151
|
Massey SH, Mroczek DK, Reiss D, Miller ES, Jakubowski JA, Graham EK, Shisler SM, McCallum M, Huestis MA, Ganiban JM, Shaw DS, Leve LD, Eiden RD, Stroud LR, Neiderhiser JM. Additive drug-specific and sex-specific risks associated with co-use of marijuana and tobacco during pregnancy: Evidence from 3 recent developmental cohorts (2003-2015). Neurotoxicol Teratol 2018; 68:97-106. [PMID: 29886244 PMCID: PMC6116514 DOI: 10.1016/j.ntt.2018.06.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Revised: 06/02/2018] [Accepted: 06/06/2018] [Indexed: 12/20/2022]
Abstract
BACKGROUND Methodologic challenges related to the concomitant use (co-use) of substances and changes in policy and potency of marijuana contribute to ongoing uncertainty about risks to fetal neurodevelopment associated with prenatal marijuana use. In this study, we examined two biomarkers of fetal neurodevelopmental risk-birth weight and length of gestation-associated with prenatal marijuana use, independent of tobacco (TOB), alcohol (ALC), other drug use (OTH), and socioeconomic risk (SES), in a pooled sample (N = 1191) derived from 3 recent developmental cohorts (2003-2015) with state-of-the-art substance use measures. We examined differential associations by infant sex, and multiplicative effects associated with co-use of MJ and TOB. METHODS Participants were mother-infant dyads with complete data on all study variables derived from Growing Up Healthy (n = 251), Behavior and Mood in Babies and Mothers (Cohorts 1 and 2; n = 315), and the Early Growth and Development Study (N = 625). We estimated direct effects on birth weight and length of gestation associated with MJ, TOB, and co-use (MJ x TOB), using linear regression analysis in the full sample, and in male (n = 654) and female (n = 537) infants, separately. RESULTS Mean birth weight and length of gestation were 3277 g (SD = 543) and 37.8 weeks (SD = 2.0), respectively. Rates of prenatal use were as follows: any use, n = 748 (62.8%); MJ use, n = 273 (22.9%); TOB use, n = 608 (51.0%); co-use of MJ and TOB, n = 230 (19.3%); ALC use, n = 464 (39.0%); and OTH use n = 115 (9.7%.) For all infants, unique effects on birth weight were observed for any MJ use [B(SE) = -84.367(38.271), 95% C.I. -159.453 to -9.281, p = .028], any TOB use [B(SE) = -0.99.416(34.418), 95% C.I. -166.942 to -31.889, p = .004], and each cigarette/day in mean TOB use [B(SE) = -12.233(3.427), 95% C.I. -18.995 to -5.510, p < .001]. Additional effects of co-use on birth weight, beyond these drug-specific effects, were not supported. In analyses stratified by sex, while TOB use was associated with lower birth weight in both sexes, MJ use during pregnancy was associated with lower birth weight of male infants [B(SE) = -153.1 (54.20); 95% C.I. -259.5 to -46.7, p = .005], but not female infants [B(SE) = 8.3(53.1), 95% C.I. -96.024 to 112.551, p = .876]. TOB, MJ, and their co-use were not associated with length of gestation. CONCLUSIONS In this sample, intrauterine co-exposure to MJ and TOB was associated with an estimated 18% reduction in birth weight not attributable to earlier delivery, exposure to ALC or OTH drugs, nor to maternal SES. We found evidence for greater susceptibility of male fetuses to any prenatal MJ exposure. Examination of dose-dependence in relationships found in this study, using continuous measures of exposure, is an important next step. Finally, we underscore the need to consider (a) the potential moderating influence of fetal sex on exposure-related neurodevelopmental risks; and (b) the importance of quantifying expressions of risk through subtle alterations, rather than dichotomous outcomes.
Collapse
Affiliation(s)
- Suena H Massey
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, 676 N Saint Clair, Suite 1000, Chicago, IL 60611, USA; Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 633 N Saint Clair, 19th Floor, Chicago, IL 60611, USA.
| | - Daniel K Mroczek
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 633 N Saint Clair, 19th Floor, Chicago, IL 60611, USA.
| | - David Reiss
- Yale Child Study Center, Yale University, 230 South Frontage Rd., New Haven, CT 06519, USA.
| | - Emily S Miller
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, 676 N Saint Clair, Suite 1000, Chicago, IL 60611, USA; Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Northwestern University Feinberg School of Medicine, 250 E. Superior Street, 05-2175, Chicago, IL 60611, USA.
| | - Jessica A Jakubowski
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, 676 N Saint Clair, Suite 1000, Chicago, IL 60611, USA.
| | - Eileen K Graham
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 633 N Saint Clair, 19th Floor, Chicago, IL 60611, USA.
| | - Shannon M Shisler
- Research Institute on Addictions, University at Buffalo, State University of New York, 1021 Main Street, Buffalo, NY 14203-1016, USA.
| | - Meaghan McCallum
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Box G-A1, Providence, RI 02912, USA.
| | - Marilyn A Huestis
- Institute for Emerging Health Professions, Thomas Jefferson University, Philadelphia, PA 19107, USA.
| | - Jody M Ganiban
- George Washington University Columbian College of Arts and Sciences, 2125 G Street, NW, Room 308, Washington, DC 20052, USA.
| | - Daniel S Shaw
- Department of Psychology, University of Pittsburgh, 4101 Sennott Square, 3rd Floor, Pittsburgh, PA 15260, USA.
| | - Leslie D Leve
- Department of Counseling Psychology and Human Services, College of Education 6217, University of Oregon, Eugene, OR 97403, USA.
| | - Rina D Eiden
- Research Institute on Addictions, University at Buffalo, State University of New York, 1021 Main Street, Buffalo, NY 14203-1016, USA.
| | - Laura R Stroud
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Box G-A1, Providence, RI 02912, USA; The Miriam Hospital Centers for Behavioral and Preventive Medicine, Coro West, 164 Summit Ave, Suite 309, Providence, RI 02906, USA.
| | - Jenae M Neiderhiser
- Department of Psychology, The Pennsylvania State University, 411 Moore Building, University Park, PA 16801, USA.
| |
Collapse
|
152
|
Luo X, Liu L, Gu H, Hou F, Xie X, Li X, Meng H, Zhang J, Xu S, Song R. Pathways linking socioeconomic status to small-for-gestational-age (SGA) infants among primiparae: a birth cohort study in China. BMJ Open 2018; 8:e020694. [PMID: 29903790 PMCID: PMC6009518 DOI: 10.1136/bmjopen-2017-020694] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVES Evidence about the relationship between socioeconomic status (SES) and small-for-gestational-age (SGA) infants was insufficient among Chinese primiparae. In addition, factors that may mediate this relationship are poorly understood. The purpose of this study was to investigate the risk of and mediators between SES and SGA. DESIGN Retrospective cohort study. SETTING Wuhan, Hubei, China. METHOD Participants were recruited from patients who gave birth in the maternity care hospital of Wuhan between September 2012 and October 2014. Logistic regression models were used to estimate the association between SES and SGA. Pathway analysis was performed to examine the contribution of maternal lifestyles and pregnancy-induced hypertension syndrome (PIH) to the relationship between SES and SGA. Total effect, direct effect and indirect effect of SES on SGA were measured. Effect sizes were evaluated by unstandardised estimates (B) and standardised estimates (ß). RESULTS Among 8737 primiparae, 927 (10.61%) pregnant women had babies with SGA. High SES was inversely associated with risk of SGA (OR 0.856; 95% CI 0.737 to 0.995) after adjustment for potential confounders. Maternal obstetric characteristics, lifestyles and PIH completely mediated SES and SGA (indirect effect: B=-0.067, 95% CI -0.108 to -0.026). The indirect effect of SES was strengthened by PIH (B=-0.029), a multivitamin supplement (B=-0.021), prepregnancy body mass index (BMI) ≥18.50 (B=-0.009) and prepregnancy BMI ≥18.50 to gestational weight gain (GWG) not below the Institute of Medicine (IOM) recommendations (B=-0.003). CONCLUSIONS Women from high SES predicted lower risk of PIH, more chances to take a multivitamin supplement during early pregnancy, keeping prepregnancy BMI ≥18.50 kg/cm2 and gaining adequate gestational weight which was not below IOM recommendations. Furthermore, lower risk of PIH, more chances to take a multivitamin supplement, prepregnancy BMI ≥18.50 kg/cm2 and GWG not below IOM recommendations were associated with a lower risk of SGA infants.
Collapse
Affiliation(s)
- Xiu Luo
- Department of Maternal and Child Health and MOE (Ministry of Education) Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Lingfei Liu
- Department of Maternal and Child Health and MOE (Ministry of Education) Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Huaiting Gu
- Department of Maternal and Child Health and MOE (Ministry of Education) Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Fang Hou
- Department of Maternal and Child Health and MOE (Ministry of Education) Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xinyan Xie
- Department of Maternal and Child Health and MOE (Ministry of Education) Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xin Li
- Department of Maternal and Child Health and MOE (Ministry of Education) Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Heng Meng
- Department of Maternal and Child Health and MOE (Ministry of Education) Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jiajia Zhang
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Shunqing Xu
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ranran Song
- Department of Maternal and Child Health and MOE (Ministry of Education) Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| |
Collapse
|
153
|
How does the social environment during life course embody in and influence the development of cancer? Int J Public Health 2018; 63:811-821. [DOI: 10.1007/s00038-018-1131-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Revised: 05/19/2018] [Accepted: 06/01/2018] [Indexed: 12/21/2022] Open
|
154
|
Associations between cumulative neighborhood deprivation, long-term mobility trajectories, and gestational weight gain. Health Place 2018; 52:101-109. [PMID: 29883957 DOI: 10.1016/j.healthplace.2018.05.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Revised: 05/18/2018] [Accepted: 05/23/2018] [Indexed: 11/21/2022]
Abstract
Existing research on neighborhood environment and gestational weight gain (GWG) focuses on point-in-time measures of neighborhood context. This precludes understanding how long-term exposure to adverse neighborhood environments influences GWG. We estimated associations between average exposure to and trajectories of long-term neighborhood socioeconomic deprivation and risk of inadequate or excessive GWG. Using data from 5690 full-term, singleton pregnancies in the 1979 National Longitudinal Survey of Youth, we estimated associations between cumulative deprivation and GWG, overall and by race/ethnicity, controlling for individual and residential covariates. A one standard deviation unit (8-point) increase in neighborhood deprivation increased risk of inadequate GWG (Relative Risk (RR): 1.08; 95% Confidence Interval (CI): 1.00-1.16) for all women and excessive GWG (RR: 1.11; 95% CI 1.02-1.21) for white women. Persistent low deprivation (RR: 0.78; 95% CI: 0.64-0.94) and upward mobility (RR: 0.76; 95% CI: 0.61-0.96), compared to persistent high deprivation, reduced risk of inadequate GWG. Persistent low deprivation also reduced risk of excessive GWG (RR: 0.84; 95% CI: 0.71-0.98). Long-term neighborhood deprivation contributes to patterns of GWG over women's life course.
Collapse
|
155
|
Härkönen J, Lindberg M, Karlsson L, Karlsson H, Scheinin NM. Education is the strongest socio-economic predictor of smoking in pregnancy. Addiction 2018; 113:1117-1126. [PMID: 29333764 PMCID: PMC5969298 DOI: 10.1111/add.14158] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Revised: 08/21/2017] [Accepted: 01/05/2018] [Indexed: 11/30/2022]
Abstract
AIMS To investigate socio-economic disparities in smoking in pregnancy (SIP) by the mother's education, occupational class and current economic conditions. DESIGN Cross-sectional analysis with linked survey and register data. SETTING South-western Finland. PARTICIPANTS A total of 2667 pregnant women [70% of the original sample (n = 3808)] from FinnBrain, a prospective pregnancy cohort study. MEASUREMENTS The outcome was smoking during the first pregnancy trimester, measured from the Finnish Medical Birth Register. Education and occupational class were linked from population registers. Income support recipiency and subjective economic wellbeing were questionnaire-based measures of current economic conditions. These were adjusted for age, partnership status, residential area type, parental separation, parity, childhood socio-economic background, childhood adversities (the Trauma and Distressing Events During Childhood scale) and antenatal stress (Edinburgh Postnatal Depression Scale). Logistic regressions and attributable fractions (AF) were estimated. FINDINGS Mother's education was the strongest socio-economic predictor of SIP. Compared with university education, adjusted odds ratios (aORs) of SIP were: 2.2 [95% confidence interval (CI) = 1.2-3.9; P = 0.011] for tertiary vocational education, 4.4 (95% CI = 2.1-9.0; P < 0.001) for combined general and vocational secondary education, 2.9 (95% CI = 1.4-6.1; P = 0.006) for general secondary education, 9.5 (95% CI 5.0-18.2; P < 0.001) for vocational secondary education and 14.4 (95% CI = 6.3-33.0; P < 0.001) for compulsory schooling. The total AF of education was 0.5. Adjusted for the other variables, occupational class and subjective economic wellbeing did not predict SIP. Income support recipiency was associated positively with SIP (aOR = 1.8; 95% CI = 1.1-3.1; P = 0.022). Antenatal stress predicted SIP (aOR = 2.0; 95% CI = 1.4-2.8; P < 0.001), but did not attenuate its socio-economic disparities. CONCLUSIONS In Finland, socio-economic disparities in smoking in pregnancy are attributable primarily to differences in the mother's educational level (low versus high) and orientation (vocational versus general).
