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1.
Afr Health Sci ; 24(1): 151-162, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-38962353

RESUMEN

Background: Approximately 15 million children are born each year prematurely, representing more than 10 percent of all childbirths worldwide. Prematurity is an acute event and the leading cause of death among newborns and children under five. Sixty percent of these premature deaths occur in Sub-Saharan Africa and Southeast Asia. Objective: The current study aimed to explore and understand women's experiences and perceptions regarding giving birth prematurely at the National Hospital of Muhimbili in Dar es Salaam, Tanzania. Method: A qualitative method, using Interpretive Phenomenological Analysis approach was chosen to understand and describe the women's experiences. A semi-structured guide was used during the interviews. All interviews were audio-recorded and transcribed verbatim. Findings: Eight in-depth interviews were conducted. The analysis revealed three superordinate themes: (a) Emotional turmoil: unmet expectations shattering maternal identity, emotional distress, and loss of hope; (b) Adapting to preterm birth and challenges: the unexpected situation, lack of proper care, strenuous breastfeeding routines, and socioeconomic challenges; (c) Significance of proper care and emotional support: good maternal care, mother-to-mother and family support. Conclusion: This study provided a deeper understanding of women's experiences and perceptions of premature childbirth. The current study indicated the importance of caregivers' awareness of the women's emotional distress, their need to adapt to a sudden unexpected situation, and the necessity of emotional support.


Asunto(s)
Nacimiento Prematuro , Investigación Cualitativa , Humanos , Femenino , Nacimiento Prematuro/psicología , Adulto , Embarazo , Tanzanía , Entrevistas como Asunto , Recién Nacido , Madres/psicología , Adulto Joven , Apoyo Social , Pueblo de África Oriental
2.
Front Public Health ; 12: 1362392, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38962762

RESUMEN

Background: Acute respiratory infections (ARIs) are the leading cause of death in children under the age of 5 globally. Maternal healthcare-seeking behavior may help minimize mortality associated with ARIs since they make decisions about the kind and frequency of healthcare services for their children. Therefore, this study aimed to predict the absence of maternal healthcare-seeking behavior and identify its associated factors among children under the age 5 in sub-Saharan Africa (SSA) using machine learning models. Methods: The sub-Saharan African countries' demographic health survey was the source of the dataset. We used a weighted sample of 16,832 under-five children in this study. The data were processed using Python (version 3.9), and machine learning models such as extreme gradient boosting (XGB), random forest, decision tree, logistic regression, and Naïve Bayes were applied. In this study, we used evaluation metrics, including the AUC ROC curve, accuracy, precision, recall, and F-measure, to assess the performance of the predictive models. Result: In this study, a weighted sample of 16,832 under-five children was used in the final analysis. Among the proposed machine learning models, the random forest (RF) was the best-predicted model with an accuracy of 88.89%, a precision of 89.5%, an F-measure of 83%, an AUC ROC curve of 95.8%, and a recall of 77.6% in predicting the absence of mothers' healthcare-seeking behavior for ARIs. The accuracy for Naïve Bayes was the lowest (66.41%) when compared to other proposed models. No media exposure, living in rural areas, not breastfeeding, poor wealth status, home delivery, no ANC visit, no maternal education, mothers' age group of 35-49 years, and distance to health facilities were significant predictors for the absence of mothers' healthcare-seeking behaviors for ARIs. On the other hand, undernourished children with stunting, underweight, and wasting status, diarrhea, birth size, married women, being a male or female sex child, and having a maternal occupation were significantly associated with good maternal healthcare-seeking behaviors for ARIs among under-five children. Conclusion: The RF model provides greater predictive power for estimating mothers' healthcare-seeking behaviors based on ARI risk factors. Machine learning could help achieve early prediction and intervention in children with high-risk ARIs. This leads to a recommendation for policy direction to reduce child mortality due to ARIs in sub-Saharan countries.


Asunto(s)
Aprendizaje Automático , Madres , Aceptación de la Atención de Salud , Infecciones del Sistema Respiratorio , Humanos , África del Sur del Sahara , Aceptación de la Atención de Salud/estadística & datos numéricos , Femenino , Preescolar , Madres/estadística & datos numéricos , Lactante , Adulto , Masculino , Algoritmos , Recién Nacido , Adolescente , Enfermedad Aguda , Persona de Mediana Edad
3.
Women Health ; 64(6): 486-500, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38955489

