Severe obesity increases the risk for negative outcomes in patients with coronavirus disease 2019 (COVID-19). Our objectives were to investigate the effect of BMI on in-hospital outcomes in our New York City Health and Hospitals’ ethnically diverse population, further explore this effect by age, sex, race/ethnicity, and timing of admission, and, given the relationship between COVID-19 and hyperinflammation, assess the concentrations of markers of systemic inflammation in different BMI groups. A retrospective study was conducted in hospitalized patients with COVID-19 in the public health care system of New York City from 1 March 2020 to 31 October 2020. A total of 8833 patients were included in this analysis (women: 3593, median age: 62 years). The median body mass index (BMI) was 27.9 kg/m2. Both overweight and obesity were independently associated with in-hospital death. The association of overweight and obesity with death appeared to be stronger in men, younger patients, and individuals of Hispanic ethnicity. We did not observe higher concentrations of inflammatory markers in patients with obesity as compared to those without obesity. In conclusion, overweight and obesity were independently associated with in-hospital death. Obesity was not associated with higher concentrations of inflammatory markers.
The health and social effects of pregnancy in married women 13-23 years of age were studied among a population of 175,000 in rural Bangladesh. Data collected by a structured questionnaire identified pregnant women who were followed twice during pregnancy and twice postpartum. Maternal mortality for the 13-17 age group was 5.8/1000 compared to 1.8/1000 for the 18-23 year olds. Major causes of death in the younger group were obstructed labor and toxemia. The neonatal death rate was 80/1000 for the younger group and 43/1000 for the older group. The major cause of death of infants born to the younger mothers was birth injury. In infants born to older mothers, it was tetanus. Perinatal death rate was 66.4/1000. All deliveries occurred at home, and 89% of births were attended by relatives, neighbors or an untrained birth attendant. Only 13% of the women had ever used contraceptives. Use varied from 2.9% at 16 years to 24.7% at 23 years. Suggestions are made for improving maternal and child health care in rural Bangladesh.
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