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Kaforau LS, Tessema GA, Jancey J, Dhamrait G, Bugoro H, Pereira G. Prevalence and risk factors of adverse birth outcomes in the Pacific Island region: A scoping review. THE LANCET REGIONAL HEALTH - WESTERN PACIFIC 2022; 21:100402. [PMID: 35243458 PMCID: PMC8873950 DOI: 10.1016/j.lanwpc.2022.100402] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Background Prevalence and exposures of adverse birth outcomes is well studied in low-and-middle-income countries but not well-established for the Pacific Island region. Our study mapped the available evidence on low birth weight (LBW), preterm birth, and small for gestational age (SGA)’s prevalence and their corresponding risks in the region. Methods We followed the five-staged Arksey and O'Malley's framework with clinicians’ consultation in the region. Five scholarly databases and non-indexed studies were searched and extracted data were analysed as numerical and thematic summaries mapping the outcomes and exposures. Findings We included 20 studies representing 11 Pacific Island countries with the following mean prevalence and associations at 95% confidence interval. Estimated mean prevalence for LBW and preterm births were 12% and 13%, respectively. LBW were associated with malaria in pregnancy [aOR 3.3 (1.00, 10.60)], and betel nut and tobacco [aOR 2.4 (1.00, 6.00)]. Preterm births were associated with malaria in pregnancy [aOR 6.6 (2.46, 17.62)] and maternal obesity [aOR 1.5 (1.00, 2.30)]. SGA were associated with short stature [aOR 1.7 (1.22, 2.41)] and no antenatal bookings [aOR 4.0 (2.12, 7.57)] Interpretation Several significant factors identified were malaria infection, obesity, betel nut and tobacco and no antenatal care, also validated by clinicians consulted. Funding Australia National Health and Medical Research Council.
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Dickinson C, Vangaveti V, Browne A. Psychological impact of neonatal intensive care unit admissions on parents: A regional perspective. Aust J Rural Health 2022; 30:373-384. [PMID: 35112425 DOI: 10.1111/ajr.12841] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Revised: 12/22/2021] [Accepted: 12/31/2021] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVE This study aimed to report the prevalence of adverse psychological symptoms and health behaviours of parents who had a baby admitted to a regional neonatal intensive care unit to spotlight mental health care in these unique settings. DESIGN This was a prospective, prevalence-based study using quantitative data. SETTING The study was conducted at the Townsville University Hospital, Queensland. PARTICIPANTS Participants comprised 114 parents of 79 infants enrolled in the study (mothers = 69 and fathers = 45). MAIN OUTCOME MEASURES Trauma, depression, anxiety, stress, alcohol and drug use, prior mental health history and bonding experience were assessed by standardised self-report questionnaires and a structured diagnostic interview within 2 weeks and at 3 months post-admission to neonatal intensive care unit. RESULTS Clinically significant acute trauma symptoms (16% of mothers only), depression (22% mothers; 4% of fathers), anxiety (27% mothers; 11% fathers) and stress (24% mothers; 13% fathers) were reported within the first 2 weeks after their baby was admitted to the neonatal intensive care unit. Notably, 18% of parents reported engaging in harmful alcohol use behaviour within 2 weeks post-birth; 29% of fathers continued to report risky drinking at 3 months. At 3 months, 21%, 8% and 6% of mothers met diagnostic criteria for generalised anxiety disorder, major depressive disorder and post-traumatic stress disorder, respectively. CONCLUSION Screening for psychological distress and alcohol use of parents of neonatal intensive care unit babies can ensure that support services are made available post-discharge to optimise family function and development of the preterm infant.
