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1.
PLOS Glob Public Health ; 3(10): e0002363, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37851664

RESUMEN

Food insecurity (FI) remains a key priority for sustainable development. Despite the well-known consequences of food insecurity on health and well-being, evidence regarding the burden and determinants of FI among pregnant women in Nigeria is limited. Framed by the social-ecological model, this study aimed to determine the prevalence of FI, and its associations with individual-/household-level and contextual-level factors among pregnant women in Nigeria. A cross-sectional study based on the Nigerian Multiple Indicator Cluster Survey (2021 Nigerian MICS6) was conducted among a sample of 3519 pregnant women aged 15-49 years. Several weighted multilevel multinomial logistic regression models were fitted to assess the association between individual-/household-s level and community-level characteristics with FI. We estimated and reported both fixed effects and random effects to measure the associations and variations, respectively. Results: The prevalence of FI among pregnant women in Nigeria was high, with nearly 75% of the participants reporting moderate to severe FI in the past 12 months (95% CI = 71.3%-75.8%) in 2021. There were also significant differences in all the experiences of food insecurity due to lack of money or resources, as measured by the Food Insecurity Experience Scale (FIES), except for feeling hungry but not eating because of lack of money or resources (p < 0.0001). Multivariate analysis revealed that higher parity, households with 5 or more members, household wealth index, urban residence, and community-level poverty were significantly associated with FI. Our study demonstrates a significantly high prevalence of FI among pregnant women in Nigeria in 2021. Given the negative consequences of FI on maternal and child health, implementing interventions to address FI during pregnancy remains critical to improving pregnancy outcomes.

2.
Artículo en Inglés | MEDLINE | ID: mdl-37681764

RESUMEN

We investigated the association between discrimination, neighborhood unsafety, and household food insecurity (FI) among Nigerian adults, as well as the gender-specific differences in these associations. Our analysis utilized data from the 2021 Multiple Indicator Cluster Survey (MICS), comprising 56,146 Nigerian adults aged 15-49 (17,346 males and 38,800 females). For bivariate analysis, we employed the Rao-Scott chi-square test to examine the relationship between predictors (discrimination, neighborhood unsafety, and a composite variable of both) and the outcome variable (FI). Food insecurity was assessed using both a dichotomous measure (food insecure vs. food secure) and a multinomial variable (food secure, mild FI, moderate FI, and severe FI). To model the association between predictors and FI while controlling for potential confounding factors, we utilized weighted binary and multinomial logistic regression. Among Nigerian adults, the prevalence of having ever experienced FI was 86.1%, with the prevalence of mild FI, moderate FI, and severe FI being 11.5%, 30.1%, and 44.5%, respectively. In the binary model, experiencing discrimination (OR = 1.36, 95% CI = 1.19-1.55), living in an unsafe neighborhood (OR = 1.33, 95% CI = 1.14-1.54), and facing both discrimination and unsafe neighborhood conditions (OR = 1.97, 95% CI = 1.57-2.48) were significantly associated with FI. In the multinomial model, discrimination, neighborhood unsafety, and experiencing both remained associated with moderate and severe FI. In the gender-specific models, discrimination and neighborhood unsafety were found to be significantly associated with FI in women but not in men. This study underscores the importance of implementing policies and programs that address the underlying causes of food insecurity, with specific attention to discrimination and neighborhood safety concerns, particularly for Nigerian women.


Asunto(s)
Población Negra , Inseguridad Alimentaria , Alimentos , Características del Vecindario , Determinantes Sociales de la Salud , Discriminación Social , Adulto , Femenino , Humanos , Masculino , Correlación de Datos , Alimentos/estadística & datos numéricos , Políticas , Características del Vecindario/estadística & datos numéricos , Discriminación Social/estadística & datos numéricos , Determinantes Sociales de la Salud/estadística & datos numéricos , Adolescente , Adulto Joven , Persona de Mediana Edad , Nigeria/epidemiología
3.
J Womens Health (Larchmt) ; 32(10): 1096-1103, 2023 10.
Artículo en Inglés | MEDLINE | ID: mdl-37579074

