While a growing number of U.S. public school districts have made abstinence education a part of their curriculum, two-thirds of districts allow at least some positive discussion of contraception to occur. Nevertheless, one school district in three forbids dissemination of any positive information about contraception, regardless of whether their students are sexually active or at risk of pregnancy or disease.
The continued global escalation of coronavirus disease 2019 (COVID-19) cases is of particular concern for pregnant and lactating individuals. While many cases of COVID-19 are asymptomatic or relatively mild, recent evidence suggests that pregnant people are at increased risk of hospitalization and have a 3-fold adjusted relative risk of needing intensive care (10.5 vs 3.9/1000 cases) and mechanical ventilation (2.9 vs 1.1/1000 cases) compared with age-matched nonpregnant individuals. 1 Pregnant people with laboratoryconfirmed severe or critical COVID-19 disease have higher adjusted relative risks of cesarean delivery (1.57 [95% CI, 1.30-1.90]), postpartum hemorrhage (2.04 [95% CI, 1.19-3.47]), hypertensive disorders of pregnancy (1.64 [95% CI, 1.21-2.23]), and preterm birth (3.53 [95% CI, 2.42-5.15]). 2 These complications are exacerbated in women who are older, have a higher body mass index, and who have medical comorbidities; evidence is emerging that racial and ethnic disparities also are related to morbidity and mortality among pregnant people. 1,2 With the development of COVID-19 vaccines, there is the potential for prevention of this illness; however, the evidence for the utility, safety, and effectiveness of the available vaccines in pregnancy is unknown.
A December 2010 meeting, “Down Syndrome: National Conference on Patient Registries, Research Databases, and Biobanks,” was jointly sponsored by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) at the National Institutes of Health (NIH) in Bethesda, MD, and the Global Down Syndrome Foundation (GDSF)/Linda Crnic Institute for Down Syndrome based in Denver, CO. Approximately 70 attendees and organizers from various advocacy groups, federal agencies (Centers for Disease Control and Prevention, and various NIH Institutes, Centers, and Offices), members of industry, clinicians, and researchers from various academic institutions were greeted by Drs. Yvonne Maddox, Deputy Director of NICHD, and Edward McCabe, Executive Director of the Linda Crnic Institute for Down Syndrome. They charged the participants to focus on the separate issues of contact registries, research databases, and biobanks through both podium presentations and breakout session discussions. Among the breakout groups for each of the major sessions, participants were asked to generate responses to questions posed by the organizers concerning these three research resources as they related to Down syndrome and then to report back to the group at large with a summary of their discussions. This report represents a synthesis of the discussions and suggested approaches formulated by the group as a whole.
Down syndrome (DS) is the most common genetic cause of intellectual and developmental disabilities (IDDs) in the United States with an estimated birth prevalence of 1:691 births (http://www.cdc.gov/ncbddd/birthdefects/data.html); however, worldwide estimates of the number of individuals with IDDs, including DS, remain speculative. Little is known about the global health impact of DS, such as heart defects, gastrointestinal malformations, and other medical and behavioral issues. Further research is needed to develop the next generation of novel therapies and compounds aimed at improving cognition, reducing dementia and mitigating other manifestations of DS. To address these challenges, the National Institutes of Health (NIH) has created the first web-based, voluntary registry and data resource called DS-Connect™: The Down Syndrome Registry (https://DSConnect.nih.gov) to collect demographic and health information about individuals with DS.
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