RESUMEN

Pregnancy and motherhood are some of the most physically and mentally challenging periods in a woman's life. The aim of current study was to examine aspects of cognitive functions in pregnancy and motherhood that are controversial in the literature. The study included 30 healthy pregnant women aged between 18-40 years in their second and third trimesters, 30 healthy controls (nulliparous and non-pregnant women) and 30 healthy mothers matched with the pregnant women for age, handedness and education level. Edinburgh Postpartum Depression Scale, Hamilton Depression Rating Scale, Hamilton Anxiety Rating Scale, Trail Making, Stroop, Digit Span, Verbal Fluency and Rey Auditory and Verbal Learning Tests (RAVLT) were applied to all participants. The pregnant group showed significantly lower performance in trail making, digit span, verbal fluency as well as RAVLT compared to other two groups suggesting deficiencies in cognitive areas such as attention, set-shifting, planning, learning, language functions, semantic memory, working memory, encoding memory and retrieval. A trend toward increased function in response inhibition was observed in the mothers. Regression analyses revealed that pregnancy significantly decreased performance in verbal fluency, trail making, and RAVLT. Our findings from rigorously selected participants may help comprehend alterations in cognitive functioning during pregnancy and motherhood, as well as shed light on the contradictory literature.


Asunto(s)
Cognición , Madres , Pruebas Neuropsicológicas , Humanos , Femenino , Embarazo , Adulto , Cognición/fisiología , Adulto Joven , Madres/psicología , Adolescente , Estudios de Casos y Controles , Escalas de Valoración Psiquiátrica , Memoria , Aprendizaje Verbal , Atención
4.
Women Health ; 64(6): 501-512, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38965034

RESUMEN

The aim of this study is to investigate the mediating role of sleep quality in the relationship between multidimensional perceived social support and fatigue among mothers of twin infants. One hundred and six (106) twin mothers participated in this cross-sectional study, who completed the Descriptive Information Form, Multidimensional Scale of Perceived Social Support, Pittsburgh Sleep Quality Index, and Checklist Individual Strength. The scale score averages of the mothers in the study are as follows: social support, 61.41 ± 23.86; fatigue, 77.64 ± 28.68; and sleep quality, 8.26 ± 2.38. According to the path model, perceived social support has a negative effect on poor sleep quality (p = .001, Beta = -0.411), and poor sleep quality has a positive effect on fatigue (p = .001, Beta = 0.335). Sleep quality also mediates the effect of multidimensional perceived social support on mothers' fatigue levels (p = .001, Beta = -0.138). The study results suggest that the perceived social support and fatigue levels of twin mothers are moderate, while their sleep quality is poor. Therefore, mothers of twin infants may benefit from increased social support to alleviate fatigue and enhance sleep quality.


Asunto(s)
Fatiga , Madres , Calidad del Sueño , Apoyo Social , Gemelos , Humanos , Femenino , Madres/psicología , Fatiga/psicología , Adulto , Estudios Transversales , Gemelos/psicología , Encuestas y Cuestionarios , Lactante , Percepción , Factores Socioeconómicos , Adulto Joven , Sueño/fisiología
5.
BMC Pediatr ; 24(1): 432, 2024 Jul 05.
Artículo en Inglés | MEDLINE | ID: mdl-38970086

RESUMEN

BACKGROUND: This study delves into newborn care and infant-feeding practices in rural Odisha, specifically focusing on the rural KBK + region of Odisha (Kalahandi-Bolangir-Koraput region), inhabited predominantly by Schedule Tribes and Schedule Castes individuals. There has been an improvement in the health indicators in these areas in recent times. In the background of improved health indicators in these areas, this research explores the current and changing newborn care practices and attempts to gain insight into people's perceptions of the factors that brought about the changes. METHODS: This qualitative study was conducted between February and July 2023 at Christian Hospital, Bissamcuttack in Odisha. The methodology involved focused group discussions with mothers and grandmothers. RESULTS: Analysis revealed healthy practices like exclusive breastfeeding till six months of age, appropriate timing of the first bath, and prompt healthcare-seeking behavior for minor illnesses among the mothers. The use of cow ghee or breast milk in a baby's eyes, the application of ash on the umbilical cord, and the use of herbal medicines for minor illnesses were practiced more by the grandmothers in the past and were not as popular among the mothers. It is noteworthy that the cultural practices to ward off the 'evil eye' were practiced by both mothers and grandmothers alike. Despite the influence of traditional cultural practices on the beliefs and norms of the community, the study identified a shift in health-seeking behavior, with increased reliance on healthcare providers and safe healthcare practices. The study identifies the pivotal role of Accredited Social Health Activists (ASHAs) as a bridge between the rural communities and the healthcare system. CONCLUSIONS: This research provides valuable insights for healthcare providers aiming to enhance community-centric safe newborn care practices in rural settings. The emphasis is on the importance of understanding the current and changing local practices. This would help the healthcare providers to encourage healthy practices while eliminating the harmful practices related to newborn care through community workers like ASHA and Anganwadi workers.