RESUMEN

Background: Despite the widespread food insecurity in the United States, there is limited research investigating its prevalence among pregnant women and the potential impact it has on maternal and child health outcomes. This study examined trends in the prevalence of, and investigated risk factors for, food insecurity among peripartum women, using a nationally representative sample in the United States. Materials and Methods: This cross-sectional study included pregnant and postpartum women aged 18-49 years who reported being currently pregnant or pregnant in the past 12 months and who participated in the National Health Interview Survey from 2019 to 2021. Weighted multivariable logistic regression analysis was used to estimate associations with food insecurity. Results: A total of 1,527 pregnant women, weighted to represent 5,588,192 women in the United States, were included in the analysis. Overall, from 2019 to 2021, 10.8% of peripartum women were food insecure. The prevalence of food insecurity changed substantially between 2019 and 2021 (2019: 10.6% confidence interval [95% CI: 8.7-13.5], 2020: 16.0% [95% CI: 10.9-22.8], 2021: 6.2% [95% CI: 4.2-9.1]). The adjusted odds of food insecurity were significantly higher among pregnant and postpartum women in 2020 (aOR 2.15), who had a health insurance coverage (aOR 2.98) and who had an unmet health care need in the preceding 12 months (aOR 6.52). Conclusion: We found that food insecurity was common among peripartum women between 2019 and 2021 and was exacerbated by the COVID-19 pandemic. Identifying the factors that predispose peripartum women to the risk of food insecurity can guide the development and implementation of targeted interventions aimed at reducing the adverse impact of food insecurity on perinatal and infant health.


Asunto(s)
COVID-19 , Pandemias , Lactante , Niño , Femenino , Embarazo , Humanos , Estados Unidos/epidemiología , Prevalencia , Estudios Transversales , Abastecimiento de Alimentos , Mujeres Embarazadas , Periodo Posparto , Factores de Riesgo , Inseguridad Alimentaria
4.
Nutrition ; 116: 112165, 2023 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-37573618

RESUMEN

OBJECTIVE: Despite the growing food insecurity crisis in the United States, limited evidence exists about the effects of food insecurity on the unmet health care needs of peripartum (pregnant and postpartum) women. The aim of this study was to examine the association between food insecurity and delayed or forgone health care among peripartum women in the United States from 2019 to 2021. METHODS: We conducted a pooled cross-sectional analysis using data from the 2019, 2020, and 2021 National Health Interview Surveys. Food security status was defined by type (high/marginal, low, and very low). Descriptive analysis and multivariable logistic regression, adjusted for sociodemographic and health-related characteristics, were conducted to estimate the overall and specific delayed or forgone health care (yes or no) between the different categories of food security. RESULTS: Of the 1525 peripartum women (weighted, N = 5,580,186), 11% of peripartum women in the United States experienced suboptimal food security in the 12 mo between 2019 and 2021, with 5% experiencing low and 5% experiencing very low food security. This included 6% (95% confidence interval [CI], 5-8%) who reported delaying filling a medical prescription, 6% (95% CI, 5-8%) who required counseling or therapy from a mental health professional but did not receive it, 6% (5-8%) who delayed counseling or therapy from a mental health professional, 8% (95% CI, 6-10%) who needed medical care but did not receive it, and 9% (95% CI, 7-10%) who delayed medical care. Peripartum women with low and very food security were more likely to delay or forego health care due to cost concerns than food-secure peripartum women. In the multivariable analyses adjusted for predisposing, enabling, and need-based factors, women with low and very low food security had higher risk for delayed or forgone health care than those with marginal or high food security. CONCLUSION: This study demonstrated a positive association between food insecurity and cost-related unmet health care needs among peripartum women. Future empirical studies are needed to assess the effects of peripartum health care interventions targeting food insecurity on reducing health care access disparities associated with costs and improving peripartum health outcomes.


