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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Children's Health".

Deadline for manuscript submissions: closed (28 February 2022) | Viewed by 42907

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Dr. Amanda Rodrigues Amorim Adegboye

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Centre for Healthcare Research (CHR), Coventry University, Coventry CV8 3LG, UK
Interests: nutrition; sustainability; maternal and women’s health; health inequality; equity and diversity
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The improvement of maternal and child health was presented as the 5th United Nations Millennium Development Goal. However, it remains a key issue in global health. The new UN’s Global Goals for 2030 emphasize that ensuring people live healthy lives can cut child mortality and raise life expectancy.

Worldwide maternal and child health-related outcomes are markedly affected by environmental and socio-demographic factors including access to health care, vaccination, good nutrition, adequate housing, clean water and sanitation, education and employment. For example, uneducated and low-income women are more likely to face stressful life events during their life course and experience childbirth-related complications and poor gestational outcomes (e.g., preterm birth, intrauterine growth restriction, neonatal death) compared to well educated and high-income women. Preterm birth and intrauterine growth restriction can set a newborn baby on a life-long course of disparities in health-related outcomes. Children born into poverty are also more likely to have delayed cognitive development and poor school performance.

Maternal nutrition and cardiometabolic health are also powerful determinants of gestational outcomes. Women suffering from diabetes, iron deficiency anemia or obesity are at a higher risk of childbearing complications. Research indicates that babies born to mothers who are overweight or obese during pregnancy are at high risk of developing type 2 diabetes in later life.

This Special Issue of the International Journal of Environmental Research and Public Health (IJERPH) aims at advancing scientific and professional knowledge in the maternal, newborn and child health field. We believe that this issue will be an excellent forum for disseminating outstanding research findings as well as sharing good practice and innovative ideas for improving maternal and child health.

This Special Issue will accept manuscripts addressing maternal and child health practice, policy and research, exploring a wide range of topics and disciplines, such as epidemiology, public health, nutrition, social sciences, demography, health status assessment, innovative service initiatives, service evaluation, economic evaluation, policy analysis, advocacy and professional development. It will include the following types of articles:

Primary research (qualitative, quantitative and mixed-methods studies)
Systematic, scoping and narrative reviews
Methodological papers
Case studies
Commentaries and position papers
Brief reports

Dr. Amanda Rodrigues Amorim Adegboye
Guest Editor

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

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Keywords

Biomarkers
Breastfeeding
Children
Epidemiology
Early years
Food and nutrition
Gestational outcomes
Health impact
Health economics
Interventions
Lifestyle and behaviour
Oral health
Pregnancy and postpartum

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Related Special Issue

Women's Health, Pregnancy and Child Health in International Journal of Environmental Research and Public Health (13 articles)

Published Papers (12 papers)

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Research

Jump to: Review, Other

17 pages, 615 KiB

Open AccessArticle

Influence of COMT (rs4680) and DRD2 (rs1076560, rs1800497) Gene Polymorphisms on Safety and Efficacy of Methylphenidate Treatment in Children with Fetal Alcohol Spectrum Disorders

by Małgorzata Śmiarowska, Bogusław Brzuchalski, Elżbieta Grzywacz, Damian Malinowski, Anna Machoy-Mokrzyńska, Anna Pierzchlińska and Monika Białecka

Int. J. Environ. Res. Public Health 2022, 19(8), 4479; https://doi.org/10.3390/ijerph19084479 - 8 Apr 2022

Cited by 1 | Viewed by 3130

Abstract

Fetal alcohol spectrum disorders (FASD) in a course of high prenatal alcohol exposure (hPAE) are among the most common causes of developmental disorders. The main reason for pharmacological treatment of FASD children is attention deficit hyperactivity disorder (ADHD), and methylphenidate (MPH) is the drug of choice. The aim of the study was to assess whether children born of hPAE with ADHD, with or without morphological FASD, differ in terms of catechol-O-methyltransferase (COMT) and dopamine receptor D2 (DRD2) gene polymorphisms, and if genetic predisposition affects response and safety of MPH treatment. The polymorphisms of COMT (rs4680) and DRD2 (rs1076560, rs1800497) were analyzed in DNA samples. A borderline significance was found for the correlation between MPH side effects and the G allele of COMT (rs4680) (p = 0.04994) in all ADHD children. No effect of COMT (rs4680) and DRD2 (rs1076560, rs1800497) polymorphisms and the treatment efficacy was observed. The analyzed DRD2 and COMT gene polymorphisms seem to play no role in MPH efficacy in ADHD children with hPAE, while low-activity COMT (Met158) variant carriers may be more intolerant to MPH. The MPH treatment is effective in ADHD independent of FASD, although the ADHD-FASD variant requires higher doses to be successful. These results may help in optimization and individualization in child psychiatry. Full article

