Association of consanguinity with neonatal asphyxia at birth: Evidence from Pakistan.

Consanguinity commonly known as inbreeding is a state of offspring borne to couple sharing same ancestors. It is a least researched non-obstetric determinant of adverse birth outcome in developing countries like Pakistan. This hospital based study was designed to investigate the association between consanguineous status and neonatal asphyxia measured measured as low APGAR scores after birth in 879 newborns.The data regarding consanguineous status was obtained retrospectively. Potential covariates were incorporated for finding confounding effects. Data was analyzed in SPSS version 26.0 as mean ± standard deviation, unadjusted & adjusted odds ratios by logistic regression at P-values ≤ 0.05 significance for associations. Over 36.1% newborns were consanguineous, delivered with APGAR < 6 at 1-minute compared to 5.2% born to non-consanguineous parents. Premature birth was the single most important factor associated with neonatal asphyxia and low APGAR at 1 & 5-minute after birth. After adjusting for confounding variables, first cousin couples' offsprings showed OR of 9.1 & 4.1 for APGAR score ≤ 6 at 1 & 5-minutes after birth, respectively (P < 0.001 & P =0.001). We conclude that consanguinity is a strong determinant for neonatal asphyxia reported as low APGAR scores in this population of new borns.

Employers' perspective of workplace breastfeeding support in Karachi, Pakistan: a cross-sectional study.

BACKGROUND: Breastfeeding is considered to be an important measure to achieve optimum health outcomes for children, women's return to work has frequently been found to be a main contributor to the early discontinuation of breastfeeding. The aim of the study is to assess workplace breastfeeding support provided to working mothers in Pakistan. METHOD: A workplace based cross-sectional survey was conducted from April through December 2014. Employers from a representative sample of 297 workplaces were interviewed on pre-tested and structured questionnaire. The response rate was 93.7 %. Prevalence of workplace breastfeeding facilities were assessed in the light of World Alliance for Breastfeeding Action (WABA) guidelines. RESULTS: Among non-physical facilities, all workplaces offered 3 months paid maternity leave, 45 % of the sites were offering task adjustment to mothers during lactation period. Only 15 % of the sites were offering breastfeeding breaks to working mothers. Physical facilities that include a breastfeeding corner, refrigerator for storing breast milk, breast milk pump and nursery for childcare were provided in less than 7 % of the sites. Multinational organizations provided better support compared to national organizations. CONCLUSION: Support for continuation of breastfeeding by working women at workplaces is inadequate; hence, women discontinue breastfeeding earlier than planned. Policies need to be developed and enforced, employers and employees need to be educated and supportive environment needs to be created to encourage and facilitate breastfeeding friendly worksite environment.