Turkish adaptation of the maternal cognition about infant sleep questionnaire

Background

Exploring early childhood sleep problems requires a detailed understanding of parental beliefs and cognitions related to infant sleep. There is a need for validated measures to investigate the cognitions of Turkish mothers about infant sleep however no scale measuring parental perceptions related to infant sleep behaviors in Turkish is available. We aimed to culturally adapt the Maternal Cognitions about Infant Sleep Questionnaire (MCISQ) in Turkish.

Methods

Subjects were recruited from an internet sample through social media. Internal consistency was evaluated by Cronbach's alpha, and test-retest reliability was determined by Pearson's correlation test and paired t-test. For factorial validity, the principal component factor analysis was performed for the components of MCISQ.

Results

A total of 417 mothers, most aged between 25 and 29 years (47.8 %), participated in the study. Infants' age ranged between 6 and 18 months, with a mean of 10.5 ± 3.9 months. Factor analysis revealed four factors after removal of item 11: Anger, doubt, safety, limit setting. Cronbach's alpha was 0.85. A subgroup of 32 mothers completed MCISQ three weeks after the initial administration. Total mean scores showed a significantly strong correlation (p:<0.01, r:0.82). Higher scores were noted in both total and subscale scores in infants with maternally reported sleep problems (p:<0.01).

Conclusion

Findings suggest a four-factor solution for MCISQ in Turkish mothers with infants aged 6-18 months. The adapted Turkish version is composed of 19 items with good reliability. Factor structure and items included in the subscales differed from the original study, highlighting the cultural factors related to maternal perceptions about infant sleep.

Sources and perceived credibility of child nutrition information in relation to maternal health literacy

OBJECTIVE

To examine sources and perceived credibility of child nutrition information by maternal health literacy.

METHODS

US mothers of children (0-12 years) who used social media regularly (N = 340) completed an online survey. Health literacy was assessed using the Newest Vital Sign. Child nutrition information sources and perceived credibility of sources were compared by health literacy using logistic and quantile regression models.

RESULTS

Seventeen percent of mothers had limited health literacy. Compared to mothers with adequate health literacy, those with limited health literacy were more likely to get child nutrition information from siblings, extended family, dietitians, doctors, nurse practitioners, or physician assistants, and government agencies, and less likely to get information from Facebook. Mothers with limited health literacy rated information from parents, friends, Facebook, and Instagram as more credible than mothers with adequate health literacy. While perceived credibility of information from doctors, nurse practitioners, or physician assistants was high overall, mothers with limited health literacy perceived information from these health care providers as less credible.

CONCLUSIONS

Sources of child nutrition information and perceived credibility differ by maternal health literacy.

PRACTICE IMPLICATIONS

Pediatric providers are encouraged to refer parents to engaging resources that provide evidence-based child nutrition information.

Effect of mHealth-based relaxation program on stress coping and anxiety levels in mothers of children with cancer: A randomized controlled study

OBJECTIVE

This study aimed to explore the effects of a mHealth-based relaxation program on anxiety and stress coping levels in mothers of children with cancer.

METHODS

This randomized controlled, single-blind, parallel-group trial was conducted in the pediatric hematology-oncology unit of a university hospital. The study was completed by 50 mothers (intervention group: n = 25; control group: n = 25). The mothers in the intervention group participated in a mHealth-based relaxation program for eight weeks (including progressive muscle relaxation, guided imagery, and the four-leaf clover of mindfulness). Videos of the relaxation program were sent to mothers' WhatsApp accounts. The mothers in the control group received routine care. The State-Trait Anxiety and Stress Coping Scales were administered during the first and eighth weeks. The registration number of this study on ClinicalTrials.gov is NCT05807295.

RESULTS

Mothers who participated in the relaxation program had lower anxiety levels and higher stress-coping scores than those in the control group (p < 0.05).

CONCLUSION

Progressive muscle relaxation exercises, guided imagery, and cognitive-based therapeutic approaches were effective in reducing mothers' anxiety and stress coping.

PRACTICE IMPLICATIONS

Pediatric oncology nurses can apply mHealth-based relaxation programs to support caregivers, particularly mothers. In this way, ensuring the continuity and integrity of care is easy.

Challenges, practices, and impact of COVID-19 among mothers of children with autism spectrum disorder in cities and remote areas in Saudi Arabia

BACKGROUND

Mothers of children with autism spectrum disorder (ASD) across Saudi Arabia have experienced tremendous challenges during the COVID-19 pandemic. However, the challenges may be different for mothers living in a city compared to those living more remotely.

AIMS

We investigated challenges and practices related to COVID-19 and their impact among Saudi mothers of children with ASD in cities and remote areas during the pandemic.

METHODS

A sample of 99 mothers (60 in cities and 39 remote) who had a child with ASD was surveyed using an electronic questionnaire.

RESULTS

Mothers who lived in remote areas reported more challenges, while mothers in cities reported adopting more new practices with children than remote mothers. Regression analyses revealed that place of residence and age of the child were significant predictors of the challenges experienced by mothers of children with ASD.

RECOMMENDATIONS

Intervention services, community-based education programs, and electronic media are recommended for use with mothers in Saudi Arabia to increase awareness of COVID-19, improve practices, and minimize challenges in protecting their children with ASD.

Mothers' experience of virtual education during and after the COVID-19 pandemic: A qualitative study

This qualitative study was conducted with the aim of investigating the experience of mothers in Tehran in the field of virtual education during the COVID-19 pandemic. The participants in this study were 17 mothers of school children who experienced virtual education in Tehran during the COVID-19 pandemic. Data collection was done through semi-structured interviews, over the phone, and lasted for approximately 30-45 min. The interviews were audio recorded with the permission of the participants, transcribed verbatim, and analyzed using the method of conventional content analysis. For this study, 17 mothers were interviewed. Of those, 7 had one school-age child, 8 had two, and 2 had three. All of the children lived with both their mother and father. The majority of the mothers (16 out of 17) held bachelor's degrees. On average, the students were 11.76 years old. Fourteen of the students attended public schools, while 3 attended private schools. Most of the mothers (14 out of 17) reported their financial status as average. Data analysis led to the identification of 3 main themes and 12 subthemes. The three main categories were family-related factors, student-related factors, and school-related factors. The 4 themes related to family included 1) the role of family as a teacher, 2) the importance of direct and indirect supervision in family education, 3) the cost, and 4) the peace of mind. Factors related to students included 5 themes; 1) the advantages and disadvantages of virtual learning environments, 2) time management in education, 3) the consequences of failing to acquire necessary skills and knowledge, 4) issues of indifference and fraud in education, 5) physical, mental, and social problems affecting students. Factors related to schools included 3 themes; 1) the role of the teacher in virtual teaching and learning, 2) the challenges of lack of prior experience in education, 3) inequality in access to education and opportunities. The findings of this study have several implications for policymakers. Paying attention to technological and educational challenges related to virtual education and providing adequate support to parents are important things that should be prioritized. In addition, psychological support services should be made available to parents so that they can cope with the emotional challenges of virtual education. Finally, the positive experiences reported by mothers suggest that virtual education can be an effective and flexible option for future education, provided that the challenges are adequately addressed. Moreover, no work has been done on this issue comprehensively and the few studies that have followed this method have had some limitations. Therefore, schools, parents, and policymakers should explore innovative ways of integrating virtual education into the educational system to provide flexible and effective learning opportunities for students.

Nurse-mother communication and support: Perceptions of mothers in neonatal units

Introduction

Having a hospitalized neonate is a stressful experience for parents, especially mothers. Thus, in recent years, a paradigm shift occurred in the neonatal units, focusing on the needs of parents and supporting them in addition to caring for neonates. The aim of this study was to evaluate the nurse-mother communication and support in neonatal units in Bushehr, Iran.

Method

This descriptive cross-sectional study was performed in neonatal units of 6 hospitals in Bushehr, Iran, in 2022. Using the census method, all eligible mothers who met the inclusion criteria were included in this study. Data collection tools included demographic information form, nurse-parent support tool and nurse-parent communication questionnaire. The collected data were analyzed by SPSS version 24 using descriptive statistics, independent t-test, one-way ANOVA and Pearson correlation test.

Results

The total mean score of nurse-parent support tool was 3.72 ± 0.72 and the total mean score of nurse-parent communication questionnaire was 59/27 ± 12/82. Caregiving support had the highest mean score (4.07 ± 73 0.73) and emotional support had the lowest (3.42 ± 91 0.91). Also, a statistically significant difference was seen between the admitted unit variable and the mean score of nurse-mother communication and support. Additionally, there was a statistically significant difference between the mechanical ventilation status of the neonate and the mean score of nurse-mother support. A significant positive correlation was seen between the neonatal gestational age and the mean score of nurse-mother communication.

Conclusions

The total mean score of nurse-parent support and communication was moderate. Therefore, nursing support and communication need to be improved. Planning is needed to enhance the role of neonatal nurses and strengthen their support and communication skills in line with the family-centered care approach.

Willingness to accept malaria vaccines amongst women presenting at outpatient and immunization clinics in Enugu state, Southeast Nigeria

BACKGROUND

There are giant steps taken in the introduction of the novel malaria vaccine poised towards reducing mortality and morbidity associated with malaria.

