OBJECTIVES: The American Academy of Pediatrics National Registry for the Surveillance and Epidemiology of Perinatal coronavirus disease 2019 (COVID-19) (NPC-19) was developed to provide information on the effects of perinatal severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. METHODS: National Registry for the Surveillance and Epidemiology of Perinatal COVID-19 participating centers entered maternal and newborn data for pregnant persons who tested positive for SARS-CoV-2 infection between 14 days before and 10 days after delivery. Incidence of and morbidities associated with maternal and newborn SARS-CoV-2 infection were assessed. RESULTS: From April 6, 2020 to March 19, 2021, 242 centers in the United States centers reported data for 7524 pregnant persons; at the time of delivery, 78.1% of these persons were asymptomatic, 18.2% were symptomatic but not hospitalized specifically for COVID-19, 3.4% were hospitalized for COVID-19 treatment, and 18 (0.2%) died in the hospital of COVID-related complications. Among 7648 newborns, 6486 (84.8%) were tested for SARS-CoV-2, and 144 (2.2%) were positive; the highest rate of newborn infection was observed when mothers first tested positive in the immediate postpartum period (17 of 125, 13.6%). No newborn deaths were attributable to SARS-CoV-2 infection. Overall, 15.6% of newborns were preterm: among tested newborns, 30.1% of polymerase chain reaction-positive and 16.2% of polymerase chain reaction-negative were born preterm (P < .001). Need for mechanical ventilation did not differ by newborn SARS-CoV-2 test result, but those with positive tests were more likely to be admitted to a NICU. CONCLUSIONS: Early in the pandemic, SARS-CoV-2 infection was acquired by newborns at variable rates and without apparent short-term effects. During a period that preceded widespread availability of vaccines, we observed higher than expected numbers of preterm births and maternal in-hospital deaths.

Background Few studies have reported odds of mortality for hospitalized premature infants stratified by postnatal age and adjusted for severity of illness. Our objective was to examine day-by-day mortality of premature infants in a large multicenter cohort of infants, adjusted for demographics, severity of illness, and receipt of therapeutic interventions. Methods This was a multicenter cohort study of infants cared for in 362 neonatal intensive care units with a shared clinical data warehouse from 1997 to 2013. We included all inborn infants born at 22–29 weeks’ gestational age with available mortality discharge data. We report the point prevalence of survival to hospital discharge stratified by gestational and postnatal age. Results We identified 64,896 infants, of whom 55,348 (85%) survived to hospital discharge. Survival increased with gestational and postnatal age, until infants reach a postmenstrual age of approximately 37 weeks, after which survival began to decrease. Overall survival increased over time (80% in 1997 to 88% in 2013, P<.001). Conclusions Given the known association between gestational age and postnatal age, survival predictions should be adjusted for both covariates.

Despite decades of concerted experimental studies dedicated to providing fundamental insights into the adsorption of aurocyanide ion, Au(CN)2(-), on activated carbon (AC) surface, such a mechanism is still poorly understood and remains a contentious issue. This adsorption process is an essential unit operation for extracting gold from ores using carbon-in-pulp (CIP) technology. We hereby attempt to shed more light on the subject by employing a range of transmission electron microscopy (TEM) associated techniques. Gold-based clusters on the AC surface are observed by Z-contrast scanning TEM imaging and energy-filtered TEM element mapping and are supported by X-ray microanalysis. Density functional theory (DFT) calculations are applied to investigate this adsorption process for the first time. Fullerene-like models incorporating convex, concave, or planar structure which mimic the eclectic porous structures on the AC surface are adopted. Pentagonal, hexagonal, and heptagonal arrangements of carbon rings are duly considered in the DFT study. By determining the favored adsorption sites in water environment, a general adsorption trend of Au(CN)2(-) adsorbed on AC surface is revealed whereby concave > convex ≈ planar. The results suggest a tendency for Au(CN)2(-) ion to adsorb on the carbon sheet defects or edges rather than on the basal plane. In addition, we show that the adsorption energy of Au(CN)2(-) is approximately 5 times higher than that of OH(-) in the alkaline environment (in negative ion form), compared to only about 2 times in acidic environment (in protonated form), indicating the Au extraction process is much favored in basic condition. The overall simulation results resolve certain ambiguities about the adsorption process for earlier studies. Our findings afford crucial information which could assist in enhancing our fundamental understanding of the CIP adsorption process.

Objective: The rates of cesarean deliveries (CD) in the United States (U.S.) have been increasing since the 1990s making it the most common operating room procedure in U.S. hospitals. CD may be necessary due to a variety of medical indications; however, it is not clear whether socioeconomic factors affect CD rates. This study examines the association between type of insurance coverage pregnant women have and rates of CD in the U.S.Methods: This is a retrospective analysis of the discharge records of pregnant women admitted to U.S. hospitals between 2012 and 2014 extracted from the National Inpatient Sample dataset. The study population was divided into two groups according to insurance coverage (public vs private). Logistic regression analysis was used to examine the association between type of insurance and CD rates while controlling for an array of demographic, medical, social and behavioral confounding factors.Results: 12,450,349 subjects were included in the analysis, of those, 29.9% had a CD. 82.6% of women are between 18-34 years old and 49.5% are Caucasians. 48.9% of women have private insurance. Women with private insurance received a higher percentage of cesarean deliveries (31.8%) compared to women with public insurance (28.3%), adjusted odds ratio (aOR): 1.30 (CI: 1.29-1.30, p&lt;0.001). This ratio was more significant in AMA women (aOR: 1.37) but not among teenagers. Although, higher in all race/ethnicity groups, African American, Hispanic and Native American women have more significant association to receive CD when covered by private insurance compared to Caucasian women. Giving birth at an urban-teaching hospital was associated with a higher CD rate (31.9% vs. 27.4%), aOR: 1.42. Delivery in the Northeast was associated with increased CD rates (32.8% vs. 27.5%) when covered with private insurance, aOR: 1.43, while in the West, private insurance was associated with less CD, aOR: 1.17.Conclusion: After controlling for demographic, clinical, behavioral, and system variables, private insurance was associated with a 30% increase in rate of CD compared to public insurance.