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Videholm S, Silfverdal SA, Gustafsson PE. Socioeconomic circumstances, health-related behaviours and paediatric infections: a mediation analysis. Arch Dis Child 2024; 109:195-200. [PMID: 37979965 PMCID: PMC10894845 DOI: 10.1136/archdischild-2023-325850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 10/16/2023] [Indexed: 11/20/2023]
Abstract
OBJECTIVE To examine how the effect of disadvantaged socioeconomic circumstances on the risk of paediatric infections is mediated by pregnancy smoking, excess weight during pregnancy and breast feeding in children under 5 years of age. DESIGN A population-level, retrospective cohort study. The Swedish Medical Birth Register was combined with the National Patient Register, the longitudinal integration database for health insurance and labour market studies, the Cause of Death Register and a local register held by the Child Health Care Unit in Uppsala Region. SETTING Uppsala Region, Sweden. PATIENTS 63 216 term and post-term singletons born to women who resided in Uppsala Region, Sweden between 1997 and 2015. MAIN OUTCOME MEASURES Number of hospital admissions for infectious diseases. Secondary outcomes were the number of hospitalisations for respiratory and enteric infections, respectively. RESULTS The effect of disadvantaged socioeconomic circumstances, that is, low maternal education on the overall risk of paediatric infections was mediated to a considerable (33%-64%) proportion by pregnancy smoking, excess weight during pregnancy and breast feeding. CONCLUSIONS Pregnancy smoking, excess weight during pregnancy and breast feeding mediate a considerable proportion of the association between deprived socioeconomic circumstances and paediatric infectious diseases. Therefore, inequalities in paediatric infectious diseases may be reduced by public health policies addressing these health-related behaviours.
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Affiliation(s)
- Samuel Videholm
- Department of Clinical Sciences, Pediatrics, Umeå University, Umea, Sweden
- Unit of Research, Development, and Education, Östersund Hospital, Ostersund, Sweden
| | | | - Per E Gustafsson
- Department of Epidemiology and Global Health, Umeå University, Umea, Sweden
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Meyrose AK, Wüstner A, Otto C, Lampert T, Ravens-Sieberer U. [Associations of maternal educational background with health and health behavior in infants]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2019; 62:1067-1076. [PMID: 31440768 DOI: 10.1007/s00103-019-02998-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The basis for healthy development is established during the first years of one's life. In this early phase, parents can significantly influence the health conditions under which their child grows up. Parental education can play a key role in this regard. This study examines the association of maternal education with health and health behavior in infants. METHODS A subsample of the representative German KiGGS study (Wave 1, 2009-2012) on the health of children and adolescents was investigated. Data from 1727 mothers who reported on health-specific characteristics of their infants (0 to 2 years), on their own educational background, and on characteristics of the family were analyzed. The influence of maternal education on indices of health and health behavior in infants was investigated by means of logistic regression; additional predictors were considered in regression models. RESULTS Higher maternal education was associated with better health behavior, but not with overall infant health. The impact of maternal education on health behavior remained significant when considering other predictors (financial worries, low maternal age at childbirth, premature birth/low birth weight). Overall, low maternal education was accompanied by an accumulation of additional risks. CONCLUSIONS Higher maternal education can help infants have a good start in their lives. The impact of poor health behavior on infant health may not become apparent until later in their lives. For prevention and intervention, it is important to identify sensitive stages of development during childhood and the underlying mechanisms of the relationship between maternal education and infant health behavior.
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Affiliation(s)
- Ann-Katrin Meyrose
- Zentrum für Psychosoziale Medizin, Klinik für Kinder- und Jugendpsychiatrie, -psychotherapie und -psychosomatik, Universitätsklinikum Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Deutschland.
| | - Anne Wüstner
- Zentrum für Psychosoziale Medizin, Klinik für Kinder- und Jugendpsychiatrie, -psychotherapie und -psychosomatik, Universitätsklinikum Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Deutschland
| | - Christiane Otto
- Zentrum für Psychosoziale Medizin, Klinik für Kinder- und Jugendpsychiatrie, -psychotherapie und -psychosomatik, Universitätsklinikum Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Deutschland
| | - Thomas Lampert
- Abteilung für Epidemiologie und Gesundheitsmonitoring, Soziale Determinanten der Gesundheit, Robert Koch-Institut, Berlin, Deutschland
| | - Ulrike Ravens-Sieberer
- Zentrum für Psychosoziale Medizin, Klinik für Kinder- und Jugendpsychiatrie, -psychotherapie und -psychosomatik, Universitätsklinikum Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Deutschland.