Collapse
Affiliation(s)
- Juho Härkönen
- Department of SociologyStockholm UniversityStockholmSweden
- Department of Political and Social SciencesEuropean University InstituteSan Domenico di FiesoleFiesoleItaly
- Faculty of Social Sciences (Sociology Unit)University of TurkuTurkuFinland
| | - Matti Lindberg
- Faculty of Social Sciences (Sociology Unit)University of TurkuTurkuFinland
| | - Linnea Karlsson
- Institute of Clinical Medicine, Turku Brain and Mind Center, FinnBrain Birth Cohort StudyUniversity of TurkuTurkuFinland
- Institute of Clinical Medicine, Department of Child PsychiatryUniversity of TurkuTurkuFinland
- Department of Child PsychiatryTurku University HospitalTurkuFinland
| | - Hasse Karlsson
- Institute of Clinical Medicine, Turku Brain and Mind Center, FinnBrain Birth Cohort StudyUniversity of TurkuTurkuFinland
- Department of PsychiatryTurku University HospitalTurkuFinland
- Department of PsychiatryUniversity of TurkuTurkuFinland
| | - Noora M. Scheinin
- Faculty of Social Sciences (Sociology Unit)University of TurkuTurkuFinland
- Institute of Clinical Medicine, Turku Brain and Mind Center, FinnBrain Birth Cohort StudyUniversity of TurkuTurkuFinland
- Department of PsychiatryTurku University HospitalTurkuFinland
| |
Collapse
|
156
|
Jakobsen SP, Charlotte Overgaard. ‘They’ll be judging us’ a qualitative study of pregnant women's experience of being offered participation in a supportive intervention. Midwifery 2018; 61:81-87. [DOI: 10.1016/j.midw.2018.02.017] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Revised: 02/12/2018] [Accepted: 02/18/2018] [Indexed: 10/18/2022]
|
157
|
Zylbersztejn A, Gilbert R, Hjern A, Wijlaars L, Hardelid P. Child mortality in England compared with Sweden: a birth cohort study. Lancet 2018; 391:2008-2018. [PMID: 29731173 PMCID: PMC5958228 DOI: 10.1016/s0140-6736(18)30670-6] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Revised: 02/27/2018] [Accepted: 03/09/2018] [Indexed: 11/16/2022]
Abstract
BACKGROUND Child mortality is almost twice as high in England compared with Sweden. We aimed to establish the extent to which adverse birth characteristics and socioeconomic factors explain this difference. METHODS We developed nationally representative cohorts of singleton livebirths between Jan 1, 2003, and Dec 31, 2012, using the Hospital Episode Statistics in England, and the Swedish Medical Birth Register in Sweden, with longitudinal follow-up from linked hospital admissions and mortality records. We analysed mortality as the outcome, based on deaths from any cause at age 2-27 days, 28-364 days, and 1-4 years. We fitted Cox proportional hazard regression models to estimate the hazard ratios (HRs) for England compared with Sweden in all three age groups. The models were adjusted for birth characteristics (gestational age, birthweight, sex, and congenital anomalies), and for socioeconomic factors (maternal age and socioeconomic status). FINDINGS The English cohort comprised 3 932 886 births and 11 392 deaths and the Swedish cohort comprised 1 013 360 births and 1927 deaths. The unadjusted HRs for England compared with Sweden were 1·66 (95% CI 1·53-1·81) at 2-27 days, 1·59 (1·47-1·71) at 28-364 days, and 1·27 (1·15-1·40) at 1-4 years. At 2-27 days, 77% of the excess risk of death in England was explained by birth characteristics and a further 3% by socioeconomic factors. At 28-364 days, 68% of the excess risk of death in England was explained by birth characteristics and a further 11% by socioeconomic factors. At 1-4 years, the adjusted HR did not indicate a significant difference between countries. INTERPRETATION Excess child mortality in England compared with Sweden was largely explained by the unfavourable distribution of birth characteristics in England. Socioeconomic factors contributed to these differences through associations with adverse birth characteristics and increased mortality after 1 month of age. Policies to reduce child mortality in England could have most impact by reducing adverse birth characteristics through improving the health of women before and during pregnancy and reducing socioeconomic disadvantage. FUNDING The Farr Institute of Health Informatics Research (through the Medical Research Council, Arthritis Research UK, British Heart Foundation, Cancer Research UK, Chief Scientist Office, Economic and Social Research Council, Engineering and Physical Sciences Research Council, National Institute for Health Research, National Institute for Social Care and Health Research, and the Wellcome Trust).
Collapse
Affiliation(s)
- Ania Zylbersztejn
- The Farr Institute of Health Informatics Research, London, UK; Population, Policy and Practice Programme, UCL Great Ormond Street Institute of Child Health, London, UK.
| | - Ruth Gilbert
- Population, Policy and Practice Programme, UCL Great Ormond Street Institute of Child Health, London, UK; Children's Policy Research Unit, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Anders Hjern
- Centre for Health Equity Studies (CHESS), Stockholm University, Stockholm, Sweden; Clinical Epidemiology Unit, Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Linda Wijlaars
- Population, Policy and Practice Programme, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Pia Hardelid
- Population, Policy and Practice Programme, UCL Great Ormond Street Institute of Child Health, London, UK
| |
Collapse
|
158
|
Canney M, Leahy S, Scarlett S, Kenny RA, Little MA, O'Seaghdha CM, McCrory C. Kidney Disease in Women is Associated with Disadvantaged Childhood Socioeconomic Position. Am J Nephrol 2018; 47:292-299. [PMID: 29779032 DOI: 10.1159/000488362] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Accepted: 03/12/2018] [Indexed: 01/21/2023]
Abstract
BACKGROUND Socioeconomic position (SEP) is an important determinant of health and it is dynamic across the entire lifespan. We sought to investigate the relationship between life-course SEP and chronic kidney disease (CKD) using 3 conceptual models: critical period, pathway and accumulation. METHODS Cross-sectional analysis of 4,996 participants from The Irish Longitudinal Study on Ageing, a nationally representative cohort of community-dwelling adults aged ≥50 years. We defined childhood and adulthood SEP according to father's and respondent's occupation respectively. SEP was categorised as high (reference), intermediate, low and never worked. CKD was defined as a glomerular filtration rate < 60 mL/min/1.73 m2 estimated from the combination of creatinine and cystatin C. We used logistic regression to estimate the age-adjusted association between SEP and CKD separately in men and women. RESULTS Low childhood SEP was strongly associated with CKD in women, after adjusting for adulthood SEP (OR 1.90 [95% CI 1.24-2.92]), supporting the critical period hypothesis. This association was not explained by traditional CKD risk factors. Women who experienced low childhood SEP and whose circumstances improved in adulthood also had increased odds of CKD, further supporting a critical period effect in childhood. There was comparatively less evidence in support of the pathway or accumulation models. We did not observe a statistically significant association between SEP and CKD in men. CONCLUSIONS Our findings suggest that women exposed to disadvantaged SEP in childhood represent an at-risk group in whom there may be opportunities for identification of CKD and facilitation of health-promoting behaviours from an early age.
Collapse
Affiliation(s)
- Mark Canney
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin, Ireland
- Trinity Health Kidney Centre, Tallaght Hospital, Dublin, Ireland
| | - Siobhan Leahy
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin, Ireland
| | - Siobhan Scarlett
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin, Ireland
| | - Rose Anne Kenny
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin, Ireland
| | - Mark A Little
- Trinity Health Kidney Centre, Tallaght Hospital, Dublin, Ireland
| | | | - Cathal McCrory
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin, Ireland
| |
Collapse
|
159
|
Mejia-Lancheros C, Mehegan J, Segurado R, Murrin C, Kelleher C. Parental population exposure to historical socioeconomic and political periods and grand-child's birth weight in the Lifeways Cross-Generation Cohort Study in the Republic of Ireland. SSM Popul Health 2018; 4:100-116. [PMID: 29349279 PMCID: PMC5769097 DOI: 10.1016/j.ssmph.2017.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Revised: 10/03/2017] [Accepted: 11/27/2017] [Indexed: 11/16/2022] Open
Abstract
Exposure to deprived socioeconomic conditions during the peri-conception and early childhood periods can have a negative long-term impact on individuals' health and that of their progeny. We aimed to examine whether relatives' birth period affected index-child (grand-child) birthweight status in the Lifeways Cross-Generation Cohort in the Republic of Ireland. Participants were 943 mothers and offspring, 890 fathers, 938 maternal grandmothers (MGM), 700 maternal grandfathers (MGF) 537 paternal grandmothers (PGM) and 553 paternal grandfathers (PGF). Index-child's birthweight was sex-for-gestational age standardised (UK1990 population), and then classified into low birthweight (≤10th percentile) and high-birthweight (≥90th percentile) and compared against normal-birthweight (>10th to <90th percentiles). Four adult birth periods were considered: The Free State (FS, 1916-1938); Emergency Act (EA, 1939-1946); Post-World War-II Baby-Boom (PWWII-BB, 1947-1964); and Modern Ireland (MI, 1964 onwards). Logistic regression was used to assess the crude and adjusted relationship between index-child's birthweight status and relatives' birth periods. Overall, there were 8.7% (n=82) index-children in the low-birthweight category, 77.9% (n=735) and 13.4% (n=126) within the normal and high birthweight groups respectively. Index-children whose mothers were born during the PWWII-BB had higher birthweight infants (Crude OR(COR)=1.81 (1.08-3.03) which remained the case only for male index-children when adjusted for co-variables (Adjusted OR(AOR)=4.61(1.71-12.42)). Parents' combined PWWII-BB birth period was positively associated with male index-child higher birthweight, even adjusted for maternal characteristics (AOR=4.60(1.69-12.50)). MGFs born during the EA were more likely to have grandchildren with low birthweight after adjustment for maternal characteristics (AOR=2.45(1.03-5.85)), particularly for female index-children (AOR=4.74(1.16-19.25)). Both PGMs and PGFs born during the FS period had higher birthweight grandchildren, adjusted for maternal-related co-variables (PGM, AOR=3.23(1.21-8.63); PGF, AOR=3.93(1.11-13.96)), with the effect of PGM more evident in her granddaughter (AOR=6.53(1.25-34.04)). In conclusion, there is some evidence that period of grandparental birth is associated with their grandchildren's birthweights, suggesting that transgenerational exposures may be particular to historical context, meriting further exploration.
Collapse
Affiliation(s)
- Cilia Mejia-Lancheros
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Woodview House, Belfield, Dublin 4, Republic of Ireland
| | | | | | | | | | | |
Collapse
|
160
|
Accrombessi M, Zeitlin J, Massougbodji A, Cot M, Briand V. What Do We Know about Risk Factors for Fetal Growth Restriction in Africa at the Time of Sustainable Development Goals? A Scoping Review. Paediatr Perinat Epidemiol 2018; 32:184-196. [PMID: 29253317 DOI: 10.1111/ppe.12433] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND The reduction in the under-5 year mortality rate to at least as low as 25 per 1000 livebirths by 2030 has been implemented as one of the new Sustainable Development Goals. Fetal growth restriction (FGR) is one of the most important determinants of infant mortality in developing countries. In this review, we assess the extent of the literature and summarize its findings on the main preventable factors of FGR in Africa. METHODS A scoping review was conducted using the Arksey and O'Malley framework. Five bibliographic databases and grey literature were used to identify studies assessing at least one risk factor for FGR. Aggregate risk estimates for the main factors associated with FGR were calculated. RESULTS Forty-five of a total of 671 articles were selected for the review. The prevalence of FGR varied between 2.6 and 59.2% according to both the African region and the definition of FGR. The main preventable factors reported were a low maternal nutritional status (aggrerate odds ratio [OR]: 2.28, 95% confidence interval [CI] 1.59, 3.25), HIV infection (aOR 1.86, 95% CI 1.38, 2.50), malaria (aOR 1.95, 95% CI 1.04, 3.66), and gestational hypertension (aOR 2.61, 95% CI 2.42, 2.82). CONCLUSION FGR is, to a large extent, preventable through existing efficacious interventions dedicated to malaria, HIV and nutrition. Further studies are still needed to assess the influence of risk factors most commonly documented in high-income countries. Improving research on FGR in Africa requires a consensual and standardized definition of FGR-for a higher comparability-between studies and settings.
Collapse
Affiliation(s)
- Manfred Accrombessi
- UMR216-MERIT, French National Research Institute for Sustainable Development (IRD), Université Paris Descartes, Paris, France.,Centre d'Étude et de Recherche sur le Paludisme Associé à la Grossesse et à l'Enfance (CERPAGE), Cotonou, Benin
| | - Jennifer Zeitlin
- Obstetrical, Perinatal, and Pediatric Epidemiology Research Team, Centre for Epidemiology and Biostatistics (U1153-EPOPé), National Institute for Health and Medical Research (INSERM), Université Paris Descartes, Paris, France
| | - Achille Massougbodji
- Centre d'Étude et de Recherche sur le Paludisme Associé à la Grossesse et à l'Enfance (CERPAGE), Cotonou, Benin
| | - Michel Cot
- UMR216-MERIT, French National Research Institute for Sustainable Development (IRD), Université Paris Descartes, Paris, France
| | - Valérie Briand
- UMR216-MERIT, French National Research Institute for Sustainable Development (IRD), Université Paris Descartes, Paris, France
| |
Collapse
|
161
|
Sania A, Smith ER, Manji K, Duggan C, Masanja H, Kisenge R, Msamanga G, Urassa W, Fawzi W. Neonatal and Infant Mortality Risk Associated with Preterm and Small for Gestational Age Births in Tanzania: Individual Level Pooled Analysis Using the Intergrowth Standard. J Pediatr 2018; 192:66-72.e4. [PMID: 29246361 PMCID: PMC5737788 DOI: 10.1016/j.jpeds.2017.09.007] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Revised: 07/20/2017] [Accepted: 09/06/2017] [Indexed: 11/19/2022]
Abstract
OBJECTIVES To evaluate the risk of newborn and infant mortality associated with preterm, small for gestational age (SGA), and low birth weight (LBW) stratified by maternal HIV status and the location of birth. STUDY DESIGN We created a prospective cohort by pooling 5 individually randomized trials. We used Cox proportional hazard models to estimate the risk of mortality for SGA defined using the recently published Intergrowth standard, preterm, LBW, and gestational age and size for gestational age categories (preterm- appropriate for gestational age [AGA], term-SGA, and preterm-SGA). Effect modification by maternal HIV status and place of residence was assessed using the likelihood ratio test. RESULTS Of the 31 988 infants, 15.3% were preterm, 16.6% were SGA, and 7.3% were LBW. The proportion of preterm and SGA births was higher among the HIV-infected cohort than in the uninfected cohort. Compared with term-AGA groups, infants born both preterm and SGA had a greater risk of neonatal mortality (hazard ratio [HR] 5.43, 95% CI 2.01-14.63) than preterm-AGA infants (HR 2.40, 95% CI 1.89-3.05) and term-SGA infants (HR 2.56, 95% CI 1.96-3.34). Maternal HIV infection modified the risk of infant mortality associated with being born preterm or LBW, with a higher relative risk among those born to HIV-uninfected women. Rural residence significantly modified the risk of neonatal mortality associated with being LBW (P for interaction = .005). CONCLUSIONS Preterm and SGA newborns had an increased risk of mortality during the first year of life. Interventions targeting these conditions, especially in HIV-exposed and rural populations, should be integrated into existing maternal and child health programs.