OBJECTIVES

This study aimed to determine the knowledge of malaria vaccine and factors militating against willingness to accept the vaccine among mothers presenting in nine hospitals in Enugu metropolis.

METHODS

This was a cross-sectional study carried out among 491 mothers who presented with their children in nine hospitals in Enugu metropolis, South-East Nigeria. A pre-tested and interviewer-administered questionnaire was used in this study.

RESULTS

A majority of the respondents, 72.1% were aware of malaria vaccine. A majority of the respondents, 83.1% were willing to receive malaria vaccine. Similarly, a majority of the mothers, 92.9%, were willing to vaccinate baby with the malaria vaccine, while 81.1% were willing to vaccinate self and baby with the malaria vaccine. The subjects who belong to the low socio-economic class were five times less likely to vaccinate self and baby with malaria vaccine when compared with those who were in the high socio-economic class (AOR = 0.2, 95% CI 0.1-0.5). Mothers who had good knowledge of malaria vaccination were 3.3 times more likely to vaccinate self and baby with malaria vaccine when compared with those who had poor knowledge of malaria vaccination (AOR = 3.3, 95% CI 1-6-6.8).

CONCLUSION

Although the study documented a high vaccine acceptance among the mothers, there exists a poor knowledge of the malaria vaccine among them.

Integrating attachment and linguistic perspectives on the coherence of narratives regarding close relationships: A qualitative illustration

In this multidisciplinary study, we offer an integrative view on the coherence of narratives regarding close relationships. We show how coherence, as conceptualized by attachment researchers, is manifested in discursive syntactic structure, as conceptualized by linguists. To illustrate this correspondence, we use narratives of six mothers about their adolescent child and their relationship. Narratives were elicited with the widely used Five Minute Speech Sample (FMSS) procedure and were coded according to the FMSS-coherence manual, tapping their clarity, consistency, and multidimensionality. In addition, the syntactic constructions employed by mothers were analyzed. FMSS were segmented into Clause Packages (CPs). Within CPs, overt syntactic markers, such as 'because,' as well as unmarked thematic and pragmatic relations, such as new vs. given information, were categorized as reflecting different levels of integration between clauses. As we demonstrate, mothers whose narratives were rated as more coherent employed more integrated CPs. We conclude by discussing the multi-layered nature of coherence. We consider how a multidisciplinary approach to coherence can enrich the understanding of personal narratives and open a new direction for research of close relationships as well as inform functional analyses of the linguistic expression of coherence.

The effect of music played to new birth mothers on postpartum blues: A randomized controlled trial

BACKGROUND

Postpartum blues/postpartum maternal blues is a psychological disorder experienced by mothers with symptoms of postpartum sadness, easy crying, easy anxiety, sensitivity, indecisiveness. The study aimed to examine the effect of music played on newly delivered mothers on postpartum blues.

METHODS

A prospective, two-arm, randomized controlled study was conducted on n = 82 (41 = control, 41 = music group) mothers who gave birth at term in Trakya University Health Research and Application Center Maternity Service between May and December 2023. The research data were collected through the Personal Information Form, Stein Blues Scale (SBS), and Edinburgh Postpartum Depression Scale (EPDS). The scales used in the study were evaluated four times: postoperative 0-3 h, 12th, 24th, and 36th hours.

RESULTS

The postoperative 0-3 h SBS test median of the new mothers in the music group was 19.00, and the 36th hours test median was 2.00, while the postoperative 0-3 h SBS test median of the control group was 21.00, and the 36th hour test median was 13.00. The postoperative 0-3 h EPDS test median of the new mothers in the music group was 22.00, and the 36th hours test median was 0.00, while the postoperative 0-3 h EPDS test median of the control group was 26.00, and the 36th hours test median was 10.00. A significant difference was found in the 12th, 24th, and 36th hours (p < .001). A statistically significant high positive correlation was found between EPDS and SBS in the 12th, 24th, and 36th hours (p < .001).

CONCLUSIONS

In the study, it was found that music played to newly delivered mothers reduced postpartum blues and depression levels.

REGISTRATION

The submission date for a clinical trial protocol is prior to completing participant recruitment and for a systematic review, prior to completing full paper screening. NCT06252155.

Long-term effects on depressive symptoms among Ugandan mothers - Findings from a follow-up of a cluster-randomized education trial in a rural low-resource setting

INTRODUCTION

Depression is increasingly affecting mothers in poor countries such as Uganda. Various interventions have been implemented to tackle this problem, but their sustainability is under-researched. Here we present follow-up data on maternal depression six years after a cluster-randomized controlled maternal education trial in rural Uganda.

METHODS

The intervention lasted six months and consisted of nutrition, hygiene, sanitation and child stimulation education, delivered to 511 mothers of 6 to 8 months' old children. Six years later we assessed maternal depressive symptoms using two psychometric tools; the Beck Depression Inventory II (BDI-II) and Center for Epidemiologic Studies Depression scale (CESD).

RESULTS

For this follow-up study, data was available from 307/511 (60 %) mothers. Intention-to-treat analyses adjusting for clustering showed that the intervention mothers had non-significantly less depression symptoms (absolute score difference - 2; 95 % CI -5 to 0; p = 0.07) on BDI-II, and borderline significantly less depression symptoms (absolute score difference - 3; 95 % CI -5 to 0; p = 0.05) on CES-D compared to the controls. For categorized depression scores, the control mothers had significantly higher proportion of women classified in the worse depression categories for both BDI-II and CESD. We did not find any baseline characteristics associated with maternal depression.

LIMITATIONS

The BDI-II and CES-D tools are both self-reported and we cannot rule out the possibility of social desirability bias in reporting of depression symptoms.

CONCLUSION

Six years after the maternal education trial, some benefits on maternal mental health were sustained. More studies are warranted on sustainability and scale-up of such interventions.

From womb to world: mapping gut microbiota-related health literacy among Italian mothers, a cross-sectional study

BACKGROUND

The gut microbiota is a key determinant of long-term health. Promoting maternal health literacy may enhance children well-being. Aim of the present study was to assess gut microbiota-related health literacy of Italian women and identify potential gaps in awareness.

METHODS

A cross-sectional survey study was conducted using an online questionnaire (17 questions) on determinants and long-term impact of infant gut microbiota. The survey targeted Italian pregnant women and mothers of children under 2 years old, and was distributed through various social media channels between September 28th and November 15th, 2022. A total score was calculated as the sum of positive answers. Data on demographics, pregnancy status, and pre-existing knowledge of the infant gut microbiota were also collected. Descriptive and inferential statistics were applied.

RESULTS

The questionnaire was completed by 1076 women. Median total score was 9 [7-11]. The 81.7% of respondents declared prior knowledge of the gut microbiota. The internet was among the most commonly cited primary sources of information. Independent predictors of total score were having a university degree (B = 0.656, p = 0.002) and prior knowledge (B = 2.246, p < 0.001). Conversely, older age was associated with lower total scores (B = -0.092, p < 0.001). The least known determinants of infant gut microbiota were gestational BMI, prematurity, mode of delivery and NICU stay. Pregnant women failed to recognize the role of breastfeeding in the development of infant gut microbiota more frequently than non-pregnant women. The 97.5% of participants reported increased interest in the gut microbiota, with heightened interest associated with prior knowledge.

CONCLUSIONS

Our study revealed a moderate level of knowledge about infant gut microbiota among respondents, emphasizing the positive impact of prior knowledge on understanding and interest. Targeted educational interventions are needed to address awareness gaps, especially concerning the influence of breastfeeding on infant gut microbiota. Healthcare providers have the potential to enhance women's knowledge and awareness of this topic.

Maternal satisfaction with delivery service and associated factors among women who gave birth at public hospitals in Guji Zone, Southern Ethiopia

BACKGROUND

Maternal satisfaction during delivery services is considered an important indicator of the quality of healthcare in a hospital setting and determines the uptake of services during subsequent pregnancies. However, there is limited information on the magnitude of women's satisfaction during delivery services in the study area. Thus, this study aimed to assess factors associated with maternal satisfaction with delivery services among women who gave birth at public hospitals in Guji Zone, Southern Ethiopia.

METHOD

A facility-based cross-sectional study was conducted at public hospitals in Guji Zone from December 1, 2020, to January 30, 2021. Two hundred forty-nine women who gave birth at public hospitals were recruited by a systematic random sampling technique. The collected data were entered into the Epi Info 7 software and then exported to SPSS Version 26 for analysis. A logistic regression model was employed to identify the association between independent variables and maternal satisfaction during delivery services. A P-value less than 0.05 and an Adjusted Odds Ratio with 95% CI was computed to determine the strength of the association between these variables.

RESULT

In this study, 138(55.4%), 95% CI (49.1-61.7) women were satisfied with delivery. Mothers who delivered through cesarean section (AOR = 2.92, 95% CI: 1.34-6.33), privacy assured (AOR = 3.14, 95% CI: 1.76-5.59), shorter duration of labor (AOR = 2.82, 95% CI: 1.64-4.62), waiting time ≤ 30 min (AOR = 5.15,95% CI:1.99-13.32) and normal fetal outcome (AOR = 2.63, 95% CI:1.42-4.85) were associated with mothers satisfaction with delivery care services.

