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Tiraboschi GA, Fitzpatrick C, Bernard JY, Monteiro JCDS, Kosak LA, Garon-Carrier G. Partners with a Highly Favorable Attitude Toward Breastfeeding Contribute to Promoting Initiation and Length of Breastfeeding for More than 5 Months in a Population-Based Canadian Study. Breastfeed Med 2024; 19:248-255. [PMID: 38452177 DOI: 10.1089/bfm.2023.0275] [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] [Indexed: 03/09/2024]
Abstract
Introduction: Promoting maternal breastfeeding for at least 6 months is important to improve children physical health during infancy and neurodevelopmental outcomes in childhood. For this guideline to be followed, it is paramount to identify what factors best support the initiation and length of breastfeeding. This study estimates the contribution of various child- and parent-level factors, as well as the sociodemographic context in predicting maternal breastfeeding initiation and duration. Methods: This study draws on data from the Quebec Longitudinal Study of Child Development. Mothers who never breastfed when the infant was 5 months old (n = 630, 28.3%) were compared to mothers who breastfed for less than 5 months (n = 844, 38.0%) and mothers breastfeeding for more than 5 months (n = 749, 33.7%), using multivariable multinomial regression models. Results: Mothers with a partner showing a positive attitude toward breastfeeding were up to 13 times more likely to breastfeed their infant for more than 5 months. The positive attitude of partners toward breastfeeding was the strongest predictor of breastfeeding duration, followed by the maternal educational attainment and timing she returns to work. Most prenatal and perinatal child-level factors and the sociodemographic context predicted breastfeeding duration, but to a lesser extent. Discussion: This finding underscores the role of the partner's attitude in promoting initiation and length of breastfeeding. As such, educational campaigns and health practitioners could target both the mother and their partner in promoting breastfeeding.
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Affiliation(s)
- Gabriel Arantes Tiraboschi
- Département de Psychoéducation, Université de Sherbrooke, Sherbrooke, Canada
- Département D'enseignement au Préscolaire et Primaire, Université de Sherbrooke, Sherbrooke, Canada
| | - Caroline Fitzpatrick
- Département D'enseignement au Préscolaire et Primaire, Université de Sherbrooke, Sherbrooke, Canada
| | - Jonathan Y Bernard
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Centre for Research in Epidemiology and Statistics (CRESS), Paris, France
| | | | - Laurie-Anne Kosak
- Département de Psychoéducation, Université de Montréal, Montréal, Canada
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Hoxha T, Youssef M, Huang V, Tandon P. Inflammatory Bowel Disease and Breastfeeding: A Narrative Review. Inflamm Bowel Dis 2024:izae033. [PMID: 38439613 DOI: 10.1093/ibd/izae033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Indexed: 03/06/2024]
Abstract
Inflammatory bowel disease (IBD) frequently affects women of childbearing age who may consider breastfeeding. Although breastfeeding has numerous benefits, there remain concerns regarding the safety of breastfeeding among women with IBD. Breastfeeding is important in developing the immune system of infants and has been shown to protect against the development of IBD. The risk of developing an increase in disease activity postpartum is the same regardless of breastfeeding status. Most IBD medications are also considered safe in breastfeeding and have no major risks to infants. Despite this, breastfeeding rates remain low among women with IBD, mostly due to concerns about the safety of IBD therapy with breastfeeding. Many women self-discontinue their IBD medications to breastfeed, and there is often uncertainty among health professionals to make recommendations about therapy. Dedicated IBD clinics can greatly support mothers during pregnancy and breastfeeding periods to enhance their knowledge, optimize their medication adherence, and improve their postpartum outcomes. This review aims to provide the most recent evidence-based literature regarding the safety of breastfeeding in women with IBD and the current recommendations about medical therapies with breastfeeding.
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Affiliation(s)
- Tedi Hoxha
- Division of Internal Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Michael Youssef
- Division of Internal Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Vivian Huang
- Division of Gastroenterology, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Parul Tandon
- Division of Gastroenterology and Hepatology, University Health Network, University of Toronto, Toronto, Ontario, Canada
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Nguyen TTT, Nishino K, Le LTH, Inthaphatha S, Yamamoto E. Strong Negative Association between Cesarean Delivery and Early Initiation of Breastfeeding Practices among Vietnamese Mothers-A Secondary Analysis of the Viet Nam Sustainable Development Goal Indicators on Children and Women Survey. Nutrients 2023; 15:4501. [PMID: 37960155 PMCID: PMC10647442 DOI: 10.3390/nu15214501] [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: 09/13/2023] [Revised: 10/22/2023] [Accepted: 10/22/2023] [Indexed: 11/15/2023] Open
Abstract
Early initiation of breastfeeding (EIBF) involves feeding a newborn with the mother's breast milk within the first hour of delivery. The prevalence of EIBF in Vietnam has recently shown a downward trend. The present study aimed to demonstrate the current prevalence of EIBF practices and identify factors associated with EIBF among Vietnamese mothers with children under 24 months of age. This study was a secondary analysis of data from the Viet Nam Sustainable Development Goal Indicators on Children and Women (SDGCW) survey 2020-2021. The study participants included 1495 mothers extracted from the SDGCW dataset. Descriptive statistics and logistic regression analyses were performed. The prevalence of EIBF practice was 25.5% among all mothers, 31.9% among vaginal-delivery mothers groups, and 9.0% among cesarean-section mothers groups. Factors negatively associated with EIBF were younger age (0.18 times), cesarean delivery (0.25 times), and absence of skin-to-skin contact with newborns immediately after birth (0.43 times). The prevalence of EIBF among Vietnamese mothers was found to be substantially low, especially among those who underwent cesarean delivery. EIBF should be promoted among younger mothers and those who underwent cesarean delivery.
