background on this tragic research. Most people are aware that giving birth to babies inside a hospital is safer due to the medical care team that is awaiting a complication and prepared to assist the mother in staying alive. Although, in Bangladesh this is something that is hard to come by due to the lack of health care facilities, especially ones that respect the values and beliefs of Bangladesh citizens. Many of the mothers in Bangladesh are very young and are prone to some birthing complications. According to Sarmistha Pal, “women younger than 20 have a 34 percent higher risk of death in the neonatal period” (Pal). This was some of the driving background information that interested Pal in investigating further.
Pal’s methods for her research were different than the last two articles I have read. She had her own sample of births from Bangladesh women that she found through Demographic Health Survey Organization and analyzed. She worked at the University of Surrey to create her research project. Between 2002 and 2007, Pal had a sample of 6141 children that she followed for the possibility of early mortality, neonatal mortality, infant mortality, and child mortality (Pal). Pal found that only 13% of the young mothers in Bangladesh gave birth inside of a hospital. A table can be found in this research article that provides the mean mortality rate for each kind of mortality; early, neonatal, infant and child. The trend seemed to be the older the child became the higher the mean of the mortality rate grew to be. Early mortality, death within a week of being born, for infants in Bangladesh had a mean value of 0.030, or 3% of 6141 individuals (Pal). Neonatal mortality, death within the first month, had the next lowest mean value of 0.042, or 4.2% of 6141 individuals, for a mortality rate (Pal). Infant mortality, within the first year, had the second highest mortality rate mean value of 0.053, or 5.3% of 6141 individuals (Pal). Child mortality, death between the first year up until the fifth year of life, had the highest mean value of 0.059, or 5.9% of 6141 individuals (Pal).
This concludes that child mortality is overall the highest and most concerning rate of all the young mortality ratings. This is believed to all stem back to the age of the mother and the care that was administered to the infant when he or she was born. Overall, infants in not only Bangladesh but other developing countries as well die every year from things that can be prevented. Low-income countries, like Bangladesh, marry and attempt to have offspring at too young of an age causing future complications. Also, the lack of adequate healthcare facilities makes healthy birthing processes to be rare. The work that needs to be done is bringing our knowledge to Bangladesh and helping them fix these easily curable issues.

Citation:
Pal, Sarmistha. “Impact of Hospital Delivery on Child Mortality: An Analysis of Adolescent Mothers in Bangladesh.” Social Science &Amp; Medicine, vol. 143, 2015, pp. 194–204.

Second Article

My second blog post will cover the “survival, morbidity, growth and developmental delay for babies born preterm in low and middle-income countries” (Gladstone). There is some background information on this topic and that would be the fact that premature births are leading in the cause of death for neonates. Premature births are high risk for children under the age of five as well, being the second most common reason for a child to pass away at an early age. The authors of this research wanted to investigate other research articles done by reliable professionals to see how prematurity affects infants on all aspects of their lives; survival rates, morbidity rates, growth and developmental issues. The methods that were used in order to conduct this experimentation were quite simple. The authors utilized an electronic database, just as I had done to find this article, then they analyzed them to see if they were worthy candidates for their research. They excluded articles that did not contain direct data, outcomes of prematurity, were in a developed country or involved a case study. When they finished critiquing the papers, these researchers only found 21 viable research articles that they could use to investigate their research. From these articles, they found results.
Many of the infants, 83.7%, were added to the research studies after they were born because there was no indication the mother was going to have a preterm delivery (Gladstone). When it came to mortality, almost all the articles used the same definition to follow by when drawing their conclusions which makes these findings to be very useful. 53.7% of the research found mortality while still in the hospital or shortly after the mother left the hospital with their newborn (Gladstone). Unlike mortality, morbidity does not have a set definition and is hard for all research articles to agree on a set definition. No statistics were stated for morbidity, but it is determined that premature infants have an increase in morbidity opposed to full term infants. Growth was hard to find in the research articles that were reviewed, because only half of the articles involved growth in their study. Infants that are born prematurely have a difficult time catching the full-term infants when it comes to growth. They very rarely reach the growth curve and are usually smaller in size. 20-28% of infants will reach the lower limit of normal growth by their full-term date (Gladstone). Development was determined a majority of the time by using “Bayley Scales of Infant Development”, but no statistics were mentioned for this section. Although this scale was used a majority of the time, it is hard to compare research when the scales are not equivalent.
They drew conclusions from the research articles that they found but additional research needs to be done. More studies, documentation, and survival states of preterm infants must be recorded and released to public knowledge so a deeper understanding of this question can be attained. Definitions and scales for the different aspects must be addressed and agreed upon so data can be compared and analyzed. There is a lot of work to be done on this research in order to get to the root of the question.
Citation:
Gladstone, Melissa, et al. “Survival, Morbidity, Growth and Developmental Delay for Babies Born Preterm in Low and Middle Income Countries – A Systematic Review of Outcomes Measured.” PLoS ONE, vol. 10, no. 3, 2015, pp. PLoS ONE, 2015, Vol.10(3).