CONCLUSION

The overall magnitude of women's satisfaction with delivery services is low, which is below the national client satisfaction target of ≥ 85%. Factors such as mode of delivery, assured privacy, short duration of labor, waiting time ≤ 30 min, and good fetal outcome were significantly associated with women's satisfaction with delivery services. Therefore, healthcare providers should provide better management during intrapartum childbirth or emergency obstetric care to improve fetal outcomes during delivery services. In addition, health facility managers should avail infrastructure that helps to maintain the privacy of women who give birth in the facility.

Do WHO criteria for gestational diabetes fit a rural population in Tanzania? - A follow-up study assessing mother and child health six years after a pregnancy diagnosed with gestational diabetes

AIMS AND METHODS

In low- and middle- income countries (LMICs) consequences of gestational diabetes (GDM) is understudied. Using a prospective cohort of mothers (n = 197)and children (n = 251), from rural north-eastern Tanzania, we assessed prediabetes and type 2 diabetes (T2D) prevalence six years after a pregnancy with/without GDM.

RESULTS

The prevalence of prediabetes (49.4 % vs. 46.4 %) orT2D (20.0 % vs. 16.1 %), p ≥ 0.36, based on fasting plasma glucose (FPG) or HbA1clevels (prediabetes: 16.9 % vs. 13.8 % and T2D 1.2 % vs. 0 %, p = 0.47), andcardio-metabolic health parameters,weresimilar between women with/without previous GDM. These results were supported by similar perinatal outcomes and child health at follow-up.The overall prevalence ofprediabetes/T2D was high, but no differences in other cardio-metabolic risk markers were observed in women with prediabetes/T2D compared to women with normal glucose tolerance.

CONCLUSIONS

Despite high prevalence of GDM amongTanzanian women, the diagnosis was not associated with adverse pregnancy outcomes, nor with increased risk of prediabetes or T2D at follow-up. FPG and HbA1c may be poor markers for diabetes in this population, and further follow-up studies with longer time intervals are warranted to evaluate which GDM diagnostic criteria are most optimal for women in rural Tanzania and similar LMIC settings.

The emotional and social concerns of mothers of children with cleft palate: A cross-sectional study

PROBLEM

Among birth defects, a cleft palate is one of the most common defects globally, with a prevalence rate of 1 in 700 live-born children per annum. Caring for a child with cleft palate is considered a challenge for mothers who provide around clock care for these children. Despite this, there is limited knowledge of their experiences and needs particularly in low resource settings.

BACKGROUND

Previous literature emphasized that mothers of children with cleft palate face many challenges involving emotional distress, social isolation, and financial burden.

QUESTION

To investigate the emotional and social concerns of mothers of children with Cleft Palate compared to mothers of children without cleft palate.

METHODS

A comparative study design was conducted at the Jordanian Royal Medical Services using convenience sample of 312 mothers of children with and without cleft palate in Jordan.

FINDINGS

There was a significant difference in the presence of anxious feelings between mothers of children with cleft palate and those mothers without cleft palate children. Within group comparison for mothers of children with cleft palate has shown a significant difference in their social concerns with regards to social support and child's future.

DISCUSSION

Mothers of children with cleft palate reported significantly higher levels of sadness feelings. These emotions could be attributed to several factors, including the financial burden associated with medical treatment and interventions, the burden of caring for a child with special needs, the social stigma related to the child's appearance, the lack of public awareness, and the insufficient social support services.

CONCLUSION

Mothers of children with Cleft Palate experience a considerable amount of emotional and social concerns which require urgent interventions.

Perceived Social Support, Normalization, and Subjective Well-Being Among Family Members of a Child with Autism Spectrum Disorder

The experience of family members of children with autism spectrum disorder (ASD) is not uniform. This study focused on mothers of a child with ASD (Study 1) and typically developing siblings (TDSs) during their emerging adulthood (Study 2). Similarities and differences were explored regarding a proposed model examining the paths of perceived social support (PSS) and normalization (a coping strategy) with subjective well-being: satisfaction with life (SWL) and positive affect (PA). Similarities were found in the paths between PSS, normalization, and SWL, in mothers and TDSs, but differences emerged regarding PA. These findings highlight the importance of PSS as a resource that contributes to normalization and SWL. Professional awareness of family members' PSS and their engagement in normalization is needed.

Parent-child associations of sleep quality: is physical activity a confounder? The EPI-FAMILY health study

INTRODUCTION

The incidence of sleep deprivation has increased in pediatric populations, however, the relationship with physical activity (PA) remains uncertain and lacks evidence. Although some studies have shown that parents' lifestyle habits can influence this process, one point that requires further clarification in the literature is whether parents' sleep quality is linked to that of their children and whether parents' physical activity could play an important role in these possible relationships.

OBJECTIVES

To investigate the relationship of sleep quality between parents and children and verify the role of physical activity in this association.

METHODS

This is a cross-sectional study. Sleep quality was assessed using the Mini Sleep Questionnaire. The amount of sleep was estimated by the number of hours slept. PA domains (occupational activities, leisure, and active commuting) were assessed using the Baecke questionnaire, while moderate to vigorous PA (MVPA) was assessed with an accelerometer. Socioeconomic status was obtained through a questionnaire. The relationship of sleep quality between parents and children was carried out using hierarchical models with Binary Logistic Regression, where the factors were inserted one by one (1. unadjusted model; 2. sociodemographic variables; 3. children's PA; 4. parents' PA).

RESULTS

The study sample consisted of 102 children and adolescents (6-17 years), 92 mothers, and 69 fathers. Poor sleep quality of mothers was associated with their children's sleep quality (OR = 3.95; 95%CI = 1.33-11.38; P = 0.013). After inserting mothers' PA intensity into the final model, the associations remained significant (OR = 8.05; 1.33-48.59; P = 0.023). No relationship was observed between poor sleep quality of fathers and their children's sleep quality.

CONCLUSION

The relationship between poor sleep quality of mothers and that of their children remained significant, regardless of confounding variables.

Three reasons why parental burnout is more prevalent in individualistic countries: a mediation study in 36 countries

PURPOSE

The prevalence of parental burnout, a condition that has severe consequences for both parents and children, varies dramatically across countries and is highest in Western countries characterized by high individualism.

METHOD

In this study, we examined the mediators of the relationship between individualism measured at the country level and parental burnout measured at the individual level in 36 countries (16,059 parents).

RESULTS

The results revealed three mediating mechanisms, that is, self-discrepancies between socially prescribed and actual parental selves, high agency and self-directed socialization goals, and low parental task sharing, by which individualism leads to an increased risk of burnout among parents.

CONCLUSION

The results confirm that the three mediators under consideration are all involved, and that mediation was higher for self-discrepancies between socially prescribed and actual parental selves, then parental task sharing, and lastly self-directed socialization goals. The results provide some important indications of how to prevent parental burnout at the societal level in Western countries.

[Letter to the Editor Concerning "Prevalence and Predictive Factors of Exclusive Breastfeeding in the First Six Months of Life"]

N/a.

Dietary patterns and their associations with postpartum weight retention: results of the MINA cohort study

PURPOSE

To examine the association of prepregnancy dietary patterns with postpartum weight retention at 6 months (PPWR6) among Lebanese and Qatari women.

METHODS

Data for this study were derived from the Mother and Infant Nutrition Assessment (MINA) prospective cohort study conducted in Lebanon and Qatar. Pregnant women were recruited during their first trimester and were followed up for three years. For the purpose of this study, data belonging to sociodemographic characteristics of participants, prepregnancy dietary intake, prepregnancy BMI as well as weight retention at 6 months were used. Dietary intake was examined using a 98-item food frequency questionnaire. Principal component analysis was used for the derivation of dietary patterns. The associations of dietary patterns with PPWR6 were examined using simple and multiple linear regressions.

RESULTS

Data was available for 177 participants (Lebanon: 93; Qatar: 84). Mean PPWR6 was 4.05 ± 5.29 kg. Significantly higher PPWR6 was observed among participants with pre-pregnancy overweight/obesity and among those with excessive gestational weight gain. Two dietary patterns were identified: the "Western" and the "Varied" patterns. After adjustment for confounders, a positive association was observed between the 'Western' pattern scores and PPWR6 (ß = 1.27; 95% CI 0.68-1.86; p value: < 0.0001).

CONCLUSION

Higher adherence to the Western pattern was associated with higher PPWR6 amongst women, hence underscoring the importance of public health interventions aimed at fostering healthier dietary habits during this crucial stage of the lifecycle.