Asunto(s)
Abastecimiento de Alimentos , Periodo Posparto , Embarazo , Humanos , Femenino , Estados Unidos , Estudios Transversales , Inseguridad Alimentaria , Atención a la Salud
5.
Front Glob Womens Health ; 4: 1149441, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37214560

RESUMEN

Background: The decision of the US Supreme Court to repeal Roe vs. Wade sparked significant media attention. Although primarily related to abortion, opinions are divided about how this decision would impact disparities, especially for Black, Indigenous, and people of color. We used advanced natural language processing (NLP) techniques to examine ethno-racial contents in Twitter discourses related to the overturn of Roe vs. Wade. Methods: We screened approximately 3 million tweets posted to Roe vs. Wade discussions and identified unique tweets in English-language that had mentions related to race, ethnicity, and racism posted between June 24 and July 10, 2022. We performed lexicon-based sentiment analysis to identify sentiment polarity and the emotions expressed in the Twitter discourse and conducted structural topic modeling to identify and examine latent themes. Results: Of the tweets retrieved, 0.7% (n = 23,044) had mentions related to race, ethnicity, and racism. The overall sentiment polarity was negative (mean = -0.41, SD = 1.48). Approximately 60.0% (n = 12,092) expressed negative sentiments, while 39.0% (n = 81,45) expressed positive sentiments, and 3.0% (n = 619) expressed neutral sentiments. There were 20 latent themes which emerged from the topic model. The predominant topics in the discourses were related to "racial resentment" (topic 2, 11.3%), "human rights" (topic 2, 7.9%), and "socioeconomic disadvantage" (topic 16, 7.4%). Conclusions: Our study demonstrates wide ranging ethno-racial concerns following the reversal of Roe and supports the need for active surveillance of racial and ethnic disparities in abortion access in the post-Roe era.

6.
AIMS Public Health ; 10(1): 105-115, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37063355

RESUMEN

Backgrounds: Data on the association between comorbid diabetes mellitus (DM) and acute pancreatitis (AP) remains limited. Utilizing a large, nationwide database, we aimed to examine the impact of comorbid diabetes mellitus on patients admitted for acute pancreatitis. Methods: This was a retrospective case-control study of adult patients with AP utilizing the National Inpatient Sample from 2015-2018, using ICD-10 codes. Hospitalization outcomes of patients admitted for AP with comorbid DM were compared to those without comorbid DM at the time of admission. The primary outcome was a mortality difference between the cohorts. Multivariable-adjusted cox proportional hazards model analysis was performed. Data was analyzed as both sex aggregated, and sex segregated. Results: 940,789 adult patients with AP were included, of which 256,330 (27.3%) had comorbid DM. Comorbid DM was associated with a 31% increased risk of inpatient mortality (aOR: 1.31; p = 0.004), a 53% increased risk of developing sepsis (aOR: 1.53; p = 0.002), increased hospital length of stay (LOS) (4.5 days vs. 3.7 days; p < 0.001), and hospital costs ($9934 vs. $8486; p < 0.001). Whites admitted for AP with comorbid DM were at a 49% increased risk of mortality as compared to Hispanics (aOR: 1.49; p < 0.0001). Different comorbidities had sex-specific risks; men admitted for AP with comorbid DM were at a 28% increased risk of mortality (aOR: 1.28; p < 0.0001) as compared to women. Men with comorbid DM plus obesity or hypertension were also at increased risk of mortality as compared to women, whereas women with comorbid DM plus renal failure were at greater risk of mortality as compared to men. Conclusions: Comorbid DM appears to be a risk factor for adverse hospitalization outcomes in patients admitted for AP with male sex and race as additional risk factors. Future prospective studies are warranted to confirm these findings to better risk stratify this patient population.