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Affiliation(s)
- Tam Thi Thanh Nguyen
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550, Japan; (T.T.T.N.)
- Department of Nutrition and Food Safety, Thai Nguyen University of Medicine and Pharmacy, Thai Nguyen 250000, Vietnam
- Thai Nguyen General Hospital, Thai Nguyen 250000, Vietnam
| | - Kimihiro Nishino
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550, Japan; (T.T.T.N.)
| | | | - Souphalak Inthaphatha
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550, Japan; (T.T.T.N.)
| | - Eiko Yamamoto
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550, Japan; (T.T.T.N.)
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Iglesias Casás S, Pérez-Fernández MR, Montenegro-Alonso MS, Parada-Cabaleiro ME, Sanmartín-Freitas L, Mena-Tudela D. Neonatal outcomes after water birth: A retrospective cohort study. ENFERMERIA CLINICA (ENGLISH EDITION) 2023; 33:292-302. [PMID: 37394138 DOI: 10.1016/j.enfcle.2023.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Accepted: 05/28/2023] [Indexed: 07/04/2023]
Abstract
OBJECTIVE To compare neonatal outcomes between water births, births with immersion only during labour, and births in which immersion was never used. METHODS A retrospective cohort study was performed including mother-baby dyads attended between 2009 and 2019 at the Hospital do Salnés regional hospital (Pontevedra, Spain). These women were categorised into 3 groups: water birth; immersion only during dilation; and women who never used immersion. Several sociodemographic-obstetric variables were studied and the main outcome was the admission of the neonate to the intensive care unit (NICU). Permission was obtained from the responsible provincial ethics committee. Descriptive statistics were used and between-group comparisons were performed using variance for continuous variables and chi-square for categorical variables. Multivariate analysis was performed with backward stepwise logistic regression and incidence risk ratios with 95%CI were calculated for each independent variable. Data were analysed using IBM SPSS® statistical software. RESULTS A total of 1191 cases were included. 404 births without immersions; 397 immersions only during the first stage of labor; and 390 waterbirths were included. No differences were found in the need to transfer new-borns to a NICU (p = .735). In the waterbirth cohort, neonatal resuscitation (p < .001, OR: 0,1), as well as respiratory distress (p = .005, OR: 0,2) or neonatal problems during admission (p < .001, OR: 0,2), were lower. In the immersion only during labor cohort, less neonatal resuscitation (p = .003; OR: 0,4) and respiratory distress (p = .019; OR: 0,4) were found. The probability of not breastfeeding upon discharge was higher for the land birth cohort (p < .001, OR: 0,4). CONCLUSIONS The results of this study indicated that water birth did not influence the need for NICU admission, but was associated with fewer adverse neonatal outcomes, such as resuscitation, respiratory distress, or problems during admission.
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Affiliation(s)
| | | | | | | | | | - Desirée Mena-Tudela
- Departamento de Enfermería, Facultad de Ciencias de la Salud, Universitat Jaume I, Castelló de la Plana, Castelló, Spain
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Rodríguez Vázquez R, García Díaz A, Jiménez Fernández R, Corral Liria I. Exploring Tandem Breastfeeding Motivations Via Self-Determination Theory: An Interpretative Phenomenological Study. J Hum Lact 2023:8903344231166910. [PMID: 37125657 DOI: 10.1177/08903344231166910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
BACKGROUND Tandem breastfeeding is defined as a situation in which a mother continues breastfeeding her child through a subsequent pregnancy, including after the new baby is born. In some countries where motherhood may be delayed and the time between births may be reduced, support for the promotion of tandem breastfeeding is necessary to help mothers continue to breastfeed their eldest child and avoid early weaning. There is no existing research about mothers' motivations to breastfeed in tandem. RESEARCH AIM To explore the motivations of women to initiate and maintain tandem breastfeeding, based on their lived experience, framed within the self-determination theory. METHODS A prospective, cross-sectional, interpretive, phenomenological study was carried out through in-depth interviews with 15 mothers in Madrid, who had practiced tandem breastfeeding for more than 6 months, and whose weaning of their eldest child had occurred within the previous year. Convenience and snowball sampling were used. The data were analyzed using an established interpretive phenomenological analysis process. RESULTS Among the motivations for initiating tandem breastfeeding, the following themes were identified: "avoid wasting the effort invested," "desire such life experience," and "exercise the freedom to decide." The motivations for maintaining tandem breastfeeding were classified as "pass on parenting values" and "benefits of teamwork." CONCLUSION The participants based their motivation to tandem breastfeed to follow their freely chosen motherhood model. They discovered the advantages of its implementation, forming a team of themselves and their children, and healing their traumatic perinatal experiences.