Collapse
Affiliation(s)
- Ayesha Sania
- ICAP, Columbia University, Mailman School of Public Health, New York, NY
| | - Emily R Smith
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA; Division of Gastroenterology, Hepatology, and Nutrition, Boston Children's Hospital, Boston, MA.
| | - Karim Manji
- Department of Pediatrics, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Christopher Duggan
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA; Division of Gastroenterology, Hepatology, and Nutrition, Boston Children's Hospital, Boston, MA; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA
| | | | - Rodrick Kisenge
- Department of Pediatrics, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Gernard Msamanga
- Department of Community Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Willy Urassa
- Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Wafaie Fawzi
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
| |
Collapse
|
162
|
Yang S, Kramer MS. Preterm birth: temporal trends and socioeconomic inequalities. JORNAL DE PEDIATRIA (VERSÃO EM PORTUGUÊS) 2018. [DOI: 10.1016/j.jpedp.2017.08.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
|
163
|
Chen I, Lalani S, Xie RH, Shen M, Singh SS, Wen SW. Association between surgically diagnosed endometriosis and adverse pregnancy outcomes. Fertil Steril 2018; 109:142-147. [DOI: 10.1016/j.fertnstert.2017.09.028] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Revised: 09/01/2017] [Accepted: 09/22/2017] [Indexed: 11/28/2022]
|
164
|
Sadovsky ADID, Matijasevich A, Santos IS, Barros FC, Miranda AE, Silveira MF. Socioeconomic inequality in preterm birth in four Brazilian birth cohort studies. J Pediatr (Rio J) 2018; 94:15-22. [PMID: 28572019 DOI: 10.1016/j.jped.2017.02.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2016] [Revised: 01/19/2017] [Accepted: 02/01/2017] [Indexed: 10/19/2022] Open
Abstract
OBJECTIVE To analyze economic inequality (absolute and relative) due to family income in relation to the occurrence of preterm births in Southern Brazil. METHODS Four birth cohort studies were conducted in the years 1982, 1993, 2004, and 2011. The main exposure was monthly family income and the primary outcome was preterm birth. The inequalities were calculated using the slope index of inequality and the relative index of inequality, adjusted for maternal skin color, education, age, and marital status. RESULTS The prevalence of preterm births increased from 5.8% to approximately 14% (p-trend<0.001). Late preterm births comprised the highest proportion among the preterm births in all studies, although their rates decreased over the years. The analysis on the slope index of inequality demonstrated that income inequality arose in the 1993, 2004, and 2011 studies. After adjustment, only the 2004 study maintained the difference between the poorest and the richest subjects, which was 6.3 percentage points. The relative index of inequality showed that, in all studies, the poorest mothers were more likely to have preterm newborns than the richest. After adjustment for confounding factors, it was observed that the poorest mothers only had a greater chance of this outcome in 2004. CONCLUSION In a final model, economic inequalities resulting from income were found in relation to preterm births only in 2004, although a higher prevalence of prematurity continued to be observed in the poorest population, in all the studies.
Collapse
Affiliation(s)
- Ana Daniela Izoton de Sadovsky
- Universidade Federal do Espírito Santo (UFES), Departamento de Pediatria, Vitória, ES, Brazil; Universidade Federal de Pelotas (UFPel), Faculdade de Medicina, Programa de Pós-Graduação em Epidemiologia, Pelotas, RS, Brazil.
| | - Alicia Matijasevich
- Universidade Federal de Pelotas (UFPel), Faculdade de Medicina, Programa de Pós-Graduação em Epidemiologia, Pelotas, RS, Brazil; Universidade de São Paulo (USP), Departamento de Medicina Preventiva, São Paulo, SP, Brazil
| | - Iná S Santos
- Universidade Federal de Pelotas (UFPel), Faculdade de Medicina, Programa de Pós-Graduação em Epidemiologia, Pelotas, RS, Brazil
| | - Fernando C Barros
- Universidade Católica de Pelotas, Programa de Pós-Graduação em Saúde e Comportamento, Pelotas, RS, Brazil
| | - Angelica Espinosa Miranda
- Universidade Federal do Espírito Santo (UFES), Programa de Pós-Graduação em Saúde Pública, Vitória, ES, Brazil
| | - Mariangela Freitas Silveira
- Universidade Federal de Pelotas (UFPel), Faculdade de Medicina, Programa de Pós-Graduação em Epidemiologia, Pelotas, RS, Brazil; Universidade Federal de Pelotas (UFPel), Faculdade de Medicina, Departamento Materno-Infantil, Pelotas, RS, Brazil
| |
Collapse
|
165
|
Hobson SR, Wallace EM, Kingdom JC, Hodges RJ. A Randomized Double-Blinded Placebo-Controlled Intervention Trial of Melatonin for the Prevention of Preeclampsia in Moderate- and High-Risk Women: The MELPOP Trial. Methods Mol Biol 2018; 1710:347-352. [PMID: 29197017 DOI: 10.1007/978-1-4939-7498-6_28] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
This chapter describes the methodologies which may be used in the development of a randomized controlled trial investigating a therapy of choice in preventing preeclampsia.
Collapse
Affiliation(s)
- Sebastian R Hobson
- Maternal Fetal Medicine Unit, Department of Obstetrics and Gynaecology, Monash Medical Centre, Monash Health and Monash University, 246 Clayton Road, Clayton, VIC, 3168, Australia.
| | - Euan M Wallace
- Maternal Fetal Medicine Unit, Department of Obstetrics and Gynaecology, Monash Medical Centre, Monash Health and Monash University, 246 Clayton Road, Clayton, VIC, 3168, Australia
| | - John C Kingdom
- Maternal Fetal Medicine Division, Department of Obstetrics and Gynaecology, Mount Sinai Hospital and University of Toronto, 600 University Avenue, Toronto, ON, M5G 1X5, Canada
| | - Ryan J Hodges
- Maternal Fetal Medicine Unit, Department of Obstetrics and Gynaecology, Monash Medical Centre, Monash Health and Monash University, 246 Clayton Road, Clayton, VIC, 3168, Australia
| |
Collapse
|
166
|
Garg R, Kumari SS, Devineni K, Sodumu N. Effects of Intimate Partner Violence on Pregnancy Outcome. ACTA ACUST UNITED AC 2018. [DOI: 10.5005/jp-journals-10006-1578] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
|
167
|
Socioeconomic inequality in preterm birth in four Brazilian birth cohort studies. JORNAL DE PEDIATRIA (VERSÃO EM PORTUGUÊS) 2018. [DOI: 10.1016/j.jpedp.2017.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
|
168
|
Yang S, Kramer MS. Preterm birth: temporal trends and socioeconomic inequalities. J Pediatr (Rio J) 2018; 94:1-2. [PMID: 28789847 DOI: 10.1016/j.jped.2017.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Affiliation(s)
- Seungmi Yang
- McGill University, Faculty of Medicine, Department of Epidemiology, Biostatistics and Occupational Health, Montreal, Canada.
| | - Michael S Kramer
- McGill University, Faculty of Medicine, Department of Epidemiology, Biostatistics and Occupational Health, Montreal, Canada; McGill University, Faculty of Medicine, Department of Pediatrics, Montreal, Canada
| |
Collapse
|
169
|
Guimarães PV, Fonseca SC, Pinheiro RS, Aguiar FP, Camargo KR, Coeli CM. The absence of birthweight paradox as a marker of disadvantages faced by low maternal education children. J Public Health (Oxf) 2017; 39:704-711. [PMID: 27980018 DOI: 10.1093/pubmed/fdw136] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background This study tested the hypothesis that the birthweight paradox would not be observed when assessing the effect of maternal education on neonatal mortality in the presence of socioeconomic inequality in access to health care. Methods Non-concurrent cohort study. Passive follow-up of live-born infants using probabilistic record linkage of birth and death records for Rio de Janeiro (2004-2010; n = 1 445 367). Maternal age, birthweight and neonatal death were evaluated according to maternal educational level strata (<4, 4-11 and ≥12 years of study). We estimated the association between maternal educational level and neonatal mortality using logistical regression models adjusted for maternal age and birthweight (<2500 g and ≥2500 g). Results Neonatal mortality was 1.8 times higher in low educational level group compared with high educational level. We did not find birthweight-specific mortality curves crossing over in the stratum under 2500 g (birthweight paradox). The odds of a low birthweight child being born in facilities without neonatal intensive care units was about 70% higher in the group of low education when compared with mothers with high education. Conclusions The absence of crossing birthweight-specific mortality curves may be a reason for concern about the severity of the disadvantages faced by low maternal education women.
Collapse
Affiliation(s)
- P V Guimarães
- Institute of Studies in Public Health (IESC), Federal University of Rio de Janeiro, Rio de Janeiro 21941-598, RJ, Brazil
| | - S C Fonseca
- Institute of Community Health (ISC), Fluminense Federal University, Niterói 24033-900, RJ, Brazil
| | - R S Pinheiro
- Institute of Studies in Public Health (IESC), Federal University of Rio de Janeiro, Rio de Janeiro 21941-598, RJ, Brazil
| | - F P Aguiar
- Institute of Studies in Public Health (IESC), Federal University of Rio de Janeiro, Rio de Janeiro 21941-598, RJ, Brazil
| | - K R Camargo
- Institute of Social Medicine (IMS), Rio de Janeiro State University, Rio de Janeiro 20550-013, RJ, Brazil
| | - C M Coeli
- Institute of Studies in Public Health (IESC), Federal University of Rio de Janeiro, Rio de Janeiro 21941-598, RJ, Brazil
| |
Collapse
|
170
|
Predictors and Patterns of Psychiatric Treatment Dropout During Pregnancy Among Low-Income Women. Matern Child Health J 2017; 22:226-236. [PMID: 29143169 DOI: 10.1007/s10995-017-2394-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Objective This study compared psychiatric treatment discontinuation rates among pregnant women using psychotropic medications, outpatient psychotherapy, or both before conception. Methods Using data from Pennsylvania Medicaid Fee-For-Service and Managed Care Organization claims and Medicaid enrollment, 3030 women were identified who gave birth between 2007 and 2009, had ≥ 1 claim for psychiatric treatment during the 120 days prior to pregnancy, and were enrolled in Medicaid until they delivered. Kaplan-Meier and Cox regression analyses were used to estimate psychiatric treatment dropout rate during pregnancy and examine relationships between treatment dropout and age, race/ethnicity, and pre-pregnancy psychiatric diagnosis and treatment pattern. Results After the first trimester, the probability of discontinuing psychotropic medications was 83 versus 37.8% for cessation of psychotherapy among combined treatment users. Two or more psychotherapy sessions in the 4 months prior to pregnancy were associated with decreased psychotherapy dropout during pregnancy. Psychotherapy during pregnancy was associated with prenatal psychotropic medication adherence. Conclusions To retain women in treatment during pregnancy, when discontinuation from care is common, innovative models of care should consider type of pre-pregnancy mental healthcare and individual characteristics.
Collapse
|
171
|
Maxson PJ, Edwards SE, Valentiner EM, Miranda ML. A Multidimensional Approach to Characterizing Psychosocial Health During Pregnancy. Matern Child Health J 2017; 20:1103-13. [PMID: 27107859 DOI: 10.1007/s10995-015-1872-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Objectives Domains of psychosocial health have been separately connected to pregnancy outcomes. This study explores the relationship between five domains of psychosocial health and their joint association with prenatal health and pregnancy outcomes. Methods Women from a prospective cohort study in Durham, North Carolina were clustered based on measures of paternal support, perceived stress, social support, depression, and self-efficacy. Clusters were constructed using the K-means algorithm. We examined associations between psychosocial health and maternal health correlates, pregnancy intention, and pregnancy outcomes using Chi square tests and multivariable models. Results Three psychosocial health profiles were identified, with the first (Resilient; n = 509) characterized by low depression and perceived stress and high interpersonal support, paternal support, and self-efficacy. The second profile (Vulnerable; n = 278) was marked by high depression and perceived stress, and low interpersonal support, paternal support, and self-efficacy. The third profile (Moderate, n = 526) fell between the other profiles on all domains. Health correlates, pregnancy intention, and pregnancy outcomes varied significantly across profiles. Women with the vulnerable profile were more likely to have risky health correlates, have an unintended pregnancy, and deliver preterm. Women with the resilient profile had better birth outcomes and fewer deleterious health correlates, preconception and prenatally. Conclusions We posit that vulnerable psychosocial health, deleterious health correlates, and the stress which often accompanies pregnancy may interact to magnify risk during pregnancy. Identifying and intervening with women experiencing vulnerable psychosocial health may improve outcomes for women and their children.