7.
Pediatr Rep ; 15(2): 272-281, 2023 Apr 06.
Artículo en Inglés | MEDLINE | ID: mdl-37092475

RESUMEN

This study examined the association between caregivers' self-rated general health, poor physical/mental health days, disease morbidity and asthma control in children from the United States with current asthma. The data analyzed for this study were obtained from 7522 children aged 0-17 years who participated in the 2012-2014, 2015-2017, 2018, and 2019 cycles of the Behavioral Risk Factor Surveillance System Asthma Call-back Survey (ACBS). We employed univariate analysis to describe the study population and weighted binary logistic regression to examine the association of predictors with asthma control. Approximately 50% of the children had uncontrolled asthma. The results show that caregivers who reported fair general health had a 61% higher likelihood of reporting uncontrolled asthma in their children compared to those who reported good/very good/excellent health (adjusted odds ratio [aOR] = 1.61; 95% confidence interval [CI], 1.14-2.26). Poor caregiver general health did not reach statistical significance in predicting uncontrolled asthma (aOR = 1.05, 95% CI, 0.62-1.75). Furthermore, having 1 to 14 poor physical/mental health days ([aOR] = 1.70; 95% CI, 1.28-2.227) and ≥15 poor physical/mental health days (aOR = 1.82, 95% CI, 1.31-2.53) was predictive of uncontrolled asthma in children. Additionally, endorsing one reported disease (aOR = 1.49, 95% CI, 1.15-1.93) and ≥2 diseases (aOR = 1.38, 95% CI, 1.08-1.78) was associated with uncontrolled child asthma. These findings underscore the association between caregivers' self-reported general health, poor mental/physical health days, disease morbidity and uncontrolled asthma among children from the U.S. with asthma. Pediatricians and child health practitioners should recall the importance of this relationship. To facilitate the identification of caregivers at risk and provide more comprehensive and effective care for children with asthma, healthcare practitioners should utilize every child asthma care encounter to inquire about the overall health of caregivers.

8.
Healthcare (Basel) ; 11(7)2023 Mar 30.
Artículo en Inglés | MEDLINE | ID: mdl-37046911

RESUMEN

This article examined the sociodemographic and health-related factors associated with the use of complementary and alternative medicine/therapy (CAM) among adults with current asthma in the United States. We used data from 76,802 adults aged 18 years and above from the 2012-2019 Behavioral Risk Factor Surveillance System (BRFSS) Asthma Call-back Survey (ACBS) cycles. Weighted binary and multinomial logistic regression was used to examine the association of these factors with ever CAM use and the number of CAM use. We found that approximately 45.2% of US adults with asthma ever used CAM. Among adults with asthma, 25.3% and 19.9% endorsed using one CAM and ≥2 CAMs, respectively. CAM use was significantly associated with adults ≤ 35 years, female gender, multiple/other race/ethnicity, higher cost barriers, adults with two or more disease comorbidities, and those with poorly controlled asthma in both binary and multinomial models. CAM use was not associated with insurance and income status. Understanding factors associated with CAM use can provide asthma care professionals valuable insights into the underlying drivers of CAM use behavior in this population, enabling them to offer more informed and effective medical advice and guidance.

9.
Epidemiologia (Basel) ; 4(1): 94-105, 2023 Mar 21.
Artículo en Inglés | MEDLINE | ID: mdl-36975618

RESUMEN

Complementary and Alternative Medicines/Therapies (CAM) are commonly used by US asthma adults, yet little is known about recent trends in their use. Our aim was to report trends in CAM use among US adults with current asthma. We conducted a serial cross-sectional study using nationally representative data from the BRFSS Asthma Call-Back Survey (ACBS) collected between 2008 and 2019 (sample size per cycle, 8222 to 14,227). The exposure was calendar time, as represented by ACBS cycle, while the main outcomes were use of at least one CAM and eleven alternative therapies. We analyzed CAM use overall and by population subgroups based on age, gender, race/ethnicity, income, and daytime and night-time asthma symptoms. Our findings show that there was an increase in the use of at least one CAM from 41.3% in 2008 to 47.9% in 2019 (p-trend < 0.001) and an upward trend in the use of herbs, aromatherapy, yoga, breathing exercises, homeopathy, and naturopathy (p-trend < 0.05). However, the use of vitamins, acupuncture, acupressure, reflexology, and other CAM therapies remained stable (p-trend > 0.05). These trends varied according to population characteristics (age, sex, race, income) and asthma symptoms. In conclusion, our study suggests that CAM use among US adults with current asthma is either increasing or stable, and further studies are needed to explore the factors influencing these trends.

