The FAOPS Funiculus: Promoting Science & Art of Perinatology (2nd Issue 2024)

The second edition of FAOPS Funiculus aims to highlight the activities conducted by our members. The first edition was published in 2023, in conjunction with the 2023 FAOPS held in Tokyo, Japan. Funiculus refers to the umbilical cord arising from the placental bed nourishing the baby, or of the stalks arising from the ovaries of plants reflecting our desire to grow and spread the knowledge of saving mothers and babies. We aim to fulfil one of the aims in the formation of the Federation of Asia Oceania Perinatal Societies or FAOPS, that is to promote the science and the art of perinatology in the region of Asia-Oceania.In this issue’s editorial as we meet during the 2024 Congress in Seoul, I wish to highlight an important issue that was raised during our recent Perinatal Society of Malaysia Congress – the health of our planet and the need to champion planetary health. In 2020, 35·3 million of 135 million live births (26·2%) are small vulnerable newborns (SVNs), i.e. (i) any baby born preterm, or (ii) SGA or (iii) both preterm and SGA. SVNs account for 99·5% of the world's 20 million LBW babies. Nearly two thirds (63·0%) of the world's term SGA newborns are in southern Asia (14·8 million, 40·9% of livebirths). Preterm birth rates have less regional variation but are also highest in southern Asia (13·2%) . Despite our efforts to provide quality maternal and newborn care, the rates of SVNs have not changed measureably in the past decade. Why? The missing link is likely the fact that our earth is ill. In 2022, 739 million children were exposed to high or extremely high water scarcity and 436 million children live in areas of high or extremely high water vulnerability. The odds of a preterm birth rises 1.05-fold per 1°C increase in temperature and 1.16-fold during heatwaves. In a meta-analysis (Chersich, 2020), higher temperature was associated with reduced birth weight in 18 of 28 studies, with considerable statistical heterogeneity. Climate changes affect both the mother and her infant. The impacts can result from both direct (weather: heat waves, weather extremes, air quality: increasing CO2 levels, rising sea levels, and indirect exposure patterns (water and food availability & quality, increasing allergens, environmental degradation). These affect both mother and baby via the epigenetic changes that take place with alterations of DNA methylation/histone modification, a rise in presence of endocrine-disrupting chemicals(EDC) such as synthetic chemicals and some pharmaceutical agents, and climate migration where groups of persons are obliged to leave their habitual place of residence, or choose to do so, either temporarily or permanently, within a State or across an international border. We, the healthcare providers of Asia-Oceania region, can protect future generations by safeguarding the health of our planet. Planetary health threats related to maternal and child health can be addressed at policy level of each country. Countries can enhance social networks and increase awareness of the impact of planetary ill-health on overall perinatal health. We need to champion community programs, implement support programs during labor/childbirth, avoid breastfeeding disruption, address issues related to equitable food supply and ensure maternal feeding programs in compromised urban and rural settlements, to ensure that no mother, or baby is left behind – whether asylum seekers, refugees or internally displaced persons. We will need to think of what we can do together for the health of the mothers and our babies. The missing gap is the state of our planet, of climate change and wars. We need to do more for our future generation. The best steps are always taken tiny bits at a time – to improve ourselves to care for our planet right from our own doorsteps. We know we can.I wish to sincerely thank the current FAOPS President, Professor Samuel Rajadurai, our FAOPS’ past president Professor Satoshi Kusuda, the incoming president Professor Han Suk Kim, and all council members and country representatives who have motivated the publication of this issue. Enjoy FAOPS 2024. Enjoy the FAOPS Funiculus!