Health, Wellbeing and Empowerment E-workshops for Mothers of Children with Disabilities: A Non-randomised Comparison Study

Mothers of children with disabilities can experience compromised health. Targeted interventions require investigation to determine effectiveness. Healthy Mothers Healthy Families (HMHF) is a health, wellbeing and empowerment program that addresses mothers need to protect, and or, recover their own health due to caregiving impacts. This study compared the effectiveness of HMHF e-workshops online compared to no intervention. The HMHF e-workshops were delivered to 290 mothers across the 2020-2022 Covid-19 pandemic and 172 participated in research. The HMHF e-workshops included 3 online 2- hour workshops facilitated by credentialled peer-facilitators, closed online group chat, e-workbook and online learning package. Participants in both groups completed surveys pre and post the workshops (or control) over 8-10 weeks. Mothers who participated in HMHF significantly increased health help seeking behaviours (p < .001), and improved mental health and health behaviors over time: health behavior (p < .001), positive wellbeing (p < .004) and depression (p < .001) and stress symptoms (p = .005). Compared to controls, HMHF e-workshop participants significantly improved health behaviours (p < .001) and self-reported symptoms of depression (p = .002) and stress (p = .005) over 8-10 weeks. E-workshops were accessible and effective for mothers of children with high care needs and family responsibilities across the COVID-19 pandemic. Compared to no intervention, the HMHF intervention was more effective for improving healthy behaviours and mental health.

Immediate postpartum anemia and associated factors at shewarobit health facilities, Amhara, Ethiopia, 2022: a cross sectional study

BACKGROUND

Immediate postpartum anemia occurs when the amount of red blood cell count is reduced or hemoglobin concentration is below 10 g/dl in the immediate postpartum. It occurs primarily due to inadequate iron intake before and during pregnancy and blood loss during delivery. The aim of this study is to assess the proportion of immediate postpartum anemia and associated factors among mothers who gave birth at Shewarobit health facilities; in Amhara, Ethiopia.

METHODS

Institutional-based cross-sectional study was conducted from June to September 2022. A systematic random sampling method was employed to select the study participants. The data were collected through interviewer-assisted questions. Data were entered into Epi Data software version 4.6.0.4 and exported to SPSS 21 for analysis, and descriptive statistics were computed. Logistic regression was applied, and P-values less than 0.05 were considered statistically significant.

RESULTS

This study was conducted among 307 study participants and, the proportion of immediate postpartum anemia was 41.4% [95% CI: 36.7-46.6]. Having postpartum hemorrhage [AOR = 4.76, 95% CI: 2.44-9.28], not taking iron and folic acid supplementation [AOR = 6.19, 95% CI: 2.69, 14.22], having a prolonged second stage of labor [AOR = 2.52, 95% CI: 1.16-5.44], and mid-upper arm circumference < 23 cm [AOR = 2.02, 95% CI: 1.11-3.68] were factors significantly associated with immediate postpartum anemia.

CONCLUSIONS

The proportion of immediate postpartum anemia was public problem in Shewarobit health facilities. Following the progress of labor using a partograph, closely monitoring and immediate intervention of PPH, and prevent undernutrition during antenatal care is recommended.

The effect of parity on time to initiate complementary feeding among mother-infant pairs in Awi Zone, Northwest Ethiopia

INTRODUCTION

Despite strategies and recommendations for complementary feeding initiation were applied globally, mothers initiated complementary feeding to the infants on time was low. Previous works of literatures were not identified the effect of parity on time to initiate complementary feeding. Particularly, evidences regarding to this in Ethiopia is scanty. Therefore, this study aimed to identify the effect of parity on time to initiate complementary feeding among mother-infants pairs in Northwest Ethiopia.

METHODS

A community-based prospective cohort study was carried out among 732 primipara, and 1464 multipara mothers who had a live birth in Northwest Ethiopia. Data were collected using Kobo collect software at the start of and on a monthly bases until the end of the follow up period. Parity as exposure variable and other confounders were analyzed using cox proportional hazard regression. Kaplan-Meier survival curve and the Schoenfeld residuals global test (P-value = 0.4861) was performed. Hazard ratio (HR) with 95% confidence intervals (CI) was used to declare statistical significance of predictors.

RESULTS

The overall incidence rate of initiation of complementary feeding among primipara and multipara mothers were 16.27 (95%CI: 15.04, 17.61) and 13.30 (95%CI: 12.53, 14.12) person months' observations respectively. The median time to initiate complementary feeding among primipara and multipara mothers for their infants was 5 and 6 months respectively. Primipara mothers had a 30% higher rate to initiate complementary feeding early (AHR = 1.30, 95%CI: 1.17, 1.43). Age from 15 to 24 and 25-34 years (AHR = 1.69, 95%CI: 1.36, 2.09; and AHR = 1.45, 95%CI: 1.17, 1.81) and Birth type (twin) (AHR = 1.29, 95%CI: 1.02, 1.64) were statistically significant predictors for time to initiate complementary feeding.

CONCLUSIONS

Parity was identified as a statistically significant predictor for time to initiate complementary feeding. The incidence rate of early and late initiation of complementary feeding was higher among primipara than multipara mothers. Besides, the median time to initiate complementary feeding was earlier among primipara than multipara mothers. So, a parity based complementary feeding practice education should be advocated to tackle the gap and further reduce infants and children malnutrition. Relatively younger age and twin delivered mothers initiated complementary feeding against the recommendation. Therefore, intervention considering such statistically significant predictors could have a public health importance.

Dissociation in mothers with borderline personality disorder: a possible mechanism for transmission of intergenerational trauma? A scoping review

BACKGROUND

Dissociation is a feature of Borderline Personality Disorder (BPD), but rarely a focus for research, particularly in the perinatal literature. BPD partly has its aetiology in childhood and is characterised by emotional changes and difficulty with self-coherence that impacts on the processes of caregiving.

METHODS

A scoping review was conducted to synthesise current perspectives on the effect of dissociation in caregivers with BPD, particularly regarding the impact of caregiver dissociation on the interactional quality of relationship within parent-child dyads. Studies were included if they explicitly mentioned dissociation in the target population, or if dissociation was implied. A thematic analysis was conducted.

RESULTS

20 studies were included; 10 experimental or quasi-experimental; 2 presenting case material; and 8 non-systematic review articles. 4 studies used the Dissociative Experiences Scale (DES) to measure dissociation, while 2 studies included a 'dissociative behaviour' subscale as part of an observational measure. The remaining studies did not measure dissociation but referenced directly or indirectly a concept of dissociation.

CONCLUSIONS

Findings suggested there was some evidence that dissociation plays a unique role in BPD caregivers' interactions with their offspring, however any findings should be interpreted with caution as the concept has been poorly operationalised and defined.

A narrative inquiry into the communication experiences of mothers caring for children with cancer in Jordan

BACKGROUND

This study aims to investigate the parenting experiences of mothers who care for children with cancer in Jordan and specifically focuses on the communication experiences of mothers who care for children with cancer.

METHODOLOGY

A qualitative research design employing a narrative inquiry methodology was adopted; it employed the implementation of twenty semi-structured interviews with the mothers of children with cancer recruited from one pediatric hospital located in Amman, Jordan.

FINDINGS

The findings of this study reveal that the majority of mothers attempted to conceal or delay any discussion regarding the diagnosis with their child, particularly during the immediate post-diagnosis period. Additionally, the mothers expressed that their relationships with the parents of children diagnosed with the same illness contain positive and negative aspects. Finally, most mothers participating in this study praised the role of hope in helping them cope with the challenging health condition of their children.

CONCLUSIONS

The findings of this study reveal that mothers would withhold diagnostic information from their children for several reasons: firstly, they wished to safeguard their children from feelings of distress; secondly, they perceived that their children were too immature to fully comprehend the seriousness of their diagnosis; and, finally, they desired to protect their children from unnecessary fear and negative emotions.

PRACTICAL IMPLICATIONS

Pediatric cancer care requires effective communication between physicians, pediatric nurses, caregivers, and children; clear and accurate communication between healthcare providers and parents of children with cancer ensures that they fully understand the diagnosis and can make values-based decisions.

Sociocultural pressures and body related experiences during pregnancy and the postpartum period: A qualitative study

Sociocultural pressures to pursue unrealistic appearance expectations and control body shape and weight during pregnancy and postpartum periods have been increasing. Little is known about messages from different sources that may constitute unhelpful or protective influences. The aim of this study was to qualitatively examine messages women received from the sociocultural environment during pregnancy and postpartum and their association with experiences of living in their bodies and body change behaviors. Twenty women, mean age (SD)= 31.85, (2.3) years, 95% White, 60% with a Master's degree or higher, participated in individual interviews and completed online surveys. Women described appearance pressure from multiple sources during and after pregnancy, that increased their concerns related to their weight and shape. For a small number, these concerns were associated with efforts to control weight. Others described protective influences from friends and family that promoted body attunement, functionality appreciation, and positive body image. Findings highlight the importance of sociocultural influences during the peripregnancy period yet how many women derive elements of positive body image from this period. These findings have implications for interventions to support body image among women during the peripregnancy period and positive outcomes among mothers and infants.