10.
Artículo en Inglés | MEDLINE | ID: mdl-36814069

RESUMEN

Since the authors are not responding to the editor's requests to fulfill the editorial requirement, therefore, the article has been withdrawn.Bentham Science apologizes to the readers of the journal for any inconvenience this may have caused.The Bentham Editorial Policy on Article Withdrawal can be found at https://benthamscience.com/editorial-policies-main.php BENTHAM SCIENCE DISCLAIMER: It is a condition of publication that manuscripts submitted to this journal have not been published and will not be simultaneously submitted or published elsewhere. Furthermore, any data, illustration, structure or table that has been published elsewhere must be reported, and copyright permission for reproduction must be obtained. Plagiarism is strictly forbidden, and by submitting the article for publication the authors agree that the publishers have the legal right to take appropriate action against the authors, if plagiarism or fabricated information is discovered. By submitting a manuscript, the authors agree that the copyright of their article is transferred to the publishers if and when the article is accepted for publication.

11.
J Clin Gastroenterol ; 57(4): 325-334, 2023 04 01.
Artículo en Inglés | MEDLINE | ID: mdl-36753461

RESUMEN

BACKGROUND AIMS: Preventative care plays an important role in maintaining health in patients with inflammatory bowel disease (IBD). We aimed to assess the overall quality, strength, and transparency of conflicts among guidelines on preventative care in IBD. METHODS: A systematic literature search was performed in multiple databases to identify all guidelines pertaining to preventative care in IBD in April 2021. All guidelines were reviewed for the transparency of conflicts of interest and funding, recommendation quality and strength, external guideline review, patient voice inclusion, and plan for update-as per Institute of Medicine standards. In addition, recommendations and their quality were compared between societies. RESULTS: Fifteen distinct societies and a total of 89 recommendations were included. Not all guidelines provided recommendations on the key aspects of preventative care in IBD-such as vaccinations, cancer prevention, stress reduction, and diet/exercise. Sixty-seven percent of guidelines reported on conflicts of interest, 20% underwent external review, and 27% included patient representation. In all, 6.7%, 21.3%, and 71.9% of recommendations were based on high, moderate, and low-quality evidence, respectively. Twenty-seven percent, 23.6%, and 49.4% of recommendations were strong, weak/conditional, and did not provide a strength, respectively. The proportion of high-quality evidence ( P =0.28) and strong recommendations ( P =0.41) did not significantly differ across societies. CONCLUSIONS: Many guidelines do not provide recommendations on key aspects of preventative care in IBD. As over 70% of recommendations are based on low-quality evidence, further studies on preventative care in IBD are warranted to improve the overall quality of evidence.


Asunto(s)
Enfermedades Inflamatorias del Intestino , Humanos , Enfermedades Inflamatorias del Intestino/terapia , Ejercicio Físico
12.
Cureus ; 15(1): e33966, 2023 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-36820113

RESUMEN

Objectives To explore the association between depression, poor mental health status, and asthma control patterns among US adults using a latent class analysis (LCA) approach. Methods We used data from 10,337 adults aged 18 years and above from the 2016 Behavioral Risk Factor Surveillance System (BRFSS) Asthma Call-back Survey. Data-reductive LCA was used to derive asthma control patterns in the population using class variables indicative of asthma control. Besides univariate analysis, adjusted and unadjusted logistic regression models were used to examine the association of depression and poor mental health on the derived asthma control patterns.  Results About 27.8% of adults aged <55 reported depression, while 27.3% aged ≥55 years were depressed. The latent class prevalence of asthma control patterns was 42.8%, 31.1%, and 26.1%, corresponding to good, fair, and poor asthma control patterns, respectively. In adults aged <55 years, odds of depression (OR=1.52, 95% CI=1.27-1.82) and poor mental health (OR=1.58, 95% CI=1.27-1.96) were higher in the poor asthma control group compared to the good asthma control group. Odds for depression (OR=1.28, 95% CI=1.06-1.53) were also higher in the moderate asthma control group compared to the good asthma control group. Among those aged ≥55 years, depression odds (OR=1.57, 95% CI=1.31-1.87) were higher in only the poor asthma control group. Conclusions These findings may have public health implications. Detecting, screening, and treating depression and mental health disorders may help improve asthma control in people with asthma.