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Salarvand S, Ghazvineh S, Mousivand F, Ahmadi Gharaei H, Bitaraf S. Health literacy and its related factors as predictors for the breastfeeding self-efficacy in a western province in Iran. BMC Public Health 2023; 23:593. [PMID: 36997892 PMCID: PMC10061825 DOI: 10.1186/s12889-023-15522-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 03/24/2023] [Indexed: 04/01/2023] Open
Abstract
BACKGROUND One of the effective factors on BF (Breastfeeding) continuation is Breastfeeding self-efficacy (BFSE). This study was conducted to determine the relationship between Health Literacy (HL) and BFSE in lactating mothers referring to primary health care centers. METHODS This cross-sectional descriptive study was carried out on lactating mothers referring to primary health care centers in 2022. Multi-stage cluster sampling was done with 160 samples. The data were collected using demographic questionnaire, Persian shortened form of the BSES is a self-reported instrument for measuring a mother's Breastfeeding self-efficacy and Health Literacy for Iranian Adults (HELIA). Data were analyzed using ANOVA, independent t-test, correlation test and liner regression by SPSS version 16, with a significance level of 5%. RESULTS There was a significant positive correlation between the HL score and its four domains( Reading, Behaviour and decision making, Accessing, and Understanding) except for the appraisal domain with BFSE score. The variables of use of formula, HL, duration of breastfeeding, and education were considered predictors of BFSE. CONCLUSION In general, the results indicate a possible relationship between BFSE and mothers' HL. Therefore, improving mother's HL can have a positive effect on promoting infants' nutrition.
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Affiliation(s)
- Shahin Salarvand
- Hepatitis Research Center, Faculty of Nursing and Midwifery, Lorestan University of Medical Sciences, Khorramabad, Iran.
| | - Sepideh Ghazvineh
- Student Research Committee, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Fatemeh Mousivand
- Student Research Committee, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Hasan Ahmadi Gharaei
- Social Development and Health Promotion Research Center, Gonabad University of Medical Sciences, Gonabad, Iran
| | - Saeid Bitaraf
- Epidemiology Clinical Sciences Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Núñez C, García-Alix A, Arca G, Agut T, Carreras N, Portella MJ, Stephan-Otto C. Breastfeeding duration is associated with larger cortical gray matter volumes in children from the ABCD study. J Child Psychol Psychiatry 2023. [PMID: 36946606 DOI: 10.1111/jcpp.13790] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/09/2023] [Indexed: 03/23/2023]
Abstract
BACKGROUND Despite the numerous studies in favor of breastfeeding for its benefits in cognition and mental health, the long-term effects of breastfeeding on brain structure are still largely unknown. Our main objective was to study the relationship between breastfeeding duration and cerebral gray matter volumes. We also explored the potential mediatory role of brain volumes on behavior. METHODS We analyzed 7,860 magnetic resonance images of children 9-11 years of age from the Adolescent Brain Cognitive Development (ABCD) dataset in order to study the relationship between breastfeeding duration and cerebral gray matter volumes. We also obtained several behavioral data (cognition, behavioral problems, prodromal psychotic experiences, prosociality, impulsivity) to explore the potential mediatory role of brain volumes on behavior. RESULTS In the 7,860 children analyzed (median age = 9 years and 11 months; 49.9% female), whole-brain voxel-based morphometry analyses revealed an association mainly between breastfeeding duration and larger bilateral volumes of the pars orbitalis and the lateral orbitofrontal cortex. In particular, the association with the left pars orbitalis and the left lateral orbitofrontal cortex proved to be very robust to the addition of potentially confounding covariates, random selection of siblings, and splitting the sample in two. The volume of the left pars orbitalis and the left lateral orbitofrontal cortex appeared to mediate the relationship between breastfeeding duration and the negative urgency dimension of the UPPS-P Impulsive Behavior Scale. Global gray matter volumes were also significant mediators for behavioral problems as measured with the Child Behavior Checklist. CONCLUSIONS Our findings suggest that breastfeeding is a relevant factor in the proper development of the brain, particularly for the pars orbitalis and lateral orbitofrontal cortex regions. This, in turn, may impact impulsive personality and mental health in early puberty.
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Affiliation(s)
- Christian Núñez
- Mental Health Research Group, Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Alfredo García-Alix
- Neonatal Neurology, NeNe Foundation, Madrid, Spain
- Iberoamerican Society of Neonatology (SIBEN), NJ, United States
| | - Gemma Arca
- Neonatal Neurology, NeNe Foundation, Madrid, Spain
- Department of Neonatology, Hospital Clínic, IDIBAPS, Barcelona, Spain
| | - Thais Agut
- Neonatal Neurology, NeNe Foundation, Madrid, Spain
- Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
- Department of Neonatology, Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
| | - Nuria Carreras
- Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
- Department of Neonatology, Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
| | - Maria J Portella
- Mental Health Research Group, Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
- Networking Research Center on Mental Health (CIBERSAM), Madrid, Spain
| | - Christian Stephan-Otto
- Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
- Networking Research Center on Mental Health (CIBERSAM), Madrid, Spain
- Pediatric Computational Imaging Group (PeCIC), Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
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Mothers' feeding practices among infants (4-12 months) and associated factors: a cross-sectional study in Saudi Arabia. J Nutr Sci 2022; 11:e83. [PMID: 36304820 PMCID: PMC9554420 DOI: 10.1017/jns.2022.85] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 08/28/2022] [Accepted: 08/30/2022] [Indexed: 12/14/2022] Open
Abstract
A global target of increasing exclusive breast-feeding (EBF) to at least 50 % by the year 2025 was set by the WHO for infants under 6 months. The lowest prevalence in the world was found in the Eastern Mediterranean region in 2010-18 and little is known about the status of mothers' feeding practices in Saudi Arabia. The present study aimed to assess mothers' actual feeding and weaning practices used with their infants by the mothers' different age groups. The present study was conducted among 247 mothers of infants aged 4-12 months who were attending public well-baby clinics. Quantitative data were obtained by nutritionists using an electronic semi-structured questionnaire about mothers' feeding practices. Only 5·3 % of mothers engaged in EBF, 44·9 % breast-fed their infants after an hour of birth, while 92·7 % of infants had ever been breast-fed. The average intent/plan to continue breast-feeding was 4·9(±3·1) months. Younger mothers introduced weaning food around 4 weeks earlier than older mothers (mean differences were -0·4, 95 % CI -0·71, -0·13; P = 0·031). A total of 64·3 % of infants received complementary feeding before completing 17 weeks. Maternal age group and delivery mode were the only factors associated with the early introduction of complementary feeding. A total of 69·2 % of the mothers believed that 'it is a good time' and 61·1 % felt that 'infants are hungry and need other sources of food'. Online sources and family advice were the top sources of information on mothers' feeding practices. Provision of professional advice about EBF and optimal weaning practices are significant areas for improvement in terms of compliance with recommended infant feeding practices.