Factors Predicting Poor Mental and Physical Health in Parents of Children with Autism Spectrum Disorder: Results from 2016 to 2019 National Survey of Children's Health

Although poor health has been reported in parents of children with autism spectrum disorder (ASD), most studies excluded fathers and focused on mental health. We combined 2016-2019 data from the National Surveys of Children's Health to determine child and parent characteristics that predict poor mental and physical health in fathers (n = 818) and mothers (n = 2111) of children with ASD. For fathers of children with ASD, higher parenting stress was significantly associated with greater odds of poor physical health, whereas racial and ethnic minorities and living at 400% above the federal poverty were significantly associated with lower odds of poor mental health. For mothers of children with ASD, greater child sleep problems were significantly associated with greater odds of poor physical health, and two-parent household living 400% above the poverty line was significantly associated with reported lower odds of poor mental health. Continued efforts to reduce parenting stress and improve child sleep problems, along with expanding existing services and coverages of ASD services, especially for low-income families, may help reduce the burden on these families, preventing adverse future health outcomes in this population.

Preterm toddlers' joint attention characteristics during dyadic interactions with their mothers and fathers compared to full-term toddlers at age 2 years

The current study investigates Joint Attention (JA) characteristics (duration, frequency, source of initiation, type of JA, agent of termination, missed and unsuccessful episodes) in preterm and full-term toddlers' interactions with their mothers and fathers, separately. Thirty-one singleton full-term (Mage = 24.07 months, SD = 1.45; 13 boys) and 17 singleton preterm toddlers (Madjustedage = 24.72 months, SD = 3.39; 12 boys) participated in the study with both parents. JA episodes were examined during dyadic five-minute free play sessions, were coded second-by-second, and were analysed using two-way mixed ANOVAs. Although the total amount of time spent in JA was not significantly different between the preterm and the full-term groups, JA episodes were more frequent, specifically supported JA episodes, and were more often terminated by the child during parent-preterm toddler interactions. Moreover, preterm toddlers missed their fathers' attempts for JA more often than their mothers' and more often than full-term toddlers missed their fathers' and mothers' bids for JA. Further, regardless of the birth status, toddlers initiated more JA with mothers than fathers, and fathers redirected their child's attention to initiate JA more than mothers. Findings indicate that preterm toddlers may struggle to respond to JA bids, especially with their fathers, and to sustain their attention on a specific object or event during interactions. Preterm toddlers may need more support to engage in JA relative to their full-term peers, and redirecting attention strategy may not be optimal for them. Also, toddlers' JA interactions may be different with their mothers and fathers. Findings contribute to the literature by demonstrating preterm toddlers' JA characteristics with both parents compared to full-term toddlers at age two.

Sensitive Child, Disturbed Kid: Stigma, Medicalization, and the Interpretive Work of Israeli Mothers of Children with ADHD

Attention-deficit/hyperactivity disorder (ADHD) is a rapidly globalizing medical category, and there is a need to attend to the on the-ground processes through which laypeople deploy the ADHD label in different local contexts. Based on in-depth interviews with Israeli mothers of children with ADHD, this article explores how mothers, as lay actors in the social field of diagnosis, interpreted the origins and meanings of their child's 'troubles'. The temporal perspective on mothers' meaning-making processes revealed a progression of four common phases through which mothers revisited their understanding of ADHD, and recast their own responsibilities and moral roles. We found that mothers' self-understanding was crucially impacted by the invisibility of the disability and the fact that diagnosis did not fully relieve them from blame for their children's stigmatizing behavior. While not all mothers accepted the validity of the diagnosis, participating in the medicalization of their child's condition allowed them to reach similar pragmatic and narrative goals. We discuss the cultural and institutional features of the Israeli ADHD landscape that shape mothers' narratives of their children, and their relations with expertise. We point to a culturally unique framing of children with ADHD in Israel as those characterized by emotional vulnerability and risk of social exclusion.

The Effect of Mindfulness on Posttraumatic Growth of Mothers of Premature Infants Admitted to Neonatal Intensive Care Unit

The purpose of this study was to determine the effect of Mindfulness-Based Stress Reduction (MBSR) on Posttraumatic Growth (PTG) in mothers of premature infants admitted to the Neonatal Intensive Care Unit (NICU) in Iran. Sixty mothers were selected by convenience sampling and assigned to the intervention and control groups. The intervention group received two MBSR sessions each week over the course of three weeks. The Posttraumatic Growth Inventory (PTGI) was used to collect data before, immediately after, and 1 month after the intervention. Based on repeated measures ANOVA, group-by-time interaction effect was significant and there was a statistically significant difference in the mean PTG scores of mothers in the two groups over time (p = 0.004). MBSR increased PTG in mothers. As a result, it is suggested that this approach be used in psychological support programs for mothers who have premature infants admitted to neonatal intensive care units.

Experiences of embodiment during pregnancy and the postpartum period: A qualitative study

Pregnancy and the postpartum period have been identified as times when women experience important changes in their physical bodies. Yet, little is known about the ways in which these experiences may be related to positive embodiment, or in contrast experienced as restricting and objectifying. Thus, the aim of this study was to qualitatively examine the way in which women experienced embodiment during the course of pregnancy and the postpartum period. Twenty women, mean age (SD)= 31.85, (2.3) years, 95 % White, participated in individual interviews and completed online surveys. Findings revealed that women described experiencing both aspects of positive embodiment including body connection and comfort, agency and functionality, attuned self-care, connection to appetite, and inhabiting the body as a subjective site. Findings also revealed negative aspects including body disconnection and discomfort, disrupted functionality, challenged self-care, appetite suppression, and the body as a public and objectified site. Findings highlight the potential for the pregnancy and postpartum periods to be important times for positive embodiment in women, and a source of appreciation of the body and its functionality. However, social pressures may also constrain embodiment during this period. These findings have implications for identifying pathways to positive embodiment in pregnancy and postpartum.

Facing a new life-The healthy transition to motherhood: What individual and environmental factors are needed? A phenomenological-hermeneutic study

OBJECTIVE

The aim of the study was to highlight first-time mothers' experiences of the transition to motherhood uncovering personal and environmental conditions facilitating or preventing the process of a healthy transition in a Swedish context.

DESIGN

A qualitative study with interview data analyzed using a phenomenological hermeneutic method.

SETTING AND PARTICIPANTS

Ten recent first-time mothers were selected from three primary healthcare centers in western Sweden.

FINDINGS

Four themes emerged, and the transition could be divided into several phases, interpreted as facing a new life, while feeling unprepared for identity and existential issues. The experience of becoming a mother was described as oscillation between a loss of former identity from previous life, and on the other hand, the joy and expectations of forming a new family. The mothers had high demands of themselves, often influenced by social media and needed to value the flow of information and `let go of control` to be able to make adequate decisions. The close family of origin was invaluable in this process being able to provide confirmation in the new role, facilitating the development of their own security and self-confidence.

KEY CONCLUSIONS

The vulnerability expressed by new mothers shows that support from the family of origin, partners and professionals are indispensable. The desired result after the transition to motherhood is a prosperous, maturity and confident mother. The main promoting factor in this process seems to be having a safe base that can provide required support.

IMPLICATIONS FOR PRACTICE

The level of wellbeing after the transition is crucial and the possibility of a warm, responsive and secure parenting needs to be strengthened. The challenge to preventive health care will be to identify a lack of support and ensure that these mothers gain sufficient support to meet today´s demands and still feel that they are good enough mothers for their children.

An exploration of women's lived experiences of care and support following perinatal death in South-Western Nigeria: A hermeneutic phenomenological study

BACKGROUND

Perinatal death results in long-lasting intense grief for bereaved mothers with a potential to negatively impact on their short- and long-term outcomes and quality of life if inadequately supported in coping with and managing their experience.

AIM

This study aimed at exploring the lived experience of women, of care and support following perinatal death in South-Western, Nigeria.

METHODS

A qualitative methodology using Heideggerian phenomenology was used. Fourteen women who had experienced perinatal death in South-Western Nigeria within the last (5) five years were interviewed, and Van Manen's approach to hermeneutic phenomenology was used in data analysis.

FINDINGS

Four main themes were identified: "they did not tell me the baby died", "response of health care professionals after the baby died", "moving on from hospital", and "support from family". The physical health status of mothers determined how they were informed of perinatal death. Health care professionals were distant, rude, nonempathetic and did not offer emotional support, in some cases. Mothers were given opportunity to see and hold their babies. There was no routine follow-up support in the community, besides a postnatal check-up appointment offered to all mothers regardless of their birth outcome. Family provided emotional support for mothers on discharge.

CONCLUSION

This study was the first to explore the lived experience of women of the care and support following perinatal death in South-Western, Nigeria. There is a need for healthcare systems to review bereavement care and support provisions for women who experience perinatal death.

Pregnancy stressors and postpartum symptoms of depression and anxiety: the moderating role of a cognitive-behavioural therapy (CBT) intervention

Background

Little is known about the association between stressors (especially positive stressors) during pregnancy and postpartum depression and anxiety.

Aims

We investigated the association between positive and negative stress events during different stages of pregnancy and postpartum mental health outcomes among low-income pregnant women with symptoms of anxiety in Pakistan and evaluated whether an intervention based on cognitive-behavioural therapy (CBT) had a regulatory effect.

