Adolescent pregnancy and linear growth of infants: a birth cohort study in rural Ethiopia

Predictors of height in Romanian infants 6-23 months old: findings from a national representative sample

BACKGROUND

The research explored the association between infants' height and various demographic factors in Romania, a country where such critical information has been lacking.

METHODS

This study was conducted on a nationally representative sample and used a family physicians database to determine a sample of 1532 children (713 girls and 819 boys) 6-23 months of age (M = 14.26; SD = 5.15). Infants' height-for-age z-scores (HAZ) were calculated using the World Health Organization's computing algorithm. A multiple regression analysis was conducted to investigate whether certain risk factors, such as infant mother's age, location, marital status, socioeconomic status (SES), as well as infant's term status at birth, age, anemia, minimum dietary diversity (MDD) and birth order, could significantly predict the HAZ.

RESULTS

The study identified several significant predictors of height. Specifically, lower HAZ was associated with rural living, preterm birth, age 18-23 months, unmarried mothers, anemia, lack of MDD and being third or later born in the family. In contrast, higher HAZ was associated with medium or high maternal SES and older maternal age.

CONCLUSIONS

The study underscores the importance of addressing these significant risk factors through distinct interventions to improve height outcomes in at-risk Romanian populations.

Maternal age at marriage and child nutritional status and development: evidence from Serbian Roma communities

OBJECTIVE

This study aimed to assess whether maternal age at first marriage is associated with nutritional and developmental penalties in Roma children.

DESIGN

Roma nationally representative population-based study. Proxies for child nutritional outcomes included children's individual-level height-for-age z (HAZ) and weight-for-age z (WAZ) scores, HAZ and WAZ scores below two standard deviations from the median of WHO's reference population (children aged 0-59 months), and Early Child Development (children aged 36-59 months). Multiple and logistic regressions were used to estimate the association between maternal age at marriage and the outcomes, and other sociodemographic determinants as possible confounders.

SETTING

Aggregated data from UNICEF's fifth and sixth Multiple Indicator Cluster Surveys for Serbian Roma settlements.

SUBJECTS

Children (n= 2652) aged 0-59 months born to ever-married women aged 15-48.

RESULTS

64% of women married before age 18, 19% of children were stunted, 9% wasted, and Early Child Development score was low. Maternal age at first marriage was not associated with either nutritional status or early development of Roma children. Weight at birth (children aged 0-24) emerged as the main predictor of children's nutritional status. Boys were more likely to be shorter, more stunted and wasted than girls. Child's age, maternal parity and unimproved toilet facility negatively impacted nutritional status, while maternal literacy mitigated against poor nutritional and developmental outcomes.

CONCLUSIONS

Roma children up to 5 years of age bear no negative consequences of maternal early marriage. The underlying determinants of children's wellbeing include improved sanitation, child characteristics, maternal literacy and reproductive behavior, and parental investment.

Differences in perinatal outcomes in teenage mothers with their first and third pregnancies and predictors of adverse neonatal events: A cross-sectional study

Background

Repeated teenage pregnancy is a major burden on the healthcare system worldwide.

Objective

We aimed to compare teenagers with their first and third pregnancies and to evaluate the likelihood of neonatal complications.

Materials and Methods

This cross-sectional study was performed on female teenagers (aged ≤ 19 yr) with singleton pregnancies. The subjects (n = 298) were screened over 12 months. Ninety-six women were excluded, based on the exclusion criteria. The remaining subjects (n = 202) were divided into two groups: teenagers with first pregnancy (n = 96) and teenagers with third pregnancy (n = 47). The subjects were observed throughout pregnancy and delivery. The final sample size of the first and third pregnancy groups was 96 and 47, respectively.