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Affiliation(s)
- Corrine Dickinson
- Queensland Children's Hospital, Children's Health Queensland, South Brisbane, QLD, Australia
| | - Venkat Vangaveti
- College of Medicine and Dentistry, James Cook University, Townsville, QLD, Australia
| | - Allyson Browne
- Medical School, University of Western Australia, Perth, WA, Australia
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Jabri L, Rosenthal DM, Benton L, Lakhanpaul M. Complementary feeding practices and nutrient intakes of children aged 6-24 months from Bangladeshi background living in Tower Hamlets, East London: a feasibility study. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2020; 39:4. [PMID: 32111257 PMCID: PMC7048146 DOI: 10.1186/s41043-020-0213-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Accepted: 02/05/2020] [Indexed: 06/10/2023]
Abstract
BACKGROUND The aim of this study was to assess dietary intakes and complementary feeding practices of children aged 6-24 months who are from Bangladeshi ancestry and living in Tower Hamlets, London, and determine the feasibility of a larger, population-representative study. METHODS Questionnaires for demographic variables and feeding practices, and 24-h dietary recalls were administered to 25 mothers to determine whether it would be feasible to conduct a similar study on a representative sample size of the same population. Data from both tools were used to determine adequacy of complementary feeding practices through the WHO indicators and an infant and child feeding index score as well as overall macronutrient and micronutrient intake. RESULTS Four children had varying suboptimal complementary feeding practices: two children failed to achieve the minimum dietary diversity, one child was being fed cow's milk before the age of 1 year, and one scored 'poor' on the infant and child feeding index. Most notably, the mean protein intake (39.7 g/day, SD 18.2) was higher than RNIs for all age groups (P = 0.001). Vitamin D intake was below recommendations (P = 0.006) for the 12-24-month age group. For the 10-12-month age group, zinc intake fell below recommendations (P = 0.028). For the 6-9-month combined age group, iron and zinc intakes were below recommendations (P = 0.021 and P = 0.002, respectively). CONCLUSIONS Given the feasibility of this study, the results obtained require a large-scale study to be conducted to confirm findings. Our initial results indicated that children from Bangladeshi heritage may not be meeting nutritional requirements; thus, a future intervention tailored to the needs of the Bangladeshi population may be required to improve aspects of complementary feeding practices and nutrient intakes of those children.
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Affiliation(s)
- Laura Jabri
- Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, 30 Guilford St, London, WC1N 1EH UK
- University College London, London, WC1E 6BT UK
| | - Diana Margot Rosenthal
- Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, 30 Guilford St, London, WC1N 1EH UK
- University College London, London, WC1E 6BT UK
- UCL Collaborative Centre for Inclusion Health, Department of Epidemiology and Public Health, London, WC1E 7HB UK
| | - Lorna Benton
- Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, 30 Guilford St, London, WC1N 1EH UK
- University College London, London, WC1E 6BT UK
| | - Monica Lakhanpaul
- Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, 30 Guilford St, London, WC1N 1EH UK
- University College London, London, WC1E 6BT UK
- UCL Collaborative Centre for Inclusion Health, Department of Epidemiology and Public Health, London, WC1E 7HB UK
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Kilcullen M, Kandasamy Y, Watson D, Cadet-James Y. Decisions to consent for autopsy after stillbirth: Aboriginal and Torres Strait Islander women's experiences. Aust N Z J Obstet Gynaecol 2019; 60:350-354. [PMID: 31591716 DOI: 10.1111/ajo.13052] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Accepted: 08/05/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND The stillbirth rate for Australian Aboriginal and Torres Strait Islander infants is twice that for non-Indigenous infants. Autopsy is the gold standard for fetal investigation; however, parental consent is often not given. There is little research investigating the drivers of parents' decision-making for autopsy after stillbirth. AIMS The current study explored the reasons why Aboriginal and Torres Strait Islander women did or did not give permission to autopsy after stillbirth. MATERIALS AND METHODS Five Aboriginal and/or Torres Strait Islander women participated in semi-structured interviews. Thematic analysis was conducted within a phenomenological framework. RESULTS Five themes were identified as reasons for giving permission - to find out why the baby died; to confirm diagnosis; to understand future risk; to help others; and doubt about maternal causes. Four themes were identified as reasons for declining permission - not asked in a sensitive manner; not enough time to think; distress about the autopsy procedure; and unwilling to agree. There was a lack of acceptability of the lengthy timeframe for the availability of autopsy results as families usually wait between three and nine months. This lengthy waiting period negatively impacted upon families' health and wellbeing. CONCLUSIONS It is important for health professionals to understand the factors that parents consider when giving permission for autopsy after stillbirth. It is hoped that an increase in autopsy rate will enhance the understanding of the causes of stillbirth and ultimately decrease the stillbirth rate for Aboriginal and Torres Strait Islander families.