Methods

Participants were 621 pregnant Pakistani women with mild anxiety. Using the Pregnancy Experience Scale-Brief Version, six scores were created to assess positive and negative stressors. We performed a multivariate linear regression to examine whether these six scores, measured both at baseline and in the third trimester, were associated with postpartum anxiety and depressive symptoms. The effect of the intervention on this relationship was examined by adding an interaction term to the regression model.

Results

Hassles frequency measured in the third trimester was positively associated with depression (B=0.22, 95% confidence interval (CI): 0.09 to 0.36) and anxiety (B=0.19, 95% CI: 0.08to 0.30). At the same timepoint, uplifts intensity was negatively associated with symptoms of depression (B=-0.82, 95% CI: -1.46 to -0.18) and anxiety (B=-0.70, 95% CI: -1.25 to -0.15), whereas hassles intensity was positively related to symptoms of depression (B=1.02, 95% CI: 0.36 to 1.67) and anxiety (B=0.90, 95% CI: 0.34 to 1.47). The intensity ratio of hassles to uplifts reported in the third trimester was positively related to both depression (B=1.40, 95% CI: 0.59 to 2.20) and anxiety (B=1.26, 95% CI: 0.57 to 1.96). The intervention strengthened the overall positive effects of uplifts and the negative effects of hassles. Pregnancy experiences at baseline during early pregnancy to mid-pregnancy were not associated with mental health outcomes.

Conclusions

Stressors in the third trimester but not earlier in pregnancy were associated with postpartum symptoms of anxiety and depression. The CBT intervention modified the association between pregnancy stressors and postpartum mental health outcomes. Programmes that promote positive experiences and reduce negative experiences, especially in late pregnancy, may mitigate postpartum mental health consequences.

Trial registration number

NCT03880032.

Health-promoting lifestyle in mothers with vaginal childbirth and cesarean section in the postpartum period

BACKGROUND

In the postpartum period, there are numerous changes in the physical and psychological dimensions of women, which reduce the quality of life of women. The aim of this study was to compare the health-promoting lifestyle of mothers with vaginal delivery and cesarean delivery in the postpartum period.

METHODS

This cross-sectional study was conducted on 77 pregnant women who had delivered vaginal or by cesarean section at Shohadaye Behshahr Hospital and were selected based on inclusion criteria. If the women were willing to participate in the study, a demographic questionnaire was completed, and the telephone numbers of the subjects were recorded so that the Porsline health-promoting lifestyle questionnaire could be sent to them. Data were analyzed with SPSS 22 using the T test, chi-square test and Repeated Measure ANOVA.

RESULTS

There was no difference in the average score of health-promoting lifestyle and its dimensions between the two groups of vaginal delivery and cesarean section at two and six weeks after delivery. However, in both groups, the total score of health-promoting lifestyle decreased significantly over time (P < 0.001).

CONCLUSIONS

There was no difference in health-promoting lifestyle between mothers with vaginal and mothers with cesarean delivery at two weeks and six weeks after delivery. This requires more attention from policy makers to make vaginal childbirth more convenient, and by reducing complications after vaginal childbirth, they can improve women's healthy lifestyles and, in turn, families. Also, it seems that the other variables apart from the method of delivery should be considered, and it is necessary to distinguish these variables such as routine episiotomy in order to prevent the decrease in the level of health-promoting behaviors among women during puerperium period.

"It's a big trauma for the family": A qualitative insight into the psychological trauma of paediatric burns from the perspective of mothers

BACKGROUND

Despite the medical and surgical improvements of paediatric burn injuries, burn injuries can be a painful and traumatic experience for the child and their family. It is therefore important to explore the experiences of caregivers who support their child throughout the burn journey. Thus, the purpose of this study was to explore the traumatic nature of paediatric burns on the family from a caregiver's perspective.

METHODS

This study used a descriptive qualitative approach to conduct online semi-structured interviews with caregivers (18 years and older) of children (aged four to 17 years) that had previously been admitted with an unintentional acute burn injury to a paediatric burns unit in Western Australia. Interviews explored the child's and caregiver's experiences throughout the burn journey from the perspective of the caregiver and were digitally recorded and transcribed verbatim. Transcripts were analysed using Braun and Clarke's six stages of reflexive thematic analysis.

RESULTS

Eleven mothers participated in the interviews and identified a range of poor psychological and psychosocial outcomes that themselves and their child experienced. Three overarching themes were elaborated from the interviews: Child and caregiver mental health difficulties during and after the burn (including medical trauma, mental health outcomes and caregiver guilt); Lifestyle and physical changes following the burn (including disruptions to routine, appearance concerns and puberty); and factors supporting or inhibiting the recovery journey (including personality factors, coping strategies, family dynamics and support).

FINAL CONSIDERATIONS

This study has presented the difficulties that children, young people, and their family face throughout a paediatric burn injury, which makes the implementation of timely and effective family centred interventions imperative. Meeting the needs and supporting these families with their mental health throughout this traumatic recovery journey, can ensure positive psychosocial outcomes and adaptive coping strategies are adopted early on.

[Letter to the Editor Regarding "Prevalence and Predictive Factors of Exclusive Breastfeeding in the First Six Months of Life"]

N/D.

The tongue microbiome of young patients with chronic kidney disease and their healthy mothers

OBJECTIVES

Oral microbiome plays a crucial role in the incidence and development of oral diseases. An altered intestinal microbiome has been reported in adults with chronic kidney disease (CKD). This study aimed to characterize the tongue microbiome of young patients with CKD compared to their healthy mothers to identify the influence of CKD-associated factors on resilient tongue ecosystem.

MATERIAL AND METHODS

Thirty patients with CKD (mean age, 14.2 years; 16 males and 14 females) and generalized gingivitis were included in the study. Swabs of the posterior tongue were collected from the patients and 21 mothers (mean age 40.8 years). Next-generation sequencing of 16S rDNA genes was employed to quantitatively characterize microbial communities.

RESULTS

The bacterial communities were similar in terms of richness and diversity between patients and mothers (p > 0.05). In patients with CKD, 5 core phyla, 20 core genera, and 12 core species were identified.

CONCLUSIONS

The tongue microbiome of the study participants showed no relevant CKD-associated differences compared to their mothers and appears to be a highly preserved niche in the oral cavity. Differences observed in the abundance of individual species in this study could be attributed to the age rather than CKD, even after a mean disease duration of 11 years.

CLINICAL RELEVANCE

CKD and its associated metabolic changes appear to have no detectable impact on the resilient tongue microbiome observed in young patients.

What matters to migrant women during labor and birth: Chinese mothers' experiences in Switzerland

BACKGROUND

In Switzerland, foreigners account for 25.3% of the permanent resident population, and the fertility rate of migrant women is higher than that of Swiss women. However, migrant women from non-European countries are more likely to report having negative childbirth experiences than Swiss women. For example, during pregnancy, Chinese migrant mothers often felt dissatisfied with the follow-up pregnancy complications and lacked information on medical procedures and prenatal courses. In this paper, we explored their childbirth experiences in Swiss hospitals and how Swiss healthcare providers supported them.

METHOD

A qualitative study employing in-depth, semi-structured interviews was conducted with 14 Chinese mothers and 13 family members. All interviews were audio-recorded, transcribed, and translated into English for data analysis. Thematic analysis was employed to generate a detailed description.

RESULTS

Three main themes were extracted from the transcripts: (1) Sense of security, (2) Intrapartum care, and (3) Postpartum needs.

CONCLUSIONS

Our study shows Chinese migrant mothers prioritized giving birth in a physically and psychologically safe environment, with pain control and practical and emotional support from their intimate partners. They desired a physiological labor and birth with minimal obstetric interventions. Our research also reveals their postpartum needs, emphasizing the importance of postpartum support and obtaining culturally sensitive care during their postpartum hospital stay. The study adds new knowledge of specific migrant studies in Switzerland, as called for by the Swiss Federal Office of Public Health. The results call for the transcultural care skills training of Swiss healthcare providers to enable migrant women to have a more positive childbirth experience.

The effect of paternal anxiety on mother-infant bonding in neonatal intensive care

BACKGROUND

The hospitalization of a preterm infant in the NICU can lead to mental health difficulties in parents, but not much is known how paternal anxiety might affect the mother-infant relationship.

METHODS

This prospective cohort study is a secondary analysis investigating how paternal anxiety levels might affect maternal bonding in the NICU using the dataset of the multinational pragmatic randomized controlled trial LongSTEP. A linear mixed-effects model was used for correlations of paternal anxiety (GAD-7) and maternal bonding (PBQ) at NICU discharge, and at 6 and 12 months infant corrected age. Secondary analyses examined effects on paternal anxiety related to: site (Argentina, Colombia, Israel, Norway, and Poland), maternal depression (EPDS), infant gestational age at birth, paternal age, and type of pregnancy.

RESULTS

Paternal anxiety did not predict maternal bonding at NICU discharge (p = 0.096), at 6 months (p = 0.316), or at 12 months infant corrected age (p = 0.473). Secondary outcomes showed a statistically significant site effect, with higher paternal anxiety levels at the two Colombian sites at baseline (p = 0.014 and p = 0.020) and for one site at discharge (p = 0.012), but not for paternal age (p = 0.925 and p = 0.793), infant gestational age at birth (p = 0.974 and p = 0.686 and p = 0.340), or type of pregnancy (p = 0.381). Maternal depression predicted paternal anxiety at baseline (p < 0.001) and at discharge (p = 0.003).