13.
AIMS Public Health ; 10(4): 739-754, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-38187902

RESUMEN

This study examined discourses related to an Indonesian soccer stadium stampede on 1st October 2022 using comments posted on Twitter. We conducted a lexicon-based sentiment analysis to identify the sentiments and emotions expressed in tweets and performed structural topic modeling to identify latent themes in the discourse. The majority of tweets (87.8%) expressed negative sentiments, while 8.2% and 4.0% of tweets expressed positive and neutral sentiments, respectively. The most common emotion expressed was fear (29.3%), followed by sadness and anger. Of the 19 themes identified, "Deaths and mortality" was the most prominent (15.1%), followed by "family impact". The negative stampede discourse was related to public concerns such as "vigil" and "calls for bans and suspension," while positive discourse focused more on the impact of the stampede. Public health institutions can leverage the volume and rapidity of social media to improve disaster prevention strategies.

14.
Artículo en Inglés | MEDLINE | ID: mdl-38248517

RESUMEN

This study examined the associations between pregnancy intention and motivational readiness for postpartum contraceptive use. Data for this cross-sectional analysis were derived from nationally representative surveys of the Performance Monitoring and Accountability 2020 (PMA2020) project conducted in eight sub-Saharan African countries. Participants included 9488 nonpregnant women of reproductive age (15-49 years) who had given birth in the last 2 years. Weighted multinomial logistic regression analyses were performed to estimate the odds ratios (OR) and their corresponding 95% confidence intervals (CIs) of the associations of motivational readiness for contraceptive adoption categorized as precontemplation, contemplation, and post-action with pregnancy intention. After adjusting for confounding factors, the findings revealed that women in Côte d'Ivoire and Nigeria who had mistimed pregnancies had significantly higher odds of being in the contemplation vs. precontemplation stage compared to those who had intended pregnancies. Similarly, women who had unwanted pregnancies in Ethiopia were also more likely to be in the contemplation stage. Furthermore, significant differences were observed for women in Burkina Faso, Côte d'Ivoire, and Nigeria regarding the association between mistimed pregnancies and being in the post-action stage. For women who had unwanted pregnancies, this association was significant only in Nigeria. Additionally, the odds of being in the contemplation stage, compared to the post-action stage, for women who had unwanted pregnancies were significantly higher in Ethiopia and Nigeria. These results indicate that recent unintended pregnancies in specific sub-Saharan African countries may motivate women to take action to prevent future unintended pregnancies. The findings underscore the importance of tailored and context-specific approaches in family-planning programs based on the stage of motivational readiness.


Asunto(s)
Anticonceptivos , Motivación , Embarazo , Femenino , Humanos , Adolescente , Adulto Joven , Adulto , Persona de Mediana Edad , Estudios Transversales , Burkina Faso , Periodo Posparto
15.
BMC Public Health ; 22(1): 212, 2022 02 01.
Artículo en Inglés | MEDLINE | ID: mdl-35105328

RESUMEN

BACKGROUND: In 2019, 1 in every 10 infants born in the United States was preterm. Prematurity has life-threatening consequences and causes a range of developmental disabilities, of which learning disability is a prevalent complication. Despite the availability of special services for children living with learning disability, gaps still exist in terms of access due to socioeconomic factors. The aim of this study is to evaluate socioeconomic and sociodemographic correlates of learning disability in preterm children. METHODS: This cross-sectional study used data from the 2016-2018 National Survey of Children's Health. Weighted multivariable analyses were conducted to ascertain the association of sociodemographic and socioeconomic factors on learning disability among preterm children. The main outcome variable was the presence of learning disability. RESULTS: Among 9555 preterm children in our study population, 1167 (12%) had learning disability. Learning disability was significantly associated with health insurance, food situation, and poverty level after adjustment for other variables. Children currently insured had lower odds of having learning disability compared to those without health insurance (OR = 0.79, 95% C.I. = 0.70-0.91). Also, children living in households that cannot afford nutritious meals are more likely to have learning disability compared to those that can afford nutritious meals at home (OR = 1.55, 95% C.I. = 1.22-1.97). CONCLUSION: These findings highlight the need for intervention efforts to target these children living with a learning disability to achieve the 2004 Individuals with Disabilities Education Act of promoting educational equality and empowerment of children living with a learning disability.