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Preventing nipple pain/trauma in breastfeeding women: a best practice implementation project at the Marqués de Valdecilla University Hospital (Spain). INT J EVID-BASED HEA 2022; 20:374-384. [DOI: 10.1097/xeb.0000000000000340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Oliver-Roig A, Rico-Juan JR, Richart-Martínez M, Cabrero-García J. Predicting exclusive breastfeeding in maternity wards using machine learning techniques. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2022; 221:106837. [PMID: 35544962 DOI: 10.1016/j.cmpb.2022.106837] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 01/07/2022] [Accepted: 04/24/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND AND OBJECTIVE Adequate support in maternity wards is decisive for breastfeeding outcomes during the first year of life. Quality improvement interventions require the identification of the factors influencing hospital benchmark indicators. Machine Learning (ML) models and post-hoc Explainable Artificial Intelligence (XAI) techniques allow accurate predictions and explaining them. This study aimed to predict exclusive breastfeeding during the in-hospital postpartum stay by ML algorithms and explain the ML model's behaviour to support decision making. METHODS The dataset included 2042 mothers giving birth in 18 hospitals in Eastern Spain. We obtained information on demographics, mothers' breastfeeding experiences, clinical variables, and participating hospitals' support conditions. The outcome variable was exclusive breastfeeding during the in-hospital postpartum stay. We tested algorithms from different ML families. To evaluate the ML models, we applied 10-fold stratified cross-validation. We used the following metrics: Area under curve receiver operating characteristic (ROC AUC), area under curve precision-recall (PR AUC), accuracy, and Brier score. After selecting the best fitting model, we calculated Shapley's additive values to assign weights to each predictor depending on its additive contribution to the outcome and to explain the predictions. RESULTS The XGBoost algorithms showed the best metrics (ROC AUC = 0.78, PR AUC = 0.86, accuracy = 0.75, Brier = 0.17). The main predictors of the model included, in order of importance, the pacifier use, the degree of breastfeeding self-efficacy, the previous breastfeeding experience, the birth weight, the admission of the baby to a neonatal care unit after birth, the moment of the first skin-to-skin contact between mother and baby, and the Baby-Friendly Hospital Initiative accreditation of the hospital. Specific examples for linear and nonlinear relations between main predictors and the outcome and heterogeneity of effects are presented. Also, we describe diverse individual cases showing the variation of the prediction depending on individual characteristics. CONCLUSION The ML model adequately predicted exclusive breastfeeding during the in-hospital stay. Our results pointed to opportunities for improving care related to support for specific mother's groups, defined by current and previous infant feeding experiences and clinical conditions of the newborns, and the participating hospitals' support conditions. Also, XAI techniques allowed identifying non-linearity relations and effect's heterogeneity, explaining specific cases' risk variations.
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Santamaría-Martín MJ, Martín-Iglesias S, Schwarz C, Rico-Blázquez M, Portocarrero-Nuñez JA, Diez-Izquierdo L, Llamosas-Falcón L, Rodríguez-Barrientos R, Del-Cura-González I. Effectiveness of a group educational intervention - prolact - in primary care to promote exclusive breastfeeding: a cluster randomized clinical trial. BMC Pregnancy Childbirth 2022; 22:132. [PMID: 35172775 PMCID: PMC8851786 DOI: 10.1186/s12884-022-04394-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 12/21/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The rates of exclusive breastfeeding at 6 months in Spain are far from recommended by the World Health Organization, which is 50% by 2025. Evidence of the effectiveness of group interventions in late postpartum is limited. The objective of this study was to evaluate the effectiveness of the PROLACT group educational intervention for increasing the proportion of mother-child dyads with exclusive breastfeeding at 6 months compared to the usual practice in primary care. METHOD Multicentre cluster randomized clinical trial. A total of 434 mother-child dyads who breastfed exclusively in the first 4 weeks of the children's life and agreed to participate were included. The main outcome was exclusive breastfeeding at 6 months. Secondary variables were type of breastfeeding, reasons for abandonment, degree of adherence and satisfaction with the intervention. To study the effectiveness, the difference in the proportions of dyads with exclusive breastfeeding at 6 months was calculated, and the relative risk (RR) and number needed to treat (NNT) were calculated with their 95% CIs. To study the factors associated with the maintenance of exclusive breastfeeding at 6 months, a multilevel logistic regression model was fitted. All analyses were performed to intention to treat. RESULTS The percentage of dyads with exclusive breastfeeding at 6 months was 22.4% in the intervention group and 8.8% in the control group. PROLACT intervention obtained an RR =2.53 (95% CI: 1.54-4.15) and an NNT = 7 (95%CI: 5-14). The factors associated with exclusive breastfeeding at 6 months were the PROLACT intervention, OR = 3.51 (95%CI: 1.55-7.93); age > 39 years, OR = 2.79 (95%CI: 1.02-7.6); previous breastfeeding experience, OR = 2.61 (95%CI: 1.29-5.29); income between 500 and 833.33 €, OR = 3.52 (95%CI 1.47-8.47).); planning to start work before the infant was 6 months old, OR = 0.35 (0.19-0.63) . CONCLUSIONS The PROLACT intervention in primary care is more effective than the usual practice for maintaining exclusive breastfeeding at 6 months, and can therefore be considered evidence-based practice for implementation in standard practice. TRIAL REGISTRATION The trial was registered with ClinicalTrials.gov under code number NCT01869920 (03/06/2013).