Asunto(s)
Abuelos , Cuidado del Lactante , Madres , Investigación Cualitativa , Humanos , Recién Nacido , Abuelos/psicología , Femenino , Cuidado del Lactante/métodos , India , Madres/psicología , Adulto , Lactancia Materna , Grupos Focales , Población Rural , Conocimientos, Actitudes y Práctica en Salud
6.
PLoS One ; 19(7): e0306534, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38968256

RESUMEN

Millions of families with children in the U.S. struggle to afford adequate housing. Housing cost burden places families at risk for homelessness, and prevention efforts are hindered by limited understanding of insecure housing experiences at the margins. The present study investigated variation in housing insecurity experiences in a sample of mothers, as well as which risk profiles were most strongly associated with subsequent homelessness. Latent class analysis identified four distinct subgroups of housing insecurity: "Stable," "Unstable," "Rent-Focused," and "Strategic Bill-Paying." Classes differed on whether they made rent or utility payments on time, experienced utility shutoffs, or were evicted. Mothers who missed rent payments were significantly more likely to experience subsequent homelessness, whereas those who prioritized rent were more likely to have their utilities shut off but remain housed. Policy efforts should emphasize increased wages, rent control, changes to zoning laws and tax codes to prioritize affordable housing, and benefits that help mothers maintain their incomes such as comprehensive healthcare, paid maternity leave, and subsidized childcare.


Asunto(s)
Vivienda , Personas con Mala Vivienda , Análisis de Clases Latentes , Madres , Humanos , Personas con Mala Vivienda/estadística & datos numéricos , Vivienda/economía , Vivienda/estadística & datos numéricos , Femenino , Adulto , Estados Unidos , Factores de Riesgo
7.
BMC Pediatr ; 24(1): 428, 2024 Jul 03.
Artículo en Inglés | MEDLINE | ID: mdl-38961360

RESUMEN

BACKGROUND: The timely introduction of complementary foods during infancy is necessary for nutritional reasons, and to enable the transition from milk feeding to family foods. In the past years, despite efforts that have been put to increase the utilization of timely initiation of complementary feeding practice in Ethiopia, improvements are not satisfactory. OBJECTIVE: To compare the prevalence of timely initiation of complementary feeding and its associated factors among mothers who have Children 6-24 months in Debre Tabor town and rural Farta district, North-west Ethiopia, 2021. METHODS: A community-based comparative cross-sectional study was employed from December 1/2020 to 30/ 2020 among 1100 mothers. Data were collected using a structured questioner and analyzed using Statistical Product and Service Solutions. Logistic regression analysis with a 95% confidence interval carried out to determine the association between explanatory and the outcome variables. A P-value of < 0.05 was considered statistically significant. RESULTS: The prevalence of timely initiation of complementary feeding among urban and rural mothers was 69.8% with (95% CI: 66%, 74%) and 51.9% with (95% CI: 48- 56%) respectively. Urban residence [AOR = 1.39, 95% CI: (1.02-1.94)], had antenatal care visits [AOR = 0.24 (95%CI: (0.13, 0.44)], had post natal care checkups [AOR = 0.44, 95%CI: (0. 27- 0.72)] and being a governmental employee [AOR = 2.82; 95% CI: (1.91-6.1)] were factors associated with timely initiation of complementary feeding among urban mothers. Whereas in rural settings: institutional delivery [(AOR = 2.21, CI: 1.35-3.65)], post natal care checkups [(AOR = 0.53, CI: (0.36-0.77)] being daily laborer [AOR = 3.47; 95% CI: (1.78-6.75)] were associated with timely initiation of complementary feeding. CONCLUSION: The prevalence of timely introduction of complementary feeding in children aged 6-24 months is still low in the study areas. There was also disparity between urban and rural mothers in which urban mothers practiced better.


Asunto(s)
Fenómenos Fisiológicos Nutricionales del Lactante , Madres , Población Rural , Humanos , Etiopía/epidemiología , Estudios Transversales , Femenino , Lactante , Adulto , Madres/estadística & datos numéricos , Adulto Joven , Población Urbana , Factores de Tiempo , Preescolar , Lactancia Materna/estadística & datos numéricos , Adolescente
8.
BMC Public Health ; 24(1): 1778, 2024 Jul 03.
Artículo en Inglés | MEDLINE | ID: mdl-38961411

