1
|
Kumar S, Hill C, Halliday TJ. Effects of COVID-19 pandemic on low birth weight in a nationwide study in India. COMMUNICATIONS MEDICINE 2024; 4:118. [PMID: 38877222 PMCID: PMC11178855 DOI: 10.1038/s43856-024-00545-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 06/05/2024] [Indexed: 06/16/2024] Open
Abstract
BACKGROUND Among newborns, those born in India have the highest prevalence of low birth weight (LBW). The COVID-19 pandemic exacerbated the risk factors for LBW. This study examined whether birth outcomes deteriorated during the pandemic period compared to those during the pre-pandemic period. METHODS This cross-sectional study included nationally representative data on 198,203 infants. Multivariate ordinary least square and logistic regression models with district fixed effects were fitted to compare the birth outcomes in the pandemic period (April 2020-April 2021) and the pre-pandemic period (July 2014-December 2019). Regression models were adjusted for covariates-gender and birth order of the child, mother's age and education, rural residence, religion, caste, and household wealth. RESULTS The pandemic cohort includes 11,851 infants (5.8%), while the pre-pandemic cohort includes 192,764 infants (94.2%). The LBW prevalence rate is 20% in the pandemic cohort and 17% in the pre-pandemic cohort. The covariate-adjusted model shows significant differences in birth weight (11 grams) and LBW (aOR: 1.08; 95% CI: 1.03-1.14) between the pandemic and pre-pandemic cohorts. CONCLUSIONS Our findings show that babies born during the COVID-19 pandemic are more likely to be LBW. The subgroup analyses indicate significant differences by religion but not by maternal education, caste, and wealth group.
Collapse
Affiliation(s)
- Santosh Kumar
- Keough School of Global Affairs, University of Notre Dame, Notre Dame, IN, 46556, USA.
| | - Clare Hill
- Keough School of Global Affairs, University of Notre Dame, Notre Dame, IN, 46556, USA
| | | |
Collapse
|
2
|
Bogl LH, Strohmaier S, Hu FB, Willett WC, Eliassen AH, Hart JE, Sun Q, Chavarro JE, Field AE, Schernhammer ES. Maternal One-Carbon Nutrient Intake and Risk of Being Overweight or Obese in Their Offspring-A Transgenerational Prospective Cohort Study. Nutrients 2024; 16:1210. [PMID: 38674900 PMCID: PMC11054902 DOI: 10.3390/nu16081210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Revised: 04/13/2024] [Accepted: 04/15/2024] [Indexed: 04/28/2024] Open
Abstract
We aimed to investigate the associations between maternal intake of folate, vitamin B12, B6, B2, methionine, choline, phosphatidylcholine and betaine during the period surrounding pregnancy and offspring weight outcomes from birth to early adulthood. These associations were examined among 2454 mother-child pairs from the Nurses' Health Study II and Growing Up Today Study. Maternal energy-adjusted nutrient intakes were derived from food frequency questionnaires. Birth weight, body size at age 5 and repeated BMI measurements were considered. Overweight/obesity was defined according to the International Obesity Task Force (<18 years) and World Health Organization guidelines (18+ years). Among other estimands, we report relative risks (RRs) for offspring ever being overweight with corresponding 95% confidence intervals across quintiles of dietary factors, with the lowest quintile as the reference. In multivariate-adjusted models, higher maternal intakes of phosphatidylcholine were associated with a higher risk of offspring ever being overweight (RRQ5vsQ1 = 1.16 [1.01-1.33] p-trend: 0.003). The association was stronger among offspring born to mothers with high red meat intake (high red meat RRQ5vsQ1 = 1.50 [1.14-1.98], p-trend: 0.001; low red meat RRQ5vsQ1 = 1.05 [0.87-1.27], p-trend: 0.46; p-interaction = 0.13). Future studies confirming the association between a higher maternal phosphatidylcholine intake during pregnancy and offspring risk of being overweight or obese are needed.
Collapse
Affiliation(s)
- Leonie H. Bogl
- Department of Epidemiology, Center for Public Health, Medical University of Vienna, 1090 Wien, Austria; (L.H.B.); (S.S.)
- School of Health Professions, Bern University of Applied Sciences, 3012 Bern, Switzerland
| | - Susanne Strohmaier
- Department of Epidemiology, Center for Public Health, Medical University of Vienna, 1090 Wien, Austria; (L.H.B.); (S.S.)
| | - Frank B. Hu
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA (J.E.C.)
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Boston, MA 02115, USA;
| | - Walter C. Willett
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA (J.E.C.)
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Boston, MA 02115, USA;
| | - A. Heather Eliassen
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA (J.E.C.)
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Boston, MA 02115, USA;
| | - Jaime E. Hart
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Boston, MA 02115, USA;
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - Qi Sun
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA (J.E.C.)
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Boston, MA 02115, USA;
| | - Jorge E. Chavarro
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA (J.E.C.)
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Boston, MA 02115, USA;
| | - Alison E. Field
- Department of Epidemiology, Brown University, Providence, RI 02903, USA
| | - Eva S. Schernhammer
- Department of Epidemiology, Center for Public Health, Medical University of Vienna, 1090 Wien, Austria; (L.H.B.); (S.S.)
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Boston, MA 02115, USA;
| |
Collapse
|
3
|
Sharma S, Bennet L, Laucyte-Cibulskiene A, Christensson A, Nilsson PM. Associations between birth weight and adult apolipoproteins: The LifeGene cohort. PLoS One 2024; 19:e0299725. [PMID: 38427666 PMCID: PMC10906835 DOI: 10.1371/journal.pone.0299725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 02/14/2024] [Indexed: 03/03/2024] Open
Abstract
BACKGROUND Early life factors may predict cardiovascular disease (CVD), but the pathways are still unclear. There is emerging evidence of an association of early life factors with apolipoproteins, which are linked to CVD. The study objective was to assess the associations between birth variables and adult apolipoproteins (apoA1 and apoB, and their ratio) in a population-based cohort. METHODS The LifeGene Study is a prospective cohort comprising index participants randomly sampled from the general population. Blood samples were collected between 2009 and 2016. In this sub-study, we used birth variables, obtained from a national registry for all participants born 1973 or later, including birth weight and gestational age, while adult CVD risk factors included age, sex, body mass index (BMI), lipids, and smoking history. We employed univariate and multivariate general linear regression to explore associations between birth variables, lipid levels and other adult CVD risk factors. The outcomes included non-fasting apoA1 and apoB and their ratio, as well as total cholesterol and triglycerides. A total of 10,093 participants with both birth information and lipoprotein levels at screening were included. Of these, nearly 42.5% were men (n = 4292) and 57.5% were women (n = 5801). RESULTS The mean (standard deviation) age of men was 30.2 (5.7) years, and for women 28.9 (5.8) years. There was an increase of 0.022 g/L in apoA1 levels per 1 kg increase in birth weight (p = 0.005) after adjusting for age, sex, BMI, gestational age, and smoking history. Similarly, there was a decrease of 0.023 g/L in apoB levels per 1 kg increase in birth weight (p<0.001) after adjusting for the same variables. There were inverse associations of birth weight with the apoB/apoA1 ratio. No independent association was found with total cholesterol, but with triglyceride levels (ẞ-coefficient (95% Confidence Interval); -0.067 (-0.114, -0.021); p-value 0.005). CONCLUSIONS Lower birth weight was associated with an adverse adult apolipoprotein pattern, i.e., a higher apoB/apoA1 ratio, indicating increased risk of future CVD manifestations. The study highlights the need of preconception care and pregnancy interventions that aim at improving maternal and child outcomes with long-term impacts for prevention of cardiovascular disease by influencing lipid levels.
Collapse
Affiliation(s)
- Shantanu Sharma
- Department of Clinical Sciences in Malmö, Lund University, Lund, Sweden
| | - Louise Bennet
- Department of Clinical Sciences in Malmö, Lund University, Lund, Sweden
- Clinical Trials Unit, Skåne University Hospital, Lund, Sweden
| | - Agne Laucyte-Cibulskiene
- Department of Clinical Sciences in Malmö, Lund University, Lund, Sweden
- Department of Nephrology, Skåne University Hospital, Malmö, Sweden
- Department of Clinical Science, Intervention and Technology, Division of Renal Medicine, Karolinska Institute, Stockholm, Sweden
| | - Anders Christensson
- Department of Clinical Sciences in Malmö, Lund University, Lund, Sweden
- Department of Nephrology, Skåne University Hospital, Malmö, Sweden
| | - Peter M. Nilsson
- Department of Clinical Sciences in Malmö, Lund University, Lund, Sweden
- Department of Internal Medicine, Research Unit, Skåne University Hospital, Malmö, Sweden
| |
Collapse
|
4
|
Ammar L, Tindle HA, Miller AM, Adgent MA, Nian H, Ryckman KK, Mogos M, Piano MR, Xie E, Snyder BM, Ramesh A, Yu C, Hartert TV, Wu P. Electronic cigarette use during pregnancy and the risk of adverse birth outcomes: A cross-sectional surveillance study of the US Pregnancy Risk Assessment Monitoring System (PRAMS) population. PLoS One 2023; 18:e0287348. [PMID: 37874824 PMCID: PMC10597477 DOI: 10.1371/journal.pone.0287348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 06/02/2023] [Indexed: 10/26/2023] Open
Abstract
BACKGROUND Research on health effects and potential harms of electronic cigarette (EC) use during pregnancy is limited. We sought to determine the risks of pregnancy EC use on pregnancy-related adverse birth outcomes and assess whether quitting ECs reduces the risks. METHODS Women with singleton live births who participated in the US Pregnancy Risk Assessment Monitoring System (PRAMS) survey study 2016-2020 were classified into four mutually exclusive groups, by their use of ECs and combustible cigarettes (CCs) during pregnancy: non-use, EC only use, CC only use, and dual use. We determined the risk of preterm birth, low birth weight, and small-for-gestational-age (SGA) by comparing cigarette users to non-users with a modified Poisson regression model adjusting for covariates. In a subset of women who all used ECs prior to pregnancy, we determined whether quitting EC use reduces the risk of preterm birth, low birth weight, and SGA by comparing to those who continued its use. All analyses were weighted to account for the PRAMS survey design and non-response rate. RESULTS Of the 190,707 women (weighted N = 10,202,413) included, 92.1% reported cigarette non-use, 0.5% EC only use, 6.7% CC only use, and 0.7% dual use during pregnancy. Compared with non-use, EC only use was associated with a significantly increased risk of preterm birth (adjusted risk ratio [aRR]: 1.29, 95% confidence interval [CI]: 1.00, 1.65) and low birth weight (aRR: 1.38, 95%CI: 1.09, 1.75), but not SGA (aRR: 1.04, 95%CI: 0.76, 1.44). Among 7,877 (weighted N = 422,533) women EC users, quitting use was associated with a significantly reduced risk of low birth weight (aRR: 0.76, 95%CI: 0.62, 0.94) and SGA (aRR: 0.77, 95%CI: 0.62, 0.94) compared to those who continued to use ECs during pregnancy. CONCLUSIONS Pregnancy EC use, by itself or dual use with CC, is associated with preterm birth and low birth weight. Quitting use reduces that risk. ECs should not be considered as a safe alternative nor a viable gestational smoking cessation strategy.