(This article belongs to the Special Issue Pregnancy and Child Health)

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14 pages, 711 KiB

Open AccessArticle

Association between Pre-Pregnancy BMI and Inflammatory Profile Trajectories during Pregnancy and Postpartum in Brazilian Women with Periodontitis: The IMPROVE Trial

by Danilo Dias Santana, Gilberto Kac, Pedro Paulo Teixeira dos Santos, Thainá Castro da Silva, Camila Benaim, Paula Guedes Cocate, Maria Beatriz Trindade de Castro, Berit Lilienthal Heitmann and Amanda Rodrigues Amorim Adegboye

Int. J. Environ. Res. Public Health 2022, 19(5), 2705; https://doi.org/10.3390/ijerph19052705 - 25 Feb 2022

Cited by 6 | Viewed by 2538

Abstract

This study aimed to explore the association between pre-pregnancy BMI and longitudinal changes in inflammatory markers from the second trimester of pregnancy to 6–8 weeks postpartum in women with periodontitis. This is a secondary exploratory analysis of 68 women who took part in a feasibility clinical trial in Rio de Janeiro, Brazil. Inflammatory markers included C-reactive protein (CRP), interleukin-6 (IL-6), interleukin-10 (IL-10), and matrix metalloproteinase-9 (MMP-9) blood concentrations at 11–22 (T0) and 30–36 gestational weeks (T1), and 6–8 weeks postpartum (T3). Longitudinal generalised linear mixed-effects models were used to identify possible associations between pre-pregnancy BMI and changes in concentrations of inflammatory markers. Pre-pregnancy excess weight (β = 4.39; 95% CI, 2.12–6.65) was significantly associated with increased CRP levels from pregnancy to postpartum. There were no significant associations between pre-pregnancy BMI and longitudinal changes in IL-6, IL-10 and MMP-9. Our findings provide evidence that a higher pre-pregnancy BMI may lead to increases in CRP levels during pregnancy in women with periodontitis, irrespective of the severity of clinical periodontal parameters. Further studies need to investigate if predictors of changes in inflammatory markers can be used as prognostic factors for gestational outcomes. Full article

(This article belongs to the Special Issue Pregnancy and Child Health)

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13 pages, 503 KiB

Open AccessArticle

Maternal Work–Life Balance and Children’s Social Adjustment: The Mediating Role of Perceived Stress and Parenting Practices

by Rikuya Hosokawa and Toshiki Katsura

Int. J. Environ. Res. Public Health 2021, 18(13), 6924; https://doi.org/10.3390/ijerph18136924 - 28 Jun 2021

Cited by 14 | Viewed by 4969

Abstract

The participation of women with young children in the Japanese labor force has increased dramatically in recent years, bringing growing potential for conflict between work and family roles amid inadequate social systems, such as childcare support. Thus, work–life balance (WLB) of mothers may influence their children’s mental health and lifestyle. This study aims to clarify the relationship between parents’ WLB and children’s mental health, as well as the underlying factors of parental stress and nurturing attitude. The study is based on a questionnaire survey administered in 2019 to fifth-grade elementary school students and their caregivers in Aichi Prefecture, Japan. The regression results indicated that the higher the work–family negative spillover, the higher the child’s externalizing and internalizing problems, and the higher the positive spillover, the lower the problems and the higher the prosocial behaviors. Path analysis indicates that maternal WLB is negatively and positively related to children’s behavior through maternal stress and parenting practices. The study suggests that maternal WLB is related to children’s emotional and behavioral problems. WLB may impact children’s emotional and behavioral problems through parents’ mental health and involvement with their children, particularly because of work arrangements changing with the COVID-19 pandemic. Full article