Collapse
Affiliation(s)
- Pamela J Maxson
- Children's Environmental Health Initiative, School of Natural Resources and Environment, University of Michigan, 440 Church Street, Ann Arbor, MI, 48109, USA.
| | - Sharon E Edwards
- Children's Environmental Health Initiative, School of Natural Resources and Environment, University of Michigan, 440 Church Street, Ann Arbor, MI, 48109, USA
| | - Ellis M Valentiner
- Children's Environmental Health Initiative, School of Natural Resources and Environment, University of Michigan, 440 Church Street, Ann Arbor, MI, 48109, USA
| | - Marie Lynn Miranda
- Children's Environmental Health Initiative, School of Natural Resources and Environment, University of Michigan, 440 Church Street, Ann Arbor, MI, 48109, USA.,Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, USA.,Department of Pediatrics and Communicable Diseases, University of Michigan, Ann Arbor, MI, USA
| |
Collapse
|
172
|
Vigoureux S, Goffinet F, Tessier V, Boulinguez V, Saurel-Cubizolles MJ, Azria E. [Observational study of a social device for women in precarious situations during pregnancy and post-partum]. ACTA ACUST UNITED AC 2017; 45:460-465. [PMID: 28869180 DOI: 10.1016/j.gofs.2017.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Accepted: 07/13/2017] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To assess the impact of the Regional experimental accompanying nutrition and breast-feeding for pregnant women (PRENAP) 75 social device on the duration of postpartum hospitalization and breast-feeding for pregnant women in precarious situation. METHODS A retrospective observational study took place between November 2013 and May 2015 in a type III Parisian maternity. Comparison of sociodemographic, perinatal and postpartum characteristics of women in precarious situations (no stable housing and no social care or universal medical coverage or state medical aid) was done according to whether they were included in the system PRENAP or not. RESULTS Over the study period, 344 (4.6%) women in precarious situations gave birth in this maternity. Among these women, the women included in the PRENAP system were more frequently in a very unfavorable social situation than those who were not included. The inclusion in the PRENAP device did not reduce the hospitalization in post-partum. Breast-feeding was chosen more frequently by the women included in the PRENAP device. CONCLUSION The PRENAP device seems to favor the use of breast-feeding, but is not associated with a diminution of the hospitalization time in post-partum. This social device, which seems to be beneficial in terms of social and medical support for women in precarious situations, deserves to be evaluated prospectively.
Collapse
Affiliation(s)
- S Vigoureux
- Inserm UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (Epopé), Center for Epidemiology and Statistics, Sorbonne Paris Cité, DHU Risks in pregnancy, Paris Descartes University, Maternité Port-Royal,75014 Paris, France; Inserm, Centre of research in epidemiology and population health (CESP), U1018, 94276 Le Kremlin-Bicêtre, France; Service de gynécologie-obstétrique, hôpital Bicêtre, GHU Sud, AP-HP, 94276 Le Kremlin-Bicêtre, France.
| | - F Goffinet
- Inserm UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (Epopé), Center for Epidemiology and Statistics, Sorbonne Paris Cité, DHU Risks in pregnancy, Paris Descartes University, Maternité Port-Royal,75014 Paris, France; Maternité Port-Royal, Paris Descartes University, Cochin Broca Hôtel-Dieu Hospital, AP-HP, DHU Risks in pregnancy, 75014 Paris, France
| | - V Tessier
- AP-HP, DHU risques et grossesse, 53, avenue de l'Observatoire, 75014, Paris, France
| | - V Boulinguez
- Groupe hospitalier Paris centre, maternité Port-Royal, DHU risques et grossesse, AP-HP, 75014 Paris, France
| | - M-J Saurel-Cubizolles
- Inserm UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (Epopé), Center for Epidemiology and Statistics, Sorbonne Paris Cité, DHU Risks in pregnancy, Paris Descartes University, Maternité Port-Royal,75014 Paris, France
| | - E Azria
- Inserm UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (Epopé), Center for Epidemiology and Statistics, Sorbonne Paris Cité, DHU Risks in pregnancy, Paris Descartes University, Maternité Port-Royal,75014 Paris, France; Maternité du groupe hospitalier de Paris Saint-Joseph, Paris Descartes University, 75014,Paris, France
| |
Collapse
|
173
|
Popo E, Kenyon S, Dann SA, MacArthur C, Blissett J. Effects of lay support for pregnant women with social risk factors on infant development and maternal psychological health at 12 months postpartum. PLoS One 2017; 12:e0182544. [PMID: 28846688 PMCID: PMC5573293 DOI: 10.1371/journal.pone.0182544] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Accepted: 07/18/2017] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND The ELSIPS (Evaluation of Lay Support in Pregnant Women with Social Risk) RCT showed that lay support for women with social risk had a positive effect on maternal mental health and mother-infant bonding. This exploratory study examined whether these observed benefits would impact infant development at 1 year. METHODS A sub-sample of women whose infants were under one year who had participated in the ELSIPS RCT which randomised women to receive either standard care or the services of a Pregnancy Outreach Worker (POW), and who were contactable, were eligible to participate in the follow up. At home visits, the Bayley Scales of Infant Development (3rd Edition) and standardised measures of depression, self efficacy, mind-mindedness and bonding were completed. RESULTS 486 women were eligible for follow up, of whom 154 agreed to participate. 61/273 were successfully followed up in the standard maternity care arm and 51/213 in the POW arm. Women who completed follow up were less depressed and had higher selfefficacy scores at 8-12 weeks postpartum than those who did not complete follow up. There were no significant differences in maternal outcomes, infant cognitive development, receptive communication, expressive communication, fine motor development or social/emotional functioning between groups at 12 month follow up. Infants of mothers who received the POW intervention had significantly better gross motor development than infants whose mothers received standard care (p<0.03). CONCLUSIONS The provision of lay support to women with social risk may facilitate infant gross motor skill development at one year but there were no other demonstrable benefits. The effects of the intervention may be underestimated given that those women who completed follow up had better mental health than the original study sample. TRIAL REGISTRATION Controlled-Trials.com ISRCTN35027323.
Collapse
Affiliation(s)
- Emma Popo
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, United Kingdom
| | - Sara Kenyon
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, United Kingdom
| | - Sophie-Anna Dann
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, United Kingdom
| | - Christine MacArthur
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, United Kingdom
| | - Jacqueline Blissett
- Centre for Technology Enabled Health Research, Coventry University, Coventry, United Kingdom
- School of Psychology, University of Birmingham, Edgbaston, Birmingham, United Kingdom
| |
Collapse
|
174
|
Ouidir M, Lepeule J, Siroux V, Malherbe L, Meleux F, Rivière E, Launay L, Zaros C, Cheminat M, Charles MA, Slama R. Is atmospheric pollution exposure during pregnancy associated with individual and contextual characteristics? A nationwide study in France. J Epidemiol Community Health 2017; 71:1026-1036. [DOI: 10.1136/jech-2016-208674] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Revised: 07/19/2017] [Accepted: 07/20/2017] [Indexed: 01/15/2023]
Abstract
BackgroundExposure to atmospheric pollutants is a danger for the health of pregnant mother and children. Our objective was to identify individual (socioeconomic and behavioural) and contextual factors associated with atmospheric pollution pregnancy exposure at the nationwide level.MethodAmong 14 921 women from the French nationwide ELFE (French Longitudinal Study of Children) mother-child cohort recruited in 2011, outdoor exposure levels of PM2.5, PM10 (particulate matter <2.5 µm and <10 µm in diameter) and NO2 (nitrogen dioxide) were estimated at the pregnancy home address from a dispersion model with 1 km resolution. We used classification and regression trees (CART) and linear regression to characterise the association of atmospheric pollutants with individual (maternal age, body mass index, parity, education level, relationship status, smoking status) and contextual (European Deprivation Index, urbanisation level) factors.ResultsPatterns of associations were globally similar across pollutants. For the CART approach, the highest tertile of exposure included mainly women not in a relationship living in urban and socially deprived areas, with lower education level. Linear regression models identified different determinants of atmospheric pollutants exposure according to the residential urbanisation level. In urban areas, atmospheric pollutants exposure increased with social deprivation, while in rural areas a U-shaped relationship was observed.ConclusionWe highlighted social inequalities in atmospheric pollutants exposure according to contextual characteristics such as urbanisation level and social deprivation and also according to individual characteristics such as education, being in a relationship and smoking status. In French urban areas, pregnant women from the most deprived neighbourhoods were those most exposed to health-threatening atmospheric pollutants.
Collapse
|
175
|
Socioeconomic differences in children’s growth trajectories from infancy to early adulthood: evidence from four European countries. J Epidemiol Community Health 2017; 71:981-989. [DOI: 10.1136/jech-2016-208556] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Revised: 02/28/2017] [Accepted: 07/07/2017] [Indexed: 12/20/2022]
Abstract
BackgroundHeight is regarded as a marker of early-life illness, adversity, nutrition and psychosocial stress, but the extent to which differences in height are determined by early-life socioeconomic circumstances, particularly in contemporary populations, is unclear. This study examined socioeconomic differences in children’s height trajectories from birth through to 21 years of age in four European countries.MethodsData were from six prospective cohort studies—Generation XXI, Growing Up in Ireland (infant and child cohorts), Millennium Cohort Study, EPITeen and Cardiovascular Risk in Young Finns Study—comprising a total of 49 492 children with growth measured repeatedly from 1980 to 2014. We modelled differences in children’s growth trajectories over time by maternal educational level using hierarchical models with fixed and random components for each cohort study.ResultsAcross most cohorts at practically all ages, children from lower educated mothers were shorter on average. The gradient in height was consistently observed at 3 years of age with the difference in expected height between maternal education groups ranging between −0.55 and −1.53 cm for boys and −0.42 to −1.50 cm for girls across the different studies and widening across childhood. The height deficit persists into adolescence and early adulthood. By age 21, boys from primary educated maternal backgrounds lag the tertiary educated by −0.67 cm (Portugal) and −2.15 cm (Finland). The comparable figures for girls were −2.49 cm (Portugal) and −2.93 cm (Finland).ConclusionsSignificant differences in children’s height by maternal education persist in modern child populations in Europe.
Collapse
|
176
|
Gerstein ED, Woodman AC, Burnson C, Cheng ER, Poehlmann-Tynan J. Trajectories of Externalizing and Internalizing Behaviors in Preterm Children Admitted to a Neonatal Intensive Care Unit. J Pediatr 2017; 187:111-118. [PMID: 28533035 PMCID: PMC5533642 DOI: 10.1016/j.jpeds.2017.04.047] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Revised: 03/06/2017] [Accepted: 04/21/2017] [Indexed: 01/26/2023]
Abstract
OBJECTIVE To examine the trajectories of internalizing and externalizing behavior problems of preterm children between 16 months and 6 years of age and predictors of trajectories, including gestational age, child dysregulation, maternal depression, socioeconomic status, and parenting. STUDY DESIGN This longitudinal study followed 148 children and their mothers from neonatal intensive care unit discharge until 6 years of age. Gestational ages ranged from 23 to 36 weeks. The study included assessment of maternal-reported behavior problems, maternal depression, neonatal and socioeconomic characteristics, and observations of dysregulated behavior and parenting. Trajectories were identified with a semiparametric group-based analytic method, and multinomial logistic regression was used to identify significant risk factors. RESULTS Three distinct trajectories for preterm children were found for both internalizing and externalizing behavior problems. For the 2 groups with greater behavior problems (groups 1 and 2), trajectories reached their peak between 24 and 36 months of age, then leveled off or decreased. Group 3 showed a stable low level of externalizing behaviors, and a low, but slightly increasing level of internalizing behaviors. Maternal depression, child dysregulation, gestational age, and socioeconomic challenges were identified as risk factors that predicted less optimal behavior problem trajectories. CONCLUSIONS Children born prematurely followed 1 of 3 distinct developmental trajectories for both internalizing and externalizing behavior problems. The most severe behavior problems started early in development and were associated with increased child dysregulation, maternal depression, and lower socioeconomic status. These findings have implications for screening and monitoring preterm children.
Collapse
|
177
|
MacVicar S, Berrang-Ford L, Harper S, Steele V, Lwasa S, Bambaiha DN, Twesigomwe S, Asaasira G, Ross N. How seasonality and weather affect perinatal health: Comparing the experiences of indigenous and non-indigenous mothers in Kanungu District, Uganda. Soc Sci Med 2017. [DOI: 10.1016/j.socscimed.2017.06.021] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
178
|
Cantarutti A, Franchi M, Monzio Compagnoni M, Merlino L, Corrao G. Mother's education and the risk of several neonatal outcomes: an evidence from an Italian population-based study. BMC Pregnancy Childbirth 2017; 17:221. [PMID: 28701151 PMCID: PMC5508478 DOI: 10.1186/s12884-017-1418-1] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Accepted: 07/05/2017] [Indexed: 11/24/2022] Open
Abstract
Background Maternal socioeconomic disparities strongly affect child health, particularly in low and middle income countries. We assessed whether neonatal outcomes varied by maternal education in a setting where healthcare system provides universal coverage of health services to all women, irrespective of their socioeconomic status. Methods A population-based study was performed on 383,103 singleton live births occurring from 2005 to 2010 in Lombardy, an Italian region with approximately 10 million inhabitants. The association between maternal education, birthplace and selected neonatal outcomes (preterm birth, low birth weight, small-for-gestational age, low 5-min Apgar score, severe congenital anomalies, cerebral distress and respiratory distress) was estimated by fitting logistic regression models. Model adjustments were applied for sociodemographic, reproductive and medical maternal traits. Results Compared with low-level educated mothers, those with high education had reduced odds of preterm birth (Odds Ratio; OR = 0.81, 95% CI 0.77–0.85), low birth weight (OR = 0.78, 95% CI 0.70–0.81), small for gestational age (OR = 0.82, 95% CI 0.79–0.85), and respiratory distress (OR = 0.84, 95% CI 0.80–0.88). Mothers born in a foreign country had higher odds of preterm birth (OR = 1.16, 95% CI 1.11–1.20), low Apgar score (OR = 1.18, 95% CI 1.07–1.30) and respiratory distress (OR = 1.19, 95% CI 1.15–1.24) than Italian-born mothers. The influence of maternal education on neonatal outcomes was confirmed among both, Italian-born and foreign-born mothers. Conclusions Low levels of education and maternal birthplace are important factors associated with adverse neonatal outcomes in Italy. Future studies are encouraged to investigate factors mediating the effects of socioeconomic inequality for identifying the main target groups for interventions. Electronic supplementary material The online version of this article (doi:10.1186/s12884-017-1418-1) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Anna Cantarutti
- Department of Statistics and Quantitative Methods, Division of Biostatistics, Epidemiology and Public Health, Laboratory of Healthcare Research and Pharmacoepidemiology, University of Milano-Bicocca, Via Bicocca degli Arcimboldi 8, U7, 20126, Milan, Italy.