RESUMEN

BACKGROUND: Providing nurturing care for young children is essential for promoting early child development (ECD). However, there is limited knowledge about how mothers and fathers across diverse contexts in sub-Saharan Africa care for their children and from whom they receive guidance and support in their caregiving roles. We aimed to examine caregivers' nurturing care practices and sources of parenting knowledge in rural Mozambique. METHODS: This is a secondary analysis using data from a qualitative evaluation of a pilot intervention to improve nurturing care for early child health and development within existing health systems. The evaluation was conducted across three primary care health facilities and their catchment areas in Nampula province, Mozambique. For this study, we analyzed data from in-depth interviews conducted with 36 caregivers (32 mothers and 4 fathers) to investigate mothers' and fathers' daily caregiving experiences. Data were analyzed using thematic content analysis. RESULTS: Caregivers described various caregiving roles relating to general caregiving of young children (e.g., feeding, bathing, caring for child's health) and stimulation (e.g., play and communication) activities. Mothers more commonly engaged in general caregiving activities than fathers, whereas both mothers and fathers engaged in stimulation activities. Other family members, including siblings, grandparents, and aunts/uncles, were also actively engaged in general caregiving activities. With respect to sources of parenting knowledge, caregivers received parenting guidance and support primarily from their own mothers/parents and facility-based health providers. CONCLUSIONS: These findings highlight the importance of adopting a holistic approach involving caregivers and their context and reveal potential strategies to promote caregiving and ECD in rural Mozambique and similar contexts.


Asunto(s)
Padre , Conocimientos, Actitudes y Práctica en Salud , Madres , Responsabilidad Parental , Investigación Cualitativa , Población Rural , Humanos , Mozambique , Femenino , Responsabilidad Parental/psicología , Masculino , Población Rural/estadística & datos numéricos , Adulto , Padre/psicología , Madres/psicología , Madres/estadística & datos numéricos , Preescolar , Lactante , Persona de Mediana Edad , Cuidadores/psicología , Adulto Joven , Entrevistas como Asunto
10.
BMJ Open ; 14(6): e077504, 2024 Jul 01.
Artículo en Inglés | MEDLINE | ID: mdl-38950996

RESUMEN

BACKGROUND: The natural and best approach to give newborns the nutrients they need for healthy growth and development is through breast feeding. Breastfeeding rates fall more sharply with time for mothers under the age of 20 years. AIM: This study sought to explore the challenges experienced by adolescent mothers who visit the department of obstetrics and gynaecology of Korle Bu Teaching Hospital in Ghana. METHOD: This study employed a qualitative phenomenology design and collected data from adolescent mothers. Data were gathered with the aid of a semistructured in-depth interview guide from 13 breastfeeding adolescent mothers. Data for the study were analysed using content analysis. The study was conducted at the obstetrics and gynaecology department of Korle Bu Teaching Hospital, Ghana. FINDINGS: Two major themes were generated from the study to be the challenges that confront adolescent breastfeeding mothers, and they are maternal factors of breastfeeding barriers and societal factors of breastfeeding barriers. Subcategories were generated for both themes during the process. CONCLUSION AND RECOMMENDATION: Training of pregnant adolescents during antenatal care visits on how to manage the inability to lactate, breastfeeding stress, painful and sore nipple, engorged breast, stigma from society will lessen their burden. Furthermore, training close family members and friends on how to be kind and support adolescent mothers during breast feeding is important. In-service training should be organised for health workers to enhance their knowledge and practice of approaching and guiding adolescent mothers on effective breast feeding and the provision of cubicles in public places where adolescent mothers can comfortably breastfeed.


Asunto(s)
Lactancia Materna , Hospitales de Enseñanza , Madres , Investigación Cualitativa , Humanos , Lactancia Materna/psicología , Lactancia Materna/estadística & datos numéricos , Ghana , Femenino , Adolescente , Madres/psicología , Adulto Joven , Embarazo , Recién Nacido , Entrevistas como Asunto , Embarazo en Adolescencia/psicología , Conocimientos, Actitudes y Práctica en Salud
11.
J Korean Med Sci ; 39(25): e192, 2024 Jul 01.
Artículo en Inglés | MEDLINE | ID: mdl-38952345

RESUMEN

BACKGROUND: Balancing parenting and work life poses challenges for women with children, potentially making them vulnerable to depression owing to their dual responsibilities. Investigating working mothers' mental health status is important on both the individual and societal levels. This study aimed to explore the relationship between economic activity participation and depressive symptoms among working mothers. METHODS: This study was a cross-sectional study and used data from the Korea National Health and Nutrition Examination Survey collected in 2014, 2016, 2018, and 2020. The participants in the study were women aged 19 to 50 who were residing with their children. In the total, 3,151 participants were used in the analysis. The independent variable was economic activity, categorized into two groups: 1) economically active and 2) economically inactive. The dependent variable was the depressive symptoms, categorized as present for a Patient Health Questionnaire-9 score of ≥ 10 and absent for a score < 10. Multiple logistic regression analysis was performed to assess the association between economic activity and depressive symptoms, and sensitivity analyses were performed based on the severity of depressive symptoms. RESULTS: Among women with children, economically active women had reduced odds ratio of depressive symptoms compared with economically inactive women (odds ratio [OR], 0.54; 95% confidence interval [CI], 0.36-0.80). In additional analysis, women working as wage earners had the lowest odds of depressive symptoms (OR, 0.43; 95% CI, 0.28-0.66). Women working an average of 40 hours or less per week were least likely to have depressive symptoms (OR, 0.42; 95% CI, 0.25-0.69). CONCLUSION: Economic activity is significantly associated with depressive symptoms among women with children. Environmental support and policy approaches are needed to ensure that women remain economically active after childbirth.


