Objective: This study explored changes of trend in anemia and body mass index (BMI) among currently pregnant nullipara adolescent women against socio-economic determinants in India from 2005 through 2015. It also explored the association between anemia in currently pregnant nullipara adolescent women versus currently pregnant nullipara older women of reproductive age. Design: We used the 2005 and the 2015 nationally representative Indian Demographic and Health Surveys (DHS). The outcomes of interest Anemia and BMI were measured based on the DHS methodology following WHO standards and indicators. Place of residence, educational attainment and wealth quintiles were used as determinants in the analysis. Setting: India. Participants: In total, 696 adolescent girls from the India 2005 DHS and 3041 adolescent girls from the India 2015 DHS. Results: The 10-year transition from the 2005 to the 2015 showed the differences between the least and most wealthy sections of society, with heaviest gains in anemia reduction over time among the latter (from 50.0% to less than 40.0%). Odds of anemia were significantly higher among the adolescent population when compared to adult women both in 2005 and in 2015 (OR=1.2). Conclusions: Despite an overall improvement in the prevalence of both BMI<18.5 and anemia among adolescents nullipara in India, the risk of anemia in the latter category was still significantly higher as compared to their adult counterparts. Since the inequalities evidenced during the first round of DHS remained unchanged in 2015, more investments in universal health care are needed in India.

Improvement of women’s access to abortion care in Italy during the COVID‐19 pandemic is critical.

No abstract

To the Editor-Healthcare workers (HCWs) have been key in the current global response against the COVID-19 epidemic; their safety can help address the clinical and public health challenges associated with SARS-CoV-2 infection. 1 As of late March, infections of HCWs in Italy reached a peak of 10.0% of the total COVID-19 cases, 2 representing a potential amplifier of the epidemic following the viral transmission within and outside the health facility environment, to HCWs, visitors, inpatients, and outpatients. The Italian National Health Institute (Istituto Superiore di Sanita, ISS), has been issuing a biweekly bulletin on the COVID-19-update since March 19, 2020. These bulletins report on Italian regional data collected by local laboratories, stratified by demographic and epidemiological variables (eg, age, province, etc). Until April 2, bulletins were also reporting the cumulative number of SARS-CoV-2-positive HCWs. 3-7 Unfortunately, no data on incident infections among HCWs have been published in the most recent reports. The available data show wide regional disparities, both in terms of HCW infection prevalence and in trajectories over the 4 weeks of monitoring (Fig. 1). On March 19, 2020, the cumulative number of positive individuals ranged from 7 in Valle d'Aosta to 19,882 in Lombardy, with a proportional attributable contribution to the total amount of cases varying from 0.2% (n = 1) in Campania to 41.5% (n = 44) in Sardinia. Although the overall national trend of positive healthcare workers out of the total cases showed a slight decrease (from 9.5% to 8.4%) from March 19 to April 2, several regional patterns were also described in the same period (Fig. 1). Some regions (eg,

BackgroundScientific literature has provided clear evidence of the profound impact of sexual violence on women’s health, such as somatic disorders and mental adverse outcomes. However, consequences related to obstetric complications are not yet completely clarified. This study aimed to assess the association of lifetime exposure to intimate partner sexual violence with eclampsia.MethodsWe considered all the seven Demographic and Health Surveys (DHS) that included data on sexual violence and on signs and symptoms suggestive of eclampsia for women of reproductive age (15-49 years). We computed unadjusted and adjusted odds ratios (OR) to evaluate the risk of suggestive eclampsia by ever subjected to sexual violence. A sensitivity analysis was conducted restricting the study population to women who had their last live birth over the 12 months before the interview.ResultsSelf-reported experience of sexual violence ranged from 3.7% in Mali to 9.2% in India while prevalence of women reporting signs and symptoms compatible with eclampsia ranged from 14.3% in Afghanistan to 0.7% in the Philippines. Reported sexual violence was associated with a 2-fold increased odd of signs and symptoms suggestive of eclampsia in the pooled analysis. The sensitivity analysis confirmed the strength of the association between sexual violence and eclampsia in Afghanistan and in India.ConclusionsWomen and girls in low-and-middle-income countries are at high risk of sexual violence, which may represent a risk factor for hypertensive obstetric complication. Accurate counseling by health care providers during antenatal care consultations may represent an important opportunity to prevent adverse outcomes during pregnancy.