| | - Matteo Franchi
- Department of Statistics and Quantitative Methods, Division of Biostatistics, Epidemiology and Public Health, Laboratory of Healthcare Research and Pharmacoepidemiology, University of Milano-Bicocca, Via Bicocca degli Arcimboldi 8, U7, 20126, Milan, Italy
| | - Matteo Monzio Compagnoni
- Department of Statistics and Quantitative Methods, Division of Biostatistics, Epidemiology and Public Health, Laboratory of Healthcare Research and Pharmacoepidemiology, University of Milano-Bicocca, Via Bicocca degli Arcimboldi 8, U7, 20126, Milan, Italy
| | - Luca Merlino
- Operative Unit of Territorial Health Services, Region Lombardia, Milan, Italy
| | - Giovanni Corrao
- Department of Statistics and Quantitative Methods, Division of Biostatistics, Epidemiology and Public Health, Laboratory of Healthcare Research and Pharmacoepidemiology, University of Milano-Bicocca, Via Bicocca degli Arcimboldi 8, U7, 20126, Milan, Italy
| |
Collapse
|
179
|
Hassan F, Asim M, Salim S, Humayun A. House ownership, frequency of illness, fathers' education: the most significant socio-demographic determinants of poor nutritional status in adolescent girls from low income households of Lahore, Pakistan. Int J Equity Health 2017; 16:122. [PMID: 28693602 PMCID: PMC5504737 DOI: 10.1186/s12939-017-0621-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Accepted: 07/04/2017] [Indexed: 11/10/2022] Open
Abstract
Background Socio demographic factors besides dietary factors play important role in determining the health status of an individual. Health and nutritional Intervention programs stand a greater chance of success if planned, keeping the socio demographic characteristics of a certain population in focus. The present study was conducted to identify those socio demographic determinants which have a significant association with poor nutritional status in adolescent girls belonging to economically deprived households of Lahore. Methods A cross-sectional analytical study of 140 adolescent girls living in the peri urban communities of Lahore was conducted. Socioeconomic and demographic data of the participants was recorded through a pretested questionnaire. Body mass index (BMI), a commonly used anthropometric measurement was taken as an indicator of nutritional status. Below normal (<18.5 m2) BMI was considered a benchmark of malnutrition in adolescent girls. Frequencies and percentages for socio demographic variables were calculated and Fisher Exact test was used to find out the association of nutritional status with socio-demographic predictors. Stepwise backward logistic regression analysis was then run to identify the most significant determinants associated with poor nutritional status in the adolescents. P < 0.05 was considered statistically significant. Results Chronic energy deficiency was highly prevalent among adolescent girls, 58% had BMI < 18.5 m2. Binary regression analysis result showed that the participants who lived in rented houses (AOR = 3.513; 95% CI = 1.366 to 9.031) who fell ill frequently (AOR = 2.996; 95% CI = 1.198 to 7.491) whose fathers were illiterate (AOR = 2.941; 95% CI = 1.187 to 7.287) were at greater odds of having poor nutritional status. Interestingly, the participants who lived in joint families (AOR = 0.411; 95% CI = 0.145 to 1.168) and were more frequently food insecure (AOR = 0.431; 95% CI = 0.164 to 1.133) had lesser odds of having poor nutritional status than those who lived in nuclear families and were food secure. Conclusion Frequency of illness, house ownership and fathers’ education are the determinants positively associated with poor nutritional status of adolescent girls. Food insecurity and joint family structure were negatively associated with poor nutritional status. The study will help in planning interventions for improving nutritional status of adolescent girls by targeting the significant socio demographic determinants of poor nutritional status among this group.
Collapse
Affiliation(s)
| | - Muhammad Asim
- Statistical officer NHRC,PHRC Research Center, Shaikh Zayed Medical Complex, Lahore, Pakistan
| | - Shafya Salim
- Government College of Home Economics, Gulberg, Lahore, Pakistan
| | - Ayesha Humayun
- Department of Public Health and Community Medicine & Deputy Director at Department of Undergraduate Medical Education, Shaikh Khalifa Bin Zayed Al-Nahyan Medical College and Shaikh Zayed Post Graduate Medical Institute, Shaikh Zayed Medical Complex, Lahore, Pakistan
| |
Collapse
|
180
|
Abdou CM. Age-Based Reproductive Healthcare Stereotype Threat (HCST) as a Stressor Affecting Prenatal Mental Health in Pregnant Women of Advanced Maternal Age: Measurement, Process, Outcomes, and Interactions with Ethnicity/Race, SES, and Other Social Identities. CURR EPIDEMIOL REP 2017; 4:133-144. [PMID: 30345220 PMCID: PMC6191845 DOI: 10.1007/s40471-017-0113-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE OF REVIEW Reproductive health, and pregnancy more specifically, is the first critical link between generations. Beginning with this first critical link, pregnancy acts as a domino, affecting the expression of genes and determining the lifespan mental and physical health and reproductive potential of offspring and, likely, of subsequent generations. Given the powerful intergenerational domino that is pregnancy, the development of innovative models to enhance reproductive health and outcomes is an invaluable public health investment. RECENT FINDINGS While U.S. pregnancy and birth outcomes have improved dramatically since the 1960s- including substantial progress within the past 15 years, largely catalyzed by the Healthy People initiative-group-based disparities remain. What's more, social change and medical advancements have led to an evolving window of female reproductive age. Despite becoming more common, being an older expectant mother remains a stigmatized social identity. The concept of healthcare stereotype threat (HCST) is introduced in relation to reproductive health. Stereotype threat is a situational predicament in which an individual who possesses a stigmatized social identity fears confirming negative group-based stereotypes. HCST is a healthcare-specific form of stereotype threat, arising out of stereotypes that are salient in healthcare settings. It is hypothesized that the experience of age-based reproductive HCST is an overlooked stressor affecting prenatal mental and physical health among women of advanced maternal age. SUMMARY The hypothesized process of age-based reproductive HCST is described; outcomes and consequences are discussed; interactions with ethnicity/race, SES, and other aspects of social identity are considered; and strategies for prevention and intervention are explored, including active and passive shifts in three areas: (1) internally, in both providers and patients; (2) in the external environment, or the physical healthcare setting itself; and (3) within interpersonal interactions that occur within healthcare settings, particularly between physicians and patients. Implications for gynecological, infertility, and obstetric care and improving the reproductive outcomes of older women are discussed.
Collapse
|
181
|
Shapiro GD, Séguin JR, Muckle G, Monnier P, Fraser WD. Previous pregnancy outcomes and subsequent pregnancy anxiety in a Quebec prospective cohort. J Psychosom Obstet Gynaecol 2017; 38:121-132. [PMID: 28079434 PMCID: PMC5383417 DOI: 10.1080/0167482x.2016.1271979] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
INTRODUCTION Pregnancy anxiety is an important psychosocial risk factor that may be more strongly associated with adverse birth outcomes than other measures of stress. Better understanding of the upstream predictors and causes of pregnancy anxiety could help to identify high-risk women for adverse maternal and infant outcomes. The objective of the present study was to measure the associations between five past pregnancy outcomes (live preterm birth (PTB), live term birth, miscarriage at <20 weeks, stillbirth at ≥20 weeks, and elective abortion) and pregnancy anxiety at three trimesters in a subsequent pregnancy. METHODS Analyses were conducted using data from the 3D Cohort Study, a Canadian birth cohort. Data on maternal demographic characteristics and pregnancy history for each known previous pregnancy were collected via interviewer-administered questionnaires at study entry. Pregnancy anxiety for the index study pregnancy was measured prospectively by self-administered questionnaire following three prenatal study visits. RESULTS Of 2366 participants in the 3D Study, 1505 had at least one previous pregnancy. In linear regression analyses with adjustment for confounding variables, prior live term birth was associated with lower pregnancy anxiety in all three trimesters, whereas prior miscarriage was significantly associated with higher pregnancy anxiety in the first trimester. Prior stillbirth was associated with greater pregnancy anxiety in the third trimester. Prior elective abortion was significantly associated with higher pregnancy anxiety scores in the first and second trimesters, with an association of similar magnitude observed in the third trimester. DISCUSSION Our findings suggest that the outcomes of previous pregnancies should be incorporated, along with demographic and psychosocial characteristics, into conceptual models framing pregnancy anxiety.
Collapse
Affiliation(s)
- Gabriel D. Shapiro
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Canada,CHU Sainte-Justine Research Centre, Université de Montréal, Montreal, Canada
| | - Jean R. Séguin
- CHU Sainte-Justine Research Centre, Université de Montréal, Montreal, Canada,Department of Psychiatry, Université de Montréal, Montreal, Canada
| | - Gina Muckle
- Centre de Recherche du Centre hospitalier universitaire de Québec, Quebec, Canada,École de psychologie, Université Laval, Quebec, Canada
| | - Patricia Monnier
- Department of Obstetrics and Gynecology, McGill University Health Centre, Montreal, Canada
| | - William D. Fraser
- CHU Sainte-Justine Research Centre, Université de Montréal, Montreal, Canada,Department of Obstetrics and Gynaecology, Université de Sherbrooke, and Centre de recherche du CHUS, Sherbrooke, Canada
| |
Collapse
|
182
|
Kandasamy S, Vanstone M, Oremus M, Hill T, Wahi G, Wilson J, Davis AD, Jacobs R, Anglin R, Anand SS. Elder women's perceptions around optimal perinatal health: a constructivist grounded-theory study with an Indigenous community in southern Ontario. CMAJ Open 2017; 5:E411-E416. [PMID: 28526704 PMCID: PMC5498402 DOI: 10.9778/cmajo.20160077] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Women play important roles in translating health knowledge, particularly around pregnancy and birth, in Indigenous societies. We investigated elder Indigenous women's perceptions around optimal perinatal health. METHODS Using a methodological framework that integrated a constructivist grounded-theory approach with an Indigenous epistemology, we conducted and analyzed in-depth interviews and focus groups with women from the Six Nations community in southern Ontario who self-identified as grandmothers. Our purposive sampling strategy was guided by a Six Nations advisory group and included researcher participation in a variety of local gatherings as well as personalized invitations to specific women, either face-to-face or via telephone. RESULTS Three focus groups and 7 individual interviews were conducted with 18 grandmothers. The participants' experiences converged on 3 primary beliefs: pregnancy is a natural phase, pregnancy is a sacred period for the woman and the unborn child, and the requirements of immunity, security (trust), comfort, social development and parental responsibility are necessary for optimal postnatal health. Participants also identified 6 communal responsibilities necessary for families to raise healthy children: access to healthy and safe food, assurance of strong social support networks for mothers, access to resources for postnatal support, increased opportunities for children to participate in physical activity, more teachings around the impact of maternal behaviours during pregnancy and more teachings around spirituality/positive thinking. We also worked with the Six Nations community on several integrated knowledge-translation elements, including collaboration with an Indigenous artist to develop a digital story (short film). INTERPRETATION Elder women are a trusted and knowledgeable group who are able to understand and incorporate multiple sources of knowledge and deliver it in culturally meaningful ways. Thus, tailoring public health programming to include elder women's voices may improve the impact and uptake of perinatal health information for Indigenous women.
