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Videholm S, Silfverdal SA, Gustafsson PE. Socioeconomic circumstances, health-related behaviours and paediatric infections: a mediation analysis. Arch Dis Child 2024; 109:195-200. [PMID: 37979965 PMCID: PMC10894845 DOI: 10.1136/archdischild-2023-325850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 10/16/2023] [Indexed: 11/20/2023]
Abstract
OBJECTIVE To examine how the effect of disadvantaged socioeconomic circumstances on the risk of paediatric infections is mediated by pregnancy smoking, excess weight during pregnancy and breast feeding in children under 5 years of age. DESIGN A population-level, retrospective cohort study. The Swedish Medical Birth Register was combined with the National Patient Register, the longitudinal integration database for health insurance and labour market studies, the Cause of Death Register and a local register held by the Child Health Care Unit in Uppsala Region. SETTING Uppsala Region, Sweden. PATIENTS 63 216 term and post-term singletons born to women who resided in Uppsala Region, Sweden between 1997 and 2015. MAIN OUTCOME MEASURES Number of hospital admissions for infectious diseases. Secondary outcomes were the number of hospitalisations for respiratory and enteric infections, respectively. RESULTS The effect of disadvantaged socioeconomic circumstances, that is, low maternal education on the overall risk of paediatric infections was mediated to a considerable (33%-64%) proportion by pregnancy smoking, excess weight during pregnancy and breast feeding. CONCLUSIONS Pregnancy smoking, excess weight during pregnancy and breast feeding mediate a considerable proportion of the association between deprived socioeconomic circumstances and paediatric infectious diseases. Therefore, inequalities in paediatric infectious diseases may be reduced by public health policies addressing these health-related behaviours.
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Affiliation(s)
- Samuel Videholm
- Department of Clinical Sciences, Pediatrics, Umeå University, Umea, Sweden
- Unit of Research, Development, and Education, Östersund Hospital, Ostersund, Sweden
| | | | - Per E Gustafsson
- Department of Epidemiology and Global Health, Umeå University, Umea, Sweden
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Descarpentrie A, Poquet D, Brugailleres P, Sauvegrain P, Frenoy P, Richard E, Bernard JY, de Lauzon-Guillain B, Vandentorren S, Lioret S. Is breastfeeding duration related to the health of migrant mother-child dyads experiencing homelessness? The ENFAMS cross-sectional survey. Eur J Public Health 2023; 33:796-802. [PMID: 37339520 PMCID: PMC10567129 DOI: 10.1093/eurpub/ckad096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/22/2023] Open
Abstract
BACKGROUND Literature from the general population shows a consensus about the health benefits associated with breastfeeding for both mothers and children. However, studies investigating these issues in the context of homelessness and migration are rare. This research aimed to examine the relations of any breastfeeding duration with health outcomes among migrant mother-child dyads experiencing homelessness. METHODS Data were collected among sheltered and mainly foreign-born mothers experiencing homelessness, and their children aged 6 months to 5 years, from the ENFAMS cross-sectional survey (n = 481, 2013-Great Paris area). Any breastfeeding duration, along with various health outcomes of both the mother and her child, was ascertained by face-to-face questionnaires administered by trained interviewers to mothers (perceived physical and emotional health and maternal depression) or by trained psychologists to children (adaptive behaviours). Nurses measured weight and height [thus allowing them to calculate body mass index (BMI)] and haemoglobin concentration (mother-child dyad) and maternal blood pressure. Multivariable linear and modified Poisson regression analyses were performed to examine outcome-wide associations between any breastfeeding duration ≥6 months and the various mother-child outcomes. RESULTS Any breastfeeding ≥6 months was associated with lower systolic blood pressure in mothers (B = -0.40, 95% confidence interval = -0.68 to -0.12). No association was observed with the other outcomes. CONCLUSIONS The relevance of supporting breastfeeding to improve mothers' physical health holds true in the context of migration and homelessness. It is therefore important to support breastfeeding in these settings. Moreover, given the documented social complexity of breastfeeding practices, interventions should take mothers' socio-cultural heritage and the structural barriers they face into account.