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3
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Alfano R, Guida F, Galobardes B, Chadeau-Hyam M, Delpierre C, Ghantous A, Henderson J, Herceg Z, Jain P, Nawrot TS, Relton C, Vineis P, Castagné R, Plusquin M. Socioeconomic position during pregnancy and DNA methylation signatures at three stages across early life: epigenome-wide association studies in the ALSPAC birth cohort. Int J Epidemiol 2019; 48:30-44. [PMID: 30590607 PMCID: PMC6443021 DOI: 10.1093/ije/dyy259] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Accepted: 11/06/2018] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Socioeconomic experiences are recognized determinants of health, and recent work has shown that social disadvantages in early life may induce sustained biological changes at molecular level that are detectable later in life. However, the dynamics and persistence of biological embedding of socioeconomic position (SEP) remains vastly unexplored. METHODS Using the data from the ALSPAC birth cohort, we performed epigenome-wide association studies of DNA methylation changes at three life stages (birth, n = 914; childhood at mean age 7.5 years, n = 973; and adolescence at mean age 15.5 years, n = 974), measured using the Illumina HumanMethylation450 Beadchip, in relation to pregnancy SEP indicators (maternal and paternal education and occupation). RESULTS Across the four early life SEP metrics investigated, only maternal education was associated with methylation levels at birth, and four CpGs mapped to SULF1, GLB1L2 and RPUSD1 genes were identified [false discovery rate (FDR)-corrected P-value <0.05]. No epigenetic signature was found associated with maternal education in child samples, but methylation levels at 20 CpG loci were found significantly associated with maternal education in adolescence. Although no overlap was found between the differentially methylated CpG sites at different ages, we identified two CpG sites at birth and during adolescence which are 219 bp apart in the SULF1 gene that encodes an heparan sulphatase involved in modulation of signalling pathways. Using data from an independent birth cohort, the ENVIRONAGE cohort, we were not able to replicate these findings. CONCLUSIONS Taken together, our results suggest that parental SEP, and particularly maternal education, may influence the offspring's methylome at birth and adolescence.
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Affiliation(s)
- Rossella Alfano
- Department of Epidemiology and Biostatistics, Imperial College London, London, UK
- Medical Research Council-Health Protection Agency Centre for Environment and Health, Imperial College London, London, UK
- Centre for Environmental Sciences, Hasselt University, Diepenbeek, Belgium
| | - Florence Guida
- Department of Epidemiology and Biostatistics, Imperial College London, London, UK
- Medical Research Council-Health Protection Agency Centre for Environment and Health, Imperial College London, London, UK
| | - Bruna Galobardes
- Department of Population Health Sciences, University of Bristol, Bristol, UK
| | - Marc Chadeau-Hyam
- Department of Epidemiology and Biostatistics, Imperial College London, London, UK
- Medical Research Council-Health Protection Agency Centre for Environment and Health, Imperial College London, London, UK
- Division of Environmental Epidemiology, Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The Netherlands
| | - Cyrille Delpierre
- INSERM, UMR1027, Université Toulouse III-Paul Sabatier, Toulouse, France
| | - Akram Ghantous
- Epigenetics Group, International Agency for Research on Cancer (IARC), Lyon, France
| | - John Henderson
- Department of Population Health Sciences, University of Bristol, Bristol, UK
| | - Zdenko Herceg
- Epigenetics Group, International Agency for Research on Cancer (IARC), Lyon, France
| | - Pooja Jain
- Department of Epidemiology and Biostatistics, Imperial College London, London, UK
- NIHR-Health Protection Research Unit, Respiratory Infections and Immunity, Imperial College London, London, UK
| | - Tim S Nawrot
- Centre for Environmental Sciences, Hasselt University, Diepenbeek, Belgium
| | - Caroline Relton
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - Paolo Vineis
- Department of Epidemiology and Biostatistics, Imperial College London, London, UK
- Medical Research Council-Health Protection Agency Centre for Environment and Health, Imperial College London, London, UK
- IIGM, Italian Institute for Genomic Medicine, Turin, Italy
| | - Raphaële Castagné
- Department of Epidemiology and Biostatistics, Imperial College London, London, UK
- INSERM, UMR1027, Université Toulouse III-Paul Sabatier, Toulouse, France
| | - Michelle Plusquin