Results

There was a significant risk of preeclampsia in the first pregnancy group (p = 0.01). Low birth weight, five-min Apgar score < 7, and neonatal intensive care unit admission were the most significant neonatal outcomes in the first pregnancy group. In the third pregnancy group, significant predictors of neonatal complications included very young age in the first pregnancy ( ≤ 15 yr), an inter-pregnancy interval < 2 yr, current anemia, and history of obstetric and/or neonatal complications in previous pregnancies.

Conclusion

Based on the results, teenagers with their first pregnancy had comparable obstetric outcomes (except for preeclampsia) as teenagers with their third pregnancy, whereas neonatal complications occurred more frequently in the first pregnancy group. Overall, we can predict high-risk neonates in the third pregnancy, based on the abovementioned parameters.

Malnutrition and contributing factors among newborns delivered at the University of Gondar Hospital, Northwest Ethiopia: a cross-sectional study

OBJECTIVES

To estimate the prevalence of various indicators of malnutrition (stunting, wasting, low birth weight, concurrent stunting and wasting, overweight/obesity and double burden malnutrition) among newborns and to investigate factors associated with these nutritional disorders.

METHODS

A hospital-based cross-sectional study was conducted from 10 March through to May 2020. A total of 419 newborns were recruited into the study to estimate the prevalence of low birth weight and stunting. After excluding 28 newborns whose length was less than 45 cm, 394 newborn-mother dyads were approached to estimate wasting and overweight/obesity. A systematic random sampling technique was used to select participants. All independent variables were entered into the multivariable logistic regression model and variables that had significant associations were identified based on a p value.

RESULTS

A very small proportion of the newborns 2.5% (0.9% to 4.1%) were concurrently wasted and stunted. The prevalence rates of low birth weight and wasting were 20.8% (16.8% to 24.6%) and 10.9% (7.82% to 14.01%), respectively. The magnitude of overweight/obesity was 12.7% (9.3% to 15.9%) where 2.8% (1.1% to 4.4%) of newborns have the double burden of malnutrition. Having a father with a primary level of education 2.82 (1.19 to 6.65) and being stunted at birth 3.17 (1.6 to 6.0) were variables that were associated with increased odds of low birth weight. The odds of being overweight/obese are significantly higher among newborns born to mothers who are urban dwellers 0.35 (0.12 to 0.99).

CONCLUSIONS

The study underscores that malnutrition is a pressing public health concern that demands due emphasis. Fathers' educational status (low level) and being stunted are associated with a high burden of low birth weight. Mothers' residency (being urban) is associated with an elevated risk of overweight/obesity among newborns. Thus, improving the health literacy of fathers and preventing stunting at birth are recommended to mitigate low birth weight.

Maternal age at first childbirth and under-five morbidity in sub-Saharan Africa: analysis of cross-sectional data of 32 countries

BACKGROUND

The prevalence of childhood morbidity remains high in low-and middle-income countries, including sub-Saharan Africa (SSA). In this study, the association between maternal age at first childbirth and under-five morbidity in SSA was examined.

METHODS

This was a cross-sectional study involving nationally-representative data from the most recent Demographic and Health Surveys conducted in 32 countries in SSA from 2010 to 2019. A sample size of 311,603 mothers of children under-five was considered. The outcome variable for this study was under-five morbidity. This variable was derived from the experience of fever, cough, and diarrhoea among children under-five. Both multilevel and binary logistic regression models were used to test the hypothesis that adolescent childbirth is associated with under-five morbidity. The results were presented as crude odds ratios (cORs) and adjusted odds ratios (aORs), with 95 % confidence intervals (CIs).

RESULTS

Children born to mothers whose first childbirth occurred at < 20 years were 16 % times more likely to suffer from under-five morbidity, compared to those whose mothers' first childbirth occurred at age ≥ 20 years [cOR = 1.16; CI = 1.13-1.19], and this persisted but with reduced odds after controlling for covariates [aOR = 1.10; CI = 1.07-1.12]. At the country level, children born to mothers whose first childbirth occurred at < 20 years were more likely to suffer from under-five morbidity, compared to those whose mothers' first childbirth occurred at age ≥ 20 years in Angola, Burundi, Congo DR, Guinea, Kenya, and Uganda.