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Affiliation(s)
| | - Susana Martín-Iglesias
- Dirección Asistencial Sur.Gerencia Asistencial de Atención Primaria, Servicio Madrileño de Salud, Madrid, Spain
| | - Christine Schwarz
- Escuela Nacional de Sanidad, Instituto de Salud Carlos III, Madrid, Spain
| | - Milagros Rico-Blázquez
- Research Unit. Gerencia Asistencial Atención Primaria. Servicio Madrileño de Salud, Calle San Martín de Porres 6, 28035, Madrid, Spain.,Health Services Research on Chronic Patients Network (REDISSEC), RICORS (RICAPPS) Instituto de Salud Carlos III, Madrid, Spain.,Nursing Department, Faculty of Nursing, Physiotherapy and Podiatry, Universidad Complutense de Madrid, Madrid, Spain.,Instituto de Investigación Sanitaria Gregorio Marañón (IISGM), Madrid, Spain
| | | | - Laura Diez-Izquierdo
- Preventive Medicine. Hospital Infanta Sofia. San Sebastian de los Reyes, Madrid, Spain
| | - Laura Llamosas-Falcón
- Preventive Medicine and Public Health, Hospital Universitario, 12 de Octubre, 28041, Madrid, Spain
| | - Ricardo Rodríguez-Barrientos
- Research Unit. Gerencia Asistencial Atención Primaria. Servicio Madrileño de Salud, Calle San Martín de Porres 6, 28035, Madrid, Spain.,Health Services Research on Chronic Patients Network (REDISSEC), RICORS (RICAPPS) Instituto de Salud Carlos III, Madrid, Spain.,Instituto de Investigación Sanitaria Gregorio Marañón (IISGM), Madrid, Spain
| | - Isabel Del-Cura-González
- Research Unit. Gerencia Asistencial Atención Primaria. Servicio Madrileño de Salud, Calle San Martín de Porres 6, 28035, Madrid, Spain. .,Health Services Research on Chronic Patients Network (REDISSEC), RICORS (RICAPPS) Instituto de Salud Carlos III, Madrid, Spain. .,Instituto de Investigación Sanitaria Gregorio Marañón (IISGM), Madrid, Spain. .,Department Medical specialties and Public Health, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain.
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12
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Mirafzali S, Akbari Sari A, Iranpour A, Alizadeh S. Breastfeeding Duration and Its Effective Factors in Kerman Province, Iran. Glob Pediatr Health 2022; 9:2333794X221133019. [DOI: 10.1177/2333794x221133019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 09/28/2022] [Indexed: 11/18/2022] Open
Abstract
Introduction Complete cessation of breastfeeding (CCB) at the right time is as important as starting breastfeeding, as well as identifying the factors that affect the duration of breastfeeding, so that breastfeeding promotion programs focus on these causes, to increase mothers’ ability and desire to breastfeed. This study aimed to determine the time of CCB and its related factors. Methods This analytical cross-sectional study was conducted in 2020. This study was performed at all health centers and health homes affiliated to Kerman University of Medical Sciences, in Kerman province, Iran. A total of 802 urban and rural mothers with children aged from 30 to 36 months completed the questionnaire. The validity and reliability of the questionnaire were confirmed by Cronbach’s alpha of 85%. Data were analyzed using SPSS software version 16. Results The mean time of breastfeeding was 19.23 ± 7.09 months and the median was 22-month-year. About 41% of children were breastfed until 24-month. There was a significant relationship between the time of CCB with contraception, number of households, place of residence, and weight at 6-month at the level of 0.05. Conclusion Duration of breastfeeding is influenced by some demographic and cultural factors. The timing of the CCB is near to the suggestions of the World Health Organization (WHO) and religious teachings.