- Department of Epidemiology and Biostatistics, Imperial College London, London, UK
- Medical Research Council-Health Protection Agency Centre for Environment and Health, Imperial College London, London, UK
- Centre for Environmental Sciences, Hasselt University, Diepenbeek, Belgium
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Leng J, Shao P, Zhang S, Li N, Pan L, Liu H, Liu E, MacIntyre J, Liu J. Maternal education and newborn thyroid-stimulating hormone level in a congenital hypothyroidism screening program. J Matern Fetal Neonatal Med 2019; 33:2730-2734. [PMID: 30563393 DOI: 10.1080/14767058.2018.1559809] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Objective: To examine the relationship between neonatal thyroid function and the formal education of mothers.Study design: Participants came from a population-based congenital hypothyroidism (CH) screening program in Tianjin, China.Methods: Of 66,390 registered births in 2015, 60,568 mothers and newborns had complete data. Mothers were categorized into one of four categories based on their educational attainment: (a) midschool or less; (b) high school or equivalent; (c) university; or (d) post graduate. Newborn thyroid-stimulating hormone (TSH) level was measured on day 3-7. Two neonatal groups were created using cutoffs of TSH > 10 μIU/ml and TSH > 20 μIU/ml. Odds ratios (OR) for CH risk by maternal education were estimated from logistic regression models after adjusting for potential confounders.Results: For TSH > 10 μIU/ml, the screen positive incidence rate for CH was 1:201 or 4.98 per 1000 births; for TSH > 20 μIU/ml, the incidence rate was 1:2222 or 0.45 per 1000 births. Screen positive incidence rates decreased with increasing maternal education level. Compared to mothers with a postgraduate education, the ORs (95% CI) for midschool or less, high school or equivalent, and university were 2.09 (1.08, 4.04), 1.45 (0.73, 2.90), and 1.61 (0.85, 3.06) using a cutoff of TSH > 10 μIU/ml. At the higher cutoff of TSH > 20 μIU/ml ORs (95% CI) for midschool or less and high school or equivalent were 3.05 (1.20,7.74) and 3.34 (1.24, 8.97), when compared to a composite reference category of university and postgraduate level education.Conclusion: Maternal education is inversely related to neonatal thyroid function though the mechanism remains unexplained.
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Affiliation(s)
- Junhong Leng
- Tianjin Women and Children's Health Centre, Tianjin, China
| | - Ping Shao
- Tianjin Women and Children's Health Centre, Tianjin, China
| | - Shuang Zhang
- Tianjin Women and Children's Health Centre, Tianjin, China
| | - Nan Li
- Tianjin Women and Children's Health Centre, Tianjin, China
| | - Lei Pan
- Tianjin Women and Children's Health Centre, Tianjin, China
| | - Hongyan Liu
- Tianjin Women and Children's Health Centre, Tianjin, China
| | - Enqing Liu
- Tianjin Women and Children's Health Centre, Tianjin, China
| | | | - Jian Liu
- Department of Health Sciences, Brock University, St Catharines, Canada
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Chala S, Houzmali S, Abouqal R, Abdallaoui F. Knowledge, attitudes and self-reported practices toward children oral health among mother's attending maternal and child's units, Salé, Morocco. BMC Public Health 2018; 18:618. [PMID: 29751753 PMCID: PMC5948847 DOI: 10.1186/s12889-018-5542-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2017] [Accepted: 05/03/2018] [Indexed: 12/17/2022] Open
Abstract
Background The occurrence of severe dental caries is particularly prevalent and harmful in children. A better understanding of parental factors that may be indicators of children’s risk of developing dental caries is important for the development of preventive measures. This study was conducted to assess knowledge, attitudes, and practices (KAP) of mothers in Salé, Morocco regarding oral health and their predictors. Methods A cross-sectional KAP study was conducted of Mother and Child units in Salé, Morocco. Mothers attending the selected units from November 2014 to 29 January 2015 were recruited. Data were collected using a semi-structured questionnaire, administered by face-to-face interviews, to record socio-demographic factors and KAPs. The main outcome measures included knowledge about oral health diseases and preventive measures, and attitudes and practices related to oral health prevention measures and dental care. KAPs scores were then recoded based on responses and scores were determined for each KAP domain. Linear regression analysis was conducted to assess predictors of KAP scores. Results Among 502 mothers included, 140 (27.8%) were illiterate and 285 (60.9%) were aware that fluoride has a beneficial effect in caries prevention. Mothers’ own practices about dental care were statistically related to their children’s use of dental care services (p < 0.001). Multiple linear regression analysis revealed that the knowledge score was associated with mother’s age (β = 0.05; 95% CI; p < 0.001), education level, and median income (β = 0.38; p = 0.04). Significant predictors of oral health-related practices were mother’s education level and children’s health status. Conclusions Limited KAP scores were observed among the studied population. A great emphasis on oral health education and some risk factor modifications are recommended. Electronic supplementary material The online version of this article (10.1186/s12889-018-5542-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Sanaa Chala