(This article belongs to the Special Issue Pregnancy and Child Health)

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16 pages, 3157 KiB

Open AccessArticle

Institute of Medicine Recommendations on the Rate of Gestational Weight Gain and Perinatal Outcomes in Rural Bangladesh

by S. M. Tafsir Hasan, Md Alfazal Khan and Tahmeed Ahmed

Int. J. Environ. Res. Public Health 2021, 18(12), 6519; https://doi.org/10.3390/ijerph18126519 - 17 Jun 2021

Cited by 10 | Viewed by 2996

Abstract

Although validated in other parts of the world, the suitability of the U.S. Institute of Medicine (IOM) 2009 recommendations on gestational weight gain (GWG) for Bangladeshi women remains to be examined. We evaluated the association between the weekly rate of weight gain during the second and third trimester of pregnancy, categorized according to IOM recommendations, and adverse perinatal outcomes among 1569 pregnant women with singleton live births in rural Matlab, Bangladesh. Gaining weight at rates below the IOM recommendations was associated with higher odds of preterm birth (adjusted odds ratio (AOR) = 2.0, 95% CI: 1.1–3.6), low birth weight (AOR = 1.4, 95% CI: 1.03–2.0), small-for-gestational-age newborns (AOR = 1.3, 95% CI: 1.04–1.7), and poor neonatal outcome (severe neonatal morbidity or death, AOR = 2.4, 95% CI: 1.03–5.6). A GWG rate above the recommendations was associated with higher odds of cesarean delivery (AOR = 1.7, 95% CI: 1.1–2.6), preterm birth (AOR = 2.2, 95% CI: 1.1–4.4), large-for-gestational-age newborns (AOR = 5.9, 95% CI: 1.5–23.1), and poor neonatal outcome (AOR = 2.7, 95% CI: 1.04–7.0). Our results suggest that the IOM 2009 recommendations on GWG rate during the second and third trimester may be suitable for guiding rural Bangladeshi women in the prenatal period, although the women should aim for rates near the lower bound of the range. Full article

(This article belongs to the Special Issue Pregnancy and Child Health)

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15 pages, 687 KiB

Open AccessArticle

Identifying Patterns of Symptom Distress in Pregnant Women: A Pilot Study

by Ching-Fang Lee, Fur-Hsing Wen, Yvonne Hsiung, Jian-Pei Huang, Chun-Wei Chang and Hung-Hui Chen

Int. J. Environ. Res. Public Health 2021, 18(12), 6333; https://doi.org/10.3390/ijerph18126333 - 11 Jun 2021

Cited by 1 | Viewed by 2747

Abstract

During pregnancy, a woman’s enlarged uterus and the developing fetus lead to symptom distress; in turn, physical and psychological aspects of symptom distress are often associated with adverse prenatal and birth outcomes. This study aimed to identify the trends in the trajectory of these symptoms. This longitudinal study recruited 95 pregnant women, with a mean age of 32 years, from the prenatal wards of two teaching hospitals in northern Taiwan. Symptom distress was measured by a 22-item scale related to pregnancy-induced symptoms. The follow-up measurements began during the first trimester and were taken every two to four weeks until childbirth. More than half of the pregnant women experienced symptom distress manifested in a pattern depicted to be “Decreased then Increased” (56.8%). Other noticeable patterns were “Continuously Increased” (28.4%), “Increased then Decreased” (10.5%) and “Continuously Decreased” (4.2%), respectively. It is worth noting that most pregnant women recorded a transit and increase in their symptom distress, revealed by their total scores, at the second trimester (mean 22.02 weeks) of pregnancy. The participants’ major pregnancy-related distress symptoms were physical and included fatigue, frequent urination, lower back pain, and difficulty sleeping. The mean scores for individual symptoms ranged from 2.32 to 3.61 and were below the “moderately distressful” level. This study provides evidence that could be used to predict women’s pregnancy-related symptom distress and help healthcare providers implement timely interventions to improve prenatal care. Full article

(This article belongs to the Special Issue Pregnancy and Child Health)

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14 pages, 711 KiB

Open AccessArticle

Knowledge, Attitudes, and Practices of Spanish Midwives and Midwifery Students toward Oral Healthcare during Pregnancy

by Sara Touriño, María del Carmen Suárez-Cotelo, María Jesús Núñez-Iglesias, Eva María Domínguez-Martís, Diego Gabriel Mosteiro-Miguéns, David López-Ares and Silvia Novío