Collapse
Affiliation(s)
- Lin Ammar
- Vanderbilt University School of Medicine, Nashville, Tennessee, United States of America
| | - Hilary A. Tindle
- Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, United States of America
- The Vanderbilt Center for Tobacco, Addiction and Lifestyle, Vanderbilt University Medical Center, Nashville, Tennessee, United States of America
- Geriatric Research Education and Clinical Centers, Veterans Affairs Tennessee Valley Healthcare System, Nashville, Tennessee, United States of America
| | - Angela M. Miller
- Division of Population Health Assessment, Tennessee Department of Health, Nashville, Tennessee, United States of America
| | - Margaret A. Adgent
- Department of Health Policy, Vanderbilt University Medical Center, Nashville, Tennessee, United States of America
| | - Hui Nian
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee, United States of America
| | - Kelli K. Ryckman
- Department of Epidemiology and Biostatistics, Indiana University School of Public Health—Bloomington, Bloomington, IN, United States of America
- Department of Epidemiology, University of Iowa, Iowa City, IA, United States of America
| | - Mulubrhan Mogos
- Vanderbilt University School of Nursing, Nashville, Tennessee, United States of America
| | - Mariann R. Piano
- Vanderbilt University School of Nursing, Nashville, Tennessee, United States of America
| | - Ethan Xie
- Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, United States of America
| | - Brittney M. Snyder
- Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, United States of America
| | - Abhismitha Ramesh
- Department of Epidemiology, University of Iowa, Iowa City, IA, United States of America
| | - Chang Yu
- Division of Biostatistics, Department of Population Health, New York University Langone Health, New York University Grossman School of Medicine, New York, New York, United States of America
| | - Tina V. Hartert
- Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, United States of America
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee, United States of America
| | - Pingsheng Wu
- Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, United States of America
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee, United States of America
| |
Collapse
|
5
|
McCaffery H, Zaituna J, Busch S, Kaciroti N, Miller AL, Lumeng JC, Rosenblum KL, Gearhardt A, Pesch MH. Developmental trajectories of eating behaviors and cross-lagged associations with weight across infancy. Appetite 2023; 188:106978. [PMID: 37495177 PMCID: PMC10844930 DOI: 10.1016/j.appet.2023.106978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 07/01/2023] [Accepted: 07/17/2023] [Indexed: 07/28/2023]
Abstract
Examining typical developmental trajectories of infant eating behaviors, correlates of those trajectories, and cross-lagged associations between eating behaviors and anthropometry, is important to understand the etiology of these behaviors and their relevance to growth early in the lifespan. Mothers (N = 276) completed the Baby Eating Behavior Questionnaire (BEBQ) and infant anthropometrics were measured at ages 1, 2, 4, 6, and 10 months. Infant and maternal characteristics were collected by maternal report. Trajectories of eating behaviors were identified using latent class growth modeling and bivariate analyses examined associations of infant eating behavior trajectory membership with infant and maternal characteristics. Cross-lagged analyses examined associations between BEBQ subscales and infant weight-for-length z-score. Infant eating behavior trajectories included: Consistently High (62%) and Consistently Moderate (38%) Enjoyment of Food; Consistently High (9%), Moderate & Decreasing (43%), and Low & Decreasing (48%) Food Responsiveness; and Consistently High (62%) and Moderate & Decreasing (38%) General Appetite. Trajectory group membership was not associated with infant sex, gestational age, birthweight, or having been exclusively fed breastmilk at 2 months. Consistently High trajectories for Enjoyment of Food, Food Responsiveness, and General Appetite were associated with maternal demographic markers of psychosocial risk (e.g., lower maternal age and educational attainment). Food Responsiveness and General Appetite tracked strongly across infancy within individuals. Cross-lagged associations of Enjoyment of Food, Food Responsiveness, and General Appetite with weight-for-length z-score across infancy were generally null. Much additional work is needed to understand eating behaviors in infancy, their development, and their etiology. Further understanding of infant eating behaviors will provide the basis for future interventions to improve life course nutrition, growth, and health.
Collapse
Affiliation(s)
- Harlan McCaffery
- Division of Developmental and Behavioral Pediatrics, Department of Pediatrics, University of Michigan, Ann Arbor, MI, USA
| | - Julie Zaituna
- Division of Developmental and Behavioral Pediatrics, Department of Pediatrics, University of Michigan, Ann Arbor, MI, USA
| | - Sophie Busch
- School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Niko Kaciroti
- Division of Developmental and Behavioral Pediatrics, Department of Pediatrics, University of Michigan, Ann Arbor, MI, USA
| | - Alison L Miller
- School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Julie C Lumeng
- Division of Developmental and Behavioral Pediatrics, Department of Pediatrics, University of Michigan, Ann Arbor, MI, USA; School of Public Health, University of Michigan, Ann Arbor, Michigan, USA.
| | | | - Ashley Gearhardt
- Department of Psychology, College of Literature, Science, and the Arts, University of Michigan, Ann Arbor, MI, USA
| | - Megan H Pesch
- Division of Developmental and Behavioral Pediatrics, Department of Pediatrics, University of Michigan, Ann Arbor, MI, USA
| |
Collapse
|
6
|
Nilsson PM. Birth weight and hypertension: nature or nurture? J Hypertens 2023; 41:909-911. [PMID: 37139694 DOI: 10.1097/hjh.0000000000003443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Affiliation(s)
- Peter M Nilsson
- Department of Clinical Sciences, Lund University, Skane University Hospital, Malmo, Sweden
| |
Collapse
|
7
|
Peter-Marske KM, Hesketh KR, Herring AH, Savitz DA, Bradley CB, Evenson KR. Association Between Change in Physical Activity During Pregnancy and Infant Birth Weight. Matern Child Health J 2023; 27:659-670. [PMID: 36738421 PMCID: PMC10023475 DOI: 10.1007/s10995-023-03604-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/18/2023] [Indexed: 02/05/2023]
Abstract
OBJECTIVE We assessed whether total, recreational, and non-recreational physical activity (PA) assessed twice during pregnancy, and its change, were associated with infant birth weight and small for gestational age (SGA). METHODS We included 1467 Pregnancy, Infection, and Nutrition 3 Study participants who self-reported PA at time 1 (T1: 17-22 weeks' gestation) and time 2 (T2: 27-30 weeks' gestation). We assessed last week absolute intensities of PA (moderate: 4.7-7.1 METs; and vigorous: > 7.1 METs) and perceived intensities. Change in hours/week of PA was assessed continuously or categorically (increase or decrease ≥ 1 hour, and no change). Associations of continuous PA hours/week at T1, T2, and its change, with sex-specific z-scores of birth weight, were assessed using multivariable linear robust regressions. We used logistic regressions to assess categorical PA measures with SGA. Models were adjusted for adequacy of maternal weight gain, general health, maternal age, parity, race/ethnicity, and smoking. RESULTS Hours/week of total and recreational absolute intensities of PA at T1, T2, and its change were generally not associated with birth weight, although two measures of non-recreational PA at T2 and its change were associated with increased birth weight. Perceived intensities of PA (at T1, T2, and its change) were largely not associated with sex-specific z-scores of infant birth weight. Absolute and perceived intensity PA were not associated with SGA. CONCLUSIONS FOR PRACTICE In this observational cohort, increases and decreases in PA during pregnancy were not associated with differential changes in birthweight or SGA.
Collapse
Affiliation(s)
- Kennedy M Peter-Marske
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| | - Kathryn R Hesketh
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | | | | | - Chyrise B Bradley
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Kelly R Evenson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| |
Collapse
|
8
|
Spry EA, Olsson CA, Aarsman SR, Mohamad Husin H, Macdonald JA, Dashti SG, Moreno-Betancur M, Letcher P, Biden EJ, Thomson KC, McAnally H, Greenwood CJ, Middleton M, Hutchinson DM, Carlin JB, Patton GC. Parental personality and early life ecology: a prospective cohort study from preconception to postpartum. Sci Rep 2023; 13:3332. [PMID: 36849463 PMCID: PMC9971123 DOI: 10.1038/s41598-023-29139-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 01/31/2023] [Indexed: 03/01/2023] Open
Abstract
Personality reliably predicts life outcomes ranging from social and material resources to mental health and interpersonal capacities. However, little is known about the potential intergenerational impact of parent personality prior to offspring conception on family resources and child development across the first thousand days of life. We analysed data from the Victorian Intergenerational Health Cohort Study (665 parents, 1030 infants; est. 1992), a two-generation study with prospective assessment of preconception background factors in parental adolescence, preconception personality traits in young adulthood (agreeableness, conscientiousness, emotional stability, extraversion, and openness), and multiple parental resources and infant characteristics in pregnancy and after the birth of their child. After adjusting for pre-exposure confounders, both maternal and paternal preconception personality traits were associated with numerous parental resources and attributes in pregnancy and postpartum, as well as with infant biobehavioural characteristics. Effect sizes ranged from small to moderate when considering parent personality traits as continuous exposures, and from small to large when considering personality traits as binary exposures. Young adult personality, well before offspring conception, is associated with the perinatal household social and financial context, parental mental health, parenting style and self-efficacy, and temperamental characteristics of offspring. These are pivotal aspects of early life development that ultimately predict a child's long-term health and development.