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Affiliation(s)
| | - Ali Akbari Sari
- Department of Health Economics and Management, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Abedin Iranpour
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Somayeh Alizadeh
- Health education & Promotion, Department of Health Education and Promotion, School of Public Health, Kerman University of Medical Sciences, Kerman, Iran
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13
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Gómez-Acebo I, Lechosa-Muñiz C, Paz-Zulueta M, Sotos TD, Alonso-Molero J, Llorca J, Cabero-Perez MJ. Feeding in the first six months of life is associated with the probability of having bronchiolitis: a cohort study in Spain. Int Breastfeed J 2021; 16:82. [PMID: 34663376 PMCID: PMC8522099 DOI: 10.1186/s13006-021-00422-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 09/13/2021] [Indexed: 12/02/2022] Open
Abstract
Background Breastfeeding is associated with lower incidence and severity of lower respiratory tract disease. However, little is known about the relationship between feeding type and breastfeeding duration with bronchiolitis in a child’s first year. Methods A prospective cohort study of 969 newborn babies were followed-up for 12 months to determine breastfeeding duration, feeding type, feeding trajectory, and bronchiolitis episodes at Marqués de Valdecilla University Hospital, Spain in 2018. Type of feeding was recorded by interviewing mothers at the time of hospital discharge and at 2, 4, 6, 9 and 12 months of life, in three categories: breastfeeding, mixed feeding and infant formula. Type of feeding at hospital discharge refers to feeding from birth to discharge. In any other times studied, it refers to feeding in the last 24 h. The association between the feeding type and bronchiolitis was analysed using logistic regression. Poisson regression was used to evaluate the association between feeding type and the number of bronchiolitis episodes with Kaplan-Meier estimators presenting the cumulative probability of suffering bronchiolitis. The results were adjusted for mother and child characteristics. Results Our data shows exclusive breastfeeding and mixed breastfeeding reduce the number of episodes of bronchiolitis. Regarding feeding at 4 months, exclusive breastfeeding reduced by 41% the number of episodes of bronchiolitis (adjusted incidence Ratio (aIR) 0.59, 95% CI 0.46, 0.76) and mixed feeding by 37% (aIR 0.63, 95% CI 0.47, 0.86). Moreover, changing from exclusive breastfeeding to mixed feeding increased the incidence of bronchiolitis compared with continuing exclusive breastfeeding. An early swap to mixed breastfeeding before months 2 or 4, was associated with a reduced the number of episodes of bronchiolitis, (aIR 0.53, 95% CI 0.39, 0.73 if introduction of mixed breastfeeding before month 2, and aIR 0.61, 95% CI 0.45, 0.83 if introduction of mixed breastfeeding before month 4), when compared with infant formula alone. Conclusions Any breastfeeding was associated with lower incidence of bronchiolitis and number of episodes of bronchiolitis in the first year of life. Consequently, promoting programmes facilitating exclusive or mixed breastfeeding would be a relevant measure in the prevention of bronchiolitis.
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Affiliation(s)
- Inés Gómez-Acebo
- Universidad de Cantabria - IDIVAL, Santander, Spain. .,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
| | | | | | - Trinidad Dierssen Sotos
- Universidad de Cantabria - IDIVAL, Santander, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | | | - Javier Llorca
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Universidad de Cantabria, Santander, Spain
| | - María J Cabero-Perez
- Universidad de Cantabria - IDIVAL, Santander, Spain.,Hospital Universitario Marqués de Valdecilla, Santander, Spain
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14
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Rivera-Diaz R, Llamas-Velasco M, Carretero G, Ruíz-Genao D, Belinchón I, Riera-Monroig J, de la Cueva P, Ferrán M, de Vega M, García-Doval I. Women with moderate-to-severe psoriasis in Spain (BIOBADADERM registry) breastfeed less when compared with general population. J Eur Acad Dermatol Venereol 2021; 36:e205-e207. [PMID: 34626521 DOI: 10.1111/jdv.17737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 08/26/2021] [Accepted: 09/16/2021] [Indexed: 11/30/2022]
Affiliation(s)
- R Rivera-Diaz
- Dermatology Department, University Hospital 12 de Octubre & Universidad Complutense, Madrid, Spain
| | - M Llamas-Velasco
- Dermatology Department, University Hospital La Princesa, Madrid, Spain
| | - G Carretero
- Dermatology Department, Universitary Hospital Gran Canaria Doctor Negrin, Gran Canaria, Spain
| | - D Ruíz-Genao
- Dermatology Department, Universitary Hopital Fundaciión Hospital Alcorcon, Madrid, Spain
| | - I Belinchón
- Dermatology Department, University General Hospital of Alicante & AlicanteInstitute of Sanitary and Biomedical Research (ISABIAL), Alicante, Spain.,Clinical Medicine Department, Miguel Herniández University of Elche, Elche, Spain
| | - J Riera-Monroig
- Dermatology Department, Hospital Cliínic de Barcelona, Universy of Barcelona, Barcelona, Spain
| | - P de la Cueva
- Dermatology Department, Universitary Hopital Infanta Leonor, Madrid, Spain
| | - M Ferrán
- Dermatology Department, Parc de Salut Mar, Barcelona, Spain
| | - M de Vega
- Academia Española de Dermatologiía y Venereologiía, Research Unit, Fundaciión Piel Sana, Madrid, Spain
| | - I García-Doval
- Academia Española de Dermatologiía y Venereologiía, Research Unit, Fundaciión Piel Sana & Complexo Hospitalario Universitario de Vigo, Servicio de Dermatologia, Vigo, Spain
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15