Int. J. Environ. Res. Public Health 2021, 18(11), 6089; https://doi.org/10.3390/ijerph18116089 - 4 Jun 2021

Cited by 9 | Viewed by 3321

Abstract

Pregnancy can affect the mother’s oral health, increasing their susceptibility to oral diseases that have been associated with harmful effects on the newborn. Despite the severity of oral diseases during pregnancy, the demand for dental care during the gestational period is low, which may improve with the participation of midwives in promoting oral health activities. The objectives of this study were: (i) to determine the knowledge, attitudes, and practices of Spanish midwives and midwifery students regarding oral health in pregnant women; and (ii) to identify the barriers faced by these healthcare professionals in addressing oral health promotion during pregnancy. An observational cross-sectional descriptive study was conducted. A total of 128 midwives and/or midwifery students ≥ 18 years old and of both sexes were invited to self-complete a questionnaire between January and April 2020. A total of 85 people participated in the study. Participants had a regular level of knowledge about oral health during pregnancy (overall knowledge score: 6.53), and although they were interested in activities that promote oral healthcare, their oral healthcare practices during pregnancy were limited. As midwives play an important role in promoting health, their training in oral healthcare could help to improve pregnant women’s oral health. Full article

(This article belongs to the Special Issue Pregnancy and Child Health)

8 pages, 286 KiB

Open AccessArticle

Associations between Child Mental Well-Being or Conflicts during Mealtime and Picky Eating Behaviour

by Maria Lepinioti, Ina Olmer Specht, Jeanett Friis Rohde, Maria Stougaard, Mina Nicole Händel, Nanna Julie Olsen and Berit Lilienthal Heitmann

Int. J. Environ. Res. Public Health 2021, 18(11), 5621; https://doi.org/10.3390/ijerph18115621 - 25 May 2021

Cited by 2 | Viewed by 4216

Abstract

Pickiness is an eating behavior that many families with young children face. Having joint family meals may impact the child’s pickiness, for instance by influencing their willingness to try novel foods. Moreover, picky children have been shown to display greater emotionality. The aim of this study was to investigate if children’s mental well-being and parent-reported conflicts during mealtime were associated with pickiness among obesity-prone children. Data was obtained from the baseline examination of the Healthy Start intervention study, the Danish Medical Birth registry and the Danish Health Visitor’s Child Health Database, and included 635 children aged 2–6 years that were all at high risk for becoming overweight later in life. Children’s mental well-being was measured by the strengths and difficulties questionnaire. Crude and adjusted ordinal logistic regressions were used to investigate the cross-sectional associations. Children had a higher odds associated with changing from a category of less pickiness to a category of more pickiness for each one point higher SDQ score (ORadj. = 1.35, 95% CI = 1.14; 1.61) and lower odds (ORadj. = 0.57, 95% CI = 0.38; 0.86) associated with changing pickiness category towards more pickiness for each one point higher SDQ prosocial score. Moreover, children with conflicts during mealtime had higher odds of being in a worse pickiness category compared to children without conflicts (ORadj. = 3.37, 95% CI = 2.27; 5.01). This study showed that among obesity-prone children, behavioral problems, as well as conflicts during mealtime, were associated with more picky behaviors. Further longitudinal studies are needed to confirm the findings, as are studies including general child population subsets. Full article

(This article belongs to the Special Issue Pregnancy and Child Health)

14 pages, 719 KiB

Open AccessArticle

Achievements and Challenges in the Prevention of Mother-to-Child Transmission of HIV—A Retrospective Cohort Study from a Rural Hospital in Northern Tanzania

by Sunniva Marie Nydal, Yuda Munyaw, Johan N. Bruun and Arne Broch Brantsæter

Int. J. Environ. Res. Public Health 2021, 18(5), 2751; https://doi.org/10.3390/ijerph18052751 - 9 Mar 2021