- Department of Endodontics and Restorative Dentistry, Faculty of Dental Medicine, BP: 6212, Rabat instituts, Rabat, Morocco. .,Laboratory of Biostatics, Clinical and Epidemiological Research, Faculty of Medicine and Pharmacy, Mohammed V University in Rabat, Rabat, Morocco. .,Mohammed V Military Teaching Hospital, Rabat, Morocco.
| | - Soumia Houzmali
- Department of Endodontics and Restorative Dentistry, Faculty of Dental Medicine, BP: 6212, Rabat instituts, Rabat, Morocco
| | - Redouane Abouqal
- Laboratory of Biostatics, Clinical and Epidemiological Research, Faculty of Medicine and Pharmacy, Mohammed V University in Rabat, Rabat, Morocco
| | - Faïza Abdallaoui
- Department of Endodontics and Restorative Dentistry, Faculty of Dental Medicine, BP: 6212, Rabat instituts, Rabat, Morocco.,Oral Biology and Biotechnology Laboraty, Mohammed V University in Rabat, Rabat, Morocco
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Formiga CKMR, Silva LPD, Linhares MBM. Identification of risk factors in infants participating in a Follow-up program. REVISTA CEFAC 2018. [DOI: 10.1590/1982-021620182038817] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Purpose: to identify the main health risk factors of infants participating in a follow-up program. Methods: a longitudinal prospective study conducted with 540 high-risk infants observed in the follow-up clinic of the Hospital Materno Infantil in Goiânia in the State of Goiás, Brazil. All biological data of the infants from birth, prenatal, and postnatal periods were collected through assessment sessions with their mothers and medical chart reviews. Data were analyzed through binary logistic regression to identify the highest-risk variables for the infants’ health. Results: in a predictive analysis, the findings showed that neonatal risk was statistically associated with a lower Apgar score at the fifth minute of life, male infants, and longer hospital stay. Infants with increased neonatal risk were more likely to show alterations identified in cranial ultrasound examinations. Moreover, the longer hospital stay was related to mixed breastfeeding after discharge. Conclusion: the main risk factors for the health of high-risk infants in the follow-up program were: low Apgar score at the fifth minute; male sex; longer hospital stay; alterations detected in transfontanellar ultrasound; and mixed feeding after discharge.
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Do Mothers with Lower Socioeconomic Status Contribute to the Rate of All-Cause Child Mortality in Kazakhstan? BIOMED RESEARCH INTERNATIONAL 2018; 2018:3629109. [PMID: 29651427 PMCID: PMC5832164 DOI: 10.1155/2018/3629109] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Accepted: 01/16/2018] [Indexed: 11/29/2022]
Abstract
Background This study aimed to explore whether or not mothers with higher educational and wealth status report lower rate of child mortality compared to those with less advantageous socioeconomic situation. Methods Data used were cross-sectional and collected from Multiple Indicator Cluster Survey in Kazakhstan conducted in 2015. Subjects experiencing childbirth were 9278 women aging between 15 and 49 years. The associations between maternal education and household wealth status with child mortality were examined by multivariate analytical methods. Results The overall prevalence of child mortality was 6.7%, with noticeable variations across the different regions. Compared with women who had the highest educational status, those with upper and lower secondary were 1.47 and 1.89 times more likely to experience child death. Women in the lowest and second lowest wealth quintile had 2.74 and 2.68 times higher odds of experiencing child death compared with those in the richest wealth status households. Conclusions Policy makers pay special attention to improving socioeconomic status of the mothers in an effort to reduce child mortality in the country. Women living in the disadvantaged regions with poor access to quality health care services should be regarded as a top priority.