Collapse
Affiliation(s)
- Sujane Kandasamy
- Affiliations: Department of Health Research Methods, Evidence, and Impact (Kandasamy, Oremus, Wahi, Anand), McMaster University; Department of Family Medicine (Vanstone), McMaster University; Centre for Health Economics and Policy Analysis (Vanstone), McMaster University, Hamilton, Ont.; School of Public Health and Health Systems (Oremus), University of Waterloo, Waterloo, Ont.; Birthing Centre (Hill, Wilson), Six Nations Health Services, Ohsweken, Ont.; Department of Pediatrics (Wahi), McMaster University, Hamilton, Ont.; Six Nations Health Services (Davis); Six Nations Health Foundation (Jacobs), Ohsweken, Ont.; Departments of Medicine (Anglin, Anand) and Psychiatry and Behavioural Neurosciences (Anglin), McMaster University, Hamilton, Ont
| | - Meredith Vanstone
- Affiliations: Department of Health Research Methods, Evidence, and Impact (Kandasamy, Oremus, Wahi, Anand), McMaster University; Department of Family Medicine (Vanstone), McMaster University; Centre for Health Economics and Policy Analysis (Vanstone), McMaster University, Hamilton, Ont.; School of Public Health and Health Systems (Oremus), University of Waterloo, Waterloo, Ont.; Birthing Centre (Hill, Wilson), Six Nations Health Services, Ohsweken, Ont.; Department of Pediatrics (Wahi), McMaster University, Hamilton, Ont.; Six Nations Health Services (Davis); Six Nations Health Foundation (Jacobs), Ohsweken, Ont.; Departments of Medicine (Anglin, Anand) and Psychiatry and Behavioural Neurosciences (Anglin), McMaster University, Hamilton, Ont
| | - Mark Oremus
- Affiliations: Department of Health Research Methods, Evidence, and Impact (Kandasamy, Oremus, Wahi, Anand), McMaster University; Department of Family Medicine (Vanstone), McMaster University; Centre for Health Economics and Policy Analysis (Vanstone), McMaster University, Hamilton, Ont.; School of Public Health and Health Systems (Oremus), University of Waterloo, Waterloo, Ont.; Birthing Centre (Hill, Wilson), Six Nations Health Services, Ohsweken, Ont.; Department of Pediatrics (Wahi), McMaster University, Hamilton, Ont.; Six Nations Health Services (Davis); Six Nations Health Foundation (Jacobs), Ohsweken, Ont.; Departments of Medicine (Anglin, Anand) and Psychiatry and Behavioural Neurosciences (Anglin), McMaster University, Hamilton, Ont
| | - Trista Hill
- Affiliations: Department of Health Research Methods, Evidence, and Impact (Kandasamy, Oremus, Wahi, Anand), McMaster University; Department of Family Medicine (Vanstone), McMaster University; Centre for Health Economics and Policy Analysis (Vanstone), McMaster University, Hamilton, Ont.; School of Public Health and Health Systems (Oremus), University of Waterloo, Waterloo, Ont.; Birthing Centre (Hill, Wilson), Six Nations Health Services, Ohsweken, Ont.; Department of Pediatrics (Wahi), McMaster University, Hamilton, Ont.; Six Nations Health Services (Davis); Six Nations Health Foundation (Jacobs), Ohsweken, Ont.; Departments of Medicine (Anglin, Anand) and Psychiatry and Behavioural Neurosciences (Anglin), McMaster University, Hamilton, Ont
| | - Gita Wahi
- Affiliations: Department of Health Research Methods, Evidence, and Impact (Kandasamy, Oremus, Wahi, Anand), McMaster University; Department of Family Medicine (Vanstone), McMaster University; Centre for Health Economics and Policy Analysis (Vanstone), McMaster University, Hamilton, Ont.; School of Public Health and Health Systems (Oremus), University of Waterloo, Waterloo, Ont.; Birthing Centre (Hill, Wilson), Six Nations Health Services, Ohsweken, Ont.; Department of Pediatrics (Wahi), McMaster University, Hamilton, Ont.; Six Nations Health Services (Davis); Six Nations Health Foundation (Jacobs), Ohsweken, Ont.; Departments of Medicine (Anglin, Anand) and Psychiatry and Behavioural Neurosciences (Anglin), McMaster University, Hamilton, Ont
| | - Julie Wilson
- Affiliations: Department of Health Research Methods, Evidence, and Impact (Kandasamy, Oremus, Wahi, Anand), McMaster University; Department of Family Medicine (Vanstone), McMaster University; Centre for Health Economics and Policy Analysis (Vanstone), McMaster University, Hamilton, Ont.; School of Public Health and Health Systems (Oremus), University of Waterloo, Waterloo, Ont.; Birthing Centre (Hill, Wilson), Six Nations Health Services, Ohsweken, Ont.; Department of Pediatrics (Wahi), McMaster University, Hamilton, Ont.; Six Nations Health Services (Davis); Six Nations Health Foundation (Jacobs), Ohsweken, Ont.; Departments of Medicine (Anglin, Anand) and Psychiatry and Behavioural Neurosciences (Anglin), McMaster University, Hamilton, Ont
| | - A Darlene Davis
- Affiliations: Department of Health Research Methods, Evidence, and Impact (Kandasamy, Oremus, Wahi, Anand), McMaster University; Department of Family Medicine (Vanstone), McMaster University; Centre for Health Economics and Policy Analysis (Vanstone), McMaster University, Hamilton, Ont.; School of Public Health and Health Systems (Oremus), University of Waterloo, Waterloo, Ont.; Birthing Centre (Hill, Wilson), Six Nations Health Services, Ohsweken, Ont.; Department of Pediatrics (Wahi), McMaster University, Hamilton, Ont.; Six Nations Health Services (Davis); Six Nations Health Foundation (Jacobs), Ohsweken, Ont.; Departments of Medicine (Anglin, Anand) and Psychiatry and Behavioural Neurosciences (Anglin), McMaster University, Hamilton, Ont
| | - Ruby Jacobs
- Affiliations: Department of Health Research Methods, Evidence, and Impact (Kandasamy, Oremus, Wahi, Anand), McMaster University; Department of Family Medicine (Vanstone), McMaster University; Centre for Health Economics and Policy Analysis (Vanstone), McMaster University, Hamilton, Ont.; School of Public Health and Health Systems (Oremus), University of Waterloo, Waterloo, Ont.; Birthing Centre (Hill, Wilson), Six Nations Health Services, Ohsweken, Ont.; Department of Pediatrics (Wahi), McMaster University, Hamilton, Ont.; Six Nations Health Services (Davis); Six Nations Health Foundation (Jacobs), Ohsweken, Ont.; Departments of Medicine (Anglin, Anand) and Psychiatry and Behavioural Neurosciences (Anglin), McMaster University, Hamilton, Ont
| | - Rebecca Anglin
- Affiliations: Department of Health Research Methods, Evidence, and Impact (Kandasamy, Oremus, Wahi, Anand), McMaster University; Department of Family Medicine (Vanstone), McMaster University; Centre for Health Economics and Policy Analysis (Vanstone), McMaster University, Hamilton, Ont.; School of Public Health and Health Systems (Oremus), University of Waterloo, Waterloo, Ont.; Birthing Centre (Hill, Wilson), Six Nations Health Services, Ohsweken, Ont.; Department of Pediatrics (Wahi), McMaster University, Hamilton, Ont.; Six Nations Health Services (Davis); Six Nations Health Foundation (Jacobs), Ohsweken, Ont.; Departments of Medicine (Anglin, Anand) and Psychiatry and Behavioural Neurosciences (Anglin), McMaster University, Hamilton, Ont
| | - Sonia Savitri Anand
- Affiliations: Department of Health Research Methods, Evidence, and Impact (Kandasamy, Oremus, Wahi, Anand), McMaster University; Department of Family Medicine (Vanstone), McMaster University; Centre for Health Economics and Policy Analysis (Vanstone), McMaster University, Hamilton, Ont.; School of Public Health and Health Systems (Oremus), University of Waterloo, Waterloo, Ont.; Birthing Centre (Hill, Wilson), Six Nations Health Services, Ohsweken, Ont.; Department of Pediatrics (Wahi), McMaster University, Hamilton, Ont.; Six Nations Health Services (Davis); Six Nations Health Foundation (Jacobs), Ohsweken, Ont.; Departments of Medicine (Anglin, Anand) and Psychiatry and Behavioural Neurosciences (Anglin), McMaster University, Hamilton, Ont
| |
Collapse
|
183
|
Adams KA, Marchman VA, Loi EC, Ashland MD, Fernald A, Feldman HM. Caregiver Talk and Medical Risk as Predictors of Language Outcomes in Full Term and Preterm Toddlers. Child Dev 2017; 89:1674-1690. [PMID: 28452393 DOI: 10.1111/cdev.12818] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
This study examined associations between caregiver talk and language skills in full term (FT) and preterm (PT) children (n = 97). All-day recordings of caregiver-child interactions revealed striking similarities in amount of caregiver talk heard by FT and PT children. Children who heard more caregiver talk at 16 months demonstrated better knowledge- and processing-based language skills at 18 months. The unique contributions of caregiver talk were tempered by medical risk in PT children, especially for processing speed. However, there was no evidence that birth status or medical risk moderated the effects of caregiver talk. These findings highlight the role of caregiver talk in shaping language outcomes in FT and PT children and offer insights into links between neurodevelopmental risk and caregiver-child engagement.
Collapse
|
184
|
Anggondowati T, El-Mohandes AAE, Qomariyah SN, Kiely M, Ryon JJ, Gipson RF, Zinner B, Achadi A, Wright LL. Maternal characteristics and obstetrical complications impact neonatal outcomes in Indonesia: a prospective study. BMC Pregnancy Childbirth 2017; 17:100. [PMID: 28351384 PMCID: PMC5371232 DOI: 10.1186/s12884-017-1280-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2015] [Accepted: 03/17/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND We investigated associations between maternal characteristics, access to care, and obstetrical complications including near miss status on admission or during hospitalization on perinatal outcomes among Indonesian singletons. METHODS We prospectively collected data on inborn singletons at two hospitals in East Java. Data included socio-demographics, reproductive, obstetric and neonatal variables. Reduced multivariable models were constructed. Outcomes of interest included low and very low birthweight (LBW/VLBW), asphyxia and death. RESULTS Referral from a care facility was associated with a reduced risk of LBW and VLBW [AOR = 0.28, 95% CI = 0.11-0.69, AOR = 0.18, 95% CI = 0.04-0.75, respectively], stillbirth [AOR = 0.41, 95% CI = 0.18-0.95], and neonatal death [AOR = 0.2, 95% CI = 0.05-0.81]. Mothers age <20 years increased the risk of VLBW [AOR = 6.39, 95% CI = 1.82-22.35] and neonatal death [AOR = 4.10, 95% CI = 1.29-13.02]. Malpresentation on admission increased the risk of asphyxia [AOR = 4.65, 95% CI = 2.23-9.70], stillbirth [AOR = 3.96, 95% CI = 1.41-11.15], and perinatal death [AOR = 3.89 95% CI = 1.42-10.64], as did poor prenatal care (PNC) [AOR = 11.67, 95%CI = 2.71-16.62]. Near-miss on admission increased the risk of neonatal [AOR = 11.67, 95% CI = 2.08-65.65] and perinatal death [AOR = 13.08 95% CI = 3.77-45.37]. CONCLUSIONS Mothers in labor should be encouraged to seek care early and taught to identify early danger signs. Adequate PNC significantly reduced perinatal deaths. Improved hospital management of malpresentation may significantly reduce perinatal morbidity and mortality. The importance of hospital-based prospective studies helps evaluate specific areas of need in training of obstetrical care providers.
Collapse
Affiliation(s)
- Trisari Anggondowati
- Center for Family Welfare, Faculty of Public Health, University of Indonesia, Depok, Indonesia.,School of Public Health, University of Nebraska Medical Center, Omaha, NE, USA
| | - Ayman A E El-Mohandes
- CUNY Graduate School of Public Health and Health Policy, 55 West 125th St., Room 714, New York, NY, 10027, USA
| | - S Nurul Qomariyah
- Center for Family Welfare, Faculty of Public Health, University of Indonesia, Depok, Indonesia
| | - Michele Kiely
- CUNY Graduate School of Public Health and Health Policy, 55 West 125th St., Room 714, New York, NY, 10027, USA.
| | | | | | - Benjamin Zinner
- U.S. Agency for International Development, Washington, District of Columbia, USA
| | - Anhari Achadi
- School of Public Health, University of Indonesia, Depok, Indonesia
| | - Linda L Wright
- George Washington University School of Medicine and Health Science, Washington, District of Columbia, USA
| |
Collapse
|
185
|
Yaya S, Bishwajit G, Ekholuenetale M, Shah V. Inadequate Utilization of Prenatal Care Services, Socioeconomic Status, and Educational Attainment Are Associated with Low Birth Weight in Zimbabwe. Front Public Health 2017; 5:35. [PMID: 28321391 PMCID: PMC5337889 DOI: 10.3389/fpubh.2017.00035] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Accepted: 02/20/2017] [Indexed: 11/22/2022] Open
Abstract
Background Globally, low birth weight (LBW) remains a leading cause of neonatal and infant mortality and poses significant challenges toward the progress of achieving infant mortality-related goals. Experience from developed countries shows that two major causes of LBW (premature delivery and intrauterine growth restriction) can be averted to a great extent by adequate utilization of maternal health-care services, during pregnancy. In this study, we attempt to measure the prevalence of LBW in Zimbabwe and explore the association between adequate utilization of prenatal care (PNC) services and LBW in Zimbabwe. We also explore other possible associations with LBW. Methodology This study was based on nationally representative, cross-sectional data from Multiple Indicator Cluster Survey round 5, conducted in 2014. Participants included 3,221 mothers from both rural and urban areas. The participants were selected regardless of their current pregnancy status. Sample characteristics were presented using descriptive statistics. Association between utilization status of ANC and LBW was measured by chi-square (bivariate) test and logistic regression methods. Results Prevalence of LBW was 12.8%. There was 11% reduction in the odds of having LBW babies for participants from urban area when compared with rural area (AOR = 0.897; 95% CI = 0.707–1.138). When compared to women with higher education, those having primary/below primary and secondary level qualification had higher odds of experiencing LBW babies by 73 and 56%, respectively. Participants who had less than four PNC/ANC visits had 34% higher odds (AOR = 1.340; 95% CI = 1.065–1.685) than those with at least four visits, and those who had given birth more than once, had 38% lower odds (AOR = 0.620; 95% CI = 0.493–0.780) of giving birth to LBW babies when compared to those who had given birth only once. Conclusion The findings of this study have programmatic and policy implications for low-resource nations and suggest that promoting access to ANC services especially in the rural areas is likely to reduce prevalence of LBW in Zimbabwe. This is important as LBW babies consume lot of health resources per se and not only in terms of hospitalization but also in terms of outpatient and physician visits during the first year of their life.