CONCLUSIONS

In this study, an association between adolescent childbirth and morbidity in children under five in SSA has been established. The study concludes that under-five morbidity is higher among children born to mothers whose first childbirth occurred before 20 years compared to those whose mothers' first childbirth occurred at 20 years and above. The findings indicate that in order to reduce under-five morbidity, there is the need to deal with adolescent childbearing through cultural and social change, coupled with engagement of adolescents and stakeholders in adolescent sexual and reproductive health programmes.

Stunting at birth and associated factors among newborns delivered at the University of Gondar Comprehensive Specialized Referral Hospital

Background

Stunting at birth is a chronic form of undernutrition majorly attributable to poor prenatal nutrition, which could persist in children’s later life and impact their physical and cognitive health. Although multiple studies have been conducted in Ethiopia to show the magnitude of stunting and factors, all are concentrated on children aged between 6 to 59 months. Therefore, this study was done to determine the prevalence and associated factors of stunting at birth among newborns delivered at the University of Gondar Comprehensive Specialized Referral Hospital, Northwest, Ethiopia.

Methods

An institution-based cross-sectional study was conducted from February 26^th to April 25^th/2020. A systematic random sampling technique was used, to select a total of 422 newborn-mother pairs. The binary logistic regression was employed to identify factors associated with stunting and all independent variables were entered into the multivariable logistic regression model to adjust for confounders. Variables that had significant association were identified based on p-value < 0.05 and the adjusted odds ratio with its respective 95% confidence interval was applied to determine the strength as well as the direction of the association.

Results

About 30.5% (95% CI: 26.3%, 35.1%) of newborns were stunted at birth. Being male [Adjusted odds ratio (AOR) = 2.9(1.62, 5.21)], newborns conceived in Kiremt(rainy season) [AOR = 2.7(1.49, 4.97)], being low birth weight [AOR = 3.1(1.64, 6.06)] were factors associated with stunting at birth. Likewise, newborns born to short stature mothers [AOR = 2.8(1.21, 6.62)] and chronically malnourished mothers [AOR = 15.3(8.12, 29.1)] were at greater risk of being stunted.

Conclusion

Just under a third of newborns are stunted at birth, implying a pressing public health problem. Newborns born to chronically malnourished and short stature mothers were more stunted. Besides, stunting was prevalently observed among male neonates, newborns conceived in Kiremet, and being low birth weight. Thus, policymakers and nutrition programmers should work on preventing maternal undernutrition through nutrition education to reduce the burden of low birth weight and stunting. Further, paying due attention to newborns conceived in Kiremet season to improve nutritional status is recommended.

Perspective: Towards Automated Tracking of Content and Evidence Appraisal of Nutrition Research

Robust recommendations for healthy diets and nutrition require careful synthesis of available evidence. Given the increasing volume of research articles generated, the retrieval and synthesis of evidence are increasingly becoming laborious and time-consuming. Information technology could help to reduce workload for humans. To guide supervised learning however, human identification of key study characteristics is necessary. Reporting guidelines recommend that authors include essential content in articles and could generate manually labeled training data for automated evidence retrieval and synthesis. Here, we present a semiautomated approach to annotate, link, and track the content of nutrition research manuscripts. We used the STROBE extension for nutritional epidemiology (STROBE-nut) reporting guidelines to manually annotate a sample of 15 articles and converted the semantic information into linked data in a Neo4j graph database through an automated process. Six summary statistics were computed to estimate the reporting completeness of the articles. The content structure, presence of essential study characteristics as well as the reporting completeness of the articles are visualized automatically from the graph database. The archived linked data are interoperable through their annotations and relations. A graph database with linked data on essential study characteristics can enable Natural Language Processing in nutrition.