Asunto(s)
Depresión , Madres , Responsabilidad Parental , Humanos , Femenino , Depresión/epidemiología , Depresión/psicología , Adulto , Estudios Transversales , República de Corea/epidemiología , Madres/psicología , Responsabilidad Parental/psicología , Adulto Joven , Persona de Mediana Edad , Encuestas Nutricionales , Oportunidad Relativa , Modelos Logísticos , Niño , Mujeres Trabajadoras/psicología
12.
Ethiop J Health Sci ; 34(1): 47-56, 2024 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-38957339

RESUMEN

Background: The Antenatal Care (ANC) Center is a conventional facility that caters for the prenatal healthcare needs of expectant mothers and ensures proper management by healthcare professionals; however, expectant mothers seek healthcare support from other sources. This study aimed to examine the utilization of social media for healthcare information among expectant mothers in the capital city of Ghana and explore the factors that influence its adoption. Method: This study employed a non-experimental survey design. The study used a questionnaire to gather data from expectant mothers. Using 580 valid responses, SmartPLS structural equation modeling (SEM) was used to analyze the study model. Results: The study findings demonstrated the significant influence of performance expectancy of social media (PESM) and facilitating conditions of social media (FCSM) on social media healthcare information usage (SMHLU). The results also revealed that emotional support on social media and perceived vulnerability were influential factors that shaped expectant mothers' choices to use social media for healthcare information. However, the study showed that perceived severity and the relative advantage of social media had no significant effects on SMHIU. Interestingly, FCSM was found to be significantly associated with PESM, emphasizing that social media support enhances performance expectancy. Conclusion: This study showed that information is important to expectant mothers, which compels them to seek digital healthcare. With these findings, healthcare providers can incorporate digital health services into their ANC service to support women during pregnancy.


Asunto(s)
Atención Prenatal , Medios de Comunicación Sociales , Humanos , Femenino , Medios de Comunicación Sociales/estadística & datos numéricos , Ghana , Embarazo , Atención Prenatal/estadística & datos numéricos , Adulto , Adulto Joven , Encuestas y Cuestionarios , Madres/psicología , Conducta en la Búsqueda de Información , Aceptación de la Atención de Salud/estadística & datos numéricos , Aceptación de la Atención de Salud/psicología , Apoyo Social , Adolescente
13.
Metabolomics ; 20(4): 70, 2024 Jul 02.
Artículo en Inglés | MEDLINE | ID: mdl-38955892

RESUMEN

INTRODUCTION: Congenital heart disease (CHD) is the most common congenital anomaly, representing a significant global disease burden. Limitations exist in our understanding of aetiology, diagnostic methodology and screening, with metabolomics offering promise in addressing these. OBJECTIVE: To evaluate maternal metabolomics and lipidomics in prediction and risk factor identification for childhood CHD. METHODS: We performed an observational study in mothers of children with CHD following pregnancy, using untargeted plasma metabolomics and lipidomics by ultrahigh performance liquid chromatography-high resolution mass spectrometry (UHPLC-HRMS). 190 cases (157 mothers of children with structural CHD (sCHD); 33 mothers of children with genetic CHD (gCHD)) from the children OMACp cohort and 162 controls from the ALSPAC cohort were analysed. CHD diagnoses were stratified by severity and clinical classifications. Univariate, exploratory and supervised chemometric methods were used to identify metabolites and lipids distinguishing cases and controls, alongside predictive modelling. RESULTS: 499 metabolites and lipids were annotated and used to build PLS-DA and SO-CovSel-LDA predictive models to accurately distinguish sCHD and control groups. The best performing model had an sCHD test set mean accuracy of 94.74% (sCHD test group sensitivity 93.33%; specificity 96.00%) utilising only 11 analytes. Similar test performances were seen for gCHD. Across best performing models, 37 analytes contributed to performance including amino acids, lipids, and nucleotides. CONCLUSIONS: Here, maternal metabolomic and lipidomic analysis has facilitated the development of sensitive risk prediction models classifying mothers of children with CHD. Metabolites and lipids identified offer promise for maternal risk factor profiling, and understanding of CHD pathogenesis in the future.