Collapse
Affiliation(s)
- Sanni Yaya
- Faculty of Social Sciences, School of International Development and Global Studies, University of Ottawa , Ottawa, ON , Canada
| | - Ghose Bishwajit
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology , Wuhan , China
| | | | - Vaibhav Shah
- Interdisciplinary School Health Sciences, University of Ottawa , Ottawa, ON , Canada
| |
Collapse
|
186
|
Herich LC, Cuttini M, Croci I, Franco F, Di Lallo D, Baronciani D, Fares K, Gargano G, Raponi M, Zeitlin J. Maternal Education Is Associated with Disparities in Breastfeeding at Time of Discharge but Not at Initiation of Enteral Feeding in the Neonatal Intensive Care Unit. J Pediatr 2017; 182:59-65.e7. [PMID: 27865429 DOI: 10.1016/j.jpeds.2016.10.046] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Revised: 08/30/2016] [Accepted: 10/12/2016] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To investigate the relationship between maternal education and breastfeeding in very preterm infants admitted to neonatal intensive care units. STUDY DESIGN This prospective, population-based cohort study analyzed the data of all very preterm infants admitted to neonatal care during 1 year in 3 regions in Italy (Lazio, Emilia-Romagna, and Marche). The use of mothers' own milk was recorded at initial enteral feedings and at hospital discharge. We used multilevel logistic analysis to model the association between maternal education and breastfeeding outcomes, adjusting for maternal age and country of birth. Region was included as random effect. RESULTS There were 1047 very preterm infants who received enteral feeding, and 975 were discharged alive. At discharge, the use of mother's own milk, exclusively or not, and feeding directly at the breast were significantly more likely for mothers with an upper secondary education or higher. We found no relationship between maternal education and type of milk at initial enteral feedings. However, the exclusive early use of the mother's own milk at initial feedings was related significantly with receiving any maternal milk and feeding directly at the breast at discharge from hospital, and the association with feeding at the breast was stronger for the least educated mothers. CONCLUSION In this population-based cohort of very preterm infants, we found a significant and positive association between maternal education and the likelihood of receiving their mother's own milk at the time of discharge. In light of the proven benefits of maternal milk, strategies to support breastfeeding should be targeted to mothers with less education.
Collapse
Affiliation(s)
- Lena Carolin Herich
- Research Unit of Perinatal Epidemiology, Clinical Care and Management Innovation Research Area, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Marina Cuttini
- Research Unit of Perinatal Epidemiology, Clinical Care and Management Innovation Research Area, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
| | - Ileana Croci
- Research Unit of Perinatal Epidemiology, Clinical Care and Management Innovation Research Area, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Francesco Franco
- Hospital Network Planning and Research Area, Lazio Regional Health Authority, Rome, Italy
| | - Domenico Di Lallo
- Hospital Network Planning and Research Area, Lazio Regional Health Authority, Rome, Italy
| | - Dante Baronciani
- Hospital Care Services, General Directorate for Health and Social Policies, Emilia Romagna Region, Bologna, Italy
| | - Katia Fares
- Neonatal Intensive Care Unit, Salesi Children's Hospital, Ancona, Italy
| | - Giancarlo Gargano
- Neonatal Intensive Care Unit, Department of Obstetrics and Pediatrics, Arcispedale Santa Maria Nuova, IRCCS, Reggio Emilia, Italy
| | - Massimiliano Raponi
- Clinical Care and Management Innovation Research Area, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Jennifer Zeitlin
- INSERM, Obstetrics, Perinatal and Paediatric Epidemiology Research Team, Center for Epidemiology and Biostatistics (U1153), and DHU Risks in Pregnancy, Paris Descartes University, Paris, France
| | | |
Collapse
|
187
|
Grytten J, Monkerud L, Skau I, Eskild A, Sørensen RJ, Saugstad OD. Saving Newborn Babies - The Benefits of Interventions in Neonatal Care in Norway over More Than 40 Years. HEALTH ECONOMICS 2017; 26:352-370. [PMID: 26842217 DOI: 10.1002/hec.3314] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2014] [Revised: 11/30/2015] [Accepted: 12/08/2015] [Indexed: 06/05/2023]
Abstract
The aim of this study was to examine the effect that the introduction of new medical interventions at birth has had on mortality among newborn babies in Norway during the period 1967-2011. During this period, there has been a significant decline in mortality, in particular for low birth weight infants. We identified four interventions that together explained about 50% of the decline in early neonatal and infant mortality: ventilators, antenatal steroids, surfactant and insure. The analyses were performed on a large set of data, encompassing more than 1.6 million deliveries (Medical Birth Registry of Norway). The richness of the data allowed us to perform several robustness tests. Our study indicates that the introduction of new medical interventions has been a very important channel through which the decline in mortality among newborn babies occurred during the second half of the last century. Copyright © 2016 John Wiley & Sons, Ltd.
Collapse
Affiliation(s)
- Jostein Grytten
- Department of Community Dentistry, University of Oslo, Oslo, Norway
- Department of Obstetrics and Gynecology, Institute of Clinical Medicine, Akershus University Hospital, Lørenskog, Norway
| | - Lars Monkerud
- Department of Community Dentistry, University of Oslo, Oslo, Norway
- Norwegian Institute for Urban and Regional Research, Oslo, Norway
| | - Irene Skau
- Department of Community Dentistry, University of Oslo, Oslo, Norway
| | - Anne Eskild
- Department of Obstetrics and Gynecology, Institute of Clinical Medicine, Akershus University Hospital, Lørenskog, Norway
| | | | - Ola Didrik Saugstad
- Department of Pediatric Research, Rikshospitalet University Hospital, University of Oslo, Oslo, Norway
| |
Collapse
|
188
|
Nur N. Association of risk factors with smoking during pregnancy among women of childbearing age: an epidemiological field study in Turkey. SAO PAULO MED J 2017; 135:100-106. [PMID: 28380202 PMCID: PMC9977337 DOI: 10.1590/1516-3180.2016.021921102016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2016] [Accepted: 10/21/2016] [Indexed: 12/12/2022] Open
Abstract
CONTEXT AND OBJECTIVE: Smoking during pregnancy is an important risk factor for maternal and infant health that is preventable. This study aimed to investigate the risk factors associated with smoking behavior during pregnancy. DESIGN AND SETTING: A household-based probability sample survey of 1,510 women was conducted in the center of the city of Sivas, Turkey, between September 2013 and May 2014. METHODS: The prevalence of smoking during pregnancy was estimated according to independent variables by means of regression analysis. RESULTS: The prevalence of smoking during pregnancy was 16.5%. Logistic regression showed that being at a relatively young age (odds ratio, OR = 1.92, P = 0.025 for 15-24 age group; and OR = 2.45, P = 0.001 for 25-34 age group), having a low educational level (OR = 1.76, P = 0.032), being unmarried (OR = 1.48, P = 0.002) and living in an extended family (OR = 1.98, P = 0.009) were the factors associated with the risk of smoking during pregnancy. CONCLUSIONS: Systematic attention should be paid to socioeconomic inequalities, to support women towards quitting smoking before or at an early stage of their pregnancies. Younger women and particularly those in lower socioeconomic groups should be targeted. This will lead to better pregnancy status, especially among young women.
Collapse
Affiliation(s)
- Naim Nur
- MD. Professor, Department of Public Health, School of Medicine, Cumhuriyet University, Sivas, Turkey.
| |
Collapse
|
189
|
Kelsey CM, Medel N, Mullins C, Dallaire D, Forestell C. An Examination of Care Practices of Pregnant Women Incarcerated in Jail Facilities in the United States. Matern Child Health J 2017; 21:1260-1266. [DOI: 10.1007/s10995-016-2224-5] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
190
|
Aryastami NK, Shankar A, Kusumawardani N, Besral B, Jahari AB, Achadi E. Low birth weight was the most dominant predictor associated with stunting among children aged 12–23 months in Indonesia. BMC Nutr 2017. [DOI: 10.1186/s40795-017-0130-x] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
|
191
|
Amegah AK, Näyhä S, Jaakkola JJK. Do biomass fuel use and consumption of unsafe water mediate educational inequalities in stillbirth risk? An analysis of the 2007 Ghana Maternal Health Survey. BMJ Open 2017; 7:e012348. [PMID: 28174221 PMCID: PMC5306511 DOI: 10.1136/bmjopen-2016-012348] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Numerous studies have explored the association between educational inequalities and stillbirth but most have failed to elaborate how low educational attainment leads to an increased risk of stillbirth. We hypothesised that use of biomass fuels and consumption of unsafe water related to low educational attainment could explain the stillbirth burden in Ghana attributable to socioeconomic disadvantage. METHODS Data from the 2007 Ghana Maternal Health Survey, a nationally representative population-based survey were analysed for this study. Of the10 370 women aged 15-49 years interviewed via structured questionnaires for the survey, 7183 primiparous and multiparous women qualified for inclusion in the present study. RESULTS In a logistic regression analysis that adjusted for age, area of residence, marital status and ethnicity of women, lower maternal primary education was associated with a 62% (OR=1.62; 95% CI 1.04 to 2.52) increased lifetime risk of stillbirth. Biomass fuel use and consumption of unsafe water mediated 18% and 8% of the observed effects, respectively. Jointly these two exposures explained 24% of the observed effects. The generalised additive modelling revealed a very flat inverted spoon-shaped smoothed curve which peaked at low levels of schooling (2-3 years) and confirms the findings from the logistic regression analysis. CONCLUSIONS Our results show that biomass fuel use and unsafe water consumption could be important pathways through which low maternal educational attainment leads to stillbirths in Ghana and similar developing countries. Addressing educational inequalities in developing countries is thus essential for ensuring household choices that curtail environmental exposures and help improve pregnancy outcomes.
Collapse
Affiliation(s)
- A Kofi Amegah
- Public Health Research Group, Department of Biomedical Sciences, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Simo Näyhä
- Center for Environmental and Respiratory Health Research, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Jouni J K Jaakkola
- Center for Environmental and Respiratory Health Research, Faculty of Medicine, University of Oulu, Oulu, Finland
| |
Collapse
|
192
|
Salvy SJ, de la Haye K, Galama T, Goran MI. Home visitation programs: an untapped opportunity for the delivery of early childhood obesity prevention. Obes Rev 2017; 18:149-163. [PMID: 27911984 PMCID: PMC5267322 DOI: 10.1111/obr.12482] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Revised: 09/02/2016] [Accepted: 09/20/2016] [Indexed: 12/11/2022]
Abstract
BACKGROUND Extant obesity efforts have had limited impact among low-income underserved children, in part because of limitations inherent to existing programs: (i) short duration and low intensity; (ii) late timing of implementation, when children are already overweight or obese; (iii) intervention delivery limiting their accessibility and sustainability; and (iv) failure to address barriers such as a lack of culturally competent services, poverty and housing instability, which interfere with healthy lifestyle changes. OBJECTIVE This concept paper proposes an innovative model of obesity prevention implemented in infancy and sustained throughout early childhood to address the limitations of current obesity prevention efforts. Specifically, we propose to integrate sustained, weekly, in-home obesity prevention as part of the services already delivered by ongoing Home Visitation Programs, which currently do not target obesity prevention. CONCLUSION The home visiting structure represents an ideal model for impactful obesity prevention as home visitation programs: (i) already provide comprehensive services to diverse low-income infants and families who are most at risk for obesity and poor health because of socio-economic and structural conditions; (ii) services are initiated in infancy and sustained throughout critical developmental periods for the formation of healthy/unhealthy behaviors; and (iii) have been in place for more than 40 years, with a widespread presence across the United States and nationwide, which is critical for the scalability and sustainability of obesity prevention.
Collapse
Affiliation(s)
| | - Kayla de la Haye
- University of Southern California, Department of Preventive Medicine
| | - Titus Galama
- University of Southern California, Center for Economic and Social Research
| | - Michael I. Goran
- University of Southern California, Department of Preventive Medicine
| |
Collapse
|
193
|
Pirini F, Goldman LR, Soudry E, Halden RU, Witter F, Sidransky D, Guerrero-Preston R. Prenatal exposure to tobacco smoke leads to increased mitochondrial DNA content in umbilical cord serum associated to reduced gestational age. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2017; 27:52-67. [PMID: 28002977 PMCID: PMC5532520 DOI: 10.1080/09603123.2016.1268677] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2016] [Accepted: 11/11/2016] [Indexed: 05/22/2023]
Abstract
We investigated if prenatal exposures to tobacco smoke lead to changes in mitochondrial DNA content (mtDNA) in cord serum and adversely affect newborns' health. Umbilical cord serum cotinine levels were used to determine in utero exposure to smoking. Cord serum mtDNA was measured by quantitative polymerase chain reaction analysis of the genes coding for cytochrome c oxidase1 (MT-CO1) and cytochrome c oxidase2 (MT-CO2). Log transformed levels of mtDNA coding for MT-CO1 and MT-CO2 were significantly higher among infants of active smokers with higher serum level of cotinine (p < 0.05) and inversely associated with gestational age (p = 0.08; p = 0.02). Structural equation modeling results confirmed a positive association between cotinine and MT-CO1 and2 (p < 0.01) and inverse associations with gestational age (p = 0.02) and IGF-1 (p < 0.01). We identified a dose-dependent increase in the level of MT-CO1 and MT-CO2 associated to increased cord serum cotinine and decreased gestational age.