First Article

This first article covered the topic of Malaria in the early stages of pregnancy and the effect that it has on the offspring. To fully understand this article, one must first have an understanding of what Malaria is. Malaria is a fever that is caused by a protozoan parasite invading your blood cells. It is spread through mosquitos and is more common in tropical areas of the world. There are drugs for Malaria but these do not help during the first trimester of pregnancy, especially if one is in a part of the world that is at high risk for Malaria. Malaria in pregnant mothers can result in maternal anemia and low birth weights for their offspring. The methods of this research included the authors reviewing research from other scientists to investigate what other scientists have found to be beneficial in preventing Malaria in pregnancies and what they have found that has not worked. The plan is to eventually create drugs that will be beneficial in fighting Malaria during the first trimester and possibly discover a vaccine for Malaria that can be administered in these high-risk regions of the world to conquer this problem. It has been determined that these women in developing countries rarely go to the doctor for an antenatal visit. These countries do not stress the importance of these visits or have enough clinics for these pregnant women to attend in order to get the help they desperately need. Insecticide-treated nets are given to pregnant mothers at their first antenatal visit, which in many of these developing countries is not until late into the pregnancy. There is not a lot of research done on antimalaria drugs used on pregnant women, especially not in the first trimester since these women are even harder to identify and do not attend regular doctor visits. The major result that was found was that artemisinin-based combination therapies have shown promise in the treatment of malaria in mother in their second or third trimester. There has not been much research with these in the first trimester, but it would be interesting to investigate this as a possible solution to the Malaria issue. Many scientists still hope to someday create a vaccine that they can administer to women at a young age to prevent Malaria from ever wreaking havoc on their pregnancy. A major conclusion drawn from their research over other scholarly articles would be the need for more antenatal visits in the first trimester of one’s pregnancy to prevent Malaria as much as possible. Drugs that are possibly helpful in preventing Malaria cannot be administered without the mother coming forward and asking for help. Also, another conclusion that was drawn was the need for more research to find a Malaria vaccine or new drugs that can be used to help mothers throughout all trimesters of their pregnancies.

Citation:

Huynh, Bich-Tram, et al. “Burden of Malaria in Early Pregnancy: A Neglected Problem?” Oxford Academic, 30 Oct. 2014, academic-oup-com.ezproxy.usd.edu/cid/article- lookup/doi/10.1093/cid/ciu848. Accessed 31 Aug. 2017.

What’s Next to Come

On this blog, I will be posting five summaries from five different scholarly articles I found pertaining to my research project I am completing in my college course. They will be approximately 400 words in length and cover the topics of background, rationale, methods, major results, and major conclusions of these different articles. There will also be a citation so all of you can view the original article that I analyze in my posts. I look forward to sharing my scientific thoughts with all the scientific minds out there!