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Peres MA, Nascimento GG, Peres KG, Demarco FF, Menezes AB. Oral health-related behaviours do not mediate the effect of maternal education on adolescents' gingival bleeding: A birth cohort study. Community Dent Oral Epidemiol 2017; 46:169-177. [PMID: 29178456 PMCID: PMC5887883 DOI: 10.1111/cdoe.12350] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Accepted: 10/17/2017] [Indexed: 12/17/2022]
Abstract
Objectives To test whether maternal education has a direct effect on gingival bleeding in adolescents aged 12 and to assess whether oral health behaviours over time mediate that association. Methods Two oral health studies nested in the 1993 Pelotas (Brazil) birth cohort study were carried out in participants aged 6 (n = 359) and 12 years (n = 339). The proportion of teeth with bleeding on probing (BOP) and the median number of teeth with gingivitis at age 12 were recorded. Maternal education at birth was the exposure. Toothbrushing frequency and dental visit at ages 6 and 12 years were investigated as mediators of the association between maternal education at birth and gingival bleeding. Time‐varying family income through childhood and adolescence was included as later confounder. Paternal education was taken as baseline confounder. The controlled direct effect (CDE) of maternal education at child's birth on gingival bleeding at age 12 was estimated using marginal structural models (MSM). Additionally, path analysis was employed to estimate standardized direct, indirect and total effects of maternal education at birth on gingival bleeding. Results Adjusted analyses using MSM showed that adolescents whose mothers had <8 years of education had 3.82 higher risk of having teeth with gingival bleeding above the median (rate ratio RR 3.82; 95% CI: 1.68‐8.19). Low maternal education doubled the proportion of gingival bleeding at age 12 not mediated by dental visit and toothbrushing frequency (RR 1.99; 95% CI: 1.52‐2.60). Path analysis revealed that maternal education had a direct effect on gingival bleeding independently of the mediators. Conclusions The pattern of oral health behaviours does not explain the association between mother's education and adolescent's gingival bleeding. Individual‐based approaches focused on oral health‐related behaviours tend to fail to prevent gingival bleeding.
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Affiliation(s)
- Marco A Peres
- Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide, SA, Australia
| | - Gustavo G Nascimento
- Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, Brazil.,Section of Periodontology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - Karen G Peres
- Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide, SA, Australia
| | - Flavio F Demarco
- Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, Brazil.,Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Ana B Menezes
- Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
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Crilly J, Cameron CM, Scuffham PA, Good N, Scott R, Mihala G, Sweeny A, Keijzers G. Emergency department presentations in infants: Predictors from an Australian birth cohort. J Paediatr Child Health 2017; 53:981-987. [PMID: 28744935 DOI: 10.1111/jpc.13617] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Revised: 03/10/2017] [Accepted: 04/10/2017] [Indexed: 12/01/2022]
Abstract
AIM Infants under 12 months of age are disproportionately represented amongst emergency department (ED) presentations, and infants are more likely to be frequent ED users. This study aimed to describe and identify psychosocial predictors of ED presentation in infants. METHODS A prospective birth cohort from Queensland and New South Wales (Environments for Healthy Living) was used to understand infant health service use. Baseline and 12-month questionnaire data pertaining to children born between 2006 and 2011 were used to identify predictors of ED presentation, using multiple regression analysis. RESULTS Of the 2184 children in the cohort with available baseline and 12-month data, 579 (27%) presented at least once to an ED during their first 12 months of life. Statistically significant predictors of ED presentation in the multivariate analysis included the mother having asthma (odds ratio (OR) 1.67, 95% confidence interval (CI) 1.15-2.39) and a higher Kessler-6 score (a measure of psychological distress) of the primary carer at baseline (OR 1.04, 95% CI 1.01-1.08). Maternal education level was not associated with ED presentations of infants. CONCLUSIONS This study describes maternal and child factors of children who present to the ED in the first year of life. Factors related to an infant's support system were found to be predictors for an ED presentation in the first year of life. This study emphasises the need to review the maternal medical history and psychosocial situation. There may be benefits for health-care practitioners to take the opportunity (such as during routine childhood immunisation) to perform a brief screening tool (such as the Kessler-6) to understand psychological distress experienced by mothers. This may influence the likelihood of a child presenting to an ED within the first 12 months of life.