Asunto(s)
Cardiopatías Congénitas , Lipidómica , Metabolómica , Madres , Humanos , Cardiopatías Congénitas/sangre , Cardiopatías Congénitas/metabolismo , Femenino , Metabolómica/métodos , Lipidómica/métodos , Adulto , Niño , Lípidos/sangre , Cromatografía Líquida de Alta Presión , Metaboloma , Masculino , Embarazo , Espectrometría de Masas/métodos
14.
Attach Hum Dev ; 26(3): 233-252, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38989771

RESUMEN

This study examined the stability of Attachment Script Assessment (ASA) deactivation, hyperactivation, and anomalous content and their significance for parenting outcomes in mothers (Mage = 31 years; 78% White/European American) and 6-month-old infants. Comparable to ASA secure base script knowledge (SBSK), mothers' ASA deactivation, hyperactivation, and anomalous content were significantly, moderately stable over two years (r's = .40 - .43). Mothers' ASA hyperactivation and anomalous content were associated with greater maternal intrusiveness, whereas ASA deactivation was associated with greater detachment and less intrusiveness. Only ASA anomalous content was associated with lower maternal sensitivity. Mothers' ASA deactivation was associated with less dynamic change in respiratory sinus arrhythmia during the Still-Face Procedure-reflective of limited mobilization of physiological resources to support responding to infants. Findings support the validity of ASA deactivation, hyperactivation, and anomalous content scripts, and demonstrate their utility in examining adult attachment stability and predictive significance for parent-child outcomes.


Asunto(s)
Relaciones Madre-Hijo , Apego a Objetos , Responsabilidad Parental , Humanos , Femenino , Lactante , Relaciones Madre-Hijo/psicología , Adulto , Responsabilidad Parental/psicología , Masculino , Madres/psicología , Conducta Materna/psicología , Arritmia Sinusal Respiratoria/fisiología
15.
BMC Pregnancy Childbirth ; 24(1): 473, 2024 Jul 11.
Artículo en Inglés | MEDLINE | ID: mdl-38992633

RESUMEN

BACKGROUND: We assessed the effect of different obstetric interventions and types of delivery on breastfeeding. METHODS: A quantitative, cross-sectional study was carried out using an online questionnaire. Data collection was performed in 2021 in Hungary. We included biological mothers who had raised their at least 5-year-old child(ren) at home (N = 2,008). The questionnaire was completed anonymously and voluntarily. In addition to sociodemographic data (age, residence, marital status, education, occupation, income status, number of biological children, and anthropometric questions about the child and the mother), we asked about the interventions used during childbirth, and the different ways of infant feeding used. Statistical analysis was carried out using Microsoft Excel 365 and SPSS 25.0. Descriptive statistics, two-sample t tests, χ2 tests and ANOVA were used to analyse the relationship or differences between the variables (p < 0,05). RESULTS: We found that in deliveries where synthetic oxytocin was used for both induction and acceleration, there was a higher incidence of emergency cesarean section. However, the occurrence of vaginal deliveries was significantly higher in cases where oxytocin administration was solely for the purpose of accelerating labour (p < 0.001).Mothers who received synthetic oxytocin also received analgesics (p < 0.001). Women giving birth naturally who used oxytocin had a lower success of breastfeeding their newborn in the delivery room (p < 0.001). Children of mothers who received obstetric analgesia had a higher rate of complementary formula feeding (p < 0.001). Newborns born naturally had a higher rate of breastfeeding in the delivery room (p < 0.001) and less formula feeding in the hospital (p < 0.001). Infants who were breastfed in the delivery room were breastfed for longer periods (p < 0.001). Exclusive breastfeeding up to six months was longer for infants born naturally (p = 0.005), but there was no difference in the length of breastfeeding (p = 0.081). CONCLUSIONS: Obstetric interventions may increase the need for further interventions and have a negative impact on early or successful breastfeeding. TRIAL REGISTRATION: Not relevant.


Asunto(s)
Lactancia Materna , Cesárea , Parto Obstétrico , Humanos , Lactancia Materna/estadística & datos numéricos , Femenino , Estudios Transversales , Hungría , Adulto , Parto Obstétrico/estadística & datos numéricos , Parto Obstétrico/métodos , Embarazo , Cesárea/estadística & datos numéricos , Encuestas y Cuestionarios , Oxitocina/administración & dosificación , Recién Nacido , Adulto Joven , Oxitócicos/administración & dosificación , Oxitócicos/uso terapéutico , Madres/estadística & datos numéricos
16.
BMC Public Health ; 24(1): 1857, 2024 Jul 11.
Artículo en Inglés | MEDLINE | ID: mdl-38992640