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Affiliation(s)
- Alexandra Descarpentrie
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), Paris, France
| | - Delphine Poquet
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), Paris, France
| | | | - Priscille Sauvegrain
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), Paris, France
- Sorbonne Université, Midwifery Unit, Paris, France
- Institut Convergences Migrations/CNRS, Aubervilliers, France
| | - Pauline Frenoy
- Université Paris Saclay, UVSQ, Université Paris-Sud, Inserm, Gustave Roussy, “Exposome and Heredity” Team, CESP, Villejuif, France
| | - Elodie Richard
- CIFRE Fnasat, Université Bordeaux, Inserm, UMR1219, Bordeaux, France
| | - Jonathan Y Bernard
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), Paris, France
| | - Blandine de Lauzon-Guillain
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), Paris, France
| | - Stéphanie Vandentorren
- Université Bordeaux, Inserm, UMR1219, PHARes Team, Bordeaux, France
- Institut Convergences Migrations/CNRS, Aubervilliers, France
- Santé Publique France, French National Public Health Agency, Saint-Maurice, France
| | - Sandrine Lioret
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), Paris, France
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Geller RJ, Inhofe NR, Crifase CC, Espinola JA, Gallegos C, Herrera N, Mitri E, Qi Y(S, Sullivan AF, Camargo CA. Case-control study of exclusive breast feeding and severe bronchiolitis in the United States. Paediatr Perinat Epidemiol 2023; 37:425-435. [PMID: 36882670 PMCID: PMC10483022 DOI: 10.1111/ppe.12966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 01/30/2023] [Accepted: 02/16/2023] [Indexed: 03/09/2023]
Abstract
BACKGROUND Bronchiolitis is a major cause of infant illness, with few known modifiable risk factors. Breast feeding may reduce risk of severe bronchiolitis, but the association of exclusive vs. partial breast feeding with severe bronchiolitis is unclear. OBJECTIVE To estimate the association of exclusive vs. partial breast feeding during ages 0-2.9 months with bronchiolitis hospitalisation during infancy. METHODS We conducted a case-control study as a secondary analysis of two prospective US cohorts in the Multicenter Airway Research Collaboration. Cases were enrolled in a 17-centre study of infants hospitalised for bronchiolitis during 2011-2014 (n = 921). Controls were enrolled in a five-centre study of healthy infants during 2013-2014 and 2017 (n = 719). Breast feeding history during ages 0-2.9 months was collected by parent interview. Among breastfed infants, the association of exclusive vs. partial breast feeding with odds of bronchiolitis hospitalisation was estimated using a multivariable logistic regression model adjusted for demographic variables, parental asthma history, and early-life exposures. As a secondary analysis, we estimated the associations of exclusive, predominant, and occasional breast feeding vs. no breast feeding with the odds of bronchiolitis hospitalisation. RESULTS Among 1640 infants, the prevalence of exclusive breast feeding was 187/921 (20.3%) among cases and 275/719 (38.3%) among controls. Exclusive vs. partial breast feeding was associated with 48% reduced odds of bronchiolitis hospitalisation (adjusted odds ratio [OR] 0.52, 95% confidence interval [CI] 0.39, 0.69). In the secondary analysis, exclusive vs. no breast feeding was associated with 58% reduced odds of bronchiolitis hospitalisation (OR 0.42, 95% CI 0.23, 0.77), whereas predominant breast feeding (OR 0.77, 95% CI 0.37, 1.57) and occasional breast feeding (OR 0.98, 95% CI 0.57, 1.69) were not associated with meaningfully reduced odds of bronchiolitis hospitalisation. CONCLUSION Exclusive breast feeding had a strong protective association against bronchiolitis hospitalisation.
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Affiliation(s)
- Ruth J. Geller
- Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA
- Department of Epidemiology, Boston University School of Public Health, Boston, MA
| | - Nancy R. Inhofe
- Department of Pediatrics, The University of Oklahoma School of Community Medicine – Tulsa, OK
| | | | - Janice A. Espinola
- Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA
| | - Catalina Gallegos
- Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA
| | - Nicole Herrera
- Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA
| | - Elie Mitri
- Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA
| | - Ying (Shelly) Qi
- Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA
| | - Ashley F. Sullivan
- Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA
| | - Carlos A. Camargo
- Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA
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Chutipongtanate S, Cetinkaya H, Zhang X, Kuhnell D, Benefield D, Haffey W, Wyder M, Patel R, Conrey SC, Burrell AR, Langevin S, Nommsen-Rivers L, Newburg DS, Greis KD, Staat MA, Morrow AL. Prenatal SARS-CoV-2 infection alters postpartum human milk-derived extracellular vesicles. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.06.01.543234. [PMID: 37398231 PMCID: PMC10312504 DOI: 10.1101/2023.06.01.543234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/04/2023]
Abstract
Human milk-derived extracellular vesicles (HMEVs) are crucial functional components in breast milk, contributing to infant health and development. Maternal conditions could affect HMEV cargos; however, the impact of SARS-CoV-2 infection on HMEVs remains unknown. This study evaluated the influence of SARS-CoV-2 infection during pregnancy on postpartum HMEV molecules. Milk samples (9 prenatal SARS-CoV-2 vs. 9 controls) were retrieved from the IMPRINT birth cohort. After defatting and casein micelle disaggregation, 1 mL milk was subjected to a sequential process of centrifugation, ultrafiltration, and qEV-size exclusion chromatography. Particle and protein characterizations were performed following the MISEV2018 guidelines. EV lysates were analyzed through proteomics and miRNA sequencing, while the intact EVs were biotinylated for surfaceomic analysis. Multi-Omics was employed to predict HMEV functions associated with prenatal SARS-CoV-2 infection. Demographic data between the prenatal SARS-CoV-2 and control groups were similar. The median duration from maternal SARS-CoV-2 test positivity to milk collection was 3 months (range: 1-6 months). Transmission electron microscopy showed the cup-shaped nanoparticles. Nanoparticle tracking analysis demonstrated particle diameters of <200 nm and yields of >1e11 particles from 1 mL milk. Western immunoblots detected ALIX, CD9 and HSP70, supporting the presence of HMEVs in the isolates. Thousands of HMEV cargos and hundreds of surface proteins were identified and compared. Multi-Omics predicted that mothers with prenatal SARS-CoV-2 infection produced HMEVs with enhanced functionalities involving metabolic reprogramming and mucosal tissue development, while mitigating inflammation and lower EV transmigration potential. Our findings suggest that SARS-CoV-2 infection during pregnancy boosts mucosal site-specific functions of HMEVs, potentially protecting infants against viral infections. Further prospective studies should be pursued to reevaluate the short- and long-term benefits of breastfeeding in the post-COVID era.