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Affiliation(s)
- Meegan Kilcullen
- College of Healthcare Sciences, James Cook University, Townsville, Queensland, Australia
| | - Yogavijayan Kandasamy
- Department of Neonatology, The Townsville Hospital, Townsville, Queensland, Australia.,Mothers and Babies Research Centre, Hunter Medical Research Institute, John Hunter Hospital, The University of Newcastle, Newcastle, New South Wales, Australia.,College of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia
| | - David Watson
- College of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia.,Department of Obstetrics and Gynaecology, The Townsville Hospital, Townsville, Queensland, Australia
| | - Yvonne Cadet-James
- Indigenous Research and Education Centre, James Cook University, Townsville, Queensland, Australia.,Apunipima Cape York Health Council, Bungalow, Queensland, Australia
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Abdullahi I, Wong K, Glasson E, Mutch R, de Klerk N, Downs J, Cherian S, Leonard H. Are preterm birth and intra-uterine growth restriction more common in Western Australian children of immigrant backgrounds? A population based data linkage study. BMC Pregnancy Childbirth 2019; 19:287. [PMID: 31399075 PMCID: PMC6688266 DOI: 10.1186/s12884-019-2437-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Accepted: 07/29/2019] [Indexed: 11/22/2022] Open
Abstract
Background To compare the prevalence of preterm birth, post term birth, intra-uterine growth restriction and distribution of Apgar scores in offspring of foreign-born women in Western Australia with that of their Australian-born non-Indigenous and Indigenous counterparts. Methods A population-based linked data study, involving 767,623 singleton births in Western Australia between 1980 and 2010 was undertaken. Neonatal outcomes included preterm birth, post term births, intra-uterine growth restriction (assessed using the proportion of optimal birth weight) and low Apgar scores. These were compared amongst foreign-born women from low, lower-middle, upper middle and high income countries and Australian-born non-Indigenous and Indigenous women over two different time periods using multinomial logistic regression adjusted for covariates. Results Compared with Australian born non-Indigenous women, foreign-born women from low income countries were at some increased risk of extreme preterm (aRRR 1.59, 95% CI 0.87, 2.89) and very early preterm (aRRR 1.63, 95% CI 0.92, 2.89) births during the period from 1980 to 1996. During the period from 1997 to 2010 they were also at some risk of extreme preterm (aRRR 1.42, 95% CI 0.98, 2.04) very early preterm (aRRR 1.34, 95% CI 1.11, 1.62) and post term birth (aRRR 1.93, 95% CI 0.99, 3.78). During this second time period, other adverse outcomes for children of foreign-born women from low income and middle income countries included increases in severe (aRRR 1.69, 95% CI 1.30, 2.20; aRRR 1.72, 95% CI 1.53, 1.93), moderate (aRRR 1.54, 95% CI 1.32, 1.81; aRRR 1.59, 95% CI 1.48, 1.70) and mild (aRRR 1.28, 95% CI 1.14, 1.43; aRRR 1.31, 95% CI 1.25, 1.38) IUGR compared to children of Australian-born non-Indigenous mothers. Uniformly higher risks of adverse outcomes were also demonstrated for infants of Indigenous mothers. Conclusions Our findings illustrate the vulnerabilities of children born to foreign women from low and middle-income countries. The need for exploratory research examining mechanisms contributing to poorer birth outcomes following resettlement in a developed nation is highlighted. There is also a need to develop targeted interventions to improve outcomes for these women and their families. Electronic supplementary material The online version of this article (10.1186/s12884-019-2437-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ifrah Abdullahi
- Telethon Kids Institute, The University of Western Australia, PO Box 855, West Perth, WA, 6872, Australia.,School of Paediatrics and Child Health, The University of Western Australia, Perth, WA, Australia
| | - Kingsley Wong
- Telethon Kids Institute, The University of Western Australia, PO Box 855, West Perth, WA, 6872, Australia
| | - Emma Glasson
- Telethon Kids Institute, The University of Western Australia, PO Box 855, West Perth, WA, 6872, Australia