Collapse
Affiliation(s)
- Elizabeth A. Spry
- grid.1021.20000 0001 0526 7079Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, Australia ,grid.1058.c0000 0000 9442 535XCentre for Adolescent Health, Murdoch Children’s Research Institute, Royal Children’s Hospital, Melbourne, Australia ,grid.1008.90000 0001 2179 088XDepartment of Paediatrics, University of Melbourne, Melbourne, Australia ,grid.1021.20000 0001 0526 7079Centre for Social and Early Emotional Development, Faculty of Health, Deakin University, 221 Burwood Highway, Burwood, VIC 3125 Australia
| | - Craig A. Olsson
- grid.1021.20000 0001 0526 7079Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, Australia ,grid.1058.c0000 0000 9442 535XCentre for Adolescent Health, Murdoch Children’s Research Institute, Royal Children’s Hospital, Melbourne, Australia ,grid.1008.90000 0001 2179 088XDepartment of Paediatrics, University of Melbourne, Melbourne, Australia
| | - Stephanie R. Aarsman
- grid.1021.20000 0001 0526 7079Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, Australia ,grid.1058.c0000 0000 9442 535XCentre for Adolescent Health, Murdoch Children’s Research Institute, Royal Children’s Hospital, Melbourne, Australia
| | - Hanafi Mohamad Husin
- grid.1058.c0000 0000 9442 535XCentre for Adolescent Health, Murdoch Children’s Research Institute, Royal Children’s Hospital, Melbourne, Australia
| | - Jacqui A. Macdonald
- grid.1021.20000 0001 0526 7079Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, Australia ,grid.1058.c0000 0000 9442 535XCentre for Adolescent Health, Murdoch Children’s Research Institute, Royal Children’s Hospital, Melbourne, Australia ,grid.1008.90000 0001 2179 088XDepartment of Paediatrics, University of Melbourne, Melbourne, Australia
| | - S. Ghazaleh Dashti
- grid.1008.90000 0001 2179 088XDepartment of Paediatrics, University of Melbourne, Melbourne, Australia ,grid.1058.c0000 0000 9442 535XClinical Epidemiology and Biostatistics Unit, Murdoch Children’s Research Institute, Royal Children’s Hospital, Melbourne, Australia
| | - Margarita Moreno-Betancur
- grid.1008.90000 0001 2179 088XDepartment of Paediatrics, University of Melbourne, Melbourne, Australia ,grid.1058.c0000 0000 9442 535XClinical Epidemiology and Biostatistics Unit, Murdoch Children’s Research Institute, Royal Children’s Hospital, Melbourne, Australia
| | - Primrose Letcher
- grid.1021.20000 0001 0526 7079Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, Australia ,grid.1058.c0000 0000 9442 535XCentre for Adolescent Health, Murdoch Children’s Research Institute, Royal Children’s Hospital, Melbourne, Australia ,grid.1008.90000 0001 2179 088XDepartment of Paediatrics, University of Melbourne, Melbourne, Australia
| | - Ebony J. Biden
- grid.1021.20000 0001 0526 7079Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, Australia ,grid.1058.c0000 0000 9442 535XCentre for Adolescent Health, Murdoch Children’s Research Institute, Royal Children’s Hospital, Melbourne, Australia
| | - Kimberly C. Thomson
- grid.1021.20000 0001 0526 7079Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, Australia ,grid.17091.3e0000 0001 2288 9830Human Early Learning Partnership, School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, Canada ,grid.498772.7Centre for Health Evaluation and Outcome Sciences, Providence Health Care Research Institute, Vancouver, Canada
| | - Helena McAnally
- grid.29980.3a0000 0004 1936 7830Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - Christopher J. Greenwood
- grid.1021.20000 0001 0526 7079Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, Australia ,grid.1058.c0000 0000 9442 535XCentre for Adolescent Health, Murdoch Children’s Research Institute, Royal Children’s Hospital, Melbourne, Australia ,grid.1008.90000 0001 2179 088XDepartment of Paediatrics, University of Melbourne, Melbourne, Australia
| | - Melissa Middleton
- grid.1008.90000 0001 2179 088XDepartment of Paediatrics, University of Melbourne, Melbourne, Australia ,grid.1058.c0000 0000 9442 535XClinical Epidemiology and Biostatistics Unit, Murdoch Children’s Research Institute, Royal Children’s Hospital, Melbourne, Australia
| | - Delyse M. Hutchinson
- grid.1021.20000 0001 0526 7079Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, Australia ,grid.1058.c0000 0000 9442 535XCentre for Adolescent Health, Murdoch Children’s Research Institute, Royal Children’s Hospital, Melbourne, Australia ,grid.1008.90000 0001 2179 088XDepartment of Paediatrics, University of Melbourne, Melbourne, Australia ,grid.1005.40000 0004 4902 0432National Drug and Alcohol Research Centre, Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - John B. Carlin
- grid.1008.90000 0001 2179 088XDepartment of Paediatrics, University of Melbourne, Melbourne, Australia ,grid.1058.c0000 0000 9442 535XClinical Epidemiology and Biostatistics Unit, Murdoch Children’s Research Institute, Royal Children’s Hospital, Melbourne, Australia
| | - George C. Patton
- grid.1058.c0000 0000 9442 535XCentre for Adolescent Health, Murdoch Children’s Research Institute, Royal Children’s Hospital, Melbourne, Australia ,grid.1008.90000 0001 2179 088XDepartment of Paediatrics, University of Melbourne, Melbourne, Australia
| |
Collapse
|
9
|
Magalhães EIDS, Lima NP, Menezes AMB, Gonçalves H, Wehrmeister FC, Assunção MCF, Horta BL. Maternal smoking during pregnancy and birthweight on the third generation: results from two birth cohort studies. Eur J Pediatr 2023; 182:2095-2104. [PMID: 36813908 DOI: 10.1007/s00431-023-04888-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 02/03/2023] [Accepted: 02/16/2023] [Indexed: 02/24/2023]
Abstract
UNLABELLED The purpose of this research is to investigate whether grandmother's smoking during pregnancy reduces the grandchildren's birthweight and whether maternal smoking during pregnancy modified this association. We also evaluated the effect of duration and intensity of smoking. This study included data from three generations from two birth cohorts carried out in Pelotas, a southern Brazilian city: women enrolled in the perinatal study in the 1982 and 1993 cohorts (G1); daughters (G2) of those G1 mothers who were followed to adulthood; and first children (G3) born from G2 women. Information on maternal smoking during pregnancy was obtained from women (G1) shortly after delivery of the two cohorts and from G2 in the follow-up in adulthood of the 1993 cohort. Mothers (G2) reported G3 birthweight during the follow-up visit at adulthood. Multiple linear regression was used to obtain effect measures adjusted for confounders. The study included 1602 grandmothers (G1), mothers (G2), and grandchildren (G3). Prevalence of maternal (G1) smoking during pregnancy was 43% and mean G3 birthweight was 3118.9 g (SD: 608.8). Grandmother's smoking in the pregnancy was not associated with grandchild's birthweight. However, offspring of both G1 and G2 smokers had lower mean birthweight than those whose mother and grandmother did not smoke (adjusted β: - 223.05; 95% CI: - 415.16, - 32.76). CONCLUSION No significant association was observed between grandmother's smoking in the pregnancy and grandchild's birthweight. But it seems that grandmother's smoking in pregnancy has an effect on grandchild's birthweight when the mother also smoked in the pregnancy. . WHAT IS KNOWN • Most studies on the association of maternal tobacco smoking in pregnancy with offspring birthweight have been restricted to two generations, and an inverse association is well known. WHAT IS NEW • Besides to investigate whether grandmother's smoking during pregnancy reduces the grandchildren's birthweight, we examined whether this association varied according to maternal smoking during pregnancy.
Collapse
Affiliation(s)
- Elma Izze da Silva Magalhães
- Postgraduate Programme in Epidemiology, Federal University of Pelotas, Rua Marechal Deodoro, 1160, 3º piso, Centro, Pelotas, Rio Grande do Sul (RS), 96020-220, Brazil.
| | - Natália Peixoto Lima
- Postgraduate Programme in Epidemiology, Federal University of Pelotas, Rua Marechal Deodoro, 1160, 3º piso, Centro, Pelotas, Rio Grande do Sul (RS), 96020-220, Brazil
| | - Ana Maria Baptista Menezes
- Postgraduate Programme in Epidemiology, Federal University of Pelotas, Rua Marechal Deodoro, 1160, 3º piso, Centro, Pelotas, Rio Grande do Sul (RS), 96020-220, Brazil
| | - Helen Gonçalves
- Postgraduate Programme in Epidemiology, Federal University of Pelotas, Rua Marechal Deodoro, 1160, 3º piso, Centro, Pelotas, Rio Grande do Sul (RS), 96020-220, Brazil
| | - Fernando C Wehrmeister
- Postgraduate Programme in Epidemiology, Federal University of Pelotas, Rua Marechal Deodoro, 1160, 3º piso, Centro, Pelotas, Rio Grande do Sul (RS), 96020-220, Brazil
| | - Maria Cecília Formoso Assunção
- Postgraduate Programme in Epidemiology, Federal University of Pelotas, Rua Marechal Deodoro, 1160, 3º piso, Centro, Pelotas, Rio Grande do Sul (RS), 96020-220, Brazil
| | - Bernardo Lessa Horta
- Postgraduate Programme in Epidemiology, Federal University of Pelotas, Rua Marechal Deodoro, 1160, 3º piso, Centro, Pelotas, Rio Grande do Sul (RS), 96020-220, Brazil
| |
Collapse
|
10
|
Unisa S, Dhillon P, Anand E, Sahoo H, Agarwal PK. Data quality of birthweight reporting in India: Evidence from cross-sectional surveys and service statistics. SSM Popul Health 2022; 19:101220. [PMID: 36160303 PMCID: PMC9493382 DOI: 10.1016/j.ssmph.2022.101220] [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: 01/27/2022] [Revised: 08/28/2022] [Accepted: 08/29/2022] [Indexed: 11/28/2022] Open
Abstract
The study aims to assess the quality of birthweight data collected in two surveys, including the National Family Health Survey (NFHS) and the Comprehensive National Nutrition Survey (CNNS), and as reported in the statistics from the Health Management Information System (HMIS). The study also aims to assess the implications of the data on the estimates of low birthweight (LBW). The percentage of newborns whose birthweight is missing continues to be high in the recent surveys (NFHS-4: 22%, CNNS: 30%) despite an improvement from 66% in NFHS-3. The under-coverage of birthweight data in HMIS is around 40%. In the surveys, the percentage of missing data on birthweight is higher among newborns belonging to poor households, Scheduled Tribes, and Scheduled Castes. Irrespective of whether birthweights are reported from the health cards or from mother's recall, there's a high reporting at multiples of 500g and heaping at 2,500g. The prevalence of missing data on birthweight and of heaping is higher among children born at home in comparison to facility-based births. Birthweight data of dead children who were more likely to have had a lower birthweight is highly underreported. The paper demonstrates state-level variations in birthweight reporting and inconsistencies across surveys and HMIS. In 2015–16, the prevalence of LBW as per HMIS data was 12.5%, whereas during the same period, NFHS-4 and CNNS reported a prevalence of 18%. The findings suggest that LBW is likely to be underestimated when missing data as well as heaping at 2,500g are highly prevalent. To generate robust LBW estimates in India, there is an urgent need to devise methods to ensure coverage of all live births (including early neo-natal deaths) as well as the stillbirths, irrespective of the facility where the deliveries take place. Birthweight data in India is highly incomplete, which led to an underestimation of LBW prevalence. Live births from lower socio-economic groups have significant missing birthweight data. HMIS underreports birthweight data and gives lower LBW estimates than surveys. Reported data from both cards and recall show the heaping pattern that further reduces LBW. Programmatic efforts to improve the quality of birthweight data are needed to get robust LBW estimates.