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Can Özalp E, Yalçın SS. Is maternal cigarette or water pipe use associated with stopping breastfeeding? Evidence from the Jordan population and family health surveys 2012 and 2017-18. Int Breastfeed J 2021; 16:43. [PMID: 34053454 PMCID: PMC8165988 DOI: 10.1186/s13006-021-00387-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 05/06/2021] [Indexed: 02/07/2023] Open
Abstract
Background Maternal smoking is suspected to have negative impacts on breastfeeding, such as decreasing the quantity of breast milk, and reducing vitamin and fat concentrations in the milk in the late lactation period. Cigarette and water pipe tobacco products are widely used in Jordan. We aimed to estimate the association between use of different tobacco products and the rates of current breastfeeding. Methods Data from Jordan’s Population and Family Health Surveys 2012 and 2017–18 were examined. Last-born, living children, aged < 25 months, from singleton births, ever breastfed, and living with their mother were included. The key outcome variables were the current breastfeeding (during last 24 h) and tobacco usage status [water pipe tobacco (hookah or narghile) and/or cigarette tobacco]. Complex sample multivariate logistic regression analysis was used to evaluate the association of the current breastfeeding with maternal smoking status. Results Overall, 6726 infants were included in the study. The current breastfeeding rate in infants aged 0–6 months was 87%, compared with 43.9% in infants aged 12–17 months and 19.4% in infants aged 18–24 months. Overall, 4.4% had mothers who smoked cigarettes, 5.4% smoked water pipe, and 1.6% both cigarettes and water pipe. The proportion of breastfed infants in non-smoking mothers was 57.7% and, those in smoke water pipe, cigarette and both tobacco products were 55.4, 44.9, and 51.0% respectively. Univariate analysis revealed that women cigarette smokers had a lower odds ratio (OR) for current breastfeeding (OR 0.60, 95% Confidence Interval [CI] 0.39, 0.92). Multivariate analysis revealed that maternal cigarette smoking was associated with a lower odds ratio for current breastfeeding compared with mothers who smoked neither water pipe nor cigarettes (AOR 0.51, 95% Cl 0.30, 0.87). Conclusions These results indicate that maternal smoking is associated with termination of breastfeeding, suggesting that structured training should be organized for healthcare professionals, expectant mothers and the general public about the association between maternal smoking and cessation of lactation.
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Affiliation(s)
- Esra Can Özalp
- Unit of Social Pediatrics Department of Pediatrics, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - S Songül Yalçın
- Unit of Social Pediatrics Department of Pediatrics, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
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16
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Santacruz-Salas E, Segura-Fragoso A, Pozuelo-Carrascosa DP, Cobo-Cuenca AI, Carmona-Torres JM, Laredo-Aguilera JA. Maintenance of Maternal Breastfeeding up to 6 Months: Predictive Models. J Pers Med 2021; 11:396. [PMID: 34064697 PMCID: PMC8151230 DOI: 10.3390/jpm11050396] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 04/30/2021] [Accepted: 05/06/2021] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND There is evidence of the benefits of exclusive breastfeeding (EBF) but maintaining EBF for the minimum recommended time of 6 months is challenging. AIMS This study aimed to determine the prevalence of breastfeeding types in a Spanish setting, explore the influencing factors, and analyze the relationships between the reasons for EBF cessation and the EBF durations achieved. METHOD This longitudinal descriptive study included 236 healthy children with standard weight followed up by the public health system. A baseline survey and three telephone interviews (1, 3, and 6 months) were conducted. RESULTS The prevalence of EBF at 6 months was 19.49%. The mean age of the mothers was 32.3 (±5.3). The variables influencing EBF maintenance were the prior decision to practice EBF (p = 0.03), the belief that EBF is sufficient (p = 0.00), not offering water or fluid to the child (p = 0.04), delaying pacifier use (p < 0.001), a longer gestation time (p = 0.05), and previous experience with practicing EBF for more than 6 months (p = 0.00). The reason for the earliest EBF cessation (mean 52.63 ± 56.98 days) was the mother's lack of self-efficacy (p = 0.05). CONCLUSION Knowing the reasons for EBF cessation among mothers is important for helping mothers and preventing early weaning. A safe environment and support can prevent early weaning.
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Affiliation(s)
- Esmeralda Santacruz-Salas
- FACSALUD (Faculty of Health Sciences), Av. Real Fábrica de la seda, s/n., Talavera de la Reina, 45600 Toledo, Spain; (E.S.-S.); (A.S.-F.)
- Multidisciplinary Research Group in Care (IMCU), UCLM. Av. Carlos III s/n., 45071 Toledo, Spain; (D.P.P.-C.); (J.M.C.-T.); (J.A.L.-A.)
- Department of Nursing, Physiotherapy and Occupational Therapy, University of Castilla la Mancha (UCLM), 45071 Toledo, Spain
| | - Antonio Segura-Fragoso
- FACSALUD (Faculty of Health Sciences), Av. Real Fábrica de la seda, s/n., Talavera de la Reina, 45600 Toledo, Spain; (E.S.-S.); (A.S.-F.)
| | - Diana P. Pozuelo-Carrascosa
- Multidisciplinary Research Group in Care (IMCU), UCLM. Av. Carlos III s/n., 45071 Toledo, Spain; (D.P.P.-C.); (J.M.C.-T.); (J.A.L.-A.)
- Department of Nursing, Physiotherapy and Occupational Therapy, University of Castilla la Mancha (UCLM), 45071 Toledo, Spain
- Faculty of Physiotherapy and Nursing of Toledo, University of Castilla la Mancha (UCLM) Av. Carlos III s/n., 45071 Toledo, Spain
| | - Ana Isabel Cobo-Cuenca
- Multidisciplinary Research Group in Care (IMCU), UCLM. Av. Carlos III s/n., 45071 Toledo, Spain; (D.P.P.-C.); (J.M.C.-T.); (J.A.L.-A.)