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Affiliation(s)
- Julia Crilly
- Menzies Health Institute, Griffith University, Gold Coast, Queensland, Australia.,Department of Emergency Medicine, Gold Coast University Hospital, Gold Coast Health, Gold Coast, Queensland, Australia
| | - Cate M Cameron
- Menzies Health Institute, Griffith University, Gold Coast, Queensland, Australia
| | - Paul A Scuffham
- Menzies Health Institute, Griffith University, Gold Coast, Queensland, Australia
| | - Norm Good
- Australian e-Health Research Centre, CSIRO, Brisbane, Queensland, Australia
| | - Rani Scott
- Menzies Health Institute, Griffith University, Gold Coast, Queensland, Australia
| | - Gabor Mihala
- Menzies Health Institute, Griffith University, Gold Coast, Queensland, Australia
| | - Amy Sweeny
- Department of Emergency Medicine, Gold Coast University Hospital, Gold Coast Health, Gold Coast, Queensland, Australia
| | - Gerben Keijzers
- Menzies Health Institute, Griffith University, Gold Coast, Queensland, Australia.,Department of Emergency Medicine, Gold Coast University Hospital, Gold Coast Health, Gold Coast, Queensland, Australia
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Lin YC, Seo DC. Cumulative family risks across income levels predict deterioration of children's general health during childhood and adolescence. PLoS One 2017; 12:e0177531. [PMID: 28520758 PMCID: PMC5433733 DOI: 10.1371/journal.pone.0177531] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Accepted: 04/29/2017] [Indexed: 12/02/2022] Open
Abstract
Family is considered an important agent in the health development of children. This process is significant but quite complex because the prevalence of potential risk factors in the family can hinder children’s health. This study examined if multiple family risks might have cumulative effect on children and youth’s health across various levels of household income. The data in this study were drawn from the 2011–2012 U.S. National Survey of Children’s Health (N = 79,601). A cumulative family risk (CFR) index was developed, which included such constructs as single-parenthood, unstable employment, large family, parenting stress, poor maternal education, poor maternal general health and poor maternal mental health. Multiple logistic regression analyses showed that CFR level was significantly related to children and youth’s poor health outcome (p < .001). When poverty levels were considered, however, the impact of CFRs on children and youth’s health was attenuated. The impact of CFRs was higher on children and youth from affluent families than on those from poor families. Overall there was a consistent pattern of trend in the point estimate as well as confidence limits as levels of affluence and numbers of family risk increased although some of the confidence intervals overlapped. Living in disadvantaged families might serve as a protective factor against CFRs possibly through repeated exposure to hardships and subsequent formation of resilience among some of the disadvantaged children.