Collapse
Affiliation(s)
- Sayeed Unisa
- Dept. of Biostatistics and Epidemiology, International Institute for Population Sciences (IIPS), Mumbai, India
| | - Preeti Dhillon
- Dept. of Survey Research and Data Analytics, IIPS, Mumbai, India
| | - Enu Anand
- Doctoral Fellow, IIPS, Mumbai, India
| | - Harihar Sahoo
- Dept. of Family and Generations, IIPS, Mumbai, India
| | | |
Collapse
|
11
|
Odjidja EN, Ansah-Akrofi R, Iradukunda A, Kwanin C, Saha M. The effect of health financing reforms on incidence and management of childhood infections in Ghana: a matching difference in differences impact evaluation. BMC Public Health 2022; 22:1494. [PMID: 35932052 PMCID: PMC9354374 DOI: 10.1186/s12889-022-13934-y] [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: 05/01/2022] [Accepted: 08/01/2022] [Indexed: 11/10/2022] Open
Abstract
Introduction In 2003, Ghana abolished direct out of pockets payments and implemented health financing reforms including the national health insurance scheme in 2004. Treatment of childhood infections is a key component of services covered under this scheme, yet, outcomes on incidence and treatment of these infections after introducing these reforms have not been covered in evaluation studies. This study fills this gap by assessing the impact on the reforms on the two most dominant childhood infections; fever (malaria) and diarrhoea. Methods Nigeria was used as the control country with pre-intervention period of 1990 and 2003 and 1993 and 1998 in Ghana. Post-intervention period was 2008 and 2014 in Ghana and 2008 and 2018 in Nigeria. Data was acquired from demographic health surveys in both countries and propensity score matching was calculated based on background socioeconomic covariates. Following matching, difference in difference analysis was conducted to estimate average treatment on the treated effects. All analysis were conducted in STATA (psmatch2, psgraph and pstest) and statistical significance was considered when p-value ≤ 0.05. Results After matching, it was determined that health reforms significantly increased general medical care for children with diarrhoea (25 percentage points) and fever (40 percentage points). Also for those receiving care specifically in government managed facilities for diarrhoea (14 percentage points) and fever (24 percentage points). Conclusions Introduction of health financing reforms in Ghana had positive effects on childhood infections (malaria and diarrhoea).
Collapse
Affiliation(s)
- Emmanuel Nene Odjidja
- Department of Monitoring and Evaluation, Kigutu Village Health Works, Kirungu, Burundi.
| | - Ruth Ansah-Akrofi
- Department of Statistics and Computer Science, University of Ghana, Accra, Ghana
| | | | - Charles Kwanin
- Ghana Health Service, University of Geneva, Geneva, Switzerland
| | - Manika Saha
- Faculty of Information Technology, Monash University, Melbourne, Australia
| |
Collapse
|
12
|
Sanjeevi N, Freeland-Graves JH. Birth weight and prediabetes in a nationally representative sample of US adolescents. Clin Obes 2022; 12:e12504. [PMID: 34951120 DOI: 10.1111/cob.12504] [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: 09/21/2021] [Revised: 11/24/2021] [Accepted: 12/08/2021] [Indexed: 11/28/2022]
Abstract
Prediabetes affects about 20% of adolescents in the United States. Previous studies have shown that low and high birth weight impairs glucose homeostasis in adults; however, limited research has examined this relationship in adolescents. To investigate association of birthweight with prediabetes in US adolescents using data from NHANES 2005-2016 and examine whether sex and obesity moderate this relationship. Adolescents, aged 12-15 years without diagnosed/undiagnosed diabetes and extreme birthweight (n = 1396), were classified as low birth weight (LBW), normal birthweight (NBW) and high birth weight (HBW). Logistic regression examined relationship of birthweight with odds of prediabetes. Likelihood ratio test tested interactions of birthweight with sex and obesity measures. In this nationally representative cross-sectional study, LBW adolescents had significantly higher odds of prediabetes compared to NBW counterparts (Odds ratio [95% confidence interval] = 1.93 (1.10, 3.38); p < .05). Sex and obesity moderated the association, such that the strength of the relationship of LBW with increased prediabetes odds was greater among male adolescents (Odds ratio [95% confidence interval] = 2.40 (1.02, 5.67); p < .05) and those with overweight/obesity (Odds ratio [95% confidence interval] = 2.13 (1.01, 4.49); p < .05). Findings imply that the adverse effects of LBW on glucose homeostasis could be manifested early in life. Further, the higher odds of prediabetes among LBW adolescents who are male or have overweight/obesity underscore the heightened need for prediabetes screening of these subgroups.
Collapse
Affiliation(s)
- Namrata Sanjeevi
- Department of Nutritional Sciences, The University of Texas at Austin, Austin, Texas, USA
| | - Jeanne H Freeland-Graves
- Bess Heflin Centennial Professor in Nutritional Sciences, The University of Texas at Austin, Austin, Texas, USA
| |
Collapse
|
13
|
Validation of birth certificate and maternal recall of events in labor and delivery with medical records in the Iowa health in pregnancy study. BMC Pregnancy Childbirth 2022; 22:232. [PMID: 35317778 PMCID: PMC8939232 DOI: 10.1186/s12884-022-04581-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 03/14/2022] [Indexed: 02/02/2023] Open
Abstract
Background Epidemiological research of events related to labor and delivery frequently uses maternal interview or birth certificates as a primary method of data collection; however, the validity of these data are rarely confirmed. This study aimed to examine the validity of birth certificate data and maternal interview of maternal demographics and events related to labor and delivery with data abstracted from medical records in a US setting. Methods Birth certificate and maternal recall data from the Iowa Health in Pregnancy Study (IHIPS), a population-based case-control study of risk factors for preterm and small-for-gestational age births, were linked to medical record data to assess the validity of events that occurred during labor and delivery along with reported maternal demographics. Sensitivity, specificity, positive and negative predictive values, and kappa scores were calculated. Results Postpartum maternal recall and birth certificate data were excellent for infant characteristics (birth weight, gestational age, infant sex) and variables related to labor and delivery (mode of delivery) when compared with medical records. Birth certificate data for labor induction had low sensitivity (46.3%) and positive predictive value (18.3%) compared to medical records. Compared to maternal interview, birth certificate data also had poor agreement for smoking and alcohol use during pregnancy. Agreement between all three methods of data collection was very low for pregnancy weight gain (kappa = 0.07-0.08). Conclusions Maternal interview and birth certificate data can be a valid source for collecting data on infant characteristics and events that occurred during labor and delivery. However, caution should be used if solely using birth certificate data to gather data on maternal demographic and/or lifestyle factors.
Collapse
|
14
|
Bowatte G, Bui DS, Priyankara S, Lowe AJ, Perret JL, Lodge CJ, Hamilton GS, Erbas B, Thomas P, Thompson B, Schlünssen V, Martino D, Holloway JW, Svanes C, Abramson MJ, Walters EH, Dharmage SC. Parental preconception BMI trajectories from childhood to adolescence and asthma in the future offspring. J Allergy Clin Immunol 2022; 150:67-74.e30. [PMID: 35007625 DOI: 10.1016/j.jaci.2021.11.028] [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: 05/03/2021] [Revised: 10/12/2021] [Accepted: 11/24/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND Recent evidence suggests that parental exposures before conception can increase the risk of asthma in offspring. OBJECTIVE We investigated the association between parental preconception Body Mass Index (BMI) trajectories from childhood to adolescence and subsequent risk of asthma in their offspring. METHODS Using group-based trajectory modeling from the Tasmanian Longitudinal Health Study (TAHS), we identified BMI trajectories for index participants (parents) when aged 4 to 15 years. Multinomial regression models adjusted for potential confounders were utilized to estimate the association between these early-life parental BMI trajectories and asthma phenotypes in their subsequent offspring. RESULTS The main analysis included 1822 parents and 4208 offspring. Four BMI trajectories from age 4 to 15 years were identified as the best fitting model: "low" (8.8%); "normal" (44.1%); "above normal" (40.2%); and "high" (7.0%). Associations were observed between father's "high" BMI trajectory and risk of asthma in offspring before the age of 10 years (RRR=1.70, 95%CI 0.98, 2.93) and also asthma ever (RRR=1.72, 95%CI 1.00, 2.97), especially allergic asthma ever (RRR=2.05, 95%CI 1.12, 3.72). These associations were not mediated by offspring birth weight. No associations were observed for maternal BMI trajectories and offspring asthma phenotypes. CONCLUSION This cohort study over six decades of life and across two generations suggests that the "high BMI" trajectory in fathers, well before conception, increased the risk of asthma in their offspring.
Collapse
Affiliation(s)
- Gayan Bowatte
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia; Department of Basic Sciences, Faculty of Allied Health Sciences, University of Peradeniya, Peradeniya, Sri Lanka
| | - Dinh S Bui
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Sajith Priyankara
- Department of Basic Sciences, Faculty of Allied Health Sciences, University of Peradeniya, Peradeniya, Sri Lanka; Department of Mathematics & Statistics, Texas Tech University, Lubbock, Tex
| | - Adrian J Lowe
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Jennifer L Perret
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Caroline J Lodge
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Garun S Hamilton
- Monash Lung, Sleep, Allergy and Immunology, Monash Health, Clayton, Australia; School of Clinical Sciences, Monash University, Melbourne, Australia
| | - Bircan Erbas
- School of Psychology and Public Health, La Trobe University, Bundoora, Australia
| | - Paul Thomas
- Prince of Wales' Clinical School, Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Bruce Thompson
- School of Health Sciences, Swinburne University of Technology, Melbourne, Australia
| | - Vivi Schlünssen
- Department of Public Health, Danish Ramazzini Center, Aarhus University and the National Research Center for the Working Environment, Copenhagen, Denmark
| | - David Martino
- Wal-yan Respiratory Research Centre, Telethon Kids Institute, The University of Western Australia, Perth, Australia
| | - John W Holloway
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Cecilie Svanes
- Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway; Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway
| | - Michael J Abramson
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - E Haydn Walters
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia; School of Medicine, University of Tasmania, Hobart, Australia
| | - Shyamali C Dharmage
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia.
| |
Collapse
|
15
|
Everett BG, Limburg A, Homan P, Philbin MM. Structural Heteropatriarchy and Birth Outcomes in the United States. Demography 2021; 59:89-110. [PMID: 34779481 DOI: 10.1215/00703370-9606030] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Emerging evidence links structural sexism and structural discrimination against lesbian, gay, and bisexual (LGB) populations to poor health outcomes, but studies have yet to examine the combined effects of these mutually reinforcing systems of inequality. Therefore, we developed a composite measure of structural heteropatriarchy-which includes state-level LGB policies, family planning policies, and indicators of structural sexism (e.g., women's political and economic position relative to men)-and examined its relationship to birth outcomes using data from Waves I to V of the National Longitudinal Study of Adolescent to Adult Health. Multivariate regression analyses demonstrated that higher levels of heteropatriarchy were associated with an increased risk of preterm birth and decreased birth weight, net of important covariates. There was no association between clinical low birth weight and heteropatriarchy, or interactions between heteropatriarchy and individuals' race, ethnicity or sexual identity, suggesting a negative effect of heteropatriarchy on birth outcomes for all pregnant people. This study demonstrates the importance of considering gender and sexuality as mutually reinforcing systems of oppression that impact population health. Future research should examine the impact of heteropatriarchy on additional health outcomes and in conjunction with other structural inequalities such as racism and transgender oppression.