CONCLUSIONS

In this study, paternal anxiety did not predict maternal bonding. Paternal anxiety varied by site, indicating a need for research on potential cultural differences in manifestation of paternal anxiety. Maternal depression predicted paternal anxiety, confirming a previously reported correlation. Further research on variations in paternal mental health in the neonatal period is warranted, as well as exploration of the social contagion of mental health in preterm parents.

TRIAL REGISTRATION

ClinicalTrials.gov NCT03564184.

Letter to the Editor concerning "Prevalence and Predictive Factors of Exclusive Breastfeeding in the First Six Months of Life"

N/a.

Doing it all: Effects of Family Responsibilities and Marital Relationship Quality on Mothers' Ambulatory Blood Pressure

BACKGROUND

The shared provider responsibility between married couples does not translate to equally shared division of childcare (CC) and household labor. While some marriages contain highly positive aspects, marriages may also simultaneously contain both positive and negative aspects. The negativity in these relationships can negate the positivity and could potentially lead to the detriment of mothers' health.

PURPOSE

We examined mothers' ambulatory blood pressure (ABP) associated with their marital relationship quality and perceived equity with her spouse on CC and household tasks.

METHODS

We investigate these associations using a mixed multilevel model analysis on a sample of 224 mothers in heterosexual marriages, all of whom had children under the age of 18 years currently living in the home.

RESULTS

Mothers' perception of equity in the division of CC responsibilities contributed to lower ABP. Additionally, mothers in supportive marital relationships (low negativity and high positivity) had lower ABP than those in ambivalent relationships (both high negativity and positivity). There was a crossover interaction such that the effect of relationship quality on ABP was moderated by the perception of equity in the division of CC. For mothers who report doing all the CC, they had lower ABP if they had a supportive marital relationship compared with mothers in ambivalent relationships. Whereas mothers who report more equity in CC and have a supportive relationship have higher ABP compared with mothers in ambivalent relationships.

CONCLUSIONS

This study has implications related to dynamics within marital relationships. These results demonstrate important relational influences on mothers' ABP.

Healthy lifestyle practices: Evidence from clinic attending mothers in the northern province, Sri Lanka

Healthy lifestyles are known to reduce noncommunicable disease-related mortalities and morbidities. Public health initiatives should encourage healthier lifestyles to prevent the risk of noncommunicable diseases. This study aimed to determine healthy lifestyle practices and their associated factors among clinic-attending mothers (mothers attending antenatal clinics, postnatal clinics, well-baby clinics, family planning clinics, well-women clinics, and polyclinics) in the Chavakachcheri Medical Officer of Health (MOH) area. We conducted a clinic-based cross-sectional study in 19 centers covering 28 Public Health Midwives (PHM) areas. Healthy lifestyle practices, such as regular exercise, consumption of recommended servings of fruits and vegetables, measuring their own BMI, and average salt consumption, were poor. In the multivariate analysis, we found only three factors that had higher odds of affecting healthy lifestyle practices that were statistically significant: attributes of higher level of perceptions about healthy lifestyle practices (AOR = 4.36, 1.32-14.39), participating in Mothers' Support Groups (AOR = 7.97, 2.17-29.27) and BMI value of < 23 kg/m2 (AOR = 4.47, 1.35-14.73). Effective targeted healthy lifestyle-related educational programs instead of regular training during clinic visits and promoting participation in peer groups at the community level may benefit clinic-attending mothers.

Oral health related knowledge, attitude and behavior among group of mothers in relation to their primary school children's oral health: a cross-sectional study

The etiology of oral diseases in children is complex and multifactorial. The oral health of children can be influenced by various factors, including parental knowledge, attitudes and behaviors, as well as socioeconomic status. The objective of this study was to assess, among mothers of children aged 6-12 years, (1) mothers' knowledge about their children's oral health, (2) mothers' attitude toward their children's oral health, and (3) mothers' dental behavior concerning their oral health and to evaluate their influence on their children's dental caries. This cross-sectional study involved three questionnaires to be filled in by mothers of primary school children in addition to an oral examination of their children to measure decayed, missing, filled teeth for primary (dmft) and permanenet (DMFT) dentitions. The mother-child pairs were recruited through multistage stratified random sampling of primary schools in Jeddah, Saudi Arabia. The questionnaire was comprised of four sections: 1-demographic characteristics and socioeconomic status 2-Hiroshima University Dental Behavioral Inventory (mothers' attitudes and behavior pertaining to their oral health) 3-mothers' knowledge regarding the oral health of their children 4-mothers' attitude toward their children oral health. A total of 1496 mother-child pairs completed the study. The mean values of dmft were 4.08 ± 3.47; DMFT was 1.82 ± 2.07; total dmft and DMFT were 5.65 ± 4.05. According to the questionnaire results, mothers in private schools had a more favorable attitude and behavior toward their oral health, as well as a more favorable knowledge and attitude toward their children's oral health. The multiple linear regression model revealed that children's dmft/DMFT scores were significantly related to mother education, mother questionnaire scores, and the Simplified Oral Hygiene Index. Children's oral health is significantly impacted by oral health-related knowledge, attitude and behaviors of their mothers in addition to income status and education level.

Maternal and Paternal Adverse Childhood Experiences (ACEs) and Offspring Health and Wellbeing: A Scoping Review

BACKGROUND

Adverse childhood experiences (ACEs) are common, often co-occur, and are associated with poor health outcomes across the life course. Emerging research has emphasized the lasting consequences of ACEs across generations, suggesting parental ACEs are associated with poor physical and mental health outcomes in children. However, the individual effects of fathers' ACEs and pathways of transmission remain unclear. A scoping review was conducted to summarize the current knowledgebase of the intergenerational consequences of parental ACEs on offspring health, clarify pathways of transmission, understand how ACEs are operationalized in the intergenerational literature, and identify gaps in knowledge.

METHODS

Six electronic databases were searched for articles published in English from 1995 to 2022 relating to the long-term consequences of parental ACEs on offspring physical and mental health. Articles underwent title, abstract, and full-text review by two investigators. Content analysis was performed to integrate findings across the included studies.

RESULTS

The search yielded 14,542 unique articles; 49 met the inclusion criteria. Thirty-six articles focused exclusively on mothers, one solely on fathers, and 12 included both mothers and fathers in their analyses. Six studies used an expanded definition of ACEs. Both direct and indirect associations between parental ACEs and poor offspring outcomes were identified, primarily through biological and psychosocial pathways.

CONCLUSIONS

Findings underscore the importance and oversight of fathers and the need to solidify a unified definition and measure of ACEs. This review identified modifiable protective factors (social support, father involvement) and pathways of transmission (parental mental health, parenting); both having important implications for intervention development.

Human papillomavirus (HPV) vaccination in males: Associations of HPV-related knowledge and perceptions with HPV vaccination intention among Korean mothers of boys

Objectives

Human papillomavirus (HPV) vaccination rates among males are suboptimal worldwide. In South Korea, little is known about parents' intention to vaccinate boys against HPV. Therefore, we examined the associations of HPV-related knowledge and perceptions with vaccination intention among Korean mothers of boys.

Methods

From August to December 2021, eligible mothers were surveyed about HPV-related knowledge, perceptions, and intention to vaccinate their sons against HPV. Mothers were categorized into no intention, contemplating, and intention to vaccinate groups. Using analysis of variance, we compared the groups' scores on the scales measuring HPV-related knowledge, attitudes, and beliefs. We conducted a multinomial logistic regression analysis to assess the associations between the variables and vaccination intention.

Results

Among 361 mothers, 43.9 % had no intention, 60.7 % were contemplating, and 4.4 % intended to vaccinate their sons. The mean percentage of correct answers on the HPV and vaccine knowledge scales were 52.5 % and 62.3 %, respectively. The mean scores on the HPV attitudes and beliefs subscales were significantly different. Higher scores on benefits (OR = 3.04, 95 % CI 1.96 - 4.70; OR = 3.94, 95 % CI 1.54 - 10.70) and influence (OR = 1.48, 95 % CI 1.03 - 2.13; OR = 2.97, 95 % CI 1.44 - 6.14) were associated with contemplating the vaccine and intending to vaccinate sons. Knowledge was not associated with mothers' vaccination intention.

Conclusions

Public health authorities and healthcare providers in Korea can use the results of this study to implement effective interventions that emphasize the importance of male HPV vaccination and encourage parent-son communication about the vaccine.

Childhood maltreatment, trait resilience and prenatal distress among expecting mothers and fathers in the FinnBrain Birth Cohort Study

BACKGROUND

In this study we examined the association between childhood maltreatment exposure (CME) and psychological distress, including symptoms of depression and anxiety, during pregnancy. Additionally, we explored the potential moderating effect of trait resilience on these associations.