Asunto(s)
Seguro de Salud , Discapacidades para el Aprendizaje , Niño , Estudios Transversales , Humanos , Lactante , Recién Nacido , Discapacidades para el Aprendizaje/epidemiología , Pobreza , Factores Socioeconómicos , Estados Unidos/epidemiología
16.
Cureus ; 13(4): e14536, 2021 Apr 17.
Artículo en Inglés | MEDLINE | ID: mdl-34017652

RESUMEN

Introduction Although studies have examined the association between childhood asthma and parental smoking and secondhand smoke, little research has explored the moderating role of birth weight and prematurity (BWP) status on this association. We examined the association between secondhand smoke exposure, asthma, and asthma severity in children aged six to 17 as well as the modifying effect of BWP on parental smoking and asthma. Methods We used data from 36,954 children from the National Survey of Children's Health 2017-2018. In addition to univariate analysis, adjusted and unadjusted logistic regression models were used to estimate the effect of secondhand smoke on asthma. The interaction term between parental smoking and BWP was tested. Multinomial regression was used to evaluate the association between secondhand smoke on asthma severity. Results About 15.1 % of children had asthma and 15.4% of parents reported smoking. Odds of asthma were higher in children living with an outdoor (AOR, 1.27; 95% CI, 1.06-1.52) and indoor (AOR, 1.46; 95% CI, 1.01-2.11) smoker in the adjusted model. The association of parental smoking with asthma differed by birth weight and premature status. Normal weight children who are premature had the highest odds ratio (AOR, 2.15; 95% CI, 1.2-3.86). In the multinomial model, low birth weight and premature children had higher odds of mild (AOR, 1.90; 95% CI, 1.40-2.56) and moderate/severe (AOR, 1.81; 95% CI, 1.16-2.84) asthma compared to the no asthma group. Conclusion The Association of parental smoking on asthma was modified by BWP. Focused asthma interventions in children should inquire about BWP status as well as parental smoking and household smoke exposure to reduce asthma morbidity and mortality.

17.
Cent Eur J Public Health ; 29(4): 284-289, 2021 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-35026067

RESUMEN

OBJECTIVES: We examined the association between exclusive breastfeeding, early introduction of feeding formula, early weaning, and asthma in children aged six months to five years in a sample of non-institutionalized US children using a propensity score approach. METHODS: Our study used data from the National Survey of Children's Health (2012-2018) of 3,820 children with physician-diagnosed asthma aged 6 months to 5 years. Propensity score matching (PSM) was applied to control selection bias with age, sex, race, birth weight, Federal Poverty Level, parent's education, and parent smoking history used as covariates in PSM. The total number in the matched sample was 6,904 (3,452 non-asthmatics; 3,452 asthmatics). Matched and unmatched samples were analysed using the χ2 test and multiple logistic regression. RESULTS: Exclusive breastfeeding was protective against asthma in the pre-matching (AOR 0.72; 95% CI: 0.54-0.97; p = 0.03) and post-matching (AOR 0.66; 95% CI: 0.55-0.81; p < 0.001) samples. Formula feeding before 6 months was associated with asthma in unmatched (AOR 1.38; 95% CI: 1.15-1.66; p < 0.001) and matched (AOR 1.31; 95% CI: 1.16-1.47; p < 0.001) sample. Early weaning before 6 months was associated with asthma in unmatched (AOR 1.62; 95% CI: 1.35-1.54; p < 0.001) and matched sample (AOR 1.37; 95% CI: 1.23-1.54; p < 0.001). CONCLUSION: Public health systems should continue to recommend the implementation of the World Health Organization exclusive breastfeeding guideline in developed countries. Asthma interventions in children under two years should continue to emphasize exclusive breastfeeding to reduce the incidence of infant asthma.


Asunto(s)
Asma , Lactancia Materna , Asma/epidemiología , Niño , Conducta Alimentaria , Femenino , Humanos , Lactante , Modelos Logísticos , Puntaje de Propensión
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