Collapse
Affiliation(s)
- Bethany G Everett
- Department of Sociology, University of Utah, Salt Lake City, UT, USA
| | - Aubrey Limburg
- Department of Sociology and Institute of Behavioral Science, University of Colorado Boulder, Boulder, CO, USA
| | - Patricia Homan
- Department of Sociology, Center for Demography and Population Health, and Pepper Institute on Aging and Public Policy, Florida State University, Tallahassee, FL, USA
| | - Morgan M Philbin
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| |
Collapse
|
16
|
Kushnick G, Behie A, Zuska F. Pregnancy outcomes among evacuees of the Sinabung volcano, 2010-2018 (North Sumatra, Indonesia): A matched cohort study. Am J Hum Biol 2021; 34:e23628. [PMID: 34137486 DOI: 10.1002/ajhb.23628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 05/20/2021] [Accepted: 05/22/2021] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVES Exposure to natural disasters during pregnancy is associated with adverse birth outcomes and increased probability of female births. Nonetheless, relatively little work has been done on evacuations of women living in close vicinity to volcanic eruptions. We conducted a retrospective cohort study among women from villages near the Sinabung volcano in North Sumatra, Indonesia, which has been active since 2010. METHODS We compared an "exposed" sample of women (n = 97) who were pregnant when forced to evacuate their villages due to the volcanic eruptions and an "unexposed" sample of non-evacuees (n = 97) matched for age and year of child's birth. We collected anthropometric data (height and weight of each woman) and conducted structured interviews about pregnancy outcomes and evacuation-related stress. RESULTS Evacuation led to an almost five-fold increase in the adjusted odds of having an early or preterm birth in non-imputed (OR = 4.84, 95% CI: 1.31-17.92) and multiply imputed (OR = 4.84, 95% CI: 1.29-19.19) analyses. It also led to approximately a 1 cm decrease in birth length in the non-imputed (β = -1.10, 95% CI: -1.96-0.24) and multiply imputed (β = -1.17, 95% CI: -1.20-0.36) analyses, both including controls for confounders. We found decreasing birth length with increasing stress among evacuees. There was no discernible effect of evacuation or stress on the other outcomes. CONCLUSIONS Both adverse effects we documented can exert negative influences on later-in-life outcomes for children of women pregnant during evacuation. This should be considered when developing protocols for supporting women and connecting them with clinical resources when evacuated from natural disasters.
Collapse
Affiliation(s)
- Geoff Kushnick
- Human Behavioural Ecology Research Group, School of Archaeology and Anthropology, Australian National University, Canberra, Australia
| | - Alison Behie
- Human Behavioural Ecology Research Group, School of Archaeology and Anthropology, Australian National University, Canberra, Australia
| | - Fikarwin Zuska
- Departemen Antropologi, Fakultas Ilmu Sosial dan Ilmu Politik, Universitas Sumatera Utara, Medan
| |
Collapse
|
17
|
Kong S, Day LT, Zaman SB, Peven K, Salim N, Sunny AK, Shamba D, Rahman QSU, K.C. A, Ruysen H, El Arifeen S, Mee P, Gladstone ME, Blencowe H, Lawn JE. Birthweight: EN-BIRTH multi-country validation study. BMC Pregnancy Childbirth 2021; 21:240. [PMID: 33765936 PMCID: PMC7995711 DOI: 10.1186/s12884-020-03355-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Accurate birthweight is critical to inform clinical care at the individual level and tracking progress towards national/global targets at the population level. Low birthweight (LBW) < 2500 g affects over 20.5 million newborns annually. However, data are lacking and may be affected by heaping. This paper evaluates birthweight measurement within the Every Newborn Birth Indicators Research Tracking in Hospitals (EN-BIRTH) study. METHODS The EN-BIRTH study took place in five hospitals in Bangladesh, Nepal and Tanzania (2017-2018). Clinical observers collected time-stamped data (gold standard) for weighing at birth. We compared accuracy for two data sources: routine hospital registers and women's report at exit interview survey. We calculated absolute differences and individual-level validation metrics. We analysed birthweight coverage and quality gaps including timing and heaping. Qualitative data explored barriers and enablers for routine register data recording. RESULTS Among 23,471 observed births, 98.8% were weighed. Exit interview survey-reported weighing coverage was 94.3% (90.2-97.3%), sensitivity 95.0% (91.3-97.8%). Register-reported coverage was 96.6% (93.2-98.9%), sensitivity 97.1% (94.3-99%). Routine registers were complete (> 98% for four hospitals) and legible > 99.9%. Weighing of stillbirths varied by hospital, ranging from 12.5-89.0%. Observed LBW rate was 15.6%; survey-reported rate 14.3% (8.9-20.9%), sensitivity 82.9% (75.1-89.4%), specificity 96.1% (93.5-98.5%); register-recorded rate 14.9%, sensitivity 90.8% (85.9-94.8%), specificity 98.5% (98-99.0%). In surveys, "don't know" responses for birthweight measured were 4.7%, and 2.9% for knowing the actual weight. 95.9% of observed babies were weighed within 1 h of birth, only 14.7% with a digital scale. Weight heaping indices were around two-fold lower using digital scales compared to analogue. Observed heaping was almost 5% higher for births during the night than day. Survey-report further increased observed birthweight heaping, especially for LBW babies. Enablers to register birthweight measurement in qualitative interviews included digital scale availability and adequate staffing. CONCLUSIONS Hospital registers captured birthweight and LBW prevalence more accurately than women's survey report. Even in large hospitals, digital scales were not always available and stillborn babies not always weighed. Birthweight data are being captured in hospitals and investment is required to further improve data quality, researching of data flow in routine systems and use of data at every level.
Collapse
Affiliation(s)
- Stefanie Kong
- Centre for Maternal, Adolescent, Reproductive & Child Health (MARCH), London School of Hygiene & Tropical Medicine (LSHTM), London, UK
| | - Louise T. Day
- Centre for Maternal, Adolescent, Reproductive & Child Health (MARCH), London School of Hygiene & Tropical Medicine (LSHTM), London, UK
| | - Sojib Bin Zaman
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Kimberly Peven
- Centre for Maternal, Adolescent, Reproductive & Child Health (MARCH), London School of Hygiene & Tropical Medicine (LSHTM), London, UK
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King’s College London, London, UK
| | - Nahya Salim
- Department of Paediatrics and Child Health, Muhimbili University of Health and Allied Sciences (MUHAS), Dar Es Salaam, Tanzania
- Department of Health Systems, Impact Evaluation and Policy, Ifakara Health Institute (IHI), Dar es Salaam, Tanzania
| | | | - Donat Shamba
- Department of Health Systems, Impact Evaluation and Policy, Ifakara Health Institute (IHI), Dar es Salaam, Tanzania
| | - Qazi Sadeq-ur Rahman
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Ashish K.C.
- Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
| | - Harriet Ruysen
- Centre for Maternal, Adolescent, Reproductive & Child Health (MARCH), London School of Hygiene & Tropical Medicine (LSHTM), London, UK
| | - Shams El Arifeen
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Paul Mee
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Public Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Miriam E. Gladstone
- Centre for Maternal, Adolescent, Reproductive & Child Health (MARCH), London School of Hygiene & Tropical Medicine (LSHTM), London, UK
| | - Hannah Blencowe
- Centre for Maternal, Adolescent, Reproductive & Child Health (MARCH), London School of Hygiene & Tropical Medicine (LSHTM), London, UK
| | - Joy E. Lawn
- Centre for Maternal, Adolescent, Reproductive & Child Health (MARCH), London School of Hygiene & Tropical Medicine (LSHTM), London, UK
| |
Collapse
|
18
|
Bjelland EK, Gran JM, Hofvind S, Eskild A. The association of birthweight with age at natural menopause: a population study of women in Norway. Int J Epidemiol 2021; 49:528-536. [PMID: 31633179 PMCID: PMC7266529 DOI: 10.1093/ije/dyz207] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/10/2019] [Indexed: 11/13/2022] Open
Abstract
Background Previous studies suggest that birthweight may influence age at natural menopause, but the evidence remains inconclusive. Thus, we aimed to estimate the association of birthweight with age at natural menopause. Methods A retrospective population study of 164 608 women in Norway, aged 48–71 years. Data were obtained by two self-administered questionnaires among participants in BreastScreen Norway during 2006–2014. We used Cox proportional hazard models to estimate hazard ratios and logistic regression models to estimate odds ratios of menopause according to birthweight. Restricted cubic splines were applied to allow for possible non-linear associations, and adjustments were made for year and country of birth. Results Women with birthweight <2500 g were median 51 years at menopause (interquartile range 49–54 years), whereas women with birthweight 3500–3999 g were median 52 years at menopause (interquartile range 49–54 years). The hazard ratio of menopause decreased with increasing birthweight up until 3500 g. At birthweights >3500 g, we estimated no further decrease (P for non-linearity = 0.007). Birthweight at 2500 g increased the odds ratios of menopause before the age of 45 [1.20; 95% confidence interval (CI): 1.14–1.25] and the age of 40 (1.26; 95% CI: 1.15–1.38) compared with birthweight at 3500 g. At birthweights 4000 g and 4500 g, the odds ratio estimates were very similar to the reference group and the CIs overlapped 1.00. Conclusions We found a non-linear dose-relationship of birthweight with age at natural menopause, and low birthweight was associated with early natural menopause. Our findings suggest that growth restriction during fetal life may influence the timing of natural menopause.