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Affiliation(s)
- Yi-Ching Lin
- Department of Early Childhood and Family Education, College of Education, National Taipei University of Education, Taipei, Taiwan
| | - Dong-Chul Seo
- Department of Applied Health Science, Indiana University School of Public Health, Bloomington, Indiana, United States of America
- * E-mail:
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11
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Danks M, Cherry K, Burns YR, Gray PH. Are behaviour problems in extremely low-birthweight children related to their motor ability? Acta Paediatr 2017; 106:568-572. [PMID: 27992071 DOI: 10.1111/apa.13712] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Revised: 11/09/2016] [Accepted: 12/12/2016] [Indexed: 12/01/2022]
Abstract
AIM To investigate whether behaviour problems are independently related to mild motor impairment in 11-13-year-old children born preterm with extremely low birthweight (ELBW). METHODS The cross-sectional study included 48 (27 males) non-disabled, otherwise healthy ELBW children (<1000 g) and 55 (28 males) term-born peers. Parents reported behaviour using the Child Behaviour Checklist (CBCL). Children completed the Movement Assessment Battery for Children (Movement ABC). RESULTS Extremely low birthweight children had poorer behaviour scores (CBCL Total Problem T score: mean difference = 5.89, 95% confidence interval = 10.29, 1.49, p = 0.009) and Movement ABC Total Motor Impairment Scores (ELBW group median = 17.5, IQR = 12.3; term-born group median = 7.5, IQR = 9, p < 0.01) than term-born peers. Behaviour was related to motor score (regression coefficient 2.16; 95% confidence interval 0.34, 3.97, p = 0.02) independent of gender, socio-economic factors or birthweight. Motor score had the strongest association with attention (ρ = 0.51; p < 0.01) and social behaviours (ρ = 0.50; p < 0.01). CONCLUSION Behaviour problems of otherwise healthy 11- to 13-year-old ELBW children are not related to prematurity independent of their motor difficulties. Supporting improved motor competence in ELBW preteen children may support improved behaviour, particularly attention and social behaviours.
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Affiliation(s)
- Marcella Danks
- School of Physiotherapy; Australian Catholic University; Brisbane Qld Australia
- Growth and Development Unit; Mater Mothers’ Hospital; Brisbane Qld Australia
| | - Kate Cherry
- School of Physiotherapy; Australian Catholic University; Brisbane Qld Australia
| | - Yvonne R. Burns
- Growth and Development Unit; Mater Mothers’ Hospital; Brisbane Qld Australia
- School of Health and Rehabilitation; The University of Queensland; Brisbane Qld Australia
| | - Peter H. Gray
- Growth and Development Unit; Mater Mothers’ Hospital; Brisbane Qld Australia
- Mater Research Institute; University of Queensland; Brisbane Qld Australia
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Ma C, Claude KM, Kibendelwa ZT, Brooks H, Zheng X, Hawkes M. Is maternal education a social vaccine for childhood malaria infection? A cross-sectional study from war-torn Democratic Republic of Congo. Pathog Glob Health 2017; 111:98-106. [PMID: 28220714 DOI: 10.1080/20477724.2017.1288971] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
In zones of violent conflict in the tropics, social disruption leads to elevated child mortality, of which malaria is the leading cause. Understanding the social determinants of malaria transmission may be helpful to optimize malaria control efforts. We conducted a cross-sectional study of healthy children aged 2 months to 5 years attending well-child and/or immunization visits in the Democratic Republic of Congo (DRC). Six hundred and forty-seven children were tested for malaria antigenemia by rapid diagnostic test and the accompanying parent or legal guardian simultaneously completed a survey questionnaire related to demographics, socioeconomic status, maternal education, as well as bednet use and recent febrile illness. We examined the associations between variables using multivariable logistic regression analysis, chi-squared statistic, Fisher's exact test, and Spearman's rank correlation, as appropriate. One hundred and twenty-three out of the 647 (19%) children in the study tested positive for malaria. Higher levels of maternal education were associated with a lower risk of malaria in their children. The prevalence of malaria in children of mothers with no education, primary school, and beyond primary was 41/138 (30%), 41/241 (17%), and 39/262 (15%), respectively (p = 0.001). In a multivariable logistic regression model adjusting for the effect of a child's age and study site, the following remained significant predictors of malaria antigenemia: maternal education, number of children under five per household, and HIV serostatus. Higher maternal education, through several putative causal pathways, was associated with lower malaria prevalence among children in the DRC. Our findings suggest that maternal education might be an effective 'social vaccine' against malaria in the DRC and globally.
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Affiliation(s)
- Cary Ma
- a Department of Pediatrics , University of Alberta , Edmonton , Canada
| | - Kasereka Masumbuko Claude
- b Department of Pediatrics , Université Catholique du Graben , Butembo , Democratic Republic of Congo
| | | | - Hannah Brooks
- a Department of Pediatrics , University of Alberta , Edmonton , Canada
| | - Xiaonan Zheng
- a Department of Pediatrics , University of Alberta , Edmonton , Canada
| | - Michael Hawkes
- a Department of Pediatrics , University of Alberta , Edmonton , Canada.,c Department of Global Health, School of Public Health , Edmonton Clinic Health Academy , Edmonton , Canada
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