RESUMEN

The COVID-19 lockdown has forced young children to spend more time on media and significantly impacted their mothers' mental health. This study explored how mothers' individual distress influences children's problematic media use during the Shanghai citywide lockdown caused by COVID-19. Data were collected from 1889 Chinese mothers (Mage = 34.69 years, SD = 3.94 years) with preschoolers aged 3-6 years (Mage = 4.38 years, SD = 1.06 years; 49.0% boys) via an online survey. The statistical analyses relied on SPSS Statistics version 26.0 and macro-program PROCESS 3.3. to investigate the associations and mediation analysis among all the study variables. The results indicated a positive association between maternal distress and children's problematic media use, mediated by parenting stress and maladaptive parenting. Specifically, the serial mediation analysis revealed that high levels of maternal distress exacerbate parenting stress, which in turn leads to maladaptive parenting practices. These maladaptive practices subsequently increase problematic media use in preschool children. The findings highlighted that parents need to enhance their ability to manage risk and promote mental health during periods of significant stress and routine disruption to reduce children's problematic media use.


Asunto(s)
COVID-19 , Madres , Responsabilidad Parental , Estrés Psicológico , Humanos , Preescolar , Femenino , China/epidemiología , Responsabilidad Parental/psicología , Masculino , COVID-19/epidemiología , COVID-19/psicología , Adulto , Madres/psicología , Madres/estadística & datos numéricos , Niño , Estrés Psicológico/epidemiología , Estrés Psicológico/psicología , Distrés Psicológico
17.
Fam Med ; 56(6): 396, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38996341
18.
BMC Endocr Disord ; 24(1): 104, 2024 Jul 08.
Artículo en Inglés | MEDLINE | ID: mdl-38977979

RESUMEN

BACKGROUND: A woman with a history of GDM has a high risk of developing type two diabetes (T2DM) in her future life. Lifestyle modifications are known to attenuate the progression of GDM to T2DM. Therefore, the aim of this study was to assess the impact of a simple, cost effective, culturally acceptable lifestyle intervention programme on the trajectory towards T2DM in women with a history of GDM. METHODS: This cluster randomized trial was conducted in 100 postpartum women in three selected districts of Sri Lanka. The subjects were divided into intervention (n = 50) and control groups (n = 50) by cluster randomization method. A culturally adapted protocol (comprised of dietary and physical activity modifications) was administered to the intervention group. The glycemic profile was assessed using fasting and 2-hour post-OGTT plasma glucose and HbA1c, and insulin resistance by HOMA-IR at baseline and after one year of intervention. RESULTS: The mean age (SD) of the subjects in the intervention and control groups were 33.0 (5.1) and 34.3 (6.5) years respectively. All glycemic and insulin resistance parameters (i.e. Fasting plasma glucose- FPG, 2-hour post-OGTT plasma glucose, HbA1c and HOMA-ir) were comparable (p > 0.05) between the two groups at baseline. FPG, 2 h post OGTT, HbA1c and HOMA-ir values between intervention vs. control (p) at 12 months were 87.3 vs. 123.2 (< 0.01); 106.5 vs. 156.1 (0.01); 5.3 vs. 6.8 (< 0.01) and 0.9 vs. 2.3 (< 0.01) respectively. All glycemic parameters showed a significant reduction in the intervention group at 12 months compared to baseline. In contrast, the control group showed a significant increase in FPG, 2-hour post-OGTT plasma glucose and HbA1c at 12 months compared to baseline. In multiple linear regression model adjusted for age, parity and family history, the control group showed an approximately 33 times risk of developing insulin resistance compared to the intervention group. CONCLUSION: The culturally acceptable and individualized lifestyle intervention was able to produce remarkable reductions in glycaemic and insulin resistance parameters among postpartum women with a history of GDM. TRIAL REGISTRATION: Ethical clearance was obtained from the Ethics Review Committee of the University of Sri Jayewardenepura, Sri Lanka (ERC 52/14), Sri Lanka Clinical trial registration number Sri Lanka Clinical Trials Registry (SLCTR/2015/021 date 25.09.2015).


Asunto(s)
Glucemia , Diabetes Gestacional , Estilo de Vida , Humanos , Femenino , Adulto , Sri Lanka , Glucemia/análisis , Glucemia/metabolismo , Embarazo , Diabetes Gestacional/sangre , Resistencia a la Insulina , Diabetes Mellitus Tipo 2/terapia , Diabetes Mellitus Tipo 2/sangre , Estudios de Seguimiento , Periodo Posparto , Ejercicio Físico , Madres
19.
J Health Popul Nutr ; 43(1): 106, 2024 Jul 08.
Artículo en Inglés | MEDLINE | ID: mdl-38978134