Collapse
Affiliation(s)
- Elisabeth K Bjelland
- Department of Obstetrics and Gynecology, Akershus University Hospital, Lørenskog, Norway
| | - Jon M Gran
- Oslo Centre for Biostatistics and Epidemiology, University of Oslo and Oslo University Hospital, Oslo, Norway
| | - Solveig Hofvind
- Department of Mammography Screening, Cancer Registry of Norway, Oslo, Norway.,Department of Life Sciences and Health, Faculty of Health Science, Oslo Metropolitan University, Oslo, Norway
| | - Anne Eskild
- Department of Obstetrics and Gynecology, Akershus University Hospital, Lørenskog, Norway.,Institute of Clinical Medicine, Campus Ahus, University of Oslo, Lørenskog, Norway
| |
Collapse
|
19
|
Banchani E, Tenkorang EY. Determinants of Low Birth Weight in Ghana: Does Quality of Antenatal Care Matter? Matern Child Health J 2020; 24:668-677. [PMID: 32026325 DOI: 10.1007/s10995-020-02895-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
OBJECTIVES Low birth weight is a public health issue that contributes to perinatal and infant mortality, especially in limited-resource settings, but there is limited understanding of the determinants of low birth weight and the contributions of quality antenatal care to maintaining healthy birth weights for newborns in such settings. This study aims at establishing links between birthweight and quality antenatal care in Ghana. METHODS We used data collected from the recent 2017 Ghana Maternal Health Survey and applied complementary log-log models to investigate relationships between the quality of antenatal care (screening/diagnostic procedures, clinical interventions, type of health provider) and low birth weight in Ghana. RESULTS The results reveal that compared to women who received low quality clinical interventions, those who received high quality interventions were significantly less likely to have a low birth weight baby. Similarly, women who made the recommended number of antenatal visits (at least eight) were significantly less likely to have a baby with low birth weight than women making fewer visits. CONCLUSION Our findings suggest that while the number of antenatal visits is important, the quality of care received during such visits is equally relevant to reducing low birth weight in Ghana.
Collapse
Affiliation(s)
- Emmanuel Banchani
- Department of Sociology, Memorial University of Newfoundland, St. John's, NL, A1C 5S7, Canada
| | - Eric Y Tenkorang
- Department of Sociology, Memorial University of Newfoundland, St. John's, NL, A1C 5S7, Canada.
| |
Collapse
|
20
|
How accurately do mothers recall prenatal visits and gestational age? A validation of Uruguayan survey data. DEMOGRAPHIC RESEARCH 2020. [DOI: 10.4054/demres.2020.43.51] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
|
21
|
Spry EA, Wilson CA, Middleton M, Moreno-Betancur M, Doyle LW, Howard LM, Hannan AJ, Wlodek ME, Cheong JLY, Hines LA, Coffey C, Brown S, Olsson CA, Patton GC. Parental mental health before and during pregnancy and offspring birth outcomes: A 20-year preconception cohort of maternal and paternal exposure. EClinicalMedicine 2020; 27:100564. [PMID: 33150327 PMCID: PMC7599306 DOI: 10.1016/j.eclinm.2020.100564] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Preterm birth (PTB) and small for gestational age (SGA) are increasingly prevalent, with major consequences for health and development into later life. There is emerging evidence that some risk processes begin before pregnancy. We report on associations between maternal and paternal common mental disorders (CMD) before and during pregnancy and offspring PTB and SGA. METHODS 398 women with 609 infants and 267 men with 421 infants were assessed repeatedly for CMD symptoms before pregnancy between age 14 and 29 and during pregnancy. Associations between preconception and antenatal CMD symptoms and offspring gestational age/PTB and size for gestational age/SGA were estimated using linear and Poisson regression. FINDINGS In men, persistent preconception CMD across adolescence and young adulthood predicted offspring PTB after adjustment for ethnicity, education, BMI and adolescent substance use (adjusted RR 7·0, 95% CI 1·8,26·8), corresponding to a population attributable fraction of 31% of preterm births. In women, antenatal CMD symptoms predicted offspring PTB (adjusted RR 4·4, 95% CI 1·4,14·1). There was little evidence of associations with SGA. INTERPRETATION This first report of an association between paternal preconception mental health and offspring gestational age, while requiring replication in larger samples, complements earlier work on stress in animals, and further strengthens the case for expanding preconception mental health care to both men and women. FUNDING National Health and Medical Research Council (Australia), Victorian Health Promotion Foundation, Australian Rotary Health, Colonial Foundation, Perpetual Trustees, Financial Markets Foundation for Children (Australia), Royal Children's Hospital Foundation, Murdoch Children's Research Institute, Australian Research Council.
Collapse
Affiliation(s)
- Elizabeth A Spry
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, Australia
- Murdoch Children's Research Institute, Melbourne, Australia
| | - Claire A Wilson
- Section of Women's Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
- South London and Maudsley NHS Foundation Trust, London, United Kingdom
- Corresponding author at: Section of Women's Mental Health, Institute of Psychiatry, Psychology and Neuroscience, PO31 King's College London, De Crespigny Park, London SE5 8AF, United Kingdom.
| | - Melissa Middleton
- Murdoch Children's Research Institute, Melbourne, Australia
- University of Melbourne, Melbourne, Australia
| | - Margarita Moreno-Betancur
- Murdoch Children's Research Institute, Melbourne, Australia
- University of Melbourne, Melbourne, Australia
| | - Lex W Doyle
- Murdoch Children's Research Institute, Melbourne, Australia
- University of Melbourne, Melbourne, Australia
- Royal Women's Hospital, Melbourne, Australia
| | - Louise M Howard
- Section of Women's Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
- South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Anthony J Hannan
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, Australia
| | | | - Jeanie LY Cheong
- Murdoch Children's Research Institute, Melbourne, Australia
- University of Melbourne, Melbourne, Australia
- Royal Women's Hospital, Melbourne, Australia
| | - Lindsey A Hines
- Population Health Science Institute, University of Bristol, Bristol, United Kingdom
| | - Carolyn Coffey
- Murdoch Children's Research Institute, Melbourne, Australia
| | - Stephanie Brown
- Murdoch Children's Research Institute, Melbourne, Australia
- University of Melbourne, Melbourne, Australia
| | - Craig A Olsson
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, Australia
- Murdoch Children's Research Institute, Melbourne, Australia
- University of Melbourne, Melbourne, Australia
| | - George C Patton
- Murdoch Children's Research Institute, Melbourne, Australia
- University of Melbourne, Melbourne, Australia
| |
Collapse
|
22
|
Atteih SE, Raraigh KS, Blackman SM, Cutting GR, Collaco JM. Predictive effects of low birth weight and small for gestational age status on respiratory and nutritional outcomes in cystic fibrosis. J Cyst Fibros 2020; 19:888-895. [PMID: 32061517 DOI: 10.1016/j.jcf.2020.02.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 02/03/2020] [Accepted: 02/04/2020] [Indexed: 12/23/2022]
Abstract
INTRODUCTION Prior literature shows that neonates with cystic fibrosis (CF) are more likely to be born low birth weight (LBW, <2500 grams) and/or small for gestational age (SGA, <10th percentile for weight) than non-CF counterparts. There is limited literature exploring the predictive effects of birth parameters on long-term outcomes. METHODS The study population (CF Twin and Sibling Study) was recruited between 2000-2013 (n = 1677). Relationships between FEV1 percent predicted at 6, 12, or 18 years or BMI z-score at 2, 6, 12, or 18 years, and predictor variables (LBW or SGA status) were assessed using adjusted linear regressions. RESULTS Mean birth weight was 3.3 ± 0.7 kg (Females: 3.2 ± 0.7kg; males: 3.4 ± 0.7kg) and mean gestational age was 38.4 ± 2.6 weeks, with 10.2% of participants classified as SGA. Predictors of LBW included female sex, pancreatic insufficiency, and prematurity. Predictors of SGA included female sex. After adjustment, LBW was associated with lower BMI at ages 2-12 years and SGA was associated with lower BMI at age 2 years. LBW was associated with lower FEV1 percent predicted only at age 6 years. SGA was not associated with FEV1. CONCLUSIONS We did not observe higher rates of LBW or SGA in full term infants compared to the general population. We observed associations particularly between LBW and BMI or FEV1, but these associations decreased with age, suggesting that alternate factors contribute to outcomes over time. In lieu of the ability to target growth during gestation, efforts could be considered to optimize infant nutritional status, which may improve later life outcomes.
Collapse
|
23
|
Recall accuracy of weekly automated surveys of health care utilization and infectious disease symptoms among infants over the first year of life. PLoS One 2019; 14:e0226623. [PMID: 31846482 PMCID: PMC6917293 DOI: 10.1371/journal.pone.0226623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Accepted: 11/30/2019] [Indexed: 11/19/2022] Open
Abstract
Automated surveys, by interactive voice response (IVR) or email, are increasingly used for clinical research. Although convenient and inexpensive, they have uncertain validity. We sought to assess the accuracy of longitudinally-collected automated survey responses compared to medical records. Using data collected from a well-characterized, prospective birth cohort over the first year of life, we examined concordance between guardians' reports of their infants' health care visits ascertained by weekly automated survey (IVR or email) and those identified by medical chart review. Among 180 survey-visit pairs, concordance was 51%, with no change as number of visits per baby increased. Accuracy of recall was higher by email compared to IVR (61 vs. 43%; adjusted OR = 2.5 95% CI: 1.3-4.8), did not vary by health care encounter type (hospitalization: 50%, ER: 64%, urgent care: 44%, primary care: 52%; p = 0.75), but was higher for fever (77%, adjusted OR = 5.1 95%CI: 1.5-17.7) and respiratory illness (58%, adjusted OR = 2.9 95%CI: 1.5-5.8) than for other diagnoses. For the 75 mothers in these encounters, 69% recalled at least one visit; among 41 mothers with two or more visits, 85% recalled at least one visit. Predictors of accurate reporting by mothers after adjusting for illness in the baby included increased age and increased years of education (age per year, β = 0.05, p = 0.03; education per year, β = 0.08, p = 0.04). Additional strategies beyond use of automated surveys are needed to ascertain accurate health care utilization in longitudinal cohort studies, particularly in healthy populations with little motivation for accurate reporting.