Cited by 4 | Viewed by 3914

Abstract

Despite the goal of eliminating new human immunodeficiency virus (HIV) infections in children, mother-to-child transmission is still common in resource-poor countries. The aims of this study were to assess the occurrence of mother-to-child transmission of HIV (MTCT) by age 18 months, risk factors for transmission, and the implementation of the national prevention of MTCT (PMTCT) program in a rural hospital in Tanzania. Data were collated from various medical registers and records. We included 172 children and 167 HIV-infected mothers. Among 88 children (51%) with adequate information, 9 (10.2%) were infected. Increased risk of MTCT was associated with late testing of the child (>2 months) [OR = 9.5 (95% CI: 1.8–49.4)], absence of antiretroviral therapy during pregnancy [OR = 9.7 (95% CI: 2.1–46.1)], and maternal CD4 cell count <200 cells/mm³ [OR = 15.3 (95% CI: 2.1–111)]. We were unable to determine the occurrence of MTCT transmission in 84 children (49%). The results from this study highlight that there is an urgent need for enhanced efforts to improve follow-up of HIV-exposed children, to improve documentation in registries and records, and to facilitate ease of linkage between these. Full article

(This article belongs to the Special Issue Pregnancy and Child Health)

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8 pages, 700 KiB

Open AccessArticle

Prevalence and Temporal Trend (2016–2018) of Anaemia among 6–23-Month-Old Infants and Young Children in China

by Jing Liu, Junsheng Huo, Zengyan Liu, Jing Sun and Jian Huang

Int. J. Environ. Res. Public Health 2021, 18(4), 2041; https://doi.org/10.3390/ijerph18042041 - 19 Feb 2021

Cited by 5 | Viewed by 2458

Abstract

Anaemia is a public health problem that can lead to various harmful effects on physical and neurodevelopment in infants and young children (IYC). This study aimed to investigate trends of anaemia and haemoglobin concentration among 6- to 23-month-old Chinese IYC from 2016 to 2018. We used data from the China Nutrition Improvement Project on Children in Poor Areas (CNIPCPA), conducted in 142 national-level poor counties of 20 provinces, autonomous regions, and municipalities from 2016 to 2018. Our study included 103,621 6- to 23-month-old IYC selected by a stratified multistage cluster sampling design. There were 26,303, 33,443, and 43,875 IYC in the survey in 2016, 2017, and 2018, respectively. The overall prevalence of anaemia was 27.0% in the three years. The prevalence of anaemia was 28.0%, 27.2%, and 26.2%, and the mean haemoglobin (Hb) was 11.82, 11.81, and 11.88 g/dL in 2016, 2017, and 2018, respectively. The prevalence of anaemia was highest in 6- to 11-month-olds, and declined with age. There was a gap in the education level between parents. However, the percentage of education improved in the rural areas of China. The prevalence of anaemia decreased significantly in the three years, which shows that prevention and control actions achieved the initial results. Full article

(This article belongs to the Special Issue Pregnancy and Child Health)

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10 pages, 642 KiB

Open AccessArticle

Predictive Accuracy of Singleton Versus Customized Twin Growth Chart for Adverse Perinatal Outcome: A Cohort Study

by Urszula Nowacka, Katarzyna Kosińska-Kaczyńska, Paweł Krajewski, Aleksandra Saletra-Bielińska, Izabela Walasik and Iwona Szymusik

Int. J. Environ. Res. Public Health 2021, 18(4), 2016; https://doi.org/10.3390/ijerph18042016 - 19 Feb 2021

Cited by 7 | Viewed by 2622

Abstract

Background: Fetal growth of twins differs from singletons. The objective was to assess the fetal growth in twin gestations in relation to singleton charts and customized twin charts, respectively, followed by a comparison of the frequency of neonatal complications in small-for-gestational-age (SGA) twins. Methods: We performed an analysis of twin pregnancies with established chorionicity with particular emphasis on postnatal adverse outcomes in newborns classified as SGA. Neonatal birth weight was comparatively assessed using both singleton and twin growth charts with following percentile estimation. Using a statistical model, we established the prediction strength of neonatal complications in SGA twins for both methods. Results: The dataset included 322 twin pairs (247 cases of dichorionic and 75 cases of monochorionic diamniotic gestations). Utilization of twin-specific normograms was less likely to label twins as SGA—nevertheless, this diagnosis strongly correlated with risk of observing adverse outcomes. Using a chart dedicated for twin pregnancies predicted newborn complications in the SGA group with higher sensitivity and had better positive predictive value regarding postnatal morbidity. Conclusions: Estimating twin growth with customized charts provides better prognosis of undesirable neonatal events in the SGA group comparing to singleton nomograms and consequently might determine neonatal intensive care prenatal approach. Full article