METHODS

The study is part of the ongoing FinnBrain Birth Cohort Study. The sample consisted of 3016 mothers and 1934 fathers. The data were collected using self-report questionnaires, including EPDS, SCL-90, CD-RISC-10 and TADS. We conducted ANOVAs and linear logistic regression analyses to examine the associations between depression, anxiety, resilience, and CMEs.

RESULTS

CMEs were associated with increased psychological distress, including depression symptoms and anxiety, and decreased trait resilience among both mothers and fathers. Additionally, trait resilience had a moderating effect on the association between fathers' CMEs and psychological distress, while no significant moderating effect was found among mothers. Furthermore, among both mothers and fathers, higher trait resilience was associated with decreased anxiety and depressive symptoms.

LIMITATIONS

Due to cross-sectionality, it is not possible to establish a causal relationship between CMEs, resilience, and parental distress. Additionally, the study does not provide insights into the underlying factors or processes that contribute to the development of trait resilience.

CONCLUSIONS

Trait resilience may have a positive impact on parents' mental health during pregnancy. This study is the first to investigate the significance of fathers' trait resilience during pregnancy. In clinical settings, it is essential to identify parents with low levels of resilience and provide them with appropriate support, recognizing them as a vulnerable group.

Australian, Irish, and Swedish women's comfort levels when breastfeeding in public

BACKGROUND

Despite a flux of global initiatives to increase and sustain breastfeeding rates, challenges persist. The decision to commence and sustain breastfeeding is influenced by multiple, complex factors. Feelings of social embarrassment, shame, fear of judgement, and lack of confidence when breastfeeding in public, compound women's decisions to breastfeed and may result in formula feeding or early cessation of breastfeeding. A greater understanding of where and how women feel most comfortable when breastfeeding in public can assist in designing interventions to support the initiation and continuation of breastfeeding.

METHODS

A cross-sectional survey was conducted with women living in Australia (n = 10,910), Sweden (n = 1,520), and Ireland (n = 1,835), who were currently breastfeeding or who had breastfed within the previous two years. Our aim was to explore where, and how often women breastfeed in public and to compare their levels of comfort when breastfeeding in public. Data were collected in 2018 using an anonymous online survey over a four-week period in Ireland, Australia, and Sweden, and were analyzed using SPSS Version 25.

RESULTS

Most respondents were highly educated, with over 70% in each country reporting having a university or college degree. Observing women breastfeeding in public was more commonly reported to be a weekly or daily occurrence in Sweden (24.5%) and Australia (28%), than in Ireland (13.3%). Women in the participating countries reported breastfeeding in public most commonly whenever their babies needed feeding. Very few women never or rarely breastfed publicly. Coffee shops/cafes, restaurants, and parks were the most popular locations. In all three countries, partners were reported to be very supportive of breastfeeding in public, which enhanced breastfeeding women's comfort levels. When asked to score out of a maximum comfort level of 10, women reported higher mean levels of comfort when breastfeeding in front of strangers (Ireland M = 7.33, Australia M = 6.58, Sweden M = 6.75) than with those known to them, particularly in front of their father-in-law (Ireland M = 5.44, Australia M = 5.76, Sweden M = 6.66 out of 10), who scored lowest in terms of women's comfort levels.

CONCLUSION

This study offers important insights into the experiences and comfort levels of women breastfeeding in public. Limitations include the anonymous nature of the surveys, thus preventing follow-up, and variances in terminology used to describe locations across the three settings. Recommendations are made for research to determine the relationships between the frequency of breastfeeding in public and breastfeeding women's perceived comfort levels, the influence of family members' perceptions of breastfeeding in public and women's experiences, and the experience of women who feel uncomfortable while breastfeeding in public, with a view to developing support measures.

Does livestock ownership predict animal-source food consumption frequency among children aged 6-24 months and their mothers in the rural Dale district, southern Ethiopia?

Background

Animal-source foods are food items that come from animals. Animal-source foods provide a variety of micronutrients that plant-source foods cannot provide to the same extent and without extra precaution. Milk, eggs, poultry, flesh meat and fish are animal-source foods mainly used in Ethiopia. Low animal-source food consumption among children and mothers is a great concern in many low-income settings. This study aimed to describe animal-source food consumption frequencies among children aged 6-24 months and their mothers in rural southern Ethiopia where livestock farming is very common. We also analysed the association between livestock ownership and animal-source food consumption among children and mothers.

Methods

A community-based cross-sectional study was conducted among 851 randomly selected households with child-mother pairs from August to November 2018. The study was conducted in the rural Dale District, southern Ethiopia. Structured and pre-tested questionnaires were used to collect data on mother and child information, livestock ownership, and animal-source foods consumption frequencies. Ordinal logistic regression analysis was used to describe associations between animal-source foods consumption and livestock ownership.

Result

Nearly, three-quarters (74.1%) of the households owned cows, and a quarter (25%) had goats or sheep. Dairy, egg and meat consumption among children during the past month was 91.8%, 83.0% and 26.2%, respectively. Likewise, the consumption of dairy, eggs and meat among mothers was 96.0%, 49.5% and 34.0%, respectively. The percentage of children who had not consumed any animal-source foods during the month prior to our survey was 6.6%, and the figure was 2.2% for the mothers. Dairy consumption was 1.8 times higher among children (aOR = 1.8, 95% CI [1.3-2.5]) and 3.0 times higher among mothers (aOR = 3.0, 95% CI [2.2-4.2]) in households that kept cows than in households without cows. The egg consumption frequency was positively associated with hen and goat/sheep ownership for both children and mothers. Meat consumption frequency among children was negatively associated with cow ownership (aOR = 0.66, 95% CI [0.45-0.95]); however, cow ownership was not associated with meat consumption among mothers.

Conclusion

Dairy products were common animal-source foods consumed by young children and mothers in the study area. However, meat consumption was low among children and mothers. Strategies like promoting the keeping of goats/sheep and hens to improve complementary feeding and mothers' nutrition are warranted in the study area.

Is the association between mothers' autistic traits and childhood autistic traits moderated by maternal pre-pregnancy body mass index?

BACKGROUND

Previous studies showed that there is a positive association between mothers' and children's autistic traits. We also tested if this association is more pronounced in mothers with a higher pre-pregnancy body mass index (BMI).

METHOD

The study was embedded in two cohorts with information available for 4,659 participants from the Generation R and for 179 participants from the Cambridge Ultrasound Siblings and Parents Project (CUSP) cohort. In both cohorts, maternal autistic traits were assessed using the short form of the Autism Spectrum Quotient, and information about maternal height and weight before pregnancy was obtained by questionnaire. Child autistic traits were assessed with the short form of Social Responsiveness Scale in Generation R (M = 13.5 years) and with the Quantitative Checklist for Autism in Toddlers (Q-CHAT) in the CUSP cohort (M = 1.6 years).

RESULT

Higher maternal autistic traits were associated with higher autistic traits in toddlerhood (CUSP cohort; βadjusted = 0.20, p < 0.01), in early childhood (Generation R; βadjusted = 0.19, p < 0.01), and in early adolescence (Generation R; βadjusted = 0.16, p < 0.01). Furthermore, a higher maternal pre-pregnancy BMI was associated with higher child autistic traits, but only in Generation R (βadjusted = 0.03, p < 0.01). There was no significant moderating effect of maternal pre-pregnancy BMI on the association between autistic traits of mothers and children, neither in Generation R nor in CUSP. In addition, child autistic traits scores were significantly higher in mothers who were underweight and in mothers who were overweight compared to mothers with a healthy weight.

CONCLUSION

We confirm the association between maternal and child autistic traits in toddlerhood, early childhood, and early adolescence. Potential interacting neurobiological processes remain to be confirmed.

MOTHERS WILLINGNESS TO VACCINATE THEIR IN-SCHOOL ADOLESCENTS AGAINST HPV INFECTION IN LAGOS STATE NIGERIA

Introduction

Human Papillomavirus (HPV) vaccine uptake rates for adolescents are still low in Nigeria despite the availability of safe and effective vaccines. The knowledge and attitudes of mothers to HPV infection and vaccines play a role in adolescents HPV vaccination uptake. This study assessed mothers' willingness to vaccinate their in-school adolescents against HPV infection in Lagos State Nigeria.

Methods

A cross-sectional descriptive study involving mothers of in-school adolescents was conducted using a multi-stage sampling technique. A self-administered questionnaire was used for data collection. Chi square test was used to determine association between categorical variable and the level of significant was set at 5%.

Results

The mean age of the respondents was 43.0 ± 5.8. Majority (92%) had poor knowledge of HPV infection and vaccination. However, majority (79%) of the respondents had a positive attitude to HPV vaccination. More than half (65.8%) of the respondents' were willing to vaccinate their adolescents against HPV. There were statistically significant associations between respondents' number of daughters and attitude about HPV vaccination (p=0.021), previous pap smear screening and willingness to vaccinate their children against HPV (p=0.012) and overall knowledge of HPV vaccination and willingness to vaccinate their children against HPV (p=0.041).

Conclusion

There is a need to increase public awareness and health education of mothers on HPV infection and cervical cancer in order to increase HPV vaccine uptake for their children. Health and education sectors can collaborate to achieve this using school-based HPV education programme.