Collapse
|
24
|
Does physical activity attenuate the association between birth weight and glycated hemoglobin in nondiabetic Japanese women? J Dev Orig Health Dis 2019; 11:379-383. [PMID: 31735182 DOI: 10.1017/s2040174419000746] [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: 01/09/2023]
Abstract
Lower birth weight is associated with a risk of type 2 diabetes in adulthood. However, it is not clear whether this association is modified by physical activity. This study aimed to examine the association between birth weight and glycemic status and whether this association is mediated by moderate- and vigorous-intensity activity (MVPA) in Japanese women. The participants were 103 nondiabetic women (47.4 ± 10.8 years), who underwent health checkups in which data of glycated hemoglobin (HbA1c) were collected. Abdominal circumference (AC) was measured at the umbilical region. Birth weight was obtained from the Maternal and Child Health Handbook records or reported based on the participant's or his/her mother's recall. Time (min/day) spent in MVPA (≥3.0 metabolic equivalents) was objectively measured using a triaxial accelerometer (Actimarker EW4800). Birth weight was inversely correlated with HbA1c (r = -0.32, P < 0.01). Multiple linear regression analyses revealed that lower birth weight was associated with increased HbA1c (β = -0.22, P < 0.05) even after adjusting for age, state of menstruation, AC, and family history of diabetes. This association was little changed when MVPA was introduced as an independent variable in the model (β = -0.23, P < 0.05). These results suggest that lower birth weight may be associated with higher HbA1c levels before the onset of type 2 diabetes, irrespective of adulthood physical activity. Early-life development should be taken into account when considering the risk of diabetes in Japanese women, even if they are physically active.
Collapse
|
25
|
Martinson ML, Choi KH. Low birth weight and childhood health: the role of maternal education. Ann Epidemiol 2019; 39:39-45.e2. [PMID: 31708407 PMCID: PMC8063216 DOI: 10.1016/j.annepidem.2019.09.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 09/03/2019] [Accepted: 09/16/2019] [Indexed: 11/16/2022]
Abstract
PURPOSE Low birth weight (LBW) is associated with myriad health and developmental problems in childhood and later in life. Less well-documented is the variation in the relationship between LBW status and subsequent child health by socioeconomic status-such as education levels and income. This article examines whether differences exist in the relationship between LBW and subsequent child health by maternal education. METHODS We used data from the 1998-2017 National Health Interview Survey to estimate multivariate logistic regression models to determine whether the association between LBW and subsequent child health as measured by general health status, developmental disability, and asthma diagnosis differed by maternal education, net of differences in children's sociodemographic factors, family background, and medical access. RESULTS The negative association between LBW and subsequent health was typically weaker for children of mothers with less than high school education than it was for children of mothers with higher levels of education. CONCLUSIONS The findings on the enduring impact of LBW status on child health for all children, especially those born to mothers with higher levels of education, suggest that all children born LBW should be provided appropriate medical and support services to reduce the lifelong repercussions of poor health at birth.
Collapse
Affiliation(s)
| | - Kate H Choi
- Department of Sociology, University of Western Ontario, London
| |
Collapse
|
26
|
Wooldridge AL, McMillan M, Kaur M, Giles LC, Marshall HS, Gatford KL. Relationship between birth weight or fetal growth rate and postnatal allergy: A systematic review. J Allergy Clin Immunol 2019; 144:1703-1713. [PMID: 31615640 DOI: 10.1016/j.jaci.2019.08.032] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Revised: 08/02/2019] [Accepted: 08/22/2019] [Indexed: 12/20/2022]
Abstract
BACKGROUND Individual susceptibility to allergic diseases is developmentally programmed by early-life exposures. Evidence from preclinical studies suggests that intrauterine growth restriction is protective against later inflammatory responses to allergens. OBJECTIVE We sought to evaluate whether prenatal growth affects susceptibility to allergy in human subjects. METHODS We systematically searched for relevant studies in 11 databases, including Web of Science, ProQuest, EMBASE, and PubMed. We included only studies that corrected for gestational age or were restricted to full-term infants to separate effects of fetal growth from those of prematurity. RESULTS The 42 eligible studies included prospective and retrospective cohort, cross-sectional, and case-control studies. Only 2 studies reported allergic asthma. A birth weight increase of 1 kg was associated with a 44% greater risk of food allergy in children (odds ratio [OR], 1.44; 95% CI, 1.04-1.99; P = .001), a 17% greater risk of ever allergic dermatitis in children (OR, 1.17; 95% CI, 1.04-1.32; P = .008), and a 34% greater risk of ever or current allergic dermatitis in infants up to 2 years of age (OR, 1.34; 95% CI, 1.08-1.68; P = .009). Risks of allergic rhinitis were not associated with birth weight. CONCLUSIONS The results of these meta-analyses suggest that intrauterine growth restriction protects against allergic diseases in human subjects consistent with preclinical evidence but that effects might differ between allergic diseases. The strongest evidence is available for infancy and early childhood, and additional studies in older children and adults are needed to determine whether the effects of prenatal growth on each allergic disease persist or differ between those with severe and mild phenotypes.
Collapse
Affiliation(s)
- Amy L Wooldridge
- Robinson Research Institute, University of Adelaide, Adelaide, Australia; Adelaide Medical School, University of Adelaide, Adelaide, Australia; School of Human Sciences, University of Western Australia, Perth, Australia
| | - Mark McMillan
- Robinson Research Institute, University of Adelaide, Adelaide, Australia; Adelaide Medical School, University of Adelaide, Adelaide, Australia; Vaccinology and Immunology Research Trials Unit (VIRTU), Women's and Children's Hospital, North Adelaide, Australia
| | - Manpreet Kaur
- Robinson Research Institute, University of Adelaide, Adelaide, Australia; School of Medicine, Deakin University, Waurn Ponds, Australia
| | - Lynne C Giles
- Robinson Research Institute, University of Adelaide, Adelaide, Australia; School of Public Health, University of Adelaide, Adelaide, Australia
| | - Helen S Marshall
- Robinson Research Institute, University of Adelaide, Adelaide, Australia; Adelaide Medical School, University of Adelaide, Adelaide, Australia; Vaccinology and Immunology Research Trials Unit (VIRTU), Women's and Children's Hospital, North Adelaide, Australia
| | - Kathryn L Gatford
- Robinson Research Institute, University of Adelaide, Adelaide, Australia; Adelaide Medical School, University of Adelaide, Adelaide, Australia.
| |
Collapse
|
27
|
Neilson E, Shen X, Cox SR, Clarke TK, Wigmore EM, Gibson J, Howard DM, Adams MJ, Harris MA, Davies G, Deary IJ, Whalley HC, McIntosh AM, Lawrie SM. Impact of Polygenic Risk for Schizophrenia on Cortical Structure in UK Biobank. Biol Psychiatry 2019; 86:536-544. [PMID: 31171358 DOI: 10.1016/j.biopsych.2019.04.013] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Revised: 04/05/2019] [Accepted: 04/05/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND Schizophrenia is a neurodevelopmental disorder with many genetic variants of individually small effect contributing to phenotypic variation. Lower cortical thickness (CT), surface area, and cortical volume have been demonstrated in people with schizophrenia. Furthermore, a range of obstetric complications (e.g., lower birth weight) are consistently associated with an increased risk for schizophrenia. We investigated whether a high polygenic risk score for schizophrenia (PGRS-SCZ) is associated with CT, surface area, and cortical volume in UK Biobank, a population-based sample, and tested for interactions with birth weight. METHODS Data were available for 2864 participants (nmale/nfemale = 1382/1482; mean age = 62.35 years, SD = 7.40). Linear mixed models were used to test for associations among PGRS-SCZ and cortical volume, surface area, and CT and between PGRS-SCZ and birth weight. Interaction effects of these variables on cortical structure were also tested. RESULTS We found a significant negative association between PGRS-SCZ and global CT; a higher PGRS-SCZ was associated with lower CT across the whole brain. We also report a significant negative association between PGRS-SCZ and insular lobe CT. PGRS-SCZ was not associated with birth weight and no PGRS-SCZ × birth weight interactions were found. CONCLUSIONS These results suggest that individual differences in CT are partly influenced by genetic variants and are most likely not due to factors downstream of disease onset. This approach may help to elucidate the genetic pathophysiology of schizophrenia. Further investigation in case-control and high-risk samples could help identify any localized effects of PGRS-SCZ, and other potential schizophrenia risk factors, on CT as symptoms develop.
Collapse
Affiliation(s)
- Emma Neilson
- Division of Psychiatry, Royal Edinburgh Hospital, Edinburgh, UK.
| | - Xueyi Shen
- Division of Psychiatry, Royal Edinburgh Hospital, Edinburgh, UK
| | - Simon R Cox
- Centre for Cognitive Ageing and Cognitive Epidemiology, Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - Toni-Kim Clarke
- Division of Psychiatry, Royal Edinburgh Hospital, Edinburgh, UK
| | | | - Jude Gibson
- Division of Psychiatry, Royal Edinburgh Hospital, Edinburgh, UK
| | - David M Howard
- Division of Psychiatry, Royal Edinburgh Hospital, Edinburgh, UK
| | - Mark J Adams
- Division of Psychiatry, Royal Edinburgh Hospital, Edinburgh, UK
| | - Mat A Harris
- Division of Psychiatry, Royal Edinburgh Hospital, Edinburgh, UK
| | - Gail Davies
- Centre for Cognitive Ageing and Cognitive Epidemiology, Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - Ian J Deary
- Centre for Cognitive Ageing and Cognitive Epidemiology, Department of Psychology, University of Edinburgh, Edinburgh, UK
| | | | - Andrew M McIntosh
- Division of Psychiatry, Royal Edinburgh Hospital, Edinburgh, UK; Centre for Cognitive Ageing and Cognitive Epidemiology, Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - Stephen M Lawrie
- Division of Psychiatry, Royal Edinburgh Hospital, Edinburgh, UK; The Patrick Wild Centre, Royal Edinburgh Hospital, Edinburgh, UK
| |
Collapse
|
28
|
De Rubeis V, Bayat S, Griffith LE, Smith BT, Anderson LN. Validity of self-reported recall of anthropometric measures in early life: A systematic review and meta-analysis. Obes Rev 2019; 20:1426-1440. [PMID: 31184422 DOI: 10.1111/obr.12881] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 04/09/2019] [Accepted: 04/26/2019] [Indexed: 01/03/2023]
Abstract
Overweight and obesity in early life are risk factors for many adult-onset chronic diseases. The objective of this study was to assess the validity of self-reported recall of early life anthropometric measures. A systematic review was conducted by searching four electronic databases (PubMed, ProQuest, EMBASE, and MEDLINE). Studies were eligible if they evaluated the validity or reliability of self-reported recall by adults of their own body mass index, height, and/or weight during earlier life periods. Meta-analyses were conducted to pool correlation coefficients and mean differences. There were 15 studies included with a total of 17 477 participants. The mean pooled difference between self-reported recall of BMI compared with prospective measures was 0.06 kg/m2 (95% CI, -0.62 to 0.73), and the pooled correlation coefficient was 0.72 (95% CI, 0.65-0.79). Self-reported weight was also strongly correlated with reference standard measures (pooled r = 0.83; 95% CI, 0.72-0.90) with a small mean difference (0.87 kg; 95% CI, 0.19-1.56; I2 = 91%). Despite significant heterogeneity, the findings from this review suggest self-reported recall of early life body mass index, height, and weight may be valid measures. This evidence may inform life-course epidemiology studies considering the use of retrospective assessment of self-reported anthropometry.