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Silfverdal SA. Breast is best also in high-income countries. Acta Paediatr 2023; 112:11-13. [PMID: 36317733 DOI: 10.1111/apa.16579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 10/14/2022] [Accepted: 10/19/2022] [Indexed: 12/13/2022]
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Hossain S, Mihrshahi S. Exclusive Breastfeeding and Childhood Morbidity: A Narrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14804. [PMID: 36429518 PMCID: PMC9691199 DOI: 10.3390/ijerph192214804] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 11/06/2022] [Accepted: 11/08/2022] [Indexed: 06/16/2023]
Abstract
Globally, diarrheal diseases and acute respiratory infections are the leading causes of morbidity and mortality in children under 5 years old. The benefits of exclusive breastfeeding in reducing the risk of gastrointestinal and respiratory infections are well documented. Optimal breastfeeding may potentially save the lives of about 800,000 children in low-income settings. Despite the evidence, around 63% of infants from birth to 6 months are not exclusively breastfed worldwide. We searched the literature published between 2010 and 2022 in Medline, Embase, and Scopus on the association between exclusive breastfeeding and infectious diseases. We selected and reviewed 70 relevant studies. Our findings expand and confirm the positive association between exclusive breastfeeding and reduced risk of a number of gastrointestinal, respiratory, and other infections in 60 out of 70 studies observed in both low- and high-income settings. Several studies analyzing exclusive breastfeeding duration reported that a longer exclusive breastfeeding duration is protective against many infectious diseases. This review also reported a lack of standardized definition for measuring exclusive breastfeeding in many studies. Overall, the results highlight the benefits of exclusive breastfeeding in many studies and suggests reporting exclusive breastfeeding in future studies using a consistent definition to enable better monitoring of exclusive breastfeeding rates.
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Nass EMA, Marcon SS, Teston EF, Leal LP, Ichisato SMT, Toso BRGDO, Moreira MAR, Bernardino FBS. Breastfeeding and diseases prevalent in the first two years of a child's life: a cross-sectional study. Rev Bras Enferm 2022; 75:e20210534. [PMID: 35674579 DOI: 10.1590/0034-7167-2021-0534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 02/11/2022] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVES to assess the association between breastfeeding and diseases prevalent in the first two years of a child's life. METHODS a retrospective cross-sectional study that analyzed electronic medical records of 401 children. Data on birth, growth, breastfeeding and medical care in the first two years of life were collected. In the analysis, Poisson regression with robust variance was used. RESULTS 27.9% of children were exclusively breastfed until six months, and, at 24 months, 93.3% had already had some prevalent childhood disease. In the crude analysis, 5-minute Apgar association, length, weight at 12 months, exclusive and non-exclusive breastfeeding time had association. In the adjusted analysis, only the variable breastfeeding at six months maintained the association with prevalent childhood diseases. CONCLUSIONS children who were not breastfed, exclusively or not, up to six months of age, had a higher prevalence of diseases compared to breastfed children.
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Affiliation(s)
| | | | - Elen Ferraz Teston
- Universidade Federal de Mato Grosso do Sul. Campo Grande, Mato Grosso do Sul. Brazil
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Nass EMA, Marcon SS, Teston EF, Leal LP, Ichisato SMT, Toso BRGDO, Moreira MAR, Bernardino FBS. Amamentação e as doenças prevalentes nos primeiros dois anos de vida da criança: estudo transversal. Rev Bras Enferm 2022. [DOI: 10.1590/0034-7167-2021-0534pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023] Open
Abstract
RESUMO Objetivos: avaliar a associação do aleitamento materno e as doenças prevalentes nos primeiros dois anos de vida da criança. Métodos: estudo transversal retrospectivo, que analisou prontuários eletrônicos de 401 crianças. Foram coletados dados sobre nascimento, crescimento, aleitamento materno e atendimentos médicos nos dois primeiros anos de vida. Na análise, utilizou-se Regressão de Poisson com variância robusta. Resultados: receberam aleitamento exclusivo até os seis meses 27,9% das crianças, e, aos 24 meses de vida, 93,3% já haviam tido alguma doença prevalente da infância. Na análise bruta, apresentaram associação Apgar no 5º minuto, comprimento, peso aos 12 meses, tempo de aleitamento exclusivo e não exclusivo. Na análise ajustada, apenas a variável aleitamento materno aos seis meses manteve a associação com as doenças prevalentes da infância. Conclusões: as crianças que não foram amamentadas, exclusivamente ou não, até os seis meses, apresentaram maior prevalência de doenças em relação às amamentadas.
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