| | - Raewyn Mutch
- Telethon Kids Institute, The University of Western Australia, PO Box 855, West Perth, WA, 6872, Australia.,School of Paediatrics and Child Health, The University of Western Australia, Perth, WA, Australia.,Department of General Paediatrics, Perth Children's Hospital, Perth, WA, Australia
| | - Nicholas de Klerk
- Telethon Kids Institute, The University of Western Australia, PO Box 855, West Perth, WA, 6872, Australia
| | - Jenny Downs
- Telethon Kids Institute, The University of Western Australia, PO Box 855, West Perth, WA, 6872, Australia.,School of Physiotherapy and Exercise Science, Curtin University, Perth, WA, Australia
| | - Sarah Cherian
- School of Paediatrics and Child Health, The University of Western Australia, Perth, WA, Australia.,Department of General Paediatrics, Perth Children's Hospital, Perth, WA, Australia
| | - Helen Leonard
- Telethon Kids Institute, The University of Western Australia, PO Box 855, West Perth, WA, 6872, Australia.
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Ireland S, Ray R, Larkins S, Woodward L. Factors influencing the care provided for periviable babies in Australia: a narrative review. Reprod Health 2015; 12:108. [PMID: 26608822 PMCID: PMC4660795 DOI: 10.1186/s12978-015-0094-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2015] [Accepted: 10/31/2015] [Indexed: 11/15/2022] Open
Abstract
Survival at extreme prematurity is becoming increasingly common. Neurodisability is an increasing risk with decreasing gestation. This review outlines the risks of extreme prematurity and the attitudes of health care providers and families in Australia of periviable babies. High quality data is difficult to find due to differing definitions and methods of assessment of disability. Meta-analyses of outcomes of prematurity published from 2008 to 2013, including babies born from 1990 onwards, suggest a severe disability rate of around 20 % at 22 to 26 weeks completed gestation, with moderate disability decreasing with increasing gestation. Studies show that Australian health care providers underestimate the survival and positive outcomes of these babies. The majority of Australian health care providers state that parental preference would determine the decision to offer care to babies at 23 weeks gestation, however, all had a threshold above which parental preference would be ignored in favour of resuscitation .This ranged from 22 to 27 completed weeks gestation. The few studies examining Australian parental involvement in resuscitation decisions, showed that the majority of parents felt that health professionals alone had made the decision to resuscitate their extremely preterm babies and the parents themselves did not wish to be the primary decision makers in withholding care. The babies progressed better than parents had expected following antenatal counselling. The attitudes of health care providers, experiences and opinions of parents seem to be at odds with the current move to increase parental decision making at the most extremes of gestation. Current Australian guidelines suggest parental decision making below 25 weeks gestation, and primarily clinician decision making over this gestation. The increased risks of prematurity and adverse outcomes for the North Queensland population is also explored. This population has a high proportion of Aboriginal and Torres Strait Islanders who have increased risks which are primarily linked to poor socioeconomic factors and are highest for the most remote residents. Attitudes towards delivery of care to these highest risk babies from health professionals and in the populations themselves have not been studied.
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Affiliation(s)
- Susan Ireland
- The neonatal unit, The Townsville Hospital, 100 Angus Smith Dve, Douglas, Queensland, 4814, Australia.
| | - Robin Ray
- College of Medicine and Dentistry, James Cook University, Douglas, Queensland, 4814, Australia.
| | - Sarah Larkins
- College of Medicine and Dentistry, James Cook University, Douglas, Queensland, 4814, Australia.
| | - Lynn Woodward
- College of Medicine and Dentistry, James Cook University, Douglas, Queensland, 4814, Australia.
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