However, preconception behaviors were uncommon overall.Chronically stress women were less likely to enter prenatal care with optimal health. However, preconception behaviors were uncommon overall. This study analyzes the intent-to-treat effect of prenatal exposure to Ramadan (the Islamic month of fasting) on outcomes including stunting and underweight for children under age 5years in Pakistan born between 2003 and 2018. The study uses observational data from four rounds of the UN-supported Multiple Indicator Cluster Survey (MICS) data collected on 204,186 children under-5 from Punjab, Pakistan in 2007-2008, 2010-2011, 2013-2014, and 2017-2018. Excluding data on outliers and observations with incomplete data, multivariate logistic regression analysis was conducted on the appended cross-sectional data of 179,943 children under-5 to assess the risk of stunting or underweight according to the month of gestation coinciding with Ramadan. We observe a significant increase in the risk of stunting and underweight associated with exposure to Ramadan following an inverted-U pattern. The peak impact of Ramadan exposure on a child being underweight occurs in the third month of pregnancy, where the probabilityernal habits during early pregnancy, especially nutritional intake, for the long-term physical development of children. To examine the impact of the COVID-19 pandemic on birth satisfaction and perceived health care discrimination during childbirth, and in turn, the influence of these birth experiences on postpartum health. We conducted a cross-sectional, bilingual web survey of 237 women who gave birth at two hospitals in New York City and assessed patient-reported experience and outcomes following the first wave of SARS-CoV-2 infections in the New York region. We ascertained SARS-CoV-2 status at delivery from the electronic medical record using participant-reported name and date of birth. We compared birth experience during the COVID-19 pandemic (March 15, 2020-May 11, 2020) to a pre-pandemic response period (January 1, 2020-March 14, 2020). We estimated risk ratios for associations between birth experience and anxiety, depressive symptoms, stress, birth-related PTSD, emergency department visits, timely postpartum visit, and exclusive breastfeeding. Multivariable models adjusted for age, race-ethnicity, insurance, education, parity, BMI, previous experience of maltreatment/abuse and cesarean delivery. Women who gave birth during the peak of the pandemic response, and those that were SARS-CoV-2 positive, Black, and Latina, had lower birth satisfaction and higher perceived health care discrimination. Women with lower birth satisfaction were more likely to report higher postpartum anxiety, stress, depressive symptoms, and lower exclusive breastfeeding. Experiencing one or more incident of health care discrimination was associated with higher levels of postpartum stress and birth-related PTSD. Hospitals and policy-makers should institute measures to safeguard against a negative birth experience during the ongoing COVID-19 pandemic, particularly among birthing people of color.Hospitals and policy-makers should institute measures to safeguard against a negative birth experience during the ongoing COVID-19 pandemic, particularly among birthing people of color. A large literature exists on positive sequelae of breastfeeding, relying heavily on maternal self-reported infant feeding behaviors. AM1241 Many such studies use PRAMS data, though estimates of reliability for the breastfeeding duration question on PRAMS have not been published. We used data from Oregon PRAMS (respondents are a median 3.5months postpartum) and PRAMS-2 (median 25months) to assess test-retest reliability of maternal self-reported breastfeeding duration, among women who had weaned prior to completing the PRAMS survey. The sample-wide kappa for the paired, self-reported breastfeeding duration was 0.014, and the intraclass correlation coefficient was 0.17, both of which indicate poor agreement. More than 80% of women reported a longer duration on PRAMS-2; the median (interquartile range) difference was +1.0 (0.31 - 2.1) months. Recent literature on this topic from high-income countries falls into two categories entirely retrospective versus "prospective" reliability assessments. Entirely retrospegly high reliability, whereas "prospective" assessments (women report infant feeding behavior during infancy, immediately after weaning, and some years later are asked to replicate their original answer) universally report poorer reliability. Interestingly, all "prospective" reliability studies, including ours, found that women over-report past breastfeeding durations by about 1 month upon the second inquiry. Researchers need not refrain from using maternal self-reported breastfeeding durations, because participants are largely still ranked correctly, relative to each other. However, such research efforts must avoid attempting to determine any optimal threshold duration. To characterize health-related quality of life (HRQoL) in patients with human epidermal growth factor receptor 2 (HER2)-positive metastatic breast cancer (MBC) from the NALA phase 3 study. In NALA (NCT01808573), patients were randomized 11 to neratinib + capecitabine (N + C) or lapatinib + capecitabine (L + C). HRQoL was assessed using seven prespecified scores from the European Organisation for Research and Treatment of Cancer Quality Of Life Questionnaire core module (QLQ-C30) and breast cancer-specific questionnaire (QLQ-BR23) at baseline and every 6weeks. Descriptive statistics summarized scores over time, mixed models evaluated differences between treatment arms, and Kaplan-Meier methods were used to assess time to deterioration in HRQoL scores of ≥ 10 points. Of the 621 patients randomized in NALA, patients were included in the HRQoL analysis if they completed baseline and at least one follow-up questionnaire. The summary, global health status, physical functioning, fatigue, constipation, and systemic therapy side effects scores were stable over time with no persistent differences between treatment groups. There were no differences in time to deterioration (TTD) for the QLQ-C30 summary score between treatment arms; the hazard ratio (HR) for N + C vs. L + C was 0.94 (95% CI 0.63-1.40). Only the diarrhea score worsened significantly more in the N + C arm as compared to the L + C arm, and this remained over time (HR for TTD for N + C vs. L + C was 1.71 [95% CI 1.32-2.23]). In NALA, patients treated with N + C maintained their global HRQoL over time, despite a worsening of the diarrhea-related scores. These results may help guide optimal treatment selection for HER2-positive MBC.In NALA, patients treated with N + C maintained their global HRQoL over time, despite a worsening of the diarrhea-related scores. These results may help guide optimal treatment selection for HER2-positive MBC.