Collapse
Affiliation(s)
- Vanessa De Rubeis
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Sawila Bayat
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Lauren E Griffith
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Brendan T Smith
- Department of Health Promotion, Chronic Disease and Injury Prevention, Public Health Ontario, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Laura N Anderson
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.,Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
| |
Collapse
|
29
|
Kim R, Rajpal S, Joe W, Corsi DJ, Sankar R, Kumar A, Subramanian SV. Assessing associational strength of 23 correlates of child anthropometric failure: An econometric analysis of the 2015-2016 National Family Health Survey, India. Soc Sci Med 2019; 238:112374. [PMID: 31345611 DOI: 10.1016/j.socscimed.2019.112374] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 06/12/2019] [Accepted: 06/17/2019] [Indexed: 12/26/2022]
Abstract
Despite the broad consensus that investments in nutrition-sensitive programmes are required to reduce child undernutrition, in practice empirical studies and interventions tend to focus on few nutrition-specific risk factors in isolation. The 2015-16 National Family Health Survey provides the first opportunity in more than a decade to conduct an up-to-date comprehensive evaluation of the relative importance of various maternal and child health and nutrition (MCHN) factors in respect to child anthropometric failures in India. The primary analysis included 140,444 children aged 6-59 months with complete data on 20 MCHN factors, and the secondary analysis included a subset of 25,603 children with additional paternal data. Outcome variables were stunting, underweight and wasting. We conducted logistic regression models to first evaluate each correlate separately in age- and sex-adjusted models, and then jointly in a mutually adjusted model. For all anthropometric failures, indicators of past and present socioeconomic conditions showed the most robust associations. The strongest correlates for stunting were short maternal stature (OR: 4.39; 95%CI: 4.00, 4.81), lack of maternal education (OR: 1.74; 95%CI: 1.60, 1.89), low maternal BMI (OR: 1.64; 95%CI: 1.54, 1.75), poor household wealth (OR: 1.25; 95%CI: 1.15, 1.35) and poor household air quality (OR: 1.22; 95%CI: 1.16, 1.29). Weaker associations were found for other correlates, including dietary diversity, vitamin A supplementation and breastfeeding initiation. Paternal factors were also important predictors of anthropometric failures, but to a lesser degree than maternal factors. The results remained consistent when stratified by children's age (6-23 vs 24-59 months) and sex (girls vs boys), and when low birth weight was additionally considered. Our findings indicate the limitation of nutrition-specific interventions. Breaking multi-generational poverty and improving environmental factors are promising investments to prevent anthropometric failures in early childhood.
Collapse
Affiliation(s)
- Rockli Kim
- Harvard Center for Population & Development Studies, Cambridge, MA, USA
| | | | - William Joe
- Institute of Economic Growth (IEG), University of Delhi Enclave, North Campus, Delhi, India
| | - Daniel J Corsi
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | | | - Alok Kumar
- National Institution for Transforming India (NITI), Government of India, New Delhi, India
| | - S V Subramanian
- Harvard Center for Population & Development Studies, Cambridge, MA, USA; Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
| |
Collapse
|
30
|
Wang KW, de Souza RJ, Fleming A, Johnston DL, Zelcer SM, Rassekh SR, Burrow S, Thabane L, Samaan MC. Birth weight and body mass index z-score in childhood brain tumors: A cross-sectional study. Sci Rep 2018; 8:1642. [PMID: 29374278 PMCID: PMC5786044 DOI: 10.1038/s41598-018-19924-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Accepted: 01/11/2018] [Indexed: 01/31/2023] Open
Abstract
Children with brain tumors (CBT) are at higher risk of cardiovascular disease and type 2 diabetes compared to the general population, in which birth weight is a risk factor for these diseases. However, this is not known in CBT. The primary aim of this study was to explore the association between birth weight and body mass measures in CBT, compared to non-cancer controls. This is a secondary data analysis using cross-sectional data from the CanDECIDE study (n = 78 CBT and n = 133 non-cancer controls). Age, sex, and birth weight (grams) were self-reported, and confirmed through examination of the medical records. Body mass index (BMI) was calculated from height and weight measures and reported as kg/m2. BMI z-scores were obtained for subjects under the age of 20 years. Multivariable linear regression was used to evaluate the relationship between birth weight and BMI and BMI z-score, adjusted for age, sex, puberty, and fat mass percentage. Higher birth weight was associated with higher BMI and BMI z-score among CBT and controls. In conclusion, birth weight is a risk factor for higher body mass during childhood in CBT, and this may help the identification of children at risk of future obesity and cardiometabolic risk.
Collapse
Affiliation(s)
- Kuan-Wen Wang
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
- Division of Pediatric Endocrinology, McMaster Children's Hospital, Hamilton, Ontario, Canada
- Medical Sciences Graduate Program, McMaster University, Hamilton, Ontario, Canada
| | - Russell J de Souza
- Medical Sciences Graduate Program, McMaster University, Hamilton, Ontario, Canada
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Adam Fleming
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
- Medical Sciences Graduate Program, McMaster University, Hamilton, Ontario, Canada
- Division of Pediatric Hematology/Oncology, McMaster Children's Hospital, Hamilton, Ontario, Canada
| | - Donna L Johnston
- Division of Pediatric Hematology/Oncology, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
| | - Shayna M Zelcer
- Pediatric Hematology Oncology, Children's Hospital, London Health Sciences Center, London, Ontario, Canada
| | - Shahrad Rod Rassekh
- Division of Pediatric Hematology/Oncology/BMT, Department of Pediatrics, British Columbia's Children's Hospital, Vancouver, BC, Canada
| | - Sarah Burrow
- Division of Orthopedic Surgery, Department of Surgery, McMaster University Medical Centre, Hamilton, Ontario, Canada
| | - Lehana Thabane
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- Department of Anesthesia, McMaster University, Hamilton, Ontario, Canada
- Centre for Evaluation of Medicines, St. Joseph's Health Care, Hamilton, Ontario, Canada
- Biostatistics Unit, St Joseph's Healthcare-Hamilton, Hamilton, Ontario, Canada
| | - M Constantine Samaan
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada.
- Division of Pediatric Endocrinology, McMaster Children's Hospital, Hamilton, Ontario, Canada.
- Medical Sciences Graduate Program, McMaster University, Hamilton, Ontario, Canada.
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada.
| |
Collapse
|
31
|
Badon SE, Littman AJ, Chan KCG, Williams MA, Enquobahrie DA. Trajectories of maternal leisure-time physical activity and sedentary behavior during adolescence to young adulthood and offspring birthweight. Ann Epidemiol 2017; 27:701-707.e3. [PMID: 29089177 DOI: 10.1016/j.annepidem.2017.09.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2017] [Revised: 08/29/2017] [Accepted: 09/28/2017] [Indexed: 11/20/2022]
Abstract
PURPOSE The objectives of the study were to determine the extent to which trajectories of maternal preconception leisure-time physical activity (LTPA) and leisure-time sedentary behavior (LTSB) during adolescence and young adulthood are associated with offspring birth weight (BW) and to test if these associations differ by offspring sex or maternal pre-pregnancy overweight-obese status. METHODS Participants with one or more birth (n = 1408) were identified from the National Longitudinal Study of Adolescent to Adult Health. Group-based trajectory modeling was used to characterize trajectories of LTPA (frequency/week) and LTSB (hours/week) which were measured, on average, over 7 years between age 15 and 22 years. Weighted regression and Wald tests were used to estimate and test mean differences and odds ratios for BW, small for gestational age, and large for gestational age (LGA). RESULTS Three trajectories were identified for LTPA and five for LTSB. Associations differed by offspring sex for continuous BW and LGA (interaction P = .10 and .008, respectively). Among female offspring, participants with high followed by decreasing LTPA delivered offspring with 90 g greater BW (95% confidence interval [CI]: -4 to 184) and 72% greater risk of LGA (95% CI: 0.94-3.14), compared with participants with low LTPA. Among male offspring, LTPA patterns were not associated with BW. A pattern of high then decreasing LTPA among normal weight, but not overweight-obese women, was associated with 2.03 times greater risk of LGA (95% CI: 1.06-3.88). LTSB trajectories were not associated with BW. CONCLUSIONS Associations of preconception trajectories of LTPA with offspring BW may differ by offspring sex and maternal pre-pregnancy overweight-obese status.
Collapse
Affiliation(s)
- Sylvia E Badon
- Department of Epidemiology, University of Washington, Seattle.
| | - Alyson J Littman
- Department of Epidemiology, University of Washington, Seattle; Seattle Epidemiologic Research and Information Center, VA Puget Sound, Seattle, WA
| | | | - Michelle A Williams
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
| | | |
Collapse
|
32
|
Abstract
BACKGROUND More than 95% of higher-order multiples are born preterm and more than 90% are low birth weight, making this group of infants especially vulnerable to sudden infant death syndrome (SIDS). Emerging evidence suggests that families with twins face challenges adhering to the American Academy of Pediatrics (AAP) recommendations to reduce SIDS risks. Adherence to the AAP recommendations in families with higher-order multiples has not been described. PURPOSE This study describes SIDS risk reduction infant care practices for higher-order multiples during the first year of life. METHODS Mothers caring for higher-order multiple-birth infants were recruited from an online support group. An online survey was used to assess infant care practices when the infants were first brought home from the hospital as well as at the time of the survey. RESULTS Ten mothers of triplets and 4 mothers of quadruplets responded. Less than 80% of the mothers practiced "back to sleep" immediately postdischarge. Supine sleep positioning decreased over time, particularly during daytime naps. Only 50% of the infants shared the parents' bedroom and approximately 30% bed-shared with their siblings. Sleep-time pacifier use was low. IMPLICATIONS FOR PRACTICE Safe sleep education must include specific questions regarding home sleeping arrangements, encouragement of breast milk feedings, supine positioning, and pacifier use at every sleep for higher-order multiple infants well before discharge in order for parents to plan a safe sleep environment at home. IMPLICATIONS FOR RESEARCH Prospective studies to identify barriers and facilitators can inform future strategies supporting adherence to safe sleep practices for higher-order multiple infants.
Collapse
|