(This article belongs to the Special Issue Pregnancy and Child Health)

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Review

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19 pages, 1674 KiB

Open AccessReview

Impact and Effectiveness of Group Strategies for Supporting Breastfeeding after Birth: A Systematic Review

by Isabel Rodríguez-Gallego, Fatima Leon-Larios, Isabel Corrales-Gutierrez and Juan Diego González-Sanz

Int. J. Environ. Res. Public Health 2021, 18(5), 2550; https://doi.org/10.3390/ijerph18052550 - 4 Mar 2021

Cited by 11 | Viewed by 4839

Abstract

Despite the multiple benefits of breastfeeding both for the mother and for the infant, during the first months there is a progressive decline in the number of mothers who continue breastfeeding, with most countries reporting lower than recommended figures. The objective of this review is to analyse the most effective group support practices for breastfeeding, as well as the characteristics associated to their success in maintaining breastfeeding. A systematic review has been conducted in the 2015–2020 period, in the following databases: MedLine, Scopus, Web of Science, Cumulative Index to Nursing and Allied Health Literature, Cochrane Library and LILACS. The findings were summarized in narrative and table formats. A total of thirteen articles were included, eight of them being experimental studies and five observational. The findings show high heterogeneity regarding the characteristics of the interventions and their periodicity. The most successful group strategies to support and maintain breastfeeding during postpartum are those that combine peer support with the leadership or counselling of a health professional or IBCLC. However, more studies are necessary, randomized and with interventions of similar characteristics, which allow for better data comparison. Full article

(This article belongs to the Special Issue Pregnancy and Child Health)

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Other

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13 pages, 732 KiB

Open AccessStudy Protocol

Lateral Kangaroo Care in Hemodynamic Stability of Extremely Preterm Infants: Protocol Study for a Non-Inferiority Randomized Controlled Trial CANGULAT

by Laura Collados-Gómez, Laura Esteban-Gonzalo, Candelas López-López, Lucía Jiménez-Fernández, Salvador Piris-Borregas, Esther García-García, Juan Carlos Fernández-Gonzalo and Esther Martínez-Miguel

Int. J. Environ. Res. Public Health 2022, 19(1), 293; https://doi.org/10.3390/ijerph19010293 - 28 Dec 2021

Cited by 7 | Viewed by 3107

Abstract

Introduction: This study aims to assess the efficacy of the modified kangaroo care lateral position on the thermal stability of preterm neonates versus conventional kangaroo care prone position. Material and methods: A non-inferiority randomized parallel clinical trial. Kangaroo care will be performed in a lateral position for the experimental group and in a prone position for the control group preterm. The study will take place at the neonatal intensive care unit (NICU) of a University Hospital. The participants will be extremely premature infants (under 28 weeks of gestational age) along the first five days of life, hemodynamically stable, with mother or father willing to do kangaroo care and give their written consent to participate in the study. The sample size calculated was 35 participants in each group. When the premature infant is hemodynamically stable and one of the parents stays in the NICU, the patient will be randomized into two groups: an experimental group or a control group. The primary outcome is premature infant axillary temperature. Neonatal pain level and intraventricular hemorrhage are secondary outcomes. Discussion: There is no scientific evidence on modified kangaroo care lateral position. Furthermore, there is little evidence of increased intraventricular hemorrhage association with the lateral head position necessary in conventional or prone kangaroo care in extremely premature newborns. Kangaroo care is a priority intervention in neonatal units increasing the time of use more and more, making postural changes necessary to optimize comfort and minimize risks with kangaroo care lateral position as an alternative to conventional prone position kangaroo care. Meanwhile, it is essential to ensure that the conventional kangaroo care prone position, which requires the head to lay sideways, is a safe position in terms of preventing intraventricular hemorrhage in the first five days of life of children under 28 weeks of gestational age. Trial registration at clinicaltrials.gov: NCT03990116. Full article

(This article belongs to the Special Issue Pregnancy and Child Health)

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