RESUMEN

BACKGROUND: Improving the minimum acceptable diet (MAD) is essential for ensuring optimal growth and development of children, as well as preventing malnutrition and its consequences. Previous studies in Ethiopia have focused on the magnitude and determinants of a minimum acceptable diet. However, much emphasis was not given to minimum acceptable diet and its associated factors among 6-23 months old children enrolled in Outpatient therapeutic programs (OTP), particularly, in the study area. This study determines the minimum acceptable diet and associated factors among 6-23-month-old children enrolled in OTP. METHODS: A community-based cross-sectional study was conducted among 346 randomly selected mothers with children aged 6-23 months who were admitted to the OTP. The data were collected using interviewer-administered structured questionnaires. The data were entered, cleaned, coded into Epidata version 4.6, and exported to SPSS version 26 for further analysis. Multivariate logistic regression was used to assess the determinants of MAD. RESULTS: The overall prevalence of minimum Acceptable diet among children aged 6-23 months enrolled to OTP was 14.5% (95% CI: 12.02-19%). The odds of MAD were 1.9 times higher among children aged 18-23 months compared to children aged 6-11 months (AOR = 1.9, 95% CI ((1.2 3.9). The odds of MAD were 2.9times higher in children whose mothers had a good knowledge on recommended feeding (AOR = 2.9, 95% CI (1.2, 6.35). Mothers who had no formal education were 81% less likely to provide minimum acceptable diets for their children compared to their counterpart.(AOR = 1.94, 95% CI = 1.24, 4.19). CONCLUSION: The practice of a minimum acceptable diet is inadequate. Nutrition education should be emphasized to improve the mothers' nutrition knowledge regarding infant and young child feeding recommendations, to support mothers in overcoming barriers to feeding their children with adequate diets, and to foster complementary feeding practices for malnourished children.


Asunto(s)
Madres , Humanos , Etiopía , Lactante , Estudios Transversales , Femenino , Masculino , Dieta/estadística & datos numéricos , Adulto , Fenómenos Fisiológicos Nutricionales del Lactante , Atención Ambulatoria/estadística & datos numéricos , Conocimientos, Actitudes y Práctica en Salud
20.
Clin Epigenetics ; 16(1): 90, 2024 Jul 08.
Artículo en Inglés | MEDLINE | ID: mdl-38978139

RESUMEN

BACKGROUND: Stress during pregnancy can lead to adverse maternal and infant health outcomes through epigenetic changes in the hypothalamic-pituitary-adrenal axis. Among farmers in low-income countries, one important stressor is food insecurity, which can be reduced using hermetic storage bags. This study aimed to determine, for the first time, whether a hermetic storage bag intervention during pregnancy positively affects maternal and infant DNA methylation of the hypothalamic-pituitary-adrenal axis-related genes FKBP5 and NR3C1. We further analyzed whether anthropometrics, stress, and mental health were associated with DNA methylation. METHODS: This study was part of a larger matched-pair randomized controlled trial focusing on the impact of improved on-farm storage on food security, poverty, and net income of smallholder farming households. A total of N = 149 mothers were recruited by telephone and invited to attend a study appointment at health facilities in Kakamega County, Western Kenya, with their infants in April or May 2021. During the appointment, anthropometric measurements were taken, questionnaires on stress and mental health were administered, and saliva samples were collected. Logistic and multiple linear regression were used to examine the effect of the intervention and related measures on DNA methylation. RESULTS: Mothers in the intervention group showed higher mean NR3C1 methylation levels than those in the control group, corrected for multiple testing. Maternal postpartum body mass index was positively associated with infant NR3C1 CpG3 DNA methylation. The more stressful life events a mother had experienced in the previous 12 months (including during pregnancy), the lower her FKBP5 CpG3 methylation levels. CONCLUSIONS: Food insecurity and stressful life events during pregnancy seem to exert significant effects on maternal DNA methylation. While these stressors did not appear to impact infant DNA methylation in the present study, maternal postpartum body mass index was significantly related to infant methylation. These findings suggest that while infants may be protected from excessive maternal glucocorticoids by placental barrier activity, maternal metabolic status is still reflected in their epigenetic make-up. Trial registration This study was part of a larger matched-pair randomized controlled trial on the impact of improved on-farm crop storage on welfare, nutrition, and human health. Registration can be found in the American Economic Association (AEA) RCT Registry, RCT ID: AEARCTR-0005845.


Asunto(s)
Metilación de ADN , Epigénesis Genética , Receptores de Glucocorticoides , Humanos , Metilación de ADN/genética , Femenino , Kenia , Adulto , Embarazo , Lactante , Receptores de Glucocorticoides/genética , Receptores de Glucocorticoides/metabolismo , Proteínas de Unión a Tacrolimus/genética , Madres/psicología , Masculino , Estrés Psicológico/genética , Granjas , Sistema Hipotálamo-Hipofisario/metabolismo , Adulto Joven , Inseguridad Alimentaria , Sistema Hipófiso-Suprarrenal/metabolismo , Recién Nacido , Productos Agrícolas/genética
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