Collapse
Affiliation(s)
- Francesca Pirini
- The Johns Hopkins University, School of Medicine, Otolaryngology Department, Head and Neck Cancer Research Division, Baltimore, USA
| | - Lynn R. Goldman
- The George Washington University, Milken Institute School of Public Health, Washington, District of Columbia, USA
| | - Ethan Soudry
- The Johns Hopkins University, School of Medicine, Otolaryngology Department, Head and Neck Cancer Research Division, Baltimore, USA
| | - Rolf U. Halden
- Arizona State University, The Biodesign Institute and Global Security Initiative, Center for Environmental Security, Tempe, Arizona
| | - Frank Witter
- The Johns Hopkins University, School of Medicine, Obstetrics and Gynecology Department, Baltimore, USA
| | - David Sidransky
- The Johns Hopkins University, School of Medicine, Otolaryngology Department, Head and Neck Cancer Research Division, Baltimore, USA
- Co-corresponding authors: Rafael Guerrero-Preston, DrPH, MPH, . David Sidransky, MD, , Johns Hopkins School of Medicine, Head and Neck Cancer Research Division, 1550 Orleans Street, Cancer Research Building II, Room 5M, Baltimore. MD, 21231, 410-502-5153
| | - Rafael Guerrero-Preston
- The Johns Hopkins University, School of Medicine, Otolaryngology Department, Head and Neck Cancer Research Division, Baltimore, USA
- University of Puerto Rico School of Medicine, Department of Obstetrics and Gynecology, San Juan, Puerto Rico
- Co-corresponding authors: Rafael Guerrero-Preston, DrPH, MPH, . David Sidransky, MD, , Johns Hopkins School of Medicine, Head and Neck Cancer Research Division, 1550 Orleans Street, Cancer Research Building II, Room 5M, Baltimore. MD, 21231, 410-502-5153
| |
Collapse
|
194
|
Gavin AR, Morris J. The Association Between Maternal Early Life Forced Sexual Intercourse and Offspring Birth Weight: The Role of Socioeconomic Status. J Womens Health (Larchmt) 2017; 26:442-449. [PMID: 28129022 DOI: 10.1089/jwh.2016.5789] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND This study utilizes a life-course framework to investigate whether maternal early life forced sexual intercourse operates in conjunction with health behaviors during adolescence, young adulthood, and the prenatal period to influence offspring birth weight. METHODS Using data from the 1994-2009 National Longitudinal Study of Adolescent Health (Add Health), we examined whether early life forced sexual intercourse predicted offspring birth weight through a mediated pathway, including depressive symptoms, substance use, and prenatal cigarette smoking. We stratify our analysis by socioeconomic status (SES) to determine whether the proposed pathways operate similarly, or differently, according to SES. RESULTS Our findings suggest that the pathways through which forced sexual intercourse affects offspring birth weight differ by SES. Among middle-to-high SES women, we found a mediated pathway linking forced sexual intercourse to offspring birth weight with prenatal cigarette smoking predicting lower offspring birth weight. Among low SES women, however, we did not find a mediated pathway linking forced sexual intercourse to birth weight. Findings suggest that prenatal cigarette smoking was not a mechanism of influence in the pathway between maternal early life forced sexual intercourse and offspring birth weight for low SES women. CONCLUSIONS Our findings suggest that forced sexual intercourse may influence infant birth weight in the next generation. Infants born with a low birth weight are at increased risk for a myriad of adverse outcomes across the life-course. Study results suggest the importance of interventions designed to reduce behavioral risks and to support health promoting behaviors among survivors in the short term, in an effort to prevent long-term consequences among later-born offspring.
Collapse
Affiliation(s)
- Amelia R Gavin
- 1 School of Social Work, University of Washington , Seattle, Washington
| | - Julia Morris
- 2 Department of Sociology, University of Washington , Seattle, Washington
| |
Collapse
|
195
|
Kressin NR, Chapman SE, Magnani JW. A Tale of Two Patients: Patient-Centered Approaches to Adherence as a Gateway to Reducing Disparities. Circulation 2017; 133:2583-92. [PMID: 27297350 DOI: 10.1161/circulationaha.116.015361] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The disparate effects of social determinants of health on cardiovascular health status and health care have been extensively documented by epidemiology. Yet, very little attention has been paid to how understanding and addressing social determinants of health might improve the quality of clinical interactions, especially by improving patients' adherence to recommended therapies. We present a case and suggested approach to illustrate how cardiovascular clinicians can use patient-centered approaches to identify and address social determinants of health barriers to adherence and reduce the impact of unconscious clinician biases. We propose that cardiovascular clinicians (1) recognize that patients may have different belief systems about illnesses' cause and treatment, which may influence their actions, and not assume they share one's experiences or explanatory model; (2) Endeavor to understand the individual patient before you; (3) based on that understanding, tailor your approach to that individual. We suggest a previously-developed mnemonic for an approach to RESPECT the patient: First, show Respect; then elicit patients' understandings of their illness by asking about their Explanatory model. Ask about the patient's Social context, share Power in the interaction, show Empathy, ask about Concerns or fears, and work to develop Trust by building the relationship over time. We provide additional clinical resources to support these efforts, including lay descriptions of cardiovascular conditions, challenges to adherence, and suggested strategies to address them.
Collapse
Affiliation(s)
- Nancy R Kressin
- From VA Boston Healthcare System, Jamaica Plain, MA (N.R.K.); Department of Medicine, Boston University School of Medicine and Boston Medical Center, MA (N.R.K., S.E.C.); and Department of Medicine, Division of Cardiology, UPMC Heart & Vascular Institute, University of Pittsburgh, PA (J.W.M.).
| | - Sheila E Chapman
- From VA Boston Healthcare System, Jamaica Plain, MA (N.R.K.); Department of Medicine, Boston University School of Medicine and Boston Medical Center, MA (N.R.K., S.E.C.); and Department of Medicine, Division of Cardiology, UPMC Heart & Vascular Institute, University of Pittsburgh, PA (J.W.M.)
| | - Jared W Magnani
- From VA Boston Healthcare System, Jamaica Plain, MA (N.R.K.); Department of Medicine, Boston University School of Medicine and Boston Medical Center, MA (N.R.K., S.E.C.); and Department of Medicine, Division of Cardiology, UPMC Heart & Vascular Institute, University of Pittsburgh, PA (J.W.M.)
| |
Collapse
|
196
|
Kozlovskaya A, Bojko E, Odland J, Grjibovski AM. Secular trends in pregnancy outcomes in 1980–1999 in the Komi Republic, Russia. Int J Circumpolar Health 2016; 66:437-48. [DOI: 10.3402/ijch.v66i5.18315] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
197
|
McRae DN, Muhajarine N, Stoll K, Mayhew M, Vedam S, Mpofu D, Janssen PA. Is model of care associated with infant birth outcomes among vulnerable women? A scoping review of midwifery-led versus physician-led care. SSM Popul Health 2016; 2:182-193. [PMID: 29349139 PMCID: PMC5757823 DOI: 10.1016/j.ssmph.2016.01.007] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2015] [Revised: 12/17/2015] [Accepted: 01/11/2016] [Indexed: 11/15/2022] Open
Abstract
This scoping review investigates if, over the last 25 years in high resource countries, midwives' patients of low socioeconomic position (SEP) were at more or less risk of adverse infant birth outcomes compared to physicians' patients. Reviewers identified 917 records in a search of 12 databases, grey literature, and citation lists. Thirty-one full documents were assessed and nine studies met inclusion criteria. Eight studies were assessed as moderate in quality; one study was given a weak rating. Of the moderate quality studies, the majority found no statistical difference in outcomes according to model of care for preterm birth, low or very low birth weight, or NICU admission. No study reported a statistically significant difference for small for gestational age birth (2 studies), or mean or low Apgar score (4 studies). However, one study found a reduced risk of preterm birth (AOR=0.70, p<0.01), and heavier mean infant birth weight (3325 g vs. 3282 g, p<0.01) for midwifery patients. Another study reported lower risk of low (RR=0.59, 95% CI: 0.46, 0.73) and very low birthweight (RR=0.44, 95% CI: 0.23, 0.85) for midwifery care. And, a third study reported a decrease in stays (1-3 days) in NICU (Adjusted Risk Difference=-1.8, 95% CI: -3.9, 0.2) for midwifery patients, though no overall difference in NICU admission of any duration. Other studies reported significant differences favoring midwifery care for mean birth weight (3598 g vs. 3407.3 g, p<0.05; 3233 g vs. 3089 g, p<0.05; 2 studies) and very low birth weight (OR=0.35, 95% CI:0.1, 0.9), for sub-groups within the larger study populations. This scoping review documented heterogeneity in study designs and analytical methods, inconsistent findings, moderate methodological quality, and lack of currency. There is a need for new studies to definitively establish if and how a midwifery-led model of care influences birth outcomes for women of low SEP.
Collapse
Affiliation(s)
- Daphne N. McRae
- Community Health and Epidemiology, University of Saskatchewan, Health Science Building, 107 Wiggins Rd., Saskatoon, Sask., Canada S7N 5E5
| | - Nazeem Muhajarine
- Community Health and Epidemiology, University of Saskatchewan, Health Science Building, 107 Wiggins Rd., Saskatoon, Sask., Canada S7N 5E5
| | - Kathrin Stoll
- School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, BC, Canada V6T 1Z3
| | - Maureen Mayhew
- School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, BC, Canada V6T 1Z3
| | - Saraswathi Vedam
- UBC Midwifery, University of British Columbia, Suite 320-5950 University Boulevard, Vancouver, BC, Canada V6T 1Z3
| | - Deborah Mpofu
- Community Health and Epidemiology, University of Saskatchewan, Health Science Building, 107 Wiggins Rd., Saskatoon, Sask., Canada S7N 5E5
- Saskatoon Health Region, 701 Queen St., Saskatoon, Sask., Canada S7K 0M7
| | - Patricia A. Janssen
- UBC Midwifery, University of British Columbia, Suite 320-5950 University Boulevard, Vancouver, BC, Canada V6T 1Z3
| |
Collapse
|
198
|
Hidaka BH, Kerling EH, Thodosoff JM, Sullivan DK, Colombo J, Carlson SE. Dietary patterns of early childhood and maternal socioeconomic status in a unique prospective sample from a randomized controlled trial of Prenatal DHA Supplementation. BMC Pediatr 2016; 16:191. [PMID: 27884184 PMCID: PMC5123236 DOI: 10.1186/s12887-016-0729-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Accepted: 11/08/2016] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Dietary habits established in early childhood and maternal socioeconomic status (SES) are important, complex, interrelated factors that influence a child's growth and development. The aim of this study was to define the major dietary patterns in a cohort of young US children, construct a maternal SES index, and evaluate their associations. METHODS The diets of 190 children from a randomized, controlled trial of prenatal supplementation of docosahexaenoic acid (DHA) were recorded at 6-mo intervals from 2-4.5 years by 24-h dietary recall. Hierarchical cluster analysis of age-adjusted, average daily intake of 24 food and beverage groups was used to categorize diet. Unrotated factor analysis generated an SES score from maternal race, ethnicity, age, education, and neighborhood income. RESULTS We identified two major dietary patterns: "Prudent" and "Western." The 85 (45%) children with a Prudent diet consumed more whole grains, fruit, yogurt and low-fat milk, green and non-starchy vegetables, and nuts and seeds. Conversely, those with a Western diet had greater intake of red meat, discretionary fat and condiments, sweet beverages, refined grains, French fries and potato chips, eggs, starchy vegetables, processed meats, chicken and seafood, and whole-fat milk. Compared to a Western diet, a Prudent diet was associated with one standard deviation higher maternal SES (95% CI: 0.80 to 1.30). CONCLUSIONS We found two major dietary patterns of young US children and defined a single, continuous axis of maternal SES that differed strongly between groups. This is an important first step to investigate how child diet, SES, and prenatal DHA supplementation interact to influence health outcomes. TRIAL REGISTRATION NCT00266825 . Prospectively registered on December 15, 2005.
Collapse
Affiliation(s)
- Brandon H Hidaka
- Department of Dietetics and Nutrition, University of Kansas Medical Center, MS 4013, 3901 Rainbow Blvd., Kansas City, KS, 66160, USA
| | - Elizabeth H Kerling
- Department of Dietetics and Nutrition, University of Kansas Medical Center, MS 4013, 3901 Rainbow Blvd., Kansas City, KS, 66160, USA
| | - Jocelynn M Thodosoff
- Department of Dietetics and Nutrition, University of Kansas Medical Center, MS 4013, 3901 Rainbow Blvd., Kansas City, KS, 66160, USA
| | - Debra K Sullivan
- Department of Dietetics and Nutrition, University of Kansas Medical Center, MS 4013, 3901 Rainbow Blvd., Kansas City, KS, 66160, USA
| | - John Colombo
- Department of Psychology, University of Kansas, 1415 Jayhawk Blvd., Lawrence, KS, 66045, USA
| | - Susan E Carlson
- Department of Dietetics and Nutrition, University of Kansas Medical Center, MS 4013, 3901 Rainbow Blvd., Kansas City, KS, 66160, USA.
| |
Collapse
|
199
|
Ahmadi R, Ziaei S, Parsay S. Association between Nutritional Status with Spontaneous Abortion. INTERNATIONAL JOURNAL OF FERTILITY & STERILITY 2016; 10:337-342. [PMID: 28042413 PMCID: PMC5134748 DOI: 10.22074/ijfs.2016.4577] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Accepted: 06/23/2016] [Indexed: 11/20/2022]
Abstract
Background Spontaneous abortion is the most common adverse pregnancy outcome.
We aimed to investigate a possible link between nutrient deficiencies and the risk of
spontaneous abortion. Materials and Methods This case-control study included the case group (n=331) experiencing a spontaneous abortion before 14 weeks of pregnancy and the control group
(n=331) who were healthy pregnant women over 14 weeks of pregnancy. The participants
filled out Food Frequency Questionnaire (FFQ), in which they reported their frequency
of consumption for a given serving of each food item during the past three months, on a
daily, weekly or monthly basis. The reported frequency for each food item was converted
to a daily intake. Then, consumption of nutrients was compared between the two groups. Results There are significant differences between the two groups regarding consumed
servings/day of vegetables, bread and cereal, meat, poultry, fish, eggs, beans, fats, oils
and dairy products (P=0.012, P<0.001, P=0.004, P<0.001, P=0.019, respectively). There
are significant differences between the two groups in all micronutrient including folic
acid, iron, vitamin C, vitamin B6, vitamin B12 and zinc (P<0.001). Conclusion Poor nutrientions may be correlated with increased risk of spontaneous abortion.
Collapse
Affiliation(s)
- Rahimeh Ahmadi
- Department of Midwifery and Reproductive Health, Faculty of Medical Science, Tarbiat Modares University, Tehran, Iran
| | - Saeideh Ziaei
- Department of Midwifery and Reproductive Health, Faculty of Medical Science, Tarbiat Modares University, Tehran, Iran
| | - Sosan Parsay
- Department of Midwifery and Reproductive Health, Faculty of Medical Science, Tarbiat Modares University, Tehran, Iran
| |
Collapse
|
200
|
Brief Report: Prevalence of Co-occurring Epilepsy and Autism Spectrum Disorder: The U.S. National Survey of Children’s Health 2011–2012. J Autism Dev Disord 2016; 47:224-229. [DOI: 10.1007/s10803-016-2938-7] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
|