- Department of Nursing, Physiotherapy and Occupational Therapy, University of Castilla la Mancha (UCLM), 45071 Toledo, Spain
- Faculty of Physiotherapy and Nursing of Toledo, University of Castilla la Mancha (UCLM) Av. Carlos III s/n., 45071 Toledo, Spain
- Maimónides Institute for Biomedical Research Córdoba (IMIBIC), 14004 Córdoba, Spain
| | - Juan Manuel Carmona-Torres
- Multidisciplinary Research Group in Care (IMCU), UCLM. Av. Carlos III s/n., 45071 Toledo, Spain; (D.P.P.-C.); (J.M.C.-T.); (J.A.L.-A.)
- Department of Nursing, Physiotherapy and Occupational Therapy, University of Castilla la Mancha (UCLM), 45071 Toledo, Spain
- Faculty of Physiotherapy and Nursing of Toledo, University of Castilla la Mancha (UCLM) Av. Carlos III s/n., 45071 Toledo, Spain
- Maimónides Institute for Biomedical Research Córdoba (IMIBIC), 14004 Córdoba, Spain
| | - José Alberto Laredo-Aguilera
- Multidisciplinary Research Group in Care (IMCU), UCLM. Av. Carlos III s/n., 45071 Toledo, Spain; (D.P.P.-C.); (J.M.C.-T.); (J.A.L.-A.)
- Department of Nursing, Physiotherapy and Occupational Therapy, University of Castilla la Mancha (UCLM), 45071 Toledo, Spain
- Faculty of Physiotherapy and Nursing of Toledo, University of Castilla la Mancha (UCLM) Av. Carlos III s/n., 45071 Toledo, Spain
- Maimónides Institute for Biomedical Research Córdoba (IMIBIC), 14004 Córdoba, Spain
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Llorca J, Lechosa-Muñiz C, Gortazar P, Fernández-Ortiz M, Jubete Y, Cabero MJ. COVID-19 in a cohort of pregnant women and their descendants, the MOACC-19 study. BMJ Open 2021; 11:e044224. [PMID: 33637549 PMCID: PMC7918808 DOI: 10.1136/bmjopen-2020-044224] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
PURPOSE The Mother and Child COVID-19 study is a cohort recruiting pregnant women and their children in Cantabria, North of Spain, during COVID-19 pandemic in order to ascertain consequences of SARS-CoV-2 infection on pregnant women and their descendants. This article reports the cohort profile and preliminary results as recruitment is still open. PARTICIPANTS Three subcohorts can be identified at recruitment. Subcohort 1 includes women giving birth between 23 March and 25 May 2020; they have been retrospectively recruited and could have been exposed to COVID-19 only in their third trimester of pregnancy. Subcohort 2 includes women giving birth from 26 May 2020 on; they are being prospectively recruited and could have been exposed to COVID-19 in both their second and third trimesters of pregnancy. Subcohort 3 includes women in their 12 week of pregnancy prospectively recruited from 26 May 2020 on; they could have been exposed to COVID-19 anytime in their pregnancy. All women are being tested for SARS-CoV-2 infection using both RT-PCR for RNA detection and ELISA for anti-SARS-CoV-2 antibodies. All neonates are being tested for antibodies using immunochemoluminiscency tests; if the mother is tested positive for SARS-CoV-2 RNA, a nasopharyngeal swab is also obtained from the child for RT-PCR analysis. FINDINGS TO DATE As of 22 October, 1167 women have been recruited (266, 354 and 547 for subcohorts 1, 2 and 3, respectively). Fourteen women tested positive to SARS-CoV-2 RNA by the day of delivery. All 14 children born from these women tested negative for SARS-CoV-2 RNA. FUTURE PLANS Children from women included in subcohort 3 are expected to be recruited by the end of 2020. Children will be followed-up for 1 year in order to ascertain the effect that COVID-19 on their development.
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Affiliation(s)
- Javier Llorca
- Universidad de Cantabria Facultad de Medicina, Santander, Cantabria, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Carolina Lechosa-Muñiz
- Breastfeeding Coordinator, Hospital Universitario Marques de Valdecilla, Santander, Cantabria, Spain
| | - Pilar Gortazar
- Universidad de Cantabria Facultad de Medicina, Santander, Cantabria, Spain
- Servicio de Pediatría, Hospital Universitario Marques de Valdecilla, Santander, Cantabria, Spain
| | - María Fernández-Ortiz
- Instituto de Investigación Sanitaria Valdecilla (IDIVAL), Santander, Cantabria, Spain
| | - Yolanda Jubete
- Universidad de Cantabria Facultad de Medicina, Santander, Cantabria, Spain
- Servicio de Obstetricia y Ginecología, Hospital Universitario Marques de Valdecilla, Santander, Cantabria, Spain
| | - Maria J Cabero
- Universidad de Cantabria Facultad de Medicina, Santander, Cantabria, Spain
- Servicio de Pediatría, Hospital Universitario Marques de Valdecilla, Santander, Cantabria, Spain
- Instituto de Investigación Sanitaria Valdecilla (IDIVAL), Santander, Cantabria, Spain
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